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Success and failure of additional immune modulators in steroid-refractory/resistant pneumonitis related to immune checkpoint blockade.

BackgroundPneumonitis related to immune checkpoint blockade is uncommon but can be severe, fatal or chronic. Steroids are first-line treatment, however, some patients are refractory or become resistant to steroids. Like many immune-related adverse events, little is known regarding the outcomes and optimal management of patients in whom steroids are ineffective.MethodsWe performed a single-center retrospective cohort study at a high-volume tertiary cancer center to evaluate the clinical course, management strategies and outcomes of patients treated for immune checkpoint pneumonitis with immune

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… Similar to previous reports of patients treated for irAEs who developed severe infections, 16 it is cautionary that four severe infections occurred, and that these infections included opportunistic infections (eg, fungemia, disseminated herpes simplex virus-HSV). …

Localized fungal osteomyelitis caused by Aspergillus sp. in the ilium and acetabulum of a dog with disseminated aspergillosis: A case report.

BACKGROUND: Osteomyelitis caused by Aspergillus sp. is uncommon in dogs and cats and may occur in cases of disseminated aspergillosis, a rare and poorly described condition in veterinary medicine. CASE DESCRIPTION: Due to the scarcity of reports documenting this disease, particularly with localized involvement of the pelvic bones, the present case report aimed to describe the condition in an 8-year-old mixed-breed dog presenting with severe pain and lameness of the right pelvic limb. Radiographic examination revealed marked periosteal bone proliferation and osteolysis extending from the right

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… Aspergillus terreus is the primary species implicated in disseminated aspergillosis, with infection occurring via inhalation of environmental spores, pulmonary penetration, and subsequent entry into the bloodstream, resulting in fungemia (Sharp, 1998; Harkin, 2003 ). …

Indwelling time of peripherally inserted central catheters and incidence of bloodstream infections in haematology patients: a cohort study.

BackgroundWe aimed to assess whether longer indwelling time of peripherally inserted central catheters (PICC) increases risk of central line associated bloodstream infections (CLABSI) in haematology patients.MethodsMulticentre retrospective cohort study among haematology patients receiving PICCs between 2013 and 2015. Occurrence of CLABSI based on CDC definitions was assessed. We calculated incidence rates, determined risk factors for CLABSI and used Poisson regression models to assess the risk of developing CLABSI as a function of PICC dwell time. We compared diagnoses and treatment character

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… Epidemiology and outcome of fungemia in a cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031) Clin Infect Dis. 2015;61(3):324–331. doi: 10.1093/cid/civ293. …

Outcomes and microbiological patterns of bacteremia in chemotherapy-related febrile neutropenia at a tertiary facility in Kenya.

IntroductionFebrile neutropenia (FN) is a major cause of mortality and morbidity in patients with malignancy post-chmotherapy. Current guidelines for managing FN recommend starting empiric antibiotic therapy (EAT) promptly. The choice of antibiotic is based on the patient's condition, local data on common microorganisms isolated, and their resistance patterns. Of note, there is a growing trend of isolating multi-drug-resistant gram-negative bacteria in these patients. In sub-Saharan Africa, there are insufficient data on the mortality rates of FN. There is also a lack of local epidemiologic da

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… There were two cases of fungemia with Candida auris. One of these cases had four repeat admissions with FN; however, the patient was noted to have infective endocarditis, and, therefore, only the initial admission was considered in our study. …

Critically Ill Immunosuppressed Host

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… These fungal processes can be difficult to diagnose because they are not always associated with detectable fungemia. …

Antibiotic de-escalation patterns and outcomes in critically ill patients with suspected pneumonia as informed by bronchoalveolar lavage results.

PurposeAntibiotic stewardship in critically ill pneumonia patients is crucial yet challenging, partly due to the limitations of noninvasive diagnostic tests. This study reports an antibiotic de-escalation pattern informed by bronchoalveolar lavage (BAL) results, incorporating quantitative cultures and multiplex PCR rapid diagnostic tests.MethodsWe analyzed data from SCRIPT, a single-center prospective cohort study of mechanically ventilated patients who underwent a BAL for suspected pneumonia. We used the Narrow Antibiotic Therapy (NAT) score to quantify day-by-day antibiotic prescription patt

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… When there was further suspicion for fungemia or bacteremia with acid-fast bacteria, fungal cultures and AFB cultures were also sent. Blood culture results were used in conjunction with BAL results to determine antibiotic treatment plan. …

The expenditures related to the use of antifungal drugs in patients with hematological cancers: a cost analysis.

ObjectiveThe aim of this study is to analyze the expenditures related to the use of antifungal drugs in patients with hematological malignancies.MethodsIn this retrospective study, the expenditures related to use of antifungal drugs for treatment of invasive fungal infections in patients with hematological malignancies between November 2010 and November 2012 were analyzed. Expenditures of antifungal drugs were calculated by converting the price billed to the Republic of Turkey Social Security Institution per patient using the US dollar ($) exchange rate.ResultsWe retrospectively analyzed the e

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… During 282 febrile episodes of 126 patients who were evaluated, 24 (8%) episodes of fungemia were recorded in 18 (14%) patients, respectively ( Table 1 ). The mean age was 51.73±14.4 years (17–82 years), and 60 patients were female. …

Случаи и характеристики инфекционных осложнений у многих пациентов с миеломой, которые лечились биконкретными антителами.

Близкие антитела (BsAbs) являются новым классом иммунотерапевтических агентов для пациентов с множественной миеломой (MM). Хотя этот новый класс лекарств связан с хорошей борьбой с болезнями, они также связаны с повышенным риском инфекционных осложнений. Поскольку эндемические общинные и носомные инфекции различны по всему миру, мы провели это исследование для представления реальных данных о инфекционных осложнениях, связанных с БСАБ у корейского населения. Мы ретроспективно проверили всех пациентов, которые прошли терапию BsAb с января. 2021 и январь 2024 в больнице Сеульского национального у

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… Systemic infection included bacteremia, viremia, fungemia and infections affecting multiple organs. …

Diagnosis and Management of Oncologic Emergencies.

Oncologic emergencies may be seen in any emergency department and will become more frequent as our population ages and more patients receive chemotherapy. Life-saving interventions are available for certain oncologic emergencies if the diagnosis is made in a timely fashion. In this article we will cover neutropenic fever, tumor lysis syndrome, hypercalcemia of malignancy, and hyperviscosity syndrome. After reading this article the reader should be much more confident in the diagnosis, evaluation, and management of these oncologic emergencies.

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… -5 10 Bishop KD Castillo JJ Risk factors associated with Clostridium difficile infection in adult oncology patients with a history of recent hospitalization for febrile neutropenia Leuk Lymphoma 2012 53 8 1617 9 22221036 10.3109/10428194.2012.654472 11 Meidani M Baniasadi M Khorvash Prevalence of fungemia …

Infections after bispecific antibodies in B-cell lymphomas.

AbstractBispecific antibodies (BsAbs) have expanded therapeutic options for patients with relapsed/refractory B-cell lymphomas, yet their use has introduced a distinct spectrum of infectious complications that remain poorly characterized. In the largest cohort study to date, to our knowledge, we evaluated 109 patients treated with CD20×CD3 BsAbs between 2016 and 2024 to assess the incidence, characteristics, and risk factors of infections. Over a median follow-up of 28.4 months, 134 infectious episodes were identified, 61.2% of which were grade ≥3. The median time to infection onset was 6.6 mo

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… Fungal infections were defined according to the criteria of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group. 13 , 14 Systemic infection included bacteremia, viremia, fungemia, and infections affecting multiple organs. …

Effect of Intravenous Immunoglobulin (IVIG) Supplementation on infection-free survival in recipients of BCMA-directed bispecific antibody therapy for multiple myeloma.

The main objective of this multi-institutional study is to understand the effect of primary intravenous immunoglobulin (IVIG) replacement on clinical outcomes in recipients of BCMA-directed bispecific antibody (bsAb), where infection remains an important cause of morbidity and mortality. This is a retrospective study of patients treated with either standard of care teclistamab or BCMA-directed investigational bsAb between Nov 2017 and Dec 2023. Primary IVIG prophylaxis was defined as starting IVIG prior to first documented infection. All analyses were adjusted for immortal-time bias inherent i

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… About 2.7% ( n = 8) had fungal infection including cases of Candida esophagitis, Candida tropicalis fungemia and Scedosporum spp lung infection. There were 5 cases of PJP pneumonia, all in patients who were not on PJP prophylaxis. …

10th Trends in Medical Mycology Held on 8 to 11 October 2021, Aberdeen, Scotland, Organized by the European Confederation of Medical Mycology (ECMM).

Plenary Sessions: [...].

Teclistamab in relapsed refractory multiple myeloma: multi-institutional real-world study.

The objective of our study was to report real-world data on the safety and efficacy of standard-of-care teclistamab in patients with relapsed/refractory multiple myeloma (MM). This is a multi-institutional retrospective cohort study and included all consecutive patients that received at least one dose of teclistamab up until August 2023. One hundred and ten patients were included, of whom, 86% had triple-class refractory disease, 76% penta-refractory disease, and 35% had prior exposure to B-cell maturation antigen (BCMA)-targeting therapies. The overall response rate (ORR) in our cohort was 62

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… Five cases of fungal infections were noted including candida esophagitis ( n = 1), candida fungemia ( n = 1) and PJP pneumonia ( n = 3). All 3 cases of PJP occurred in patients who were not on any primary PJP prophylaxis. In this cohort, grade 1/2 infections accounted for 31 (40%) cases. …

Clinical outcomes of antimicrobial resistance in cancer patients: a systematic review of multivariable models.

BackgroundInfections are major causes of disease in cancer patients and pose a major obstacle to the success of cancer care. The global rise of antimicrobial resistance threatens to make these obstacles even greater and hinder continuing progress in cancer care. To prevent and handle such infections, better models of clinical outcomes building on current knowledge are needed. This internally funded systematic review (PROSPERO registration: CRD42021282769) aimed to review multivariable models of resistant infections/colonisations and corresponding mortality, what risk factors have been investig

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… Jung DS Farmakiotis D Jiang Y Tarrand JJ Kontoyiannis DP Uncommon candida species fungemia among cancer patients, Houston, Texas, USA Emerg Infect Dis 2015 21 1942 1950 10.3201/eid2111.150404 26488845 PMC4625381 159. … Le A Farmakiotis D Tarrand JJ Kontoyiannis DP Initial treatment of cancer patients with fluconazole-susceptible dose-dependent Candida glabrata Fungemia: Better Outcome with an Echinocandin or Polyene compared to an azole? …

Treatment of Fusarium Infection of the Central Nervous System: A Review of Past Cases to Guide Therapy for the Ongoing 2023 Outbreak in the United States and Mexico.

INTRODUCTION: Fusariosis of the central nervous system (CNS) is extremely uncommon. Treatment and outcome data from previously published cases may provide some guidance in light of the ongoing fungal meningitis outbreak in 2023 involving Fusarium spp. in the United States and Mexico. METHODS: We reviewed the published literature describing cases of invasive fusariosis of the (CNS) that included data on patient demographic characteristics, treatment, and outcome. RESULTS: Twenty-six cases met inclusion criteria. The mean age was 36 years, 55% involved females, 60% had underlying hematologic m

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… Fusariosis typically presents with fungal pneumonia, skin lesions and fungemia, while infections of the central nervous system (CNS) have been very rarely reported [ 6 , 7 ]. Disseminated fusariosis has a fatality rate of 50–70% in immunocompromised individuals [ 8 ]. …

Periodontal inflamed surface area in oral cavity associated with febrile neutropenia in patients with hematologic malignancy undergoing chemotherapy.

Febrile neutropenia (FN) is an infectious complication that develops during chemotherapy. Although the oral cavity can be an important infection route, it is unknown whether the oral environment is associated with FN. The present study examined the relationship between the oral environment using periodontal inflamed surface area (PISA), a new periodontal disease parameter, and FN in hematologic cancer patients undergoing chemotherapy. In this retrospective cohort study, 157 patients were divided into FN onset during chemotherapy (n = 75) and the FN negative groups (n = 82). The associations of

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… Yoshida M Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group Int. J. Hematol. 1987 93 66 73 10.1007/s12185-010-0746-y 21213127 43. …

Changes in C-Reactive Protein Forecast Infection Risk Following Treatment with Chimeric Antigen Receptor T Cells.

BACKGROUND: Immunosuppressive conditioning regimens for chimeric antigen receptor-modified T cell immunotherapy (CARTx) and subsequent T cell dysfunction increase risk for infection. However, it is difficult to discern infection from CRS in the early (up to Day 30) and late (Days 31-180) periods after CARTx due to overlapping signs and symptoms. METHODS: We analyzed infectious complications and predictors of infection during the early and late periods after CARTx in 213 adult patients with malignancies over a 5-year period. RESULTS: Overall, 75 patients (35%) had at least one infection, most

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… Included infections were diagnosed by culture isolation from a sterile site (bacteremia or fungemia) or positive PCR. …

9th Trends in Medical Mycology Held on 11-14 October 2019, Nice, France, Organized under the Auspices of EORTC-IDG and ECMM.

Dear Friends and Colleagues,It is a great honor and pleasure for us to invite you cordially to participate in the 9th Congress on Trends in Medical Mycology (TIMM-9) [...].

Oral mucositis induced by anticancer treatments: physiopathology and treatments.

Oral mucositis is a frequent and devastating side effect of anticancer treatments. It impairs the patient's quality of life and also can be life threatening because severe infections and delayed or incomplete anticancer treatments may result. This problem has been largely overlooked and underestimated in the past. However, recently studies have been performed to precisely identify the epidemiology, cost, consequences, physiopathology, and treatments of oral mucositis. Clinical guidelines have recently been published to help the daily management of this frequent complication. In addition, some

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… We recently reported the case of a head-and-neck cancer patient with extensive stomatitis who developed a Saccharomyces cerevisiae fungemia infection during concomitant chemoradiotherapy ( Henry et al 2004 ). Oral mucositis has important economic costs. …

Infectious Diseases

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