We present the case of a 54 year-old male from Moldavia with diabetes mellitus (type II diabetic), admitted to hospital in January 1999, with ketoacidosis and consolidation of the lower left lobe. The diagnosis of mucormycosis was confirmed by identification of large, nonseptate hyphae of the order Mucorales. A strain of Rhizopus oryzae (Rhizopus arrhizus) was isolated from culture on sabouraud medium. The patient was treated by systemic amphotericin B, associated with surgical debridement (lobectomy). The treatment with amphotericin B was stopped after ten days and the patient was completely asymptomatic and returned to Moldavia. Mucormycoses are rare, and tend to be encountered in individuals with predisposing factors such as malignant blood disorders (immunocompromised patients) or diabetes mellitus. Prognosis is poor, resembling infection with Aspergillus, despite aggressive treatment as in the present case. The gravity of the condition can be accounted for by the thrombotic and necrosing nature of the fungal invasion of lung vessels.
Journal Article Persistence of Cryptococcus neoformans in the Prostate: Failure of Fluconazole Despite High Doses Get access M. P. Bailly, M. P. Bailly Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar A. Boibieux, A. Boibieux Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar F. Biron, F. Biron Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar I. Durieu, I. Durieu Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar M. A. Piens, M. A. Piens Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar D. Peyramond, D. Peyramond Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar J. L. Bertrand J. L. Bertrand Department of Infectious Diseases, Hopital de la Croix-Rousse, Lyon, France Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 164, Issue 2, August 1991, Pages 435–436, https://doi.org/10.1093/infdis/164.2.435 Published: 01 August 1991
The aim of this study was to evaluate pristinamycin in the treatment of MSSA bone and joint infection (BJI).A retrospective, single-centre cohort study (2001-11) investigated outcome in adults receiving pristinamycin for MSSA BJI and pristinamycin-related adverse events (AEs).One hundred and two MSSA BJIs were assessed in 98 patients [chronic infection, 33.3%; and orthopaedic device-related infection (ODI), 67.6%]. Surgery was performed in 77.5% of total cases, and in all but three ODIs, associated with antibiotic therapy of a median total duration of 29.2 weeks. Pristinamycin was prescribed as a part of the initial intensive treatment phase (29.4%) and/or included in final maintenance therapy (83.3%) at a dose of 47.6 (45.5-52.6) mg/kg/day for 9.3 (1.4-20.4) weeks. AEs occurred in 13.3% of patients, consisting of gastrointestinal disorder (76.9%) or allergic reaction (23.1%), leading to treatment interruption in 11 cases. AEs were related to daily dose (OR, 2.733 for each 10 additional mg/kg/day; P = 0.049). After a follow-up of 76.4 (29.6-146.9) weeks, the failure rate was 34.3%, associated with ODI (OR, 4.421; P = 0.006), particularly when the implant was retained (OR, 4.217; P = 0.007). In most patients, the pristinamycin companion drug was a fluoroquinolone (68.7%) or rifampicin (21.7%), without difference regarding outcome.Pristinamycin is an effective, well-tolerated alternative therapeutic option in MSSA BJI, on condition that a daily dosage of 50 mg/kg is respected.
A Cambodian-born French 61-year-old man with several cardiovascular risk factors (current smoker, dyslipidaemia, diabetes mellitus without renal impairment, excessive alcohol use or iron overload) was admitted 6 months after his last travel in Cambodia during the wet season. The patient complained of subacute abdominal pains, which became recently intense, without fever or diarrhoea. Abdominal CT scan revealed infrarenal abdominal mycotic aortic aneurysm with signs of cracking (figure 1). Laparotomy, aneurysmectomy, insertion of a …
