This study aimed to evaluate the current management of tinea capitis in the United States, specifically focusing on patients aged 0-2 months, 2 months to 2 years, and 2 years to 18 years. An online survey, distributed through the Pediatric Dermatology Research Alliance and the Society of Pediatric Dermatology, revealed the following preferences: fluconazole for those under 2 months, griseofulvin for those aged 2 months to 2 years, and terbinafine for those aged 2 years and older. There exists inter-provider variation in tinea capitis treatment regimens within the pediatric dermatology community.

Description Mucormycosis is a rare devastating fungal infection with a high mortality rate often associated with diabetic and immunosuppressed individuals. However, infections found in postoperative states and in immunocompetent patients are rare. Systemic liposomal amphotericin is viewed as a first line treatment for mucormycosis in addition to aggressive debridement to prevent the spread of infection. Literature describing the treatment of mucormycosis with both systemic and topical amphotericin B is scarce. We present a case of an immunocompetent male admitted for perforated diverticulitis who received a left hemicolectomy with colostomy creation. During hospitalization, stool from the colostomy bag was reportedly leaking into the wound. The patient was found to have extensive necrotic tissue with mold growing in his postoperative incision site. The wound culture and pathology report confirmed mucormycosis. The patient was treated with intravenous (IV) liposomal amphotericin B, wound dressings with an amphotericin/saline mixture twice daily and serial wound debridements. The patient was discharged in stable condition with successful wound healing.

UNASSIGNED: Ecthyma gangrenosum (EG) is a relatively uncommon cutaneous manifestation of an underlying Pseudomonas aeruginosa infection and is clinically described as necrotic with gangrenous ulcers surrounded by erythematous halos. Cases of EG may occur in the absence of bacteremia and have been increasingly reported in literature. Here we present a patient with features of both EG and panniculitis, despite the lack of underlying bacteremia.
UNASSIGNED: A 57-year-old male presented to the emergency department with unrelenting right-sided lower back pain and an \"itchy and painful\" rash of four to five day duration. The patient had an extensive history of intravenous drug abuse and had been hospitalized multiple times for Pseudomonas bacteremia. Upon examination, there were diffuse, erythematous subcutaneous nodules and several individual necrotic ulcerations on the abdomen, upper and lower extremities, surrounded by erythematous halos. An MRI revealed myositis and edema in the right paraspinal region, and blood cultures were negative for Pseudomonas.
UNASSIGNED: EG is typically classified as bacteremic or non-bacteremic in nature, and there are limited reports of panniculitis in the absence of bacteremia. This patient\'s presentation was unusual for the diffuse presentation of non-bacteremic EG with panniculitis. Due to the patient\'s past medical history of deep-seeded Pseudomonas infections, bacteria could have been directly inoculated into the skin at various injection sites.
UNASSIGNED: While EG is an uncommon but well-recognized dermatologic feature of Pseudomonas bacteremia, panniculitis is reportedly less commonly and likely underrecognized. Physicians should become aware of the cutaneous manifestations of underlying Pseudomonas infection so appropriate antibiotic therapy can be initiated.

COVID-19 is a serious global infectious disease impairing the quality of life of people across the world. SARS-CoV-2 may reside in nasopharyngeal and salivary secretions of COVID-19-infected patients and spreads mainly through respiratory droplets and fomites. It has presented a challenge to dentistry, as many dental procedures generate aerosols that could lead to cross-contamination. It also presents many post-infection complications that may continue to debilitate patients, even after successful management of the virus. One such complication may be osteomyelitis of the jaw. Two cases of post-COVID-19 osteomyelitis of the jaw are presented that were determined to be unrelated to mucormycosis in otherwise healthy individuals with no prior dental complaints. An attempt is made to shed light on clinical signs in post-COVID cases that may point to a diagnosis of the condition. The pathophysiology is also discussed, which may help in formulating guidelines to prevent and manage post-COVID osteomyelitis of the jaw.

BACKGROUND: Invasive aspergillosis of the central nervous system is a rare but increasingly prevalent disease. We present the unusual case of an immunosuppressed patient suffering from unexpected superinfected invasive aspergillosis with cerebral, pulmonal, and adrenal manifestations, mimicking a metastasized bronchial carcinoma. This report reveals the importance of including aspergillosis in the differential diagnosis of a cerebral mass lesion in the light of unspecific clinical findings.
METHODS: A 58-year-old immunocompromised female presented to our emergency department with a single tonic-clonic seizure. Imaging showed a ring enhancing cerebral mass with perifocal edema and evidence of two smaller additional hemorrhagic cerebral lesions. In the setting of a mass lesion in the lung, and additional nodular lesions in the left adrenal gland the diagnosis of a metastasized bronchus carcinoma was suspected and the cerebral mass resected. However, histology did not reveal any evidence for a neoplastic lesion but septate hyphae consistent with aspergillus instead and microbiological cultures confirmed concomitant staphylococcal infection.
CONCLUSIONS: A high index of suspicion for aspergillus infection should be maintained in the setting of immunosuppression. Clinical and radiological findings are often unspecific and even misleading. Definite confirmation usually relies on tissue diagnosis with histochemical stains. Surgical resection is crucial for establishing the diagnosis and guiding therapy with targeted antifungal medications.

Infectious complications can be a major cause of morbidity and mortality in solid organ transplant recipients. Preservation fluid is necessary to maintain organ viability but may serve as a vector or infection. The utility of screening preservation fluid routinely for microbial growth and the impact of culture-positive preservation fluid is controversial. Research Question: What is the clinical impact of a culture positive preservation fluid in a kidney transplant recipient?
This retrospective study was performed to define the incidence of post-operative infection related to PF and examine the negative sequelae of culture-positive PF. One hundred and fifty-two deceased donor renal transplant recipients from January 2015 to December 2017 were included for analysis.
Overall, 67% of patients (102/152) received an allograft from a culture-positive PF. Nearly 80% of microbial growth was consistent with skin flora, and coagulase-negative staphylococci was the most frequently isolated organism (56%). Sixty-seven percent of patients (68/102) with culture-positive PF received antimicrobial treatment for an average duration of 5 days. There was no difference in the incidence of infection between patients with culture positive PF compared to culture-negative PF. Furthermore, there were no cases of infection related to PF regardless of whether culture-positive PF was treated or untreated. The incidence of subsequent C. difficile infection and multidrug-resistant organisms was similar.
This study suggests antimicrobial treatment for culture positive PF may not be necessary with pathogens that are common contaminants and of low virulence. Interventional studies are needed to validate this strategy.

This report presents the case of a 13-year-old female patient with history of acute myeloid leukemia, who, after a bone marrow transplant, began to vomit and experienced rapidly progressive deterioration of consciousness, in addition to disseminated erythematous-violaceous macules, and some blisters with hemorrhagic content inside. Skin biopsy evidenced intravascular filamentous structures. A blood culture confirmed the presence of Fusarium oxysporum. Intravenous treatment with voriconazole was initiated. The patient evolved unfavorably with multiple necrotic skin lesions, ischemic brain lesions, and death.

According to clinical guidelines, there are no differences in early infection rates when utilizing antimicrobial prophylaxis regimens beyond 24 hours. We shortened the prophylaxis regimen from 72 to 24 hours in liver transplant recipients due to rising rates of resistance. The objective of this study is to evaluate the difference in posttransplant outcomes, following the protocol change.
We reviewed adult patients undergoing orthotopic liver transplantation between June 2013 and December 2015. Patients were stratified into 2 cohorts: 24 and 72 hours. Patients were excluded if donor cultures were positive. The primary objective of this study is to evaluate the incidence and time to posttransplant infections. The secondary objectives included analysis of total and intensive care unit length of stay and rates of Clostridioides difficile infection.
Forty-four patients were included, 20 in the 72-hour and 24 in the 24-hour cohorts. The incidence of post-OLT infection (30% vs 8%, P = .115, 95% CI: -1% to 45%) was higher in the 72-hour cohort. Total (21 vs 14, P = .332, 95% CI: -4% to 28%) and intensive care unit LOS (11 vs 6, P = .201, 95% CI, -5% to 31%) were longer in the 72-hour group. No difference was observed in the incidence of CDI (15% vs 13%, P = 1.000).
There was no increase in posttransplant infections in the 24-hour cohort. Shorter antibiotic exposure may be associated with a reduction in length of stay and be favorable in this patient population.

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