Publications by authors named "Bianca Grassi de Miranda"
Epidemiology, clinical aspects, outcomes and prognostic factors associated with Trichosporon fungaemia: results of an international multicentre study carried out at 23 medical centres.
J Antimicrob Chemother
June 2021
Article Synopsis
- Trichosporon fungaemia (TF) cases have risen, with high mortality rates, prompting a need for better understanding of its treatment and underlying factors.
- A study conducted from 2005 to 2018 analyzed 88 TF episodes in South America, highlighting that many patients had serious underlying conditions and a strong association with the use of central venous catheters (CVCs).
- Key findings included a 30-day mortality rate of 51.1%, with predictors like age and mechanical ventilation worsening outcomes, while removing CVCs significantly reduced mortality risk.
Background: Empirical antifungal therapy in high-risk ICU patients is an attractive strategy, but overuse of antifungal agents is a potential problem.
Objectives: We evaluated if ICU patients at high risk to develop candidaemia identified by a prediction rule could discontinue empirical antifungal therapy on the basis of repeatedly negative 1-3-β-d-glucan (BDG) tests.
Methods: We conducted a multicentre cohort study in 85 ICU patients receiving antibiotics or with central venous catheter plus two additional factors (dialysis, parenteral nutrition, surgery, pancreatitis or receipt of corticosteroids or other immunosuppressive agents) plus either fever, hypothermia, hypotension, acidosis, elevated C-reactive protein or leucocytosis.
We present two cases of juvenile form of paracoccidioidomycosis (PCM), a systemic mycosis frequently found in rural areas, whose prognosis is poor in children and young adults. They are a 14-year-old boy and a 25-year-old woman, both residents in an urban area in São Paulo - Brazil, without any history of travelling to an endemic area. They have been admitted to the hospital due to fever, weight loss and lymphadenopathy.
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