Impact of obesity on clinical outcomes of methicillin-susceptible bloodstream infections.

Obesity affects over one-third of U.S. adults and complicates the treatment of methicillin-susceptible (MSSA) bloodstream infections (BSI).

Gastrointestinal Stromal Tumor Masquerading As Acute Decompensated Heart Failure: A Challenging Diagnosis.

Gastrointestinal stromal tumors (GISTs) are rare lesions of the gastrointestinal tract that have a strong predisposition to the stomach and small intestine. We present a case of an 89-year-old female who initially presented to the emergency room with signs and symptoms of acute decompensated heart failure (HF) and was later discovered to have a 23-centimeter GIST in her abdominal cavity. This case emphasizes the implications of large intraperitoneal neoplasms and the unique constellation of symptoms they may present with.

The Time for Action Is Now: The Impact of Timing of Infectious Disease Consultation for Staphylococcus aureus Bacteremia.

This retrospective cohort study was performed to compare clinical outcomes between patients with Staphylococcus aureus bacteremia who received an early versus late infectious disease consultation. Early consultation resulted in significantly greater adherence to quality care indicators and shorter hospital stays.

Fusariosis: An Invasive Fungal Disease in a Neutropenic Patient With Acute Myeloid Leukemia.

Although rare in the U.S invasive Fusariosis (IF) is increasingly being recognized as a cause of severe invasive fungal disease in patients with neutropenia in the setting of hematologic malignancy and hematopoietic stem cell transplants (HSCT). IF in these patients is associated with high mortality, moreover there are no guidelines on effective therapy, thus early diagnosis and involvement of an expert with experience in treating Fusariosis are imperative.

Effectiveness and Safety of Beta-Lactam Antibiotics with and without Therapeutic Drug Monitoring in Patients with Pseudomonas aeruginosa Pneumonia or Bloodstream Infection.

This objective of this study was to compare clinical outcomes in hospitalized patients with Pseudomonas aeruginosa pneumonia (PNA) or bloodstream infection (BSI) receiving beta-lactam antibiotic (BLA) infusions with and without the guidance of therapeutic drug monitoring (TDM). A retrospective, parallel cohort study was conducted at two academic medical centers between December 2015 and January 2020, UF Shands Gainesville, which uses BLA TDM for select patients (BLA TDM), and UF Health Jacksonville, which does not use BLA TDM (No-BLA TDM). All hospitalized adult patients with respiratory or blood culture positive for P.

A Case Report of Melioidotic Prostatic Abscess in a Traveler.

A 48-year-old man who had returned from Panama 5 weeks prior presented with fever, dysuria, hematuria, flank pain, and suprapubic pain and was found to have a prostatic abscess. Abscess fluid obtained during transurethral drainage grew . Blood cultures remained negative, and imaging did not show any other visceral abscess.

Influence of Antimicrobial Stewardship and Molecular Rapid Diagnostic Tests on Antimicrobial Prescribing for Extended-Spectrum Beta-Lactamase- and Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae in Bloodstream Infection.

The objective of this study was to evaluate whether the addition of the Verigene BC-GN molecular rapid diagnostic test to standard antimicrobial stewardship practices (mRDT + ASP) decreased the time to optimal and effective antimicrobial therapy for patients with extended-spectrum beta-lactamase (ESBL)- and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae bloodstream infections (BSI) compared to conventional microbiological methods with ASP (CONV + ASP). This was a multicenter, retrospective cohort study evaluating the time to optimal antimicrobial therapy in 5 years of patients with E. coli or K.

: An Unexpected Cause of Polyarthritis and Meningitis.

, a gram-negative coccus, is a major cause of morbidity among sexually active individuals. Hematogenous spread of from the initial site of infection is thought to occur in only 0.5% to 3% of infected patients.

Comparison of acute kidney injury in patients prescribed vancomycin in combination with piperacillin-tazobactam or cefepime for diabetic foot infections.

Concomitant therapy with vancomycin (VAN) and piperacillin-tazobactam (PTZ) has been associated with acute kidney injury (AKI). Diabetic patients may be more susceptible to AKI due to various factors. In an observational, retrospective, cohort study of adults treated for diabetic foot infections (DFIs), rates of AKI were compared between groups receiving VAN+PTZ versus VAN+cefepime (CFP).

Mosquito borne illness in a Floridian hiker.

Chikungunya is an arboviral infection that manifests as an acute viral illness associated with an inflammatory arthritis. It was first described during an outbreak in Tanzania in 1952 and, until 2013, outbreaks had been limited in Africa, Asia, Europe and the Indian and Pacific Oceans. In late 2013, the first local transmission of Chikungunya was identified in Caribbean countries with subsequent spread throughout Central and South America.

A Rare Case of Metastatic Hepatocellular Carcinoma Masquerading as a Forehead Hematoma.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and can arise from any form of chronic liver disease or cirrhosis. With increasing rates of metabolic syndrome and obesity, it is not surprising that NASH is quickly becoming a leading cause of chronic liver disease and HCC in the western hemisphere (Wang and Malhi, 2018). Metastasis is usually found in advanced stages of the disease, owing to its poor prognosis.

Preanalytical Challenges During Capillary Fingerstick Sampling Preclude Its Widespread Use in Adult Hospitalized Patients.

Objectives: Patient compliance with laboratory testing is one of the most underrecognized challenges in developing a treatment plan for acute and chronically ill patients. The ability to offer alternatives to standard venipuncture blood draws would greatly increase a laboratory's ability to provide testing to patients and health care providers.

Methods: We performed a prospective observational study on paired venous and fingerstick capillary blood samples from admitted patients undergoing vancomycin therapy.

Peripheral blood lymphocyte-to-monocyte ratio as a screening marker for influenza infection.

Influenza outbreaks occur annually and account for significant morbidity and mortality. The overall burden of influenza infections, in the USA, for the 2017-2018 season, was an estimated 45 million cases, 810 000 hospitalizations and 61 000 deaths. Literature suggests that leukocyte count and differential, particularly lymphopenia and/or monocytosis, can provide diagnostic value for influenza infection.

Clinical impact of a pharmacist-led antimicrobial stewardship initiative evaluating patients with colitis.

is the most common cause of healthcare-associated infection and gastroenteritis-associated death in the USA. Adherence to guideline recommendations for treatment of severe infection (CDI) is associated with improved clinical success and reduced mortality. The purpose of this study was to determine whether implementation of a pharmacist-led antimicrobial stewardship program (ASP) CDI initiative improved adherence to CDI treatment guidelines and clinical outcomes.

Rapidly progressive necrotizing cellulitis secondary to infection in an immunocompromised host.

The incidence of invasive fungal infection is increasing as the population of immunosuppressed patients grows. Many species that were previously thought to be benign are now known pathogens. The most commonly isolated organisms (>80 %) include C and .

Central nervous system nocardiosis masquerading as metastatic brain lesions.

Nocardiosis is an uncommon infection, however it needs to be included in the differential diagnosis, especially in immunocompromised hosts. Central nervous system (CNS) nocardiosis, in particular, is an even rarer entity with a higher mortality. This is a case of CNS Nocardia infection with an atypical presentation that was initially concerning for metastatic disease.

Methicillin-resistant (MRSA) sepsis complicated by warm autoimmune haemolytic anaemia secondary to antimicrobial therapy.

A 61-year-old Caucasian woman presented to the emergency room complaining of left-sided chest pain and altered mentation for 3 days. Her medical history included liver cirrhosis and coronary artery disease. On admission, she was found to have methicillin-resistant (MRSA) bacteraemia.

Methicillin-resistant pericarditis causing cardiac tamponade.

Community acquired methicillin-resistant (MRSA) is an organism that can cause life threatening injuries with 6 cases of purulent pericarditis secondary to MRSA being reported so far. We report a 66 year-old -female who presented to our hospital with a two-week history of worsening shortness of breath, associated with pleuritic chest pain and chills. Patient was found to be positive for influenza type A virus two weeks prior to this presentation, but was never treated.

Kaposi sarcoma with musculoskeletal manifestations in a well-controlled HIV patient.

We present here a case of relapsed HIV-related Kaposi Sarcoma (KS), manifesting as a plantar ulcer with underlying bone involvement in a patient with well-controlled HIV. Radiographic and magnetic resonance imaging of the patient's right foot showed bone destruction suggestive of osteomyelitis. However, when a bone biopsy was done, this was consistent with KS, without any signs of bone infection.

Endocarditis caused by A rare presentation of an emerging opportunistic pathogen.

First isolated in 1943, () has historically been of little significance as it was considered a pathogen of low virulence noted to rarely infect immunocompromised hosts. However, over the last 30 years the prevalence of infection caused by the organism has increased significantly. Bacterial endocarditis from remains exceedingly rare with only a small number of reported cases in the literature.

Trivalvular infective endocarditis secondary to and .

We present a case of a 42-year-old Caucasian man that came to our facility complaining of dyspnea and subjective fevers and was found to have infective endocarditis. His blood cultures initially grew and he was started on penicillin and gentamicin. Repeat blood cultures, drawn 48 h later, became positive for .