Microbiology of pancreatoduodenectomy and recommendations for antimicrobial prophylaxis.

Background: The microbiology of pancreatoduodenectomy is challenging and published guidelines regarding perioperative antimicrobial prophylaxis are variable with poor adherence.

Methods: A retrospective analysis of the microbiological results of 294 consecutive patients who underwent pancreatoduodenectomy was performed. Intraoperative specimen culture results were available for 50 patients and their medical records were reviewed to determine the following demographics and factors; age; sex; tumour location, histopathology, grade and stage; neoadjuvant chemotherapy and radiotherapy; preoperative biliary stenting; surgeon; surgery type and antimicrobial prophylaxis coverage.

empyema in a patient receiving ibrutinib for diffuse large B-cell lymphoma and a review of the literature.

We report a case of pulmonary infection complicated by empyema in a 79-year-old man with diffuse large B-cell lymphoma treated with R-CHOP and ibrutinib. A literature review identified 25 cases of cryptococcal pleural disease published since 1980. Most cases were caused by the species in immunocompromised hosts with an exudative pleural effusion and lymphocyte-predominant infiltrate.

Candida costochondritis associated with recent intravenous drug use.

Candida osteoarticular infections are being reported with increasing frequency, possibly due to an expanding population at risk. However, Candida costochondritis is uncommon. We report two cases of Candida costochondritis in patients who presented with subacute-onset chest wall swelling and whose only identifiable risk factor was a history of recent intravenous drug use.

Three cases of presumed pneumocystis pneumonia in patients receiving bortezomib therapy for multiple myeloma.

Introduction: This paper presents three probable cases of pneumocystis pneumonia in patients receiving bortezomib therapy for multiple myeloma.

Presentation Of Cases: Three patients receiving bortezomib therapy for multiple myeloma presented with dyspnoea, non-productive cough, and fevers. These patients deteriorated despite receiving broad-spectrum antibiotic therapy with piperacillin + tazobactam and azithromycin and an assortment of other antimicrobials but promptly responded to sulfamethoxazole + trimethoprim therapy.