Decreasing voriconazole requirement in a patient after extracorporeal membrane oxygenation discontinuation: A case report.

Patients receiving extracorporeal membrane oxygenation (ECMO) may display large decreases in drug concentrations due to increases in volume of distribution and drug binding to ECMO circuits, tubing, oxygenator, and coating materials. We report a case of a critically ill male with a 10-month status post-deceased donor renal transplant and being treated with voriconazole for suspected aspergillosis. Initially, multiple dose increases, up to 11.

Assessing patient and caregiver understanding of and satisfaction with the use of contact isolation.

Background: Contact isolation is a method used for limiting the spread of antimicrobial-resistant organisms when caring for patients. This policy has been linked to several adverse outcomes and less patient satisfaction. We assessed patient and caregiver understanding and satisfaction with the use of contact isolation.

BK virus encephalitis: case report, review of the literature, and description of a novel treatment modality.

Objective: To describe a case of BK virus encephalitis with attempted direct antiviral therapy, review the reported cases of BK virus in the central nervous system, and report the novel use of intravenous cimetidine in place of oral probenecid to minimize the toxicities of intravenous cidofovir.

Case Summary: A 36-year-old male with acute myelomonocytic leukemia and subsequent myelodysplastic syndrome underwent allogeneic hematopoietic stem cell transplant. His course was complicated by severe graft-versus-host disease involving his skin and gastrointestinal tract.

Early onset versus late onset peripherally inserted central venous catheter infections: an analysis of risk factors and microbiology.

The risks and microbiology for peripherally inserted central catheters (PICCs) are less well described than those for traditional central catheters, particularly as they pertain to duration of catheterization. We compared patients with early- and late-onset PICC bloodstream infections at our institution and found significant differences in microbiologic etiologies.

An outbreak of Pseudomonas aeruginosa respiratory tract infections associated with intrinsically contaminated ultrasound transmission gel.

We describe an outbreak of Pseudomonas aeruginosa respiratory tract infections related to intrinsically contaminated ultrasound gel used for intraoperative transesophageal echocardiograms in cardiovascular surgery patients. This investigation led to a product safety alert by the Food and Drug Administration and the development of guidelines for appropriate use of ultrasound gel.

Recognition and prevention of nosocomial vascular device and related bloodstream infections in the intensive care unit.

Central venous catheters have become a mainstay in the care of critically ill patients but, unfortunately, are associated with a significant risk of bloodstream infections. There are 80,000 catheter-related bloodstream infections that occur annually in the United States, with a high human and financial cost. This paper reviews the main tools for prevention and diagnosis of central venous catheter-related bloodstream infections in the intensive care unit.

Case of fatal Blastoschizomyces capitatus infection occurring in a patient receiving empiric micafungin therapy.

We report the first case, to our knowledge, of Blastoschizomyces capitatus infection occurring in a patient receiving empirical echinocandin therapy for neutropenic fevers. Clinicians should consider B. capitatus infection in those neutropenic patients who remain febrile despite echinocandin therapy or who develop yeast bloodstream infections while receiving an echinocandin.

A summary of national reports of foodborne outbreaks of Salmonella Heidelberg infections in the United States: clues for disease prevention.

We analyzed national foodborne outbreak data from 1973 through 2001 to determine the proportion of Salmonella Heidelberg outbreaks caused by specific foods. Among 6633 outbreaks with known etiology, 184 (3%) were caused by Salmonella Heidelberg. A vehicle was identified in 101 outbreaks; at least 53 were poultry or egg-related.