8 research outputs found
Recurrent Scedosporium apiospermum mycetoma successfully treated by surgical excision and terbinafine treatment: a case report and review of the literature
Background:
Scedosporium apiospermum
is an emerging opportunistic filamentous fungus, which is notorious for its
high levels of antifungal
âresistance. It is able to cause localized cutaneous or subcutaneous infections in both immuâ
nocompromised and immunocompetent persons, pulmonary infections in patients with predisposing pulmonary
diseases and invasive mycoses in immunocompromised patients. Subcutaneous infections caused by this fungus
frequently show chronic mycetomatous manifestation.
Case report:
We report the case of a 70
âyear
âold immunocompromised man, who developed a fungal mycetomaâ
tous infection on his right leg. There was no history of trauma; the aetiological agent was identified by microscopic
examination and ITS sequencing. This is the second reported case of
S. apiospermum
subcutaneous infections in
Hungary, which was successfully treated by surgical excision and terbinafine treatment. After 7
months, the patient
remained asymptomatic. Considering the antifungal susceptibility and increasing incidence of the fungus,
Sce
-
dosporium
related subcutaneous infections reported in the past quarter of century in European countries were also
reviewed.
Conclusions:
Corticosteroid treatment represents a serious risk factor of
S. apiospermum
infections, especially if the
patient get in touch with manure
âenriched or polluted soil or water. Such infections have emerged several times in
European countries in the past decades. The presented data suggest that besides the commonly applied voriconaâ
zole, terbinafine may be an alternative for the therapy of mycetomatous
Scedosporium
infections
Continuum of care among HIV-1 positive patients in a single center in Italy (2007–2017)
Filippo Lagi,1 Seble Tekle Kiros,1 Irene Campolmi,1 Susanna Giachè,1 Pier Giorgio Rogasi,2 Marcello Mazzetti,2 Filippo Bartalesi,2 Michele Trotta,2 Patrizia Nizzoli,3 Alessandro Bartoloni,1,2 Gaetana Sterrantino2 1Infectious Disease Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; 2Infectious and Tropical Disease Unit, Azienda Ospedaliero – Universitaria Careggi, Florence, Italy; 3Department of Pharmaceuticals, USL Toscana Centro, Florence, Italy Aim: This study aimed to determine rates of retention in care, viral suppression, and use of antiretroviral therapy (ART) and identify risk factors for loss to follow-up (FU) in an adult cohort from a tertiary teaching hospital in Florence, Italy. Methods: We included all newly diagnosed HIV-infected patients aged >18 years who were linked to our clinic from July 2007 to December 2015. On July 31, 2017, we evaluated the proportion of patients retained in care, on ART, and having HIV RNA <50 copies/mL. We assessed predictors of loss to FU through univariate and multivariate analyses. Results: We included 423 patients. By July 2017, 23 (5.5%) patients died, 25 (5.9%) moved to a different center, and 64 (15.1%) were lost to follow-up. Among the remaining 311 patients (73.5%), 96.5% were on ART and 95% had HIV RNA <50 copies/mL. After adjustment for sex, age at diagnosis, origin, and risk of transmission, our results showed a lower retention rate in those not on ART at the end of the follow-up (adjusted HR [aHR]: 10.33, 95% CI 5.80–18.40, P<0.001), non-Italians (aHR: 1.69, 95% CI: 0.99–2.89, P=0.054) and <35 years old (aHR: 1.85; 95% CI 1.04–3.30, P=0.037). Conclusion: In our hospital in Florence, we found a gap in retention in care among foreigners, people <35 years old, and those who were not in treatment at the end of the follow-up. The results of this study may help to identify opportunities for appropriate future interventions. Keywords: HIV-1, continuum of care, retention in care, Italy, 90-90-90 target, predictors associated to loss to follow-u
Characterization of the vaginal microbiota of healthy Canadian women through the menstrual cycle
The intestinal immune system is severely affected by HIV and circulating microbial products from the intestinal tract that provide an ongoing source of systemic inflammation and concomitant viral replication. In addition, HIV-infected individuals can have a deregulated immune response that may hamper the anti-viral capacity of the host. Various probiotic organisms and prebiotic agents have been shown to enhance intestinal epithelial barrier functions, reduce inflammation, and support effective Th-1 responses. As these characteristics may benefit HIV patients, this review aims to provide a theoretical framework for the development of probiotic and prebiotic interventions specifically for this population. © 2010 Informa Healthcare USA, Inc