Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and... more
Although uncommon, Brucella infection can occur outside the areas of high endemicity, such as the USA. In the southern USA, hunters of wild swine are at risk for brucellosis. We present a case of a patient with fever, headache and constitutional symptoms that were ongoing for 11 months. He was diagnosed with neurobrucellosis. The patient was treated successfully with intravenous ceftriaxone, oral doxycycline and oral rifampin therapy. He had persistent neurological sequelae after completing treatment. This case illustrates the high index of suspicion needed to diagnose neurobrucellosis in a non-endemic country because initial symptoms can be subtle. The disease can be treated successfully, but long-lasting neurological sequelae are common.
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Bacterial infection is a frequent, morbid, and mortal complication of liver transplantation. Selective bowel decontamination (SBD) has been reported to reduce the rate of bacterial infection after liver transplantation in uncontrolled... more
Bacterial infection is a frequent, morbid, and mortal complication of liver transplantation. Selective bowel decontamination (SBD) has been reported to reduce the rate of bacterial infection after liver transplantation in uncontrolled trials, but benefits of this intervention have been less clear in controlled studies. Eighty candidates for liver transplantation were randomly assigned in a double-blinded fashion to an SBD regimen consisting of gentamicin 80 mg+polymyxin E 100 mg+nystatin 2 million units (37 patients) or to nystatin alone (43 patients). Both treatments were administered orally in 10 ml (increasing to 20 ml, according to predefined criteria), four times daily, through day 21 after transplantation. Anal fecal swab cultures were performed on days 0, 4, 7, and 21. Rates of infection, death, and charges for medical care were assessed from day 0 through day 60. More than 85% of patients in both treatment groups began study treatment more than 3 days before transplantation. Rates of infection (32.4 vs. 27.9%), death (5.4 vs. 4.7%), or charges for medical care (median $194,000 vs. $163,000) were not reduced in patients assigned to SBD. On days 0, 4, 7, and 21, growth of aerobic gram-negative flora in fecal cultures of patients assigned to SBD was significantly less than that of patients taking nystatin alone; growth of aerobic gram-positive flora, anaerobes, and yeast was not significantly different. Routine use of SBD in patients undergoing liver transplantation is not associated with significant benefit.
Research Interests: Surgery, Gastroenterology, Medicine, Transplantation, Prospective studies, and 15 moreHumans, Internal Medicine, Female, Male, Liver Transplantation, Intestines, Middle Aged, Colistin, Randomized Controlled Trial, Combination drug therapy, Yeasts, Regimen, Nystatin, Gentamicins, and Medical and Health Sciences
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In June 1980, 23% of our Pseudomonas aeruginosa isolates and 53% of our Serratia species were resistant to gentamicin and tobramycin. During a 3 1/2-year period of almost exclusive amikacin usage, we noted a fall in overall resistance of... more
In June 1980, 23% of our Pseudomonas aeruginosa isolates and 53% of our Serratia species were resistant to gentamicin and tobramycin. During a 3 1/2-year period of almost exclusive amikacin usage, we noted a fall in overall resistance of gram-negative organisms to tobramycin and gentamicin from 18.8% and 19.3% to 15.2% and 16.2%, respectively. This fall in resistance was most notable for Escherichia coli, Proteus mirabilis, and Serratia species. During this period there was no increase in amikacin resistance. Age, hospitalization, prior antibiotic therapy, and Foley catheter use were predisposing factors in acquiring amikacin-resistant organisms. Amikacin-resistant gram-negative bacilli were usually sensitive to newer penicillins or cephalosporins.
Research Interests: Microbiology, Medicine, Catheterization, Humans, Hospitalization, and 15 moreMicrobial genetic and drug resistance, Pseudomonas aeruginosa, Tennessee, Aged, Middle Aged, Gram-negative bacteria, Age Factors, Microbial Sensitivity Tests, Bacterial infections, Pseudomonas Aeruginosa, Proteus Mirabilis, Tobramycin, Gentamicins, Gentamicin, and Medical and Health Sciences
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Gram-negative bacillary pneumonia has become an increasingly important disease in immunosuppressed, elderly, and hospitalized patients. The clinical features, etiologic agents, population at risk, treatment, and outcome in patients with... more
Gram-negative bacillary pneumonia has become an increasingly important disease in immunosuppressed, elderly, and hospitalized patients. The clinical features, etiologic agents, population at risk, treatment, and outcome in patients with well-documented gram-negative pneumonia were compared in two groups of patients: those with bacteremic pneumonia and those with nonbacteremic pneumonia documented by transtracheal aspiration. Clinical features were frequently subtle in both groups. A wide range of gram-negative bacilli were implicated as pathogens and pneumonias documented by transtracheal aspiration were frequently mixed infections. Pseudomonas aeruginosa and Serratia marcescens were the most common pathogens causing bacteremic pneumonias, whereas Escherichia coli and Klebsiella were more common in the nonbacteremic group. Gram-negative bacillary pneumonia was frequently a lethal disease despite two-drug therapy, particularly in bacteremic patients.
Research Interests: Adolescent, Medicine, Humans, Female, Pneumonia, and 15 moreMale, Aged, Middle Aged, Autopsy, Adult, Bacteremia, Age Factors, Microbial Sensitivity Tests, Combination drug therapy, Haemophilus Infections Market, La revue du praticien, Klebsiella pneumonia, Medical and Health Sciences, Cross Infection, and Legionnaires Disease
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Research Interests: Demography, Environmental Health, Malaria, Communicable Diseases, Infectious Diseases, and 15 moreAdolescent, Biological Sciences, Categorical data analysis, Humans, Child, Infectious Disease, Female, Infant, Aged, Adult, Department of Medicine, International Travel, Communicable disease control, Clinical Infectious Diseases, and Child preschool
Research Interests: Microbiology, Medical Microbiology, Biology, Medicine, Vancomycin, and 11 moreHumans, Staphylococcus aureus, Microbial Sensitivity Tests, Methicillin Resistant Staphylococcus Aureus, Gentamicin, Drug synergism, Fosfomycin, Methicillin, Pharmacology and pharmaceutical sciences, Cross Infection, and Trimethoprim
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Travelers seen for pretravel health encounters are frequently prescribed new travel-related medications, which may interact with their previously prescribed medications. In a cohort of 76 324 travelers seen at 23 US clinics, we found that... more
Travelers seen for pretravel health encounters are frequently prescribed new travel-related medications, which may interact with their previously prescribed medications. In a cohort of 76 324 travelers seen at 23 US clinics, we found that 2650 (3.5%) travelers were prescribed travel-related medications with potential for serious drug interactions.
Phlegmonous gastritis is an uncommon acute bacterial infection of the stomach that carries a fatal prognosis in spite of the advent of antibiotics. A high index of suspicion is required in patients with risk factors. An immunocompromised... more
Phlegmonous gastritis is an uncommon acute bacterial infection of the stomach that carries a fatal prognosis in spite of the advent of antibiotics. A high index of suspicion is required in patients with risk factors. An immunocompromised state is identified as one of the most important risk factors. We hereby report a case of successful antimicrobial treatment of phlegmonous gastritis in a patient who was receiving intensive chemotherapy for acute myelogenous leukemia. We have also carried out a review of literature over the past ten years. is identified as the most common causative organism, and patient presentation is usually nonspecific. Conservative treatment with prompt institution of antibiotics can lead to rapid resolution in the majority of patients.
To evaluate our institutional experience with Mycobacterium abscessus infections occurring in lung transplant recipients (LTR). We retrospectively reviewed our prospectively collected institutional adult lung transplant database from 2001... more
To evaluate our institutional experience with Mycobacterium abscessus infections occurring in lung transplant recipients (LTR). We retrospectively reviewed our prospectively collected institutional adult lung transplant database from 2001 to 2015 to identify patients with M. abscessus or Mycobacterium chelonae/abscessus infection before or after transplantation. Untreated, colonized patients were excluded from the study. Electronic health records of nine out of 516 lung recipients (1.74%) with clinical infection were reviewed to determine outcomes. Seven patients acquired the infection after transplantation. Indications for transplantation were: idiopathic pulmonary fibrosis (in 6), chronic obstructive pulmonary disease (in 2), and cystic fibrosis (in 1). Five patients (55.5%) underwent bilateral lung transplantation; one patient required bilateral re-transplantation for complications from infection. M. abscessus was isolated from the respiratory tract with a median time of 7.5 mont...
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To present our experience with culture-positive, nontuberculous mycobacterial infections (NTMI) of the upper extremity and to compare the clinical features and outcomes of treatment among immunocompetent and immunocompromised patients.... more
To present our experience with culture-positive, nontuberculous mycobacterial infections (NTMI) of the upper extremity and to compare the clinical features and outcomes of treatment among immunocompetent and immunocompromised patients. All patients at our medical center diagnosed with NTMI of the upper extremity from December 1, 2000, through December 31, 2015, were included. We performed a retrospective analysis of patient demographic characteristics, delay to diagnosis, risk factors, clinical presentation, specific location, diagnostic testing, treatment regimens, and outcomes. These variables were compared between immunocompetent and immunocompromised patients. Forty-four patients were identified with culture-positive NTMI of the upper extremity. Of the patients, 27 (61%) were men (median age, 59 years [range, 23-83 years]). Twenty (45%) patients were immunocompromised. Immunocompromised patients had fewer known inoculation injuries compared with immunocompetent patients (45% vs ...
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... Colleen S. Thomas, MS3, Jefree Shalev, BS4, John J. Cawley, MMSc.5, Michael R. Keating,MD1, Salvador Alvarez, MD1 Divisions of Infectious Diseases1, Transplant Pulmonology2, Biostatistics3, Transplant Information Technology4,... more
... Colleen S. Thomas, MS3, Jefree Shalev, BS4, John J. Cawley, MMSc.5, Michael R. Keating,MD1, Salvador Alvarez, MD1 Divisions of Infectious Diseases1, Transplant Pulmonology2, Biostatistics3, Transplant Information Technology4, Laboratory Medicine and Pathology5 ...
An occurrence of multiple chronic lung abscesses managed by lobectomy is described. These abscesses were present for 13 years in the patient, a nonimmunocompromised wood pulp worker. The patient had hemoptysis at presentation. The... more
An occurrence of multiple chronic lung abscesses managed by lobectomy is described. These abscesses were present for 13 years in the patient, a nonimmunocompromised wood pulp worker. The patient had hemoptysis at presentation. The organism isolated was Ochroconis gallopavum, a dematiaceous fungus known to cause disease in immunocompromised patients and epidemic encephalitis in poultry. The fungus is typically found in warm environments and in decaying compost; for this reason, we postulate that his illness was occupationally acquired.
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In immunocompetent patients, Mycobacterium avium/Mycobacterium intracellulare complex (MAC) has been associated with pulmonary infection in adults, cervical lymphadenitis in children, and disseminated infection in children and adults. MAC... more
In immunocompetent patients, Mycobacterium avium/Mycobacterium intracellulare complex (MAC) has been associated with pulmonary infection in adults, cervical lymphadenitis in children, and disseminated infection in children and adults. MAC rarely has been recognized as a cause of localized soft-tissue infection in immunocompetent hosts. Six cases of granulomatous tenosynovitis due to MAC are reported; five cases occurred after local surgical procedures, trauma, or corticosteroid injection. In four cases, cure was achieved with combined medical and surgical intervention. In these six cases and 11 previously reported cases, both males and females were affected equally, usually in the fifth to seventh decades of life, and the distal upper extremity was predominantly involved. Surgical debridement with appropriate culture was critical for diagnosis and management. Antimycobacterial chemotherapy seemed to be a beneficial adjunctive measure in most cases but was clearly necessary for cure in only a few cases.
Research Interests: Biological Sciences, Humans, Female, Male, Bacteria, and 14 moreWrist joint, Aged, Middle Aged, Anti-Bacterial Agents, Hand, Microbial Sensitivity Tests, Combination drug therapy, Soft Tissue, Debridement, Granuloma, Clinical Infectious Diseases, Immunocompetence, Mycobacterium avium complex, and Medical and Health Sciences
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Mechanism of action, antimicrobial spectrum, pharmacology, adverse reactions and therapeutic uses of nitrofurantoin, a broad-spectrum antimicrobial agent, are discussed. The frequency and potential severity of reactions attributed to... more
Mechanism of action, antimicrobial spectrum, pharmacology, adverse reactions and therapeutic uses of nitrofurantoin, a broad-spectrum antimicrobial agent, are discussed. The frequency and potential severity of reactions attributed to nitrofurantoin, plus its inability to achieve therapeutic blood concentrations, relegate this drug to a position of secondary importance. Nitrofurantoin compares favorably with other standard agents for the therapy of acute and recurrent urinary tract infections in women which may be caused by susceptible organisms, and it is an effective chemoprophylactic agent for patients with recurrent urinary tract infections. The compound has no apparent adverse effects on the developing fetus and can be used in pregnant women. This is not sanctioned by the package insert, however. Nitrofurantoin should not be administered when the possibility of bacteremia exists, as the drug does not achieve therapeutic serum levels when administered orally. Nitrofurantoin is co...
Research Interests: Kidney diseases, Drug interactions, Humans, Child, Female, and 15 moreMale, Lung Diseases, Urinary Tract Infections, Recurrence, Intestinal absorption, Adult, Microbial Sensitivity Tests, Bacterial infections, Hematologic Diseases, Drug Induced Liver Injury, Nervous System Diseases, Nitrofurantoin, Child preschool, Tissue distribution, and Pharmacology and pharmaceutical sciences
The performance characteristics of the Isolator (Wampole Laboratories, Cranbury, N.J.) and the BacT/Alert (Organon Teknika Corporation, Durham, N.C.) aerobic blood culture systems were compared for 6,009 blood culture sets obtained from... more
The performance characteristics of the Isolator (Wampole Laboratories, Cranbury, N.J.) and the BacT/Alert (Organon Teknika Corporation, Durham, N.C.) aerobic blood culture systems were compared for 6,009 blood culture sets obtained from patients with suspected bloodstream infections. The BacT/Alert aerobic bottle [BTA(O2)] was continuously agitated while it was incubated in 5% CO2 at 36 degrees C; culture plates prepared from the Isolator tube [I(O2)] were incubated in 5% CO2 at 37 degrees C. From 394 blood cultures, 416 clinically significant isolates of bacteria and yeasts were recovered. The overall yields for BTA(O2) and I(O2) were not significantly different (319 versus 336; P = 0.20). I(O2) recovered significantly more staphylococcus (P < 0.05) and yeast isolates (P < 0.01). BTA(O2) recovered significantly more aerobic and facultatively anaerobic gram-negative bacilli (P < 0.05). In blood culture sets which produced growth of the same organisms in both the BTA(O2) and...
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The normal defense mechanisms against infection include (1) normal skin and mucous membranes, (2) humoral immunity, (3) phagocytic system, and (4) cellular immunity. The compromised (immunocompromised) host is an individual who has one or... more
The normal defense mechanisms against infection include (1) normal skin and mucous membranes, (2) humoral immunity, (3) phagocytic system, and (4) cellular immunity. The compromised (immunocompromised) host is an individual who has one or more deficiencies in these defense mechanisms. This article reviews potential infections in the compromised host as well as an approach to evaluation of these patients.
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The mechanism of action, spectrum of antimicrobial activity, pharmacokinetics, adverse effects, therapeutic use, and dosage of methenamine hippurate and methenamine mandelate are reviewed. The antimicrobial activity of methenamine depends... more
The mechanism of action, spectrum of antimicrobial activity, pharmacokinetics, adverse effects, therapeutic use, and dosage of methenamine hippurate and methenamine mandelate are reviewed. The antimicrobial activity of methenamine depends on its conversion in the urine to formaldehyde. Formaldehyde's spectrum of antibacterial activity encompasses all urinary tract pathogens. Urinary concentrations of formaldehyde vary with pH and urine volume; however, there is no documentation that acdification of the urine enhances methenamine's therapeutic activity. Adverse reactions to methenamine, including gastrointestinal intolerance and skin reactions, are mild and reversible and occur infrequently. Methenamine mandelate and hippurate are effective in the prevention of recurrent urinary tract infections except in patients with Foley catheters or who require intermittent catheterization.
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We scheduled two-stage skin testing for tuberculosis with Candida and mumps controls on 618 residents of our domiciliary unit at the Veterans Administration Medical Center, Johnson City, Tennessee. Of the 618 residents in the unit, 30... more
We scheduled two-stage skin testing for tuberculosis with Candida and mumps controls on 618 residents of our domiciliary unit at the Veterans Administration Medical Center, Johnson City, Tennessee. Of the 618 residents in the unit, 30 (4.8%) were not available for evaluation, 77 (13%) had a prior history of active tuberculosis or positive skin test, and 1 resident refused testing. Of these 510 patients who received first-step testing with purified protein derivative (PPD), 153 (30%) had greater than to 10 mm induration. Those patients with less than 10 mm induration had a repeat PPD 2 wk later. Fifty-nine (19.2%) of the 307 patients who received a second PPD had a booster response. A total of 50.9% of the residents had evidence of tuberculosis exposure by skin testing. There were no differences between patients with significant and nonsignificant reactions when comparing age, length of stay, functional status evaluated by Karnofsky scale, or number of underlying diseases. Second test conversion occurred in 4.3% of those patients who had been in the unit for less than 1 month and in 36% of those who had been residents for a period of 3 to 6 months (p less than 0.05). Regardless of the size of the initial reading, it is important to perform a two-stage PPD in residents of chronic care facilities who have a negative first test. INH prophylaxis should be considered in patients admitted to chronic care facilities such as the domiciliary when they have significant Mantoux reactions.
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Mycobacterium gordonae has been considered a true saprophyte of the respiratory tract, unable to produce pulmonary disease. We have reported a case of progressive pulmonary disease due to Mycobacterium gordonae which has failed to improve... more
Mycobacterium gordonae has been considered a true saprophyte of the respiratory tract, unable to produce pulmonary disease. We have reported a case of progressive pulmonary disease due to Mycobacterium gordonae which has failed to improve with multiple combinations of antituberculous drugs over a period of eight years.
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Enterobacter species have not been well recognized as important lower respiratory tract pathogens. We describe 11 cases of Enterobacter pneumonia, seven diagnosed by transtracheal aspiration and four by simultaneous blood and sputum... more
Enterobacter species have not been well recognized as important lower respiratory tract pathogens. We describe 11 cases of Enterobacter pneumonia, seven diagnosed by transtracheal aspiration and four by simultaneous blood and sputum cultures. The infections were usually nosocomial, and were fatal in five patients. Our patients were old (mean age 65 +/- 12.3 years) with chronic obstructive pulmonary disease (COPD) as a common underlying disease. Enterobacter species are important pathogens causing nosocomial pneumonias, especially in elderly patients with COPD.
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The importance of Branhamella catarrhalis pneumonia has only recently been appreciated. Predisposing underlying illness associated with this organism have not yet been clarified. We report five cases of Branhamella catarrhalis pneumonia... more
The importance of Branhamella catarrhalis pneumonia has only recently been appreciated. Predisposing underlying illness associated with this organism have not yet been clarified. We report five cases of Branhamella catarrhalis pneumonia occurring in patients with diseases associated with documented quantitative immunoglobulin deficiencies. Normal immunoglobulins appear to be important host defense mechanisms in preventing infection with this organism.
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Intravesical application of bacillus of Calmette-Guérin (BCG) has proved to be an effective form of treatment for some stages of bladder cancer. Infrequent, serious complications of this treatment have become apparent as its use has... more
Intravesical application of bacillus of Calmette-Guérin (BCG) has proved to be an effective form of treatment for some stages of bladder cancer. Infrequent, serious complications of this treatment have become apparent as its use has become more widespread. We report a case of Mycobacterium bovis mycotic abdominal aortic aneurysm and a case of M. bovis mycobacteremia that developed as complications of intravesical BCG therapy. These cases are discussed in the context of a review of reported complications of intravesical BCG therapy and a review of measures currently advocated to prevent them.
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Following uncomplicated cataract surgery, a patient receiving etanercept for psoriatic arthritis developed Mycobacterium chelonae endophthalmitis. Vitrectomy, capsulectomy, and intraocular lens removal was followed by intravitreal... more
Following uncomplicated cataract surgery, a patient receiving etanercept for psoriatic arthritis developed Mycobacterium chelonae endophthalmitis. Vitrectomy, capsulectomy, and intraocular lens removal was followed by intravitreal amikacin, topical gatifloxacin, intravenous imipenem, and oral clarithromycin for six months. The patient achieved a final corrected visual acuity of 20/20. Etanercept has been implicated in the development of numerous, severe granulomatous infections, though not previously with M. chelonae. This represents the first reported case of visual recovery following M. chelonae endophthalmitis.
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Spanish-language versions of standardized questionnaires are important for facilitating inclusion of Hispanic populations in epidemiologic, genetic, and clinical studies. We aimed at producing a culturally adapted Spanish translation of... more
Spanish-language versions of standardized questionnaires are important for facilitating inclusion of Hispanic populations in epidemiologic, genetic, and clinical studies. We aimed at producing a culturally adapted Spanish translation of the Questionnaire for Verifying Stroke-free Status (QVSS), an instrument used to screen for cerebrovascular end points and to ensure that subjects serving as controls in studies on stroke are indeed stroke free. Five professional translators and ten bilingual physicians independently translated the English-language version of the QVSS into Spanish. Blinded back-translation confirmed conceptual equivalence of the original English-language and final Spanish-language versions.
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Research Interests: NDT and Clinical Sciences
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We aimed to determine the clinical features, predisposing factors, and outcome of left-sided Pseudomonas aeruginosa endocarditis in persons with no history of injection drug use. We performed a retrospective review of patient medical... more
We aimed to determine the clinical features, predisposing factors, and outcome of left-sided Pseudomonas aeruginosa endocarditis in persons with no history of injection drug use. We performed a retrospective review of patient medical records from Mayo Clinic (Rochester, MN; Scottsdale, AZ; and Jacksonville, FL) for all cases of left-sided P. aeruginosa endocarditis. We identified 4 cases. We present these cases, as well as a review of the English-language medical literature. Data gathered included the year the case was reported; the valve involved; treatment, including valve replacement surgery; and outcome, if known. Left-sided P. aeruginosa endocarditis in persons without injection drug use is a rare but serious infection, with a history of instrumentation as a common predisposing condition. Valvular surgery is indicated, when possible, for the best chance of survival, along with extended therapy with combination antibiotics for complete recovery.
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Research Interests: Adolescent, Medicine, Prevention, Complication, Humans, and 15 moreFemale, Male, Cytomegalovirus, Mayo Clinic, Liver Transplantation, Incidence, Association, Aged, Middle Aged, Adult, Cytomegalovirus Infections, Mayo Clinic Proceedings, Antiviral Agents, Postoperative Complications, and Medical and Health Sciences
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Antifungal prophylaxis has been proposed for liver transplant recipients at increased risk for invasive mold infection. Risk factors for invasive mold infection after liver transplantation were selected to divide recipients into 3 groups:... more
Antifungal prophylaxis has been proposed for liver transplant recipients at increased risk for invasive mold infection. Risk factors for invasive mold infection after liver transplantation were selected to divide recipients into 3 groups: (1) high risk-transplantation on hemodialysis or delay of hospital discharge beyond day 7 after transplantation because of allograft or renal insufficiency; (2) intermediate risk-retransplantation or transplantation for fulminant hepatic failure; (3) low risk-absence of conditions in groups 1 and 2. During an intervention period (February 1999-April 2001), prophylactic administration of a lipid complex of amphotericin (Abelcet) at 5 mg/kg intravenously every 24 to 48 hours was recommended for high-risk recipients. The frequency of mold infection was compared to that of a preintervention period (February 1998-January 1999) when antifungal prophylaxis was not provided. During the intervention period, invasive mold infection developed in 2 (6%) of 35 high-risk recipients, 0 of 28 intermediate-risk recipients, and 1 (0.5%) of 187 low-risk recipients. Overall, of 58 liver transplant recipients, 3 (5%) developed an invasive mold infection during the preintervention period, compared with 3 (1%) of 250 during the intervention period (P = 0.08). The only death from invasive mold infection occurred during the preintervention period. Rates of pulse corticosteroid treatment of rejection and cytomegalovirus infection were lower during the intervention period. In conclusion, readily identifiable patient characteristics can be used to stratify liver transplant recipients for risk of invasive mold infection. Antifungal prophylaxis given to high-risk recipients may provide cost-effective prevention of these infections.
Research Interests: Nonparametric Statistics, Risk assessment, Probability, Humans, Liver, and 15 moreFemale, Male, Liver Transplantation, Antibiotic Prophylaxis, Clinical Sciences, Immunocompromised host, Retrospective Studies, Risk Stratification, Antifungal Agents, Risk Assessment, Graft Rejection, Aspergillosis, Cohort Studies, Postoperative Complications, and Opportunistic Infections
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Abstract A case of disseminated P. decumbens infection is reported in a 32-yr-old man with AIDS. The clinical presentation was nonspecific but 4 blood cultures obtained on different days yielded P. decumbens. Therapy with amphotericin B... more
Abstract A case of disseminated P. decumbens infection is reported in a 32-yr-old man with AIDS. The clinical presentation was nonspecific but 4 blood cultures obtained on different days yielded P. decumbens. Therapy with amphotericin B (total dose 900 mg over 4 wks) ...