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  1. Article ; Online: When Epidemiology Is the Clue to a Positive Outcome: A Case of Malaria During Pregnancy.

    de Lima Corvino, Daniela F / Chandorkar, Aditya A / Mora Carpio, Andres L / Climaco, Antonette

    The American journal of case reports

    2018  Volume 19, Page(s) 128–132

    Abstract: BACKGROUND Malaria infection during pregnancy is associated with increased perinatal and maternal morbidity and mortality. CASE REPORT A 29-year-old primigravida at 37 weeks of gestation, with no significant medical history, presented complaining of ... ...

    Abstract BACKGROUND Malaria infection during pregnancy is associated with increased perinatal and maternal morbidity and mortality. CASE REPORT A 29-year-old primigravida at 37 weeks of gestation, with no significant medical history, presented complaining of fever, chills, and generalized body aches. She had been living in Malawi for 1 year and was on atovaquone/proguanil prophylaxis until she was found to be pregnant. Prophylaxis was changed to mefloquine and discontinued upon her return to the US. Six weeks prior to presentation, she traveled to Malawi for 1 month when she was off prophylaxis. On admission, vital signs and physical exam results were normal. Given epidemiologic findings, a malaria smear was performed and showed 4% parasitemia. She was treated with mefloquine and discharged. Two days after discharge, she again presented with fever, chills, and body aches. A malaria smear showed <0.01% parasitemia, with 2 ring forms. Serologies for dengue, chikungunya, leptospira, and blood cultures were negative. These symptoms were deemed secondary to early recrudescence. The species was later identified as P. falciparum. The patient was treated with quinine sulfate and clindamycin. She delivered at full term without complication. CONCLUSIONS Pregnant women are more susceptible to severe forms of malaria, such as P. falciparum. A high index of suspicion and early identification of malaria are vital to prevent deleterious outcomes.
    MeSH term(s) Adult ; Female ; Humans ; Malaria, Falciparum/diagnosis ; Malaria, Falciparum/therapy ; Pregnancy ; Pregnancy Complications, Parasitic/diagnosis ; Pregnancy Complications, Parasitic/therapy
    Language English
    Publishing date 2018-02-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/ajcr.905543
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Granulomatous response to invasive pulmonary aspergillosis in an immunotherapy-naive host, a maladaptive response?

    Mora Carpio, Andres L / Stempel, Jessica M / de Lima Corvino, Daniela / Garvia, Veronica / Climaco, Antonette

    Respiratory medicine case reports

    2018  Volume 24, Page(s) 158–162

    Abstract: Pulmonary aspergillosis causes a wide spectrum of disease, ranging from asymptomatic airway colonization to severe invasive disease, contingent on the host's immune status and underlying pulmonary anatomy. The invasive form of aspergillosis is a rare ... ...

    Abstract Pulmonary aspergillosis causes a wide spectrum of disease, ranging from asymptomatic airway colonization to severe invasive disease, contingent on the host's immune status and underlying pulmonary anatomy. The invasive form of aspergillosis is a rare occurrence in the immunocompetent population. Nevertheless, patients with a compromised innate immune response are at greatest risk. We present a case of a patient with known Crohn's disease who developed invasive pulmonary aspergillosis. His clinical picture was further complicated by an uncommon immune response characterized by the development of granulomas encasing the
    Language English
    Publishing date 2018-05-16
    Publishing country England
    Document type Case Reports
    ZDB-ID 2666110-X
    ISSN 2213-0071
    ISSN 2213-0071
    DOI 10.1016/j.rmcr.2018.05.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Polymicrobial infective endocarditis caused by Neisseria sicca and Haemophilus parainfluenzae.

    Koshkelashvili, Nikoloz / Shah, Mahek / Codolosa, J Nicolas / Climaco, Antonette

    IDCases

    2015  Volume 4, Page(s) 3–5

    Abstract: Infective endocarditis is a common clinical problem in industrialized countries. Risk factors include abnormal cardiac valves, a history of endocarditis, intracardiac devices, prosthetic valves and intravenous drug use. We report a case of polymicrobial ... ...

    Abstract Infective endocarditis is a common clinical problem in industrialized countries. Risk factors include abnormal cardiac valves, a history of endocarditis, intracardiac devices, prosthetic valves and intravenous drug use. We report a case of polymicrobial infective endocarditis in a 33 year-old female with a history chronic heroin use caused by Neisseria sicca and Haemophilus parainfluenzae. We believe the patient was exposed to these microbes by cleansing her skin with saliva prior to injection. Pairing a detailed history with the consideration of atypical agents is crucial in the proper diagnosis and management of endocarditis in patients with high-risk injection behaviors.
    Language English
    Publishing date 2015-11-26
    Publishing country Netherlands
    Document type Journal Article ; Case Reports
    ZDB-ID 2745454-X
    ISSN 2214-2509
    ISSN 2214-2509
    DOI 10.1016/j.idcr.2015.11.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Antibiotic Utilization in Deceased Organ Donors.

    Anesi, Judith A / Lautenbach, Ebbing / Han, Jennifer / Lee, Dong Heun / Clauss, Heather / Climaco, Antonette / Hasz, Richard / Bilker, Warren B / Molnar, Esther / Alimenti, Darcy / West, Sharon / Tolomeo, Pam / Blumberg, Emily A

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2021  Volume 73, Issue 7, Page(s) 1284–1287

    Abstract: Antibiotic use in deceased organ donors has not been previously described. In a retrospective cohort of 440 donors, we found 427 (97%) received at least one antibiotic course, 312 (71%) received broad-spectrum antibiotics, and 61 (14%) received ... ...

    Abstract Antibiotic use in deceased organ donors has not been previously described. In a retrospective cohort of 440 donors, we found 427 (97%) received at least one antibiotic course, 312 (71%) received broad-spectrum antibiotics, and 61 (14%) received potentially redundant antibiotics during their terminal hospitalization, suggesting a need for stewardship.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Humans ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Tissue and Organ Procurement
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2021-05-20
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciab463
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Impact of deceased donor multidrug-resistant bacterial organisms on organ utilization.

    Anesi, Judith A / Han, Jennifer H / Lautenbach, Ebbing / Lee, Dong H / Clauss, Heather / Climaco, Antonette / Bilker, Warren B / Hasz, Richard / Molnar, Esther / Alimenti, Darcy / West, Sharon / Tolomeo, Pam / Blumberg, Emily A

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2020  Volume 20, Issue 9, Page(s) 2559–2566

    Abstract: The extent to which donor multidrug-resistant organisms (MDROs) affect organ utilization remains unclear. We performed a retrospective cohort study at 4 transplant centers between 2015 and 2016 to evaluate this question. All deceased donors who donated ... ...

    Abstract The extent to which donor multidrug-resistant organisms (MDROs) affect organ utilization remains unclear. We performed a retrospective cohort study at 4 transplant centers between 2015 and 2016 to evaluate this question. All deceased donors who donated at least one organ were included. Exposed donors had at least one MDRO on culture. Unexposed donors had no MDRO-positive cultures. Only cultures obtained during the donor's terminal hospitalization were evaluated. Multivariable regression was used to determine the association between donor MDRO and (1) number of organs transplanted per donor and (2) the match run at which each organ was accepted. Subsequently, we restricted the analysis to donors with MDR-Gram-negative (GN) organisms. Of 440 total donors, 29 (7%) donors grew MDROs and 7 (2%) grew MDR-GNs. There was no significant association between donor MDRO and either measure of organ utilization. However, donor MDR-GNs were associated with a significant reduction in the number of organs transplanted per donor (incidence rate ratio 0.43, 95% confidence interval [CI] 0.39-0.48, P < .01), and organs were accepted significantly further down the match list (relative count 5.08, 95% CI 1.64-15.68, P = .01). Though donor MDR-GNs were infrequent in our study, their growing prevalence could meaningfully reduce the donor pool over time.
    MeSH term(s) Humans ; Retrospective Studies ; Tissue Donors ; Tissue and Organ Procurement ; Transplants
    Language English
    Publishing date 2020-03-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15830
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Risk factors for multidrug-resistant organisms among deceased organ donors.

    Anesi, Judith A / Blumberg, Emily A / Han, Jennifer H / Lee, Dong H / Clauss, Heather / Climaco, Antonette / Hasz, Richard / Molnar, Esther / Alimenti, Darcy / West, Sharon / Bilker, Warren B / Tolomeo, Pam / Lautenbach, Ebbing

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2019  Volume 19, Issue 9, Page(s) 2468–2478

    Abstract: Donor infection or colonization with a multidrug-resistant organism (MDRO) affects organ utilization and recipient antibiotic management. Approaches to identifying donors at risk of carrying MDROs are unknown. We sought to determine the risk factors for ... ...

    Abstract Donor infection or colonization with a multidrug-resistant organism (MDRO) affects organ utilization and recipient antibiotic management. Approaches to identifying donors at risk of carrying MDROs are unknown. We sought to determine the risk factors for MDROs among transplant donors. A multicenter retrospective cohort study was conducted at four transplant centers between 2015 and 2016. All deceased donors who donated at least one organ were included. Cultures obtained during the donor's terminal hospitalization and organ procurement were evaluated. The primary outcome was isolation of an MDRO on culture. Multivariable Cox regression was used to determine risk factors associated with time to donor MDRO. Of 440 total donors, 64 (15%) donors grew an MDRO on culture. Predictors of an MDRO on donor culture included hepatitis C viremia (hazard ratio [HR] 4.09, 95% confidence interval [CI] 1.71-9.78, P = .002), need for dialysis (HR 4.59, 95% CI 1.09-19.21, P = .037), prior hematopoietic cell transplant (HR 7.57, 95% CI 1.03-55.75, P = .047), and exposure to antibiotics with a narrow gram-negative spectrum (HR 1.13, 95% CI 1.00-1.27, P = .045). This is the first study to determine risk factors for MDROs among deceased donors and will be important for risk stratifying potential donors and informing transplant recipient prophylaxis.
    MeSH term(s) Adult ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/therapeutic use ; Cross Infection ; Drug Resistance, Multiple, Bacterial ; Female ; Hematopoietic Stem Cell Transplantation ; Hepatitis C/complications ; Hospitalization ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Tissue and Organ Procurement ; Transplant Recipients ; Treatment Outcome
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2019-06-26
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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