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fungemia case reports summary

Page history last edited by jens 7 years, 6 months ago

00:46

  • Fungemia Case reports of patients on Florastor

  • Lungarotti

    • 1mo preterm infant, revieving parenteral nutrition, CVC present

    • recovered with treatment

    • used to prevent SIBO

    • ref: Lungarotti MS, Mezzetti D, Radicioni M. Methaemoglobinaemia with concurrent blood isolation of Saccharomyces and Candida. Arch Dis Child Fetal Neonatal Ed 2003;88:F446.

  • Perapoch

    • 3mo w/ cardiomyopathy, on parenteral nutrition, CVC, used to treat diarrhea, unknown immuncompetence

    • fungemia resolved with treatment

    • ref: Perapoch J, Planes AM, Querol A, et al. Fungemia with Saccharomyces cerevisiae in two newborns, only one of whom had been treated with Ultra-Levura. Eur J Clin Microbiol Infect Dis 2000;19:468–70

  • Cesaro

    • 8mo leukemia, CVC, chemo, not immunocompetent

    • oral therapy, used to prevent AAD

    • ref: Cesaro S, Chinello P, Rossi L, Zanesco L. Saccharomyces cerevisiae fungemia in a neutropenic patient treated with Saccharomyces boulardii. Support Care Cancer 2000;8:504–5.

  • Pletinex

    • 1yo, w/ pneumonia, enteritis, on parenteral nutrition, CVC, malnutrition, immunocompromised

    • 600mg/d oral, used to treat diarrhea

    • ref: Pletincx M, Legein J, Vandenplas Y. Fungemia with Saccharomyces boulardii in a 1-year-old girl with protracted diarrhea. J Pediatr Gastroenterol Nutr 1995;21:113–5.

  • Viggiano

    • 14yo burn pt, on enteral nutrition, CVC, unknown immuncompetence

    • 150mg/day per PEG used to prevent diarrhea

    • ref: Viggiano M, Badetti C, Bernini V, Garabedian M, Manelli JC. Fonge ́mie a` Saccharomyces boulardii chez un bruˆle ́ grave. [Saccharomyces boulardii fungemia in a patient with severe burns.] Ann Fr Anesth Reanim 1995;14:356–8

  • Burkhardt

    • 19yo Tetraparesis, entereal nutrition, on PPI and prokinetic

    • 150mg/d per PEG used to prevent diarrhea

    • ref: Burkhardt O, Ko ̈hnlein T, Pletz M, Welte T. Saccharomyces boulardii induced sepsis: successful therapy with voriconazole after treatment failure with fluconazole. Scand J Infect Dis 2005;37:69–72.

  • Zunic

    • 33 yo Colectomy, septic, enteral nutrition, CVC, H2 antagonist, unknown immuncompetence

    • 1500mg/day per NGT used to prevent AAD

    • Ref: Zunic P, Lacotte J, Pegoix M, et al. Fonge ́mie a` Saccharomyces bou- lardii. A propos d’un cas. [Saccharomyces boulardii fungemia. Apro- pos of a case.] Therapie 1991;46:498–9 (in French).

  • Lestin

    • 48yo Diabetic w/ foot necrosis, pneumonia, CVC, active C diff

    • used to treat CDAD, 150mg/day per NGT

    • ref: Lestin F, Pertschy A, Rimek D. Funga ̈mie nach oraler Gabe Saccha- romyces boulardii bei einem multimorbiden Patienten. [Fungemia after oral treatment with Saccharomyces boulardii in a patient with multiple comorbidities.] Dtsch Med Wochenschr 2003;128:2531–3 (in German).

  • Fredenucci

    • 49 yo w/ pneumonia, on enteral nutrition, on antibiotics, unknown immuncompetence

    • used to treat enteral nutrition diarrhea

    • ref: Fredenucci I, Chomarat M, Boucaud C, Flandrois JP. Saccharomyces boulardii fungemia in a patient receiving Ultra-Levure therapy. Clin Infect Dis 1998;27:222–3.

  • hennequin

    • 2yo w/ cystic fibrosis, ileal atresia, on parenteral nutrition, CVC, unknown immuncompetence

    • 750mg/day to prevent diarrhea

    • ref: Hennequin C, Kauffmann-Lacroix C, Jobert A, et al. Possible role of catheters in Saccharomyces boulardii fungemia. Eur J Clin Microbiol Infect Dis 2000;19:16–20.

  • henniquin

    • 36 yo with HIV/aids, lymphoma, parenteral nutrition, CVC, on chemo, not immunocompetent

    • 150mg/day to treat diarrhea

    • recovered

  • Henniquin

    • 47 yo with esophageal cancer, on enteral nutrition, CVC, unknown immuncompetence

    • 2000mg/day used to treat AAD

  • henniquin

    • 78 yo with ‘pulmonary disease’, on enteral nutrition, CVC, unknown immuncompetence

    • 1500mg/day to prevent diarrhea

  • Lherm

    • 50 yo cardiac arrest, on enteral nutrition, CVC, ICU, immunocompetent

    • 1500mg/day to prevent diarrhea

    • death not attributable to fungemia

    • ref: Lherm T, Monet C, Nougiere B, et al. Seven cases of fungemia with S. boulardii in critically ill patients. Intensive Care Med 2002;28: 797–801.

  • Lherm

    • 51 yo F aortic surgery, cachexia, on enteral nutrition, CVC, ICU, not immuncompetent

    • 1000mg/day to prevent diarrhea

    • death (not attributable to fungemia)

  • Lherm

    • 71 yo F stroke patient, on enteral nutrition, CVC, ICU, not immunocompetent

    • 3000mg/day to prevent diarrhea

  • Lherm

    • 75 yo M respiratory failure patient on enteral nutrition, CVC, ICU, unknown immunocompetence

    • 2000mg/day to prevent diarrhea

  • Lherm

    • 77 yo M with peritonitis, on enteral nutrition, CVC, ICU, not immuncompetent

    • 3000mg/day to prevent diarrhea

  • Lherm

    • 82 yo F with respiratory failure, enteral nutrition, CVC, ICU, unknown immunocompetence

    • 1500mg/d to prevent diarrhea

  • Lolis

    • 56 yo with pneumonia, sepsis, on parenteral nutrition, CVC

    • 2000mg/day by NGT to treat diarrhea

    • ref: Lolis N, Veldekis D, Moraitou H, et al. Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin. Crit Care 2008;12:414.

  • Henry

    • 65 yo with oropharyngeal cancer, on parenteral nutrition, CVC, mucositis

    • 6 capsules/day to treat diarrhea

    • ref: Henry S, D’Hondt L, Andre ́ M, Holemans X, Canon JL. Saccharo- myces cerevisiae fungemia in a head and neck cancer patient: a case report and review of the literature. Acta Clin Belg 2004;59:220–2.

  • Munoz

    • 65 yo s/p cardiac surgery on EN and PN, CVC, active c diff

    • per NGT to treat CDAD

    • ref: Munoz P, Bouza E, Cuenca-Estrella M, et al. Saccharomyces cerevisiae fungemia: an emerging infectious disease. Clin Infect Dis 2005;40: 1625–34. g/day per PEG to “prevent” CDAD?

  • Munoz

    • 74 yo s/p MV replacement, on EN and PN, CVC, active c diff

    • per ngt to treat CDAD

  • Munoz

    • 76 yo s/p MV replacement and cardiac arrest, on EN and PN, CVC, active c diff

    • per NGT to treat CDAD

  • Rijinders

    • 74 yo neurosurgery pt with subarachnoidal hematoma, ICU patient, CVC, colitis,

    • 600mg/day to treat EN diarrhea

    • immunocompetent

    • ref: Rijnders BJ, Van Wijngaerden E, Verwaest C, Peetermans WE. Sac- charomyces fungemia complicating Saccharomyces boulardii treatment in a non-immuno-compromised host. Intensive Care Med 2000;26:825.

  • Niault

    • 78 yo with pulmonary disease, on EN, CVC

    • 1500mg/day per NGT to treat diarrhea

    • ref: Niault M, Thomas F, Prost J, Ansari FH, Kalfon P. Fungemia due to Saccharomyces species in a patient treated with enteral Saccharomyces boulardii. Clin Infect Dis 1999;28:930.

  • Cherifi

    • 89 yo with C diff, anorexia nervosa, on EN, PVC

    • 300m

    • Cherifi S, Robberecht J, Miendje Y. Saccharomyces cerevisiae funge- mia in an elderly patient with Clostridium difficile colitis. Acta Clin Belg 2004;59:223–4.

  • Bassetti

    • 51 yo F with CVC, intestinal disease, unknown immuncompetence

  • Neighbor cases

  • Gavazzi

    • 66 yo gastric adenocarcinoma, active chemo, high dose steroids, CVC, TPN

    • a patient in neighboring room was receiving S boulardii preparation for C diff diarrhea

    • Patient developed S Cerevisiae bacteremia

    • Patient died of metastatic cancer, fungemia may have contributed

    • ref: Graf C, Gavazzi G. Saccharomyces cerevisiae fungemia in an immu- nocompromised patient not treated with S. boulardii preparation. J Infect 2007;54:310–1.

  • Cassone Case 1

    • 34 yo M head and thoracic trauma patient, immunocompetent, in ICU, receiving enteral nutrition, CVC present, neighbor receiving S boulardii, developed S. Cerevisiae fungemia, resolved with tx.

  • Cassone Case 2

    • 48 yo M w/ cerebral aneurysm rupture, immunocompetent, in ICU, receiving enteral nutrition, CVC present, developed fever and S. Cerevisiae fungemia, resolved with tx.

  • Cassone Case 3:

    • 75 yo F w/ acute MI, immunocompetent, on enteral nutrition, ICU patient, CVC present, developed S. Cerevisiae fungemia. CVC tip + for S. Cerevisiae. Responded to tx.

    • Ref: Cassone M, Serra P, Mondello F, et al. Outbreak of Saccharomyces cerevisiae subtype boulardii fungemia in patients neighboring those treated with a probiotic preparation of the organism. J Clin Microbiol 2003;41:5340–3.

  • Perapoch

    • 1mo with intestinal disease, CVC, unknown immuncompetence

    • resolved with treatment

    • ref: Perapoch J, Planes AM, Querol A, et al. Fungemia with Saccharomyces cerevisiae in two newborns, only one of whom had been treated with Ultra-Levura. Eur J Clin Microbiol Infect Dis 2000;19:468–70

  • Lherm

    • 50 yo M with ARDS, gastric ulcer, CVC, ICU, immunocompetent

    • 1500mg/day to prevent diarrhea

    • catheter tip grew S boulardii.

    • Authors presume fungemia was from neighbor contamination

    • Resolved with treatment

    • ref: Lherm T, Monet C, Nougiere B, et al. Seven cases of fungemia with S. boulardii in critically ill patients. Intensive Care Med 2002;28: 797–801.

 

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