Medicine and Health Sciences Commons^™

Securing Nasogastric Tubes In Children, Julie Ann Lavoie

Dissertations (1934 -)

Nasogastric tubes (NGTs) are commonly placed in children at risk for malnutrition in order to provide temporary nutrition support until the child achieves independent oral feedings or requires durable tube placement. Accurate securement of NGTs is necessary to safely provide nutrition, particularly in infants and toddlers who are at highest risk for dislodging their NGT. Dislodgement of an NGT has a cascade effect on the medical management, requiring increased exposure to the healthcare system with every replacement. Nasal bridles are widely used to secure NGTs in adults but are not widely used with children. The purpose of this retrospective, correlational …

Socio-Economic And Geographical Inequalities In Adolescent Fertility Rate In Ghana, 1993–2014, Bright Opoku Ahinkorah, Eugene Budu, Henry Ofori Duah, Joshua Okyere, Abdul-Aziz Seidu

College of Nursing Faculty Research and Publications

Background

Despite public health interventions to control adolescent fertility, it remains high in sub-Saharan Africa. Ghana is one of the countries in sub-Saharan Africa with the highest adolescent fertility rates. We examined the trends and socio-economic and geographical patterns of disparities in adolescent fertility in Ghana from 1993 to 2014.

Methods

Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the 1993–2014 Ghana Demographic and Health surveys were analyzed. First, we disaggregated adolescent fertility rates (AFR) by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely …

The Other “Front Line”: Public Health Nursing Clinical Instruction During Covid-19, Lyndsay G. Degroot, Jessica L. Zemlak, Sarah E. Lafave, Lea Marineau, Deborah Wilson, Nicole Warren

College of Nursing Faculty Research and Publications

No abstract provided.

Central And Peripheral Arterial Diseases In Chronic Kidney Disease: Conclusions From A Kidney Disease: Improving Global Outcomes (Kdigo) Controversies Conference, Kirsten L Johansen, Pranav S Garimella, Caitlin W Hicks, Philip A Kalra, Dearbhla M Kelly, Sven Martens, Kunihiro Matsushita, Pantelis Sarafidis, Manish M Sood, Charles A Herzog, Michael Cheung, Michel Jadoul, Wolfgang C Winkelmayer, Holger Reinecke, Conference Participants

Faculty, Staff and Students Publications

Chronic kidney disease (CKD) affects about 10% of all populations worldwide, with about 2 million people requiring dialysis. Although patients with CKD are at high risk of cardiovascular disease and events, they are often underrepresented or excluded in clinical trials, leading to important knowledge gaps about how to treat these patients. KDIGO (Kidney Disease: Improving Global Outcomes) convened the fourth clinical Controversies Conference on the heart, kidney and vasculature in Dublin, Ireland, in February 2020, entitled Central and Peripheral Arterial Diseases in Chronic Kidney Disease. A global panel of multidisciplinary experts from the fields of nephrology, cardiology, neurology, surgery, radiology, …

High Burden Of Subclinical And Cardiovascular Disease Risk In Adults With Metabolically Healthy Obesity: The Atherosclerosis Risk In Communities (Aric) Study, Yvonne Commodore-Mensah, Mariana Lazo, Olive Tang, Justin B Echouffo-Tcheugui, Chiadi E Ndumele, Vijay Nambi, Dan Wang, Christie Ballantyne, Elizabeth Selvin

Faculty, Staff and Students Publications

OBJECTIVE: It is controversial whether adults who are obese but "metabolically healthy" have cardiovascular disease (CVD) risk comparable with that of normal-weight adults. High-sensitivity cardiac troponin T (hs-cTnT), a biomarker of myocardial damage, is useful in characterizing subclinical CVD. We categorized obesity phenotypes and studied their associations with subclinical and clinical CVD and CVD subtypes, including heart failure (HF).

RESEARCH DESIGN AND METHODS: We conducted cross-sectional and prospective analyses of 9,477 adults in the Atherosclerosis Risk in Communities (ARIC) study. We used the Adult Treatment Panel III criteria and BMI to define obesity phenotypes as follows: metabolically healthy normal weight, …

Cd8+ T Cells Inhibit Metastasis And Cxcl4 Regulates Its Function, Robiya Joseph, Rama Soundararajan, Suhas Vasaikar, Fei Yang, Kendra L Allton, Lin Tian, Petra Den Hollander, Sevinj Isgandarova, Monika Haemmerle, Barbara Mino, Tieling Zhou, Crystal Shin, Melisa Martinez-Paniagua, Aysegul A Sahin, Jaime Rodriguez-Canales, Juri Gelovani, Jeffrey T Chang, Ghanashyam Acharya, Anil K Sood, Ignacio I Wistuba, Don L Gibbons, Luisa M Solis, Michelle C Barton, Navin Varadarajan, Jeffrey M Rosen, Xiang H Zhang, Sendurai A Mani

Faculty, Staff and Students Publications

Background

The mechanism by which immune cells regulate metastasis is unclear. Understanding the role of immune cells in metastasis will guide the development of treatments improving patient survival.

Methods

We used syngeneic orthotopic mouse tumour models (wild-type, NOD/scid and Nude), employed knockout (CD8 and CD4) models and administered CXCL4. Tumours and lungs were analysed for cancer cells by bioluminescence, and circulating tumour cells were isolated from blood. Immunohistochemistry on the mouse tumours was performed to confirm cell type, and on a tissue microarray with 180 TNBCs for human relevance. TCGA data from over 10,000 patients were analysed as …

The Detrimental Association Between Fear Of Falling And Motor Performance In Older Cancer Patients With Chemotherapy-Induced Peripheral Neuropathy, Gu Eon Kang, Tamiko K Murphy, Mark E Kunik, Hoda J Badr, Biruh T Workeneh, Sarvari V Yellapragada, Yvonne H Sada, Bijan Najafi

Faculty, Staff and Students Publications

BACKGROUND: Cancer patients with chemotherapy-induced peripheral neuropathy (CIPN) are at increased risk of falls and developing fear of falling (FoF). Although FoF may continue to impair motor performance and increase the risk of falling even further, this association remains unexplored in CIPN.

RESEARCH QUESTION: Does high FoF in patients with CIPN further deteriorate motor performance beyond the impairment from CIPN-related sensory deficits?

METHODS: In this secondary analysis of data collected from two clinical trials, gait parameters during habitual walking condition and postural sway parameters during 30-second quiet standing (eye-open and eyes-closed) were compared among older participants (≥ 65 years) with …

High Burden Of Subclinical And Cardiovascular Disease Risk In Adults With Metabolically Healthy Obesity: The Atherosclerosis Risk In Communities (Aric) Study, Yvonne Commodore-Mensah, Mariana Lazo, Olive Tang, Justin B Echouffo-Tcheugui, Chiadi E Ndumele, Vijay Nambi, Dan Wang, Christie Ballantyne, Elizabeth Selvin

Faculty, Staff and Students Publications

OBJECTIVE: It is controversial whether adults who are obese but "metabolically healthy" have cardiovascular disease (CVD) risk comparable with that of normal-weight adults. High-sensitivity cardiac troponin T (hs-cTnT), a biomarker of myocardial damage, is useful in characterizing subclinical CVD. We categorized obesity phenotypes and studied their associations with subclinical and clinical CVD and CVD subtypes, including heart failure (HF).

RESEARCH DESIGN AND METHODS: We conducted cross-sectional and prospective analyses of 9,477 adults in the Atherosclerosis Risk in Communities (ARIC) study. We used the Adult Treatment Panel III criteria and BMI to define obesity phenotypes as follows: metabolically healthy normal weight, …

Deteriorated Regional Calf Microcirculation Measured By Contrast-Free Mri In Patients With Diabetes Mellitus And Relation With Physical Activity, Jie Zheng, Christopher Sorensen, Ran Li, Hongyu An, Charles F Hildebolt, Mohamed A Zayed, Michael J Mueller, Mary K Hastings

2020-Current year OA Pubs

OBJECTIVE: To evaluate regional calf muscle microcirculation in people with diabetes mellitus (DM) with and without foot ulcers, compared to healthy control people without DM, using contrast-free magnetic resonance imaging methods.

METHODS: Three groups of subjects were recruited: non-DM controls, DM, and DM with foot ulcers (DM + ulcer), all with ankle brachial index (ABI) > 0.9. Skeletal muscle blood flow (SMBF) and oxygen extraction fraction (SMOEF) in calf muscle were measured at rest and during a 5-min isometric ankle plantarflexion exercise. Subjects completed the Yale physical activity survey.

RESULTS: The exercise SMBF (ml/min/100 g) of the medial gastrocnemius muscle were …

Infective Endocarditis Due To Streptococcus Salivarius Presenting As Septic Arthritis, Mishita Goel, Zachary Johnson, Manishkumar Patel, Raashi Chawla, Tanaz Salimnia

Conference Presentation Abstracts

No abstract provided.

Sex-Related Disparities In Cardiovascular Health Care Among Patients With Premature Atherosclerotic Cardiovascular Disease, Michelle T Lee, Dhruv Mahtta, David J Ramsey, Jing Liu, Arunima Misra, Khurram Nasir, Zainab Samad, Dipti Itchhaporia, Safi U Khan, Richard S Schofield, Christie M Ballantyne, Laura A Petersen, Salim S Virani

Faculty, Staff and Students Publications

IMPORTANCE: There is a paucity of data regarding secondary prevention care disparities in women with premature and extremely premature atherosclerotic cardiovascular disease (ASCVD), defined as an ASCVD event at 55 years or younger and 40 years or younger, respectively.

OBJECTIVE: To evaluate sex-based differences in antiplatelet agents, any statin, high-intensity statin (HIS) therapy, and statin adherence in patients with premature and extremely premature ASCVD.

DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional, multicenter, nationwide VA health care system-based study with patients enrolled in the Veterans With Premature Atherosclerosis (VITAL) registry. The study assessed patients who had at least 1 primary …

Implementing An Electronic Clinical Decision Support Tool Into Routine Care: A Qualitative Study Of Stakeholders' Perceptions Of A Post-Mastectomy Breast Reconstruction Tool, Jessica Boateng, Clara N Lee, Randi E Foraker, Terence M Myckatyn, Kimi Spilo, Courtney Goodwin, Mary C Politi

2020-Current year OA Pubs

No abstract provided.

Oral Once-Daily Berotralstat For The Prevention Of Hereditary Angioedema Attacks: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Trial, Bruce Zuraw, H James Wedner, Et Al.

2020-Current year OA Pubs

BACKGROUND: Berotralstat (BCX7353) is an oral, once-daily inhibitor of plasma kallikrein in development for the prophylaxis of hereditary angioedema (HAE) attacks.

OBJECTIVE: Our aim was to determine the efficacy, safety, and tolerability of berotralstat in patients with HAE over a 24-week treatment period (the phase 3 APeX-2 trial).

METHODS: APeX-2 was a double-blind, parallel-group study that randomized patients at 40 sites in 11 countries 1:1:1 to receive once-daily berotralstat in a dose of 110 mg or 150 mg or placebo (Clinicaltrials.gov identifier NCT03485911). Patients aged 12 years or older with HAE due to C1 inhibitor deficiency and at least 2 …

The New (Version 9) American Joint Committee On Cancer Tumor, Node, Metastasis Staging For Cervical Cancer, Alexander B Olawaiye, Thomas P Baker, M Kay Washington, David G Mutch

2020-Current year OA Pubs

The American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) staging for all cancer sites has been periodically updated as a published manual for many years. The last update, the eighth edition AJCC Cancer Staging Manual went into use on January 1, 2018. The AJCC has since restructured and updated its processes, and all AJCC staging-related data are now housed on its new application programming interface. Consequently, the next AJCC TNM staging update, AJCC version 9 TNM staging, will be published electronically and will be released chapter by chapter. The first chapter of version 9 AJCC TNM staging is …

Sonothermogenetics For Noninvasive And Cell-Type Specific Deep Brain Neuromodulation, Yaoheng Yang, Christopher Pham Pacia, Dezhuang Ye, Lifei Zhu, Hongchae Baek, Yimei Yue, Jinyun Yuan, Mark J Miller, Jianmin Cui, Joseph P Culver, Michael R Bruchas, Hong Chen

2020-Current year OA Pubs

BACKGROUND: Critical advances in the investigation of brain functions and treatment of brain disorders are hindered by our inability to selectively target neurons in a noninvasive manner in the deep brain.

OBJECTIVE: This study aimed to develop sonothermogenetics for noninvasive, deep-penetrating, and cell-type-specific neuromodulation by combining a thermosensitive ion channel TRPV1 with focused ultrasound (FUS)-induced brief, non-noxious thermal effect.

METHODS: The sensitivity of TRPV1 to FUS sonication was evaluated in vitro. It was followed by in vivo assessment of sonothermogenetics in the activation of genetically defined neurons in the mouse brain by two-photon calcium imaging. Behavioral response evoked by sonothermogenetic …

Machine Learning For Modeling The Progression Of Alzheimer Disease Dementia Using Clinical Data: A Systematic Literature Review, Sayantan Kumar, Inez Oh, Suzanne Schindler, Albert M Lai, Philip R O Payne, Aditi Gupta

2020-Current year OA Pubs

OBJECTIVE: Alzheimer disease (AD) is the most common cause of dementia, a syndrome characterized by cognitive impairment severe enough to interfere with activities of daily life. We aimed to conduct a systematic literature review (SLR) of studies that applied machine learning (ML) methods to clinical data derived from electronic health records in order to model risk for progression of AD dementia.

MATERIALS AND METHODS: We searched for articles published between January 1, 2010, and May 31, 2020, in PubMed, Scopus, ScienceDirect, IEEE Explore Digital Library, Association for Computing Machinery Digital Library, and arXiv. We used predefined criteria to select relevant …

Results From 2 Cohort Studies In Central Africa Show That Clearance Of Wuchereria Bancrofti Infection After Repeated Rounds Of Mass Drug Administration With Albendazole Alone Is Closely Linked To Individual Adherence, Jérémy T Campillo, Naomi P Awaca-Uvon, Francois Missamou, Jean-Paul Tambwe, Godefroy Kuyangisa-Simuna, Gary J Weil, Frédéric Louya, Michel Boussinesq, Sébastien D S Pion, Cédric B Chesnais

2020-Current year OA Pubs

BACKGROUND: Two community trials conducted from 2012 to 2018 in the Republic of Congo and the Democratic Republic of the Congo demonstrated the efficacy of semiannual mass drug administration (MDA) with albendazole (ALB) alone on lymphatic filariasis (LF). However, a high interindividual heterogeneity in the clearance of infection was observed.

METHODS: We analyzed trial data to assess the effect of individual adherence to ALB MDA on clearance of circulating filarial antigenemia (CFA) and microfilaremia. Community residents were offered a single dose of ALB every 6 months and tested for LF with a rapid test for CFA at baseline and then …

Mechanisms Underlying Disorders Of Consciousness: Bridging Gaps To Move Toward An Integrated Translational Science, Andrea I Luppi, Joshua Cain, Lennart R B Spindler, Urszula J Górska, Daniel Toker, Andrew E Hudson, Emery N Brown, Michael N Diringer, Robert D Stevens, Marcello Massimini, Martin M Monti, Emmanuel A Stamatakis, Melanie Boly, Curing Coma Campaign And Its Contributing Collaborators

2020-Current year OA Pubs

AIM: In order to successfully detect, classify, prognosticate, and develop targeted therapies for patients with disorders of consciousness (DOC), it is crucial to improve our mechanistic understanding of how severe brain injuries result in these disorders.

METHODS: To address this need, the Curing Coma Campaign convened a Mechanisms Sub-Group of the Coma Science Work Group (CSWG), aiming to identify the most pressing knowledge gaps and the most promising approaches to bridge them.

RESULTS: We identified a key conceptual gap in the need to differentiate the neural mechanisms of consciousness per se, from those underpinning connectedness to the environment and behavioral …

Outcomes For Continuous Subcutaneous Insulin Infusion Users In Young Adults From Lower Socioeconomic Backgrounds, Alexis M Mckee, Stewart G Albert, Noor Al-Hammadi, Leslie J Hinyard

2020-Current year OA Pubs

OBJECTIVE: Diabetes technology is available and its efficacy and safety have been demonstrated; however, there is little evidence as to how this technology is being utilized and its effectiveness in vulnerable populations. This study evaluated differences in outcomes for young adults in the United States (U.S.) from lower socioeconomic (SES) backgrounds with type 1 diabetes (T1D) managed on continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) or fixed-dose insulin (FDI).

RESEARCH DESIGN METHODS AND PARTICIPANTS: Utilizing the Optum® de-identified Electronic Health Record data set between 2008 and 2018 to perform a retrospective, cohort study, we identified 805 subjects …

Riociguat: Clinical Research And Evolving Role In Therapy, James R Klinger, Murali M Chakinala, David Langleben, Stephan Rosenkranz, Olivier Sitbon

2020-Current year OA Pubs

Riociguat is a first-in-class soluble guanylate cyclase stimulator, approved for the treatment of adults with pulmonary arterial hypertension (PAH), inoperable chronic thromboembolic pulmonary hypertension (CTEPH), or persistent or recurrent CTEPH after pulmonary endarterectomy. Approval was based on the results of the phase III PATENT-1 (PAH) and CHEST-1 (CTEPH) studies, with significant improvements in the primary endpoint of 6-minute walk distance vs placebo of +36 m and +46 m, respectively, as well as improvements in secondary endpoints such as pulmonary vascular resistance and World Health Organization functional class. Riociguat acts as a stimulator of cyclic guanosine monophosphate synthesis rather than as …

Active Surveillance Of Metastatic Renal Cell Carcinoma: Results From A Prospective Observational Study (Marcc), Michael R Harrison, Russell K Pachynski, Et Al.

2020-Current year OA Pubs

BACKGROUND: Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow-growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature.

METHODS: This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient-related outcomes. Wilcoxon 2-sample rank-sum tests and χ

RESULTS: Of 504 patients, mRCC …

Lanterns In Marrakesh, Stefan Mann

HCA Healthcare Journal of Medicine

This photo was taken in Marrakesh, Morocco in 2014. I decided to travel there after a few friends inspired me with their descriptions of a beautiful desert-filled country with kind people, mountains and incredibly delicious food. For me, traveling is truly food for the soul. It allows you to break out of the monotony of work-life and potentially step outside of your comfort zone. I absolutely love exploring various cultures and over the course of my life I have traveled to over thirty countries and have back-packed numerous countries solo. There’s no better feeling than embarking on an adventure free …

Clinical Characteristics And Laboratory Biomarkers For Patients With Suspected Covid-19 Infection Within Hca Healthcare, Scott Gutovitz, Justin Hanson, Christian Vandever, Dietrich Jehle

HCA Healthcare Journal of Medicine

Background

The coronavirus infection (COVID-19), also known as the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2), caused significant illness and a worldwide pandemic beginning in 2020. Early case reports showed common patient characteristics, clinical variables and laboratory values in these patients. We compared a large population of American COVID-19 patients to see if they had similar findings to these smaller reports. In addition, we examined our population to identify any differences between mild or severe COVID-19 infections.

Methods

We retrospectively accessed a de-identified, multi-hospital database managed by HCA Healthcare to identify all adult emergency department (ED) patients that were tested …

The Effect Of Starting A New Residency Program On The Quality Of Care Measures At A Community Hospital: A 2-Year Follow-Up, Javad Savoj, Christine Mikhail, Napatkamon Ayutyanont, Rajesh Gulati, Remus Popa, Alina Popa

HCA Healthcare Journal of Medicine

Background

Introducing graduate medical education to a non-teaching hospital has been a challenging issue due to its perceived possible negative impact on quality and cost of care.

Objective

To assess the impact of starting a new Internal Medicine (IM) residency program on the quality of care measures in a Graduate Medical Education (GME) naïve community hospital.

Methods

In a retrospective longitudinal study, we compared quality of care parameters (mortality rate, 30-day readmission rate, length of stay, case mix index and severity level) for a hospitalist group ten months before (September 2015–June 2016) and two consecutive years (July 2016–June 2018) after …

Impact Of A Meds To Beds Program On Re-Presentation Rates In Medical And Surgical Patients At A Community Hospital, Nowshin Islam, Aubrie Rafferty, Elizabeth L. Michalets

HCA Healthcare Journal of Medicine

ABSTRACT

Background

While the benefits of bundled transitions of care services are understood, only a limited number of studies have analyzed the impact of a stand-alone bedside medication delivery service on repeat hospital encounters, and those published have reported mixed results.

Methods

A retrospective analysis was conducted in medical and surgical patients at a large community hospital. Adult patients discharged from either the cardiology, medicine, pulmonary, orthopedic/spine surgery, or women’s surgery unit and prescribed at least one new prescription upon discharge to home between September 2015 and March 2018 were included. The primary objective was to compare unplanned 30-day re-presentation …

A Retrospective Study Of Admission Nt-Probnp Levels As A Predictor Of Readmission Rate, Length Of Stay And Mortality, Kunjan Udani, Dveet Patel, Andrew Mangano

HCA Healthcare Journal of Medicine

Introduction

Serum levels of pro-B-type natriuretic peptide (BNP) and N-terminal (NT) proBNP are measured at admission to assess the likelihood of acutely decompensated heart failure (ADHF). Elevated NT-proBNP levels on initial presentation are a reliable marker of ADHF. However, the prognostic significance of NT-proBNP levels measured on admission remains unknown. With a better understanding of how admitting NT-proBNP levels impacts readmission rates, length of stay and mortality, future prospective studies with specific interventions can be developed to reduce all-cause readmissions, shorten length of stay and reduce mortality.

Methods

In this retrospective study, we evaluated heart failure with reduced ejection fraction …

May-Thurner Compressive Syndrome Unmasked By Rapid Weight Loss, Hesham A. Hassan, Jan-Paul Sambataro, James C. Abraham

HCA Healthcare Journal of Medicine

May-Thurner Syndrome (MTS) is an anatomical syndrome characterized by a predisposition to clot formation when there is compression of the left iliac vein by the right iliac artery. In this case, we discuss an atypical presentation of MTS in a young male after rapid weight loss. The patient was admitted for an unprovoked massive proximal deep vein thrombosis (DVT) after a two-hundred-pound weight loss during the preceding six-month period. Treatment involved mechanical thrombectomy by interventional radiology, initiation of apixaban and recommended follow up with vascular surgery for angioplasty instead of immediate stent placement.

Acute Psychosis With Recurrent Neurocysticercosis: A Case Presentation, Nasir F. Siddique, Kristy A. Fisher, Joshua Chang, Clara L. Alvarez Villalba

HCA Healthcare Journal of Medicine

Neurocysticercosis, a parasitic infection of the central nervous system (CNS) caused by the Taenia solium cestode, presents clinically with a large and diverse spectrum of symptomatology, dependent upon lesion number, locale and ensuing inflammatory response. To this date, there are only two documented cases of psychosis presenting in patients with neurocysticercosis, both of which were published in India. This case presentation depicts the first documented case of Psychotic Disorder Due to Another Medical Condition: Neurocysticercosis in the United States. The authors postulate that the atypical presentation of the neuropsychiatric instability with the aberrant recurrence of neurocysticercosis is predominantly attributable to …

Colonic Migration Of A Nephroureteral Stent Through A Colovesical Fistula, Nicholas Pigg, Kevin Carr, Julio Zayas, Eduardo Franca

HCA Healthcare Journal of Medicine

We describe a case of a patient with a two-year history of prostate cancer who underwent placement of nephroureteral stents. He subsequently presented to the hospital with complications from prolonged retention of the stents, which ultimately lead to a secondary diagnosis of adenocarcinoma of the rectum. A colonoscopy performed approximately two weeks after a bilateral nephroureteral tube exchange demonstrated what was believed to be locoregional metastatic disease and a fistulous connection with the distal nephroureteral stents. Radiographic features of this complication are discussed together with proper management and possible complications of distal nephroureteral stents. Both nephroureteral stents were explanted, and …

A Case Report: Utilization Of Topical Amphotericin In Postoperative Mucormycosis, Kenny Wang, Jomel Jacinto, Alex Davis, Andrei Hetman, Alok Kumar

HCA Healthcare Journal of Medicine

Mucormycosis is a rare devastating fungal infection with a high mortality rate often associated with diabetic and immunosuppressed individuals. However, infections found in postoperative states and in immunocompetent patients are rare. Systemic liposomal amphotericin is viewed as a first line treatment for mucormycosis in addition to aggressive debridement to prevent the spread of infection. Literature describing the treatment of mucormycosis with both systemic and topical amphotericin B is scarce. We present a case of an immunocompetent male admitted for perforated diverticulitis who received a left hemicolectomy with colostomy creation. During hospitalization, stool from the colostomy bag was reportedly leaking into …