Bacterial Infections and Mycoses Commons^™

A Rare Case Of Leprosy In West Florida, Adrian Lugo, Taylor Studsrud, Nemer Dabage, James Demaio

West Florida Division GME Research Day 2020

• Leprosy is caused by acid-fast bacilli of the M. leprae complex, which includes M. leprae and M. lepromatosis.
• Transmission in the U.S. is rare, but has been documented in hunters who handle wild ninebanded armadillo.
• The origins of M. leprae infection among armadillos, the geographic range of the infected animals, and the potential risks infected armadillos present to people have been topics of concern.
• The infection originated amongst armadillos decades before they were ever used in leprosy research, and numerous surveys have confirmed that armadillos in the southern United States are a large natural reservoir for M. leprae; its prevalence …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

A Case Of Pott's Disease: Typical Presentation Of An Uncommon Disease In The United States, Neha Patel, Ravi Patel, Marek Krysztofiak, K V. Sundaresh

West Florida Division GME Research Day 2020

Pott’s disease (PD), also known as tuberculosis spondylitis, is a rare disease of the spine which is typically caused by extraspinal infection. The basic lesion in Pott's disease is a combination of osteomyelitis and arthritis, usually affecting more than one vertebra. The anterior aspect of the vertebral body adjacent to the subchondral plate is commonly involved. Spinal TB can include any of the following: progressive bone destruction leading to vertebral collapse and kyphosis, cold abscess formation (due to extension of infection into adjacent ligaments and soft tissues), spinal canal narrowing by abscesses, granulation tissue or direct dural invasionresulting in spinal …

Pasteurella Multocida Bacteremia Secondary To Multiple Cat Scratches, Charles Boadu, Andrea Hernandez, Bassem Zeidan, John T. Young, Johnathan Frunzi

West Florida Division GME Research Day 2020

Pasteurella multocida(P. multocida)is part of the normal gastrointestinal and upper respiratory flora of domestic and wild animals such as dogs, cats, rabbits, opossums, boars, tigers, lions and horses ^{(1, 2)}. Transmission of P. multocidais usually through scratches and bites leading to infections of the soft tissue and skin ^(3,4). P. multocida bacteremia is rare, but occurs in individuals with major risk factors including chronic pulmonary disease, diabetes mellitus, end state renal disease (ESRD), and an immunocompromised state ^(3,4). Non traumatic infections of P. multocida in immunocompromised individuals,are more likely to require care in the intensive care unit …

Novel Infection Status Post Electrocution Requiring A 4th Ray Amputation, William R. Judson, John D. Murphy, Phillip H. Sussman, John N. Harker

West Florida Division GME Research Day 2020

• Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.^{1, 2}
• Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.¹ The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.^{3, 4}
• Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy. …

New Onset Psychosis Secondary To Neurosyphilis, Samantha Linda Jane Vu, Lauren Angela Demarco, Francis Butler, Nihal Shah

West Florida Division GME Research Day 2020

Syphilis is a highly contagious sexually transmitted infection (STI) caused by the spirochetal bacterium Treponema pallidum. Transmission occurs through direct contact of painless ulcerative lesions, chancres, located on the genitalia (penis, labia) and oral mucosa. Neurosyphilis is any involvement of the central nervous systems (brain, meninges, or spinal cord) by the bacterium.

Bilateral Sporotrichoid Cutaneous Atypical Mycobacterial Infection Due To Primary Inoculation, Erin Lowe, Alexa Broderick, Richard Miller

West Florida Division GME Research Day 2020

The group of mycobacterial species that excludes Mycobacteria tuberculosis and Mycobacteria leprae is known as nontuberculosis or atypical mycobacteria. Nearly all atypical mycobacteria species can cause cutaneous infection. The diagnosis is challenging as disease may take months to become clinically apparent, morphology is non-specific, routine culture has a low sensitivity, and organisms can be sparse on histopathologic examination. Antibiotic resistance and further complicates management. The Gulf Coast is the highest incidence region of cutaneous atypical mycobacterial infections. Here we present a challenging case of bilateral sporotrichoid atypical mycobacterial infection due to primary inoculation.

Swimming Through Lake Placid: A Major Headache, Elizabeth Severson, Claudia Leonard

Providence St. Vincent Internal Medicine 2020

Introduction: Leptospirosis is caused by Leptospira species, a spirochete bacterium that affects animals and humans. The disease can range from mild flu-like illness to multi-organ failure. While likely underreported, the incidence according to the World Health Organization can range from 0.1 to 10 per 100,000 depending on climate Leptospirosis is commonly associated with occupational or recreational exposures

Case Report: A 43 year-old previously healthy man presented with two weeks of myalgias, fevers, neck pain and throbbing headache. The patient competed in an Iron Man event in upstate New York one month prior to presentation. Initial investigation demonstrated a …

Engagement Of Private Healthcare Providers For Case Finding Of Tuberculosis And Diabetes Mellitus In Pakistan, Shifa Salman Habib, Sana Rafiq, Wafa Zehra Jamal, Shaikh Muhammad Ayub, Rashida Abbas Ferrand, Aamir Khan, Syed Mohammad Asad Zaidi

Community Health Sciences

Background: The rising co-epidemic of tuberculosis (TB) and diabetes mellitus (DM) is a challenge for constrained health systems in low and middle-income countries. Diabetes is a known risk factor for tuberculosis and associated with poor tuberculosis treatment outcomes, while tuberculosis is associated with worsening glycemic control. We investigated the performance of bi-directional TB and DM case finding approaches through a private-sector engagement model in Karachi, Pakistan.
Methods: Between July 2016 and July 2018, private health care providers were engaged to generate referrals for bi-directional TB and DM screening at private diagnostic and treatment centers in Karachi, Pakistan. Individuals diagnosed with …

Evaluation Of Computer Aided Detection Of Tuberculosis On Chest Radiography Among People With Diabetes In Karachi Pakistan, Shifa Salman Habib, Sana Rafiq, Syed Mohammad Asad Zaidi, Rashida Abbas Ferrand, Jacob Creswell, Bram Van Ginneken, Wafa Zehra Jamal, Kiran Sohail Azeemi, Saira Khowaja, Aamir Khan

Community Health Sciences

Pakistan ranks fifth among high tuberculosis (TB) burden countries and also has seventh highest burden for diabetes mellitus (DM). DM increases the risk of developing TB and contributes to adverse TB treatment outcomes hence screening and integrated management for both diseases in high burden countries is suggested. Computer-Aided Detection for TB (CAD4TB) can potentially be used as triage tool in low resource settings to pre-screen individuals for Xpert MTB/RIF testing. The aim of this study was to evaluate the diagnostic accuracy and performance of CAD4TB software in people with diabetes (PWD) enrolled in a TB screening program in Karachi, Pakistan. …

Computer Aided Detection Of Tuberculosis On Chest Radiographs: An Evaluation Of The Cad4tb V6 System, Keelin Murphy, Shifa Salman Habib, Syed Mohammad Asad Zaidi, Saira Khowaja, Aamir Khan, Jaime Melendez, Ernst T. Scholten, Farhan Amad, Steven Schalekamp, Maurits Verhagen

Community Health Sciences

There is a growing interest in the automated analysis of chest X-Ray (CXR) as a sensitive and inexpensive means of screening susceptible populations for pulmonary tuberculosis. In this work we evaluate the latest version of CAD4TB, a commercial software platform designed for this purpose. Version 6 of CAD4TB was released in 2018 and is here tested on a fully independent dataset of 5565 CXR images with GeneXpert (Xpert) sputum test results available (854 Xpert positive subjects). A subset of 500 subjects (50% Xpert positive) was reviewed and annotated by 5 expert observers independently to obtain a radiological reference standard. The …

Non-Tuberculous Mycobacterial Infections-A Neglected And Emerging Problem, Imran Ahmed, Simon Tiberi, Joveria Farooqi, Kauser Jabeen, Dorothy Yeboah-Manu, Giovanni Battista Migliori, Rumina Hasan

Department of Pathology and Laboratory Medicine

Non-tuberculous mycobacteria (NTM) are ubiquitous dwellers of environmental niches and are an established cause of natural and nosocomial infections. The incidence of NTM infections is rising owing to a growing population of immunocompromised and vulnerable individuals, complex medical and surgical procedures, as well as increased awareness and diagnostic capabilities. The prevalence of different NTM varies between continents, regions, and countries. The true global burden of pulmonary and extrapulmonary disease is unknown and estimates are subject to under and/or over-estimation. Diagnosis requires confirmation by isolation of NTM along with clinical and radiological criteria, which may be suboptimal at all levels. Susceptibility …

A Novel Case Of Bacterial Meningitis In A Patient With Loeys-Dietz, Lacey D. Colvin Do, Christy Fagg

Infectious Disease

No abstract provided.

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Always Remember To Floss... Or Else, Arunmozhi (Sankavi) Aravagiri Md, Muhammad Zain Md, Rajesh Gulati Md

Internal Medicine

No abstract provided.

Prevalence Of The Hypervirulent Nap1/Bi/027 Strain Of C. Difficile In Southwestern Virginia And Risk Factors Associated With Infection, Andrew O. Hanna, Anthony Baffoe-Bonnie, Shikha Vasudeva

Graduate Medical Education (GME) Resident and Fellow Research Day Posters

C. difficile infection (CDI) incidence has increased over the last several decades. The BI/NAP1/027 ribotype was discovered in 2005 and has since been responsible for multiple outbreaks in the US and Canada. This subtype of C. Difficile is known to be more virulent in vivo and produce more severe disease. Limited regional data of the prevalence of this ribotype is available, which could help guide treatment. Using infection control data from a large regional hospital and a VA medical center, this study documented the prevalence of the 027 ribotype in Southwest Virginia. Patients were included if they were tested at …

Tick-Borne Infections In New Hampshire: An Evaluation Of The Diagnostic Process In A Local Patient Population, Katherine Anderson

Honors Theses and Capstones

Overall, approximately 95 percent of reported cases of vector-borne disease were associated with ticks, making these the most medically important group of arthropods in the United States.¹ Despite the prevalence of tick-borne infections, the process for the diagnosis of this condition is not well studied. This study aims to analyze data from a pool of 100 patients who underwent testing for tick-borne disease in the same institution in Dover, New Hampshire during the most recent peak tick season of 2019. Information utilized in this study included: patient age, sex, location of testing (inpatient versus outpatient), diagnostic testing methods used …

Impact Of Required Antibiotic Stop Dates And Indications On Length Of Treatment In Hospitalized Patients With Pneumonia, Amanda Haddad, Kathryn Hernando, Kayihura Manigaba, Abigail Antigua

Infectious Disease

Purpose: The CDC Core Elements of Hospital Antibiotic Stewardship Programs recommends implementing policies to support optimal antibiotic prescribing including documentation of dose, duration and indication. On January 31, 2017, the study institution implemented new physician order entry screens in the electronic health record requiring the input of indication and duration on all antibiotic orders. The objective of this study is to determine if implementation of mandatory indication and duration for antibiotic orders decreases antibiotic duration of therapy in hospitalized patients with pneumonia.

Methods: This study was submitted to the Institutional Review Committee for approval. The clinical pharmacy surveillance platform, …

Impact Of Methicillin-Resistant Staphylococcus Aureus (Mrsa) Nasal Swab On Total Duration Of Mrsa Therapy For Pneumonia Patients, Darren D. Yum, Kayihura Manigaba, Danielle Gagne, Heather Ellis

Infectious Disease

Purpose: Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program tool for avoiding unnecessary empiric anti-MRSA therapy for pneumonia. MRSA is an important cause of pneumonia and clinicians must determine when empiric antimicrobial therapy directed toward this pathogen is needed. Negative MRSA nasal swab has been shown to have a high negative predictive value ( >95%) across different types of pneumonia. The objective of this study is to assess the impact of negative MRSA nasal swabs on the duration of anti-MRSA therapy in a community hospital setting.

Methods: This study will be submitted to the institutional …

Prevalence Of Methicillin Resistant Staph Aureus Over Time In Resident Physicians, Lexus Dickson, Morgan Smith Md, Scott Gutovitz, Danielle Kocsis, Jean B. Wiggins, Steve Warrington Md, Stephen Thacker Md, Nayda Parisio Poldiak

Emergency Medicine

No abstract provided.

A Case Of Transient Complete Av Block Caused By Infective Endocarditis With Abiotrophiadefectiva, Jung Yoon Do, Wilco Civil Sr, Urvish Patel, Jermaine Ekobena, Arun Abraham, Michael Strobbe

Internal Medicine

No abstract provided.

Oral Fungal Microbiota: To Thrush And Beyond, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The oral microbiota is complex, multikingdom, interactive, and involves extensive biofilm formation. While dominated by bacteria, Candida is a frequent member of this microbiota; however, several other potentially pathogenic fungi (among around 100 identified species) appear to reside in some individuals, including Cryptococcus, Aspergillus, and Fusarium. Oral candidiasis may manifest as a variety of disease entities in normal hosts and in the immunocompromised. These include pseudomembranous candidiasis (thrush), hyperplastic or atrophic (denture) candidiasis, linear gingival erythema, median rhomboid glossitis, and angular cheilitis. The purpose of this review is to describe the oral fungal microbiota (ie, oral mycobiota), …

Listen To Your Heart, Or At Least Theirs: Maintaining A High Index Of Suspicion For Infective Endocarditis, Mollie Powell Do, Mahesh Setty Md

Emergency Medicine

After an endothelial injury, a fibrin and platelet cap forms. This cap is typically sterile but in times of infection can become colonized by microbes leading to a vegetation. When this occurs on the endothelium of the heart, it is termed infective endocarditis (IE). IE is a difficult diagnosis to make in the ED. The symptoms are vague. Classic exam findings are often absent, murmur auscultation can be challenging and there is not a single diagnostic test. A delayed or missed diagnosis can be fatal; therefore, it is essential that ED physicians maintain a high index of suspicion in high …

Spontaneous Fungal Peritonitis: A Rare Complication Of Ascites Secondary To Right Heart Failure: A Case Report, Saaah Siddiqui Md, Dharti R. Patel Md, Arshad M. Iqbal Md, Ateeq Mubarik Md, Salman Muddassir Md, Fahad Zafar Md

Internal Medicine

•Spontaneous fungal peritonitis (SFP) is an infection defined as a neutrophil count (> 250 cells/mL) in the ascitic fluid with the evidence of positive fungal culture (1) while excluding other intra-abdominal infections. SFP is not as common as spontaneous bacterial peritonitis and has higher mortality rates due to late recognition and difficulty in differentiation between SFP and SBP. (1,2). The common risk factors that have shown to increase the mortality for SFP include hepatorenal syndrome, patient on SBP prophylaxis, elevated APACHE II scores on admission, and elevated lactate levels (2,3). Candida albicans and Candida glabrata are the two …

Cavitary Lesion In An Immunocompromised Adult, Syed Talha Qasmi, Turuvekere Jayaram, Enrique Rincon

Internal Medicine

No abstract provided.

Rare Infective Endocarditis Caused By Dental Source Due To Streptococcus Bovis Masquerading As Cardiac Failure, Ravish Patel, Pratikkumar Vekaria, Devin Vaishnani, Johnnie Mao, Asif Shah

Internal Medicine

No abstract provided.

Sterile Compounding: Regulations Addressed After The Meningitis Outbreak Of 2012, Kelly M. Dye, Tara M. Tokar, Halle M. Orlinski, Heather Helsel, Marcia M. Worley

Pharmacy and Wellness Review

No abstract provided.

Legionnaires' Disease, A Rising Occurrence In The United States, Jennifer Harklerode, Olivia Henton, Myranda Smith, Rebecca Worden, Andrew Roecker

Pharmacy and Wellness Review

Legionella pneumophila, a microscopic bacterium usually responsible for a number of illnesses and fatalities, can eliminate a local population, a region or even a nation. In 1976, L. pneumophila was first discovered due to a number of cases presenting with pneumonia-like symptoms. These cases occurred in an isolated population attending an American Legion convention in Philadelphia, Pennsylvania, therefore lending to the name Legionella. Usually found in aquatic environments such as lakes, streams, cooling towers, air conditioning systems and hot tubs, its ability to thrive in artificial and natural environments makes it an ideal bacterium. L. pneumophila can be transmitted via …

Combating Antibiotic Resistance In The 21st Century, Kevin Krivanek, Brian Heilbronner, Brendan Rasor, Kelsey Lindsley, Andrew Roecker

Pharmacy and Wellness Review

Antibiotic resistance is one of the most significant challenges facing the medical community today. In response, the Centers for Disease Control and Prevention (CDC) created a list of the greatest antibiotic resistance threats, a number of which are gram-positive bacteria. The cell wall of these organisms has long been a favored target of antibiotic therapies, but the development of numerous resistance mechanisms has led to widespread resistance against nearly all major antibiotic compounds on the market. The medical community is faced with the task of developing better antibiotic compounds that preclude the spread of bacterial resistance and also increasing the …

Whooping Cough: A Pharmacist's Role In An Emerging Endemic, Haley Armstrong, Lydia Suchecki, Sarah Lipperman, Taylor Roberson, Andrew M. Roecker

Pharmacy and Wellness Review

Pertussis is an acute infectious disease caused by the organism Bordetella pertussis and characterized by a "whooping cough." Incidence of the disease had declined since the development of a vaccine, but is now increasing in reported cases. This increase has been attributed to both an increased awareness but also surmised to be related to a decrease in vaccinations. The pertussis vaccine is given in conjunction with tetanus and diphtheria vaccines to children before the age of 6 in five separate injections over the course of four to six years. A booster is now recommended for the older child and adults …