Treatment of critically ill patients with candidemia
ABSTRACT Early initiation of effective antimicrobial therapy is crucial for the prognosis of any infection, especially in the critically ill patient. This is particularly true in the case of candidemia. However, the earlier an empirical antimicrobial regimen is started, the greater the probability of diagnostic error and the possibility of side-effects. Recent experience of the clinical efficacy and good tolerance of echinocandins in the treatment of candidemia obliges us to review the indications for empirical antifungal treatment and the choice of antifungal agent in the critically ill patient.
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ABSTRACT: This case series describes 3 horses rescued from flooded areas, hospitalised and treated at the Louisiana State University Veterinary Teaching Hospital in the wake of Hurricane Isaac. The purpose of the paper is to familiarise practitioners with the injuries that may be found in flood-afflicted horses and livestock. Case 1 presented with a degloving injury of the right hindlimb. The gelding developed neurological signs and was subjected to euthanasia; necropsy was consistent with Salmonella sepsis and disseminated mycosis due to Candida krusei, the first case reported in a horse. Case 2 presented with dermatitis attributable to chemical exposure and pneumonia and was subjected to euthanasia due to severe bilateral laminitis. Case 3 sustained a degloving injury of the left hindlimb and was subjected to euthanasia due to intractable pain. This case series illustrates the need for preparation and evacuation to avoid life-threatening injuries in equids and livestock caused by hurricanes and their aftermath.05/2015; 27(6). DOI:10.1111/eve.12322
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