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Elizabeth Vale, Australia

Geake J.B.,The Lyell McEwin Hospital | Reid D.W.,The Prince Charles Hospital | Reid D.W.,QIMR Berghofer Medical Research Institute | Bell S.C.,The Prince Charles Hospital | And 20 more authors.
BMC Pulmonary Medicine | Year: 2015

Background: Several cases of Burkholderia pseudomallei infection in CF have been previously reported. We aimed to identify all cases globally, risk factors for acquisition, clinical consequences, and optimal treatment strategies. Methods: We performed a literature search to identify all published cases of B. pseudomallei infection in CF. In addition we hand-searched respiratory journals, and contacted experts in infectious diseases and CF around the world. Supervising clinicians for identified cases were contacted and contemporaneous clinical data was requested. Results: 25 culture-confirmed cases were identified. The median age at acquisition was 21 years, mean FEV1 % predicted was 60 %, and mean BMI was 19.5 kg/m2. The location of acquisition was northern Australia or south-east Asia for most. 19 patients (76 %) developed chronic infection, which was usually associated with clinical decline. Successful eradication strategies included a minimum of two weeks of intravenous ceftazidime, followed by a consolidation phase with trimethoprim/sulfamethoxazole, and this resulted in a higher chance of success when instituted early. Three cases of lung transplantation have been recorded in the setting of chronic B. pseudomallei infection. Conclusion: Chronic carriage of B. pseudomallei in patients with CF appears common after infection, in contrast to the non-CF population. This is often associated with an accelerated clinical decline. Lung transplantation has been performed in select cases of chronic B. pseudomallei infection. © 2015 Geake et al. Source

Robinson D.R.,The Queen Elizabeth Hospital | Kanhere H.,The Queen Elizabeth Hospital | George B.,The Lyell McEwin Hospital | Benveniste G.L.,The Queen Elizabeth Hospital
EJVES Extra | Year: 2012

Introduction: Gentamicin impregnated beads have been used in the treatment and prevention of infections in vascular surgery. Report: A patient presented with sepsis 6 years after repair of an infrarenal aortic mycotic aneurysm with an in situ polytetrafluoroethylene (PTFE) graft and implanted gentamicin beads. Several beads migrated into the duodenum resulting in a paraprosthetic sinus. The patient was successfully treated with duodenal resection and Roux-en-Y anastomosis. Discussion: This report highlights a serious complication relating to the implantation of gentamicin beads in the retroperitoneum. We would advocate aggressive debridement and coverage of the infected field with well-vascularised tissue rather than permanent gentamicin bead implantation. © 2012 European Society for Vascular Surgery. Source

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