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P C Bacha

Publications and source records attributed to P C Bacha.

7 recordsLinked to original sources
PubMed1997

Risk factors and attributable mortality associated with superinfections in neutropenic patients with cancer.

To identify the risk factors and attributable mortality associated with superinfections in febrile neutropenic patients with hematologic malignancies, we prospectively evaluated 333 episodes of fever and neutropenia by means of univariate and multivariate analyses. Superinfection was defined as any infection either occurring during antibiotic therapy or developing within 1 week after discontinuation of antibiotic therapy. Of 333 episodes, 46 (13.8%) were defined as superinfection; these episodes occurred in 46 patients. The risk factors for superinfection in the multivariate analysis were longer duration of profound neutropenia (P < .0001), lack of use of quinolones as prophylaxis (P < .0001), presence of a central venous catheter (P = .02), and persistence of fever after 3 days of antibiotic therapy (P = .02). The crude mortality rate among patients with superinfection was 48%, and the attributable mortality rate was 24% (95% confidence interval, 3%-45%). Identifying risk factors for superinfections in neutropenic patients might allow clinical practices to reduce the negative impact of this complication.

Adolescent↗
PubMed1992

Three cases of infection with Fusarium species in neutropenic patients.

Three cases are reported of disseminated infection due to Fusarium species in severely neutropenic patients. The clinical findings in all patients included fever, painful disseminated nodular skin lesions and severe myalgia. The outcome was fatal despite early administration of amphotericin B. The portal of entry of the organism was probably the nasal sinus in two cases.

Adolescent↗
PubMed1981

[Sézary-Baccaredda syndrome].

One case of Sezary Syndrome is presented and studied from the clinical, histopathological and hematological point of view. Clinically the patient presented besides keratodermia on the palms and a severe pruritus, an erythrodermia of very ostensive redness, like the so-called Hallopeau's red man. On the skin, by histological examination, it was observed an infiltration with some round cells, whose nucleus were hyperchromatic and irregular, as it is to be seen in the Sezary's cells. A lymph node taken from the cervical region did not show any specific infiltrate but only a dermopathic adenopathy. Lymphoid cells of folded nucleus were revealed by the hemogram, quite suggestive of Sezary's lymphoma. In the marrow, the normal cells kept on their regular proportion, but some abnormal and invasive ones stand out with their convoluted nucleus, quite suggestive of Sezary's cells. These typical Sezary's cells have been found in the skin lesions, in the blood and in the marrow. The possible origin--in the skin or in the lymph nodes, but not in the marrow--of such cells is put to a summarized discussion. Finally, the Sezary's Syndrome may be an erythrodermic or leukemic variant of "morbus fungoide". Treatment on the basis of MOPP and CHOP methods with Bleomycin association has been attempted but, so far, the results have not been satisfactory in spite of an 18 month treatment.

Antineoplastic Agents↗
PubMedDate not supplied

Amphotericin B followed by itraconazole in the treatment of disseminated fungal infections in neutropenic patients.

The role of the new triazoles in the treatment of disseminated fungal infections in neutropenic patients is at present under scrutiny. Six neutropenic patients with disseminated fungal infections were treated with amphotericin B during neutropenia and itraconazole after bone marrow recovery. There were three pulmonary aspergillomas, one Aspergillus fumigatus sinusitis, one Fusarium-mycosis and one disseminated candidosis. Four patients were cured of the infection. This approach seems to be safe and effective in the treatment of disseminated fungal infections in neutropenic patients, with the advantages of low side-effects and the possibility of early discharge from hospital.

Adult↗
PubMedDate not supplied

Fungal infections in neutropenic patients. A 8-year prospective study.

In this paper we report a eight-year prospective study designed to further characterize incidence, epidemiology, specific syndromes, treatment and prognosis associated with fungal infections in neutropenic patients. During the study period 30 fungal infections were diagnosed in 30 patients among 313 episodes of fever and neutropenia (10%). There were 15 cases of candidiasis, 5 pulmonary aspergillosis, 3 sinusitis by Aspergillus fumigatus, 5 infections by Fusarium sp., one infection by Trichosporon sp., and one infection due to Rhodotorula rubra. Blood cultures were positive in 18 cases (60%). The predisposing factors for fungal infection in multivariate analysis were the presence of central venous catheter (p < 0.001), longer duration of profound (< 100/mm3) neutropenia (p < 0.001), the use of corticosteroids (p < 0.001), gram-positive bacteremia (p = 0.002) and younger age (p = 0.03). In multivariate analysis only recovery of the neutropenia (p < 0.001) was associated with good prognosis whereas the diagnosis of infection by Fusarium sp. (p = 0.006) was strongly associated with a poor outcome. The death rate was 43%. There was no statistically significant difference in the death rate between patients who did receive (52%) or did not receive (50%) antifungal treatment. Identifying patients at risk, specific syndromes and prognostic factors may help to reduce the high mortality associated with disseminated fungal infections in neutropenic patients.

Adolescent↗