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X Latorre

Publications and source records attributed to X Latorre.

28 records · Page 2Linked to original sources

Systemic candidiasis in heroin abusers. Cutaneous findings.

Systemic candidiasis in intravenous drug abusers (IVDA) is a new syndrome caused by Candida albicans and characterized by the sequential development of skin, eye, and osteoarticular lesions, which together form a typical clinical picture. We studied 30 patients with suggestive skin lesions: papules, nodules, and pustules in hair-bearing areas, particularly the scalp and beard area, associated with hair invasion by candidal hyphae. Ocular and osteoarticular involvement and presence of candidemia in some of the patients suggested blood-borne colonization of C. albicans. The infection has been related to "brown" heroin. The origin of C. albicans and the reasons for its exclusive localization in the skin and these organs are discussed. The characteristic clinical picture is widely different from that of classic disseminated candidiasis in immunodeficient patients. Therapy is also discussed.

Adult↗

Lymphocyte subpopulations in Spanish parenteral drug addicts.

Lymphocyte subpopulations were studied in 29 symptom-free Spanish prisoners who were active parenteral drug abusers. In 16/29 drug addicts (55%) the helper-inducer/suppressor-cytotoxic ratio (Leu 3a/Leu 2a) was less than 1. None of these 16 patients had lymphopenia and only 2 had a reduction in the number of Leu 3a cells. In drug addicts the number of lymphocytes (p less than 0.01) and the number and percentage of Leu 2a cells (p less than 0.001) were significantly raised. The addicts also had a higher absolute number of T cells when measured by their ability to react with the Leu 4 antibody (p less than 0.01). However, the E-rosette forming cells were significantly reduced. Thus the E-rosette test may lead to an overestimation of "null" cells. Furthermore drug addicts had a higher percentage (p less than 0.001) of Leu 7 positive cells (NK and K cells), but a normal percentage of B and phagocytic cells. Five drug addicts had generalized persistent lymphadenopathies, and 2 had skin anergy. We believe that most of the immunologic abnormalities seen in these apparently healthy drug abusers can be explained by an antigenic overload.

Adolescent↗

Nosocomial bacteremia in a large Spanish teaching hospital: analysis of factors influencing prognosis.

Five hundred forty-three episodes of nosocomial bacteremia were prospectively followed in a large Spanish university hospital. The commonest isolates were Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida species. The most frequent sources of infection were intravenous lines, urinary tract, and lower respiratory tract. Overall mortality was 18%. A step-forward logistic regression analysis defined eight variables independently influencing the outcome: shock, underlying rapidly fatal disease, high-risk source of bacteremia (intraabdominal, lower respiratory tract, or not identified), age more than 70 years, hospitalization in intensive care or medical units, inappropriate antibiotic treatment, infection due to a high-risk microorganism (P. aeruginosa, Serratia marcescens, Klebsiella, Bacteroides, or Candida), and development of septic metastasis. The identification of those factors independently influencing the outcome and their possible modification may represent a further step in the control of nosocomial bacteremia by improving its prognosis.

Adult↗

Diagnostic value of serum antibody and antigen detection in heroin addicts with systemic candidiasis.

The diagnostic value of antibody detection by indirect hemagglutination (IHA), indirect immunofluorescence (IFA), and counterimmunoelectrophoresis (CIE) and of Candida albicans mannan antigen detection by latex agglutination was studied in 36 cases of systemic candidiasis in heroin addicts. The IHA and IFA techniques were highly sensitive (97% and 91%, respectively), but their specificity was low (60% and 50%). When a titer of greater than or equal to 1:2,560 was used as a criterion for IHA positivity, the specificity of the test rose to 87%, with sensitivity at 75%. CIE had a high degree of specificity (96%) but a low degree of sensitivity (58%). A good correlation was found between clinical evolution of infection and serologic data. Two of 12 patients who could be followed for 9-16 months had a rise in antibody titer detected either by IFA or by IHA and CIE. These two patients had a persistent chondrocostal tumor and C. albicans endocarditis, respectively. All of the other patients, who were cured, had a decrease in titer detected by IHA and IFA and had negative CIE results at the end of follow-up. Serum mannan antigen was not found in any case. The detection of antibody to C. albicans may be useful for diagnosis and follow-up of such patients.

Adult↗