The presence of fungi in ecosystem had a great impact on the evolution of bacteria. The decomposition niches have been lost for the bacteria and fungi has created the new bacterial niches. From the investigation of interaction of fungi and bacteria, the influence of fungi on bacteria was elucidated. The inability of the bacteria to bridge air-filled voids limits bacterial motility in soils. This disadvantage is overcome by mycelial growth. The study of fungal-bacterial interactions in soils is not only interesting from a basic point of view but has yielded findings of social and economical relevance. Fungi that are harmful to bacteria may potentially form a source of new antibiotics.
Anti-Bacterial Agents ; Bacteria* ; Ecosystem ; Fungi* ; Soil

BACKGROUND: Patients with prolonged empirical broad spectrum antibiotics for febrile neutropenia (FN) with cancer, inevitably have increased risk of invasive fungal infections owing to the altered endogenous microbial environment. OBJECTIVE: The purpose of this study is to evaluate the impact of empirical antifungal therapy on occurrence of invasive fungal infections (IFIs) during FN with cancer. METHODS: We retrospectively reviewed medical records of patients with FN after cytotoxic chemotherapy due to cancer from July, 2003 to June, 2007. RESULTS: We identified 91 patients with FN after cytotoxic chemotherapy. Most common underlying conditions were lymphoma (20/91, 22%) and leukemia (20/91, 22%). IFIs occurred in 10% (9/91). In a comparison of patients with empirical antifungal therapy with no antifungal therapy, the duration of neutropenia was significantly increased with IFIs (p=0.09). The mortality of IFIs was 55.5% (5/9). CONCLUSION: We found that the duration of FN than empirical antifungal therapy affected occurrence of IFIs.
Anti-Bacterial Agents ; Antifungal Agents ; Humans ; Leukemia ; Lymphoma ; Medical Records ; Neutropenia ; Retrospective Studies

As the number of people vaccinated increases, people who complain of adverse reactions continue to occur. We experienced a case characterized by low blood pressure, persistent fever, edema due to increased systemic vascular permeability, and systemic inflammation confirmed by image and laboratory examinations after ChAdOx1 coronavirus disease 2019 (COVID-19) vaccination. The diagnostic criteria for multisystem inflammatory syndrome (MIS) in adults are known as fever of 3 days or more in adults, 2 or more mucocutaneous/ gastrointestinaleurologic symptoms, elevation of inflammatory markers, and clinical/ imaging diagnosis of heart failure. A 67-year-old man who was medicated for hypertension and diabetes was admitted complaining of fever, maculopapular rash, diarrhea, headache, chills, and dizziness 6 days after the first vaccination of ChAdOx1 nCoV-19 in Korea.The COVID-19 test was negative but with low blood pressure, leukocytosis, skin rash, pulmonary edema, and increased inflammation markers. His lab findings and clinical course were consistent with those of MIS after COVID-19 vaccination. He was medicated with methylprednisolone 1 mg/kg and diuretics and recovered rapidly. He was discharged after 2 weeks and confirmed cure at outpatient clinic. We report an MIS case after COVID-19 vaccination in Korea.

PURPOSE: We wanted to determine the efficacy of performing pedicle screw fixation to treat pediatric spinal deformities and we also wanted to evaluate its long-term effects on the growing spine. MATERIALS AND METHODS: Thirty-eight consecutive spinal deformity patients (25 congenital, 9 idiopathic and 4 other etiologies) under 10 years old at the time of the surgery who underwent pedicle screw instrumentation were reviewed after a minimum follow up of 2 years (range: 2 to 7 years). To evaluate the effect of the pedicle screws on the growing spine, a thin slice CT scan was performed in 27 patients (72%) at the last follow up. The patients were treated by posterior fusion with segmental pedicle screw fixation being performed in 21 patients, vertebral column resection combined with segmental pedicle screw fixation was done in 16 patients and combined anterior and posterior correction was done in 1 patient. RESULTS: The frontal correction was 67.2% in the posterior fusion group, 71.5% in the posterior resection group and 64.7% in the patients who underwent combined anterior and posterior correction. A mean correction of 20degrees was obtained in the sagittal plane. A total of 341 pedicle screws were inserted (an average of 8.9 screws per patient). The complications were comprised of 7 screw malpositions (2.1%), 1 loss of fixation (screw pull-out), 1 recurrence of deformity and one superficial infection. There were no significant neurological or vascular complications. Any Symptoms or radiological evidence suggestive of spinal stenosis were not detected in any of the patients. CONCLUSION: Pedicle screw fixation may be used with the same efficacy for pediatric spinal deformities, and even for the patients under 10 years old, without causing any hazard of iatrogenic spinal stenosis.
Child* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Recurrence ; Spinal Stenosis ; Spine ; Tomography, X-Ray Computed

Hepatobronchial fistula, an anatomic communication between the liver parenchyma and the bronchial tree, is a rare condition, which usually develops as a complication of amoebiasis, hydatid cysts, and trauma. We report on a case of a pyogenic liver abscess complicated by a hepatobronchial fistula, which responded well to treatment with antibiotics and percutaneous drainage. A 36-year-old male patient presented with a two-week history of dry cough, shortness of breath, right side abdominal pain, and fever. Chest computed tomography scan showed a heterogeneously enhanced abscess measuring approximately 6 cm in the right liver dome. Percutaneous drainage was performed and antibiotics were administered against Group C Streptococcus cultured from the abscess. After nine days of therapy, repositioning of the drainage catheter was performed and the patient coughed suddenly during injection of contrast media, and communication from abscess to bronchus was discovered. While maintaining abscess drainage and antibiotic therapy, the fistula diminished gradually and disappeared completely with resolution of the liver abscess.
Abdominal Pain ; Abscess ; Adult ; Amebiasis ; Anti-Bacterial Agents ; Bronchi ; Bronchial Fistula ; Catheters ; Contrast Media ; Cough ; Drainage ; Dyspnea ; Echinococcosis ; Fever ; Fistula ; Humans ; Liver ; Liver Abscess ; Liver Abscess, Pyogenic ; Male ; Streptococcus ; Thorax

BACKGROUND: Successful therapy for community-acquired pneumonia (CAP) requires appropriate empirical antimicrobial therapy based on the local microbe and resistance patterns. However, the available data on the bacterial etiology and antimicrobial susceptibility of CAP in Korea is very limited. MATERIALS AND METHODS: A nationwide prospective multicenter study of CAP in adult patients was carried out between March 2009 and February 2010. Most patients underwent detailed assessment for bacterial and viral pathogens (cultures, urinary antigen testing, serological methods and polymerase chain reaction). RESULTS: A total of 619 patients were studied. More than half (50.4%) of the patients were > or =65 years, 59.3% were males and 48.1% had underlying illness. The etiology was identified in 246 (39.7%) of the patients. The most common etiologic agent was Streptococcus pneumoniae (52 episodes, 21.1%), and the majority (36/52) of which were diagnosed by a positive urinary antigen test alone. The other common bacterial agents included Mycoplasma pneumoniae (41, 16.7%), Klebsiella pneumoniae (26, 10.6%), Chlamydia pneumoniae (13, 5.3%), Pseudomonas aeruginosa (11, 4.3%) and Staphylococcus aureus (8, 3.1%). All S. pneumoniae isolates were susceptible to penicillin with MIC of 2 microg/mL or less, only 1/16 (6.2%) was resistant to levofloxacin and 10/16 (62.5%) were resistant to erythromycin. Of the 26 K. pneumoniae isolates, 25 (96.2%) were susceptible to cefotaxime and ciprofloxacin. CONCLUSIONS: S. pneumoniae remains the most frequent pathogen in adults with CAP and this should be covered with empirical antimicrobial treatment. Atypical pathogens such as M. pneumoniae and C. pneumoniae were the second most common etiologic agents and they should be tested for. The rate of CAP caused by gram-negative bacilli such as K. pneumoniae and P. aeruginosa was high, which is similar to that of the previous Korean studies. Further study, with excluding healthcare-associated pneumonia, is needed to clarify the etiology of CAP in Korea.
Adult ; Cefotaxime ; Chlamydophila pneumoniae ; Erythromycin ; Humans ; Klebsiella pneumoniae ; Korea ; Male ; Mycoplasma pneumoniae ; Ofloxacin ; Penicillins ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae

A diffuse alveolar hemorrhage (DAH) is a distinct form of pulmonary hemorrhage that originates from the pulmonary microcirculation. Disseminated intravascular coagulation (DIC) is one cause of DAH. Although HELLP syndrome associated with DIC can cause DAH, there are no published case reports that the authors are aware of. We report the case of a pregnant woman with HELLP syndrome who developed DAH. Because pregnant women with HELLP syndrome can develop DAH as a form of ARDS, a bronchoalveolar lavage may be used to make a differential diagnosis of this lung manifestation.
Bronchoalveolar Lavage ; Dacarbazine ; Diagnosis, Differential ; Disseminated Intravascular Coagulation ; Female ; HELLP Syndrome ; Hemorrhage* ; Humans ; Liver* ; Lung ; Microcirculation ; Pregnancy ; Pregnant Women

A 51-year-old man diagnosed with Plasmodium vivax malaria was transferred to our clinic with newly developed drowsy mentality and myoclonus after the initiation of hydroxychloroquine therapy. Following therapy to treat the vivax malaria and supportive care, the patient recovered completely with no sequelae. Cerebral complications caused by vivax malaria are very rare worldwide, and only two cases have been reported in Korea. Here, we report the third published case of P. vivax infection with cerebral complications in Korea.
Humans ; Hydroxychloroquine ; Korea ; Malaria, Cerebral ; Malaria, Vivax ; Middle Aged ; Myoclonus ; Plasmodium ; Plasmodium vivax

Hypereosinophilic syndrome is a clinical disorder characterized by peripheral eosinophilia and eosinophilic infiltration of multiple organ systems, including the cardiovascular system. The manifestations are variable, but cardiac involvement is the major source of morbidity and mortality, and several case reports have highlighted the various types of cardiac involvement. However, no reported case has simultaneously presented with pericardial effusion, myocarditis, and ascites. We report a case of a 28-year-old woman with hypereosinophilic syndrome involving both the heart and intra-abdominopelvic cavity.
Adult ; Ascites ; Cardiovascular System ; Eosinophilia ; Eosinophils ; Female ; Heart ; Humans ; Hypereosinophilic Syndrome ; Myocarditis ; Pericardial Effusion

BACKGROUND: Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is associated with high mortality. One of the strategies to reduce the mortality in patients with CRAB infections is to use intravenous colistin early but the effect of this strategy has not been proven. Therefore, we investigated the association of early colistin therapy with 28-day mortality in patients with CRAB bacteremia. METHODS: This retrospective multicenter propensity score-matching analysis was conducted in the Korea by reviewing the medical records of adult patients with CRAB bacteremia between January 2012 and March 2015. Early colistin therapy was defined as intravenous colistin administration for > 48 hours within five days after the blood culture collection. To identify the risk factors associated with the 28-day mortality in CRAB bacteremia, the clinical variables of the surviving patients were compared to those of the deceased patients. RESULTS: Of 303 enrolled patients, seventy-six (25.1%) patients received early colistin therapy. The 28-day mortality was 61.4% (186/303). Fatal or rapidly-fatal McCabe classifications, intensive care unit admission, Sequential Organ Failure Assessment scores ≥ 8, vasopressor use, and acute kidney injury were statistically independent poor prognostic factors. Catheter-related infection and early colistin therapy (adjusted odds ratio [aOR], 0.45; 95% confidence interval [CI], 0.21–0.94) were independent favorable prognostic factors associated with 28-day mortality in patients with CRAB bacteremia. Early colistin therapy was still significantly associated with lower 28-day mortality in the propensity score-matching analysis (aOR, 0.31; 95% CI, 0.11–0.88). CONCLUSION: This study suggests that early colistin therapy might help reduce the mortality of patients with CRAB bacteremia.
Acinetobacter ; Acinetobacter baumannii ; Acute Kidney Injury ; Adult ; Bacteremia ; Catheter-Related Infections ; Classification ; Colistin ; Humans ; Intensive Care Units ; Korea ; Medical Records ; Mortality ; Odds Ratio ; Organ Dysfunction Scores ; Retrospective Studies ; Risk Factors