Objective: To report an uncommon incidence of sporadic bloodstream infection (BSI) caused by Pantoea agglomerans in preterm neonates. Case Presentation and Intervention: Fives cases of nosocomial BSI with P. agglomerans in preterm neonates (weight ≤1,500 g; age 8–17 days; gestational age 26–30 weeks) are presented. All cases were late onset neonatal sepsis (>7 days of age). Lethargy, skin mottling and bradycardia were often present. Although there was no evidence of pneumonia, desaturation was a common feature. Thrombocytopenia developed in 4 patients, metabolic acidosis in 2 and jaundice in 2. No bleeding tendency or disseminating intravascular coagulation was recorded. Organisms cultured from blood were identified by the Vitek-2 system (bioMérieux, France) and the findings confirmed by testing the isolate on the API 20E system. All isolates shared in vitro susceptibility to gentamicin, amikacin, ciprofloxacin, piperacillin/tazobactam and meropenem. One patient was treated with a cefotaxime/amikacin combination, 2 with meropenem and the remaining 2 with tazocin. All patients responded well to antibiotic treatment and survived. Conclusion:P. agglomerans is an unusual pathogen in the etiology of neonatal sepsis. Despite significant clinical deterioration, early detection and proper antibiotic therapy carry a favorable outcome.
Purpose: Pheochromocytoma and paraganglioma (PGL), together called PPGL, are rare tumors with a limited number of studies on the diagnostic performance of 68 Ga-DOTA (0)-Tyr (3)-octreotate positron emission tomography-computed tomography ( 68 Ga-DOTATATE PET/CT) from the Asian-Indian subcontinent. Materials and Methods: In this retrospective study, PPGL suspects ( n = 87) who had undergone at least contrast-enhanced computed tomography (CECT) and 68 Ga-DOTATATE PET/CT, were included. Lesion-wise, patient-wise, and region-wise sensitivities of 68 Ga-DOTATATE PET/CT, 18 F fluorodeoxyglucose positron emission tomography CT ( 18 F-FDG PET/CT, n = 53), 131 I-metaiodobenzylguanidine ( 131 I-MIBG, n = 37), and CECT were compared, and diagnostic performance of 68 Ga-DOTATATE PET/CT in the detection of PPGL was calculated. Results: 68 Ga-DOTATATE PET/CT had significantly higher lesion-wise sensitivity than 131 I-MIBG for both primary (94% vs 75%, P = 0.004) and metastatic disease (85% vs 59%, P = 0.001) and higher sensitivity than CECT for metastatic lesions (83% vs 43%, P = 0.0001). The lesion-wise sensitivity of 68 Ga-DOTATATE PET/CT was similar to 18 F-FDG PET/CT for both primary tumors (94% vs 85%, P = 0.08) and metastatic lesions (82% vs 84%, P = 0.76) in the whole cohort but tended to be inferior in the head to head comparison. Conclusion: 68 Ga-DOTATATE PET/CT had higher sensitivity for detection of PPGL than 131 I-MIBG (primary and metastatic) and CECT (metastatic) but similar to 18 F-FDG PET/CT (primary and metastatic).
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