A middle-aged woman presented with fever and lethargy, and was diagnosed with acute myeloid leukaemia (AML) after thorough work-up. She underwent standard induction chemotherapy (IA 3+7) and received fluconazole prophylaxis in view of cost concerns. She developed neutropenic fever 3 days after completion of chemotherapy, and was prescribed IV imipenem after an extended-spectrum beta-lactamase (ESBL)-producing Klebsiella […]
Interpretation of syphilis serological results is one of the more common reasons for referrals to infectious disease physicians in Singapore. Back in the restructured hospitals, syphilis serology was usually performed as part of a panel for patients with altered mental status, or occasionally for those with cerebrovascular accidents or peripheral neuropathy (because neurosyphilis may present with such features). […]
It is well known that patients with haematological disorders are at high risk for developing infections caused by different fungi. Part of this is due to the inherent immune system defects that develop as a consequence of their haematological disorders, but the greater part of the risk can be attributed to the treatment that they receive […]
After close to 5 years, we have finally had our Asia-Pacific epidemiological survey on invasive fungal diseases (IFDs) among patients with haematological disorders accepted for publication in the European journal Clinical Microbiology & Infection (it is unfortunately behind the infamous Elsevier pay wall!). This study was funded by the pharmaceutical giant Merck, Sharpe & Dohme, (MSD) and […]
A middle-aged woman underwent chemotherapy after being diagnosed with acute lymphoblastic leukaemia (ALL). She was re-admitted 4 days post-completion of #1A and #1B hyperCVAD with septic shock requiring dopamine support. Her absolute neutrophil count (ANC) was 0.02 and her initial chest X-ray was normal. She was treated with intravenous (IV) imipenem as per protocol, and blood cultures grew Pseudomonas […]
The idea for this post arose from discussions and tutorials with local ID trainees, all (at least those I have contact with) of whom routinely send patients with community-acquired Klebsiella pneumoniae bacteraemia for eye screening by an ophthalmologist to “exclude endophthalmitis”, and some who apply the same practice even to patients with hospital-acquired Klebsiella pneumoniae bacteraemia. Endogenous endophthalmitis occurs as a result […]
A question was raised regarding the prevalence of rapidly-growing mycobacteria (RGM) in Singapore following the previous post. Researchers in several countries have found that the prevalence of infections caused by RGM had been increasing over time, including in UK between 1995-2006, Taiwan between 2000-2008, Queensland (Australia) between 1999-2005, and in Minnesota (USA) between 1980-2009. Other than in […]
I have generally followed the World Economic Forum with interest over the past few years, particularly with regards to infectious diseases topics that feature on the agenda of the great and the good. Their perspectives are often different from the healthcare professionals on the ground, as the focus is primarily on global economics and trade, […]
I have finally had the chance to read the Nature article (behind a pay wall) that has been making waves in the recent news, including the Guardian, Forbes and Bloomberg among others. The authors, who are from academic institutions in the USA (Boston) and Germany (Bonn), as well as a drug discovery company from the UK (Selcia, Ongar, […]
MIPHIDIC 