JUSSARA BIANCHI CASTELLI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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article 3 Citação(ões) na Scopus Fatal adenoviral necrotizing bronchiolitis case in a post-cardiac surgery intensive care unit(2011) CASTELLI, Jussara Bianchi; SICILIANO, Rinaldo F.; VIEIRA, Ricardo D.; AIELLO, Vera D.; STRABELLI, Tania M. V.We report a case of a 67 year-old-male patient admitted to the intensive care unit in the post-coronary bypass surgery period who presented cardiogenic shock, acute renal failure and three episodes of sepsis, the latter with pulmonary distress at the 30th post-operative day. The patient expired within five days in spite of treatment with vancomycin, imipenem, colistimethate and amphotericin B. At autopsy severe adenovirus pneumonia was found. Viral pulmonary infections following cardiovascular surgery are uncommon. We highlight the importance of etiological diagnosis to a correct treatment approach.- Community-acquired culture-negative endocarditis: clinical characteristics and risk factors for mortality(2014) SICILIANO, Rinaldo Focaccia; MANSUR, Alfredo Jose; CASTELLI, Jussara Bianchi; ARIAS, Vanessa; GRINBERG, Max; LEVISON, Matthew E.; STRABELLI, Tania Mara VarejaoObjectives: We studied the clinical characteristics, in-hospital mortality, and long-term prognosis of patients with culture-negative endocarditis. Methods: In total, 221 episodes of definite endocarditis were studied (2004-2009). We compared the clinical, laboratory, and echocardiography characteristics and the survival rates of patients with culture-negative and culture-positive endocarditis. Survival after hospital discharge was evaluated using the Kaplan-Meier method and coefficient of mortality comparisons. Results: Culture-negative endocarditis occurred in 51/221 (23.1%) episodes. Compared with the culture-positive endocarditis patients, the time elapsed between admission and initiation of antibiotic therapy was longer in patients with culture-negative endocarditis (p < 0.001), and these patients also had lower C-reactive protein levels at admission (p < 0.001). In-hospital mortality rates were not different between culture-negative and culture-positive patients. After hospital discharge, there was also no significant difference between groups in survival curves (p = 0.471). Severe sepsis (adjusted prevalence ratio 3.32, p = 0.010) and diabetes mellitus (adjusted prevalence ratio 2.32, p = 0.009) were independently associated with in-hospital death in culture-negative patients. Conclusions: Culture-negative endocarditis patients presented with lower levels of C-reactive protein at admission and required more time for initiation of antibiotic therapy, although there was no difference in in-hospital mortality or long-term survival between culture-negative and culture-positive endocarditis patients. Diabetes mellitus and severe sepsis were associated with in-hospital death in patients with culture-negative endocarditis. (C) 2014 The Authors.
- Bartonella spp. and Coxiella burnetii Associated with Community-Acquired, Culture-Negative Endocarditis, Brazil(2015) SICILIANO, Rinaldo Focaccia; CASTELLI, Jussara Bianchi; MANSUR, Alfredo Jose; SANTOS, Fabiana Pereira dos; COLOMBO, Silvia; NASCIMENTO, Elvira Mendes do; PADDOCK, Christopher D.; BRASIL, Roosecelis Araujo; VELHO, Paulo Eduardo Neves Ferreira; DRUMMOND, Marina Rovani; GRINBERG, Max; STRABELLI, Tania Mara VarejaoWe evaluated culture-negative, community-acquired endocarditis by using indirect immunofluorescent assays and molecular analyses for Bartonella spp. and Coxiella burnetii and found a prevalence of 19.6% and 7.8%, respectively. Our findings reinforce the need to study these organisms in patients with culture-negative, community-acquired endocarditis, especially B. henselae in cat owners.
- The Role of F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Left-sided Endocarditis: Native vs Prosthetic Valves Endocarditis(2020) CAMARGO, Raphael Abegao de; BITENCOURT, Marcio Sommer; MENEGHETTI, Jose Claudio; JR, Jose Soares; GONCALVES, Luis Fernando Tonello; BUCHPIGUEL, Carlos Alberto; PAIXAO, Milena Ribeiro; FELICIO, Marilia Francesconi; SOEIRO, Alexandre de Matos; STRABELLI, Tania Mara Varejao; MANSUR, Alfredo Jose; TARASOUTCHI, Flavio; JR, Mucio Tavares de Oliveira; CASTELLI, Jussara Bianchi; GUALANDRO, Danielle Menosi; POCEBON, Lucas Zoboli; BLANKSTEIN, Ron; ALAVI, Abass; MOORE, John Edmund; MILLAR, Beverley Cherie; SICILIANO, Rinaldo FocacciaBackground: F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT) has emerged as a useful diagnostic tool for suspected infective endocarditis (IE) in patients with prosthetic valves or implantable devices. However, there is limited evidence regarding use of F-18-FDG-PET/CT for the diagnosis of native valve endocarditis (NVE). Methods: Between 2014 and 2017, 303 episodes of left-sided suspected IE (188 prosthetic valves/ascending aortic prosthesis and 115 native valves) were studied. F-18-FDG-PET/CT accuracy was determined in the subgroups of patients with NVE and prosthetic valve endocarditis (PVE)/ascending aortic prosthesis infection (AAPI). Associations between inflammatory infiltrate patterns and F-18-FDG-PET/CT uptake were investigated in an exploratory ad hoc histological analysis. Results: Among 188 patients with PVE/AAPI, the sensitivity, specificity, and positive and negative predictive values of F-18-FDG-PET/CT focal uptake were 93%, 90%, 89%, and 94%, respectively, while among 115 patients with NVE, the corresponding values were 22%, 100%, 100%, and 66%. The inclusion of abnormal F-18-FDG cardiac uptake as a major criterion at admission enabled a recategorization of 76% (47/62) of PVE/AAPI cases initially classified as ""possible"" to ""definite"" IE. In the histopathological analysis, a predominance of polymorphonuclear cell inflammatory infiltrate and a reduced extent of fibrosis were observed in the PVE group only. Conclusions: Use of F-18-FDG-PET/CT at the initial presentation of patients with suspected PVE increases the diagnostic capability of the modified Duke criteria. In patients who present with suspected NVE, the use of F-18-FDG-PET/CT is less accurate and could only be considered a complementary diagnostic tool for a specific population of patients with NVE.
article 9 Citação(ões) na Scopus Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis(2011) CASTELLI, Jussara Bianchi; SICILIANO, Rinaldo Focaccia; ABDALA, Edson; AIELLO, Vera DemarchiNocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IF caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IF caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients.- Cytomegalovirus colitis in immunocompetent critically ill patients(2014) SICILIANO, Rinaldo F.; CASTELLI, Jussara B.; RANDI, Bruno A.; VIEIRA, Ricardo D.; STRABELLI, Tania M. V.Objectives: Cytomegalovirus (CMV) is a ubiquitous virus and its reactivation may lead to CMV end-organ disease ( CMV EOD) in immunocompromised patients and also in immunocompetent patients when they are critically ill. We aimed to investigate the frequency and the clinical features of proven CMV EOD in previously non-immunosuppressed patients admitted to our institution. Methods: From January 2000 to March 2013, the records of all patients with a histopathological diagnosis of CMV EOD at our teaching hospital were reviewed retrospectively. CMV EOD was diagnosed histologically by the identification of true cytomegalic viral inclusion involving endothelial, stromal, and/or epithelial cells on hematoxylin and eosin staining, and was subsequently confirmed by immunohistochemistry using specific antibody against CMV antigens. Immunocompromised patients were excluded. Results: CMV EOD manifesting as colitis was diagnosed in 14 previously immunocompetent intensive care unit (ICU) patients. The mean age of the patients was 64 years. All had co-morbidities and developed shock before CMV EOD. The major manifestation was gastrointestinal bleeding. The in-hospital mortality rate was 71.4% despite specific treatment with ganciclovir. Conclusions: Despite being a rare condition, lower gastrointestinal bleeding in this profile of ICU patients could be the clinical manifestation of CMV colitis, and intensivists should be alert to this condition.
- Disseminated Skin Lesions After Allogeneic Hematopietic Stem Cell Transplantation(2018) NEFFA, Pedro Pereira; SCHMIDT FILHO, Jayr; RAMOS, Jessica Fernandes; OKAY, Thelma Suely; CASTELLI, Jussara Bianchi; ROCHA, Vanderson; COSTA, Silvia Fiqueiredo; BATISTA, Marjorie Vieira