Diaz Reyes, Nelson Fidel

Cargando...
Miniatura
Nombre preferido
Diaz Reyes, Nelson Fidel
Afiliación principal
ORCID
ID de autor de Scopus

Ajustes

Mostrando 1 - 10 de 20
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    P-997. Successful Implementation of an Infectious Disease-Led Non-Restrictive Antimicrobial Stewardship Program in a Peruvian Hospital
    (2026-01-01)
    Carreras, Xosse
    ;
    Sofia Salcedo, Andrea
    ;
    Muñoz, Sara
    ;
    Diaz Reyes, Nelson Fidel  
    ;
    Salinas, Jorge
    Abstract Background Peru reports high carbapenem and vancomycin usage with concerning resistance rates, including 60.6% third-generation cephalosporin resistance in E.coli bloodstream infections. National legislation requires antimicrobial stewardship programs (ASPs) in secondary and tertiary facilities. Methods We implemented an infectious disease physician-led ASP at a 107-bed Peruvian hospital and report 12-month outcomes. Implementation phases included education and guideline development, prospective audit and feedback without restrictions, and data collection. The ASP targeted meropenem, vancomycin, and linezolid in medicine and ICU wards. Medical students conducted chart reviews with recommendations communicated to physicians. Results We audited 191 records of predominantly elderly patients (median 78 years), with meropenem most prescribed (89.4%). Guideline adherence was 84.7%. Common recommendations included limiting duration (39.2%), adjusting based on cultures (31.7%), and de-escalation (18.5%)(Table1). Implementation rate was 78.8%. In medicine, consumption decreased during intervention: meropenem by 57.1% (10.5 to 4.5 DDD/100 patient-days), vancomycin by 76.7% (1.8 to 0.42), and linezolid by 50% (1.0 to 0.5)(Figure1). In ICU, reductions were 48.6% for meropenem, 50% for vancomycin, with continued post-intervention decreases(Figure2). Challenges included physician resistance, risk-averse prescribing, and suboptimal diagnostics. Conclusion ASPs can be effectively implemented in resource-limited settings through leadership, education, and non-restrictive approaches. Success factors included collaborative methods, multimodal communication, continuous education, and transparent reporting. The post-prescription audit and feedback model maintained physician autonomy while reducing broad-spectrum antibiotic use. Disclosures All Authors: No reported disclosures
    Citas (OpenAlex): 0metric-badges.view 3
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Cardiac hydatidosis mimicking ischemic heart disease: A case report
    (2026-01-01)
    Chaponan-Lavalle, Andres
    ;
    Quiroz Cortegana, Cherie
    ;
    Gordillo Velasquez, Luis Ivan
    ;
    Caceres Pizarro, Jaime
    ;
    Diaz Reyes, Nelson Fidel  
    , is a zoonotic disease with cardiac involvement reported in less than 2 % of cases but associated with significant clinical challenges. We describe a 44-year-old woman from Peru who presented with exertional chest pain and T-wave inversions on electrocardiography. Imaging revealed a large multiloculated cystic mass with peripheral calcifications in the left ventricular wall, and Western Blot serology confirmed CE. The patient underwent surgical excision under cardiopulmonary bypass, followed by albendazole therapy. Histopathology confirmed a non-viable hydatid cyst. Postoperative recovery was uneventful, and she remained asymptomatic at 16-month follow-up. This case underscores the importance of considering cardiac hydatidosis in endemic regions when evaluating patients with angina-like symptoms in the presence of a cystic cardiac mass on imaging. Public awareness, improved medical education, and ongoing research are crucial to better managing this condition.
    Citas (OpenAlex): 0metric-badges.view 6
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Atypical presentation of Lyme disease in a returning traveler: a case report
    (2025-11-11)
    Salcedo, Andrea S.
    ;
    Carreras, Xosse
    ;
    Saavedra, Joe
    ;
    Saldaña, Sandy
    ;
    Diaz Reyes, Nelson Fidel  
    Lyme disease, caused by Borrelia burgdorferi and transmitted by Ixodes ticks, is rare in South America and is often misdiagnosed in returning travelers. We report the case of a 19-year-old Peruvian male who presented with pruritic erythematous maculopapular lesions and abdominal pain after travel to Maryland, United State of America. His atypical cutaneous findings, including a crusted lesion with ill-defined borders and a maculopapular rash, were initially misinterpreted as bacterial cellulitis, resulting in multiple unsuccessful courses of antibiotics. Further evaluation, guided by his travel history, led to the diagnosis of Lyme disease through serological testing and histopathology. Treatment with doxycycline achieved complete resolution. This case illustrates the diagnostic challenges posed by atypical presentations of Lyme disease in nonendemic regions. Greater awareness among clinicians in South America is essential to recognize imported cases, facilitate early diagnosis, and prevent complications associated with delayed treatment.
    Citas (OpenAlex): 1metric-badges.view 6
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Citas (OpenAlex): 2metric-badges.view 12
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Refractory livedoid vasculopathy successfully treated with immunosuppressive therapy
    (2025-10-15)
    Chaponan-Lavalle, Andres
    ;
    Quiroz Cortegana, Cherie
    ;
    Estrada-Grossmann, Jose M.
    ;
    Mena, Elar Quispe
    ;
    Diaz Reyes, Nelson Fidel  
    Citas (OpenAlex): 0metric-badges.view 1
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Lemierre-like syndrome after soft tissue infection due to methicillin-resistant Staphylococcus aureus: A case report and literature review
    (2024-02-16)
    Carreras, Xosse
    ;
    Salcedo, Andrea S.
    ;
    Ponce-Rosas, Linda
    ;
    Gonzales-Zamora, Jose A.
    ;
    Diaz Reyes, Nelson Fidel  
    RATIONALE: Lemierre-like syndrome (LLS) is characterized by bacteremia, septic thrombophlebitis of the internal jugular vein, and metastatic abscesses. In contrast to classic Lemierre syndrome, sources of infection are not related to oropharyngeal infections, as are frequent soft tissue infections. In recent years, Staphylococcus aureus has been identified as an emergent pathogen that causes this syndrome. The mortality rate of LLS caused by this pathogen is approximately 16%. Timely diagnosis, antibiotic treatment, and infection control are the cornerstones to treat LLS. Anticoagulant therapy as adjuvant treatment remains controversial. PATIENT CONCERNS: A 31-year-old woman from California, United States (US), was admitted to the emergency room with a history of 2 days of fever and severe throbbing pain in the left cervical region. Thorax and neck CT tomography revealed confluent cavities suggestive of septic embolism in the lungs and a filiform thrombus in the lumen of the left internal jugular vein, with moderate swelling of the soft and muscular tissues. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from the blood culture. DIAGNOSIS: The thrombus in the internal jugular vein associated with cellulitis in the neck and multiple cavitary lesions in the lungs support the diagnosis of LLS caused by MRSA with septic embolization. INTERVENTIONS: During treatment, the patient received vancomycin IV for 25 days and returned to the US with linezolid orally. In addition, assisted video-thoracoscopy and bilateral mini-thoracotomy with pleural decortication were performed for infectious source control, where 1700cc of purulent pleural fluid was drained. OUTCOMES: The patient was discharged with optimal evolution. LESSONS: LLS should be suspected in patients with skin and soft tissue infections who develop thrombosis or metastatic infections. MRSA infections should be considered in patients from areas where this pathogen is prevalent.
    Citas (OpenAlex): 3metric-badges.view 5
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Opsoclonus-Myoclonus Syndrome Possibly Associated With Mumps Infection
    (2022-10-01)
    Salazar, Ana Laura
    ;
    Kobayashi, Takaaki
    ;
    Salcedo, Andrea S.
    ;
    Carreras, Xosse
    ;
    Salinas, Jorge L.
    Opsoclonus-myoclonus syndrome (OMS) is an infrequent yet serious neurologic entity related to neoplastic, infectious, toxic, and metabolic diseases. In recent years, OMS associated with multiple infections have been reported. In contrast to neoplastic and autoimmune etiologies, OMS from infectious diseases occurs in younger patients and has a favorable outcome. Though the data are limited, the use of corticosteroids and immunotherapy remain the treatments of choice for the management of OMS symptoms. We present a patient case of OMS possibility associated with mumps virus in an immunocompetent young adult who was successfully treated with steroids.
    Citas (OpenAlex): 0metric-badges.view 7
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Acute appendicitis in intestinal malrotation. Case report.
    (2020-09-11)
    Febres Ramos, Richard J.
    ;
    Diaz Reyes, Nelson Fidel  
    Intestinal malrotation is a congenital abnormality of the embryological rotation of the intestine, it is estimated that more than 90% of patients with intestinal malrotation will be presented in the first 12 months of life. The clinical presentation in adults is manifested in a progressive way that usually occurs during the postprandial period, presenting: intermittent vomiting, abdominal pain, weight loss, chronic diarrhea, peritonitis, food intolerance, among Another. Treatment will depend on presentation, either acute or chronic, requiring emergency laparotomy to determine the cause. There is a case of acute surgical abdomen for acute appendicitis in a 27-year-old patient with intestinal malrotation, with initial clinical presentation of severe abdominal pain, diarrhea, positive lumbar percussion fist, which finally reached a Proper resolution and a good prognosis.
    Citas (OpenAlex): 2metric-badges.view 4
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Treatment Burden in Peru across Settings and Regions among People with Multiple Long-Term Conditions: A Cross-Sectional Study
    (2025-01-01)
    Miranda, J. Jaime
    ;
    Perez, Silvana
    ;
    Mendoza‐Quispe, Daniel
    ;
    Cuba-Fuentes, Maria Sofia
    ;
    Bazo-Alvarez, Juan Carlos
    Citas (OpenAlex): 0metric-badges.view 12
  • Publicación
    Algunas métricas están bloqueadas por su 
    configuración de consentimiento
    Item type:Publicación,
    Rhino-Orbital-Cerebral Mucormycosis in a Post-COVID-19 Patient from Peru
    (2022-03-15)
    Ponce-Rosas, Linda
    ;
    Gonzales-Zamora, Jose
    ;
    Diaz Reyes, Nelson Fidel  
    ;
    Alarco-Cadillo, Oliver
    ;
    Alave Rosas, Jorge Luis  
    Mucormycosis has been reported increasingly in patients affected by COVID-19, especially in India where the first cases were described. In Latin America, there is limited information about this association, mainly coming from Brazil, Mexico, and Peru. Herein, we report the case of a 66-year-old female that presented with rhino-orbital-cerebral mucormycosis, diabetic ketoacidosis, and COVID-19. The patient had the compromise of all the sinuses, orbital invasion, and intracranial extension. Isavuconazole was promptly initiated because amphotericin B was not available. She had a single open surgical debridement of necrotic tissues at the beginning of the diagnosis then multiple manual sessions to clear the residual or recurrent disease during approximately 5 months. Isavuconazole was effective and well-tolerated for 10 months without side effects. We highlight the importance of considering mucormycosis in post-COVID-19 patients with uncontrolled diabetes. The report emphasizes the favorable outcome of isavuconazole as an alternative therapy.
    Citas (OpenAlex): 5metric-badges.view 7