1/823. Late complications of Silastic duraplasty: low-virulence infections. Case report.The authors describe three patients with expanding hemorrhagic mass lesions who presented 13 to 18 years after undergoing Silastic duraplasty. In all patients, results of bacteriological cultures of the masses obtained intraoperatively were positive, revealing low-virulence bacteria. Two of the patients were treated with antibiotic drugs and made a good recovery. The third did not receive antibiotic medications initially and later developed an epidural empyema that necessitated reoperation, but subsequently made a complete recovery. Vascularized neomembranes are generally agreed to be causes of the expanding masses, but the possibility that patients could be harboring chronic infections must be considered. Thus, on removal of duraplasty materials a complete bacteriological culture should be obtained, and if it is positive the proper antibiotic therapy should be administered. Furthermore, the creation of a registry of patients who have received implants is advocated to facilitate tracking of implanted material in case of complications.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/823. Crohn's disease presenting as septic thrombophlebitis of the portal vein (pylephlebitis): case report and review of the literature.Septic thrombophlebitis of the portal vein, or pylephlebitis, is an extremely rare complication of intraabdominal infection, most commonly caused by diverticulitis (1). The following case report describes a patient without previous significant medical history presenting with painless jaundice and presumed malignancy. Workup revealed pylephlebitis due to an ileal abscess secondary to Crohn's disease. The patient was successfully treated with broad spectrum antibiotics and terminal small bowel and right colon resection. To our knowledge, this is the first reported case of Crohn's disease diagnosed after presentation with pylephlebitis.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
3/823. Value of 111indium leukocyte scanning in febrile organ transplant patients.Immunosuppressed febrile organ transplant patients present a diagnostic and therapeutic dilemma since symptomatology is often altered by immunosuppression, which also masks the location of infection. Fifty 111indium leukocyte ( 111In WBC) scans were performed to determine their usefulness in the organ transplant patient. The results were compared with computerized tomography (CT) and gallium 67-citrate (Ga) scanning. Eleven patients received both 111In WBC and Ga scans; 22 received both 111In WBC and CT scans. Ten 111In WBC scans had subtraction of 99m Tc sulfur or albumin colloid for liver evaluation and four 111In WBC scans had subtraction of 99m Tc DMSA for kidney evaluation. The overall sensitivity and specificity for 111In WBC scans was 90% and 90%, respectively. lung uptake was sensitive (89%) and specific (97%) for pulmonary infections, including bacterial, fungal and cytomegalovirus pneumonias. Renal graft uptake occurred in 15 cases (41%), all except 2 being due to rejection, pyelonephritis, urinary tract infections, or cytomegalovirus infections. pyelonephritis and renal abscesses were diagnosed in 3 cases with 99m Tc DMSA subtraction. Perihepatic abscesses (2), and infected liver cysts (4) were diagnosed with 99m Tc sulfur or albumin colloid subtraction. There were five false-negative CT scans and three false-negative Ga scans. Therefore, when compared with 111In: sensitivity = 88% vs 64% (CT), specificity = 80% vs 86% (CT); and sensitivity = 111In 90% vs 67% (Ga), specificity = 100% for both 111In WBC and Ga scans.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 0.8keywords = infection (Clic here for more details about this article) |
4/823. Postoperative infection of lumbar intervertebral disk space.Sixteen cases of postoperative intervertebral disk space infection are reviewed. Most occurred after diskectomy, but one followed an unsuccessful attempt at a spinal anesthetic and two followed diskography. Treatment varied from aggressive surgery, either by a posterior, lateral, or anterior approach, to drain the infected disk space or spaces, to more conservative immobilization. Antibiotics were used in all cases. Needle biopsy is valuable in establishing diagnosis and identifying the organism and its antibiotic sensitivities. In some cases fusion occurred spontaneously from the infection; in others, fusion was a result of surgical fusion preceding or following the infection.- - - - - - - - - - ranking = 1.4keywords = infection (Clic here for more details about this article) |
5/823. stenotrophomonas (xanthomonas) maltophilia infection in necrotizing pancreatitis.CONCLUSION: Although the therapy of infected pancreatic collections or organized pancreatic necrosis remains surgical, we have demonstrated that infected organized pancreatic necrosis can be treated endoscopically. BACKGROUND: stenotrophomonas (xanthomonas) maltophilia has been increasingly recognized as a nosocomial pathogen associated with meningitis, pneumonia, conjunctivitis, soft tissue infections, endocarditis, and urinary tract infections. This organism is consistently resistant to imipenem, a drug commonly employed in patients with necrotizing pancreatitis to prevent local and systemic infections. methods AND RESULTS: We report the first case of infected pancreatic necrosis by S. (X.) maltophilia. Our patient was treated successfully with endoscopic drainage of the pancreatic fluid collection and appropriate antibiogram-based antibiotic therapy. Endoscopic drainage has emerged as one of the treatment modalities for pancreatic fluid collections.- - - - - - - - - - ranking = 1.4keywords = infection (Clic here for more details about this article) |
6/823. Treatment of skin and soft tissue infections with cefadroxil, a new oral cephalosporin.Oral cefadroxil in doses of 0-6-1-8 g per day given on twice or three times daily schedules was effective in the treatment of thirty-six patients with infections such as abscesses, carbuncles, cellulitis, furunculosis and impetigo. staphylococcus aureus strains and beta-haemolytic streptococci, alone or in combination, were cultured from lesions before treatment. in vitro studies with test discs showed that all the organisms were sensitive to cefadroxil, but twenty-three of twenty-nine S aureus strains and one of the seven streptococci strains were resistant to penicillin g. Pre- and post-treatment laboratory tests of renal, hepatic and haematopoietic functions produced no evidence of drug toxicity. The cefadroxil dosage effective in this study is lower than that recommended for currently available oral cephalosporins, which must be given on a four times daily schedule.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/823. Cerebral bacterial aneurysms in subacute bacterial endocarditis.Bacterial aneurysms are aneurysms which develop on a vascular wall weakened as a result of a bacterial infection. They can develop anywhere. This paper describes a female patient with subacute bacterial endocarditis and multiple cerebral aneurysms. Conservative treatment followed.- - - - - - - - - - ranking = 6.0759604957035keywords = bacterial infection, infection (Clic here for more details about this article) |
8/823. Generalized tetanus in a patient with a diabetic foot infection.tetanus is a preventable disease that continues to affect people in the united states due to poor immunization practices in our health care system. A 57-year-old man with type 2 diabetes mellitus, hypertension, and end-stage renal disease with many hospital admissions came to the hospital emergency department because of a blackened great toe. He denied pain in the toe or knowledge of foot injury. The patient also complained of temporomandibular tenderness accompanied by inability to open his mouth completely. The man's problems progressed to generalized tetanus and required a long hospitalization. clostridium tetani can flourish in the anaerobic environment of a diabetic foot infection. Practitioners should be aware of tetanus as a rare but potentially serious complication of diabetic foot infections.- - - - - - - - - - ranking = 1.2keywords = infection (Clic here for more details about this article) |
9/823. Loss of endothelial surface expression of e-selectin in a patient with recurrent infections.Neutrophil accumulation at sites of inflammation is mediated by specific groups of cell adhesion molecules including the beta2 (CD18) integrins on leukocytes and the selectins (P- and e-selectin on the endothelium and l-selectin on the leukocyte). This is supported by studies of patients with leukocyte adhesion deficiency syndromes whose leukocytes are genetically deficient in the expression of beta2 integrins or selectin carbohydrate ligands (eg, sialyl-Lewis(x)). However, inherited deficiency or dysfunction of endothelial cell adhesion molecules involved in leukocyte recruitment has not been previously described. In this report we describe a child with recurrent infections and clinical evidence of impaired pus formation reminiscent of a leukocyte adhesion deficiency syndrome, but whose neutrophils were functionally normal and expressed normal levels of CD18, l-selectin, and sialyl-Lewis(x). In contrast, immunohistochemical staining of inflamed tissue from the patient showed the absence of e-selectin from the endothelium, although e-selectin mRNA was present. However, e-selectin protein was expressed as significantly elevated levels of circulating soluble e-selectin were detected, the molecular size of which was consistent with a proteolytically cleaved form of e-selectin. Gene sequencing failed to show evidence of a secreted mutant variant. These data represent, to our knowledge, the first description of a potentially inherited dysfunction of an endothelial cell adhesion molecule involved in leukocyte recruitment and provide additional human evidence of the importance of endothelial selectins in the inflammatory response.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/823. Endogenous endophthalmitis: case report and brief review.Endogenous endophthalmitis is a potentially blinding ocular infection resulting from hematogenous spread from a remote primary source. The condition is relatively rare but may become more common as the number of chronically debilitated patients and the use of invasive procedures increase. Many etiologic organisms (gram-positive, gram-negative and fungal) have been reported to cause endogenous endophthalmitis. risk factors are well defined and include most reasons for immune suppression. A high clinical suspicion is needed for early diagnosis and treatment. Early intravenous antibiotic therapy remains the cornerstone of treatment. The roles of intravitreal antibiotics and vitrectomy are evolving and may become more widely accepted as therapeutic modalities. The authors report a case of endogenous endophthalmitis and provide a brief review of the literature.- - - - - - - - - - ranking = 0.2keywords = infection (Clic here for more details about this article) |
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