1/4. Brucellar spinal epidural abscess of cervical location: report of four cases.Spinal epidural abscesses account for 1 or 2 of every 10,000 hospital admissions, staphylococcus aureus being the bacterium most frequently involved. brucellosis is a disorder of worldwide distribution, relatively frequent in south america and in Mediterranean countries in europe and africa. Whilst in the USA only 200 cases are reported every year, in spain it is the most frequent zoonosis. This systemic disease seldom produces spondylodiscitis which in a minority of cases may be complicated by spinal epidural abscesses, in general of lumbar location. The purpose of this article is to analyse 4 cases of brucellar spinal epidural abscess of cervical location and diagnosed in the Province of Teruel, spain, an endemic area for the disease, through 10 consecutive years (1990-1999). We consider noteworthy the following facts: the first case was a technical employee who acquired the infection in our laboratory of microbiology, the second presented with an extensive purulent collection invading prevertebral and retropharyngeal regions, the third case was cured only with antibiotics without residual deficits. In the fourth case we were not able to demonstrate spondylodiscitis accompanying the epidural abscess at the C2-C6 levels. We discuss especially the epidemiological aspects of brucellosis, the existence of epidural abscess without spondylodiscitis, the clinical manifestations, the diagnosis by means of magnetic resonance imaging, specific serological tests for Brucella, antibiotic treatment and the prognosis of our cases.- - - - - - - - - - ranking = 1keywords = bacterium (Clic here for more details about this article) |
2/4. Infective endocarditis in renal transplant recipients.Because of the increasing number of renal transplantations performed and the rarity of reported cases of infective endocarditis in these patients, we studied the clinical characteristics of this infection in this population. We report on two cases from our experience and review reported cases of infective endocarditis in renal transplant recipients retrieved from the medline system. In addition, we reviewed a large series of infective endocarditis looking for patients with renal transplants. In addition to our 2 cases, 12 previously reported cases were found. The mean time from transplantation to diagnosis of infective endocarditis was 3.5 years (range 2 months to 15 years). Causative organisms included fungi, staphylococcus aureus (3 cases each), corynebacterium sp. (2 cases), streptococcus viridans, VRE, Brucella sp., clostridium sp., nocardia sp. and erysipelothrix sp. (one case each). skin manifestations of endocarditis and/or splenomegaly were not reported in these patients. Septic emboli and mycotic aneurysms were relatively common. The overall mortality rate was 50% (7 of 14 patients died). Infective endocarditis seems to be rare in renal transplant recipients. The few reported cases are characterized by unusual causative micro-organisms and atypical clinical presentation. Further studies are needed to delineate the magnitude and scope of this association.- - - - - - - - - - ranking = 1keywords = bacterium (Clic here for more details about this article) |
3/4. brucella melitensis: review of the human infection case.During the last several years, brucellosis has become an important public-health problem on a large territory part of Bosnia and Herzegovina. The disease belongs to the zoonosis group, and can be caused by several bacterium species from Brucella genus. For human and veterinarian medicine, B. abortus, B. melitensis, B. suis and B. canis from Brucella genus are important, while other brucella species are found only in animals. The results of laboratory process of isolating brucella melitensis, as well as of detection of specific antibacterial antibodies, are presented in this work. Namely, B. melitensis was isolated from blood samples (chemo-culture), as a causal agent of disease in one sixty years-old patient, treated during 2001. In pair serum samples of the patient, the presence of specific anti-brucella antibodies was confirmed qualitatively and quantitatively. In the serum I, ELISA test confirmed the presence of specific IgM antibodies of 25,7 U/ml, and IgG antibodies of 252 U/ml. In the serum II, IgM antibodies of 24,9 U/ml, and IgG antibodies of 311 U/ml were found. These results suggest and confirm established work diagnosis, and etiology causality of the disease with isolated bacterium.- - - - - - - - - - ranking = 2keywords = bacterium (Clic here for more details about this article) |
4/4. Infective endocarditis caused by uncommon bacteria.The present study is an attempt to define the uncommon bacteria (UB) causing endocarditis and to evaluate their prevalence and clinical significance. review of 13 series (including ours) revealed that UB were the infecting organisms in 105/1989 patients (5.3%). The leading bacteria were: Pneumococcus, haemophilus sp., corynebacterium sp., neisseria sp., streptobacillus moniliformis, cardiobacterium hominis and erysipelothrix sp. These data are similar to those obtained from 111 sporadic case reports published in English during the last 6 yr and cited in the Index Medicus. infection by UB usually resembles that by the common bacteria. However, haemophilus sp. seems to affect mainly the young and is associated with major arterial occlusions, and Brucella is claimed to have a greater affinity to the aortic valve. UB are more frequent in patients with polymicrobial infections and their diagnosis is often delayed. Greater awareness to the possibility of infections with UB is needed for early diagnosis and improved prognosis.- - - - - - - - - - ranking = 2keywords = bacterium (Clic here for more details about this article) |