1/10. Acute fatty liver of pregnancy showing microbial infection in the liver.A 24-year-old, nulliparous woman in her 30th week of pregnancy was admitted due to threatened premature delivery. Ritodrin chloride relieved the premature contraction of the uterus but jaundice and drowsiness appeared 7 weeks later. Laboratory data revealed disseminated intravascular coagulation (DIC) with intrahepatic cholestasis, and ultrasound examination showed fatty liver. The patient was diagnosed with acute fatty liver of pregnancy (AFLP). Emergency delivery by Caesarean section was performed at 37 weeks of pregnancy and the liver function and DIC improved immediately. Liver biopsy 13 days after delivery showed nuclear swelling and cytoplasmic ballooning with mild fatty deposition. These findings were relatively compatible with acute AFLP. Higher magnification and electron microscopy revealed intracytoplasmic bacteria and fungus in the residual stage. The bacterial infection could be considered related to AFLP.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/10. vibrio vulnificus septicemia in a patient with the hemochromatosis HFE C282Y mutation.vibrio vulnificus is an extremely invasive gram-negative bacillus found in marine waters that causes overwhelming bacteremia and shock that is associated with high mortality. Impaired iron metabolism has been implicated in the susceptibility to V vulnificus bacterial infections. We report a case of fatal V vulnificus sepsis in a 56-year-old man who died within 1 to 3 days after consuming raw seafood. At autopsy, he was found to have micronodular cirrhosis and iron overload. Postmortem genetic analysis revealed the presence of the hemochromatosis gene (HFE) C282Y mutation. To our knowledge, this is this first documented fatal case of V vulnificus infection in a patient proven to carry the HFE C282Y mutation. Because this patient was heterozygous for the major hereditary hemochromatosis mutation and was not previously diagnosed with clinical iron overload, the spectrum of clinical susceptibilities to V vulnificus infection may include carriers of the C282Y mutation.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/10. Yersinia septic shock following an autologous transfusion in a pediatric patient.Although the literature on infections transmitted via transfused blood focuses on viruses, yersinia enterocolitica can also cause severe infections in patients receiving transfusions. A 13-year-old patient developed severe sepsis after an autologous blood transfusion contaminated with Y. enterocolitica. The patient was an otherwise healthy female undergoing posterior spinal fusion for congenital scoliosis. Prior to surgery, the patient donated blood for perioperative and postoperative use. A few days before the donation, she had complained of abdominal pain and was experiencing mild diarrhea. The patient received four units of packed red blood cells (PRBCs) during the surgery. Intraoperatively, the patient developed fever up to 103.6 degrees F, became hypotensive requiring epinephrine and dopamine, and developed metabolic acidosis with serum bicarbonate concentration dropping to 16 mmol/l. The surgery team believed the patient was experiencing malignant hyperthermia and attempted to cool patient during the procedure. Postoperatively, the patient was transferred to the pediatric intensive care unit and treated for severe shock of unknown etiology. The patient further developed disseminated intravascular coagulation. The patient received supportive care and was started on ampicillin/sulbactam on postoperative day (POD) one which was changed to clindamycin, ciprofloxacin and tobramycin on POD two when blood cultures grew gram-negative bacilli. On POD three, cultures were identified as Y. enterocolitica and antibiotics were changed to tobramycin and cefotaxime based on susceptibility data. Sequelae of the shock included adult respiratory distress syndrome requiring intubation and a tracheostomy and multiple intracranial hemorrhagic infarcts with subsequent seizure disorder. Due to severe lower extremity ischemia, she required a bilateral below the knee amputation. The cultures of the snippets from the bags of blood transfused to the patient also grew Y. enterocolitica. This case illustrates the importance of considering transfusion related bacterial infections in patients receiving PRBCs. All patients in shock following any type of transfusion may require aggressive antibiotic therapy, until the diagnosis and etiology are known.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/10. hiv infection presenting as severe autoimmune hemolytic anemia with disseminated intravascular coagulation in an infant.Autoimmune hemolytic anemia is rare in children. It is generally diagnosed in relation to a viral or bacterial infection but has also been described in association with drugs, autoimmune disease, malignancy, and immunodeficiency. The authors describe a 5-month-old infant who presented with severe autoimmune hemolytic anemia and disseminated intravascular coagulation as his initial manifestation of hiv infection.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
5/10. Promyelocytic leukaemoid reaction: an atypical presentation of mycobacterial infection.A young woman presented with mild pyrexia and antepartal haemorrhage due to disseminated intravascular coagulation. She had pancytopenia in the peripheral blood and granulocytic maturation arrest at the promyelocyte stage in the bone marrow. Her urine and bone marrow grew mycobacterium kansasii on culture. Antituberculous treatment eliminated the infection and restored the normality of bone marrow and peripheral blood.- - - - - - - - - - ranking = 4keywords = bacterial infection (Clic here for more details about this article) |
6/10. Postsplenectomy pneumococcemia in adults.We describe two adults with fulminant pneumococcemia and disseminated intravascular coagulation aftertraumatic splenectomy. One died in a few days, and the other survived with amputation of gangrenous toes and fingers. Although the relationship between the serious blood-borne bacterial infection with disseminated intravascular coagulation and lack of adequate splenic tissue has been well established, the mechanism is poorly understood and there are no specific therapeutic measures available. We review the literature in regard to the possible prophylactic measures and discuss the benefits of various measures.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
7/10. Circulating factor xi antibody and disseminated intravascular coagulation.association of a circulating factor xi anticoagulant and disseminated intravascular coagulation (DIC) is described in a 33-year-old woman. Although the patient had rheumatoid arthritis and a bacterial infection treated with antibiotics, the anticoagulant was thought to be secondary to systemic lupus erythematosus. Curiously, the low levels of factor xi did not prevent the DIC from developing.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
8/10. Spontaneous rupture of the liver in pregnancy.A case of spontaneous rupture of the liver in pregnancy, fatal to mother and child, is described. The patient, a multiparous, 36-year-old diabetic, presented in the 27th week of pregnancy with upper abdominal pains resembling biliary dyskinesia. After 8 hours' observation in the hospital she suddenly developed hypovolaemic shock and fetal heart tones disappeared. On acute cesarean section a dead fetus was delivered. Hemoperiteoneum was present, arising from a huge subcapsular hematoma of the right lobe of the liver, with rupture of Glisson's capsule. The hematoma was evaluated and tears in the liver parenchyma sutured. Disseminated intravasal coagulation complicated the early postoperative cause. A bacterial infection supervened later and the patient died in a septic stage on the 19th postoperative day. The literature is reviewed, and it is pointed out that greater awareness of the diagnosis could lead to better timing of surgery and an improved prognosis for mother and child.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
9/10. Severe autoimmune protein s deficiency in a boy with idiopathic purpura fulminans.Idiopathic purpura fulminans usually occurs in young children and is frequently preceded by a preparatory viral or bacterial infection. Following a severe streptococcal pharyngitis, an 8-year-old boy developed purpura fulminans with disseminated intravascular coagulation and severe protein s deficiency (total antigen < 0.05 u/ml). Despite generous plasma infusions, skin necrosis progressed rapidly into compartment syndrome which required fasciotomy and skin grafting and resulted in the loss of three digits of the right foot. Total protein S remained low for over a month despite plasma supplementation and complete normalization of protein c levels. A polyclonal anti-protein S IgG was demonstrated in the patient's plasma, which decreased to 25% of baseline titre after 1 month and was undetectable 6 months after purpura fulminans, when plasma protein S had returned to normal. Transient, isolated and severe deficiencies of protein S have been reported in patients with idiopathic purpura fulminans and a previous preparatory infection. Autoimmune protein s deficiency may play a key role in the aetiopathogenesis of idiopathic purpura fulminans.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
10/10. Lobectomy for traumatic pulmonary pseudocysts with disseminated intravascular coagulation: case report.A 10-year-old boy was injured in a traffic accident, and computed tomography revealed cavitary pulmonary lesions in the left lower lobe. Although there was no evidence of bacterial infection, thrombocytopenia due to disseminated intravascular coagulation progressed. We performed a left lower lobectomy, and the patient improved rapidly.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
| | Next -> |