Cases reported "Gastrointestinal Diseases"

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1/6. Open-label, multicentre, emergency-use study of clinafloxacin (CI-960) in the treatment of patients with serious life-threatening infections.

    In an open-label emergency-use study, 23 patients with bacterial infections caused by multiply drug resistant pathogens were treated with clinafloxacin. Efficacy and safety were evaluated by tabulating investigators' assessments at the end of treatment, treatment discontinuations and adverse event data. Most of the patients were seriously ill and had multi-organ infections, primarily respiratory tract infections such as nosocomial pneumonia and gastrointestinal infections. Eleven patients were successfully treated, two had treatment failure and 10 were not evaluable because the patients died of their underlying disease. Considering that most of the patients had several infections caused by multiply resistant pathogens, clinafloxacin may be useful for the treatment of such life-threatening episodes.
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keywords = bacterial infection
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2/6. Isolated gastric malakoplakia: a case report and review of the literature.

    A 62-year-old African American woman presented with weight loss and dyspepsia. She did not have any clinical evidence of immunodeficiency. Upper gastrointestinal endoscopy revealed multiple small polypoid lesions in the gastric body and fundus that appeared larger and more erythematous than usual fundic gland polyps. Examination of biopsy specimens revealed an infiltrate of large histiocytes with eosinophilic granular cytoplasm located in the lamina propria and containing Michaelis-Gutmann bodies. These histologic findings were diagnostic of gastric malakoplakia. Gastrointestinal malakoplakia is uncommon, and exclusive gastric involvement is extremely rare. Because occult bacterial infection has been postulated as the underlying cause of malakoplakia, the presence of helicobacter pylori infection was investigated using immunohistochemical and serologic techniques, and the presence of yersinia enterocolitica or yersinia pseudotuberculosis infection was investigated by polymerase chain reaction assay. There was no evidence of H pylori, Y enterocolitica, or Y pseudotuberculosis in these biopsy specimens, and there was no evidence of malakoplakia or concurrent malignancy at any other site. Follow-up examination 12 months later revealed no endoscopic or histologic improvement.
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keywords = bacterial infection
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3/6. Three rare cases of anthrax arising from the same source.

    anthrax is an acute bacterial infection caused by bacillus anthracis. humans become infected under natural conditions by contact with infected animals or contaminated animal products. About 95% of human anthrax is cutaneous and 5% respiratory. Gastrointestinal anthrax is very rare, and has been reported in less than 1% of all cases. anthrax meningitis is a rare complication of any of the other three forms of disease. We report three rare cases of anthrax (gastrointestinal, oropharyngeal and meningitis) arising from the same source. The three patients were from a single family and were admitted with different clinical pictures after the ingestion of half-cooked meat from a sick sheep. These cases emphasize the need for awareness of anthrax in the differential diagnosis in areas where the disease remains endemic.
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ranking = 1
keywords = bacterial infection
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4/6. Disseminated strongyloides stercoralis infection.

    A case of disseminated S stercoralis is an immunosuppressed patient manifested with diarrhea, a rash, and progressive respiratory insufficiency. The parasites were eradicated with thiabendazole despite continued steroid therapy, and the patient survived the hospitalization. The characteristics of S stercoralis allow it to be harbored within a host for prolonged periods of time, only to disseminate once cell-mediated immunity is suppressed. A diagnosis of strongyloidiasis should be considered in an immunocompromised patient with a petechial rash. Prompt diagnosis and initiation of thiabendazole therapy provides the greatest opportunity for patient survival. Secondary bacterial infections should be aggressively sought. mortality from disseminated strongyloidiasis approaches 80%.
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ranking = 1
keywords = bacterial infection
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5/6. hiv infection and Salmonella septic arthritis.

    Human immunodeficiency virus (hiv) infection predisposes to bacterial infection at may sites but septic arthritis is notably uncommon. An hiv seropositive patient who presented with oligoarticular septic arthritis due to salmonella enteritidis and who responded poorly to antibiotic therapy and repeated aspiration of involved joints is described. Unusual features included the clinical presentation of septic arthritis in more than one joint, a protracted clinical course with radiological destruction of the hip, bone marrow suppression induced by cotrimoxazole, and death thought to be due to a gastropathy induced by non-steroidal anti-inflammatory therapy at a time when the septic arthritis appeared to have responded to treatment. Cure of Salmonella septic arthritis in hiv infected patients may be difficult and require aggressive prolonged treatment. Septic arthritis should be considered in the differential diagnosis in a patient with hiv infection and arthritis.
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ranking = 1
keywords = bacterial infection
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6/6. invasive pulmonary aspergillosis in a critically ill neonate: case report and review of invasive aspergillosis during the first 3 months of life.

    We report a fatal case of invasive pulmonary aspergillosis in a severely ill neonate and review 43 additional cases of invasive aspergillosis reported from 1955 through 1996 that occurred during the first 3 months of life. Eleven of the 44 patients had primary cutaneous aspergillosis, 10 had invasive pulmonary aspergillosis, and 14 had disseminated disease. Most infections were nosocomial in origin. Prematurity (43%); proven chronic granulomatous disease (14%); and a complex of diarrhea, dehydration, malnutrition, and invasive bacterial infections (23%) accounted for the majority of underlying conditions. At least 41% of the patients had received corticosteroid therapy before diagnosis, but only one patient had been neutropenic. Among patients who received medical and/or surgical treatment, outcome was relatively favorable, with an overall survival rate of 73%. Invasive aspergillosis may occur in neonates and young infants and warrants consideration under certain circumstances. Current therapeutic approaches consist of high-dose amphotericin b and appropriate surgical interventions.
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ranking = 1
keywords = bacterial infection
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