1/6. An amebic lung abscess: report of a case.Recently the number of amebiasis cases has increased in japan. Pleuropulmonary amebiasis is a very rare complication of liver amebiasis. We report herein the case of a 54-year-old man presenting with an amebic lung abscess in his right lower lung. The diagnosis of lung amebiasis was established from a direct examination of the pus in which trophozoites of entamoeba histolytica were detected. After the oral administration of metronidazole, the laboratory findings improved and he thus underwent a right lower lobectomy. He was discharged without any relapse of infection 20 days after a thoracotomy. We conclude that a protozoan infection should thus be suspected in the case of a pleuropulmonary infection in which several types of antibiotics prove to be ineffective.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/6. myxedema ileus. A form of intestinal pseudo-obstruction.myxedema ileus uncommonly complicates the hypothyroid state. It is a rare cause of intestinal pseudo-obstruction that can be reversed with thyroid hormone therapy. Our two patients with myxedema ileus had concurrent infection. Intestinal ileus was completely reversed with the administration of thyroid hormone.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/6. piperacillin/tazobactam-induced paresthesiae.OBJECTIVE: To describe a case of a delayed-type hypersensitivity (DTH) reaction to piperacillin/tazobactam in which painful paresthesiae were a predominant feature. CASE SUMMARY: A 27-year-old man with a history of intravenous drug abuse was admitted for treatment of a pulmonary parenchymal abscess in the setting of lower-limb deep-venous thrombosis and methicillin-sensitive staphylococcus aureus bacteremia. He was treated with intravenous piperacillin/tazobactam 4.5 g 3 times daily; however, after 2 weeks of therapy, he developed symptoms (eg, fever, chills) and laboratory abnormalities (eg, white blood cell count 2.1 x 10(3)/mm3, erythrocyte sedimentation rate 63 mm/h) suggestive of a DTH reaction. This was accompanied by infusion-related painful paresthesiae. The symptoms and laboratory abnormalities resolved within 48 hours of treatment being switched to flucloxacillin. DISCUSSION: Due to the close temporal association and the absence of any other obvious explanation, we believe these paresthesiae represent an additional feature of the DTH reaction to piperacillin/tazobactam in this patient. Use of the Naranjo probability scale indicated a probable relationship between the paresthesiae and administration of piperacillin/tazobactam. CONCLUSIONS: To our knowledge, as of March 24, 2006, this is the first case in which a DTH reaction to piperacillin/tazobactam manifesting as fever, neutropenia, and thrombocytopenia has been associated with paresthesiae.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/6. Complications of postoperative intrapleural BCG in lung cancer.Sixty-four patients received bacillus Calmette- Guerin (BCG) in different dosages intrapleurally through a chest drain following resection for lung cancer. In 27 patients this procedure was followed by fever for a few days; the fever was attributed to the BCG. Late complications attributable to the BCG included recurrent fever in 4 patients, abscesses at the site of the drain in 4, wound infections in 2, consolidations on the chest roentgenogram in 3, 1 of whom had subsequent cavitation, and hemoptysis in 2. Side-effects were not dose-dependent. No relationship was found between the preoperative tuberculin response and the frequency or severity of complications. Treatment with isoniazid and rifampin failed to induce an apparent clinical response in patients with complications. We conclude that the intrapleural administration of BCG is not a safe procedure. The side-effects may considerably impair the patient's quality of life.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/6. lemierre syndrome: postanginal sepsis.BACKGROUND: lemierre syndrome, or postanginal sepsis, was first described in the early part of this century and is characterized by pharyngitis, followed by high fever and rigors, cervical adenopathy, thrombophlebitis of the internal jugular vein, distant abscess formation, and icterus, associated with isolation of fusobacterium necrophorum from blood. methods: This report describes a case of postanginal sepsis and reviews the medical literature on postanginal sepsis obtained through the medline data base using Fusobacterium as the key search word. RESULTS: The features of lemierre syndrome have changed little since the original description, through the prognosis has improved dramatically since the development of antibiotics. Appropriate management includes prompt administration of an antibiotic with good anaerobic coverage, drainage of persistent abscesses, and continued antibiotic therapy until radiographic resolution of abscess is achieved. CONCLUSIONS: Although lemierre syndrome is a relatively uncommon disease, the primary care physician needs to be aware of the clinical features and management to treat appropriately.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/6. Disseminated infection due to actinomyces meyeri: case report and review.actinomyces meyeri is rarely isolated in cases of actinomycosis. We present a case of disseminated actinomycosis due to A. meyeri; the patient had an abscess of the lung, osteomyelitis of the tibia, and multiple skin abscesses. Cure was achieved with surgical debridement and administration of intravenous penicillin, followed by oral penicillin, for 1 year. A concomitant gram-negative bacillus, actinobacillus actinomycetemcomitans, was also isolated. review of the literature revealed only 26 well-documented cases of infection with A. meyeri. male adults are mainly affected, and alcoholism is frequently the underlying condition in these patients. Associated bacteria were isolated in two-thirds of these cases. In contrast to other species of actinomyces, A. meyeri often causes pulmonary infection and shows a tendency for hematogenous dissemination. Even though multiple organs are involved, the outcome for these patients is excellent when penicillin is administered for several months and surgical procedures are performed when necessary.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |