1/110. Necrotizing pneumococcal pneumonia in childhood.We describe the rare complication of necrotizing pneumonia and invasive pneumococcal infection in 3 previously healthy pediatric patients. Lobar consolidation and pleural effusions appeared initially, followed within several days by the appearance of multiple small lucencies in the area of consolidation. In one case, necrosis progressed to a large abscess cavity. Surgical intervention was limited to treatment of pleural space complications. There were no deaths. Pulmonary parenchymal residual was limited to a thin-walled cavity in one case.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/110. pneumonectomy in cystic fibrosis.A 17-year-old boy and a 12-year-old girl with cystic fibrosis (forced expiratory volume in 1 sec, 36% and 14% of predicted values, respectively) developed severe right-sided lung infections with abscess formations and complete atelectases unresponsive to medical therapy. In both patients, unilateral emergency pneumonectomy resulted in rapid clinical improvement. Despite her severe underlying lung disease, the girl experienced a remarkable increase in quality of life; 2 years after surgery, she died from respiratory failure. The male patient has now survived for 4 years, and lung transplantation still remains a therapeutic option for him. We believe that pneumonectomy is a valuable rescue therapy for patients with cystic fibrosis and intractable unilateral lung infections who are at high risk of dying while waiting for lung transplantation.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
3/110. Response of complicated methicillin-resistant staphylococcus aureus endocarditis to the addition of trovafloxacin.The newer fluoroquinolones have many properties such as safety, bioavailability, and tissue penetration that make them attractive in the therapy of complicated infections. Unfortunately, the rapid development of resistance by Staphylococcus aureus to ciprofloxacin has dampened interest in these agents for serious staphylococcal infections. A patient with right-sided methicillin-resistant staphylococcus aureus (MRSA) endocarditis with a complicated clinical course received trovafloxacin in addition to vancomycin and rifampin. He was initially treated with vancomycin, gentamicin, and rifampin for serious MRSA infection, but because of complications, including septic central nervous system emboli, persistent fever, and leukocytosis, gentamicin was stopped and trovafloxacin begun. After this addition the patient improved and completely recovered. in vitro and animal model data show that many newer fluoroquinolones have excellent activity against S. aureus, including MRSA, and are also less likely to induce resistance. Animal models of endocarditis support their efficacy in serious staphylococcal infections.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
4/110. Swyer-James syndrome complicated by lung abscess.Swyer-James syndrome, a rare disease with unilateral hyperlucent lung due to bronchiolitis obliterans and pulmonary artery hypoplasia, generally develops after lower respiratory tract infection during early childhood. Invasive procedures, including bronchoscopy and angiography, are often necessary for a definitive diagnosis. We report a 17-year-old man admitted because of cystic bronchiectasis complicated by lung abscess. Chest roentgenography showed the typical findings of Swyer-James syndrome. Noninvasive magnetic resonance angiography was used to confirm hypoplasia of the right pulmonary artery. The patient received antibiotic therapy, underwent a right lower lobectomy for the lung abscess, and recovered.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
5/110. Disseminated aspergillosis in a renal transplant patient: Diagnostic difficulties re-emphasized.An asymptomatic and radiographically occult lung abscess was the primary focus of infection in this case of fatal disseminated aspergillosis in a renal transplant recipient. Extensive neurological evaluation in response to a change in personality failed to reveal a brain abscess, which was the cause of death. This case illustrates the variability in presentations of aspergillosis and the continuing difficulties in diagnosing this infection in immunosuppressed patients.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
6/110. Persistent legionella infection in a patient after bone marrow transplantation.We report on a patient who developed legionella pneumonia after bone marrow transplantation. Despite appropriate antibiotic treatment, disease progressed. The patient developed a lung abscess from which legionella and prevotella were isolated. Cure was achieved by surgical resection. The resected material was sterile, but 16S ribosomal dna analysis revealed legionella dna.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
7/110. Congenital cystic adenomatoid malformation in an adult presenting as lung abscess.The case of a 21-year-old male with congenital cystic adenomatoid malformation is presented. His medical history started after his birth with recurrent pulmonary infections during his infancy. lung abscess of the right lower lobe was suspected and right lower lobectomy was performed to remove a sizeable mass infiltrating the largest part of the lobe. The clinical features, diagnostic procedures, differential diagnosis, pathologic characteristics, therapeutic assessment, etiopathology and prognosis of the tumor are discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/110. aspergillus flavus mitral valve endocarditis after lung abscess.A 16-year-old male with bone marrow failure due to chemotherapy for recurrent acute lymphoblastic leukemia developed an abscess in the lower lobe of the left lung draining through a bronchogastric fistula, as well as mitral valve endocarditis with large vegetations. After a course of antifungal therapy, the left lobe was removed and the fistula closed. The mitral valve was then replaced, after a failed attempt at valve repair, by a mechanical, double-leaflet prosthesis. microscopy of the lung and heart specimens disclosed hyphae. Cultures of both specimens on Sabouraud's medium recovered a fungus, which was identified by culturing on Czapek's medium as aspergillus flavus. Despite further antifungal therapy, fatal embolism developed. The emboli contained the same A. flavus as the valve and lung specimens. This case confirms the grim prognosis of primary Aspergillus endocarditis in immunocompromised patients, and suggests that delayed surgical treatment and the presence of another focus of Aspergillus infection may increase the risk of death.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/110. Lemierre's syndrome presenting as multiple lung abscesses.Lemierre's syndrome is thrombophlebitis of the internal jugular vein (IJV), complicating an oropharingeal infection. The causative organism is fusobacterium, an anaerobic bacillus, and the syndrome typically occurs in previously healthy teenagers and young adults. Thromboembolic metastases are a common sequela, and the lungs are most frequently affected. We present a case of a 25-year-old woman, who presented with multiple lung abscesses, in whom IJV thrombophlebitis was subsequently noted.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
10/110. Bronchial atresia with relapsing pulmonary infection in a middle-aged man.Congenital bronchial atresia (CBA) is a rare disorder, first reported in 1953. Less than 100 cases are reported in the literature, mostly in young, asymptomatic male patients with involvement of the apical-posterior segment of the left upper lobe. patients may complain of fever, cough, or shortness of breath, symptoms that result from post-obstructive, sometimes recurrent, infections. Chest radiography and computed tomography reveal a tubular branching density representing mucus impaction or mucocele with surrounding focal hyperinflation. Surgical excision is reserved for symptomatic cases. We report an unusual case of CBA in a middle-aged man with a history of relapsing infections, who was found to have an atretic superior segment of the left lower lobe, with surrounding areas of organizing pneumonia.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
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