1/14. herpes simplex peritonitis: case report.It has been previously reported that the most common cause of peritonitis in patients undergoing chronic ambulatory peritoneal dialysis (CAPD) is infection by a single gram-positive bacterial species. Polymicrobial bacterial infections are identified that may be secondary to bowel perforation. In 20% of cases bacterial cultures are negative. Although cultures may be negative when infection is due to a fastidious organism, when antibiotic therapy has been administered, and in cases of chemical peritonitis, a viral etiology should also be considered. We report the first documented case of herpes simplex peritonitis, which involved a 60-year-old female undergoing CAPD. Viral peritonitis may be an important form of peritonitis that has been previously unrecognized and should be considered in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/14. peritonitis due to mycobacterium fortuitum infection following gastric cancer surgery.mycobacterium fortuitum is a well-documented cause of nosocomial infection. However, no studies have reported peritonitis with M. fortuitum as a postoperative complication. We describe a case of peritonitis with M. fortuitum biovariant peregrinum following gastric cancer surgery. Gram-positive bacterial infection coexisted. Although the source of the infection was unclear, the patient was successfully treated with drainage tube exchange and combination therapy consisting of sparfloxacin, clarithromycin, and imipenem/cilastatin sodium. Thus for postoperative infectious pathogens, not only bacteria but also nontuberculous mycobacteria should be considered.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/14. Sclerosing encapsulating peritonitis and non-occlusive mesenteric infarction found at autopsy in a man who had undergone continuous ambulatory peritoneal dialysis: a histochemical and immunohistochemical study.This is a report of a post-mortem histological, histochemical, and immunohistochemical examination of a rare case of sclerosing encapsulating peritonitis (SEP) and non-occlusive mesenteric infarction (NOMI), two serious complications of continuous ambulatory peritoneal dialysis (CAPD), with which a man suffering hepatitis c virus (HCV)-induced liver cirrhosis for 7 years and trauma-induced paraplegia for 50 years had been treated for 1 year. The direct cause of death was encephalopathy caused by extreme hyperammonemia (11 250 microg/dL in serum). The autopsy revealed that the SEP had drastically reduced the length of the small intestine to 210 cm, 180 cm of which presented acute ischemic enteritis with Gram-negative bacterial infection. Histological examination of the SEP revealed that the exterior was composed of normal serosal elastic lamina, but with a cocoon-like appearance remarkably thickened by fibrosis to 3-8 times that of the normal subserosal layer and consisting of spindle cells and blood vessels, with some infiltration of mast cells and lymphocytes. The immunohistochemical examination of the spindle cells revealed few AE1/AE3( ) cells, HHF35( ) cells, and CD34( ) cells, many CD117( ) cells with slight proliferative activity based on MIB-1 positivity (proliferation index <1%), but no CD44( ) cells. It was concluded that either the few CD34( ) and/or the many CD117( ) cells were mesenteric stem cells that had originated from the serosa, proliferated, then differentiated into myofibroblasts or fibroblasts, producing collagen and hyaluronic acid in the matrix, leading to the gradual formation of the SEP, which was induced by the continual irritation of CAPD.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/14. Expanded-spectrum beta-lactamase producing klebsiella pneumoniae-related peritonitis in a patient on peritoneal dialysis.While hospitalized for pneumonia with ventilator-dependent respiratory failure, a 45-year-old man on continuous ambulatory peritoneal dialysis (CAPD) had nosocomial peritonitis secondary to infection by expanded spectrum beta-lactamase producing klebsiella pneumoniae (ESBL-Kp). He was treated successfully with a 3-week course of intraperitoneal (IP) flomoxef therapy without subsequent relapse, loss of peritoneal catheter, ultrafiltration failure, or dialysis inadequacy. The International consensus Panel recommends IP ceftazidime as the treatment of choice for CAPD patients suffering Klebsiella species-related peritonitis. However, the most appropriate form of IP antibiotic therapy and the outcomes for expanded-spectrum beta-lactamase (ESBL)-producing bacteria-related peritonitis for CAPD patients have not been established yet. Further, the ability to correctly report minimal inhibitory concentrations (MICs) of ceftazidime for ESBL bacteria in the resistant range varies between laboratories, making the diagnosis of ESBL-Kp-related CAPD peritonitis more complex and difficult. Thus, it appears reasonable to suggest that its incidence is probably underestimated and its significance ignored. The authors suggest that a 3-week IP treatment with flomoxef, a synthesized oxacephem, with loading and maintenance doses of 250 and 125 mg/L, respectively, is effective and safe for ESBL-Kp-related peritonitis in these patients. ESBL producing bacterial infection should be considered as a possible cause of overt CAPD-related peritonitis. Early detection of ESBLB pathogens and institution of effective antibiotic treatment may improve the prognosis.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
5/14. Spontaneous bacterial peritonitis following treatment for cervical carcinoma.Spontaneous bacterial peritonitis (SBP) is an acute bacterial infection usually associated with ascites and cirrhosis or is a complication of peritoneal dialysis. There are very few case reports of cancer patients who developed this disease. Furthermore, there have been no published case reports of successfully treated gynecological cancer patients who later developed SBP. We present a case involving a 41-year-old woman who was treated for cervical carcinoma in 1992. She underwent radical surgery and adjuvant chemoradiation therapy. Two years later, the patient presented with streptococcal group B cellulitis associated with left leg lymphedema. She recovered following antibiotic treatment but had recurrent episodes of streptococcal cellulitis in her leg over the past 10 years. In 2003, the patient was admitted to the hospital because of sepsis, acute renal failure, and SBP. She was treated and recovered following treatment. SBP is usually associated with cirrhosis. Although SBP is rarely seen in successfully treated gynecological cancer patients, oncologists should be aware of this clinical entity. Timely treatment is essential to maximize chances of survival.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
6/14. chylous ascites and encapsulating peritonitis: unusual complications of spontaneous bacterial peritonitis.Spontaneous bacterial peritonitis was diagnosed in a 36-yr-old woman 3 wk after she had delivered. The patient had no past history of abdominal or pelvic disease. ampicillin therapy was started and determined complete resolution of infectious manifestations. Ten days later, chylous ascites and chyluria were evidenced. Thereafter an ascitic effusion persisted for 2 months, when an occlusive syndrome developed, requiring emergency surgery. An encapsulating peritonitis was recognized, encasing small bowel loops, stomach and partially, pelvic organs. In this case, encapsulating peritonitis was most likely a consequence of simultaneous bacterial infection and transient lymphatic blockade. Both mechanisms should be considered in the development of this rare and usually unexplained disease.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
7/14. Spontaneous bacterial peritonitis.Spontaneous bacterial peritonitis is an infection of the ascitic fluid of patients who, in general, have severe chronic liver disease. Several variants of this disease exist including bacterascites, culture-negative neutrocytic ascites, and secondary bacterial peritonitis. Spontaneous bacterial peritonitis is frequently manifested by signs and symptoms of peritonitis although the findings may be subtle; however, occasionally it may be completely without clinical manifestation. The clinician must have a high index of suspicion in order to make this diagnosis at a relatively earlier stage of infection. An abdominal paracentesis is required to make the diagnosis of spontaneous bacterial peritonitis. This paracentesis should be performed on all patients who are admitted to the hospital for ascites and should be repeated if there is any manifestation of bacterial infection during the hospitalization. patients with severe intrahepatic shunting--as manifested by marked redistribution of activity from the liver to the spleen and to the bone marrow on liver-spleen scan as well as patients with an ascitic fluid total protein concentration of less than 1 g/dl--appear to be particularly susceptible to bacterial infection of their ascites. In order to optimize the yield of ascitic fluid culture, it is probably appropriate to inject blood culture bottles with ascites at the bedside immediately after the abdominal paracentesis. The mortality of spontaneous bacterial peritonitis continues to be very high. Perhaps routine admission paracentesis and prompt empiric antibiotic therapy with a third-generation cephalosporin will decrease the mortality of this infection if the Gram stain of the ascitic fluid demonstrates bacteria or the ascitic fluid neutrophil count is greater than 250 cells/cu mm. Repeating the paracentesis after 48 hours of treatment to reculture the fluid and reassess the ascitic fluid neutrophil count appears to be the best way to assess efficacy of treatment. After 48 hours of treatment the ascitic fluid neutrophil count should be less than 50% of the original value if the antimicrobial therapy is appropriate. The optimal duration of antibiotic treatment is unknown; however, until controlled trials provide data regarding duration of treatment it is appropriate to treat with parenteral antibiotics for 10 to 14 days. research is also needed to determine if there are measures which can be taken to prevent the development of spontaneous peritonitis.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
8/14. Severe jaundice as presenting symptom of generalized peritonitis following cesarean section.jaundice complicating severe bacterial infection has already been described; much less common is its occurrence as the presenting symptom of severe sepsis. A case is presented describing a patient who developed rapid increasing jaundice on the 4th day after an elective cesarean section, accompanied by deterioration in her general status. Various diagnostic means (abdominal CT, ultrasound investigation and hepatosplenic scanning) were performed in order to confirm or rule out the possibility of intraabdominal sepsis and the only finding on physical examination, being the absence of peristaltics. In spite of negative results of all the image processing techniques the patient underwent an explorative laparotomy on the 6th day, which revealed a generalized purulent peritonitis. It should be emphasized that: Severe jaundice maybe the presenting symptom of sepsis. False negative results of several modern image processing procedures may mislead the diagnostic approach and the subsequent therapeutic methods.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
9/14. Spontaneous bacterial peritonitis associated with cardiac ascites.A patient who developed fatal spontaneous bacterial peritonitis associated with cardiac ascites is reported. Spontaneous bacterial peritonitis most frequently occurs in patients with decompensated cirrhosis of alcoholic or nonalcoholic type. Although there are reports of spontaneous bacterial peritonitis occurring in patients with nephrotic syndrome, or with acute or chronic hepatitis, there appear to be no reports of spontaneous bacterial infection developing in cardiac ascites.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
10/14. Pseudoleukemia due to infection. A case report.A 29-year-old white female developed fever, vomiting, diarrhea, and hypovolemic shock. Twenty-four hours after resection of intraperitoneal adhesions she had granulocytopenia and leukopenia with a marked "left shift"; a bone marrow aspirate was interpreted as showing acute non-lymphocytic leukemia. The clinical presentation made this diagnosis unlikely and the subsequent course indicated that this was a reaction to bacterial infection.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
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