1/29. Primary peritonitis due to group A streptococcus.Primary peritonitis is a rare condition occurring, by definition, in patients without underlying causes, such as perforated viscus, pre-existing ascites, or nephrosis. We report a case of primary peritonitis and shock due to group A beta-hemolytic streptococcus, a rare etiology. A review of the world's literature shows a predilection for women to have this condition. The entry site is obscure in most cases. Asymptomatic genital tract colonization may be a portal of entry in some women. shock or toxic shock syndrome often accompany the abdominal findings. laparotomy to exclude a perforated viscus may be unavoidable. Despite the significant morbidity, expeditious and appropriate antibiotic therapy is curative.- - - - - - - - - - ranking = 1keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
2/29. Recurrent bacteremic peritonitis caused by enterococcus cecorum in a patient with liver cirrhosis.enterococcus cecorum (formerly Streptococcus cecorum), originally isolated from poultry intestines, has rarely been encountered in human diseases. A 60-year-old man with liver cirrhosis and hepatocellular carcinoma developed peritonitis on the seventh day of his hospitalization. Cultures of one blood sample and one ascites fluid sample obtained on that day both grew E. cecorum. The patient received intravenous cefoxitin therapy and initially responded well. Unfortunately, another episode of peritonitis associated with septic shock developed 24 days after the start of treatment, and culture of one blood specimen yielded the same organism. The isolates were identified by the conventional biochemical tests, the API Rapid ID 32 Strep system, and the API ZYM system (both systems from bioMerieux, Marcy L'Etoile, france) and were further confirmed by cellular fatty acid chromatography and 16S rRNA gene partial sequencing. The identical biotype, antibiotype, and random amplified polymorphic dna pattern of the three isolates documented the long-term persistence of this organism in the patient. To the best of our knowledge, this is the first clinical description of recurrent bacteremic peritonitis caused by E. cecorum.- - - - - - - - - - ranking = 0.15689813376433keywords = shock, septic shock (Clic here for more details about this article) |
3/29. Necrotizing proctitis caused by streptococcus pyogenes.We report the case of a 65-year-old patient with peritonitis, septicaemia and toxic shock syndrome in whom the primary focus of infection was acute purulent proctitis with necrosis. streptococcus pyogenes serotype T28R28 was isolated from blood culture and peritoneal pus. The patient recovered after a prolonged period of intensive therapy and four abdominal operations including anterior resection of the rectum. We believe this to be the first clinical description of streptococcal necrotizing proctitis.- - - - - - - - - - ranking = 0.90328582636124keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
4/29. Spontaneous uterine perforation of pyometra. A report of three cases.BACKGROUND: Spontaneous perforation of pyometra is a rare cause of generalized peritonitis; only 17 cases have been reported. CASES: Three cases of spontaneous perforation of pyometra occurred; two were associated with carcinoma of the cervix. All were treated with exploratory laparotomy and drainage. The first patient died of recurrent carcinoma of the cervix five months after laparotomy. The second patient died of septic shock shortly after the operation. The third patient made a good postoperative recovery. CONCLUSION: pyometra is a serious medical condition, because of both its association with malignant disease and the danger of spontaneous perforation, which carries significant morbidity and mortality. Although rare, ruptured pyometra should be considered in the differential diagnosis of acute abdomen in elderly women, especially those with malignant disorders of the genital tract. The treatment of pyometra rupture is immediate laparotomy, peritoneal lavage and drainage, or simple hysterectomy.- - - - - - - - - - ranking = 0.15689813376433keywords = shock, septic shock (Clic here for more details about this article) |
5/29. Streptococcal toxic shock syndrome revealed by a peritonitis. Case report and review of the literature.Group A streptococcus (GAS) or streptococcus pyogenes cause a variety of life-threatening infectious complications including necrotizing fasciitis, purpura fulminans and streptococcal toxic shock syndrome (STSS). exotoxins that act as superantigens are felt to be responsible for STSS. These exotoxins are highly destructive to skin, muscle and soft tissue. This syndrome has a rapid and fulminant course with frequently fatal outcome. GAS remains sensitive to penicillin but in serious infection a combination of clindamycin and ceftriaxone or meropenemum is recommended. Several studies have shown that mortality was dramatically reduced in STSS patients treated with immunoglobulin g given intravenously (IVIG). Early recognition of this most rapidly progressive infection and prompt operative debridement are required for successful management. This report presents a female patient at two month post-partum with a peritonitis and multi-organ failure.- - - - - - - - - - ranking = 4.5164291318062keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
6/29. Invasive group a streptococcus associated with an intrauterine device and oral sex.BACKGROUND: peritonitis due to group A Streptococcus (GAS) and toxic shock syndrome occurred in a previously healthy 45-year-old woman with an intrauterine device. The intrauterine device was believed to be the portal of entry. In addition, her husband was found to be an asymptomatic carrier of GAS in his oropharynx. GOAL: The goal was to increase physicians' awareness of oral sex as a risk factor for transmission of invasive GAS disease. STUDY DESIGN: This is a case report of the development of GAS peritonitis and toxic shock syndrome in a woman after acquisition of the organism through oral sex. RESULTS: The GAS strains isolated from the patient and her husband were identical in their M-type, T-type, and exotoxin gene pattern. CONCLUSION: Because the couple practices oral sex, it was postulated that this was the mode of transmission of the GAS.- - - - - - - - - - ranking = 1.8065716527225keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
7/29. Streptococcal toxic shock syndrome manifesting as peritonitis in a child.Streptococcal toxic shock syndrome (TSS) with the initial manifestation of peritonitis is rare. We report the case of a 5-year-old girl who presented with peritonitis and shock. Emergency laparotomy was performed but no perforated visceral organ was found. Acute respiratory distress syndrome, impaired renal function, and coagulopathy developed later. Group A beta-hemolytic Streptococcus (GAS) was isolated from the pleural effusion and the diagnosis of streptococcal TSS was made. This association highlights the need for thorough examination and close observation in the management of childhood peritonitis.- - - - - - - - - - ranking = 4.613143305445keywords = toxic shock syndrome, shock syndrome, toxic shock, shock (Clic here for more details about this article) |
8/29. adult staphylococcus scalded skin syndrome in a peritoneal dialysis patient.staphylococcal scalded skin syndrome (SSSS), a generalized exfoliative dermatitis complicating infections by exfoliative toxin-producing strains of Staphylococcus aureus, is rarely observed in adults, especially in those with chronic renal failure. In contrast to the mortality in infants, the mortality in adults is usually high. A case of generalized SSSS in a peritoneal dialysis patient is reported. A-62-year old Japanese man in whom peritoneal dialysis had been carried out was admitted to our hospital with acute peritonitis. It was intractable peritonitis in terms of resistance to various antibiotics; however, improvement of the peritonitis was shown after the injection of vancomycin. Nine days after the completion of this medication, erythema appeared in the eyes and mouth, and around the nostrils, with an exothermic reaction at 39.0 degrees C. Radial cracks formed in the face within a few days, and the erythema rapidly expanded to the neck, axilla, the whole body. The blood pressure was also lowered, and this led to a state of shock. culture of skin biopsy specimens yielded identical strains of S. aureus. A presumptive diagnosis of SSSS was made. The patient was treated with antibiotics that were effective against the organisms and with both fluid supplementation and dopamine, resulting in subsidence of the signs and symptoms. The exothermic reaction and skin symptoms were improved promptly, with improvement in the general condition, including the state of shock. This appears to be the first reported case of SSSS caused by S. aureusin an adult patient with peritoneal dialysis who was treated successfully. It is very important that SSSS be differentiated from toxic epidermal necrosis, as the treatment is different.- - - - - - - - - - ranking = 0.19342834727752keywords = shock (Clic here for more details about this article) |
9/29. enterocolitis due to methicillin-resistant staphylococcus aureus--report of two cases.Two cases of postoperative enterocolitis due to methicillin-resistant staphylococcus aureus (MRSA) after gastrectomy were experienced. Case 1: A 59-year-old male underwent subtotal gastrectomy for advanced gastric cancer. Diffuse peritonitis progressed after the first operation, so reoperation for drainage was required. Two days after the second operation, a profuse watery diarrhea developed. Case 2: A 46-year-old male underwent total gastrectomy for early gastric cancer. On the fourth postoperative day, frequent vomiting and cholera-like diarrhea started, followed by profound shock several hours later. Both cases were treated successfully by the administration of vancomycin. Stool cultures of both cases revealed MRSA and it had the same minimal inhibitory concentration, coagulase type and enterotoxin type, so that nosocomial infection was indicated.- - - - - - - - - - ranking = 0.096714173638758keywords = shock (Clic here for more details about this article) |
10/29. Cecal volvulus: a report of two cases occurring after the antegrade colonic enema procedure.BACKGROUND: Many children with chronic constipation and fecal incontinence have benefited from the antegrade colonic enema (ACE) procedure. Routine antegrade colonic lavage often allows such children to avoid daytime soiling. This report describes 2 children in whom the ACE procedure was complicated by a cecal volvulus. methods: A retrospective review of 164 children with an ACE procedure was conducted. Two instances of cecal volvulus were identified. RESULTS: The first child presented with abdominal pain and difficulty intubating the ACE site. Over the subsequent day, his pain worsened, and radiographs depicted a colonic obstruction. At laparotomy, a cecal volvulus resulting in bowel necrosis was observed, and resection of the affected bowel and appendix (in the right lower quadrant) and end ileostomy was required. He subsequently had the stoma closed and a new ACE constructed with a colon flap. The second child presented with shock and evidence of an acute abdomen. At laparotomy, a cecal volvulus was noted, and ileocolic resection including the ACE stoma (located at the umbilicus) and an ileostomy and Hartmann pouch was performed. He had a protracted hospital course requiring ventilator and inotropic support. He currently is well and still has an ileostomy stoma. CONCLUSIONS: A high index of suspicion for a potentially life-threatening cecal volvulus should be maintained in children undergoing an ACE procedure who present with abdominal pain, evidence of bowel obstruction, or difficulty in advancing the ACE irrigation catheter.- - - - - - - - - - ranking = 0.096714173638758keywords = shock (Clic here for more details about this article) |
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