1/20. Pseudomonal pericarditis complicating cystic fibrosis.patients with advanced cystic fibrosis typically have chronic bacterial infection of the upper and lower respiratory tracts, but rarely develop extrapulmonary sites of infection. We report a case of purulent pericarditis due to Pseudomonas aeruginosa in a patient with cystic fibrosis and no other risk factors for pericarditis. This is a previously unreported complication in cystic fibrosis prior to lung transplantation.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/20. Improvement of c-reactive protein levels and body temperature of an elderly patient infected with pseudomonas aeruginosa on treatment with Mao-bushi-saishin-to.OBJECTIVE: To examine the effectiveness of Mao-bushi-saishin-to (Ma-Huang-Fu-Zi-Xi-Xin-Tang in Chinese medicine) (Tochimototenkaido Co. Ltd., Osaka, japan), one of the traditional herbal medicines, against resistant bacterial infection. SETTING: The nursing Center Himawari, Izumo, japan DESIGN, PATIENT, AND PREPARATION: Half of the standard dose of Mao-bushi-saishin-to was prescribed for 7 days to one elderly patient with fever and positive c-reactive protein (CRP) levels suffering from drug resistant pseudomonas aeruginosa. The daily standard dose of Mao-bushi-saishin-to is prepared from 1200 mg of dried extract obtained from three crude drugs, Ephedrae Herba (4 g), Asiasari Radix (3 g), and Aconiti Tuber (1 g). It is certified by the Japanese Ministry of health and Welfare. RESULTS: The patient's fever and CRP level returned to normal levels. CONCLUSIONS: In cases in which the fever does not fall in response to antibiotics for at least 3 days, half of the standard dose of Mao-bushi-saishin-to for 7 days might be worth trying to induce remission, especially for elder patients.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/20. Pseudomonas sepsis with neutrophagocytosis in a premature newborn.Secondary hemophagocytic syndrome may develop during certain severe infections commonly due to viral infections, but is rarely associated with bacterial infections, and its appearance in a premature newborn is uncommon. We present a case of hemophagocytosis during pseudomonas aeruginosa septicemia in a premature infant. After sepsis treatment with imipenem-cilastatin and aminoglycoside, remission of hemophagocytosis was achieved.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/20. Outbreak of pseudomonas aeruginosa by multiple organ transplantation from a common donor.Transmission of bacterial infections from donor to recipient may occur with donor bacteremia. We describe a novel mechanism for transmission of Pseudomonas to multiple recipients through direct contamination of a donor innominate artery graft. Patient data were collected by chart review from the donor and the kidney, kidney-pancreas, heart, lung, and liver recipients. The donor was not bacteremic but had P. aeruginosa isolated from routine tracheal cultures. Spillage of tracheal contents onto the innominate artery and subsequent contamination of intra-abdominal organs likely occurred. Vascular anastomotic infections with graft loss caused by Pseudomonas occurred in three patients (liver, kidney, and kidney-pancreas), and the lung patient developed severe pneumonia. All Pseudomonas isolates were identical by molecular typing. Donors may transmit bacterial infections to multiple recipients by mechanisms other than donor bacteremia. Although donor tracheal cultures are commonly positive, in certain settings antimicrobial treatment of recipients may be needed.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
5/20. Botryomycosis ('bacterial ball') of the sinonasal tract caused by pseudomonas aeruginosa.BACKGROUND: Botryomycosis is a chronic bacterial infection that typically presents as a cutaneous lesion. Visceral involvement may occur, but mucosal disease is uncommon. We report two cases of sinonasal tract botryomycosis that clinically simulated a neoplasm. methods: Two cases of sinonasal tract botryomycosis were identified from the Otolaryngic Tumor Registry at the Armed Forces Institute of pathology, washington, DC. The clinical records, slides, and paraffin blocks were available for both cases. Histochemical stains, including Brown and Hopps, Gomori's methenamine-silver, acid-fast bacilli, mucicarmine, periodic acid-Schiff, and Warthin-Starry, were performed. RESULTS: The patients were an 81-year-old man and a 43-year-old woman. The man presented with acute ethmoiditis and a bulging eye. Radiographic studies showed a soft tissue mass in his left maxillary antrum with osseous erosion of adjacent anatomic sites. The woman presented with persistent headaches of more than 1 year's duration, with increasing severity in the months prior to presentation. An expansile soft tissue mass was identified in her right maxillary and ethmoid sinuses. Surgery was performed on both patients. The histology included amorphous, acellular material and separate, rounded eosinophilic granules associated with a neutrophilic infiltrate. A Splendore-Hoeppli phenomenon was seen. Filamentous gram-negative bacilli, identifiable only by histochemical staining, were morphologically compatible with pseudomonas aeruginosa. Cultures of samples taken from both patients intraoperatively confirmed the organisms as P. aeruginosa. CONCLUSIONS: Sinonasal botryomycosis is a rare localized disease that may be mistaken clinically for an aggressive neoplasm. Complete surgical evacuation is curative.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
6/20. Acute severe deterioration in cystic fibrosis associated with influenza a virus infection.BACKGROUND: The role of non-bacterial infection in respiratory exacerbations of cystic fibrosis has been studied less than that of bacterial infection. Some non-bacterial infections, such as influenza A, may be associated with acute respiratory deterioration and may be preventable. methods AND RESULTS: Three patients with cystic fibrosis showed severe deterioration in lung function and general wellbeing during the influenza a virus epidemic in the winter of 1989-90. Serological confirmation of influenza a virus infection was obtained in each case. CONCLUSIONS: As immunisation against influenza a virus is safe and provokes an adequate antibody response in patients with cystic fibrosis, it is concluded that patients with cystic fibrosis should be offered immunisation at the beginning of each influenza season. Rapid diagnostic tests and the use of antiviral drugs may have a prophylactic role in minimising lung damage.- - - - - - - - - - ranking = 3keywords = bacterial infection (Clic here for more details about this article) |
7/20. Bacterial infection-induced generalized Hailey-Hailey disease successfully treated by etretinate.Hailey-Hailey disease (HHD; familial benign chronic pemphigus) is a hereditary blistering disorder characterized by episodic maceration and erosions mainly in intertriginous areas, and generalized eruptions are rarely seen. We report here a 51-year-old woman with generalized HHD who was successfully treated with oral etretinate. The present case suggests that oral etretinate is effective against the generalized eruptions even in cases in which bacterial infection has triggered the generalization of HHD.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
8/20. Fulminant pseudomonal keratitis and scleritis in human immunodeficiency virus-infected patients.patients with human immunodeficiency virus infection are predisposed to fungal, parasitic, and viral infections. Bacterial infection can also be seen, although ocular bacterial infections have not been reported in patients with acquired immunodeficiency syndrome until recently. We present two cases of Pseudomonas corneoscleritis and one case of Pseudomonas keratitis in patients with human immunodeficiency virus infection that failed to respond to antibiotic treatment. Predisposing factors included extended-wear soft contact lens use in one patient and exposure secondary to Bell's palsy in another patient. All three patients had neutropenia that may have contributed to their poor response to treatment. Enucleation was required to treat two patients with overwhelming infection. Enucleation has been rarely required for treatment of corneoscleritis in immunocompetent patients treated at our institution. Pseudomonas keratitis in human immunodeficiency virus-infected patients represents a serious ocular infection requiring early diagnosis and aggressive treatment.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
9/20. Utility of the indium 111-labeled human immunoglobulin g scan for the detection of focal vascular graft infection.The ability to diagnose and localize vascular graft infections has been a major challenge. Recent studies in animal models and humans with focal bacterial infection have shown that radiolabeled, polyclonal, human immunoglobulin g accumulates at the site of inflammation and can serve as the basis for an imaging technique. This study investigated this new technique for the diagnosis and localization of vascular graft infections. Twenty-five patients with suspected vascular infections involving grafts (22), atherosclerotic aneurysms (2), and subclavian vein thrombophlebitis (1) were studied. Gamma camera images of the suspected area were obtained between 5 and 48 hours after intravenous administration of 1.5 to 2.0 mCi (56 to 74 mBq) of indium 111-labeled, human, polyclonal immunoglobulin g. Scan results were interpreted without clinical information about the patient and were subsequently correlated with surgical findings, other imaging modalities, and/or clinical follow-up. In 10 of 10 patients found to have positive scan results, localized infections were confirmed at the involved sites. In 14 of 15 patients whose scan results were interpreted as negative, no vascular infections were identified at follow-up. The patient with false-negative results and recurrent bacteremia from an aortoduodenal fistula was found to have a negative scan outcome at a time when his disease was quiescent. These data suggest that nonspecific, human, indium 111-labeled immunoglobulin g scanning can be a useful noninvasive means of localizing vascular infections.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
10/20. Gangrenous cellulitis associated with gram-negative bacilli in pancytopenic patients: dilemma with respect to effective therapy.INTRODUCTION: Gangrenous (necrotizing) cellulitis is a progressive bacterial infection of skin and soft tissue; the infection can spread into subcutaneous tissue with involvement of superficial and deep fascia (necrotizing fasciitis). We describe two pancytopenic patients with polymicrobial gram-negative bacteremia and fulminating gangrenous cellulitis. case reports: pseudomonas aeruginosa was isolated from a localized hemorrhagic area of the face in one patient. The chronology of infection in these two patients is documented in a series of dramatic color photographs. Despite appropriate antibiotic therapy, the infections progressed relentlessly and both patients died. COMMENTS: We discuss the dilemma of establishing the correct diagnosis prior to the appearance of the characteristic cutaneous manifestations of hemorrhagic necrosis and gangrene. Once the diagnosis is established, surgical excision is universally recommended. Unfortunately, bleeding diatheses in pancytopenic patients with co-existing coagulation deficiencies pose logistic obstacles in urgent, real-life situations. The timing and conditions for surgery need to be elucidated in these patients. An approach to this infection is proposed. The utility of frozen-section biopsy of the involved tissue and computed tomographic scans of the involved area remains to be evaluated.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
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