1/8. Clinical and pathologic characteristics of nontyphoidal salmonella encephalopathy.OBJECTIVE: To investigate the clinical and pathologic characteristics of primary encephalopathy caused by nontyphoidal salmonellosis (NTS). methods: Case records of six Japanese hospitals from 1994 to 1999 were reviewed. Eight cases of primary NTS encephalopathy were identified based on strictly defined criteria: 1) encephalopathic feature defined as altered state of consciousness, altered cognition or personality, or seizures; 2) detection of nontyphoidal Salmonella species in stool; 3) absence of other viral or bacterial infection associated with CNS abnormalities; and 4) absence of alternative explanation by underlying neurologic or systemic disease. Three patients died, three had severe sequelae, and two recovered completely. The authors analyzed their clinical course, neurologic symptoms, and histopathologic findings. RESULTS: NTS encephalopathy was clinically characterized by diffuse and rapidly progressive brain dysfunction and circulatory failure that developed following enteritis. There was no evidence of severe dehydration or sepsis, and encephalopathy was rarely accompanied by abnormal laboratory data, except elevated CSF opening pressure, brain edema on CT, and slow waves on EEG. Pathologic findings included minimal ischemic damage and mild edema in the brain, microvesicular fatty change of the liver, severe enterocolitis but no evidence of dehydration, and no fatal organ damage including microvasculature and endothelial cells. CONCLUSION: Noninfectious encephalopathy associated with nontyphoidal salmonella infection is a distinctive clinical entity that can be differentiated from Reye's syndrome and Ekiri.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/8. enzyme replacement therapy in the management of longstanding skeletal and soft tissue salmonella infection in a patient with Gaucher's disease.A splenectomised patient with Gaucher's disease who developed multiple foci of osteomyelitis and soft tissue abcesses, after a severe episode of group C salmonella sepsis, is described. Aggressive antibiotic treatment and surgical drainage had little effect and the patient's condition continued to deteriorate. With initiation of enzyme replacement therapy (ERT) in addition to specific antibiotic treatment, defervescence and gradual healing occurred. Complete resolution of the infection was seen after 15 months. The possible role of ERT in healing bacterial infections in Gaucher's disease is discussed.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/8. Susceptibility to mycobacterial infections due to interferon-gamma and interleukin-12 pathway defects.A case of interferon-gamma (IFN-gamma)/interleukin-12 (IL-12) pathway defect is presented. Pathophysiology, clinical characteristics, diagnostic test, and case management are reviewed. Clinical Pearls and Pitfalls include: (1) A high probability of a defect in the IFN-gamma/IL-12 cascade exists in patients with disseminated or recurrent infection due to poorly pathogenic mycobacteria or systemic infections caused by non-typhi Salmonella species that are persistent and recurrent despite antibiotic therapy. (2) Although less frequent, patients with impaired IFN-gamma/IL-12 mediated immunity are more susceptible to cytomegalovirus, human herpesvirus 8, herpes simplex virus, listeria monocytogenes, and histoplasma capsulatum.- - - - - - - - - - ranking = 4keywords = bacterial infection (Clic here for more details about this article) |
4/8. Atypical bacterial infections explained by a concomitant virus infection.Because both viral and bacterial infections are common during early childhood, dual infections are not unexpected. However, the clinical manifestation of such combined infections may be, difficult to interpret, and they are often misdiagnosed as "atypical bacterial infection." Five patients with concomitant viral-bacterial infections are described. In all five cases, virus detection enabled the physicians to better understand an otherwise puzzling clinical presentation. In view of the recent progress in rapid viral diagnoses and the potential of antiviral drugs, the possibility of dual infection should be investigated more often.- - - - - - - - - - ranking = 7keywords = bacterial infection (Clic here for more details about this article) |
5/8. An open study of ceftazidime in the treatment of serious bacterial infection.ceftazidime, a new parenteral cephalosporin, was given by intravenous bolus injection to 50 patients admitted to hospital with a variety of serious infections. These included septicaemia, bronchopulmonary, urinary, gastro-intestinal and soft tissue infections. The drug proved to be effective against a wide range of organisms, notably opportunistic pseudomonas aeruginosa infections. In the 32 patients with positive cultures there was a cure rate of 85%. All Ps. aeruginosa infections were eradicated, but two relapsed post treatment in patients with recurrent urinary infections related to indwelling catheters. The drug was well tolerated and no serious side effects occurred. Two patients with salmonella septicaemia relapsed after an initial clinical response, and one of these died.- - - - - - - - - - ranking = 4keywords = bacterial infection (Clic here for more details about this article) |
6/8. Concurrent systemic lupus erythematosus and salmonellosis.Salmonellosis was diagnosed in 4 patients with systemic lupus erythematosus (SLE). Three patients were taking prednisolone, and 3 had evidence of nephritis. All patients were febrile with clinical evidence of lupus activity at the time of diagnosis. Two patients had evidence of hyposplenism during the infection. Because salmonellosis manifests clinical symptoms like those of active SLE, the diagnosis of the salmonella infection was delayed. In 3 patients, the salmonella infection localized to a site of clinical SLE involvement and in all 4 patients, it occurred simultaneously with other bacterial infections. Multiple factors, including impaired mononuclear phagocytic system function, may predispose SLE patients to bacterial infections, especially intracellular parasites such as salmonella.- - - - - - - - - - ranking = 2keywords = bacterial infection (Clic here for more details about this article) |
7/8. hiv infection and Salmonella septic arthritis.Human immunodeficiency virus (hiv) infection predisposes to bacterial infection at may sites but septic arthritis is notably uncommon. An hiv seropositive patient who presented with oligoarticular septic arthritis due to salmonella enteritidis and who responded poorly to antibiotic therapy and repeated aspiration of involved joints is described. Unusual features included the clinical presentation of septic arthritis in more than one joint, a protracted clinical course with radiological destruction of the hip, bone marrow suppression induced by cotrimoxazole, and death thought to be due to a gastropathy induced by non-steroidal anti-inflammatory therapy at a time when the septic arthritis appeared to have responded to treatment. Cure of Salmonella septic arthritis in hiv infected patients may be difficult and require aggressive prolonged treatment. Septic arthritis should be considered in the differential diagnosis in a patient with hiv infection and arthritis.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
8/8. Mycotic aneurysm leading to iliac arteriovenous fistula diagnosed by vascular duplex color scan.arteriovenous fistula between common iliac vessels is uncommon. Most of the reported cases are secondary to lumbar disc surgery. Mycotic aneurysm of iliac vessels caused by bacterial infection is even rarer. We describe the case of a 63 year old man with dyspnea, abdominal pain, bipedal edema, chills and fever. He had a right common iliac AVF as a result of a ruptured salmonella mycotic aneurysm, and the diagnosis was made by vascular duplex color scan.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |