1/978. Septic arthritis following arthroscopic meniscus repair: a cluster of three cases.Three cases of staphylococcus epidermidis septic arthritis following inside-out arthroscopic meniscus repair within a 4-day period at the same facility are described. All three patients responded to surgical debridement and 4 to 6 weeks of intravenous antibiotics. In each instance, the meniscus and repair sutures were left intact; 12- to 38-month follow-up revealed no evidence of infection or meniscal symptoms. Epidemiological investigation implicated the meniscus repair cannulas as one of the few factors common to all three cases. molecular typing of bacterial dna revealed that two of the three isolated organisms showed identical pulsed-field gel electrophoretic patterns, implying a common source of inoculation. Experimental contamination of the cannulas revealed that only sterilization involving ultrasonification, lumen washing by water jet, and steam sterilization resulted in clean and sterile cannulas.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/978. Familial deficiency of the seventh component of complement associated with recurrent bacteremic infections due to Neisseria.The serum of a 29-year old woman with a recent episode of disseminated gonococcal infection and a history of meningococcal meningitis and arthritis as a child was found to lack serum hemolytic complement activity. The seventh component of complement (C7) was not detected by functional or immunochemical assays, whereas other components were normal by hemolytic and immunochemical assessment. Her fresh serum lacked complement-mediated bactericidal activity against neisseria gonorrhoeae, but the addition of fresh normal serum or purified C7 restored bactericidal activity as well as hemolytic activity. The absence of functional C7 activity could not be accounted for on the basis of an inhibitor. Opsonization and generation of chemotactic activity functioned normally. Complete absence of C7 was also found in one sibling who had the clinical syndrome of meningococcal meningitis and arthritis as a child and in this sibling's clinically well eight-year-old son. HLA histocompatibility typing of the family members did not demonstrate evidence for genetic linkage of C7 deficiency with the major histocompatibility loci. This report represents the first cases of C7 deficiency associated with infectious complications and suggests that bactericidal activity may be important in host defense against bacteremic neisseria infections.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
3/978. Pylephlebitis associated with appendicitis.Pylephlebitis usually occurs secondary to infection in the region drained by the portal venous system. A most common antesecent focus of infection is diverticulitis and the most common blood isolate is E. coli (54%), followed by proteus mirabilis (23%). overall mortality is 32% and most of the patients who had died had severe sepsis prior to the initiation of antibiotic therapy. We describe a case of pylephlebitis which had appendicitis and consequent septic thrombosis of the portal vein and its branches, with dissemination of infection to the liver. The patient had recovered due to timely antibiotic treatment alone and resulted in complete resolution. early diagnosis and treatment are basic to a favorable clinical course.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
4/978. Rapid and definitive diagnosis of infectious diseases using peripheral blood smears.A timely diagnosis is essential in the management of septicemia and septic shock. Three patients are described, all of whom presented with fever and one of whom was hypotensive at the time of admission. In each patient, rapid diagnosis of the cause of fever was possible because microorganisms were identified on a peripheral blood smear obtained at the time of admission. This identification permitted prompt initiation of appropriate antimicrobial therapy. In addition, a literature review of use of peripheral blood smears in the diagnosis of bacterial, fungal, and parasitic infections is provided.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
5/978. Systemic lupus erythematosus complicated by necrotizing fasciitis.A case of necrotizing fasciitis (NF) is described in a 46-year-old woman with recent onset systemic lupus erythematosus (SLE). Deep-tissue infections are more common in SLE patients on high-dose corticosteroids, but, to our knowledge, this is the second case described in association with SLE. Although NF may initially be difficult to diagnose, the presence of marked systemic symptoms out of proportion to the local findings should suggest the correct diagnosis. NF diagnostic criteria, treatment and prognosis are discussed.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
6/978. erythema nodosum secondary to meningococcal septicaemia.We report a case of erythema nodosum (EN) secondary to neisseria meningitidis infection in a 77-year-old woman. histology of two biopsy specimens from two different lesions showed characteristic features of EN. blood culture showed neisseria meningitidis group C.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
7/978. Staphylococcal coronary arteritis as a complication of septicemia.We describe a case of staphylococcal coronary arteritis in the setting of sepsis due to arteriovenous fistula and dialysis catheter infection. The left circumflex coronary artery was the only vessel involved. The patient was a 77-year-old, insulin-dependent diabetic man with chronic renal failure. The immunosuppressed state in diabetes with subsequent septicemia may have facilitated a large number of bacteria to lodge in the atheromatous plaque of the coronary artery. We briefly review previously reported cases and suggest that bacterial arteritis may be an underrecognized cause of acute coronary occlusion.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
8/978. Staged operative treatment in a septic patient with an infected, unstable pelvis, and a missed bladder rupture.This case demonstrates once again the potential and serious complications of pelvic fractures, especially when associated urogenital injuries are missed. Missing the bladder rupture proved almost fatal to our patient. Second, it was confirmed that in very unstable pelvic fractures, external fixation alone does not provide enough stability. Local stability is the cornerstone in the treatment of (bone) infection, and in these cases, maximal stability is only obtainable with internal fixation. The advantages of metal implants in infected areas outweigh the disadvantages by far. For the bladder-rupture, we chose a two-stage approach. First, we performed a urinary diversion, to avoid surgical closure of the infiltrated bladder wall. All cavities, including the open bladder, were packed with omentum to fill the dead space with highly vital tissue to offer stout resistance to infection. Two years later, with the patient in excellent physical condition, urinary undiversion was carried out. Ultimately physical and social recovery was complete.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
9/978. Community-acquired methicillin-resistant staphylococcus aureus: a cause of musculoskeletal sepsis in children.Between August 1996 and August 1997, 130 children were admitted to our pediatric orthopaedic unit with Staphylococcus aureus musculoskeletal infection. Twenty-six of the 130 staphylococcal isolates were resistant to methicillin, an incidence of 20%. All but one of the infections, a femoral fixator-pin infection, were community-acquired. Twenty-two of the infections were superficial; however, there were four cases of deep musculoskeletal sepsis due to methicillin-resistant S. aureus. In areas where methicillin-resistant S. aureus is prevalent in the community, methicillin resistance should be considered in any overwhelming staphylococcal infection not responding to conventional antibiotics despite adequate surgical debridement.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
10/978. vibrio cholerae O2 sepsis in a patient with AIDS.vibrio cholerae strains other than O1 and 0139 (non-O1 vibrio cholerae) are associated with sporadic diarrheal disorders and limited outbreaks of diarrhea and have often been reported in association with extraintestinal infections. The following is a presentation of a fatal case of non-O1 vibrio cholerae septicemia with disseminated intravascular coagulation and cutaneous bullous lesions that occurred in a patient infected with the acquired immunodeficiency syndrome. In order to prevent vibrio cholerae infection, patients with underlying diseases should be warned of the risk factors for acquiring such infection, including consumption of raw shellfish and exposure to sea and fresh water where shellfish are found.- - - - - - - - - - ranking = 3keywords = infection (Clic here for more details about this article) |
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