1/11. central nervous system (CNS) tuberculosis following allogeneic stem cell transplantation.tuberculosis is an uncommon infectious complication after stem cell transplantation. We report a patient who presented with a brain mass, 3 months after pulmonary tuberculosis had been diagnosed and while he was receiving triple antituberculous therapy. He had extensive chronic GVHD. The diagnosis was made after biopsy of the lesion. The cerebral mass was excised, antituberculous treatment was maintained and the patient made a complete neurologic recovery. Six months later, he died of gram-negative septic shock. Mycobacterial infections should be considered in allograft recipients with chronic GVHD and solid lesions in the brain. bone marrow transplantation (2000) 25, 567-569.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/11. Acquired subglottic stenosis caused by methicillin resistant staphylococcus aureus that produce epidermal cell differentiation inhibitor.Local infection of the trachea in intubated neonates is one of the main risk factors for development of acquired subglottic stenosis, although its role in the pathogenesis is unclear. methicillin resistant staphylococcus aureus (MRSA) is often the cause of critical illness in neonatal patients. Two cases are reported of acquired subglottic stenosis following bacterial infection of the trachea, suggesting an association with the staphylococcal exotoxin, epidermal cell differentiation inhibitor (EDIN). EDIN-producing MRSA were isolated from purulent tracheal secretions from both infants. Acquired subglottic stenosis in both cases was probably caused by delayed wound healing as the result of EDIN inhibition of epithelial cell migration.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
3/11. Yersinia septic shock following an autologous transfusion in a pediatric patient.Although the literature on infections transmitted via transfused blood focuses on viruses, yersinia enterocolitica can also cause severe infections in patients receiving transfusions. A 13-year-old patient developed severe sepsis after an autologous blood transfusion contaminated with Y. enterocolitica. The patient was an otherwise healthy female undergoing posterior spinal fusion for congenital scoliosis. Prior to surgery, the patient donated blood for perioperative and postoperative use. A few days before the donation, she had complained of abdominal pain and was experiencing mild diarrhea. The patient received four units of packed red blood cells (PRBCs) during the surgery. Intraoperatively, the patient developed fever up to 103.6 degrees F, became hypotensive requiring epinephrine and dopamine, and developed metabolic acidosis with serum bicarbonate concentration dropping to 16 mmol/l. The surgery team believed the patient was experiencing malignant hyperthermia and attempted to cool patient during the procedure. Postoperatively, the patient was transferred to the pediatric intensive care unit and treated for severe shock of unknown etiology. The patient further developed disseminated intravascular coagulation. The patient received supportive care and was started on ampicillin/sulbactam on postoperative day (POD) one which was changed to clindamycin, ciprofloxacin and tobramycin on POD two when blood cultures grew gram-negative bacilli. On POD three, cultures were identified as Y. enterocolitica and antibiotics were changed to tobramycin and cefotaxime based on susceptibility data. Sequelae of the shock included adult respiratory distress syndrome requiring intubation and a tracheostomy and multiple intracranial hemorrhagic infarcts with subsequent seizure disorder. Due to severe lower extremity ischemia, she required a bilateral below the knee amputation. The cultures of the snippets from the bags of blood transfused to the patient also grew Y. enterocolitica. This case illustrates the importance of considering transfusion related bacterial infections in patients receiving PRBCs. All patients in shock following any type of transfusion may require aggressive antibiotic therapy, until the diagnosis and etiology are known.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/11. Fatal necrotizing fasciitis of dental origin.Necrotizing fasciitis is a potentially fatal, acute bacterial infection characterized by extensive fascial and subcutaneous tissue necrosis. Four factors that contribute significantly to the morbidity and mortality of necrotizing fasciitis are: 1) delayed treatment, due to difficulty in recognizing the condition; 2) inappropriate treatment; 3) host debilitation; and 4) a polymicrobial infection.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
5/11. ecthyma gangrenosum and septic shock syndrome secondary to chromobacterium violaceum.chromobacterium violaceum is a gram-negative bacterium of soil and water in tropical and subtropical environments. Typically, it is considered a bacterium of low virulence although, uncommonly, it causes human infection, particularly in persons with defects in host defenses. Infection generally follows exposure of broken skin to contaminated water and soil, and is often characterized by pustules, lymphadenitis, fever, and vomiting, as well as rapid dissemination and a high mortality rate. Unfortunately, because C violaceum is ubiquitous, it is often dismissed as a contaminant when cultured. Because rapid diagnosis (by taking appropriate specimens) and treatment are vital to a good prognosis, it is imperative that physicians be aware of this organism. In addition, patients with chromobacterial infections should have an immunologic workup because infections in immunocompetent individuals are rare. Here we report an aggressive yet nonfatal case of C violaceum septicemia in an adolescent male, diagnosed through a punch biopsy of a skin lesion, and resulting in a new diagnosis of chronic granulomatous disease.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
6/11. The Jarisch-Herxheimer reaction in leptospirosis: possible pathogenesis and review.The importance of treating leptospirosis with penicillin is emphasized by two case reports and a review documenting the occurrence of the Jarisch-Herxheimer reaction (JHR) in patients with this bacterial infection. The JHR is significant both as a cause of morbidity and mortality and as an indication of the therapeutic efficacy of penicillin. The possible etiology of the JHR is discussed, and comparisons with the changes occurring in septic shock are made; a study of either condition facilitates the understanding of the other. Tumor necrosis factor is hypothesized to play a key role in both. Current treatment of the JHR consists of general clinical support. Specific measures such as oxpentifylline therapy may play a role in the future.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
7/11. A transient granulocyte killing defect secondary to a varicella infection.A varicella infection in a previously healthy young girl was complicated by bacterial sepsis, arthritis, and osteomyelitis in multiple locations. This secondary complication caused by staphylococcus aureus was associated with a transient defect in granulocyte function and an alteration in the representation of CD4 and CD8 positive lymphocyte subpopulation. The mechanism responsible for secondary bacterial infections following varicella may be due to transient defects in granulocyte function.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
8/11. 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) |
9/11. The clinical spectrum of critical illness polyneuropathy.OBJECTIVE: To describe the entity of critical illness polyneuropathy and review our experience with six cases. DESIGN: We present case reports of six patients with polyneuropathy associated with critical illness, who received medical care at the Mayo Clinic between 1992 and 1994, and discuss similar cases from the literature. RESULTS: critical illness may damage peripheral nerves. In previous studies, sepsis and multiorgan failure have been found to trigger a peripheral neuropathy. Of our six patients with critical illness polyneuropathy, all had a preceding severe bacterial infection or septic shock. In one patient who had long-term administration of vecuronium bromide and had received massive intravenous doses of corticosteroids, sural nerve and quadriceps muscle biopsy specimens were available; they revealed axonal neuropathy and notable myopathic changes, respectively. The outcome was good in patients who survived the critical illness. CONCLUSION: Polyneuropathy in critically ill patients may be a cause of severe generalized limb weakness and occurs in the setting of a sepsis syndrome. The long-term outcome is good in patients who recover from the underlying critical illness. Compression neuropathies may be a cause of permanent sequelae.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
10/11. The human immunodeficiency virus and nonmenstrual toxic shock syndrome: a female case presentation.Toxic shock syndrome (TSS) generally is associated with tampon use among menstruating women. Descriptions from the early 1980's detailed this sudden, multisystem, frequently fatal disease. The bacterial agent, staphylococcus aureus produced exotoxins, which were quickly identified as the cause of TSS as well as a host of other systemic, bacterial infections. While S. aureus has become one of the more common bacterial pathogens in patients with Acquired Immune Deficiency syndrome (AIDS), staphylococcal toxin-related disorders rarely have been reported in individuals infected with Human Immunodeficiency Virus (hiv) or individuals diagnosed with AIDS. To date all published cases of TSS attendant with hiv involved homosexual, hemophiliac, or drug injecting male patients. This report describes a woman infected with hiv and diagnosed with the classic array of symptoms found in toxic-shock syndrome, and provides information specific to women and their experience with hiv infection.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
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