1/10. Diagnostic odyssey of a cutaneous mycobacteriosis rare in central europe.Cutaneous infection with mycobacterium chelonae is an uncommon disease, although this atypical mycobacterium is an acid-fast bacillus ubiquitous in the environment. It is often misdiagnosed and treated as a fungal or common bacterial infection. We report a case of disseminated atypical mycobacterial skin infection of a 72-year-old woman who was treated with different topical and systemic antimycotic and antibiotic drugs over a period of 5 months without remarkable improvement. Eventually, repeated tissue cultures on special medium and performance of PCR led to the diagnosis of M. chelonae infection. The patient was treated successfully with oral clarithromycin within 8 weeks. In case of abscessing cutaneous infection, M. chelonae should be considered in the differential diagnosis of prolonged disease when common antibiotics are not effective after 2-4 weeks of treatment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/10. Community-acquired pseudomonas pneumonia in a normal host complicated by metastatic panophthalmitis and cutaneous pustules.pseudomonas aeruginosa is a frequent pathogen of patients with chronic underlying disease in the hospital environment. This organism is, however, an extremely rare cause of either community-acquired pneumonia in a normal host, metastatic bacterial endophthalmitis or metastatic cutaneous pustules. We report here a case combining these three rare manifestations in a previously well young woman, to highlight the serious disease that may result from this pathogen and the difficulties of treatment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/10. Vibrio sepsis in a cirrhotic patient.vibrio vulnificus should be suspected in any soft tissue infection occurring after exposure to the marine environment. Early recognition followed by appropriate antibiotic therapy and debridement of involved tissue are essential features in the treatment of these infections.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/10. pseudomonas infections associated with hot tubs and other environments.Infections due to pseudomonas aeruginosa are not confined to the hospital intensive care unit. This paper examines the association of P. aeruginosa and several community-acquired infections. Hot tub folliculitis is a recently described disorder occurring in outbreaks among persons who unknowingly immerse themselves in contaminated whirlpools, spas, or swimming pools. The green nail syndrome and other dermatoses are also reviewed. Infective endocarditis, invasive external otitis, and puncture would osteomyelitis are serious infections that carry high risks for the patient and challenge the physician's most potent therapies.- - - - - - - - - - ranking = 4keywords = environment (Clic here for more details about this article) |
5/10. Sporotrichoid cutaneous infection due to Mycobacterium chelonei.Extensive cutaneous lesions that simulated sporotrichosis developed in a patient. Mycobacterium chelonei, a facultative pathogen that exists as a saprophyte in the environment and rarely produces clinical disease in humans, grew from culture of biopsy material. There was no evidence of visceral involvement, and the lesions healed spontaneously within six months.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/10. Vibrio hand infections: a case report and review of the literature.A case of vibrio vulnificus infection of the hand is presented. The role of Vibrio species as primary pathogens in infections associated with exposure to a marine environment is discussed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/10. Pseudomonas folliculitis acquired from a health spa whirlpool.Three cases of an unusual Pseudomonas skin infection acquired from a health spa whirlpool were reported, and an epidemiologic survey showed 17 additional cases. This dermatosis is characterized by the abrupt onset of urticarial papules and superficial and deep papulopustules that spare only the head and neck and occur eight to 48 hours after using the whirlpool. Cultures from one patient's pustules and from the spa whirlpool environment were positive for P aeruginosa, serotype O-11. The condition cleared in all but one patient, without treatment, within seven to ten days. This patient continues to have recurrent follicular pustules three months after exposure. Samples from whirlpools at six other selected establishments were also positive for P aeruginosa.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/10. vibrio vulnificus infection. Case report and update since 1970.vibrio vulnificus infections is being reported with increasing frequency in coastal regions of the united states. Raw seafood consumption, particularly raw oysters, and wounds acquired in a marine environment predispose to infection. patients with advanced liver disease are at increased risk of developing septicemia. V. vulnificus is a virulent pathogen producing significant morbidity and mortality; its virulence relates in part to the production of exotoxin. skin lesions occur early in the clinical course of infection and provide means of specific diagnosis. The patient and the consulting physician are well served by the dermatologist capable of recognizing this infectious disease.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/10. Nosocomial salmonella epidemic.A patient admitted to the hospital with diarrhea due to salmonella heidelberg subsequently developed fatal disseminated salmonellosis, despite vigorous antimicrobial treatment. Beginning five weeks after the initial patient's death, nine patients developed hospital-acquired S heidelberg infections characterized by diarrhea (in seven) and bacteremia (in two). A careful search for salmonellosis among patients and hospital staff revealed two asymptomatic excretors. Extensive culturing of samples from the environment did not show any contaminated objects or reservoirs. The epidemic ended after initiation of an energetic handwashing campaign and isolation procedures. The strain of S heidelberg isolated was resistant to chloramphenicol, ampicillin, and gentamicin. Especially interesting in the epidemic were the prolonged time between death of the index case and the appearance of nosocomial cases, the high fatality rate, and the marked antibiotic resistance.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/10. Cutaneous infection due to Mycobacterium abscessus. A case report.Erythematous nodular and ulcerating skin lesions occurred in a 56-year-old woman treated with chemotherapy and glucocorticosteroids for metastatic breast cancer. Subsequent culture yielded Mycobacterium abscessus, a facultative pathogen which exists as a saprophyte in the environment and rarely produces clinical disease in humans. This organism is usually relatively resistant to antituberculous as well as a number of other antimicrobial agents. On the basis of in vitro susceptibility results, treatment with clarithromycin and clofazimine was installed and resolution of the lesions initiated. This report emphasizes once again that one should investigate any new or unusual skin lesions in immunocompromised patients by histology and culture of biopsies, including cultures for acidfast organisms.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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