1/520. 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 = organ (Clic here for more details about this article) |
2/520. A case of cryptic miliary tuberculosis mimicking cholecystitis with sepsis.Miliary tuberculosis is a rare form of tuberculosis in industrialized countries. We report on a 69-year-old woman presenting a sepsis syndrome caused by cryptic miliary tuberculosis clinically mimicking a case of cholecystitis with sepsis. The patient died of a multi-organ failure on day 6 of her hospital stay.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
3/520. Central line sepsis in a child due to a previously unidentified mycobacterium.A rapidly growing mycobacterium similar to strains in the present mycobacterium fortuitum complex (M. fortuitum, M. peregrinum, and M. fortuitum third biovariant complex [sorbitol positive and sorbitol negative]) was isolated from a surgically placed central venous catheter tip and three cultures of blood from a 2-year-old child diagnosed with metastatic hepatoblastoma. The organism's unique phenotypic profile and ribotype patterns differed from those of the type and reference strains of the M. fortuitum complex and indicate that this organism may represent a new pathogenic taxon.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
4/520. 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 = organ (Clic here for more details about this article) |
5/520. Trauma, sepsis, and disseminated intravascular coagulation.disseminated intravascular coagulation (DIC) was first observed clinically in a case of sepsis following severe trauma. It was postulated that the observed clotting defect and bleeding were due to the using up of clotting factors in an episode of intravascular clotting. It was also postulated that the multiple organ failure observed was due to obstruction of the microcirculation of the organs by microclots. Evidence for this process was worked out in many animal studies. It was then postulated that if these microclots could be lysed before organ necrosis was produced, organ failure could be prevented. This prevention was shown to be possible in animals. It was then tried in humans using plasminogen activators, and the approach was found to be effective. Using a low dose of plasminogen activator over a 24-hour period caused no changes in the coagulation profile or bleeding.- - - - - - - - - - ranking = 4keywords = organ (Clic here for more details about this article) |
6/520. Subcutaneous nodules with pseudomonas septicaemia in an immunocompetent patient.Pseudomonas septicaemia presenting with subcutaneous nodules, though rare, is well described in immunocompromized populations. It is, however, very uncommon in immunocompetent patients. We describe a case of a 42-year-old woman who presented with community-acquired. pseudomonas aeruginosa septicaemia and subcutaneous nodules. No precipitating cause or immune dysfunction was found. She was successfully treated with appropriate antibiotics, respiratory and cardiovascular support in the intensive care Unit. The difficulty in eradicating the organism from the skin lesion and the need for investigating the immune function of septicaemia patients are discussed.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/520. Anticonvulsant hypersensitivity syndrome occurring as sepsis with multiorgan dysfunction.phenytoin is a highly effective and widely prescribed anticonvulsant agent. However, it is associated with both dose-related side effects and hypersensitivity reactions. life-threatening anticonvulsant hypersensitivity syndrome in one patient was characterized by a skin eruption and multisystem organ dysfunction.- - - - - - - - - - ranking = 5keywords = organ (Clic here for more details about this article) |
8/520. Endogenous endophthalmitis associated with bacillus cereus bacteremia in a cocaine addict.A 22-year-old black female intravenous cocaine addict presented with an endophthalmitis of the right eye. Diagnostic evaluation included an immediate anterior chamber paracentesis and a delayed vitreous aspiration. Although cultures from the involved eye were negative, all 7 blood cultures grew Bacillus cereus suggesting that this organism was the responsible agent of an endogenous endophthalmitis. The patient was treated with appropriate systemic and local antibiotics with resolution of the acute inflammatory signs. However, a phthisical eye has been noted on follow-up examinations.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
9/520. Cirrhosis in a child with hypothalamic syndrome and central precocious puberty treated with cyproterone acetate.Before the advent of gonadotropin-releasing-hormone analogues, cyproterone acetate (CPA) had been widely prescribed for the treatment of precocious puberty. Although it is usually well tolerated, liver toxicity has been recognized as a complication of its long-term use. We report the occurrence of cirrhosis in a 10-year-old boy with hypothalamic syndrome and precocious puberty who was treated with CPA for over 50 months. Despite discontinuation of the medication, the liver disease progressed. The patient died of sepsis and multiorgan failure at the age of 14 years. This is the first paediatric report of substantial liver damage and liver toxicity progressing to cirrhosis associated with CPA treatment. CONCLUSION: Prolonged cyproterone acetate treatment may induce cirrhosis. Monitoring of liver function both during treatment and for several months after discontinuation of therapy is recommended.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
10/520. purpura as a cutaneous association of sickle cell disease.A common chronic feature of sickle cell disease is the presence of painful, punched-out leg ulcers. Other cutaneous findings in patients with homozygous sickle cell disease have not been described in the literature. We present a case of a 50-year-old black woman with sickle cell disease who was admitted for acute onset of arm and hip pain. After admission she deteriorated clinically, with multiorgan failure and mental status changes. Examination of the skin revealed erythematous papules and plaques with scaly centers and purpura on the upper trunk. The clinical differential diagnosis was vasculitis versus sepsis. skin biopsy of two representative lesions was performed. hematoxylin- and eosin-stained sections showed a superficial perivascular mixed inflammatory infiltrate with numerous eosinophils and extravasated erythrocytes, some of which exhibited bizarre morphology of sickled red blood cells. These findings indicated that the patient's cutaneous lesions, possibly multifactorial in origin, could be a component of her sickle cell crisis. This case is presented as an unusual one in which evaluation of erythrocyte morphology contributed to patient management and to emphasize the importance of examining erythrocyte morphology as a part of the histologic evaluation of stained tissue.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
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