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1/52. alcaligenes xylosoxidans endophthalmitis 8 months after cataract extraction.

    PURPOSE: To report a case of alcaligenes xylosoxidans endophthalmitis and to increase awareness of its potential as an intraocular pathogen. methods: An 80-year-old woman in good general health developed A. xylosoxidans endophthalmitis 8 months after an uncomplicated cataract extraction performed at another institution. Eventually, vitrectomy with removal of the intraocular lens and capsule was performed because of recurrent disease after intravitreal antibiotic injections. RESULTS: Microbiologic examination of the vitreous biopsies and capsule disclosed A. xylosoxidans, a motile, gram-negative rod resistant to many antibiotics. CONCLUSION: A. xylosoxidans should be considered as a cause of low-grade endophthalmitis after cataract surgery.
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2/52. chorioamnionitis with intact membranes caused by capnocytophaga sputigena.

    We report a case of chorioamnionitis with intact membranes caused by capnocytophaga sputigena. The pregnant woman was hospitalised in preterm labor without fever, neither tenderness, just regular contractions. In spite of the tocolitic treatment the patient gave birth to a girl at 29 weeks' gestation, weighing 1220 g and transferred to intensive care. The newborn had clinical and biological signs of infections and was initially treated by ampicillin, cephalosporin and metronidazol. capnocytophaga sputigena was found on membranes, cord, amniotic fluid and placenta. It was also identified in maternal endocervix culture. Histologic findings showed a focal chorioamnionitis. This was the fourteenth reported case of infection due to capnocytophaga species occurring in pregnancy. All the cases are reviewed.
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3/52. Respiratory foreign bodies and eikenella corrodens brain abscess in two children.

    We report the coexistence of aspirated foreign bodies and brain abscess in two boys. One child had aspirated a metallic needle, and in the other boy partially embedded sunflower seeds were found in the bronchial wall. Both patients had growth of eikenella corrodens (oral gram-negative flora) from the abscess. Aspirated foreign body in the respiratory tract should be one of the diagnostic considerations if any of the normal oropharyngeal organisms such as E. corrodens is the causative organism of brain abscess.
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ranking = 14.834604533639
keywords = respiratory tract, tract
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4/52. Late aortic homograft valve endocarditis caused by cardiobacterium hominis: a case report and review of the literature.

    An unusual case of cardiobacterium hominis endocarditis involving an aortic homograft valve is presented. Although the patient was young (a 17 year old man) and showed few of the characteristic features of the disease, the report does illustrate a number of the problems associated with this illness and highlights the need for the careful assessment of apparent culture negative endocarditis. The organism itself is susceptible to most antibiotics but further treatment, including surgery, may be necessary. patients must therefore be examined repeatedly and assessed for haemodynamic deterioration, valve destruction or embolic phenomena. Homograft valve replacement may offer some benefits in the setting of aortic valve endocarditis and is therefore an attractive option in this situation.
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5/52. stenotrophomonas maltophilia endophthalmitis after intraocular lens implantation.

    BACKGROUND: stenotrophomonas maltophilia is an opportunistic, gram-negative bacillus. endophthalmitis induced by S. maltophilia has been described in only two cases after intraocular lens implantation. We report S. maltophilia endophthalmitis in two patients with diabetes mellitus after intraocular lens implantation and compare the characteristics of the S. maltophilia-induced endophthalmitis with two previous cases. methods: A 68-year-old woman and a 74-year-old man with diabetes mellitus developed S. maltophilia endophthalmitis within 5 days of intraocular lens implantation. We performed intraocular lens removal and vitrectomy, which resolved the inflammation. No recurrences were found. RESULTS: Cultures grew S. maltophilia in both cases, and one of the organisms was multi-resistant. The final visual acuity was counting fingers and 0.3. The first case revealed a tractional retinal detachment during vitrectomy. CONCLUSIONS: S. maltophilia is a potential opportunistic intraocular pathogen, and the incidence of multiresistant S. maltophilia is increasing. S. maltophilia causes acute endophthalmitis, and its prognosis may not be poor unless the eye has a history of serious disease before the cataract surgery. The combined procedure of intraocular lens removal and vitrectomy was useful in resolving the inflammation and preventing recurrences.
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6/52. alcaligenes xylosoxidans and propionibacterium acnes postoperative endophthalmitis in a pseudophakic eye.

    PURPOSE: To report a case of persistent polymicrobial postoperative endophthalmitis caused by alcaligenes xylosoxidans and propionibacterium acnes in a pseudophakic eye. A. xylosoxidans is a gram-negative bacteria resistant to most antibiotics. methods: Case report. RESULTS: A 72-year-old man presented with clinical signs of endophthalmitis on the first postoperative day after a phacoemulsification procedure with posterior chamber intraocular lens, left eye. Initial treatment included topical, subconjunctival, and oral antibiotics. After initial clearing, there was recrudescence of infection on postoperative day 37 that prompted referral of the patient to the Cullen eye Institute. Treatment at that time included anterior chamber and vitreous taps with intravitreal antibiotic injections. Complete pars plana vitrectomy and intraocular lens explantation were eventually required because of persistent infection with a resistant organism. Cultures from the first procedure grew A. xylosoxidans and P. acnes. Cultures from the vitrectomy grew only A. xylosoxidans. At the final follow-up visit 6 months after the initial procedure. The eye was without inflammation with best-corrected visual acuity of 20/40. CONCLUSION: Both A. xylosoxidans and P. acnes can cause chronic progressive endophthalmitis after cataract extraction often resistant to corrective antibiotic therapy. Successful intervention may require complete vitrectomy with intraocular lens and capsule removal.
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7/52. veillonella parvula meningitis: case report and review of veillonella infections.

    veillonella parvula is a small, nonfermentative anaerobic gram-negative coccus that is part of the normal flora of the mouth, gastrointestinal tract, and vagina in humans. When isolated from clinical specimens, V. parvula is often regarded as a contaminant or commensal, but it has been implicated as a pathogen in infections of the sinuses, lungs, heart, bone, and central nervous system. meningitis, however, is extremely rare; to our knowledge, only 2 cases have been previously described in the literature. We report a case of V. parvula meningitis and review the literature on veillonella infections.
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8/52. Subdural empyema after tooth extraction in which capnocytophaga species was isolated.

    We describe a patient with meningitis and a subdural empyema arising from an infection after teeth extraction in which capnocytophaga species was detected. The patient was a 54-y-old man without any underlying diseases. A computerized tomography scan showed a subdural empyema 21 d after the extraction.
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ranking = 1.2
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9/52. Identification of arcobacter cryaerophilus isolated from a traffic accident victim with bacteremia by 16S ribosomal rna gene sequencing.

    Traditional ways of identifying slow growing bacteria is slow and often difficult. In this study, a small, Gram-negative, facultative anaerobic, slow growing bacillus was isolated from the blood culture of a 7-year old traffic accident victim. The bacterium was non-hemolytic, catalase and oxidase positive. An attempt to use the Vitek system (GNI ) and the API system (20NE) to identify the strain was unsuccessful as the growth controls showed negative results. 16S ribosomal rna gene sequencing showed that there was 1 base difference between the isolate and arcobacter cryaerophilus (GenBank Accession no. U25805), 1 base difference between the isolate and A. cryaerophilus (GenBank Accession no. U34387), 10 base differences between the isolate and A. cryaerophilus (GenBank Accession no. L14624), 34 base differences between the isolate and A. butzleri (GenBank Accession no. U34386), 34 base differences between the isolate and A. butzleri (GenBank Accession no. U34387), and 38 base differences between the isolate and A. butzleri (GenBank Accession no. L14626), indicating that the isolate most closely resembled a strain of A. cryaerophilus. Identification of the isolate in our case by conventional methods was difficult, as the absence of a curved morphology has made it confused with other Gram-negative non-fermentative bacteria, and the slow growth rate has made it unidentifiable by both the Vitek and API systems. Although the exact source of infection and route of transmission in our case remains elusive, we speculate that the bacteria were transmitted through the respiratory tract while the boy was suffocated in the mud. The present report represents an example of showing the usefulness of 16S rRNA gene sequencing for identification of slow growing bacteria.
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ranking = 14.834604533639
keywords = respiratory tract, tract
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10/52. Acral necrosis by stenotrophomonas maltophilia.

    BACKGROUND: stenotrophomonas maltophilia (SM) has been considered a nosocomial pathogen. Nevertheless, community acquired infection may occur more frequently than usually recognized. CASE: We describe distal necrosis of the fingers by SM in a farmer, contracted in the community and successfully treated with a combination of cotrimoxazole and ciprofloxacin. The patient was diagnosed with chronic lymphocytic leukaemia 6 months later. CONCLUSIONS: This unusual presentation shows that infection with SM should be included in the differential diagnosis of the skin and soft tissue infection, even in apparently healthy patients.
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ranking = 0.2
keywords = tract
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