1/27. ochrobactrum anthropi bacteremia.ochrobactrum anthropi (O. anthropi ), formerly known as achromobacter CDC group Vd, is a gram-negative bacillus that is aerobic, oxidase producing, and nonlactose fermenting. This organism has been found in environmental and hospital water sources and has pathogenic potential in humans. Most reports in the literature of O. anthropi bacteremia are associated with intravenous line infections. We describe a case of bacteremia with O. anthropi in a 33-month-old boy with acute osteomyelitis. O. anthropi bacteremia also has been reported in immunocompromised hosts. Rarely, O. anthropi has been a cause of soft tissue or bone infection.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
2/27. Aeromonas sobria infection with severe soft tissue damage and segmental necrotizing gastroenteritis in a patient with alcoholic liver cirrhosis.A 49-year-old man, who had a 3-year history of liver dysfunction but had not been treated, was admitted to the hospital with a sudden onset of fever and generalized muscle pain. He subsequently developed generalized purpura with scattered hemorrhagic bullae of the skin and massive bloody stools. Aeromonas sobria was proven by culture of both blood and bullous fluid. In spite of the extensive treatment with antibiotics and other medications in the intensive care unit (ICU), the patient went into septic shock and died 2 days after admission. Pathological examination on autopsy revealed segmental necrotizing gastroenteritis with bacterial colonies and alcoholic liver cirrhosis, in addition to extensive severe soft tissue damage involving cellulitis and rhabdomyolysis and epidermolysis. Although the prognosis for vibrio vulnificus infection with severe soft tissue damage in patients with liver cirrhosis, malignancy, diabetes mellitus or other pre-existing diseases is poor, the unfavorable progression of Aeromonas species, especially A. sobria infection is rare. This is thought to be the first report of an autopsied case.- - - - - - - - - - ranking = 6keywords = soft (Clic here for more details about this article) |
3/27. 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.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
4/27. Necrotizing fasciitis secondary to peritonsillar abscess: a new case and review of eight earlier cases.Necrotizing fasciitis is a potentially fatal soft-tissue infection that occurs only rarely in the head and neck region. Broad-spectrum parenteral antibiotics and surgical debridement are the mainstays of treatment. Until now, only eight cases of necrotizing fasciitis secondary to peritonsillar abscess have been described in the English-language literature. In this article, we report a new case that occurred in an otherwise healthy 43-year-old woman. In addition to standard treatment, the patient underwent a hot tonsillectomy. After 23 months of follow-up, she is in good health.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
5/27. Fulminant stenotrophomonas maltophilia soft tissue infection in immunocompromised patients: an outbreak transmitted via tap water.Soft tissue infection caused by stenotrophomonas maltophilia is uncommon, but nosocomial infections had been reported. We describe herein 2 young female patients, with severe neutropenia, on broad spectrum antimicrobial agents for neutropenic fever, with Hickman-type central venous catheter, who developed mucocutaneous and soft tissue infections with rapidly progressive and devastating course. Cultures from the skin of both patients and from blood of one of them grew S. maltophilia. Both patients died and post mortem examination of the patient with S. maltophilia bacteremia revealed extensive soft tissue necrosis and a vegetation on the mitral valve that grew S. maltophilia. The infection occurred in both patients at the same time and in the same ward. Epidemiological study was done, and surveillance cultures grew the organism from the faucets from the room of 1 patient and also from some of the neighboring rooms in our ward but not from any other ward nor in the water reservoir of the building.- - - - - - - - - - ranking = 6keywords = soft (Clic here for more details about this article) |
6/27. Clinical presentation of microbial keratitis with daily wear frequent-replacement hydrogel lenses: a case series.Microbial keratitis (MK) is a serious complication associated with contact lens wear. In this case series we report three clinical presentations of MK associated with daily-wear monthly-replacement soft contact lenses. All of these patients were using vifilcon A (55% water content, ionic, U.S. food and Drug Administration [FDA] group IV) monthly-replacement soft contact lenses. A gram-stained smear of the corneal scrapings of two patients showed numerous gram-negative cocci bacilli, and tissue cultures showed significant growth of pseudomonas aeruginosa. In the third patient, the corneal scrapings showed numerous gram-negative bacilli, along with gram-positive cocci, and tissue culture showed significant growth of Aeromonas species and alpha-hemolytic streptococci. All these cases were resolved by medical therapy. This case series highlights the importance of patient symptoms, clinical features, and microbiologic work-up in making a differentiation between MK and sterile contact lens-induced peripheral ulcer (CLPU). A high index of suspicion and close follow-up care will avoid misdiagnosis and reduce complications.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
7/27. photorhabdus species: bioluminescent bacteria as emerging human pathogens?We report two Australian patients with soft tissue infections due to photorhabdus species. Recognized as important insect pathogens, photorhabdus spp. are bioluminescent gram-negative bacilli. bacteria belonging to the genus are emerging as a cause of both localized soft tissue and disseminated infections in humans in the united states and australia. The source of infection in humans remains unknown.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
8/27. Microbial keratitis and vision loss with contact lenses.PURPOSE: Microbial keratitis is the only sight-threatening adverse event that occurs with contact lens wear. This article gives a preliminary estimation of the incidence of microbial keratitis and vision loss with continuous-wear contact lenses made from highly oxygen permeable (Dk) materials. methods: The most up-to-date data available on microbial keratitis and vision loss are collected from a range of sources including industry, private practice, and publications and is reviewed. RESULTS: There have been 16 cases of microbial keratitis with high-Dk silicone hydrogel lenses. Of the 13 where data are available, none have lost two or more lines of best-corrected visual acuity (BCVA). CONCLUSION: First approximation indicates that the incidence of microbial keratitis with high-Dk silicone hydrogel lenses may be lower than the incidence with low-Dk soft lenses during extended wear. The rate of loss of more than two lines of BCVA is low in patients that develop microbial keratitis with low- and high-Dk soft lenses.- - - - - - - - - - ranking = 2keywords = soft (Clic here for more details about this article) |
9/27. Musculoskeletal and soft tissue Aeromonas infection: an environmental disease.During a 4-year period from November 1985 to November 1989, Aeromonas was isolated from wounds and soft tissues with clinical evidence of infection in 28 patients at our institution. Of the 28 patients, 23 (82%) had sustained an acute open or penetrating injury, more than half of which (13 of the 23) were water-related trauma. One patient had Aeromonas osteomyelitis. Five patients had no history of trauma, and three of these five had an underlying chronic disease. Treatment included debridement and antimicrobial agents. Susceptibility testing on 25 isolates from 23 patients showed uniform resistance to ampicillin and considerable resistance to cefazolin sodium (68%), but all isolates were sensitive to gentamicin sulfate, cefuroxime sodium, and the third-generation cephalosporins.- - - - - - - - - - ranking = 5keywords = soft (Clic here for more details about this article) |
10/27. aeromonas caviae keratitis associated with contact lens wear.OBJECTIVE: We report the first case of bilateral contact lens-related aeromonas caviae keratitis associated with A. caviae contamination of the contact lens case. The presence of virulence factors produced by Aeromonas species was also investigated. DESIGN: Case report. INTERVENTION AND TESTING: Conjunctival swabs and corneal scrapings from both eyes were inoculated for culture. The contact lens case was also cultured. The isolate was analyzed for the presence of virulence properties, such as gelatinase and protease production. The presence of virulence genes, such as the cytolytic enterotoxin (AHCYTOEN) and type IV Aeromonas pilus (tap) genes, was investigated using polymerase chain reaction. The susceptibility of A. caviae to 6 commercial contact lens disinfecting solutions was tested. MAIN OUTCOME MEASURES: culture results, protease activity, and gelatinase production were analyzed. polymerase chain reaction amplification products were visualized in ethidium bromide-stained agarose gel. Bacterial growth after exposure to contact lens disinfecting solutions was assessed. RESULTS: aeromonas caviae was grown bilaterally from the conjunctiva, cornea, and contact lens case. The organism showed protease and gelatinase production. polymerase chain reaction amplification revealed that the A. caviae strain contained the AHCYTOEN and tap virulence genes. Incubation for the minimum recommended time with all tested disinfecting solutions was effective in killing A. caviae. CONCLUSIONS: aeromonas caviae should be considered a possible etiologic agent of contact lens-associated keratitis. The presence of virulence factors may be important in determining corneal infection. Commercial contact lens disinfecting solutions, along with proper lens case hygiene, may be effective in preventing A. caviae keratitis in soft contact lens wearers.- - - - - - - - - - ranking = 1keywords = soft (Clic here for more details about this article) |
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