1/7. streptococcus pneumoniae peritonitis postpartum.A peritonitis caused by an ascending infection is a rare complication postpartum. A 37-year-old woman presented with a secondary peritonitis due to streptococcus pneumoniae. The patient had given birth to a healthy boy 4 weeks before and showed no symptoms of a bronchitis on admission. An operation was performed after the patient developed an acute abdomen, showing a diffuse peritonitis. High vaginal swabs and blood cultures taken on admission were positive for S. pneumoniae as well as the specimen taken during the operation. Thus we concluded that this was a case of an ascending infection. After antibiotic therapy with penicillin the patient could be discharged 8 days after the operation.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/7. A new etiology of acute abdominal emergencies in cirrhotic patient: secondary pneumococcal peritonitis with jejunitis.We report the first case of secondary pneumococcal peritonitis associated with acute jejunitis in a 52-year-old homeless child-Pugh C cirrhotic man without ascitis. The patient was admitted with clinical signs of peritonitis, and jaundice. Morphologic examination was unremarkable. A laparotomy revealed a diffuse peritonitis, and an acute jejunitis with prenecrotic lesion. The lesion was located within the first centimeters of the jejunum, immediately after the duodeno-jejunal angle, extented on 15 cm. A resection of the first 15 cm of the jejunum was performed with duodeno-jejunal side-to-side manual anastomosis. Gram-stain and cultures of blood, peritoneal pus, and jejunal mucosa revealed a penicillin-sensitive streptococcus pneumoniae. Appropriate parenteral antibiotic treatment was initiated (aminopenicillin). The postoperative course was marked by a transient hepatic failure associated with an ascitis controlled by diuretics. The patient was discharged on the 26th day after surgery. This case reports a new etiology of acute abdominal emergencies in cirrhotic patients.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
3/7. Pneumonia presenting as acute abdomen in children: a report of three cases.From 10th September 1998 till 5th June 1999, the Paediatric and Cardiothoracic Surgery Units of Sultanah Aminah Hospital Johor Bahru managed three children with lung collapse secondary to pneumonia. The dominant initial clinical presentation in all three cases was acute abdominal pain. Basal pneumonia was diagnosed in two cases post-operatively after surgical contributory causes were excluded intra-operatively. thoracotomy, evacuation of infected debris and decortication of the collapsed lung was done in all three cases. In children presenting with acute abdominal pain, basal pneumonia should be considered as a possible contributory cause.- - - - - - - - - - ranking = 0.5keywords = pneumonia (Clic here for more details about this article) |
4/7. capnocytophaga canimorsus sepsis presenting as an acute abdomen in an asplenic patient.Acute abdominal symptoms are frequently caused by surgical intra-abdominal problems. However, the differential diagnosis also includes several internal diseases. Overwhelming infections may present with acute abdominal signs, particularly in the immunocompromised host. Asplenic patients are highly susceptible to infections with encapsulated bacteria such as streptococcus pneumoniae, haemophilus influenzae and neisseria meningitidis. Severe infections due to capnocytophaga canimorsus (DF2), are also common in this group. C. canimorsus is a Gram-negative rod, present as a commensal organism in cat and dog saliva. We describe the atypical presentation of a fatal C. canimorsus-sepsis in a 46-year-old man, who underwent traumatic splenectomy two decades earlier.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |
5/7. A bronchopleurocutaneous fistula caused by an unusual foreign body aspiration simulating acute abdomen.A 12-year-old boy was admitted to hospital for abdominal pain, vomiting and fever. On physical examination he had rales on the lower right hemithorax without any respiratory complaints. Chest X-ray revealed a condensation in the right lower chest. Abdominal findings were secondary to lobar pneumonia. Treatment of pneumonia with antibiotics showed no improvement over 2 days. On bronchoscopy no foreign body was seen, but pus was aspirated. Two days later a mass appeared on the right hemithorax and fistulized. An organic foreign body, hordeum murinum, with 3-5 ml of pus was observed. Chest X-ray taken at the day of fistulization showed no pneumothorax or subcutaneous emphysema. Less than 11 cases of pneumocutaneous fistulas secondary to aspiration of grasses have been reported in literature. Why an ear of hordeum murinum can migrate only in a forward direction and why a pneumothorax had not developed is discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = pneumonia (Clic here for more details about this article) |
6/7. Pneumonia in unexpected locations: an occult cause of pediatric abdominal pain.Although pneumonia is a known cause of pediatric abdominal pain, it may go unrecognized on a patient's initial evaluation. This is particularly true when the infection lies outside of the typically described basilar location. We report three pediatric patients in whom acute abdominal pain was the sole or primary manifestation of a nonbasilar pneumonia.- - - - - - - - - - ranking = 0.33333333333333keywords = pneumonia (Clic here for more details about this article) |
7/7. Postsplenectomy capnocytophaga canimorsus sepsis presenting as an acute abdomen.patients with intra-abdominal processes that require prompt surgical intervention, including appendicitis, perforated viscus, ischemic bowel, volvulus, and bowel obstruction, often present with signs and symptoms of an acute abdomen. Several medical problems can mimic an acute abdomen. Overwhelming postsplenectomy infection is a life-threatening condition that can present with acute abdominal symptoms. The incidence of overwhelming postsplenectomy infection ranges from 1% to 25%, and is caused by streptococcus pneumoniae in 50% of cases. capnocytophaga canimorsus, a bacteria commonly found in dog saliva, accounts for less than 1% of cases. Overwhelming postsplenectomy infection has a rapidly deteriorating course that progresses to respiratory and renal failure, cardiovascular collapse, and death. The mortality associated with overwhelming postsplenectomy infection is 60% to 80%. early diagnosis and institution of appropriate antibiotic therapy and supportive care is essential to improve patient outcome. A previously healthy woman who had undergone splenectomy secondary to trauma 11 years earlier presented with symptoms of an acute abdomen. A diagnosis of overwhelming postsplenectomy infection due to C canimorsus was made based on her peripheral blood smear and blood culture findings. Early aggressive care and antibiotic treatment resulted in a successful outcome for this patient with no long-term morbidity. This patient's clinical course demonstrates the importance of early diagnosis and treatment of overwhelming postsplenectomy infection.- - - - - - - - - - ranking = 0.16666666666667keywords = pneumonia (Clic here for more details about this article) |