1/11. trichosporon asahii: an unusual cause of invasive infection in neonates.trichosporon asahii causes white piedra, an infection of hair shafts and onychomycosis in immunocompetent patients, as well as various localized or disseminated invasive infections in immunodeficient hosts. We describe a 26-week gestation 890-g vaginally delivered female neonate who had severe respiratory distress syndrome and on the sixth day of life developed klebsiella pneumoniae sepsis. At the same time two blood cultures were positive for T. asahii. The neonate was also colonized with T. asahii in the pharynx and perineum. The infant was successfully treated with conventional amphotericin b.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
2/11. Ruptured tubo-ovarian abscess as a complication of IVF treatment: clinical, ultrasonographic and histopathologic findings. A case report.Tuboovarian abscess is a rare complication of IVF treatment, which can be lethal on rupture. Hereby, we present a case of a ruptured tubo-ovarian abscess, following transvaginal ultrasound-guided oocyte retrieval for IVF and transcervical embryo trasfer in a 38-year-old white female patient with five years of primary infertility who underwent aspiration of bilateral hydrosalpinges at the time of oocyte retrieval. This case suggests that the reactivation of latent pelvic infection due to a previous pelvic inflammatory disease (PID) was the possible route of infection after transvaginal ultrasound-directed follicle aspiration--transcervical embryo transfer. We conclude that physicians should consider the diagnosis of tubo-ovarian abscess in the differential diagnosis of abdominal pain, fever and leukocytosis after ovum retrieval and transcervical embryo transfer for IVF treatment. Preservation of the uterus and unaffected uterine adnexa should be attempted in such cases if future pregnancy is desired.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
3/11. Infected solitary hepatic cyst.An unusual case involving an infected hepatic cyst in which the correct diagnosis was made without operation is reported. A 93-year-old woman presented with acute onset of right upper quadrant abdominal pain, mild left lower quadrant abdominal pain, diarrhea, and fever. On admission, computed tomography revealed a 15 cm solitary hepatic cyst in the anterior-superior segment of the liver with a thickened wall that enhanced with contrast media. ultrasonography demonstrated a 15 cm anechoic lesion with a hypoechoic area in the dependent portion of the cyst and a thickened wall. The serum concentration of c-reactive protein was 24.3 mg/dL, and the white blood cell count was 13,800/microL. A diagnosis of infected hepatic cyst was suspected, and percutaneous transhepatic drainage of the cyst was performed. Milky yellow fluid was obtained and the patient's right upper quadrant abdominal pain resolved after drainage. klebsiella pneumoniae was cultured from the drainage fluid. The patient was discharged 20 days after drainage. Infection has not recurred and the hepatic cyst has not enlarged after 18 months.- - - - - - - - - - ranking = 9.8538095371695keywords = blood cell, white (Clic here for more details about this article) |
4/11. klebsiella pneumoniae peritonitis shortly after kidney transplantation.We report a case of spontaneous bacterial peritonitis caused by klebsiella pneumoniae in a 34-year-old male recipient shortly after kidney transplantation. On posttransplant day 10, the patient started complaining of severe abdominal pain and nausea. body temperature was 38.4 degrees C. The abdomen was diffusely tender with rigidity and rebound. Laboratory data showed a normal erythrocyte sedimentation rate and serum creatinine level but a slightly elevated C-reactive protein concentration and leukocytosis of 36,200 cells/mm(3) with 88% neutrophils. Explorative laparotomy revealed diffuse purulent peritonitis without an intraabdominal source of infection, such as intestinal perforation. The peritoneal fluid revealed greater than 1000/mm(3) white blood cells and many gram-negative bacilli. Fluid cultures yielded growth of klebsiella pneumoniae. The patient responded to antibiotic therapy; he was discharged in good condition. This case report draws attention to the impaired host defense that may predispose to spontaneous bacterial peritonitis in renal transplant recipients and alerts the clinician to the possibility of this rare disease.- - - - - - - - - - ranking = 9.8538095371695keywords = blood cell, white (Clic here for more details about this article) |
5/11. Transfusion-transmitted klebsiella pneumoniae fatalities, 1995 to 2004.Transfusion-transmitted bacterial sepsis is the third most common cause of transfusion-related fatalities reported to the food and Drug Administration. Between October 1, 1995, and September 30, 2004, there were 665 reported transfusion fatalities. Eighty-five (13%) deaths were due to transfusion-transmitted bacterial infections, of which 58 (68%) were due to gram-negative organisms. The most common gram-negative organism associated with transfusion-transmitted deaths after receipt of platelets was klebsiella pneumoniae. This article summarizes retrospectively the case series of deaths due to transfusion-transmitted K pneumoniae infection, reported to the food and Drug Administration, 1995 to 2004. There were 12 deaths due to transfusion-transmitted K pneumoniae infection with 7 (58%) of the 12 cases occurring in 2002. Eleven deaths were caused by the transfusion of contaminated platelets and 1 death attributed to contaminated red blood cells. Extensive review of the seven 2002 fatality reports did not identify a common (shared) lot for items used during collection or processing of the blood product. In conclusion, in cases of suspected transfusion-transmitted septicemia, broad spectrum antibiotic coverage including coverage of gram-negative organisms should be considered. Strict adherence to infection control measures while collecting, processing, and handling all blood and blood components in both the clinical settings and in the laboratory should be followed. Further development of simple and effective test procedures for detecting bacteria in the blood is needed.- - - - - - - - - - ranking = 8.8538095371695keywords = blood cell (Clic here for more details about this article) |
6/11. Septic monoarthritis and osteomyelitis in an elderly man following klebsiella pneumoniae genitourinary infection: case report.INTRODUCTION: klebsiella pneumoniae septic arthritis and osteomyelitis, albeit uncommon in adults, are important sites of disseminated infection. Many case reports have shown K. pneumoniae as a cause of nosocomial transmitted septic arthritis in neonates and children. We report a rare case of an elderly patient with K. pneumoniae genitourinary infection spreading to the liver and other extra hepatic sites like the prostate and peripheral joint. CLINICAL PICTURE: The patient presented with a short history of general malaise, fever and urinary symptoms, associated with an acute monoarthritis of the ankle. On admission, he was in septic shock. Investigations suggested an infective cause, as evidenced by raised total white cell count and pyuria. K. pneumoniae was cultured from both urine and ankle synovial fluid. Imaging confirmed multiple liver and prostatic abscesses, as well as osteomyelitis of the foot bones adjacent to the ankle. TREATMENT: Treatment in this case included surgical drainage of the affected joint and surrounding soft tissue structures, in addition to a 6-week course of systemic antibiotics. OUTCOME: The patient had good clinical response following treatment. In addition, we noted a normalisation of his laboratory parameters and resolution of the intraabdominal and pelvic abscesses. CONCLUSION: This case emphasises the importance of timely and accurate diagnosis followed by appropriate treatment in disseminated K. pneumoniae infection to prevent significant morbidity and mortality.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
7/11. Persistent CSF leucocytosis associated with intrathecal gentamycin.A case where the administration of intrathecal gentamycin, used to treat a ventriculitis consequent upon a ventriculoperitoneal shunt infection, with a persistent elevation of the CSF leucocyte count is described. In a situation where the number of white cells in the CSF is taken to indicate resolution of infection, it is important to recognise that apparent failure of resolution of infection may be due to the gentamycin itself and not persistent infection.- - - - - - - - - - ranking = 1keywords = white (Clic here for more details about this article) |
8/11. Bacterial esophagitis in immunocompromised patients.We studied the clinical and pathologic features of bacterial esophagitis in three index cases identified by endoscopic biopsy and in 20 autopsy cases. Fourteen of the 23 patients had malignant hematologic conditions, aplastic anemia, or solid tumors; ten were profoundly neutropenic (white blood cell count, less than 100/mm3 [less than 0.1 X 10(9)/L]). The organisms involved in bacterial esophagitis were gram-positive cocci in 14, gram-negative bacilli in three, mixed gram-negative bacilli and gram-positive cocci in five, and gram-positive bacilli in one. Four patients had bacteremic bacterial esophagitis; all were immunocompromised, three by profound neutropenia and one by gestational prematurity. Bacteria causing bacteremic bacterial esophagitis were all gram-positive: viridans-group streptococci. staphylococcus aureus, Staphylococcus epidermis, and bacillus species. Our study suggests that bacterial esophagitis is more common than has been recognized in the past and should be considered as a potential source of bacteremia in immunocompromised patients.- - - - - - - - - - ranking = 9.8538095371695keywords = blood cell, white (Clic here for more details about this article) |
9/11. Spurious elevated platelet counts associated with bacteremia.Spuriously elevated automated platelet counts secondary to in vivo bacteremia have not been reported previously. Two patients are described with blood cultures positive for escherichia coli and klebsiella pneumoniae, respectively, and bacteria present on peripheral blood smear. Those bacteria caused falsely elevated platelet counts to be generated by the Ortho ELT-8. These cases illustrate an unusual artifact and demonstrate that spurious counts can be generated by laser optical blood cell counters.- - - - - - - - - - ranking = 8.8538095371695keywords = blood cell (Clic here for more details about this article) |
10/11. Bacterial pneumonia in the elderly: clinical features, diagnosis, etiology, and treatment.diagnosis of bacterial pneumonia in the elderly depends on an awareness of the various forms of presentation and identification of the etiologic agent(s). The reliability of sputum or nasopharyngeal aspirates can be assessed by the number of squamous epithelial cells and white blood cells per 100 X field (low-power). Transtracheal aspiration should be considered in select patients with life-threatening pneumonias. Community-acquired pneumonias are caused primarily by S. pneumoniae (40-60%), hospital-acquired pneumonias by gram-negative bacilli (45%) and institution-acquired pneumonias by mixed flora (35%) and S. pneumoniae (30%). Initial choice of antimicrobial agents is based on an interpretation of the Gram stain. Choice of empiric antimicrobial treatment depends on host characteristics and the setting in which the pneumonia occurs.- - - - - - - - - - ranking = 9.8538095371695keywords = blood cell, white (Clic here for more details about this article) |
| | Next -> |