1/63. Cervico-facial necrotising fasciitis occurring with facial paralysis: case report.Necrotising fasciitis is a soft tissue infection, usually polymicrobial, characterised by necrosis of fascia and subcutaneous tissue. It frequently involves the groin, abdomen and extremities, but rarely involves the cervico-facial region. A case is presented of a 70-year old man who, following a futile attempt to extract a lower left first molar, developed a cervico-facial necrotising faciitis with facial nerve paralysis. Bacteriological investigations revealed the presence of Klebsiella spp and viridans streptococci. It is emphasized that early detection of this disease followed by aggressive surgical debridement and antibiotic therapy are most important.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
2/63. Ruptured klebsiella pneumoniae liver abscess after high-dose cyclophosphamide for severe aplastic anemia.A 19-year-old woman with severe aplastic anemia who had previously failed antithymocyte globulin/cyclosporine A received high-dose cyclophosphamide without bone marrow rescue. On day 14, she complained of right upper quadrant abdominal pain and fever. A CT scan of the abdomen showed multiple liver abscesses with rupture and klebsiella pneumoniae was isolated from blood. In spite of aggressive antibiotic therapy, she rapidly deteriorated and died of overwhelming sepsis. To our knowledge, our patient is the first case of fatal ruptured liver abscess after high-dose cyclophosphamide in a patient with severe aplastic anemia.- - - - - - - - - - ranking = 0.0066127279314093keywords = upper (Clic here for more details about this article) |
3/63. Pyogenic liver abscesses due to klebsiella pneumoniae in a diabetic patient.Pyogenic liver abscess due to klebsiella pneumoniae is a rare clinical entity. It has emerged as an important infection complication in diabetics and its incidence in diabetics without intraabdominal or biliary tract infections is increasing. We present herein a case of multiple pyogenic liver abscesses due to K. pneumoniae in a diabetic patient and discuss clinical course, treatment and possible reasons for association between K. pneumoniae liver abscess and diabetes.- - - - - - - - - - ranking = 141.80959575198keywords = tract infection, tract (Clic here for more details about this article) |
4/63. Endogenous Klebsiella endophthalmitis.PURPOSE: To report 4 cases of endogenous Klebsiella endophthalmitis. This disease is a rare but devastating complication of Klebsiella sepsis. Familiarity with its varied clinical presentations would aid in early diagnosis and institution of appropriate therapy. methods: We report 5 eyes of 4 patients with endogenous Klebsiella endophthalmitis from December 1995 to September 1996 and review the literature regarding previously successfully treated cases. RESULTS: The mean age of the patients was 67.5 years (range 37-85 years). One patient had bilateral involvement. At presentation, 3 eyes had a visual acuity of no perception of light (NPL) and the 1 patient with bilateral involvement had an acuity of counting fingers in one eye and 20/40 in the other. The primary source of sepsis was the pulmonary system in 2 patients, the hepatobiliary system in 1 patient and the urinary tract in 1 patient. One patient had coexisting diabetes mellitus. Two patients had a pupillary hypopyon. Local and systemic treatment with an aminoglycoside and cephalosporin was initiated. Despite treatment, 2 eyes remained NPL. One eye developed a globe perforation and was eviscerated. The patient with bilateral involvement was treated within 8 h and recovered fully with a final visual acuity of 20/20 in both eyes. CONCLUSION: It is important to have a high index of suspicion in patients with septicaemia presenting with intraocular inflammation, especially in diabetics with suppurative liver disease, urinary tract infection or pulmonary infection. As the visual prognosis for patients with Klebsiella endophthalmitis is generally poor, early diagnosis and treatment with intravenous and intravitreal antibiotics may improve the visual outcome.- - - - - - - - - - ranking = 142.80959575198keywords = tract infection, tract (Clic here for more details about this article) |
5/63. klebsiella pneumoniae psoas abscess: predominance in diabetic patients and grave prognosis in gas-forming cases.Seven cases of psoas abscess caused by klebsiella pneumoniae were observed at the National Cheng Kung University Hospital within a period of 4.5 years. These cases constituted 25% of a total 28 episodes of non-tuberculous psoas abscess, ranking second to those caused by staphylococcus aureus (8 cases). Eight cases of psoas abscess caused by K. pneumoniae were identified from medline, and 5 of which were reported from taiwan. Of these 8 cases, 1 neonatal case was excluded, and the remaining 7 adult cases were combined with the 7 cases in this series for analysis. The mean age was 53.8 years, and diabetes mellitus was the most common underlying disease. fever and pain on the flank and back area were the common findings. The interval between the onset of symptoms and diagnosis ranged from 1 to 60 days. The most common sites of concurrent infection were the urinary tract (6 cases; 43%) and bone (3 cases; 21%). All patients received percutaneous or surgical drainage in addition to antibiotic treatment. Gas formation was present in 5 of the 12 patients recorded, and 4 of them died during hospitalization. Only 1 patient had a metastatic infection with osteomyelitis of the left radius and right humerus; he had experienced 5 episodes of recurrent K. pneumoniae infections in different sites. We concluded that K. pneumoniae should be considered as an important endemic pathogen of psoas abscess in diabetics in taiwan. The high mortality rate in the gas-forming cases should also be highlighted. Early recognition, empiric antimicrobial coverage for K. pneumoniae, and aggressive drainage or debridement are indicated in these patients.- - - - - - - - - - ranking = 1keywords = tract (Clic here for more details about this article) |
6/63. An unusual case of neonatal brain abscess following klebsiella pneumoniae septicemia.A case of solitary brain abscess in a term neonate caused by Kiebsiella pneumoniae is described. K. pneumoniae, although a common cause of neonatal septicemia, is rarely implicated as an etiological agent for cerebral abscess in this age-group. The interest of this case lies in the rarity of the causative organism and atypical features. In the absence of predisposing factors in the neonate, we suspect that the infection was transmitted vertically from the mother before or at the time of delivery since there was evidence of asymtomatic urinary tract infection in the antenatal period.- - - - - - - - - - ranking = 141.80959575198keywords = tract infection, tract (Clic here for more details about this article) |
7/63. Unusual clinical presentation of klebsiella pneumoniae induced endogenous endophthalmitis and xanthogranulomatous pyelonephritis in a non-nephrolithiasis and non-obstructive urinary tract.The genitourinary tract is well recognized as a route through which bacteria could gain access to the blood circulation. Under some circumstances, metastatic infections may occur in distant organs, including endogenous endophthalmitis. Xanthogranulomatous pyelonephritis (XGP) is an unusual variant of chronic pyelonephritis. It most often occurs in middle-aged women who frequently have a history of recurrent urinary tract infections combined with obstruction and a kidney of poor function. We reported an unusual case of urinary tract infection in a non-nephrolithiasis and non-obstructive urinary tract complicated by klebsiella pneumoniae endogenous endophthalmitis and developed XGP in two months.- - - - - - - - - - ranking = 289.61919150396keywords = tract infection, tract (Clic here for more details about this article) |
8/63. Rapidly fatal acute bacterial myocarditis in a nonneutropenic child with acute lymphoblastic leukemia in remission.The authors report a fatal case of acute bacterial myocarditis in a nonneutropenic child with acute lymphoblastic leukemia. She was admitted to the hospital with a urinary tract infection resulting from and remained persistently febrile despite resolution of the infection. On hospital day 4 signs of acute cardiac failure developed. Despite aggressive resuscitation measures, she died. Pathologic examination revealed the cause of death to be bacterial myocarditis. In addition, she was found to have a generalized decrease in her serum immunoglobulin levels. Acute bacterial myocarditis in patients with malignancy has been rarely reported. The rapid clinical deterioration and death in the patient in this report is particularly interesting.- - - - - - - - - - ranking = 141.80959575198keywords = tract infection, tract (Clic here for more details about this article) |
9/63. Current implications of drug resistance in spinal cord injury.A 54-yr-old man with C6 quadriplegia and a neurogenic bowel and bladder was evaluated for clearance of a urinary tract infection after treatment for organisms susceptible to the antibiotics used, and an organism resistant to all antibiotics on the panel grew on the initial follow-up urine culture. Multidrug-resistant organisms present increasing challenges and risks in the management of the neurogenic bladder in patients with spinal cord injury. In an effort to control and reduce the impact and risk associated with these organisms, management methods of the neurogenic bladder and infection control policies should be adjusted according to guidelines from the Centers for disease Control and related research; such policies could include surveillance for multidrug-resistant organisms and isolation of patients who test positive for these organisms.- - - - - - - - - - ranking = 141.80959575198keywords = tract infection, tract (Clic here for more details about this article) |
10/63. Septic arthritis in an infant with vesicoureteral reflux and urinary tract infection.A 4-week-old boy with previous urinary tract infection and documented vesicoureteral reflux presented with urosepsis and septic arthritis of the right hip. compliance with prophylactic antibiotic therapy had been poor at home. Complications such as bone and joint infection are known to occur after urinary tract infection in children with urologic abnormalities. However, previous similar reports describe discovery of the urinary tract anomalies only as part of an evaluation performed after the systemic complications have occurred. The purpose of this report is to stress the importance of defining urinary tract abnormalities in a case of antenatal hydronephrosis or at the time of the first urinary tract infection in infants so that appropriate investigations, management, and support of parental compliance can be undertaken to avoid systemic complications.- - - - - - - - - - ranking = 994.66717026386keywords = tract infection, tract (Clic here for more details about this article) |
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