1/14. moraxella catarrhalis endocarditis: report of a case and literature review.A 53-year-old man developed severe acute systemic illness three weeks after an upper respiratory tract infection. Serial blood cultures grew moraxella catarrhalis. During antibiotic treatment, fever and infectious parameters disappeared, but severe aortic regurgitation developed. aortic valve replacement was performed, during which extensive destruction of the aortic valve was noted. endocarditis due to M. catarrhalis is very rare with, to our knowledge, only six cases having been reported to date. M. catarrhalis is a normal commensal of the upper respiratory tract, but in unpredictable circumstances can become an important pathogen. bacteremia due to this organism therefore requires prompt treatment, as serious organ complications, including endocarditis, can occur.- - - - - - - - - - ranking = 1keywords = upper respiratory tract, respiratory tract, tract infection, tract, upper (Clic here for more details about this article) |
2/14. Posttrabeculectomy endophthalmitis caused by moraxella nonliquefaciens.moraxella nonliquefaciens, a commensal organism of the upper respiratory tract, is generally considered to have low pathogenic potential. We report here two cases of severe endophthalmitis occurring 9 years and 2 months after glaucoma filtration surgery, respectively. Apart from sulfonamide, very low MICs were recorded for several antibiotics tested. Identification was based on phenotypic characteristics in combination with sequencing of the 16S rRNA gene.- - - - - - - - - - ranking = 0.49483073832416keywords = upper respiratory tract, respiratory tract, tract, upper (Clic here for more details about this article) |
3/14. osteomyelitis/septic arthritis caused by kingella kingae among day care attendees--minnesota, 2003.kingella kingae is a fastidious gram-negative coccobacillus that colonizes the respiratory and oropharyngeal tract in children. K. kingae occasionally causes invasive disease, primarily osteomyelitis/septic arthritis in young children, bacteremia in infants, and endocarditis in school-aged children and adults. Although diagnosis of this organism frequently is missed, invasive disease is uncommon. Only sporadic, non-epidemiologically linked cases have been reported previously. In October 2003, the minnesota Department of health (MDH) investigated a cluster of two confirmed cases and one probable case of osteomyelitis/septic arthritis caused by K. kingae among children aged 17-21 months attending the same toddler classroom in a day care center. All reported within the same week with onset of fever, preceding or concurrent upper respiratory illness (URI), and refusal to bear weight on the affected limb. This report summarizes these cases and describes the epidemiologic investigation of the day care center. The findings underscore the need for clinicians and laboratorians to consider K. kingae infection in young children with Gram stain--negative or culture-negative skeletal infections.- - - - - - - - - - ranking = 0.00035333295181648keywords = tract, upper (Clic here for more details about this article) |
4/14. Vasculitic purpura with antineutrophil cytoplasmic antibody-positive acute renal failure in a patient with streptococcus bovis case and Neisseria subflava bacteremia and subacute endocarditis.Subacute bacterial endocarditis is frequently associated with extracardiac manifestations and renal failure. Clinical variety of endocarditis manifestation is wide and has the potential to mimic vasculitis. Whereas streptococcus bovis is often isolated and associated with colonic tumors, neisseriaceae are rarely found. An association of subacute bacterial endocarditis and antineutrophil cytoplasmic antibodies has been described. We report on a 62-year-old man who was admitted to our hospital with acute oliguric renal failure and a nonpruritic purpural rush without fever. Antineutrophil cytoplasmic antibody diagnostic revealed perinuclear staining with a titre of 1 : 512 and antiproteinase-3 specificity. Immune complex-mediated glomerulonephritis without extracapillary proliferation was diagnosed in renal biopsy. Finally, blood cultures became positive for streptococcus bovis and Neisseria flava. echocardiography showed mobile vegetations on tricuspid valve. Under treatment with penicillin g and gentamicin, skin efflorescences and renal function recovered, but vegetations increased. A colonic tumor could be excluded, a disastrous dental status may have been a predisposal factor. When classical findings of subacute bacterial endocarditis are less clear, the presence of renal failure and antineutrophil cytoplasmic antibodies in absence of fever may lead to misdiagnosis and deleterious immunosuppressive therapy. Neisseria subflava, an upper respiratory tract commensal, may cause subacute bacterial endocarditis without typical symptoms.- - - - - - - - - - ranking = 0.49483073832416keywords = upper respiratory tract, respiratory tract, tract, upper (Clic here for more details about this article) |
5/14. Outbreak of osteomyelitis/septic arthritis caused by kingella kingae among child care center attendees.OBJECTIVE: kingella kingae often colonizes the oropharyngeal and respiratory tracts of children but infrequently causes invasive disease. In mid-October 2003, 2 confirmed and 1 probable case of K kingae osteomyelitis/septic arthritis occurred among children in the same 16- to 24-month-old toddler classroom of a child care center. The objective of this study was to investigate the epidemiology of K kingae colonization and invasive disease among child care attendees. methods: Staff at the center were interviewed, and a site visit was performed. Oropharyngeal cultures were obtained from the staff and children aged 0 to 5 years to assess the prevalence of Kingella colonization. Bacterial isolates were subtyped by pulsed-field gel electrophoresis (PFGE), and dna sequencing of the 16S rRNA gene was performed. A telephone survey inquiring about potential risk factors and the general health of each child was also conducted. All children and staff in the affected toddler classroom were given rifampin prophylaxis and recultured 10 to 14 days later. For epidemiologic and microbiologic comparison, oropharyngeal cultures were obtained from a cohort of children at a control child care center with similar demographics and were analyzed using the same laboratory methods. The main outcome measures were prevalence and risk factors for colonization and invasive disease and comparison of bacterial isolates by molecular subtyping and dna sequencing. RESULTS: The 2 confirmed case patients required hospitalization, surgical debridement, and intravenous antibiotic therapy. The probable case patient was initially misdiagnosed; MRI 16 days later revealed evidence of ankle osteomyelitis. The site visit revealed no obvious outbreak source. Of 122 children in the center, 115 (94%) were cultured. Fifteen (13%) were colonized with K kingae, with the highest prevalence in the affected toddler classroom (9 [45%] of 20 children; all case patients tested negative but had received antibiotics). Six colonized children were distributed among the older classrooms; 2 were siblings of colonized toddlers. No staff (n = 28) or children aged <16 months were colonized. Isolates from the 2 confirmed case patients and from the colonized children had an indistinguishable PFGE pattern. No risk factors for invasive disease or colonization were identified from the telephone survey. Of the 9 colonized toddlers who took rifampin, 3 (33%) remained positive on reculture; an additional toddler, initially negative, was positive on reculture. The children of the control child care center demonstrated a similar degree and distribution of K kingae colonization; of 118 potential subjects, 45 (38%) underwent oropharyngeal culture, and 7 (16%) were colonized with K kingae. The highest prevalence again occurred in the toddler classrooms. All 7 isolates from the control facility had an indistinguishable PFGE pattern; this pattern differed from the PFGE pattern observed from the outbreak center isolates. 16S rRNA gene sequencing demonstrated that the outbreak K kingae strain exhibited >98% homology to the ATCC-type strain, although several sequence deviations were present. Sequencing of the control center strain demonstrated more homology to the outbreak center strain than to the ATCC-type strain. CONCLUSIONS: This is the first reported outbreak of invasive K kingae disease. The high prevalence in the affected toddler class and the matching PFGE pattern are consistent with child-to-child transmission within the child care center. rifampin was modestly effective in eliminating carriage. dna sequence analysis suggests that there may be considerable variability within the species K kingae and that different K kingae strains may demonstrate varying degrees of pathogenicity.- - - - - - - - - - ranking = 0.14588151936027keywords = respiratory tract, tract (Clic here for more details about this article) |
6/14. Severe aortic regurgitation due to neisseria mucosa endocarditis.A rare occurrence of neisseria mucosa endocarditis on a native aortic valve not known to be diseased is reported. Despite vigorous antibiotic therapy, severe aortic regurgitation developed necessitating aortic valve replacement. At operation, the right coronary cusp was retracted with two small nodules attached to its edge and the non-coronary cusp was perforated. neisseria mucosa endocarditis is very rare, and involves abnormal mitral or prosthetic valves predominantly. infection of a native aortic valve, with no known history of disease, is exceptional.- - - - - - - - - - ranking = 0.00032416533663316keywords = tract (Clic here for more details about this article) |
7/14. Bronchopulmonary infection with moraxella catarrhalis in infants requiring extracorporeal membrane oxygenation.moraxella (formerly Branhamella) catarrhalis is now a well-recognized pathogen of the upper and lower respiratory tract. Four pediatric cases of life-threatening pneumonia requiring extracorporeal membrane oxygenation are presented. M. Catarrhalis was isolated within 48 hours of admission in three of the cases and within 24 hours of an acute deterioration in the fourth. We conclude that M. catarrhalis is either a significant pathogen in its own right, a marker of severe disease, or a secondary invader.- - - - - - - - - - ranking = 0.14591068697546keywords = respiratory tract, tract, upper (Clic here for more details about this article) |
8/14. Spectrum and significance of bacteremia due to moraxella catarrhalis.Fifty-eight cases of bacteremia due to moraxella catarrhalis, including seven that occurred in patients treated at our facilities, are analyzed. The host's medical history plays a major role in the presentation and outcome of M. catarrhalis bacteremia. bacteremia is typically accompanied by pneumonia in adults with underlying respiratory disease. Many neutropenic patients do not manifest a focus of infection; in contrast, the source identified in healthy, immunocompetent patients is usually the upper airway or the ears. In the recent literature, it has been reported that a rash is typically absent in adults with bacteremic pneumonia and in immunocompetent hosts and that only some neutropenic patients have a rash. The prognosis is grave for patients with endocarditis and for patients with immunoglobulin deficiency or neutropenia not related to a hematologic malignancy. In addition, mortality is substantial among bacteremic patients with respiratory conditions or other chronic debilities, especially when respiratory copathogens are present. The prognosis is good for febrile neutropenic patients with underlying leukemia or lymphoma when the neutropenia resolves. When healthy, immunocompetent individuals are affected with M. catarrhalis bacteremia, their presentations range from self-limited febrile illness to life-threatening disease.- - - - - - - - - - ranking = 2.9167615183323E-5keywords = upper (Clic here for more details about this article) |
9/14. Quinolone resistance in Oligella urethralis-associated chronic ambulatory peritoneal dialysis peritonitis.Oligella urethralis is an organism which is normally isolated as a commensal from the genitourinary tract. We describe the first two reported cases of CAPD-associated peritonitis caused by this organism. Both isolates were found to be resistant to ciprofloxacin, while relatively sensitive to a wide range of antimicrobial drugs. These findings indicate that this organism may be an opportunistic pathogen for CAPD patients, and that extensive ciprofloxacin usage provides a selection pressure for emergence of resistance.- - - - - - - - - - ranking = 0.00032416533663316keywords = tract (Clic here for more details about this article) |
10/14. Pyocolpos: diagnosis and treatment.Pyocolpos is a rare complication of hydrocolpos. hydrocolpos usually presents during adolescence and is associated with an imperforate hymen. The following is a case of a 3-month-old girl with pyocolpos. Her history was significant for a urinary tract infection (UTI) at 7 weeks of age. The authors believe that her UTI was caused by urinary retention secondary to hydrocolpos. A complete evaluation may have prevented the complication of pyocolpos.- - - - - - - - - - ranking = 0.010662688688309keywords = tract infection, tract (Clic here for more details about this article) |
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