1/24. Febrile lady with acute renal failure and desquamating erythema.A 63-year-old woman developed acute renal failure and streptococcal toxic shock syndrome caused by streptococcus group G. Initially, an erythema resembling vasculitis was misleading. The subsequent clinical course, however, was typical for streptococcal toxic shock syndrome and met the criteria put forward by The Working Group on Severe streptococcal infections. In patients infected with streptococcus group G, toxic shock syndrome is rare. The streptococcus group G strains isolated from this patient did not produce pyrogenic exotoxins. Instead they produced an M-like protein related to group C and G streptococci that do not act as superantigens.- - - - - - - - - - ranking = 1keywords = streptococcus (Clic here for more details about this article) |
2/24. Continuous intrathecal pump infusion of baclofen with antibiotic drugs for treatment of pump-associated meningitis. Case report.Intrathecal baclofen administered by means of an implantable pump is being increasingly used for successful treatment of spasticity. meningitis following intrathecally administered baclofen is a rare but serious complication that is difficult to treat without removal of the pump. Because success rates with intravenously administered antibiotic drugs for the treatment of meningitis have been low, intrathecal administration of antibiotic agents is often required to eradicate the pathogen. The authors report the case of a patient in whom staphylococcus epidermidis meningitis developed after insertion of an intrathecal baclofen pump. The patient was successfully treated by intrathecal coadministration of vancomycin and baclofen.- - - - - - - - - - ranking = 0.072472293070589keywords = meningitis (Clic here for more details about this article) |
3/24. Double prosthetic valve endocarditis caused by streptococcus pneumoniae.Infective endocarditis (IE) caused by streptococcus pneumoniae is a rare disease. Only eight cases of pneumococcal prosthetic valve endocarditis have been described in the literature. In this report we describe the first case of pneumococcal endocarditis involving two prosthetic heart valves. The patient had pneumonia as the probable portal of entry but no predisposing conditions for invasive pneumococcal disease. Our case also illustrates the importance of transesophageal echocardiography (TEE) for the early diagnosis of IE and a timely decision for cardiac surgery.- - - - - - - - - - ranking = 0.13032320260183keywords = pneumoniae (Clic here for more details about this article) |
4/24. Primary meningococcal arthritis in a prosthetic knee joint.neisseria meningitidis is known to cause a spectrum of diseases, including bacteraemia without sepsis, meningococcaemia without meningitis, meningitis with or without meningococcaemia, and chronic meningococcaemia. Less common manifestations of meningococcal infection include pharyngitis, pneumonia, pericarditis, urethritis and arthritis. To our knowledge, there have been no previous reports of N. meningitidis causing prosthetic joint infection. Herein, we report a case of primary meningococcal arthritis in a woman with a prosthetic knee joint. After surgical drainage the prosthesis was retained and the patient received appropriate and prolonged antibiotic treatment. The outcome was favourable, as with primary meningococcal arthritis affecting native joints.- - - - - - - - - - ranking = 0.02415743102353keywords = meningitis (Clic here for more details about this article) |
5/24. Ultrastructural analysis of an infected collagen-coated vascular graft.The incidence of infection following arterial reconstruction using synthetic graft materials varies from less than 1 to 5%. One of three mechanisms is thought to be responsible: 1. intraoperative contamination, 2. extension from adjacent infected or colonized tissue, or 3. hematogenous or lymphogenous seeding. We present ultrastructural data of a patient with a polymicrobial graft infection due to a prostheto-enteric fistula 16 years after reconstruction of an aortobifemoral graft. The polymer surface showed signs of biodegradation and was completely covered with a layer of plasma proteins. Disrupted fibroblasts on the intersegmental graft surface were surrounded by bundles of collagen. Gram-negative rods and grampositive cocci were embedded in an extracellular EPS matrix. Bacterial culture confirmed growth of eikenella corrodens, fusobacterium nucleatum and peptostreptococcus species. fibrin and granulation tissue from the neoadventitia started to mark off the inflammatory process. Transmission electron microscopy is a valuable tool for the investigation of alloplastic arterial devices. After 16 years of implantation the graft shows different signs of biodegradation.- - - - - - - - - - ranking = 0.33333333333333keywords = streptococcus (Clic here for more details about this article) |
6/24. liver abscess caused by an infected ventriculoperitoneal shunt.Pyogenic liver abscess in taiwan is most commonly due to klebsiella pneumoniae infection in diabetic patients, and less frequently due to biliary tract infections. liver abscess caused by ventriculoperitoneal (VP) shunt is very rare. We report a case of liver abscess caused by methicillin-resistant Staphylococcus aureus (MRSA), which developed as a complication of an infected VP shunt. A 53-year-old woman, who had shad a VP shunt implanted 3 months previously for hydrocephalus due to intracranial hemorrhage, presented with fever off and on, drowsiness and seizure attacks for 1 week. Computed tomography (CT) of the brain showed only mild right-sided hydrocephalus, and was negative for intracranial hemorrhage and intracranial mass. Analysis of cerebrospinal fluid showed significant pleocytosis and hypoglycorrhachia. CT scan of the abdomen disclosed a huge abscess in the right lobe of the liver. Cultures of both the cerebrospinal fluid and aspirated liver abscess isolated MRSA. The patient was treated with intraventricular and intravenous vancomycin, intravenous teicoplanin and oral rifampicin, followed by oral chloramphenicol and rifampicin. Percutaneous drainage of the liver abscess and externalization of the VP shunt were performed. The liver abscess had resolved almost completely on ultrasonography after 2 weeks of therapy. liver abscess in patients with a VP shunt should be considered a possible abdominal complication of the VP shunt, and may be caused by unusual pathogens. Diagnosis requires CT scan and direct aspiration and culture of the liver abscess. Treatment requires management of both the liver abscess and the infected shunt.- - - - - - - - - - ranking = 0.026064640520366keywords = pneumoniae (Clic here for more details about this article) |
7/24. endocarditis due to peptostreptococcus anaerobius: case report and literature review of peptostreptococcal endocarditis.Infective endocarditis caused by anaerobic streptococci occurs rarely, and only five cases have been described in detail, with two additional cases mentioned in a review of anaerobic infective arthritis. All have resulted from infection caused by peptostreptococci. Another case of anaerobic gram-positive endocarditis caused by peptostreptococcus anaerobius has recently been encountered. The patient was successfully treated with a beta-lactam for six weeks, plus gentamicin (to which the organism was resistant in vitro) for two weeks. In reviewing these six cases, all but one involved a prosthetic valve, and in three instances the organism was isolated only from the infected valve. In four of six patients the aortic valve was involved, and five of the six survived with appropriate antimicrobial therapy. Embolic phenomena were confirmed in only one patient, who also manifested the only non-diagnostic echocardiogram.- - - - - - - - - - ranking = 1.6666666666667keywords = streptococcus (Clic here for more details about this article) |
8/24. Six cases of bacterial infection in porous orbital implants.BACKGROUND: We present 6 cases of bacterial infection that developed after porous orbital implant surgery. CASES: Five patients with hydroxyapatite implants showed lid swelling, discharge, and suppurative granuloma 14 days to 3 years after surgery. The hydroxyapatite implants were removed 14 days to 41 months postoperatively, and synthetic porous polyethylene orbital implants were inserted. Thick discharge and conjunctival melting was noted 14 months after primary Medpor implant surgery in the sixth patient, and the infection was controlled by medical therapy. OBSERVATIONS: The culture of specimens removed with swabs from the conjunctiva of patients and from the hydroxyapatite implants showed growth of staphylococcus aureus, staphylococcus epidermidis, alpha-hemolytic streptococcus and peptostreptococcus in 4 patients, whereas streptococcus pyogenes were cultured from the conjunctiva in the Medpor implant patient. culture for the remaining patient was negative .CONCLUSIONS: If there is continuous pain, injection, and discharge after porous implant insertion, bacterial infection in the implant should be considered immediately. Systemic antibiotics and topical eye drops should be administered without delay. If no improvement is observed, the implant should be removed and a different approach must be considered.- - - - - - - - - - ranking = 0.66666666666667keywords = streptococcus (Clic here for more details about this article) |
9/24. Late infection of a total knee arthroplasty with streptococcus bovis in association with carcinoma of the large intestine.Infection of a total knee arthroplasty with streptococcus bovis in a 76-year-old man that led to the diagnosis of a bowel carcinoma is reported. Investigation revealed a malignancy in the ascending colon with extension into the adrenal gland. S bovis in conjunction with colonic neoplasia has been reported in several orthopedic conditions: vertebral osteomyelitis, discitis, lateral neck abscess, and osteomyelitis of the ileum. The relationship of S bovis to endocarditis, meningitis, brain abscesses, and peritonitis has also been well described. However, S bovis is a rare pathogen infecting joint prostheses and should raise the possibility of a gastrointestinal lesion.- - - - - - - - - - ranking = 0.012078715511765keywords = meningitis (Clic here for more details about this article) |
10/24. A case of septicaemia, meningitis and pneumonia caused by streptococcus bovis type II.We present a case of septicaemia, pneumonia and meningitis due to streptococcus bovis type-II in a patient who had undergone a total hip prosthesis under general anaesthesia three weeks earlier. This organism is an uncommon human pathogen that sometimes causes bacteraemia and endocarditis and is usually connected with colon pathology and dental procedures. In the reported case, there were no risk factors for S. bovis infection except for the hip operation. S. bovis type II sensitive to penicillin was isolated from all blood and pleural fluid cultures. The patient recovered and was discharged from hospital two weeks after presentation.- - - - - - - - - - ranking = 0.060393577558824keywords = meningitis (Clic here for more details about this article) |
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