1/15. The spectrum of bacillus bacteremias in heroin addicts.bacillus bacteremias occurred in two heroin addicts. The first patient had one day of fever and chills after intravenous heroin use. Persistent cereus bacteremia consistent with endocarditis was documented and responded to four weeks of antibiotic therapy. The second patient had non-cereus bacillus species isolated from blood cultures three times over eight days, each time after renewed heroin use. The patient remained well, and the bacteremias cleared spontaneously. Because bacillus species frequently contaminate heroin injection materials and because the bacillus bacteremias were temporally associated with intravenous heroin use, bacillus bacteremias in both patients probably eventuated from heroin abuse. These cases, in conjunction with two previously reported cases of bacillus endocarditis in heroin addicts, suggest that heroin addicts are at risk for developing bacillus bacteremias, which may vary in severity from endocarditis to benign transient bacteremias.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
2/15. Guess what! pseudomonas aeruginosa sepsis.A 62-year-old woman affected by end-stage renal disease secondary to Waldenstrom's disease was admitted to place a central venous catheter for hemodialysis purposes. During the admission, she gradually developed a number of necrotic ulcerative and fluctuant nodular skin lesions on the submammary flexures, groins and limbs accompanied by high fever and chills. Yellow-green purulent material could be drained from the site of introduction of the jugular catheter. skin biopsies were taken from the edge of an inguinal necrotic-ulcerative lesion and from a fluctuant nodular lesion of the thigh, where pus was drained and cultured.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
3/15. lemierre syndrome in a previously healthy young girl.lemierre syndrome is a severe postanginal sepsis complicated by internal jugular thrombophlebitis. We report on a 14 y-old girl affected by high fever, shivering chills, headache, severe lateral neck pain, left ocular proptosis and general malaise. magnetic resonance imaging of the head and neck showed right internal jugular vein and sigmoid sinus thrombosis. fusobacterium sp. was identified in the blood culture. CONCLUSION: Our report is a reminder that lemierre syndrome still exists and remains potentially life threatening. A high index of suspicion is necessary to prompt diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
4/15. Bacterial contamination of platelet units: a case report and literature survey with review of upcoming american association of blood banks requirements.The most common transfusion-associated infectious risk in the united states today is bacterial contamination of platelet components. Bacterial contamination is estimated to occur at an incidence of 1:1000 to 1:3000 in platelet units, with severe episodes estimated to occur in about one sixth of contaminated products. Increased awareness and prompt reaction of the medical team can greatly affect the outcome and save a patient's life. The following case history illustrates this issue. A young woman developed chills and rigors while receiving 1 unit of leuko-reduced apheresis platelets for severe thrombocytopenia. The transfusion was stopped, blood cultures were drawn, and the patient developed clinical signs of sepsis. Cultures of both the platelet unit and the patient's blood revealed coagulase-negative staphylococcus. Microbial susceptibilities in both samples were identical. Pretransfusion blood cultures taken from the patient earlier that day were negative. The platelet unit had been stored for 5 days. We review this case and the literature describing the persistent problem of platelet unit contamination and at the same time highlight the efforts now directed by the American association of blood banks and College of American Pathologists to address this issue. Although there is no uniform approach to dealing with bacterial contamination of platelets, the American association of blood banks and the College of American Pathologists have promulgated new accreditation requirements in an effort to prevent bacterial sepsis associated with platelet transfusion. A new American association of blood banks standard, which will be effective March 1, 2004, requires a combination of strategies both to limit the initial inoculation of bacteria into the blood component and to detect subsequent growth at room temperature (American association of blood banks association Bulletin #03-12). The new College of American Pathologists checklist question, which became effective in December 2003, is a Phase 1 requirement that calls for inspected facilities to have a platelet bacteria detection method in place.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
5/15. bacteremia and septic arthritis caused by moraxella catarrhalis.moraxella catarrhalis was isolated from blood from a 41-year-old man who had a 24-hour history of increasing pain in and swelling of the left knee. No history of trauma, arthropathy, fever, chills, cough, or chest pain was noted. What is believed to be the first case of bacteremia caused by M. catarrhalis that was associated with septic arthritis is described in this report. The case presented suggests the pathophysiology of this rare condition. One previous case of septic arthritis caused by M. catarrhalis without documented bacteremia has been reported.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
6/15. Transfusion reactions due to bacterial contamination of blood and blood products.bacterial infections transmitted by blood or blood products, although rare, remain a serious threat to the recipient of a transfusion. We report on five cases of adverse reactions due to bacterial contamination of blood products, and we review 76 similar cases reported in the English-language literature. Most cases (70%) have been reported from the united states. Various sources of contamination have been suggested, including infection in the donor and invasion of the blood product during the process of collection, preparation, and storage. Frequent clinical manifestations are fever (80%), chills (53%), hypotension (37%), and nausea or vomiting (26%). The overall mortality is 35% (28 of 81 patients). In 38 patients (47%) the adverse reactions have appeared during transfusion; in the others the interval between completion of the transfusion and appearance of symptoms has ranged from 15 minutes to 17 days. A wide spectrum of bacteria have been implicated as causes of adverse reactions, with Pseudomonas species involved in 28% of episodes. Many such reactions are probably misdiagnosed or overlooked, the result being underestimation of the extent of the problem.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
7/15. salmonella cholerasuis bacteremia and mycotic aneurysm of abdominal aorta--report of five cases.From August 1986 to October 1987, there were 5 cases of primary mycotic aneurysm of the lower abdominal aorta in Chang Gung Memorial Hospital at Kaoshiung. All patients were proved to have salmonella cholerasuis (Sal. chol.) septicemia by blood culture. The ages ranged from 60 to 80 years old, the mean age was 71.6 years old. The male to female ratio was 4 to 1, 3 patients had diabetes mellitus (DM) and 3 had hypertension. The duration of symptoms lasted from 1 week to 2 months before diagnosis. Clinically, all patients had sepsis with fever, chills, leucocytosis, and complained of pain in the lower abdomen (80%), at flank (20%) or low back (20%). Abdominal tenderness was present in 3 (60%). Two patients underwent surgery, 1 expired during the operation, the other expired 1 month after operation because of retroperitoneal abscess and sepsis. Three were discharged in septic shock and expired within 1 day. The mortality rate was 100%. The diagnosis of complicated aneurysm of the lower abdominal aorta was established in all by computed tomography (CT). In conclusion, when there are clinical manifestations of sepsis, positive blood culture for Sal. chol., and pain or tenderness in the lower abdomen, flank area or back, one should consider the possibility of mycotic aneurysm of the lower abdominal aorta. Although the prognosis is poor, early surgical intervention may improve the outcome. And the diagnosis is best established by CT.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
8/15. Benign meningococcemia with IgG and IgM antimeningococcal antibodies measured by ELISA.Six patients with benign meningococcemia are presented. The clinical picture was typically intermittent fever with chills, skin eruptions, maculopapules (often hemorrhagic) and arthritis/arthralgia in a person in good general condition. Meningococci of serogroup B were isolated from the blood of 3 patients, from the cerebrospinal fluid of 1 patient and from the nasopharynx of the remaining 2 patients. In 4 patients we assayed the levels of IgG and IgM antibodies against meningococcus serogroup B in an enzyme-linked immunosorbent test (ELISA), using whole bacteria as the antigen. All of them had higher antibody levels than the geometric means for healthy controls of both IgG and IgM, except for 1 patient who did not develop IgG antibodies.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
9/15. Septicemic plague in new mexico.Eighteen of the 71 cases of plague reported in new mexico from 1980 to 1984 were septicemic. We reviewed these cases to better describe the clinical presentation of this disorder and to identify risk factors for developing septicemic plague. The symptoms (fever, chills, malaise, headache, and gastrointestinal symptoms) and signs (tachycardia, tachypnea, and hypotension) of septicemic plague are similar to those of other forms of gram-negative septicemia. abdominal pain was reported in nearly half of the cases, and differential white blood cell counts revealed a marked shift to the left. The risk of developing septicemic plague was higher for persons greater than 40 years of age. Because of empirical antibiotic treatment of older persons, deaths from septicemic plague occurred primarily among persons less than 30 years old. Deaths from septicemic plague could be reduced by aggressive antibiotic therapy for patients with a clinical presentation suggesting gram-negative septicemia, especially patients less than 30 years old.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
10/15. vibrio vulnificus septicemia.A 33-year-old Japanese male, who had a three year history of biopsy-proved liver cirrhosis, was admitted to the hospital on June, 24, 1983 with a sudden onset of fever (38.6 degrees C), chills, generalized pain, nausea, anorexia, weakness, and eruption over the entire body. The patient went into shock and died about 7 hours after admission. Blood cultures before death were positive for V. vulnificus. Postmortem microscopic examination revealed "necrotizing vasculitis" in the small and large intestines, stomach, and skin, and also showed marked toxic epidermal necrolysis. This case matches the primary septicemia caused by V. vulnificus described by Blake et al. In addition, this case suggests that the septicemia was acquired through the gastrointestinal tract, especially the small intestine, because the V. vulnificus was isolated from blood and numerous Gram-negative bacilli around the submucosal vessels were observed in the area with acute necrotizing vasculitis.- - - - - - - - - - ranking = 1keywords = chill (Clic here for more details about this article) |
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