Cases reported "Bacterial Infections"

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21/50. Microvascular injury and repair in acute human bacterial pyelonephritis.

    Acute inflammatory cell-capillary endothelial cell interactions, related to injury and repair, were investigated light and electron microscopically in acute human bacterial pyelonephritis. In inflammatory infiltrate-adjacent microvessels, the small capillaries were completely occluded by leukocyte plugs and the large capillaries were densely filled with acute inflammatory cells adhering to the endothelium. Severe damage to small and large capillaries was observed around endothelium adherent, degranulated neutrophil granulocytes containing phagocytosed bacteria. There were spaces in the endothelium, degradation of the vascular basement membrane, of the perivascular interstitial matrix and of collagen fibrils, with fibrin deposition and vessel wall fragmentation. In the small capillaries relatively distant from the interstitial infiltrates, emigration of leukocytes was frequently seen. Around the escaping cells the endothelial lining displayed occasional discontinuities, allowing leakage of vascular fluid into the interstitial space. Some small capillaries not related to the infiltrate were occluded by fibrin thrombi with apparent damage to the endothelial cells and disruption of the capillary wall. Various reparative changes were noticed in association with this change including capillary neovascularization. The findings confirm the existence of polymorphonuclear leukocyte-mediated injury of capillaries during the development of inflammatory responses in acute pyelonephritis.
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22/50. Successful treatment of early, postoperative, necrotizing infection of the abdominal wall.

    Unique treatment of a necrotizing infection of the abdominal wall, using a temporary closure with polyvinyl, led to survival in a patient with a stab wound, who developed extensive abdominal myofascial necrosis. A large abdominal wall defect was repaired later with polypropylene mesh and a split-thickness autograft.
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ranking = 0.052673215691455
keywords = necrotizing
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23/50. Necrotizing fasciitis.

    Necrotizing fasciitis is a relatively uncommon severe soft tissue infection that is characterized by rapid widespread superficial fascial necrosis with undermining of surrounding soft tissue. Recent advances in anaerobic culture techniques have allowed identification of anaerobic organisms, which are now considered to have a vital role in the pathogenesis of this soft tissue infection. Therapy requires both rapid institution of a high level of antibiotics and a radical surgical incision and drainage procedure. All of the aerobic and anaerobic organisms isolated in the reported case of necrotizing fasciitis arising from a periapically infected mandibular third molar demonstrated in vitro sensitivity to penicillin.
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ranking = 0.010534643138291
keywords = necrotizing
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24/50. lactobacillus pneumonia in a patient with oesophageal carcinoma.

    We report a case of necrotizing pneumonia caused by lactobacillus secondary to a tracheo-oesophageal fistula created by an oesophageal carcinoma. We emphasize the presence of resistance of lactobacillus to clindamycin and cotrimoxazole, previously reported to be effective.
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keywords = necrotizing
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25/50. Severe gastrointestinal involvement in children with the acquired immunodeficiency syndrome.

    Five children with the acquired immunodeficiency syndrome (AIDS) and unusual gastrointestinal disease are described. Two children presented with malnutrition, abdominal distention, and diarrhea. One was found to have moderately severe villus atrophy on jejunal biopsy and was initially thought to have celiac disease. Jejunal biopsy from the second child revealed infiltration of the mucosa with acid-fast bacilli-laden macrophages. A third child suffered recurrent abdominal pain, progressive weight loss, diarrhea, and severe gastrointestinal hemorrhage secondary to infection with cytomegalovirus. Pseudomembranous necrotizing jejunitis associated with overgrowth of klebsiella pneumoniae in the duodenal fluid occurred in one patient. The fifth child presented in the newborn period with serratia marcescens cholecystitis. Gastrointestinal disease in children with AIDS may be due to idiopathic villus atrophy and bacterial or opportunistic infection.
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ranking = 0.010534643138291
keywords = necrotizing
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26/50. Renal involvement in relapsing polychondritis.

    Twenty-nine of the 129 patients with RP seen at the Mayo Clinic between 1943 and 1984 had renal involvement. These patients were older, had arthritis and extrarenal vasculitis more frequently, and had a significantly worse survival rate than those without renal involvement. Renal biopsies were obtained in 11 of these 29 patients. The predominant lesions were mild mesangial expansion and cell proliferation, and segmental necrotizing glomerulonephritis with crescents. Small amounts of electron-dense deposits, predominantly mesangial, were noted on electron microscopy. Immunofluorescence revealed faint deposition of C3 and/or IgG or IgM, predominantly in the mesangium. Autopsies were obtained in 13 of the 47 patients who had died. Information regarding the renal pathology was available in 10 of these 13 autopsies. At the time of the initial evaluation at the Mayo Clinic, 6 of these 10 patients had evidence of renal involvement. At autopsy, none of these 10 patients had evidence of active renal vasculitis or segmental necrotizing glomerulonephritis, but 8 of the 10 patients exhibited variable degrees of vascular and glomerular sclerosis, segmental mesangial proliferation, tubular loss, and interstitial lymphocytic infiltrates. These observations expand the limited information available in the literature, which is based on 11 previously published case reports of renal involvement in RP. In only a few of our patients and previously reported patients were the manifestations of the disease limited to the systems characteristically involved in pure RP. The frequent coexistence of other autoimmune and connective tissue diseases supports the role of immune mechanisms in the pathogenesis of this syndrome. Deposition of immune complexes is likely to play a role in the pathogenesis of the glomerular lesions associated with RP. Administration of corticosteroids alone is sufficient to induce a complete remission in some cases, while in others the addition of a cytotoxic agent is necessary to control the activity of the disease or to spare corticosteroid side effects and maintain a remission. immunosuppression-related infectious complications and undetected relapses after discontinuation of immunosuppressive therapy are largely responsible for the morbidity and mortality observed in these patients.
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ranking = 0.021069286276582
keywords = necrotizing
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27/50. Suppurative bacterial pyelonephritis as a cause of acute renal failure.

    Acute oliguric renal failure associated with bacterial pyelonephritis is a rarely recognized clinical entity. We report a woman with an ectopic pregnancy who developed acute renal failure requiring dialytic support. The renal biopsy revealed focal microabscess formation and leukocyte interstitial infiltration compatible with suppurative pyelonephritis. Although her renal function improved gradually with antimicrobial treatment, the process was incomplete and renal dysfunction persisted at a 10-week follow-up, suggesting permanent renal damage.
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ranking = 1
keywords = pyelonephritis
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28/50. Craniocervical necrotizing fasciitis: critical factors in management.

    Necrotizing fasciitis involving the head and neck is rare. The authors describe two such patients treated at their institution and analyse 39 cases reported in the literature. This entity may be divided into two groups based on the site of origin of the infection: group 1 (13 cases) infections, originating in the scalp and eyelids, mostly secondary to trauma, do not progress rapidly, respond well to medical and operative measures and result in minimal permanent disability. These infections usually are caused by hemolytic streptococci and staphylococcus aureus. Group 2 (28 cases) infections, originating in the face or neck and mostly complications of dental and pharyngeal sepsis, progress rapidly to adjoining sites including the chest wall and mediastinum. These infections are caused by a wide variety of microorganisms including anaerobes; fatal complications are frequent and the death rate is high (32%). Early and very aggressive debridement and drainage are mandatory and should be repeated if warranted.
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ranking = 0.042138572553164
keywords = necrotizing
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29/50. Infectious morbidity in gynecologic cancer.

    A retrospective investigation of infectious morbidity in gynecologic oncology patients documented that 54 (11%) of 494 patients and 68 (6%) of 1204 patient admissions were complicated by a serious infection. The highest rate of infectious morbidity by admission was 21%, occurring in patients admitted for cancer of the vulva. The highest surgical infectious morbidity, 22%, occurred in patients admitted for cervical cancer. Important factors in determining infection risk include multiple host factors, radical surgical procedures, factors inherent in the tumor itself, and additional irradiation and chemotherapy. These serious polymicrobial infections dictate intelligent selection of antimicrobials and appropriate monitoring to anticipate complications inherent in antimicrobial therapy. beta-Lactamase induction, superinfection, nephrotoxicity, and necrotizing enterocolitis are documented problems in these patients.
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ranking = 0.010534643138291
keywords = necrotizing
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30/50. epididymitis as cause of antibody-coated bacteria in urine.

    The antibody-coated bacteria (ACB) immunofluorescence test has emerged as the preferred noninvasive technique to distinguish reliably between pyelonephritis and cystitis. Investigators have recently correlated a positive test with chronic bacterial prostatitis and cystitis complicating a bladder tumor or stone. We present data that appear to prove that acute bacterial epididymitis associated with bacteriuria can also evoke a positive ACB determination.
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ranking = 0.16666666666667
keywords = pyelonephritis
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