Cases reported "Bacteroides Infections"

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11/89. Fusobacterial brain abscess: a review of five cases and an analysis of possible pathogenesis.

    OBJECT: The cases of five patients with fusobacterial brain abscess are presented. The authors discuss their attempt to determine the pathogenesis. methods: The clinical and microbiological features of five cases of fusobacterial brain abscess are reviewed. Isolates of 2031 Fusobacterium spp. and other anaerobes collected (1989-2002) at our institution were analyzed and compared for incidences and isolation sources. The findings were correlated with extensive literature on the subject. The five patients were men between 45 and 74 years of age. All experienced an insidious onset of the disease and probable hematogenous seeding of the organism(s). One patient had a monomicrobic fusobacterium necrophorum abscess, whereas the others had polymicrobic F. nucleatum abscesses. Despite surgery and a regimen of antibiotic medications and dexamethasone, three patients experienced a paradoxical deterioration 3 days postoperatively that necessitated reevacuation of the lesion. The evacuants observed at that time contained numerous leukocytes but no microorganisms, suggesting intensified inflammation as the likely cause of deterioration. This explanation is supported by literature that fusobacteria strongly activate neutrophils. An analysis of the 2031 anaerobes from blood, wounds, and abscesses showed the considerable virulence of Fusobacterium spp., which were able to enter and/or sustain themselves in the blood circulation. This pattern was similar to that of Clostridium spp., but different from those of peptostreptococcus spp., Bacteroides spp., and prevotella spp., which were less invasive but more abundant. CONCLUSIONS: Some fusobacterial brain abscesses may be associated with a paradoxical postoperative deterioration, which is probably due to intensified inflammation following treatment. The blood-borne dissemination and invasive behavior of fusobacteria likely initiate such a brain abscess, and further seeding of other synergic bacteria leads to a polymicrobic abscess.
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12/89. Septic thrombophlebitis of the portal and superior mesenteric veins as a complication of appendicitis: report of a case.

    Pylephlebitis is extremely rare and associated with high mortality, even in this modern era. It usually occurs secondary to infection in the region drained by the portal systems or in the structure contiguous to the portal vein. We report a case of septic thrombophlebitis of the portal and superior mesenteric veins (SMV) with multiple liver abscesses caused by acute appendicitis with an abscess of the mesoappendix. We performed appendectomy and successfully removed the thrombi using a Fogarty catheter. Postoperative histopathological examination confirmed a diagnosis of appendicitis and septic thrombophlebitis of the portal vein and SMV. The patient recovered completely with appropriate medical and surgical treatment.
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13/89. brain abscess due to gemella haemolysans.

    We present a case of brain abscess due to gemella haemolysans and Bacteroides species in a 60-year-old-immunocompetent man who underwent dental procedures. The patient completely recovered following intravenous therapy with ampicillin and metronidazole for 6 weeks.
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14/89. Acute tongue abscess. Report of three cases.

    Abscess of the tongue seems to be a rare clinical entity and is a potentially life-threatening infection. It may result in airway compromise and disseminated infection to other regions. Thus, a tongue abscess should be considered in all cases of acute tongue swelling, especially when host defences are severely impaired. In acute cases the diagnosis of tongue abscess can be reached clinically. Needle aspiration of pus collection is a useful diagnostic and therapeutic tool, which provides considerable amelioration of symptoms. Three cases of tongue abscess are reported, along with discussion of the presentation, pathophysiology, differential diagnosis, and management of this disease.
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15/89. Right colon adenocarcinoma presenting as bacteroides fragilis liver abscesses.

    Pyogenic abscesses of the liver occur in association with a variety of diseases. Sometimes they are caused by anaerobic infections of liver metastases. Uncommonly, however, multiple hepatic abscesses caused by anaerobic bacteria are the presenting signs of unsuspected colonic cancer in the absence of liver metastases. We report a 60-year-old man who presented with febrile cholestatic liver disease initially thought to be metastases. Repeated ultrasound-directed liver biopsies yielded a diagnosis of multiple abscesses. bacteroides fragilis was grown from the liver specimen and the patient responded well to metronidazole treatment. Two months later, however, overt symptoms of large bowel disease led to the diagnosis of colonic adenocarcinoma. After a 6-month postoperative follow-up, the patient is free of liver metastases. Anaerobic liver abscesses should always alert the clinician to possible silent colonic cancer.
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16/89. Early treatment of cavernositis resulted in erectile function preservation.

    INTRODUCTION: Some of the more common complications of intracavernous injection (ICI) therapy include pain and prolonged erections. Rare reported complications include intracorporeal needle breakage and postinjection cavernositis. AIM: We report a case of early management of postinjection cavernositis resulting in preservation of erectile function with no angulation. methods: A 53-year-old male with no history of diabetes mellitus presented to our department with a small painful penile swelling 36 hours after ICI of 15 microg prostaglandin E1. Clinical, laboratory, and ultrasound assessments suggested the occurrence of cavernositis. Surgical debridement, abscess drainage, and antibiotics resulted in marked improvement. Follow-up showed normal erectile function with minimal scarring. CONCLUSIONS: Timely management of cavernositis can help prevent loss of erectile function. Stringent supervision of patients, after adequate ICI training, together with drug prescription, is essential.
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17/89. Spondylodiscitis due to bacteroides fragilis: two cases and review.

    Non-iatrogenic spondylodiscitis caused by anaerobic bacteria remains exceptional. We describe 2 cases of spondylodiscitis with epidural abscess due to Bacteroides fragilis, 1 after colonoscopy with biopsy and 1 in a cirrhotic patient. The clinical and imaging findings were not discriminant relative to other pyogenic spondylodiscitis. One should consider B. fragilis when treating a spondylodiscitis with epidural abscess, especially in patients with a possibly digestive portal of entry.
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18/89. Bacteroides thetaiotaomicron in posthysterectomy infection.

    We report a patient with clinically significant vaginal posthysterectomy infection due to Bacteroides thetaiotaomicron. The microorganism isolated from the vaginal cuff abscess was beta-lactamase producer and the antibiotic susceptibility pattern showed its resistance to piperacillin-tazobactam and cefoxitin, while the susceptibility to amoxicillin associated with clavulanic acid, metronidazole, and the newer fluoroquinolone moxifloxacin was confirmed.
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19/89. Obturator abscess after transobturator tape for stress urinary incontinence.

    BACKGROUND: A transobturator tape is a nonwoven, thermally bonded polypropylene tape recently approved in europe for minimally invasive treatment of stress urinary incontinence. CASE: Three cases of obturator abscess after transobturator tape procedures are reported. patients presented with groin pain and vaginal discharge, and physical examination showed vaginal erosions. magnetic resonance imaging confirmed the obturator abscess. All patients had complete sling removal and were treated with antibiotics. The organism responsible for the obturator abscess was bacteroides fragilis in all three cases, suggesting that the infection occurred through a vaginal erosion. CONCLUSION: Persistent painful or irritating symptoms after suburethral tape procedures may be due to a vaginal erosion that can be associated with an obturator abscess. Appropriate evaluation and treatment result in marked symptomatic improvement, although stress incontinence may recur.
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20/89. Anaerobic septicemia after transrectal prostatic biopsy.

    Transrectal biopsy of the prostate resulted in anaerobic septicemia in two patients, despite parenteral gentamicin sulfate prophylaxis. bacteroides fragilis sepsis developed subacutely in one patient having a postbiopsy pelvic abscess. clostridium perfringens sepsis occurred fulminantly in another patient 24 hours after biopsy of a gland extensively involved with adenocarcinoma. These cases indicate a potential hazard of sepsis due to anaerobic contamination with rectal microflora at the time of transrectal prostatic biopsy and the futility of prophylaxis directed only at aerobic bacteria.
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