1/90. bacteroides fragilis bacteremia and infected aortic aneurysm presenting as fever of unknown origin: diagnostic delay without routine anaerobic blood cultures.We report the case of a 71-year-old male with bacteroides fragilis bactermia and infected aortic aneurysm that went undiagnosed, in part, because routine anaerobic blood cultures were not obtained. bacteremia caused by anaerobes has been reported to be declining, and recommendations to discontinue routine anaerobic blood cultures have been implemented in some hospitals. To our knowledge, this is the first report of an anaerobic bacteremia and infection that had a delay in diagnosis due to this change in blood-culturing protocol. The potential impact of deleting anaerobic blood cultures from routine protocols is discussed.- - - - - - - - - - ranking = 1keywords = fragilis (Clic here for more details about this article) |
2/90. Contained rupture of the aneurysm of common iliac artery associated with pyogenic vertebral spondylitis.STUDY DESIGN: A case report. OBJECTIVES: To report and discuss a case of contained rupture of the aneurysm of common iliac artery associated with pyogenic vertebral spondylitis, so that investigators and practitioners may avoid the diagnostic and therapeutic pitfalls associated with pyogenic vertebral spondylitis and aortic disease. SUMMARY OF BACKGROUND DATA: Pyogenic vertebral spondylitis is a rare disorder that may have serious consequences, including death, if it is not diagnosed promptly and treated effectively. The association of pyogenic vertebral spondylitis with infection of the aorta is a rare but potentially fatal condition that requires prompt diagnosis and aggressive surgical and medical therapy. To our knowledge, this is the first report of a contained rupture of the aneurysm of common iliac artery case associated with pyogenic vertebral spondylitis resulting from an infection with bacteroides fragilis,although Salmonellae infections are commonly associated with vertebral osteomyelitis and lesions of the contiguous aorta. methods: A 60-year-old man with chronic lower back pain began to experience a severe pain and had increased difficulty in walking. An MRI scan showed an increased signal in the L4-L5 disc space and an abscess extending into the spinal canal. The presumptive diagnosis was infective spondylitis. While performing a CT-guided needle biopsy, an unexpected contained rupture of the aneurysm of common iliac artery was discovered. RESULTS: A wide resection of all infected tissue, including the right common iliac artery and bony lesions, was performed in combination with antimicrobial therapy. A cryopreserved aortic allograft was used to reconstruct the artery, and an iliac strut graft was used to fill the debrided vertebral cavity. The patient's postoperative recovery was uneventful. CONCLUSION: The coexistence of pyogenic vertebral spondylitis and lesions of the aorta is rare, but may be lethal if not diagnosed promptly and treated effectively. Even if a patient's condition is stable and the hematocrit is normal, it is important to consider the possibility of a contained rupture of a mycotic abdominal aneurysm in all patients with vertebral osteomyelitis who have acute episodes of unusual severe back pain. CT is sometimes more beneficial than MRI in the identification and characterization of contained rupture of aneurysms.- - - - - - - - - - ranking = 0.2keywords = fragilis (Clic here for more details about this article) |
3/90. bacteroides fragilis vertebral osteomyelitis secondary to anal dilatation.STUDY DESIGN: A case report of anaerobic vertebral osteomyelitis after anal dilatation. OBJECTIVES: To present a patient with monomicrobial anaerobic vertebral osteomyelitis secondary to a previously undescribed source of infection. SUMMARY OF BACKGROUND DATA: A 17-year-old boy presented with low back pain 3 months after anal dilatation. methods: physical examination, technetium-99m bone scan, plain radiograph, CT, and MRI studies of the lumbar spine were used to clinically diagnose lumbar osteomyelitis. culture material from the involved disc was positive for bacteroides fragilis. RESULTS: The patient recovered after 8 weeks of treatment with oral metronidazole. CONCLUSIONS: bacteroides fragilis hematogenous osteomyelitis is a rare entity. This is the first reported case of such disease after anal dilatation.- - - - - - - - - - ranking = 1.2000000267444keywords = fragilis, bone (Clic here for more details about this article) |
4/90. Gram-Negative anaerobic endocarditis: two case reports and review of the literature.The rarity of anaerobic gram-negative endocarditis limits the ability of physicians to define its prognosis. Two cases of endocarditis due to Bacteroidesfragilis are described, and a review of the English literature for all cases of anaerobic gram-negative endocarditis reported since 1940 is presented. The disease predominantly affects males. Clinical features are similar to those of endocarditis due to nonanaerobic organisms, but underlying heart disease is less common and the rate of thromboembolic complications is high. All deaths reported were due to Bacteroides spp.; no deaths due to fusobacterium spp. have been reported. Treatment with metronidazole has dramatically improved the prognosis of patients with endocarditis due to anaerobic gram-negative bacilli.- - - - - - - - - - ranking = 0.2keywords = fragilis (Clic here for more details about this article) |
5/90. Delayed post-traumatic subdural empyema.A case of subdural empyema is reported, treated through a frontal bone flap, with exenteration of the infected frontal sinus at operation, and subdural instillation of antibiotics for 48 hours postoperatively. Diagnostic findings are reviewed, and the likelihood of anaerobic infection this case and similar cases discussed.- - - - - - - - - - ranking = 2.6744366654239E-8keywords = bone (Clic here for more details about this article) |
6/90. Some clinical, immunological and bacteriological observations in a case of pyogenic arthritis due to bacteroides fragilis.A case of recurrent pyogenic arthritis in a knee joint and abscess formation of the lower limb is described. The infection occurred in a 70-year-old male patient treated with steroids for rheumatoid arthritis. A strain of bacteroides fragilis was repeatedly isolated both from the knee joint and the abscess. The isolated strain was used as antigen in tube agglutination tests and significant titre changes were observed during the course of the disease. The isolated strain was initially sensitive to doxycycline but developed resistance to this drug during therapy. The sensitivity to lincomycin remained unaffected.- - - - - - - - - - ranking = 1keywords = fragilis (Clic here for more details about this article) |
7/90. Primary psoas abscess. Report of three cases.BACKGROUND: Primary psoas abscesses are a rare clinical entity with subtle and non specific symptoms, most commonly seen in patients predisposed to infections. early diagnosis and appropriate management are therefore challenging aspects for physicians. patients AND methods: We present three patients with primary pyogenic psoas abscess, treated at the Heraklion University Hospital, during a 5-year period. The two male and one female patient, aged 36-51 years were admitted with fever, abdominal pain and a palpable tender mass. RESULTS: The classical sign of limping was absent in all cases. Positive psoas symptoms were detected in only two patients. CT scan accurately confirmed the diagnosis in all cases. The patients were successfully treated with antibiotics and prolonged surgical drainage. staphylococcus aureus was the causative microorganism in the first two and bacteroides fragilis in the third patient. This is the first reported case resulting from this specific bacteria. None of our patients had any predisposing risk factor. CONCLUSIONS: A high index of suspicion is mandatory to enable early recognition of this rare clinical disease. CT scan is the standard diagnostic tool to confirm diagnosis. Prolonged drainage and appropriate antibiotics are essential for the successful treatment of primary psoas abscesses.- - - - - - - - - - ranking = 0.2keywords = fragilis (Clic here for more details about this article) |
8/90. Stent graft infection after abdominal aortic aneurysm repair: a case report.A 77-year-old man had clinical and radiologic signs of graft infection develop 1 year after stent grafting for abdominal aortic aneurysm. blood cultures grew bacteroides fragilis, and cultures of the aneurysm sac grew enterococcus. The patient's condition was successfully managed with staged extraanatomic revascularization followed by graft excision. Although stent graft infection to date is extremely rare, some aspects peculiar to the placement of these devices potentially could increase their susceptibility to infection. Recognition and standard techniques in management can lead to successful outcome.- - - - - - - - - - ranking = 0.2keywords = fragilis (Clic here for more details about this article) |
9/90. bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin iii and protein c deficiency: a case report.Hypercoagulability is one of the causes of portal vein and superior mesentery vein thrombosis. We report a case of bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin iii and protein c deficiency. The patient presented with high fever for more than 3 weeks. Abdominal sonography revealed a liver cyst of 1.7 cm in diameter over segment 4 and a renal stone of 0.7 cm in size over the lower portion of the right kidney but no evidence of hydronephrosis. Elevation of liver enzymes was also noted. Intermittent fever was noted despite treatment with ceftriaxone and doxycycline. On Day 15 of hospitalization, blood culture revealed B. fragilis, which prompted further investigation of the source of intraabdominal and pelvic infection. Abdominal computed tomography revealed portal vein and superior mesentery vein thrombosis. Endoscopic studies of the gastrointestinal tract showed no tumor or diverticulum. Study of coagulation factors disclosed deficiency of antithrombin iii and protein C. Clinicians should remain aware of the need to promptly search for a portal or mesentery vein thrombosis in cases of Bacteroides bacteremia of unknown origin.- - - - - - - - - - ranking = 1.2keywords = fragilis (Clic here for more details about this article) |
10/90. A case of 'circling seizures' and an intratumoral abscess.We describe a case of a 38-year-old woman who presented with 'circling' seizures and was found to have an intracranial mass with features consistent with a meningioma. Three weeks prior to her presentation she underwent an uncomplicated vaginal hysterectomy. However, after discharge to home she developed a 4-day history of fever, chills and night sweats that eventually resolved. She underwent surgical removal of her intracranial mass without difficulty but intra-operative pathology showed features of acute cerebritis at the margins of the tumor. Further sectioning of the mass revealed evidence of an intratumoral abscess. culture of the meningioma revealed heavy growth of bacteroides fragilis. The patient was treated with intravenous antibiotics, discharged home in excellent health and has had no recurrence of seizures. In our case report we will review the historical literature on the incidence and features of intratumoral abscess. Although it is considered a rare event, our case demonstrates both common and unique features about this occurrence and highlights an unusual chain of events in the natural history of the patient's meningioma and the way in which it became clinically apparent.- - - - - - - - - - ranking = 0.2keywords = fragilis (Clic here for more details about this article) |
| | Next -> |