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1/525. flavobacterium meningosepticum sepsis in an infant with a diarrheal prodrome.

    A full term, previously normal 2 1/2-month-old black boy was transferred to our hospital from an outlying facility on hospital day 5 for failure to thrive. Three weeks before transfer, the infant was hospitalized for a diarrheal illness with fever. The baby received 3 days of ceftriaxone empirically and was discharged home after the sepsis evaluation was negative. Mild diarrhea and steady weight loss continued and the baby was readmitted. blood culture done on admission grew flavobacterium meningosepticum, an organism previously described as an uncommon cause of sepsis in neonates and immunocompromised individuals. As it is water-borne, it has been associated with infection via contaminated water. This organism is usually resistant to antibiotics commonly used for empiric treatment. To our knowledge, this is the first reported case of flavobacterium bacteremia associated with a prodromal and concurrent diarrheal illness. ( info)

2/525. ochrobactrum anthropi bacteremia.

    ochrobactrum anthropi (O. anthropi ), formerly known as achromobacter CDC group Vd, is a gram-negative bacillus that is aerobic, oxidase producing, and nonlactose fermenting. This organism has been found in environmental and hospital water sources and has pathogenic potential in humans. Most reports in the literature of O. anthropi bacteremia are associated with intravenous line infections. We describe a case of bacteremia with O. anthropi in a 33-month-old boy with acute osteomyelitis. O. anthropi bacteremia also has been reported in immunocompromised hosts. Rarely, O. anthropi has been a cause of soft tissue or bone infection. ( info)

3/525. alcaligenes xylosoxidans endophthalmitis 8 months after cataract extraction.

    PURPOSE: To report a case of alcaligenes xylosoxidans endophthalmitis and to increase awareness of its potential as an intraocular pathogen. methods: An 80-year-old woman in good general health developed A. xylosoxidans endophthalmitis 8 months after an uncomplicated cataract extraction performed at another institution. Eventually, vitrectomy with removal of the intraocular lens and capsule was performed because of recurrent disease after intravitreal antibiotic injections. RESULTS: Microbiologic examination of the vitreous biopsies and capsule disclosed A. xylosoxidans, a motile, gram-negative rod resistant to many antibiotics. CONCLUSION: A. xylosoxidans should be considered as a cause of low-grade endophthalmitis after cataract surgery. ( info)

4/525. Fulminant infection by uncommon organisms in animal bite wounds.

    In 1995 and 1996, 215 patients exposed to different species of animals were treated at the Amarnath Polyclinic, Balasore, in india. Among them were two children infected by uncommon organisms, i.e., capnocytophaga canimorsus and pasteurella multocida; the patients recovered with appropriate antibiotic therapy. ( info)

5/525. chorioamnionitis with intact membranes caused by capnocytophaga sputigena.

    We report a case of chorioamnionitis with intact membranes caused by capnocytophaga sputigena. The pregnant woman was hospitalised in preterm labor without fever, neither tenderness, just regular contractions. In spite of the tocolitic treatment the patient gave birth to a girl at 29 weeks' gestation, weighing 1220 g and transferred to intensive care. The newborn had clinical and biological signs of infections and was initially treated by ampicillin, cephalosporin and metronidazol. capnocytophaga sputigena was found on membranes, cord, amniotic fluid and placenta. It was also identified in maternal endocervix culture. Histologic findings showed a focal chorioamnionitis. This was the fourteenth reported case of infection due to capnocytophaga species occurring in pregnancy. All the cases are reviewed. ( info)

6/525. bacteremia caused by a novel isolate resembling leptotrichia species in a neutropenic patient.

    We report a case of leptotrichia species bacteremia in a patient undergoing treatment for acute myelogenous leukemia. Like previously reported leptotrichia species, this is a gram-variable, pleomorphic rod that is catalase negative and utilizes glucose and sucrose. However, it is more fastidious than previously reported isolates of leptotrichia and may represent a novel species. ( info)

7/525. Two cases of chromobacterium violaceum infection after injury in a subtropical region.

    chromobacterium violaceum is a gram-negative rod and is isolated from soil and water in tropical and subtropical regions. The species have pigmented and nonpigmented colony types. Infections caused by nonpigmented strains are rare. We report on two cases of infection caused by both pigmented and nonpigmented strains of C. violaceum. Two 24-year-old korea Airline stewardesses were admitted to Inha University Hospital, Inchon, South korea, on 9 August 1997, 3 days after an airplane accident in guam. Both had multiple lacerations on exposed parts of their bodies. There was swelling, tenderness, and pus discharge. The wounds contained many small fragments of stones and weeds. A pigmented strain was isolated from the left hand and a nonpigmented strain was isolated from the left knee of one patient. For the other patient only a nonpigmented strain was isolated from a foot wound. The nonpigmented colonies from the left-knee and the left-foot wounds did not produce any pigment even after an extended period of incubation. The biochemical characteristics were the same for each strain except for oxidase and indole reactions. The pigmented strain was oxidase negative and indole positive, whereas the nonpigmented strains were oxidase positive and indole negative. The patients were successfully treated by debridement and with appropriate antibiotics. ( info)

8/525. Primary shewanella alga septicemia in a patient on hemodialysis.

    We report the first Japanese case of primary septicemia with shewanella alga and also describe the bacteriological characteristics of and results of antibiotic susceptibility tests of the isolate. S. alga was repeatedly isolated, at times simultaneously with escherichia coli, from the blood of a 64-year-old female undergoing hemodialysis. The isolated organism was determined to be S. alga based on recently published identification criteria, such as hemolysis on sheep blood agar, no acid production from carbohydrates, and growth on agar containing 6. 5% NaCl. Results of antibiotic susceptibility tests demonstrated that the isolate was sensitive to levofloxacin and cefpirome (MICs, cefazolin, ceftizoxime, and imipenem (MICs, >128, 64, and 8 microg/ml, respectively). Although the role of S. alga as a human pathogen has not been fully determined, accumulating data suggest that this organism may be a potential pathogen, especially in compromised hosts. ( info)

9/525. edwardsiella tarda bacteraemia--complicated by acute pancreatitis and pyomyoma.

    edwardsiella tarda (E. tarda) has recently become recognized as a pathogen in humans. Here we report a new case of E. tarda bacteraemia complicated by acute pancreatitis and pyomyoma. A 46-year-old female came to our emergency room complaining of sudden onset of left upper quadrant pain and vomiting for the previous few hours after drinking three bottles of wine. An abdominal computed tomography (CT) scan revealed multiple biliary stones, acute pancreatitis with extensive inflammatory change, and a large uterine myoma. fever, watery diarrhoea, and mild suprapubic discomfort with vaginal spotting were noted soon after admission. The patient's blood cultures yielded E. tarda and symptoms subsided after antibiotic therapy. fever and severe suprapubic pain with rebound tenderness developed 12 days later. Repeat abdominal CT scan revealed an enlarged uterine myoma with central necrosis. The patient subsequently underwent anterior total hysterectomy and bilateral salpingo-oophorectomy, revealing a uterine myoma with infarction and abscess formation. The patient recovered uneventfully and was discharged 1 week later. ( info)

10/525. Arterial homografts in the management of infected axillofemoral prosthetic grafts.

    Two lower limb amputees with infected contralateral axillofemoral prosthetic grafts received preserved human arteries after removal of the infected materials. Both grafts grew organisms (enterococcus species, plus staphylococcus species in one). Long length arterial conduits were fashioned from freshly harvested (in one patient) and cryopreserved (in another one) cadaveric iliac and femoral arteries. One arterial homograft had ABO-compatibility with the recipient. No immunosuppressive drugs were administered after repeat arterial reconstructions. After 12 and 15 months both grafts are still patent, without parietal changes at ultrasonography; the patients have a viable remaining lower extremity and are free of symptoms or re-infection. ( info)
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