Cases reported "Klebsiella Infections"

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1/21. klebsiella pneumoniae with extended spectrum beta-lactamase activity associated with a necrotizing enterocolitis outbreak.

    BACKGROUND: Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in newborn infants, affecting primarily premature neonates. Clustering of cases in epidemics is well-described; many are associated with an identifiable pathogen. patients AND methods: case reports are presented of six neonates seen with NEC during a 2-month period in 1998. All bacterial isolates were subjected to antibiotic testing, determination of MIC and molecular fingerprinting. RESULTS: klebsiella pneumoniae with extended spectrum beta-lactamase production was isolated from blood cultures of all six patients. In five patients the isolate appeared to be a single clone. The onset of NEC in the patients was earlier, more rapid and more severe than usual. Four of the six required surgery and five required mechanical ventilation. Two of the six patients died, but only one was directly related to a complication of NEC. All of the patients developed severe thrombocytopenia (platelet count <20 x 10(9)/l), and three developed hepatitis. The K. pneumoniae proved difficult to eradicate. Extended courses of multiple antibiotics were administered and measures were introduced to reduce overcrowding and improve infection control. CONCLUSION: The isolation of a single clone of K. pneumoniae with extended spectrum of beta-lactamase activity during an NEC outbreak highlights the need for strict infection control. This organism caused significant morbidity and was difficult to treat.
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keywords = necrotizing
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2/21. Perianal necrotizing fasciitis in a neonate.

    A two-week-old term male infant, weighing 1,600 grams was transferred to the neonatology unit of Dokuz Eylul University hospital with sharply demarcated cutaneous gangrene surrounding the perianal region. He did well at birth. In his history, on the 10th postnatal day, a red, painful, warm cutaneous lesion was observed which was thought to be secondary to repeated and inappropriate rectal temperature measurements. Besides an ill-appearing child, a nontender frank cutaneous gangrene developed within several days. klebsiella pneumoniae was cultured from the involved area. Blood cultures were negative. A frozen section of soft tissue biopsy could not be performed because of the localization of the lesion. The patient was successfully treated by surgical debridement and high doses of parenteral antibiotics.
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ranking = 1
keywords = necrotizing
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3/21. Bilateral emphysematous pyelonephritis with perirenal abscess cured by conservative therapy.

    Emphysematous pyelonephritis is a rare life-threatening infection of the renal parenchyma. It usually affects unilateral kidney and occurs mostly in diabetic patients. It is characterized by the presence of gas within the renal parenchyma and requires prompt diagnosis and early aggressive therapy. Bilateral emphysematous pyelonephritis is even more rare and is associated with high mortality. We describe a case of a 62-year-old diabetic woman who presented with nonketotic hyperosmolar coma and bilateral emphysematous pyelonephritis caused by klebsiella pneumoniae. diagnosis of bilateral emphysematous pyelonephritis was confirmed by an abdominal computed tomographic scan and microbiologic studies. Our patient was successfully treated using percutaneous catheter drainage and long-term antibiotic therapy.
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ranking = 59.582723337284
keywords = pyelonephritis
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4/21. Acute renal failure caused by klebsiella pneumoniae pyelonephritis.

    We report a 34-year-old male patient without prior medical history who presented with acute renal failure due to acute bacterial pyelonephritis. Both blood and urine cultures grew klebsiella pneumoniae. Although a kidney biopsy revealed extensive necrosis and no viable glomeruli, renal function recovered to near normal after intermittent hemodialysis and antibiotic therapy. We believe that it is important to include this entity in the differential diagnosis of acute renal failure since proper diagnosis and treatment is essential for recovery of renal function. Furthermore, we would like to draw attention to klebsiella pneumoniae as an important potential pathogen in such cases, in addition to escherichia coli.
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ranking = 37.239202085803
keywords = pyelonephritis
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5/21. A novel type of metastatically spreading subcutaneous aspergillosis without epidermal lesions following allogeneic stem cell transplantation.

    Systemic mycosis is among the most feared opportunistic infections in the immunocompromised host. Difficulty and delay in diagnosis and treatment often result in poor outcomes. In this communication a metastatically spreading form of subcutaneous aspergillosis developed in a patient with a history of allogeneic stem cell transplantation for relapsed Hodgkin's lymphoma. Strikingly, necrotizing cutaneous papules or ulcerating lesions were absent. diagnosis was accomplished after excision of a clinically non-suggestive subcutaneous nodule. Despite prompt initiation of antimycotic therapy the outcome was fatal; dosage of conventional and liposomal amphotericin b was limited due to treatment-related toxicities. This case report describes a novel form of aspergillosis and underlines the need for an aggressive diagnostic approach in severely immunocompromised patients.
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ranking = 0.25
keywords = necrotizing
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6/21. Acute fulminant hepatic infection causing fatal "emphysematous hepatitis": case report.

    We describe a case of fatal fulminant hepatic infection with gas replacement of the hepatic parenchyma and no evidence of a liquified abscess in a diabetic patient: a case of "emphysematous hepatitis," the hepatic equivalent of emphysematous pyelonephritis. Computed tomography and clinical findings are described.
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ranking = 7.4478404171605
keywords = pyelonephritis
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7/21. Unusual clinical presentation of klebsiella pneumoniae induced endogenous endophthalmitis and xanthogranulomatous pyelonephritis in a non-nephrolithiasis and non-obstructive urinary tract.

    The genitourinary tract is well recognized as a route through which bacteria could gain access to the blood circulation. Under some circumstances, metastatic infections may occur in distant organs, including endogenous endophthalmitis. Xanthogranulomatous pyelonephritis (XGP) is an unusual variant of chronic pyelonephritis. It most often occurs in middle-aged women who frequently have a history of recurrent urinary tract infections combined with obstruction and a kidney of poor function. We reported an unusual case of urinary tract infection in a non-nephrolithiasis and non-obstructive urinary tract complicated by klebsiella pneumoniae endogenous endophthalmitis and developed XGP in two months.
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ranking = 44.687042502963
keywords = pyelonephritis
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8/21. Necrotizing fasciitis of the neck and chest. Report of a case.

    A case is presented of necrotizing fasciitis of the neck and chest characterized by rapid progressive necrosis of subcutaneous tissue, fascia and skin. The diagnosis and management is discussed.
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ranking = 0.25
keywords = necrotizing
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9/21. Acute appendicitis with fulminant necrotizing fasciitis in a neonate.

    The authors report on a neonate who presented with acute appendicitis and who went on to have fatal necrotizing fasciitis. Although recognized in adults, this rare combination of conditions has not been reported previously in the neonate and requires rapid recognition with aggressive medical and surgical intervention.
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ranking = 1.25
keywords = necrotizing
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10/21. Cervical necrotizing fasciitis with facial nerve paralysis.

    Necrotizing fasciitis (NF) is a very aggressive infection with associated high mortality. risk factors of acquiring this infection may include diabetes mellitus, surgery, trauma, and infection. This infection necessitates prompt recognition and aggressive management in order to avoid its unfavourable outcomes. Associated nerve paralysis may indicate the involvement of deeper tissue. The present report highlights a case of cervical NF that was complicated by facial nerve paralysis, a feature that has rarely been reported.
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ranking = 1
keywords = necrotizing
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