Cases reported "Multiple Organ Failure"

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1/3. vibrio vulnificus septicemia in a patient with the hemochromatosis HFE C282Y mutation.

    vibrio vulnificus is an extremely invasive gram-negative bacillus found in marine waters that causes overwhelming bacteremia and shock that is associated with high mortality. Impaired iron metabolism has been implicated in the susceptibility to V vulnificus bacterial infections. We report a case of fatal V vulnificus sepsis in a 56-year-old man who died within 1 to 3 days after consuming raw seafood. At autopsy, he was found to have micronodular cirrhosis and iron overload. Postmortem genetic analysis revealed the presence of the hemochromatosis gene (HFE) C282Y mutation. To our knowledge, this is this first documented fatal case of V vulnificus infection in a patient proven to carry the HFE C282Y mutation. Because this patient was heterozygous for the major hereditary hemochromatosis mutation and was not previously diagnosed with clinical iron overload, the spectrum of clinical susceptibilities to V vulnificus infection may include carriers of the C282Y mutation.
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ranking = 1
keywords = bacillus
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2/3. Fatal sepsis following intravesical bacillus Calmette-Guerin administration for bladder cancer.

    Intravesical administration of bacillus Calmette-Guerin has been shown to be highly effective treatment of superficial bladder cancer. Complications from bacillus Calmette-Guerin therapy are usually minor but serious and even fatal reactions can occur. Five recent cases illustrate the gravity of bacillus Calmette-Guerin sepsis. One man with severe debility and the organic brain syndrome died acutely with a fever of 40 C. Two men had frank sepsis that progressed to multiorgan failure and death. sepsis progressed despite the use of isoniazid, rifampin and streptomycin. Two men who had equally progressive sepsis with intravesical bacillus Calmette-Guerin survived with the use of cycloserine for the first 72 hours of treatment. Triple antituberculous antibiotics, including cycloserine, may be lifesaving. sepsis resulted from intravenous absorption through inflamed or disrupted urothelium. bacillus Calmette-Guerin treatment should not be administered in the presence of severe cystitis or after grossly traumatic catheterization.
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ranking = 8
keywords = bacillus
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3/3. Fatal capnocytophaga canimorsus (DF-2) septicaemia. A case report.

    A 45-year-old man died 2 months after being bitten on the hand by a dog. He developed the rare but characteristic clinical picture of fulminant septicaemia and peripheral gangrene caused by a Gram-negative bacillus, capnocytophaga canimorsus, previously known as dysgonic fermenter type 2 (DF-2), which is an occasional commensal in the oral flora of dogs and cats. This disease must be anticipated and dog bites appropriately managed to avoid the mortality associated with infection by this micro-organism. Initial treatment includes appropriate prophylactic antibiotics and debridement, while early exchange transfusion and emergency amputation may be of value in fulminant cases.
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ranking = 1
keywords = bacillus
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