Cases reported "Necrosis"

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1/12. enteritis necroticans (pigbel) in a diabetic child.

    BACKGROUND AND methods: enteritis necroticans (pigbel), an often fatal illness characterized by hemorrhagic, inflammatory, or ischemic necrosis of the jejunum, occurs in developing countries but is rare in developed countries, where its occurrence is confined to adults with chronic illnesses. The causative organism of enteritis necroticans is clostridium perfringens type C, an anaerobic gram-positive bacillus. In December 1998, enteritis necroticans developed in a 12-year-old boy with poorly controlled diabetes mellitus after he consumed pig intestines (chitterlings). He presented with hematemesis, abdominal distention, and severe diabetic ketoacidosis with hypotension. At laparotomy, extensive jejunal necrosis required bowel resection, jejunostomy, and ileostomy. Samples were obtained for histopathological examination. Polymerase-chain-reaction (PCR) assay was performed on paraffin-embedded bowel tissue with primers specific for the cpa and cpb genes, which code for the alpha and beta toxins produced by C. perfringens. RESULTS: Histologic examination of resected bowel tissue showed extensive mucosal necrosis, the formation of pseudomembrane, pneumatosis, and areas of epithelial regeneration that alternated with necrotic segments--findings consistent with a diagnosis of enteritis necroticans. Gram's staining showed large gram-positive bacilli whose features were consistent with those of clostridium species. Through PCR amplification, we detected products of the cpa and cpb genes, which indicated the presence of C. perfringens type C. Assay of ileal tissue obtained during surgery to restore the continuity of the patient's bowel was negative for C. perfringens. CONCLUSIONS: The preparation or consumption of chitterlings by diabetic patients and other chronically ill persons can result in potentially life-threatening infectious complications.
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ranking = 1
keywords = bacillus
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2/12. Primary sclerosing lipogranuloma with broad necrosis of the scrotum.

    A-25-year-old man was admitted because of a painless tumor of the scrotum. The patient denied a history of exogenous material injection and trauma in the scrotum. Physical and radiological examination revealed a mass in the scrotum, and blood laboratory tests showed no significant findings except for mild eosinophilia (5.6%). Resection of the mass was performed. The mass was isolated and located in the subcutaneous tissue of the scrotum. The mass was rectangular and symmetrical, and measured 65 x 45 x 15 mm. Histologically, the mass was composed of adipose tissue with fibrosis. Many epithelioid granulomas with multinucleated giant cells of foreign body and Langhans' types and heavy infiltrates of lymphocytes and eosinophils were recognized. Characteristically, the lesion showed broad coagulative and lytic necrosis. Congestion and edema suggestive of ischemia were seen in some areas. Special stains for acid-fast bacteria, gram-positive bacteria and fungi failed to detect any microorganisms. polymerase chain reaction for mycobacterium tuberculosis revealed no reaction products. Immunohistochemically, the majority of lymphocytes were CD45RO-positive T cells, and S-100 protein-positive cells and CD68-positive macrophages were scattered in small amounts. The appearances were typical for sclerosing lipogranuloma except for the necrosis. Although the pathological mechanism of the broad necrosis is unclear, the necrosis might be the result of ischemia. Our case suggests that primary sclerosing lipogranuloma of the scrotum might show broad necrosis, and that T-cell-mediated immune response might play a part in the formation of lipogranuloma.
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ranking = 0.31371219701171
keywords = mycobacterium
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3/12. A case of primary tularemic pneumonia presenting with necrotizing mediastinal and hilar lymph nodes.

    tularemia is an unusual disease caused by the gram-negative coccobacillus francisella tularensis. The clinical features of the disease depend on the route of inoculation. Ulceroglandular and typhoidal forms have been recognized as occurring in tularemia, however primary or secondary pneumonic infections have also been reported. Symptoms, laboratory markers and radiological features are non-specific in tularemic pneumonia. diagnosis is made on clinical grounds and evidence of elevated agglutinating antibodies to F. tularensis (> 1:128). We report a case of primary tularemic pneumonia presenting with pulmonary infiltrates and necrotizing mediastinal and hilar lymph nodes in an otherwise healthy subject from a non-endemic area. diagnosis of tularemia was obtained serologically, and antibiotic therapy with doxycycline and streptomycin resolved symptoms and radiological abnormalities. We suggest that tularemia should be considered in the differential diagnosis of pneumonia with mediastinal and/or hilar lymphadenopathy.
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ranking = 1
keywords = bacillus
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4/12. pasteurella multocida endophthalmitis: case report and review of the literature.

    BACKGROUND: Postoperative bacterial endophthalmitis is caused by the patient's endogenous flora in most cases (80 %). pasteurella multocida (PM) is a Gram-negative coccobacillus found in the upper respiratory tract of dogs and cats and is very rarely implicated in postoperative endophthalmitis. history AND SIGNS: We describe a case of PM endophthalmitis that developed after cataract surgery. THERAPY AND OUTCOME: Cultures of both the conjunctiva and the aqueous humor were positive for PM. Topical, intravitreous and intravenous antibiotics were administered. Despite treatment, the outcome was unfavourable and complicated by a corneal perforation. CONCLUSIONS: The prognosis of postoperative PM endophthalmitis remains poor, despite adequate treatment of the infection. A history of recent pet exposure should alert physicians to this possible aetiological factor.
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ranking = 1
keywords = bacillus
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5/12. Pancreatic necrosis infection due to lactobacillus paracasei in an immunocompetent patient.

    An immunocompetent patient recovering from gallstone-induced pancreatitis had to be readmitted due to abdominal pain, fever, and rapid deterioration. Computed tomography guided needle aspiration established the diagnosis of pancreatic necrosis infection; microbiological investigations revealed monoinfection with lactobacillus paracasei subspecies tolerans. To our knowledge, this is the first description of a pancreatic necrosis infection due to L. paracasei in an immunocompetent patient without any known risk factors for lactobacillus infections.
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ranking = 6
keywords = bacillus
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6/12. pseudomonas aeruginosa endophthalmitis in a preterm infant.

    Bacterial endophthalmitis is rare in the neonatal period. It occurs in susceptible individuals such as preterm infants. pseudomonas aeruginosa, a Gram-negative bacillus, has been identified as the causative organism in more than 75% of invasive neonatal eye infections. The source may be endogenous; secondary to septicemia or exogenous, including reports of nosocomial infections and those infections arising from the birth canal. We report the case of a preterm infant who developed pseudomonas endophthalmitis, septicemia, and meningitis after a corneal abrasion.
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ranking = 1
keywords = bacillus
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7/12. Isolation of agent associated with cat scratch disease bacillus from pretibial biopsy.

    We describe the isolation and cultural characteristics of a Gram-negative bacillus that is very similar to the presumed etiologic agent of cat scratch disease. The organism was isolated from a tibial lesion of a male patient who had been hospitalized for severe necrotizing pancreatitis. The significance of the isolate in this patient remains uncertain.
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ranking = 5
keywords = bacillus
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8/12. Dysgonic fermenter type 2 septicemia with purpura fulminans. Dermatologic features of a zoonosis acquired from household pets.

    Dysgonic fermenter type 2, a gram-negative bacillus that is part of the normal oral flora of dogs and cats, is responsible for increasing numbers of cases of fulminant septicemia in humans. patients usually have preexisting medical illnesses, but infection also occurs in otherwise healthy individuals. Most infections are acquired through animal contact. Dermatologic eruptions occur in half of the patients with dysgonic fermenter type 2 infection, and include petechiae, purpura, cellulitis, and gangrene.
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ranking = 1
keywords = bacillus
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9/12. Necrotizing pneumonia caused by mixed infection with actinobacillus actinomycetemcomitans and actinomyces israelii: case report and review.

    actinobacillus actinomycetemcomitans is an important cause of human pulmonary infections, either alone or with actinomyces species. It may be critical to isolate actinobacillus in patients with pulmonary infection for selection of an effective antimicrobial regimen. clindamycin has superseded penicillin as the sole antimicrobial drug for anaerobic bacterial necrotizing pneumonia and abscess. In the case presented herein, therapy with clindamycin failed to halt worsening necrotizing pneumonia or to prevent hematogenous dissemination. After clindamycin-resistant A. actinomycetemcomitans in addition to actinomyces israelii were isolated, the patient was treated with penicillin, ciprofloxacin, and cefazolin and was ultimately cured.
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ranking = 6
keywords = bacillus
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10/12. peritonsillar abscess, retropharyngeal abscess, mediastinitis, and nonclostridial anaerobic myonecrosis: a case report.

    peritonsillar abscess is a potentially life-threatening complication of acute tonsillitis. On occasion, peritonsillar abscess can extend to neck spaces and/or to the mediastinum. We describe a case of a patient with a peritonsillar abscess that extended to the neck, producing bilateral retropharyngeal abscesses and myonecrosis of the strap muscles. culture of a specimen of the necrotic muscle yielded prevotella intermedia, Prevotella buccae, lactobacillus catenaforme, another lactobacillus species, peptostreptococcus anaerobius, and some nonanaerobes. culture of the peritonsillar abscess yielded P. intermedia and P. buccae plus P. anaerobius, peptostreptococcus asaccharolyticus, bifidobacterium dentium, viridans and group F streptococci, and citrobacter diversus. culture of the retropharyngeal abscess yielded fusobacterium nucleatum and actinomyces odontolyticus in addition to most of the aforementioned organisms. The patient underwent repeated drainage and debridement procedures and was treated with various antimicrobial agents and ultimately recovered. This case highlights the polymicrobial nature of peritonsillar abscess and the serious complications that this infection may lead to.
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ranking = 2
keywords = bacillus
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