Cases reported "Pneumonia"

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1/23. rhodococcus equi cavitary pneumonia in hiv-infected patients: an unsuspected opportunistic pathogen.

    Two patients seropositive for human immunodeficiency virus (hiv) and with no previous acquired immunodeficiency syndrome-defining conditions developed cavitary pneumonia and pleural disease caused by rhodococcus equi. R. equi was isolated from these patients' sputum and lung biopsy specimens, respectively, but the microorganism was initially considered to be a contaminant (patient 1) or misidentified as a nontuberculous mycobacterium (patient 2). The R. equi infection was fatal in one patient, who died after 4 months without specific antimicrobial therapy; the second patient was unresponsive to combination therapy with various antimicrobial agents. R. equi may cause life-threatening infections in hiv-infected patients. microbiology laboratories should be cognizant of the need to exclude R. equi as a cause of infection in highly immunosuppressed patients.
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ranking = 1
keywords = mycobacterium
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2/23. pericarditis, pneumonia and brain abscess due to a combined actinomyces--actinobacillus actinomycetemcomitans infection.

    A patient is described in whom there developed a pulmonary infiltrate and constrictive pericarditis caused by a combined actinomyces and actinobacillus actinomycetemcomitans infection, presumably originating from his poor dentition. The diagnosis was only made following repeated thoracotomy. After surgery, long-term treatment with antibiotics led to complete clinical recovery. None the less, some months later he was found to have a brain abscess which resolved during a further course of antibiotics. The variable clinical picture of actinomycosis is discussed, as well as the role of other bacteria frequently associated with actinomycotic infection, in particular actinobacillus actinomycetemcomitans. The therapeutic implications are described.
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ranking = 15.161377554742
keywords = bacillus
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3/23. actinobacillus actinomycetemcomitans pneumonia with chest wall involvement and rib destruction.

    There are four cases of actinobacillus actinomycetemcomitans pulmonary infections reported in the English literature prior to 1990. We report a case of A actinomycetemcomitans pulmonary infection with invasion of overlying soft tissue, rib, and sternum. This manifestation has not been previously reported. The clinical manifestation is similar to that of actinomyces israelii, which may be misinterpreted as malignancy initially. The portal of entry of A actinomycetemcomitans may be via hematogenous spread or aspiration. The diagnosis depends on culture after prolonged incubation of the involved tissue obtained by aspiration or biopsy. Elevated serum antibody is helpful for diagnosis of active infection. A actinomycetemcomitans is susceptible to most antibiotics, but is frequently resistant to penicillin, vancomycin, clindamycin, and erythromycin. Isolation of the organism and an in vitro drug sensitivity testing are important in managing the patient. Our patient recovered after a three-month regimen of penicillin.
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ranking = 12.634481295618
keywords = bacillus
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4/23. Antineutrophil cytoplasmic antibody vasculitis associated with mycobacterium avium intracellulare infection.

    A variety of possible associations between infection and antineutrophil cytoplasmic antibody (ANCA) associated vasculitis have been reported. We describe a 75-year-old woman who presented with chronic nonproductive cough, migratory polyarthralgias, and microscopic hematuria. She had an elevated perinuclear ANCA and antimyeloperoxidase antibody. She had a positive PPD test and a cavitary lesion in the right upper lung lobe; biopsy of the lung lesion showed granulomatous vasculitis, but the culture grew mycobacterium avium intracellulare (MAI). There are clinical and histiologic similarities between ANCA vasculitis and pulmonary MAI infection. Treatment of vasculitis with immunosuppressive agents could be detrimental in patients with MAI infection. Thus, when ANCA associated vasculitis is considered, mycobacterium infection should be excluded before starting immunosuppressive therapy.
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ranking = 5
keywords = mycobacterium
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5/23. Gram negative aerobic bacillus pneumonia in oral and maxillofacial surgery--a case for comment.

    A case illustrating the potentially fatal complication of endogenous Gram Negative Aerobic Bacillus (GNAB) septicaemia secondary to nosocomial pneumonia is presented along with current theories as to its aetiology. The technique of selective decontamination of the digestive tract is designed and advocated to prevent such occurrences; oral and maxillofacial surgeons should be aware of this approach. It may be, however, that by using much simpler manoeuvres such as changes in policy regarding gastric stress ulcer prophylaxis, the already small risk of such an occurrence will be further reduced. awareness of this condition will allow a higher index of suspicion when presented with catastrophic septic complications on the ITU and aid in more rational planning of antimicrobial therapy.
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ranking = 10.107585036495
keywords = bacillus
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6/23. The use of external fixation for the treatment of spine infection with actinomyces bacillus.

    OBJECTIVE: External fixation can be used for stabilization of the spine in salvage cases, especially in cases of infection of the spine. The advantages of this method are avoiding the needs for internal fixation devices and for postoperative bracing. The literature on this is scant. Reported is a rare case of osteomyelitis of the D2 vertebra with an epidural abscess caused by actinomyces israelii that spread from the lung and was treated by decompression and external fixation. methods: A 51-year-old man with right upper lobe pneumonia due to A. israelii coccobacillus developed osteomyelitis of the D2 vertebra and an epidural abscess with a gradual paraparesis. He underwent a laminectomy of D1-D3 and 3 weeks later stabilization of the upper thoracic spine using a tubular external fixator that was inserted from C7-D1 to D3-D4. The patient was treated with antibiotic intravenously and later orally. After 2 months, the external fixator was removed. RESULTS: At the last follow-up, the patient had no fever, the erythrocyte sedimentation rate and c-reactive protein level had normal values, and there was only a slight limitation in the range of motion of the cervical paraparesis. radiography and magnetic resonance imaging demonstrated stabilization of the affected segment without any sign of active osteomyelitis. There were no complications associated with the use of the external fixator. CONCLUSIONS: The use of external fixation offers an appropriate alternative for stabilization of the spine as a salvage procedure. The procedure could be performed easily and without any major complications. Especially for the treatment of complicated cases of spinal infection, the use of an external fixator can be of great benefit.
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ranking = 12.634481295618
keywords = bacillus
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7/23. Severe rhodococcus equi pneumonia: case report and literature review.

    rhodococcus equi is an aerobic, gram-positive, non-motile pleomorphic bacillus infecting immunocompromised patients. Forty-nine cases of rhodococcus equi infection have been reported, mainly in patients infected with the human immunodeficiency virus (hiv). A case in which rhodococcus equi caused severe pulmonary infection, the most common presentation, is described. Clinically, patients have symptoms of pneumonia with hemoptysis as a prominent feature. X-ray will often show a cavitating upper-lobe infiltrate, resembling infection with mycobacteria. rhodococcus equi is easily cultured from blood or sputum on standard media, but is frequently regarded as a contaminant. mortality from rhodococcus equi pneumonia is high (25%) and early surgical intervention has been recommended. Based on this review, the benefit of surgery seems dubious, whereas good results have been obtained using long-term antibiotic treatment with erythromycin plus rifampicin, or vancomycin in combination with either of these antibiotics.
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ranking = 2.5268962591237
keywords = bacillus
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8/23. rhodococcus equi causing human pulmonary infection: review of 29 cases.

    rhodococcus equi is a gram-positive pleomorphic bacillus that has been identified as a life-threatening pulmonary pathogen in the immunocompromised host. infection with R equi may go unrecognized by physicians unacquainted with its presentation and unaware of the organism's ability to mimic diphtheroids and to stain weakly positive with an acid-fast stain.
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ranking = 2.5268962591237
keywords = bacillus
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9/23. lactobacillus pneumonia in a patient with oesophageal carcinoma.

    We report a case of necrotizing pneumonia caused by lactobacillus secondary to a tracheo-oesophageal fistula created by an oesophageal carcinoma. We emphasize the presence of resistance of lactobacillus to clindamycin and cotrimoxazole, previously reported to be effective.
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ranking = 15.161377554742
keywords = bacillus
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10/23. Systemic bacillus-Calmette Guerin infection after transurethral administration for superficial bladder carcinoma.

    It is well known that intravesical bacillus Calmette-Guerin therapy is a safe and effective treatment for superficial bladder carcinoma with few serious complications. However, we report a case of pneumonitis, hepatitis, azotemia, fever and pancytopenia in a patient after transurethral administration of bacillus Calmette-Guerin. Even though severe systemic complications are rare, patients who have high fevers of signs of other systemic manifestations require documentation of the extent of the infection. Also, we address the use of prophylactic antituberculous drugs, not only to prevent these symptoms but also to raise the questions of diminishing the immunological effect of the treatment.
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ranking = 15.161377554742
keywords = bacillus
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