Cases reported "Salmonella Infections"

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1/53. Salmonella infection in total hip replacement--report of successful reimplantation and review of the literature.

    A case of salmonella enteritidis group C infection following total hip replacement was treated by resectional arthroplasty and appropriate antibiotics. Total hip replacement with reimplantation of an antibiotic-impregnated cemented hip prosthesis was performed five months later. The postoperative course was smooth and hip function was good, without any sign of infection recurrence throughout 10 years of follow-up. The treatment protocol and clinical results are discussed along with a review of the literature.
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2/53. Fatal hemoptysis in dissecting aortic aneurysm and salmonellosis: a case report.

    hemoptysis is a rare manifestation of dissecting aortic aneurysm and aortobronchial fistula may occur when an aortic aneurysm is mycotic, atherosclerotic, traumatic or postoperative. Aortobronchial fistulas are generally fatal if not treated surgically. An aggressive diagnostic approach to patients with hemoptysis and prompt surgical intervention in those suspected of aortobronchial fistulas should result in additional survivors. Imaging studies, including chest radiography, chest computerized tomography, arteriography and bronchoscopy provide useful diagnostic information. However, challenges remain when we encounter this condition. Sometimes, the final exsanguinating hemorrhage is preceded by a distinct prodromal period of intermittent hemoptysis. This allows clinicians time to recognize such fistulas and perform emergency surgery. We present a patient with this condition to alert clinicians to this potentially deadly cause of hemoptysis.
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3/53. Primary repair with in-situ interposition graft for infrarenal mycotic aortic pseudoaneurysm.

    This is a case report of a pseudoaneurysm due to Salmonella aortitis in a 52 year old man. The condition is rare and represents one of the few cases reported in malaysia. The diagnosis was made preoperatively by ultrasonography and computed tomography. This was confirmed at surgery where there was a 3 cm defect at the posterior wall of the aorta at L2/3 level. The aneurysmal sac extended to the retrocrural space at the 12th vertebra level cranially on the right side to the lower border of the 3rd lumbar vertebra caudally. It had a smooth fibrous wall and contained a mixture of organised haematoma and pus. At operation the aneurysm was excised, the affected region was carefully debrided and the aorta grafted with an in-situ in-lay graft. Antibiotic therapy was instituted until clinical response was evident, leukocytosis was reduced and blood culture was negative. However 4 months after surgery, the patient returned in irreversible shock and succumbed to disseminated intravascular coagulation secondary to massive upper gastrointestinal haemorrhage from an aortoduodenal fistula.
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4/53. An unusual post-operative wound infection with salmonella typhi: case report.

    A 25 year old male student presented with a discharging sinus and swelling over right forearm, which on culture yielded S. typhi, sensitive to ciprofloxacin. Predisposing factors were absent but there was a history of surgery for chronic osteomyelitis of right ulna and injury with cricket ball at same site. Pus obtained during surgery was sterile. Patient responded to oral ciprofloxacin. soft tissue infections are uncommon manifestation of salmonellosis. This case is an unusual presentation of post-operative salmonella typhi wound infection.
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5/53. Cecal perforation presenting as abdominal-wall necrotizing fasciitis.

    The preoperative diagnosis of a cecal perforation associated with Salmonella infection as a cause of abdominal-wall necrotizing fasciitis (AWNF) is clinically difficult. Computed tomography of the abdomen is helpful, and can detect the combined presence of a pneumoscrotum and pneumoperitoneum. Its presence indicates a patent processus vaginalis, which acts as the primary route for the spread of the intra-abdominal infectious process into the abdominal wall. An exploratory laparotomy should be done to confirm the presence of intra-abdominal pathology in order to avoid delayed treatment.
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6/53. Mycotic aneurysm of the carotid bifurcation in the neck: case report and review of the literature.

    OBJECTIVE AND IMPORTANCE: Mycotic aneurysms of the extracranial carotid artery are rare and difficult to diagnose. A search of the world literature published since 1966 reveals at least six cases of mycotic carotid aneurysms due to a Salmonella septicemia. We present an exceptional case of mycotic pseudoaneurysm of the bifurcation of the carotid artery due to Salmonella septicemia and discuss the pathogenesis as well as various aspects of the diagnosis and surgical management. CLINICAL PRESENTATION: A 68-year-old man presented in poland with Salmonella sepsis; 1 month later, he was admitted to the emergency department of the Sir Mortimer B. Davis-Jewish General Hospital in Montreal with a bulky and pulsatile right cervical mass. An angiogram and a computed tomographic scan revealed a voluminous and partially thrombosed aneurysm the size of a tangerine originating from the posterior aspect of the carotid junction. INTERVENTION: Balloon trapping was attempted at the Montreal Neurological Hospital. Subsequently, the patient developed a significant neurological deficit, which was quickly reversed by the administration of hypertensive, hypervolemic, and hemodilution therapy. Thereafter, the pseudoaneurysm was resected surgically, and the internal and external carotid arteries were sacrificed. Pathological examination of the excised specimen of the carotid junction revealed a pseudoaneurysm. Bacterial culture of the lesion showed growth of Salmonella. CONCLUSION: The postoperative course was satisfactory except for laryngeal paralysis due to involvement of the vagus nerve. Four months later, a computed tomographic scan showed only small lacunae in both centra semiovale.
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7/53. A rare case of Salmonella osteomyelitis in the humerus as a differential diagnosis to a malignant bone tumor.

    Salmonella osteomyelitis without predisposing factors is seldom seen and thus difficult to diagnose. We report on a 14-year-old healthy boy with Salmonella osteomyelitis which occurred 2 years after trauma. Radical operative debridement is recommended. Intravenous ciprofloxacin has proved to be effective because of good tissue penetration and sensitivity towards Salmonella.
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8/53. ceftriaxone-resistant salmonella enterica serovar Hadar: evidence for interspecies transfer of blaCMY-2 in a Taiwanese university hospital.

    The emergence of resistance to extended-spectrum cephalosporins in salmonellae is an increasing clinical problem. We report the characteristics of a ceftriaxone-resistant salmonella enterica serovar Hadar strain collected in 2001 from a patient with a postoperative wound infection in a university hospital in taiwan. Resistance to extended-spectrum cephalosporins was found to be due to production of the plasmid-mediated CMY-2 AmpC beta-lactamase. To our knowledge, this is the first report of S. hadar harboring blaCMY-2. Seven CMY-2-producing escherichia coli isolates collected in 2000 were investigated for comparison. Conjugation experiments and plasmid analysis showed an identical plasmid carrying blaCMY-2 in both the Salmonella isolate and one E. coli isolate, suggesting the possibility that the Salmonella isolate acquired the resistance plasmid from E. coli. These findings suggest that measures are necessary to restrict antibiotic use and so prevent the spread and development of antibiotic resistance in taiwan.
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9/53. Postoperative mediastinitis due to Salmonella.

    mediastinitis remains one of the most serious and dreaded complications of median sternotomy. Salmonella is a rare cause of mediastinal infection. The case is reported of a patient who underwent heart valve surgery and developed a salmonella enteritidis bacteraemia in the postoperative period, which caused aortic dissection and mediastinitis.
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10/53. Successful treatment of a Salmonella aortic arch aneurysm.

    A 52-year-old man hospitalized for hoarseness and chest pain was found in chest computed tomography to have an impending aortic arch aneurysm rupture. Laboratory studies showed the presence of severe inflammation. Based on a clinical diagnosis of infected aortic arch aneurysm, we conducted total arch replacement. Salmonella was identified in the aneurismal wall and antibiotics were administered long-term. The postoperative course was uneventful. The patient was discharged on postoperative day 48. He has remained afebrile and asymptomatic in the 10 months since surgery but continues to take 300 mg/d of oral levofloxacin.
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