scholarly journals Mycobacterium fortuitum abdominal wall abscesses following liposuction

2008 ◽  
Vol 41 (01) ◽  
pp. 58-61
Author(s):  
Hussam Al Soub ◽  
Eman Al-Maslamani ◽  
Mona Al-Maslamani
Keyword(s):  
Antibiotic Therapy ◽  
Abdominal Wall ◽  
Broad Spectrum ◽  
Mycobacterium Fortuitum ◽  
Surgical Drainage ◽  
Abdominal Abscesses ◽  
Broad Spectrum Antibiotics

ABSTRACTwe describe here a case of abdominal abscesses due to mycobacterium fortuitum following liposuction. the abscesses developed three months after the procedure and diagnosis was delayed for five months. the clues for diagnosis were persistent pus discharge in spite of broad spectrum antibiotics and failure to grow any organisms on routine culture. this condition has been rarely reported; however, the increasing number of liposuction procedures done and awareness among physicians will probably result in the identification of more cases. combination antibiotic therapy with surgical drainage in more extensive diseases is essential for cure.

scholarly journals Fournier′s gangrene of the penis

2005 ◽  
Vol 38 (02) ◽  
pp. 154-156
Author(s):  
Francis Leo Tauro ◽  
M Roshan ◽  
B S Sathish Rao ◽  
J Ravikrishnan ◽  
Leo T Menezes
Keyword(s):  
Abdominal Wall ◽  
Broad Spectrum ◽  
Normal Skin ◽  
Skin Grafting ◽  
Early Therapy ◽  
Broad Spectrum Antibiotics ◽  
Localized Disease

ABSTRACTFournier′s gangrene is a rare, fulminant, though generally localized disease of the scrotum and penis with occasional extension up the abdominal wall. The usual organism is an anaerobic streptococcus synergistic with some second organism. Our case was unusual in that only the penis was involved without involving the scrotum or abdominal wall. Early therapy is the key, including hospitalization, debridement of entire shaft of the penis distal to the devasted area without excising the normal skin, parenteral broad-spectrum antibiotics & skin grafting. Only few cases of Fournier′s gangrene of the penis have been reported.

scholarly journals Pseudomonal breast infection

2010 ◽  
Vol 92 (3) ◽  
pp. e20-e22 ◽  
Author(s):  
DP Harji ◽  
S Rastall ◽  
C Catchpole ◽  
R Bright-Thomas ◽  
S Thrush
Keyword(s):  
Septic Shock ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Abscess Formation ◽  
Causative Organism ◽  
Breast Infection ◽  
Broad Spectrum Antibiotics

Breast infection and breast sepsis secondary to Pseudomonas aeruginosa is uncommon. We report two cases of pseudomonal breast infection leading to septic shock and abscess formation in women with non-responding breast infection. The management of breast infection is broad-spectrum antibiotics and ultrasound with aspiration of any collection. To treat breast infection effectively, the causative organism must be isolated to enable appropriate antibiotic therapy.

scholarly journals A Decision Tree Using Patient Characteristics to Predict Resistance to Commonly Used Broad-Spectrum Antibiotics in Children With Gram-Negative Bloodstream Infections

2019 ◽  
Vol 9 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Anna C Sick-Samuels ◽  
Katherine E Goodman ◽  
Glenn Rapsinski ◽  
Elizabeth Colantouni ◽  
Aaron M Milstone ◽  
...  
Keyword(s):  
High Risk ◽  
Decision Tree ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Intestinal Transplantation ◽  
Empiric Antibiotic Therapy ◽  
Gram Negative ◽  
Broad Spectrum Antibiotics

Abstract Background As rates of multidrug-resistant gram-negative infections rise, it is critical to recognize children at high risk of bloodstream infections with organisms resistant to commonly used empiric broad-spectrum antibiotics. The objective of the current study was to develop a user-friendly clinical decision aid to predict the risk of resistance to commonly prescribed broad-spectrum empiric antibiotics for children with gram-negative bloodstream infections. Methods This was a longitudinal retrospective cohort study of children with gram-negative bacteria cared for at a tertiary care pediatric hospital from June 2009 to June 2015. The primary outcome was a bloodstream infection due to bacteria resistant to broad-spectrum antibiotics (ie, cefepime, piperacillin-tazobactam, meropenem, or imipenem-cilastatin). Recursive partitioning was used to develop the decision tree. Results Of 689 episodes of gram-negative bloodstream infections included, 31% were resistant to broad-spectrum antibiotics. The decision tree stratified patients into high- or low-risk groups based on prior carbapenem treatment, a previous culture with a broad-spectrum antibiotic resistant gram-negative organism in the preceding 6 months, intestinal transplantation, age ≥3 years, and ≥7 prior episodes of gram-negative bloodstream infections. The sensitivity for classifying high-risk patients was 46%, and the specificity was 91%. Conclusion A decision tree offers a novel approach to individualize patients’ risk of gram-negative bloodstream infections resistant to broad-spectrum antibiotics, distinguishing children who may warrant even broader antibiotic therapy (eg, combination therapy, newer β-lactam agents) from those for whom standard empiric antibiotic therapy is appropriate. The constructed tree needs to be validated more widely before incorporation into clinical practice.

scholarly journals Cerebral Abscess with Cranial Hypertension in Young Infants: A Case Report and Systematic Review

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Náthalie Angélica Cardoso Marqui ◽  
Marina Lucca de Campos Lima ◽  
Rafaela de Fátima Ferreira Baptista ◽  
Rawene Elza Veronesi Gonçalves Righetti ◽  
Tauane Rene Martins ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Broad Spectrum ◽  
Central Nervous System Infection ◽  
Mass Effect ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Surgical Drainage ◽  
Young Infants

Objective: To report a Central Nervous System infection evolving with brain abscess and to address aspects of the treatment of the disease. Results: even with advances in treatment and diagnosis, the pathology has a high mortality. However, the best prognosis is noticed when there is a suspicion through the clinic, neuroradiological images readily available, antimicrobial therapy against commonly encountered agents, and surgical drainage procedures. One study, which combined antibiotic therapy and surgery to drain the abscess, in most of the cases, studied, demonstrated a mortality rate of 12%, and another study, a 42% mortality rate when using antibiotic therapy alone. Another reference suggests the use of antibiotic therapy alone in less severe cases with less neurological impairment. Neurological clinical sequelae can be found in up to 30% of cases. The time of antibiotic therapy still needs to be debated, as well as the surgical indication for drainage. Final Considerations: Pediatric brain abscess is an uncommon disease, still with high morbidity and mortality. Surgical drainage or excision of pediatric abscesses remains the basis of treatment both to relieve the mass effect and to provide a microbiological diagnosis. The literature demonstrates that broad-spectrum antibiotics and access to CT and MRI images decrease the rates of morbidity and mortality. It is concluded that the therapeutic approach involves the administration of broad-spectrum intravenous antibiotics and surgical drainage in more complex cases.

Antibiotic therapy in patients with surgical sepsis and pulmonary-broncho-pulmonary complications

1997 ◽  
Vol 78 (4) ◽  
pp. 298-299
Author(s):  
K. M. Bogus
Keyword(s):  
Antibiotic Therapy ◽  
Laboratory Investigation ◽  
Broad Spectrum ◽  
Pulmonary Complications ◽  
Broad Spectrum Antibiotics

In 152 patients with pulmonary-broncho-pleural complications (PBLS) developing against the background of surgical sepsis, rational antibiotic therapy was administered. Before laboratory microflora examination, 2 antibiotics were prescribed, and 3 antibiotics were prescribed for anaerobic sepsis, based on the clinical assumption of the pathogen type. Broad-spectrum antibiotics (claforan, amikacin, gentamicin, metronidazole, etc.) were used. After laboratory investigation, according to the bacteriogram data, targeted antibiotic therapy was switched to.

Possible Heparin-Inouceo Subcutaneous Necrosis in a CAPO Patient

1987 ◽  
Vol 7 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Peter J. Somerville ◽  
Elizabeth O'Brien ◽  
Michael Kaye
Keyword(s):  
At Risk ◽  
Peritoneal Dialysis ◽  
Abdominal Wall ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Broad Spectrum ◽  
Anterior Abdominal Wall ◽  
Broad Spectrum Antibiotics

A patient developed subcutaneous necrosis of the tissue of the anterior abdominal wall while carrying out continuous ambulatory peritoneal dialysis (CAPD). This necrosis was preceded by a leak of heparin-containing dialysate into the area. We believe this represents an example of the entity -heparin-induced subcutaneous necrosis. After reviewing the appropriate literature, we have concluded that intraperitoneal heparin should be used with caution in CAPD patients, who are at risk for leakage and heparin necrosis, i.e. those who are diabetic, elderly, obese, and receiving broad spectrum antibiotics.

scholarly journals Rate of broad-spectrum antibiotic overuse in patients receiving outpatient parenteral antibiotic therapy (OPAT)

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Jessa R. Brenon ◽  
Stephanie E. Shulder ◽  
Sonal S. Munsiff ◽  
Colleen M. Burgoyne ◽  
Angela K. Nagel ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Broad Spectrum Antibiotic ◽  
Parenteral Antibiotic ◽  
Once Daily ◽  
Antibiotic Overuse ◽  
Broad Spectrum Antibiotics ◽  
Outpatient Parenteral Antibiotic Therapy

Abstract Broad-spectrum antibiotics with once-daily dosing are often chosen for outpatient parenteral antibiotic therapy (OPAT) due to convenience even when narrower-spectrum antibiotics are appropriate. At our institution, up to 50% of select broad-spectrum OPAT regimens had potential to be narrowed, highlighting the need to re-evaluate regimens for de-escalation prior to discharge.

scholarly journals Multistep antimicrobial stewardship intervention on antibiotic prescriptions and treatment duration in children with pneumonia

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257993
Author(s):  
Sara Rossin ◽  
Elisa Barbieri ◽  
Anna Cantarutti ◽  
Francesco Martinolli ◽  
Carlo Giaquinto ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Antibiotic Stewardship ◽  
Clinical Pathways ◽  
Community Acquired Pneumonia ◽  
Broad Spectrum Antibiotics ◽  
Outpatient Group ◽  
Before And After ◽  
Tract Infections ◽  
The Impact

Introduction The Italian antimicrobial prescription rate is one of the highest in Europe, and antibiotic resistance has become a serious problem with high costs and severe consequences, including prolonged illnesses, the increased period of hospitalization and mortality. Inadequate antibiotic prescriptions have been frequently reported, especially for lower respiratory tract infections (LRTI); many patients receive antibiotics for viral pneumonia or bronchiolitis or broad-spectrum antibiotics for not complicated community-acquired pneumonia. For this reason, healthcare organizations need to implement strategies to raise physicians’ awareness about this kind of drug and their overall effect on the population. The implementation of antibiotic stewardship programs and the use of Clinical Pathways (CPs) are excellent solutions because they have proven to be effective tools at diagnostic and therapeutic levels. Aims This study evaluates the impact of CPs implementation in a Pediatric Emergency Department (PED), analyzing antibiotic prescriptions before and after the publication in 2015 and 2019. The CP developed in 2019 represents an update of the previous one with the introduction of serum procalcitonin. The study aims to evaluate the antibiotic prescriptions in patients with community-acquired pneumonia (CAP) before and after both CPs (2015 and 2019). Methods The periods analyzed are seven semesters (one before CP-2015 called PRE period, five post CP-2015 called POST 1–5 and 1 post CP-2019 called POST6). The patients have been split into two groups: (i) children admitted to the Pediatric Acute Care Unit (INPATIENTS), and (ii) patients evaluated in the PED and sent back home (OUTPATIENTS). We have analyzed all descriptive diagnosis of CAP (the assessment of episodes with a descriptive diagnosis were conducted independently by two pediatricians) and CAP with ICD9 classification. All antibiotic prescriptions for pediatric patients with CAP were analyzed. Results A drastic reduction of broad-spectrum antibiotics prescription for inpatients has been noticed; from 100.0% in the PRE-period to 66.7% in POST1, and up to 38.5% in POST6. Simultaneously, an increase in amoxicillin use from 33.3% in the PRE-period to 76.1% in POST1 (p-value 0.078 and 0.018) has been seen. The outpatients’ group’s broad-spectrum antibiotics prescriptions decreased from 54.6% PRE to 17.4% in POST6. Both for outpatients and inpatients, there was a decrease of macrolides. The inpatient group’s antibiotic therapy duration decreased from 13.5 days (PRE-period) to 7.0 days in the POST6. Antibiotic therapy duration in the outpatient group decreased from 9.0 days (PRE) to 7.0 days (POST1), maintaining the same value in subsequent periods. Overlapping results were seen in the ICD9 group for both inpatients and outpatients. Conclusions This study shows that CPs are effective tools for an antibiotic stewardship program. Indeed, broad-spectrum antibiotics usage has dropped and amoxicillin prescriptions have increased after implementing the CAP CP-2015 and the 2019 update.

Peritonitis-related Deaths among CAPD Patients

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 9-11 ◽  
Author(s):  
S.S.A. Fenton
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Features ◽  
Imaging Techniques ◽  
Low Grade ◽  
Conventional Imaging ◽  
Surgical Drainage ◽  
Abdominal Abscesses ◽  
Abdominal Symptoms ◽  
Symptoms And Signs ◽  
Prolonged Antibiotic Therapy

In 18 deaths related to peritonitis in CAPD patients over the period 1977 to 1982, the main clinical features included persistent low-grade fever and leukocytosis, with or without abdominal symptoms and signs. These deaths were not prevented by catheter removal, laparotomy with surgical drainage and prolonged antibiotic therapy. Conventional imaging techniques such as ultrasound, CA T scan and Gallium scans may not detect intra-abdominal abscesses in such patients. In this series the risk of dying during a peritonitis episode was 2.3%, namely one death for each 480 patient months of experience: it remained unchanged over the five year period of the study.

scholarly journals Infectious Esophagitis in Romanian Children: From Etiology and Risk Factors to Clinical Characteristics and Endoscopic Features

2020 ◽  
Vol 9 (4) ◽  
pp. 939
Author(s):  
Mădălina Adriana Bordea ◽  
Alexandru Pîrvan ◽  
Dan Gheban ◽  
Ciprian Silaghi ◽  
Iulia Lupan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastrointestinal Tract ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Post Mortem ◽  
Appetite Loss ◽  
Broad Spectrum Antibiotics ◽  
Prolonged Antibiotic Therapy

Objectives. The aim of this study is to provide information about prevalence, etiology, risk factors, clinical characteristics and endoscopic features of various types of infectious esophagitis in children. Methods. We performed a total of 520 upper gastrointestinal tract endoscopies in Pediatric Clinic II, Emergency Hospital for Children, Cluj-Napoca. Indications for endoscopy in our cohort were gastrointestinal tract symptoms such as dysphagia, heartburn, or appetite loss. Results. The prevalence of infectious esophagitis in the study population was 2.11% (11 patients). Candida albicans (C. albicans) was the most frequent cause. Our data illustrates that herpes simplex virus (HSV)-induced esophagitis is common in immunocompromised patients and should be systematically suspected in cases of severe dysphagia, heartburn, or hematemesis. In the present study, all cytomegalovirus (CMV) esophagitis patients were immunocompromised. Immunodeficiency (81.8%) and prolonged antibiotic therapy with broad-spectrum antibiotics were by far the most important risk factors involved in the pathogenicity of the disease. Dysphagia, appetite loss, heartburn, epigastralgia, and hematemesis were the main clinical manifestations. Infectious esophagitis was associated with significant mortality. In four patients, endoscopy during life showed signs of infectious esophagitis; however, the precise etiology was only established post-mortem, in the pathological anatomy laboratory department. A risk factor involved in pathogenesis of post-mortem diagnosed infectious esophagitis is the DiGeorge syndrome for CMV and HSV patients. Conclusions. The study illustrates that infectious esophagitis should be considered in immunocompromised infants with prolonged antibiotic therapy with broad-spectrum antibiotics.

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