scholarly journals Enterobacter cloacae Endophthalmitis: Report of Four Cases

1998 ◽  
Vol 36 (1) ◽  
pp. 48-51 ◽  
Author(s):  
N. Okhravi ◽  
L. Ficker ◽  
M. M. Matheson ◽  
S. Lightman
Keyword(s):  
Severe Disease ◽  
Visual Outcome ◽  
Enterobacter Cloacae ◽  
Acute Onset ◽  
Rapid Progression ◽  
Gram Negative ◽  
Severe Visual Loss ◽  
Ocular Symptoms ◽  
First Case ◽  
Resistance To Infection

Members of the genus Enterobacter are commensal organisms of the gastrointestinal tract and are considered pathogenic only for patients with lowered resistance to infection (e.g., chronic infection, cancer, or diabetes mellitus) or those with impaired immunity (congenital, acquired, or impaired immunity secondary to therapy). We report on four cases of endophthalmitis caused byEnterobacter cloacae: two in patients with acute postoperative endophthalmitis, one in a patient with delayed bleb-related endophthalmitis, and one in a patient presenting with presumed posttraumatic endophthalmitis. Each patient presented with severe disease many days after the onset of ocular symptoms, and two patients had systemic risk factors accounting for a reduced resistance to infection. Endophthalmitis caused by gram-negative bacilli is characterized by acute onset, rapid progression, and poor final visual outcome. Each of these patients was treated by a standard protocol with intravitreal, systemic, and topical antibiotics and systemic steroids. Despite treatment, the final visual outcomes for three of these patients was no perception of light, and that for one patient remained perception of hand movements only. In common with endophthalmitis caused by other gram-negative organisms, intraocular infection secondary to Enterobacter cloacae infection is a devastating disease which, despite treatment, results in extensive ocular damage and severe visual loss. Since 1966, only four cases of endophthalmitis secondary to infection with members of this genus have been reported. This report presents four cases which occurred over a period of 14 months and, to the best of our knowledge, the first case of bleb-related endophthalmitis secondary to E. cloacaeinfection.

Hurst’s encephalitis. Lecture with a description of clinical cases

2021 ◽  
Vol 2 (2) ◽  
pp. 89-93
Author(s):  
Eugenia A. Komarova ◽  
Alexey S. Kotov
Keyword(s):  
White Matter ◽  
Severe Disease ◽  
Intensive Therapy ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Acute Onset ◽  
Brain Hemispheres ◽  
First Case ◽  
The Brain ◽  
Clinical Cases

Hirst’s encephalitis is a severe disease characterized by an acute onset and rapidly progressive inflammation with symmetrical multifocal lesions of the brain, less often the cerebellum, brain stem, or spinal cord, manifested by white matter necrosis and numerous hemorrhages. Cases of Hirst’s encephalitis are quite rare; by 2014, about 100 cases of the disease have been described in the literature. The mortality rate for this disease reaches 70%. Its etiology remains unclear, and in most cases, the diagnosis is made heuristically, based on the similarity of clinical manifestations in a particular patient with the “classical” descriptions available in the literature. The article presents two clinical cases of Hirst’s encephalitis. In the first case, the disease debuted at the age of 14 with mental disorders, manifested by panencephalitis, depression of consciousness, and epileptic seizures. Against the background of aggressive therapy, it was possible to achieve a positive result, however, with an outcome in gross neurological and cognitive deficits. In the second case, the disease debuted at the age of 49 with loss of consciousness, manifested itself as resistant status epilepticus and multifocal inflammatory lesions of the white matter of both brain hemispheres with foci of hemorrhagic impregnation. Despite intensive therapy, this case was fatal. In conclusion, a description of the approaches to the diagnosis and treatment of Hirst’s encephalitis based on the data of modern literature is presented.

scholarly journals Mevalonate Kinase-Associated Diseases: Hunting for Phenotype–Genotype Correlation

2021 ◽  
Vol 10 (8) ◽  
pp. 1552
Author(s):  
Guilaine Boursier ◽  
Cécile Rittore ◽  
Florian Milhavet ◽  
Laurence Cuisset ◽  
Isabelle Touitou
Keyword(s):  
Severe Disease ◽  
Compound Heterozygous ◽  
Mevalonate Kinase ◽  
Kinase Gene ◽  
New Associations ◽  
Associated Diseases ◽  
Ocular Symptoms ◽  
Disseminated Superficial Actinic Porokeratosis ◽  
Increased Risk ◽  
Genotype Correlation

Mevalonate kinase-associated diseases (MKAD) are caused by pathogenic mutations in the mevalonate kinase gene (MVK) and encompass several phenotypically different rare and hereditary autoinflammatory conditions. The most serious is a recessive systemic metabolic disease called mevalonic aciduria, and the most recently recognized is disseminated superficial actinic porokeratosis, a dominant disease limited to the skin. To evaluate a possible correlation between genotypes and (1) the different MKAD clinical subtypes or (2) the occurrence of severe manifestations, data were reviewed for all patients with MVK variants described in the literature (N = 346), as well as those referred to our center (N = 51). The genotypes including p.(Val377Ile) (homozygous or compound heterozygous) were more frequent in mild systemic forms but were also sometimes encountered with severe disease. We confirmed that amyloidosis was more prevalent in patients compound heterozygous for p.(Ile268Thr) and p.(Val377Ile) than in others and revealed new associations. Patients homozygous for p.(Leu264Phe), p.(Ala334Thr) or compound heterozygous for p.(His20Pro) and p.(Ala334Thr) had increased risk of severe neurological or ocular symptoms. All patients homozygous for p.(Leu264Phe) had a cataract. The variants associated with porokeratosis were relatively specific and more frequently caused a frameshift than in patients with other clinical forms (26% vs. 6%). We provide practical recommendations focusing on phenotype–genotype correlation in MKAD that could be helpful for prophylactic management.

scholarly journals Successful extracorporeal membrane oxygenation resuscitation of patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 746-751
Author(s):  
Tao Wang ◽  
Qiancheng Xu ◽  
Xiaogan Jiang
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Tumour Size ◽  
Acute Onset ◽  
Left Ventricular ◽  
Vanillylmandelic Acid ◽  
Membrane Oxygenation ◽  
First Case ◽  
Va Ecmo

Abstract A 29-year-old woman presented to the emergency department with the acute onset of palpitations, shortness of breath, and haemoptysis. She reported having an abortion (56 days of pregnancy) 1 week before admission because of hyperthyroidism diagnosis during pregnancy. The first diagnoses considered were cardiomyopathy associated with hyperthyroidism, acute left ventricular failure, and hyperthyroidism crisis. The young woman’s cardiocirculatory system collapsed within several hours. Hence, venoarterial extracorporeal membrane oxygenation (VA ECMO) was performed for this patient. Over the next 3 days after ECMO was established, repeat transthoracic echocardiography showed gradual improvements in biventricular function, and later the patient recovered almost completely. The patient’s blood pressure increased to 230/130 mm Hg when the ECMO catheter was removed, and then the diagnosis of phaeochromocytoma was suspected. Computed tomography showed a left suprarenal tumour. The tumour size was 5.8 cm × 5.7 cm with central necrosis. The vanillylmandelic acid concentration was 63.15 mg/24 h. Post-operation, pathology confirmed phaeochromocytoma. To our knowledge, this is the first case report of a patient with cardiogenic shock induced by phaeochromocytoma crisis mimicking hyperthyroidism which was successfully resuscitated by VA ECMO.

scholarly journals Operating Room Fomites as Potential Sources for Microbial Transmission in Burns Theatres

2021 ◽  
Vol 2 (1) ◽  
pp. 1-8
Author(s):  
Mariam Rela ◽  
Sophia Opel ◽  
Sarah Williams ◽  
Declan P. Collins ◽  
Kevin Martin ◽  
...  
Keyword(s):  
Bacterial Contamination ◽  
Point Of Care ◽  
Enterobacter Cloacae ◽  
Operating Table ◽  
Healthcare Associated Infections ◽  
Burn Patients ◽  
Degree Of Contamination ◽  
First Case ◽  
Bacterial Transmission ◽  
Healthcare Associated

Background: Burn patients are susceptible to healthcare-associated infections. Contaminated surfaces play a role in microbial transmission. This study aimed to quantify the degree of contamination of burns theatre fomites during routine clinical use. Methods: The Patslide Patient Transfer Board (PAT slide) and operating table were investigated using two methods—bacterial swabs to culture viable organisms and adenosine triphosphate (ATP) swabs to measure biological material. Both items were sampled four times a day: before the first case, immediately after a case, immediately before the next case after cleaning and after the terminal clean. Results: Among 82 bacterial samples, four organisms were isolated, including Staphylococcus aureus, Enterobacter cloacae (E. cloacae) x2 and Pseudomonas aeruginosa (P. aeruginosa), all from the PAT slide. The E. cloacae persisted after cleaning. In 9/82 swabs, the ATP count was >10 relative light units (RLU). In all cases where an organism was identified, the ATP count was >10 RLU. Hence the sensitivity and specificity of ATP > 10 RLU in detecting an organism were 100% and 94% respectively. Conclusions: Within burns theatres, there are instances of bacterial contamination on surfaces that persist despite cleaning. ATP luminometers as a point-of-care device may have a role in determining the cleanliness of surfaces, potentially minimizing onwards-bacterial transmission.

BRAF-MAD1L1 and BRAF-ZC3H7A: novel gene fusion in Rhabdomyosarcoma and Lung adenocarcinoma

2021 ◽  
Author(s):  
Jiang Da ◽  
Hui Jin ◽  
Xinliang Zhou ◽  
Shaoshuang Fan ◽  
Mian Xu ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Gene Fusion ◽  
Tumor Resection ◽  
Kinase Domain ◽  
Rapid Progression ◽  
First Line ◽  
Case Presentation ◽  
First Case ◽  
Exon 11 ◽  
Domain Exon

Abstract Background: Rhabdomyosarcoma (RMS) and lung adenocarcinoma (LADC) epitomizes the success of cancer prevention by the development of conventional therapy, but huge challenges remain in the therapy of advanced diseases.Case presentation: We reported two cases of novel BRAF gene fusion. The first case was a 34-year-old female with RMS harboring a BRAF-MAD1L1 fusion. She suffered tumor resection, recurrence and rapid progression. The second case was a 72-year-old female with LADC harboring a BRAF-ZC3H7A fusion, and she gained rapid progression after receiving a first-line course of chemotherapy.Conclusions: These two BRAF fusions retain the intact BRAF kinase domain (exon 11-18) and showed poor prognosis in RMS and LADC.

scholarly journals Comparison of the Superpolymyxin and ChromID Colistin R Screening Media for the Detection of Colistin-Resistant Enterobacteriaceae from Spiked Rectal Swabs

2018 ◽  
Vol 63 (1) ◽  
Author(s):  
Delphine Girlich ◽  
Thierry Naas ◽  
Laurent Dortet
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Confidence Interval ◽  
Enterobacter Cloacae ◽  
Bacterial Isolates ◽  
Colistin Resistance ◽  
Gram Negative ◽  
Content Type ◽  
Rectal Swabs ◽  
Stool Samples

ABSTRACT The dissemination of carbapenemase-producing Enterobacteriaceae (CPE) has led to the increased use of colistin, which has resulted in the emergence of colistin-resistant Enterobacteriaceae worldwide. One of the most threatening scenarios is the dissemination of colistin resistance in CPE, particularly the plasmid-encoded resistance element MCR. Thus, it has now become mandatory to possess reliable media to screen for colistin-resistant Gram-negative bacterial isolates, especially Enterobacteriaceae. In this study, we evaluated the performances of the Superpolymyxin medium (ELITechGroup) and the ChromID Colistin R medium (bioMérieux) to screen for colistin-resistant Enterobacteriaceae from spiked rectal swabs. Stool samples were spiked with a total of 94 enterobacterial isolates (Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Enterobacter cloacae), including 53 colistin-resistant isolates. ESwabs (Copan Diagnostics) were then inoculated with those spiked fecal suspensions, and culture proceeded as recommended by both manufacturers. The sensitivity of detection of colistin-resistant Enterobacteriaceae was 86.8% (95% confidence interval [95% CI] = 74.0% to 94.0%) using both the Superpolymyxin medium and the ChromID Colistin R plates. Surprisingly, the isolates that were not detected were not the same for both media. The specificities were high for both media, at 97.9% (95% CI = 87.3% to 99.9%) for the Superpolymyxin medium and 100% (95% CI = 90.4% to 100%) for the ChromID Colistin R medium. Both commercially available media, ChromID Colistin R and Superpolymyxin, provide useful tools to screen for colistin-resistant Enterobacteriaceae from patient samples (rectal swabs) regardless of the level and mechanism of colistin resistance.

scholarly journals First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1046
Author(s):  
Robert Kuthan ◽  
Anna K. Kurowska ◽  
Justyna Izdebska ◽  
Jacek P. Szaflik ◽  
Anna Lutyńska ◽  
...  
Keyword(s):  
Contact Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Ocular Infection ◽  
Corneal Perforation ◽  
Purpureocillium Lilacinum ◽  
First Case ◽  
Pars Plana ◽  
Tof Ms

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS.

scholarly journals Acute Onset Polymyositis after Prolactinoma Extirpation

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
Juan Jakez-Ocampo ◽  
Yemil Atisha-Fregoso ◽  
Luis Llorente
Keyword(s):  
Autoimmune Diseases ◽  
Muscle Biopsy ◽  
Steroid Therapy ◽  
Acute Onset ◽  
Pituitary Macroadenoma ◽  
Inflammatory Infiltration ◽  
Total Recovery ◽  
First Case ◽  
Very High

Hyperprolactinemia has been related to autoimmune diseases. Herein, we describe a case of a female with a prolactin producer pituitary macroadenoma who developed severe polymyositis one month after its removal. The patient had very high levels of CPK and muscle biopsy showed remarkable inflammatory infiltration. Steroid therapy was followed with total recovery. To the best of our knowledge, this is the first case reported of acute polymyositis after pituitary macroadenoma exeresis.

scholarly journals Post-Malaria Neurological Syndrome - A Case of Bell’s Palsy After Plasmodium Vivax Malaria

2013 ◽  
Vol 33 (1) ◽  
pp. 66-67 ◽  
Author(s):  
AK Singh ◽  
S Chakraborti ◽  
S Subhranag
Keyword(s):  
Plasmodium Vivax ◽  
Vivax Malaria ◽  
Clinical Symptoms ◽  
Bell’S Palsy ◽  
Acute Onset ◽  
Blood Film ◽  
Bell's Palsy ◽  
Neurological Syndrome ◽  
First Case ◽  
Plasmodium Vivax Malaria

 Post-malaria neurological syndrome (PMNS) is defined as the acute onset of neurological or neuropsychiatric syndrome in a patient who had recently recovered from malaria and have negative blood film at the time of onset of neurological symptoms. It is relatively rare, with various clinical symptoms. We report first case of Bell’s palsy developing on 10th day of afebrile period after successful treatment of Plasmodium vivax (P.vivax) malaria and which completely recovered in next two weeks. DOI: http://dx.doi.org/10.3126/jnps.v33i1.6893 J Nepal Paediatr Soc. 2013;33(1):66-67

Fatal Neutropenia and Thrombocytopenia Associated with Ticlopidine

1994 ◽  
Vol 28 (11) ◽  
pp. 1236-1238 ◽  
Author(s):  
James A. Carlson ◽  
Jon E. Maesner
Keyword(s):  
Renal Function ◽  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Impaired Renal Function ◽  
Healthcare Professionals ◽  
Severe Neutropenia ◽  
Gram Negative ◽  
Case Summary ◽  
First Case

OBJECTIVE: To report the first case of ticlopidine-associated neutropenia resulting in sepsis and death. CASE SUMMARY: An 83-year-old Filipino man was started on ticlopidine 250 mg bid. By the seventh week of therapy his absolute neutrophil count (ANC) had dropped to 2700 from 7600 × 106 cells/L. The ticlopidine was stopped. Six days later, he was admitted to the hospital. He died 18 hours later of gram-negative sepsis. DISCUSSION: Although ticlopidine therapy was discontinued four days after the patient's ANC was 2700 × 106 cells/L, the ANC dropped to and remained at 0 until his death eight days later. This may be associated with the patient's decreased clearance of ticlopidine given his age and impaired renal function. This is the first reported case of moderate or severe neutropenia in a nonwhite patient and the first reported case of sepsis and death caused by ticlopidine CONCLUSIONS: Healthcare professionals must be aware of the possibility of severe neutropenia and death caused by ticlopidine, even when the manufacturers' monitoring guidelines are followed.

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