Case of flexor tenosynovitis caused by Mycobacterium arupense

2021 ◽  
Vol 14 (10) ◽  
pp. e245130
Author(s):  
Kushali Patel ◽  
John Flaherty
Keyword(s):  
Drinking Water ◽  
Case Report ◽  
Water Systems ◽  
The Other ◽  
Empiric Antibiotic Therapy ◽  
Joint Infections ◽  
Empiric Antibiotic ◽  
Environmental Pathogens ◽  
Fish Tanks ◽  
Flexor Tenosynovitis

Mycobacterium arupense is a member of the Mycobacterium terrae complex (MTC) that is implicated in bone and joint infections, among others. This group of environmental pathogens can be found in soil, reclaimed and drinking water systems, rodents, fish tanks and bioaerosols in duck houses. Interestingly, while M. arupense is genotypically closely related to the other agents in the MTC, antibiotic susceptibility of these mycobacteria can vary widely and empiric antibiotic therapy is controversial. Our case report contributes to the very limited literature on M. arupense tenosynovitis—as only six cases have been reported since 2008—and sheds light on different courses of treatment. While previous cases have been successfully treated, a streamlined course of therapy for M. arupense tenosynovitis is still needed.

scholarly journals Fishing-Injury-Related Flexor Tenosynovitis of the Hand: A Case Report and Review

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Danny A. Young-Afat ◽  
Deniz Dayicioglu ◽  
John C. Oeltjen ◽  
Audene P. Garrison
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Empiric Antibiotic Therapy ◽  
Illustrative Case ◽  
Soft Tissue Infections ◽  
Severe Damage ◽  
Appropriate Treatment ◽  
Empiric Antibiotic ◽  
Infectious Disease Specialists ◽  
Flexor Tenosynovitis

Hand infections occurring after fishing and other marine-related activities may involve uncommon bacteria that are not susceptible to the conventional or empiric antibiotic therapy used to treat soft tissue infections. Therefore appropriate treatment is often delayed and could lead to severe hand damage. An illustrative case of fishing-related injury leading to complicated tenosynovitis and horseshoe abscess caused byMycobacterium marinumand its treatment course is outlined. Laceration of the skin during boating is fairly common. Because of the rarity of some of the bacteria, referrals to the appropriate specialist including hand surgeons and infectious disease specialists should occur in early stages.M. marinuminfections should always be considered in injuries related to seawater and fishing as this may lead to early appropriate treatment and prevent severe damage.

scholarly journals Acute pancreatitis in a COVID-19 patient in Brazil: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Caroline Petersen da Costa Ferreira ◽  
Kalynne Rodrigues Marques ◽  
Gustavo Henrique Ferreira de Mattos ◽  
Tércio de Campos
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Epigastric Pain ◽  
White Male ◽  
Empiric Antibiotic Therapy ◽  
Pancreatic Involvement ◽  
Number Of Patients ◽  
Empiric Antibiotic

Abstract Background The consequences of the coronavirus disease 2019 pandemic have already exceeded 10 million infected and more than 560,000 deaths worldwide since its inception. Currently, it is known that the disease affects mainly the respiratory system; however, recent studies have shown an increase in the number of patients with manifestations in other systems, including gastrointestinal manifestations. There is a lack of literature regarding the development of acute pancreatitis as a complication of coronavirus disease 2019. Case report We report a case of acute pancreatitis in a white male patient with coronavirus disease 2019. A 35-year-old man (body mass index 31.5) had acute epigastric pain radiating to his back, dyspnea, nausea, and vomiting for 2 days. The patient was diagnosed with severe acute pancreatitis (AP)-APACHE II: 5, SOFA: 3, Marshall: 0; then he was transferred from ED to the semi-intensive care unit. He tested positive for severe acute respiratory syndrome coronavirus 2 on reverse transcription-polymerase chain reaction, and his chest computed tomography findings were compatible with coronavirus disease 2019. Treatment was based on bowel rest, fluid resuscitation, analgesia, and empiric antibiotic therapy. At day 12, with resolution of abdominal pain and improvement of the respiratory condition, the patient was discharged. Conclusion Since there is still limited evidence of pancreatic involvement in severe acute respiratory syndrome coronavirus 2 infection, no definite conclusion can be made. Given the lack of other etiology, we consider the possibility that the patient’s acute pancreatitis could be secondary to coronavirus disease 2019 infection, and we suggest investigation of pancreas-specific plasma amylase in patients with coronavirus disease 2019 and abdominal pain.

scholarly journals Suspected nitrite poisoning in pigs caused by Capsella bursa-pastoris (L.) Medik. ('herderstassie', shepherd's purse) : case report

2001 ◽  
Vol 72 (3) ◽  
Author(s):  
W.J. Wiese ◽  
J.P.J. Joubert
Keyword(s):  
Drinking Water ◽  
Case Report ◽  
The Other ◽  
Northern Province ◽  
Daily Ration ◽  
First Report

Nitrite poisoning in pigs was suspected when 4 of 18 pigs died in a piggery near Ellisras in the Northern Province. The pigs showed typical brownish discolouration of the blood at autopsy. It was established that they ingested vegetable tops and weeds from the adjacent garden as part of their daily ration. Of the available plants, only Capsella bursa-pastoris contained nitrites. The drinking water and some of the other plants tested positive for nitrates but not for nitrites. This is the first report of suspected nitrite poisoning in pigs caused by Capsella bursa-pastoris.

scholarly journals Is There a Difference in Microbiological Epidemiology and Effective Empiric Antimicrobial Therapy Comparing Fracture-Related Infection and Periprosthetic Joint Infection? A Retrospective Comparative Study

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 921
Author(s):  
Markus Rupp ◽  
Susanne Baertl ◽  
Nike Walter ◽  
Florian Hitzenbichler ◽  
Martin Ehrenschwender ◽  
...  
Keyword(s):  
Statistical Difference ◽  
Joint Infection ◽  
Empiric Therapy ◽  
Empiric Antibiotic Therapy ◽  
Joint Infections ◽  
Empiric Antibiotic ◽  
Retrospective Comparative Study ◽  
Resistance Rates ◽  
Susceptibility Profiles ◽  
Common Infection

This study aims to investigate (1) microbial patterns in fracture-related infections (FRIs) in comparison to microbiological patterns of periprosthetic joint infections (PJIs), (2) the identification of effective empiric antibiotic therapy for FRIs and PJIs and (3) analysis of difficult-to-treat (DTT) pathogens. Patients treated for FRIs or PJIs from 2017 to 2020 were evaluated for pathogens detected during treatment. Antibiotic susceptibility profiles were examined with respect to broadly used antibiotics and antibiotic combinations. Resistance rates to rifampicin or fluoroquinolone were determined. A total of 81 patients with PJI and 86 with FRI were included in the study. For FRIs Staphylococcus aureus was the most common infection-causing pathogen (37.4% vs. 27.9% for PJI). Overall, there was no statistical difference in pathogen distribution (p = 0.254). For FRIs, combinations of gentamicin + vancomycin (93.2%), co-amoxiclav + glycopeptide and meropenem + vancomycin (91.9% each) would have been effective for empiric therapy, similar to PJIs. Difficult to treat pathogens were more frequently detectable in PJIs (11.6% vs. 2.3%). Empiric therapy combinations such as gentamicin + vancomycin, co-amoxiclav + glycopeptide or meropenem + vancomycin, are effective antibiotic strategies for both FRI and PJI patients. More DTT pathogens were detectable in PJIs compared to FRIs.

scholarly journals Delayed Rifampin Administration in the Antibiotic Treatment of Periprosthetic Joint Infections Significantly Reduces the Emergence of Rifampin Resistance

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1139
Author(s):  
Ali Darwich ◽  
Franz-Joseph Dally ◽  
Mohamad Bdeir ◽  
Katharina Kehr ◽  
Thomas Miethke ◽  
...  
Keyword(s):  
Pathogen Detection ◽  
Joint Infection ◽  
Empiric Antibiotic Therapy ◽  
Resistant Organism ◽  
Joint Infections ◽  
Treatment Failure Rate ◽  
Empiric Antibiotic ◽  
Rifampin Resistance ◽  
Group 2 ◽  
Group 1

Rifampin is one of the most important biofilm-active antibiotics in the treatment of periprosthetic joint infection (PJI), and antibiotic regimens not involving rifampin were shown to have higher failure rates. Therefore, an emerging rifampin resistance can have a devastating effect on the outcome of PJI. The aim of this study was to compare the incidence of rifampin resistance between two groups of patients with a PJI treated with antibiotic regimens involving either immediate or delayed additional rifampin administration and to evaluate the effect of this resistance on the outcome. In this retrospective analysis of routinely collected data, all patients who presented with an acute/chronic PJI between 2018 and 2020 were recorded in the context of a single-center comparative cohort study. Two groups were formed: Group 1 included 25 patients with a PJI presenting in 2018–2019. These patients received additional rifampin only after pathogen detection in the intraoperative specimens. Group 2 included 37 patients presenting in 2019–2020. These patients were treated directly postoperatively with an empiric antibiotic therapy including rifampin. In all, 62 patients (32 females) with a mean age of 68 years and 322 operations were included. We found a rifampin-resistant organism in 16% of cases. Rifampin resistance increased significantly from 12% in Group 1 to 19% in Group 2 (p < 0.05). The treatment failure rate was 16% in Group 1 and 16.2% in Group 2 (p = 0.83). The most commonly isolated rifampin-resistant pathogen was Staphylococcus epidermidis (86%) (p < 0.05). The present study shows a significant association between the immediate start of rifampin after surgical revision in the treatment of PJI and the emergence of rifampin resistance, however with no significant effect on outcome.

scholarly journals Update on Acute Bone and Joint Infections in Paediatrics: A Narrative Review on the Most Recent Evidence-Based Recommendations and Appropriate Antinfective Therapy

Antibiotics ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 486 ◽  
Author(s):  
Giovanni Autore ◽  
Luca Bernardi ◽  
Susanna Esposito
Keyword(s):  
Septic Arthritis ◽  
Laboratory Data ◽  
Underlying Disease ◽  
Narrative Review ◽  
Empiric Antibiotic Therapy ◽  
Evidence Based ◽  
First Line ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Empiric Antibiotic

Acute bone and joint infections (BJIs) in children may clinically occur as osteomyelitis (OM) or septic arthritis (SA). In clinical practice, one-third of cases present a combination of both conditions. BJIs are usually caused by the haematogenous dissemination of septic emboli carried to the terminal blood vessels of bone and joints from distant infectious processes during transient bacteraemia. Early diagnosis is the cornerstone for the successful management of BJI, but it is still a challenge for paediatricians, particularly due to its nonspecific clinical presentation and to the poor specificity of the laboratory and imaging first-line tests that are available in emergency departments. Moreover, microbiological diagnosis is often difficult to achieve with common blood cultures, and further investigations require invasive procedures. The aim of this narrative review is to provide the most recent evidence-based recommendations on appropriate antinfective therapy in BJI in children. We conducted a review of recent literature by examining the MEDLINE (Medical Literature Analysis and Retrieval System Online) database using the search engines PubMed and Google Scholar. The keywords used were “osteomyelitis”, OR “bone infection”, OR “septic arthritis”, AND “p(a)ediatric” OR “children”. When BJI diagnosis is clinically suspected or radiologically confirmed, empiric antibiotic therapy should be started as soon as possible. The choice of empiric antimicrobial therapy is based on the most likely causative pathogens according to patient age, immunisation status, underlying disease, and other clinical and epidemiological considerations, including the local prevalence of virulent pathogens, antibiotic bioavailability and bone penetration. Empiric antibiotic treatment consists of a short intravenous cycle based on anti-staphylococcal penicillin or a cephalosporin in children aged over 3 months with the addition of gentamicin in infants aged under 3 months. An oral regimen may be an option depending on the bioavailability of antibiotic chosen and clinical and laboratory data. Strict clinical and laboratory follow-up should be scheduled for the following 3–5 weeks. Further studies on the optimal therapeutic approach are needed in order to understand the best first-line regimen, the utility of biomarkers for the definition of therapy duration and treatment of complications.

Temporal variability of disinfection by-products concentration in urban public water system

2013 ◽  
Vol 14 (4) ◽  
pp. 393-398
Keyword(s):  
Drinking Water ◽  
Water Samples ◽  
Temporal Variability ◽  
Water System ◽  
The Other ◽  
Major Constituent ◽  
System P ◽  
Public Water System ◽  
Drinking Water Samples ◽  
By Products

The occurrence of trihalomethanes (THMs) was studied in the drinking water samples from urban water supply network of Karachi city that served more than 18 million people. Drinking water samples were collected from 58 locations in summer (May-August) and winter (November-February) seasons. The major constituent of THMs detected was chloroform in winter (92.34%) and summer (93.07%), while the other THMs determined at lower concentrations. Summer and winter concentrations of total THMs at places exceed the levels regulated by UEPA (80 μg l-1) and WHO (100 μg l-1). GIS linked temporal variability in two seasons showed significantly higher median concentration (2.5%-23.06%) of THMs compared to winter.

Legionnaire’s disease and COVID-19: Could Legionella be acting in conjunction with the Corona virus to aggravate the COVID-19 disease?

2020 ◽  
Author(s):  
Andrew John PENDERY
Keyword(s):  
Drinking Water ◽  
Air Conditioning ◽  
Water Systems ◽  
Contaminated Water ◽  
Cooling Towers ◽  
Age Group ◽  
Corona Virus ◽  
The Usa ◽  
Legionnaire's Disease ◽  
Legionnaire’S Disease

There are some striking similarities between Legionnaire’s disease and COVID-19. Thesymptoms, age group and sex at risk are identical. The geographical distribution of both diseases is similar in Europe overall, and within the USA, France and Italy. The environmental distributions are also similar. However Legionnaire’s disease is caused by Legionella bacteria while COVID-19 is caused by the Corona virus. Whereas COVID-19 is contagious, Legionnaire’s disease is environmental. Legionella bacteria are commonly found in drinking water systems and near air conditioning cooling towers. Legionnaire’sdisease is caught by inhaling contaminated water droplets. The Legionella bacteria does not spread person to person and only causes disease if it enters the lungs.Could the Corona virus be making it easier for Legionella bacteria to enter the lungs?

Enteric viruses in drinking water supplies

2002 ◽  
Vol 2 (3) ◽  
pp. 17-22
Author(s):  
A.P. Wyn-Jones ◽  
J. Watkins ◽  
C. Francis ◽  
M. Laverick ◽  
J. Sellwood
Keyword(s):  
Drinking Water ◽  
Heavy Rainfall ◽  
Liquid Culture ◽  
Plaque Assay ◽  
Enteric Viruses ◽  
Enteric Virus ◽  
The Other ◽  
Raw Water ◽  
Rt Pcr ◽  
Water Supplies

Two rural spring drinking water supplies were studied for their enteric virus levels. In one, serving about 30 dwellings, the water was chlorinated before distribution; in the other, which served a dairy and six dwellings the water was not treated. Samples of treated (40 l) and untreated (20 l) water were taken under normal and heavy rainfall conditions over a six weeks period and concentrated by adsorption/elution and organic flocculation. Infectious enterovirus in concentrates was detected in liquid culture and enumerated by plaque assay, both in BGM cells, and concentrates were also analysed by RT-PCR. Viruses were found in both raw water supplies. Rural supplies need to be analysed for viruses as well as bacterial and protozoan pathogens if the full microbial hazard is to be determined.

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