scholarly journals A Fatal Case ofKlebsiella pneumoniaeMycotic Aneurysm

2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
Chien-Ming Chao ◽  
Kun-Kuang Lee ◽  
Chia-Sheng Wang ◽  
Ping-Jen Chen ◽  
Tsung-Chih Yeh
Keyword(s):  
Staphylococcus Aureus ◽  
Klebsiella Pneumoniae ◽  
Surgical Management ◽  
Clinical Condition ◽  
Mycotic Aneurysm ◽  
Antimicrobial Agents ◽  
Fatal Case ◽  
Morbidity And Mortality ◽  
Significant Morbidity

Mycotic aneurysm is a serious clinical condition with significant morbidity and mortality.Staphylococcus aureusandSalmonellaspecies are the most common causative pathogens.Klebsiella pneumoniaewas rarely reported as a possible pathogen causing mycotic aneurysm; therefore, we describe aK. pneumoniae-related fatal bacteremia mycotic aneurysm in a patient in spite of appropriate antimicrobial agents and surgical management.

Burns

2005 ◽  
pp. 411-431
Author(s):  
Patricia Sylla
Keyword(s):  
Surgical Management ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Initial Management ◽  
The Face ◽  
Burn Patient

• Introduction 412 • Initial management checklist 416 • Initial management 418 • Assessing the burn patient 422 • Stabilizing the burn patient 426 • Surgical management of burns 428 Burns are systemic injuries, which result in significant morbidity and mortality. They present a major challenge, not only during the resuscitation phase, but also with later reconstruction. With burns of the face, a ...

ATUALIZAÇÃO SOBRE ETIOLOGIA E TERAPIA DAS INFECÇÕES CERVICOFACIAIS DE ORIGEM ODONTOGÊNICA

2019 ◽  
Vol 1 (40) ◽  
Author(s):  
Isabelly De Vasconcellos Pereira
Keyword(s):  
Staphylococcus Aureus ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Therapy ◽  
Streptococcus Pyogenes ◽  
Antimicrobial Agents ◽  
Hospital Environment ◽  
Adequate Treatment ◽  
Viridans Streptococcus ◽  
Odontogenic Origin ◽  
Amoxicillin Clavulanate

RESUMO No ambiente hospitalar, percebe-se com frequência a ocorrência de casos de celulites e abscesso na região cervicofacial de origem odontogênica, principalmente relacionados ao comprometimento pulpar dos elementos dentários. Elas provêm das estruturas constituintes dos dentes e periodonto, sendo a maioria de etiologia polimicrobiana, devido à diversidade da microbiota bucal. Do grupo das bactérias aeróbias mais frequentes, causadoras dessas infeccões, destacam-se Streptococcus do grupo viridans, Streptococcus pyogenes, Staphylococcus aureus e Klebsiella pneumoniae. Dos anaeróbios destacam-se Peptostreptococcus, Bacteroides, Prevotella e Fusobacterium. A terapia antimicrobiana preconizada para estas infecções inclui combinações de amoxicilina-clavulanato e metronidazol ou amoxicilina-clavulanato e clindamicina. Atualmente, observa-se uma dificuldade crescente nesses tratamentos, necessitando de múltiplos agentes antimicrobianos. Isso parece estar relacionado à ocorrência de resistência bacteriana aos antibióticos mais comuns e demanda estudos que determinem a susceptibilidade das amostras isoladas nestes processos infecciosos. Para o sucesso terapêutico, pode ser necessária a internação do paciente,  pelo risco de disseminação da infecção para outros sítios, além da ocorrência de trismo, gerando dificuldade de alimentação e necessidade do acesso endovenoso do medicamento. O tratamento consiste, de antibioticoterapia adequada, drenagem e remoção da causa, ou seja, tratamento adequado do dente envolvido, o que envolve exodontia ou tratamento endodôntico. Considerando que em muitas situações a antibioticoterapia inicial não resulta em resposta clínica favorável, o objetivo deste estudo é analisar os dados disponíveis na literatura sobre a etiologia, tratamento e evolução clínica dos quadros infecciosos cervicofaciais de origem odontogênica. Palavras-chave: Infecção cervicofacial. Infecção odontogênica. Antibioticoterapia. Celulite. Abscesso. ABSTRACT In the hospital environment, the occurrence of cases of cellulitis and abscess in the cervicofacial region of odontogenic origin is frequently observed, mainly related to the pulp involvement of the theeth. They come from the structures of the teeth and periodontium, being the majority of polymicrobial etiology, due to the diversity of the buccal microbiota. Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus and Klebsiella pneumoniae are among the most common of the aerobic bacteria that cause these infections. Among the anaerobes are Peptostreptococcus, Bacteroides, Prevotella and Fusobacterium. The recommended therapy for these infections include combinations of amoxicillin-clavulanate and metronidazole or amoxicillin-clavulanate and clindamycin. Currently, there is an increasing difficulty in these treatments, requiring multiple antimicrobial agents. This seems to be related to the resistance to the most common antibiotics and requires studies to determine the susceptibility of the species in these infections. For therapeutic success, it may be necessary to hospitalize the patient, the risk of dissemination of the infection to other sites, in addition to the occurrence of trismus, generating difficulty in feeding and need for intravenous drug access. The treatment consists of adequate antibiotic therapy, drainage and removal of the cause, that is, adequate treatment of the involved tooth, which involves exodontia or endodontic treatment. Considering that in many situations initial antibiotic therapy does not result in a favorable clinical response, the objective of this study is to analyze data available in the literature on the etiology, treatment and clinical evolution of cervicofacial infections of odontogenic origin. Keywords: Cervicofacial infection. Odontogenic infection. Antibiotic therapy. Cellulitis. Abscess.

scholarly journals In-vitro antibacterial activity of sequential crude extracts from Datura stramonium seeds

2016 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Powar Priyatama V ◽  
Powar Trupti A
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Antimicrobial Activity ◽  
Bacillus Subtilis ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Agents ◽  
Datura Stramonium ◽  
Seed Extract ◽  
Zone Of Inhibition

The growing phenomenon of antibiotic resistance, particularly to pathogenic microorganisms, in current medicine, has directed the concern of scientists for finding novel antimicrobial agents from plant origin with negligible side effect. The present study was aimed to phytochemical investigation and antimicrobial activity of seed extract of Datura stramonium in sequentially with different organic solvents. For this, antimicrobial properties were tested against bacteria Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumonia and Bacillus subtilis by cup plate method. Among the tested bacterial Klebsiella pneumoniae was the most inhibited majorly with the chloroform extract. Datura stramonium chloroform seed extract produced maximum zone of inhibition 26 mm against Klebsiella pneumoniae and 12 mm against Bacillus subtilis and 13 mm against Escherichia coli. Datura Stramonium methanol seed extract produced maximum zone of inhibition 27 mm against Pseudomonas aeruginosa and 15 mm against Bacillus subtilis, 14 mm against Staphylococcus aureus and 19 mm against Escherichia coli. Datura stramonium petroleum ether seed extract produced 16 mm zone of inhibition against Escherichia coli. Datura stramonium aqueous seed extract exhibits 24 mm zone of inhibition against Bacillus subtilis. All the experienced solvent extracts showed potential antimicrobial activity Index against various tested microorganisms. Owning to the results, it can be concluded that the extracts of the Datura stramonium can be used to design different herbal antimicrobial agents.

scholarly journals ATUALIZAÇÃO SOBRE ETIOLOGIA E TERAPIA DAS INFECÇÕES CERVICOFACIAIS DE ORIGEM ODONTOGÊNICA

2019 ◽  
Author(s):  
Isabelly De Vasconcellos Pereira
Keyword(s):  
Staphylococcus Aureus ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Therapy ◽  
Streptococcus Pyogenes ◽  
Antimicrobial Agents ◽  
Hospital Environment ◽  
Adequate Treatment ◽  
Viridans Streptococcus ◽  
Odontogenic Origin ◽  
Amoxicillin Clavulanate

RESUMO No ambiente hospitalar, percebe-se com frequência a ocorrência de casos de celulites e abscesso na região cervicofacial de origem odontogênica, principalmente relacionados ao comprometimento pulpar dos elementos dentários. Elas provêm das estruturas constituintes dos dentes e periodonto, sendo a maioria de etiologia polimicrobiana, devido à diversidade da microbiota bucal. Do grupo das bactérias aeróbias mais frequentes, causadoras dessas infeccões, destacam-se Streptococcus do grupo viridans, Streptococcus pyogenes, Staphylococcus aureus e Klebsiella pneumoniae. Dos anaeróbios destacam-se Peptostreptococcus, Bacteroides, Prevotella e Fusobacterium. A terapia antimicrobiana preconizada para estas infecções inclui combinações de amoxicilina-clavulanato e metronidazol ou amoxicilina-clavulanato e clindamicina. Atualmente, observa-se uma dificuldade crescente nesses tratamentos, necessitando de múltiplos agentes antimicrobianos. Isso parece estar relacionado à ocorrência de resistência bacteriana aos antibióticos mais comuns e demanda estudos que determinem a susceptibilidade das amostras isoladas nestes processos infecciosos. Para o sucesso terapêutico, pode ser necessária a internação do paciente,  pelo risco de disseminação da infecção para outros sítios, além da ocorrência de trismo, gerando dificuldade de alimentação e necessidade do acesso endovenoso do medicamento. O tratamento consiste, de antibioticoterapia adequada, drenagem e remoção da causa, ou seja, tratamento adequado do dente envolvido, o que envolve exodontia ou tratamento endodôntico. Considerando que em muitas situações a antibioticoterapia inicial não resulta em resposta clínica favorável, o objetivo deste estudo é analisar os dados disponíveis na literatura sobre a etiologia, tratamento e evolução clínica dos quadros infecciosos cervicofaciais de origem odontogênica. Palavras-chave: Infecção cervicofacial. Infecção odontogênica. Antibioticoterapia. Celulite. Abscesso. ABSTRACT In the hospital environment, the occurrence of cases of cellulitis and abscess in the cervicofacial region of odontogenic origin is frequently observed, mainly related to the pulp involvement of the theeth. They come from the structures of the teeth and periodontium, being the majority of polymicrobial etiology, due to the diversity of the buccal microbiota. Streptococcus viridans, Streptococcus pyogenes, Staphylococcus aureus and Klebsiella pneumoniae are among the most common of the aerobic bacteria that cause these infections. Among the anaerobes are Peptostreptococcus, Bacteroides, Prevotella and Fusobacterium. The recommended therapy for these infections include combinations of amoxicillin-clavulanate and metronidazole or amoxicillin-clavulanate and clindamycin. Currently, there is an increasing difficulty in these treatments, requiring multiple antimicrobial agents. This seems to be related to the resistance to the most common antibiotics and requires studies to determine the susceptibility of the species in these infections. For therapeutic success, it may be necessary to hospitalize the patient, the risk of dissemination of the infection to other sites, in addition to the occurrence of trismus, generating difficulty in feeding and need for intravenous drug access. The treatment consists of adequate antibiotic therapy, drainage and removal of the cause, that is, adequate treatment of the involved tooth, which involves exodontia or endodontic treatment. Considering that in many situations initial antibiotic therapy does not result in a favorable clinical response, the objective of this study is to analyze data available in the literature on the etiology, treatment and clinical evolution of cervicofacial infections of odontogenic origin. Keywords: Cervicofacial infection. Odontogenic infection. Antibiotic therapy. Cellulitis. Abscess.

scholarly journals DRESS syndrome in the setting of oxacillin therapy—a call for better patient preparedness: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hawa Ozien Abu ◽  
Sajjadh M. J. Ali ◽  
Anil Phuyal ◽  
Akil Sherif ◽  
Gregory T. Williams ◽  
...  
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Drug Reaction ◽  
Early Recognition ◽  
Elevated Serum ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Drug Induced ◽  
Life Threatening ◽  
Systemic Symptoms

Abstract Background Drug reaction with eosinophilia and systemic symptoms syndrome is a rare but severe and potentially life-threatening hypersensitivity reaction, with significant morbidity and mortality. The clinical presentation of drug reaction with eosinophilia and systemic symptoms may include extensive skin rash, fever, lymphadenopathy, internal organ involvement, eosinophilia, and atypical lymphocytosis, most commonly due to drug-induced reaction. Our case is a rare occurrence of drug reaction with eosinophilia and systemic symptoms syndrome in the setting of oxacillin therapy. Case presentation A 55-year-old Caucasian male presented to the emergency department on account of acute onset, 2-day history of generalized pruritic rash with associated fever, occurring 3 weeks after commencing therapy with intravenous oxacillin for methicillin-sensitive Staphylococcus aureus bacteremia. He had no known drug allergies. Two days prior to hospitalization, he had a telehealth visit with the infectious diseases specialist on account of his rash, and was recommended to use oral diphenhydramine. However, with the onset of fever and persistence of his rash, he was advised to discontinue the oxacillin and present to the emergency department. On examination, he was febrile at 101.2 °F and had a generalized blanchable maculopapular and morbilliform rash involving the face, trunk, upper and lower extremities, but sparing the palms, soles, and oral mucosa. He had palpable nontender lymph nodes in the cervical and inguinal regions bilaterally. Laboratory studies revealed atypical lymphocytosis, eosinophilia, neutrophilia, and elevated serum transaminases. He was started on intravenous diphenhydramine and admitted to the in-patient medical service. On the second day of hospitalization, his fever resolved. However, his rash was persistent and generalized, as well as elevated transaminases and an abnormal cell count on the second day of hospitalization. To complete his 6-week course of antibiotics for methicillin-sensitive Staphylococcus aureus bacteremia, he was switched to an alternative therapy with cefazolin, and he was scheduled for weekly follow-up assessments following hospital discharge. Conclusions Healthcare providers should increasingly be aware of the significant morbidity and mortality attributable to drug reaction with eosinophilia and systemic symptoms syndrome and the potential medications which may incite such life-threatening reactions. Early recognition of drug reaction with eosinophilia and systemic symptoms syndrome and prompt institution of management strategies can promote improved clinical outcomes. Enhanced patient–provider communication strategies should be implemented to better prepare patients for the likelihood of such drug reactions, with the goal of improving patient-centered care and adherence with treatment strategies.

scholarly journals 559. Two Different Beasts: Comparing Epidemiology of Healthcare-Associated vs. Community-Acquired Methicillin-Resistant Staphylococcus aureus Bacteremia

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S265-S265
Author(s):  
Luke McLaughlin ◽  
Stephanie Smith
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Morbidity And Mortality ◽  
Common Source ◽  
Significant Morbidity ◽  
Methicillin Resistant ◽  
Icu Admission ◽  
Mrsa Infection ◽  
Healthcare Associated ◽  
Mrsa Colonization

Abstract Background Methicillin-resistant staphylococcus aureus (MRSA) bloodstream infection (BSI) is associated with significant morbidity and mortality. Healthcare-associated (HCA) MRSA infection (occurring >48 hours after hospitalization or in those with prior healthcare exposure) has traditionally been associated with severe invasive disease, while community-associated (CA) MRSA infection (occurring within 48 hours of hospitalization and without prior healthcare exposure) has been observed in otherwise healthy individuals. We characterized the epidemiology, resistance patterns, and clinical outcomes associated with MRSA BSI over a 5 year period comparing patients with community-onset bacteremia to those with hospital onset bacteremia. Methods We performed a retrospective chart review of 151 MRSA bloodstream infections from 2013–2018 at the University of Alberta Hospital (Edmonton, Canada). We assessed each BSI by: classification (CA vs. HCA), presence of MRSA risk factors, source of infection, MRSA resistance, rate of ICU admission, and 30-day mortality. Results The median age of all patients with MRSA BSI was 53 years (range 23–94). MRSA BSI occurred more commonly in males for both CA and HCA infection (53% and 62%). HCA-MRSA infections had a higher rate of previous MRSA colonization (64.8%) compared with CA-MRSA patients (41.7%). Injection drug use was higher in CA-MRSA infections (47% vs. 11%). The most common source of CA-BSI was bone/joint (30%) while line-associated infections were the most common in HCA-BSI. Clindamycin resistance was common (46–53% susceptible) while resistance to tetracyclines (91–97% susceptible) and trimethoprim/sulfamethoxazole (98–100% susceptible) was uncommon. HCA-MRSA BSI was associated with a higher rate of ICU admission (44% vs. 33%) and 30-day mortality (18.7% vs. 11.7%). Conclusion Invasive MRSA infection continues to be associated with significant morbidity and mortality. We found that healthcare-associated MRSA BSI was associated with a high rate of prior MRSA colonization as well as a higher rate of ICU admission and 30-day mortality. There are significant differences in the demographics of patients with CA BSI compared with HCA BSI. Interventions to prevent these infections need to be targeted to the geographic location of acquisition. Disclosures All authors: No reported disclosures.

scholarly journals Percutaneous caecostomy for the management of closed loop large bowel obstruction: A delayed complication of severe gallstone pancreatitis

2019 ◽  
Vol 101 (1) ◽  
pp. e17-e19
Author(s):  
J Aldoori ◽  
J Cast ◽  
IA Hunter
Keyword(s):  
Surgical Management ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Closed Loop ◽  
Large Bowel Obstruction ◽  
Morbidity And Mortality ◽  
Gallstone Pancreatitis ◽  
Significant Morbidity ◽  
Delayed Complication ◽  
General Surgeons

Colonic complications following pancreatitis are unusual events ranging from 1% to 15%. In a patient with a hostile abdomen and multiple previous laparotomies, surgical management of a closed-loop large-bowel obstruction risks significant morbidity and mortality for the patient, necessitating other strategies for management. Caecostomy in the management of large bowel obstruction is an often forgotten weapon in the general surgeons’ armoury.

Activité antibactérienne de l’huile essentielle de Pelargonium x asperum et son potentiel synergique avec la nisine

2019 ◽  
Vol 17 (3) ◽  
pp. 140-148 ◽  
Author(s):  
A. Ouelhadj ◽  
L. Ait Salem ◽  
D. Djenane
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Nous Avons ◽  
Activité Antibactérienne

Ce travail vise l’étude de l’activité antibactérienne de l’huile essentielle (HE) de Pelargoniumx asperum et de la bactériocine, la nisine seul et en combinaison vis-à-vis de six bactéries dont quatre sont multirésistantes d’origine clinique. L’activité antibactérienne in vitro a été évaluée par la méthode de diffusion sur gélose. La concentration minimale inhibitrice (CMI) est aussi déterminée pour HE. Les résultats ont révélé une activité antibactérienne significative exercée par HE visà-vis de Staphylococcus aureus (ATCC 43300), Staphylococcus aureus et Escherichia coli avec des diamètres d’inhibition de 36,00 ; 22,50 et 40,00 mm, respectivement. Cependant, l’HE de Pelargonium asperum a montré une activité antibactérienne supérieure par rapport à la nisine. Les valeurs des CMI rapportées dans cette étude sont comprises entre 1,98–3,96 μl/ml. Les combinaisons réalisées entre HE et la nisine ont montré un effet additif vis-à-vis de Escherichia coli (ATCC 25922) avec (50 % HE Pelargonium asperum + 50 % nisine). Par contre, nous avons enregistré une synergie vis-à-vis de Klebsiella pneumoniae avec (75 % HE Pelargonium asperum + 25 % nisine) et contre Pseudomonas aeruginosa avec les trois combinaisons testées. Les résultats obtenus permettent de dire que l’HE de Pelargonium asperum possède une activité antibactérienne ainsi que sa combinaison avec la nisine pourrait représenter une bonne alternative pour la lutte contre l’antibiorésistance.

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