A Case of Urinary Sepsis Secondary to Streptococcus sanguinis

We report a case of a 71-year-old male with a history of BPH who presented with flank pain, fever, chills, abdominal pain, and nausea. He had a dental cleaning 1 month prior to admission and flosses daily. Laboratory data revealed both urine and blood cultures to be positive for streptococcus sanguinis. Computed tomography revealed a 10 mm right ureteral stone, and an ultrasound demonstrated moderate right hydronephrosis. He underwent an ureteroscopy with stent placement. A transesophageal echocardiogram was negative for endocarditis. He completed 2 weeks of IV ceftriaxone and made a complete recovery.

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The Prevalence of Nephrolithiasis in Patients with Primary Gout: A Cross-sectional Study Using Helical Computed Tomography

The Journal of Rheumatology ◽

10.3899/jrheum.081128 ◽

2009 ◽

Vol 36 (9) ◽

pp. 1958-1962 ◽

Cited By ~ 14

Author(s):

TORU SHIMIZU ◽

HIROSHI HORI

Keyword(s):

Computed Tomography ◽

Confidence Interval ◽

Laboratory Data ◽

Helical Computed Tomography ◽

Cross Sectional ◽

Patients Âgés ◽

Primary Gout ◽

Stone Formers ◽

Significant Difference ◽

History Of

Objective.To investigate the prevalence of nephrolithiasis in gouty patients by computed tomography (CT) imaging and to compare it with the “prevalence” of urolithiasis calculated from histories of urinary tract calculus.Methods.The kidneys of 383 male patients with primary gout were examined using an unenhanced 2-row helical CT detector, imaging at 2 mm collimation and a helical pitch of 3. The urolithiasis history of the 383 patients was investigated by inquiry. Patients’ ages, body mass index, and laboratory data from a 1-hour clearance test were determined.Results.CT scans confirmed nephrolithiasis in 103 (26.9%, 95% confidence interval 22.5%–31.6%) of the 383 gouty patients, and history of urinary calculus was positive in 65 (17.0%, 95% confidence interval 13.4%–21.1%) of the 383. However, 64 (62%) of the 103 stone-formers identified by CT had no history of urolithiasis. There was a significant difference between the ages of the 103 stone-formers identified by CT and the 65 stone-formers identified from the history.Conclusion.The prevalence of nephrolithiasis obtained using CT was 26.9% in the 383 patients with primary gout. Our results imply that we cannot determine an accurate prevalence of urolithiasis from a patient’s history. Most of the “prevalence” reported in the past may not correspond to a statistically justifiable one, but instead to the “cumulative incidence” during the contraction period of gout. Thus, the prevalence of nephrolithiasis confirmed by a cross-sectional method and the “prevalence” of urolithiasis calculated from patients’ calculus histories should be clearly distinguished.

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Periorbital and Orbital Cellulitis in Children

PEDIATRICS ◽

10.1542/peds.61.2.272 ◽

1978 ◽

Vol 61 (2) ◽

pp. 272-277 ◽

Cited By ~ 1

Author(s):

Andrew M. Gellady ◽

Stanford T. Shulman ◽

Elia M. Ayoub

Keyword(s):

Laboratory Data ◽

Blood Cultures ◽

Orbital Cellulitis ◽

Type B ◽

Sinus Disease ◽

Clinical Presentations ◽

High Incidence ◽

Focus Of Infection ◽

History Of ◽

Group A

The clinical and laboratory data on 87 cases of orbital and periorbital cellulitis were reviewed. Two distinct clinical presentations were encountered. One group of 45 patients had no history of trauma on apparent focus of infection. Blood cultures on these patients were positive in 34%. Haemophilus influenzae accounted for 82% of the positive blood cultures. This group of patients shares common features with children who have facial cellulitis due to H. influenzae type b. The second group consisted of 42 patients with adjacent soft tissue focus of infection. There was only one positive blood culture in this group. Staphylococcus aureus and/or group A β-hemolytic Streptococcus were isolated from conjunctival or wound exudate in the majority of these patients. Thirteen patients with orbital cellulitis were encountered among the 87 cases. These patients were older and had a high incidence of demonstrable sinus disease when compared with the overall group. The pathophysiology of orbital and periorbital cellulitis is reviewed and an approach to the management of these disorders is formulated.

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Capnocytophaga canimorsus meningitis and bacteraemia without a dog bite in an immunocompetent individual

BMJ Case Reports ◽

10.1136/bcr-2021-242432 ◽

2021 ◽

Vol 14 (7) ◽

pp. e242432

Author(s):

Fiona O'Riordan ◽

Aoife Ronayne ◽

Arthur Jackson

Keyword(s):

Complete Recovery ◽

Human Infection ◽

Blood Cultures ◽

Invasive Infection ◽

Dog Bite ◽

Capnocytophaga Canimorsus ◽

Oral Flora ◽

Immunocompetent Individual ◽

Laboratory Confirmation ◽

History Of

We describe the case of an immunocompetent 75-year-old man with Capnocytophaga canimorsus bacteraemia and meningitis. C. canimorsus is commonly found in the oral flora of dogs with human infection typically occurring following a bite. Unusually, while our patient was a dog owner, there was no history of bite nor scratch mark. Admission blood cultures flagged positive for Gram-negative bacilli, but prolonged molecular analysis was required before C. canimorsus was isolated in blood and cerebrospinal fluid. There is a high mortality rate in invasive infection, and in our patient’s case, antibiotic therapy was commenced prior to laboratory confirmation with our patient making a complete recovery. This case highlights the importance of including C. canimorsus in the differential diagnosis of unwell patients who keep dogs, even without a bite. This case occurred amid heightened awareness of COVID-19, which may represent predisposition for zoonoses during social isolation and increased human–pet contact.

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Successfully Treated Intra-Abdominal Abscess Caused by Fish Bone With Perforation of Ascending Colon: A Case Report

International Surgery ◽

10.9738/intsurg-d-14-00163.1 ◽

2015 ◽

Vol 100 (3) ◽

pp. 428-430 ◽

Cited By ~ 2

Author(s):

Mami Yamamoto ◽

Kentaroh Yamamoto ◽

Takamitsu Sasaki ◽

Daisuke Fukumori ◽

Fumio Yamamoto ◽

...

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Laboratory Data ◽

Fish Bone ◽

Abdominal Abscess ◽

Ascending Colon ◽

Hospital Visit ◽

History Of ◽

Upper Abdominal ◽

The Right

Ingestion of a foreign body is not uncommon, but rarely results in perforation of the gastrointestinal tract. The most common sites of perforation are reportedly the narrowest parts of the bowel, and perforation of the right side of the colon is rare. We report herein the case of a 69-year-old man who presented with an 8-week history of right upper abdominal pain. Laboratory data revealed inflammation at the first hospital visit. Computed tomography revealed a hypodense lesion containing a hyperdense foreign body in the abdomen. Intra-abdominal abscess caused by foreign body perforation was diagnosed. After administering antibiotics for 2 weeks, surgery was performed. Symptoms had resulted from perforation of the ascending colon by a fish bone.

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A Case ofAcinetobacterSeptic Pulmonary Embolism in an Infant

Case Reports in Infectious Diseases ◽

10.1155/2016/5241571 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Poonam Wade ◽

Anitha Ananthan ◽

Jane David ◽

Radha Ghildiyal

Keyword(s):

Computed Tomography ◽

Pulmonary Embolism ◽

Blood Culture ◽

Early Diagnosis ◽

Complete Recovery ◽

Blood Cultures ◽

Lower Zone ◽

Septic Pulmonary Embolism ◽

The Right ◽

Case Characteristics

Case Characteristics. An 11-month-old girl presented with fever and breathlessness for 5 days. Patient had respiratory distress with bilateral coarse crepitations. Chest radiograph revealed diffuse infiltrations in the right lung with thick walled cavities in mid and lower zone. Computed tomography showed multiple cystic spaces and emboli. Blood culture grewAcinetobacterspecies.Intervention. Patient was treated with Meropenem and Vancomycin.Outcome. Complete clinical and radiological recovery was seen in child.Message. Blood cultures and CT of the chest are invaluable in the evaluation of a patient with suspected septic pulmonary embolism. With early diagnosis and appropriate antimicrobial therapy, complete recovery can be expected in patients with septic pulmonary embolism.

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Emphysematous Pyelitis With Query Intraparenchymal Involvement

Canadian Journal of General Internal Medicine ◽

10.22374/cjgim.v14i4.330 ◽

2019 ◽

Vol 14 (4) ◽

pp. e30-e31

Author(s):

Taraneh Tofighi ◽

Karen Lien ◽

Raphael Rush

Keyword(s):

Diabetes Mellitus ◽

Computed Tomography ◽

Type 2 Diabetes ◽

Renal Calculus ◽

Flank Pain ◽

Elevated Blood ◽

Past Medical History ◽

History Of

We report the ccase of a 65-year-old woman presenting with urosepsis in the context of a one-week history of progressive right flank pain and a past medical history of type 2 diabetes mellitus. Computed Tomography (CT) demonstrated evidence of emphysematous pyelitis, a rare infection caused by gas-producing bacteria associated with elevated blood glucose. The patient responded well to fluid resuscitation and was discharged home with follow-up arranged for blood sugar management and outpatient lithotripsy addressing obstructive renal calculus.

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Budd-Chiari syndrome due to segmental obstruction of the inferior vena cava successfully managed with endovascular stenting

MedPharmRes ◽

10.32895/ump.mpr.2.3.22 ◽

2018 ◽

Vol 2 (3) ◽

pp. 22-26

Author(s):

Uyen Vo ◽

Duc Quach ◽

Luan Dang ◽

Thao Luu ◽

Luan Nguyen

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Laboratory Data ◽

Transaminase Level ◽

Vena Cava ◽

Budd Chiari Syndrome ◽

Endovascular Stenting ◽

Massive Ascites ◽

Chiari Syndrome ◽

History Of

Budd–Chiari syndrome (BCS), a rare and life-threatening disorder due to hepatic venous outflow obstruction, is occasionally associated with hypoproteinemia. We herein report the first case of BCS with segmental obstruction of the intrahepatic portion of inferior vena cava (IVC) and hepatic veins (HVs) successfully treated by endovascular stenting in Vietnam. A 32-year-old female patient presented with a 2-month history of massive ascites and leg swelling. She refused history of oral contraceptives use. Hepatosplenomegaly without tenderness was noted. Laboratory data showed polycythemia, mild hypoalbuminemia and hypoproteinemia, slightly high total bilirubin and normal transaminase level. The serum ascites albumin gradient was 1.9 g/dL and ascitic protein level was 1.1 g/dL. The other data were normal. BCS was suspected because of the discrepancy between mild liver failure and massive ascites; and the presence of hepatosplenomegaly and polycythemia. On abdominal magnetic resonance imaging, the segmental obstruction of three HVs and IVC was 2-3 cm long without thrombus. Cavogram revealed the severe segmental stenosis of intrahepatic portion of IVC with no visualized HV and extensive collateral veins. A Protégé stent was deployed to IVC. Leg swelling and ascites were completely resolved within 3 days after stenting. During 1-year follow-up, edema was not recurred and repeated laboratory results were all normal.

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Refractory Ascites as the Only Presenting Symptom of Chronic Calcified Constrictive Pericarditis: A Diagnostic Challenge

The Heart Surgery Forum ◽

10.1532/hsf98.2013251 ◽

2014 ◽

Vol 17 (1) ◽

pp. 42

Author(s):

Shi-Min Yuan

Keyword(s):

Computed Tomography ◽

Liver Cirrhosis ◽

Female Patient ◽

Constrictive Pericarditis ◽

Delayed Diagnosis ◽

Young Female ◽

Refractory Ascites ◽

Diagnostic Challenge ◽

Massive Ascites ◽

History Of

Extracardiac manifestations of constrictive pericarditis, such as massive ascites and liver cirrhosis, often cover the true situation and lead to a delayed diagnosis. A young female patient was referred to this hospital due to a 4-year history of refractory ascites as the only presenting symptom. A diagnosis of chronic calcified constrictive pericarditis was eventually established based on echocardiography, ultrasonography, and computed tomography. Cardiac catheterization was not performed. Pericardiectomy led to relief of her ascites. Refractory ascites warrants thorough investigation for constrictive pericarditis.

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Glucose Levels and Outcome After Primary Intraventricular Hemorrhage

Current Neurovascular Research ◽

10.2174/1567202616666190131164108 ◽

2019 ◽

Vol 16 (1) ◽

pp. 40-46

Author(s):

Rui Guo ◽

Ruiqi Chen ◽

Chao You ◽

Lu Ma ◽

Hao Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Blood Glucose Level ◽

Incidence Rate ◽

Glucose Level ◽

Intraventricular Hemorrhage ◽

Laboratory Data ◽

History Of ◽

Poor Outcomes ◽

The Impact

Background and Purpose: Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH. Methods: Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes. Results: One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders. Conclusion: Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.

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Scopolamine fatal outcome in an inmate after buscopan® smoking

International Journal of Legal Medicine ◽

10.1007/s00414-021-02583-2 ◽

2021 ◽

Author(s):

Sabina Strano-Rossi ◽

Serena Mestria ◽

Giorgio Bolino ◽

Matteo Polacco ◽

Simone Grassi ◽

...

Keyword(s):

Computed Tomography ◽

Drug Abuse ◽

Muscarinic Receptors ◽

Histopathological Examination ◽

Fatal Outcome ◽

Post Mortem ◽

Butyl Bromide ◽

Cannabis Abuse ◽

Toxic Concentration ◽

History Of

AbstractScopolamine is an alkaloid which acts as competitive antagonists to acetylcholine at central and peripheral muscarinic receptors. We report the case of a 41-year-old male convict with a 27-year history of cannabis abuse who suddenly died in the bed of his cell after having smoked buscopan® tablets. Since both abuse of substances and recent physical assaults had been reported, we opted for a comprehensive approach (post-mortem computed tomography CT (PMCT), full forensic autopsy, and toxicology testing) to determine which was the cause of the death. Virtopsy found significant cerebral edema and lungs edema that were confirmed at the autopsy and at the histopathological examination. Scopolamine was detected in peripheral blood at the toxic concentration of 14 ng/mL in blood and at 263 ng/mL in urine, and scopolamine butyl bromide at 17 ng/mL in blood and 90 ng/mL in urine. Quetiapine, mirtazapine, lorazepam, diazepam, and metabolites and valproate were also detected (at therapeutic concentrations). Inmates, especially when they have a history of drug abuse, are at risk to use any substance they can find for recreational purposes. In prisons, active surveillance on the management and assumption of prescribed drugs could avoid fatal acute intoxication.

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