scholarly journals Clinical presentation and management of leuconostoc bacteremia in patient with prolonged ICU stay: Case report

2021 ◽  
Vol 6 (4) ◽  
pp. 234-236
Author(s):  
Deepali Bhandari Parashar ◽  
Manav Manchanda ◽  
Sunil Nagar
Keyword(s):  
Clinical Presentation ◽  
Stool Culture ◽  
Blood Cultures ◽  
Immunocompromised Patients ◽  
Intravenous Catheter ◽  
Vancomycin Therapy ◽  
Recurrent Vomiting ◽  
Prolonged Icu Stay ◽  
Leuconostoc Pseudomesenteroides ◽  
Multiple Episodes

A 54 years old female came to emergency with the complaints of pain in abdomen, recurrent vomiting, abdominal distention and not able to pass flatus since two days. Patient was managed in intensive care unit and was empirically put on Meropenem and Targocid. She developed multiple episodes of loose motion, and stool culture was sent which was positive for Clostridium defficle. Therefore, patient was put on Vancomycin and Metrogyl. The blood cultures reported growth of Leuconostoc pseudomesenteroides. Infection with Leuconostoc may cause fever, intravenous catheter-related sepsis, bacteremia, abdominal pain, gastroenteritis, colitis or meningitis. To summarize this rare organism which is most commonly seen in immunocompromised patients, was isolated in a previously healthy individual, post Vancomycin therapy with prolonged ICU stays.

scholarly journals Enucleation of a giant symptomatic gastric lipoma, a safe surgical approach

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Rafaela Parreira ◽  
Tiago Rama ◽  
Teresa Eloi ◽  
Vítor Carneiro ◽  
Maria Inês Leite
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Clinical Presentation ◽  
Pyloric Obstruction ◽  
Asymptomatic Patients ◽  
Recurrent Vomiting ◽  
Low Incidence ◽  
Diagnostic Modalities ◽  
Benign Tumours ◽  
Gastric Lipoma

Abstract Gastric lipomas are rare, representing 2–3% of all benign tumours of the stomach. Most of these stomach neoplasms are small and detected incidentally during endoscopic or radiology evaluations. Computed tomography is highly specific imaging for lipoma diagnosis. Endoscopy and endoscopic ultrasound are other important diagnostic modalities to confirm the diagnosis. Identifying typical features can avoid biopsy or surgery in asymptomatic patients. In patients with larger lesions, usually more than 2 cm, clinical presentation may encompass haemorrhage, abdominal pain, pyloric obstruction and dyspepsia. As a result of its extreme low incidence, treatment is not standardized, though it is widely accepted that a symptomatic tumour mandates resection. Here, we present the case of a 60-year-old female presenting with abdominal pain and recurrent vomiting due to a giant gastric lipoma (80 × 35 × 35 mm). The patient underwent laparotomy and an enucleation was performed.

scholarly journals Aerococcus viridansNative Valve Endocarditis

2013 ◽  
Vol 24 (3) ◽  
pp. 155-158 ◽  
Author(s):  
Wenwan Zhou ◽  
Vanessa Nanci ◽  
Andreanne Jean ◽  
Amir H Salehi ◽  
Fahad Altuwaijri ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Infective Endocarditis ◽  
Mitral Valve ◽  
Surgical Approach ◽  
Clinical Presentation ◽  
Blood Cultures ◽  
Human Pathogen ◽  
Aerococcus Viridans ◽  
Time To Diagnosis ◽  
Echocardiographic Findings

Aerococcus viridansis an infrequent human pathogen and few cases of infective endocarditis have been reported. A case involving a 69-year-old man with colon cancer and hemicolectomy 14 years previously, without recurrence, is reported. A diagnosis of native mitral valve endocarditis was established on the basis of clinical presentation, characteristic echocardiographic findings and pathological specimen examination after urgent valve replacement.A viridansendocarditis appears to be particularly virulent, requiring a surgical approach in four of 10 cases reported and death in one of nine. Given the aggressive nature ofA viridansendocarditis and the variable time to diagnosis (a few days to seven months), prompt recognition of symptoms and echocardiography, in addition to blood cultures, should be performed when symptoms persist.

scholarly journals Rat Bite Fever Resembling Rheumatoid Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ripa Akter ◽  
Paul Boland ◽  
Peter Daley ◽  
Proton Rahman ◽  
Nayef Al Ghanim
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Presentation ◽  
Blood Cultures ◽  
Zoonotic Infection ◽  
Presumptive Diagnosis ◽  
Rat Bite Fever ◽  
Rare Manifestation ◽  
History Of ◽  
High Index Of Suspicion ◽  
Culture Positive

Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

scholarly journals Multiple liver abscesses caused by Streptococcus intermedius bacteremia in the setting of a routine dental cleaning

2020 ◽  
Vol 13 (2) ◽  
pp. e233097 ◽  
Author(s):  
Angy Hanna ◽  
Zaid Imam ◽  
Fadi Odish ◽  
Bhavin Dalal
Keyword(s):  
Septic Shock ◽  
Gastrointestinal Tract ◽  
Immunocompetent Patient ◽  
Blood Cultures ◽  
Immunocompromised Patients ◽  
Ultrasound Guided ◽  
Streptococcus Intermedius ◽  
Liver Abscesses ◽  
The Brain ◽  
Gram Positive Cocci

Streptococcus intermedius is a Gram-positive cocci, normally found in the oral cavity and gastrointestinal tract. It has been associated with deep-seated purulent abscesses commonly in the brain or liver in immunocompromised patients. Here, we discuss the case of a 21-year-old immunocompetent patient that presented with septic shock in the setting of multiple pyogenic liver abscesses with positive blood cultures for S. intermedius. The patient had a dental cleaning 3 months prior to admission. The abscesses resolved with ultrasound guided drainage and antibiotic therapy.

scholarly journals Delayed neurological deterioration due to progressive pneumocephalus

2015 ◽  
Vol 22 (1) ◽  
pp. 128-131
Author(s):  
Amit Agrawal ◽  
S. Satish Kumar ◽  
Umamaheswara Reddy V.
Keyword(s):  
Ct Scan ◽  
Clinical Presentation ◽  
Mass Effect ◽  
Neurological Status ◽  
Tension Pneumocephalus ◽  
Delayed Neurological Deterioration ◽  
Mass Lesions ◽  
Multiple Episodes ◽  
Significant Mass Effect ◽  
Significant Mass

Abstract Pneumocephalus can develop immediately following head trauma or clinical presentation may be delayed for days. We report a case of 35 year male whose initial CT scan brain plain small specks of pneumocephalus in left para-sellar region. However the next day he was complaining of severe headache and had multiple episodes of vomiting. Repeat CT scan showed increase in the size of pneumocephalus including appearance of intraventricular air with mild cerebral edema. The patient recovered well with conservative management. The present case is a gentle reminder that in a subgroup of head injury patients, intracranial air can produce significant mass effect leading to tension pneumocephalus which can can behave like other intracranial mass lesions and causes worsening of the neurological status of these patients.

scholarly journals Minimally invasive approach to esophageal lipoma

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Daniele Bernardi ◽  
Davide Ferrari ◽  
Stefano Siboni ◽  
Matteo Porta ◽  
Barbara Bruni ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Gastrointestinal Endoscopy ◽  
Clinical Presentation ◽  
Upper Gastrointestinal Endoscopy ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Life Saving ◽  
Recurrent Vomiting ◽  
Life Threatening ◽  
Upper Gastrointestinal

Abstract Esophageal lipoma is a rare neoplasm with heterogeneous and sometimes life-threatening clinical presentation. We report the case of two patients, a 77-year-old man and a 69-year-old woman presenting with heartburn and dysphagia, and with recurrent vomiting and asphyxia, respectively. Upper gastrointestinal endoscopy and computed tomography were highly suggestive of the diagnosis of esophageal lipoma and identified an intramural and an intraluminal pedunculated mass originating, respectively, from the distal and the cervical esophagus. The first patient was treated by laparoscopic transhiatal enucleation and the second by transoral endoscopic resection under general anesthesia. Both had an uneventful postoperative course and were discharged home on postoperative day 2. Minimally invasive excision of esophageal lipoma is feasible and effective. It may be life-saving in patients with pedunculated tumors who suffer from intermittent regurgitation of a bulky polypoid mass in the mouth causing asphyxia.

scholarly journals Asymptomatic Cholecystocolonic Fistula: A Diagnostic and Therapeutic Dilemma

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Nicola Antonacci ◽  
Giovanni Taffurelli ◽  
Riccardo Casadei ◽  
Claudio Ricci ◽  
Francesco Monari ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Preoperative Imaging ◽  
Diagnostic Tools ◽  
Review Of The Literature ◽  
Imaging Studies ◽  
Common Site ◽  
Biliary Tract Surgery ◽  
Cholecystocolonic Fistula ◽  
Multiple Episodes ◽  
Variable Clinical Presentation

Cholecystocolonic fistulas (CCF) are rare complications of gallstones with a variable clinical presentation. Despite modern diagnostic tools, cholecystocolonic fistulas are often asymptomatic and it is difficult to diagnose them preoperatively. Biliary-enteric fistulae have been found in 0.9% of patients undergoing biliary tract surgery. The most common site of communication of the fistula is the cholecystoduodenal (70%), followed by the cholecystocolic (10–20%), and the least common is the cholecystogastric fistula. Herein, we report a case of female patient with multiple episodes of acute recurrent cholangitis due to common bile duct and gallbladder stones in which preoperative imaging studies were negative for cholecystocolonic fistula that was incidentally discovered and treated during surgery and was appropriately treated. A review of the literature is reported too.

scholarly journals Respiratory adenovirus infections in immunocompetent and immunocompromised adult patients

2019 ◽  
Vol 147 ◽  
Author(s):  
S. Cederwall ◽  
L. I. Påhlman
Keyword(s):  
Respiratory Tract Infections ◽  
Clinical Presentation ◽  
Respiratory Infections ◽  
Antiviral Treatment ◽  
Adult Patients ◽  
Immunocompromised Patients ◽  
Severe Infections ◽  
Tract Infections ◽  
Immunocompetent Adults ◽  
Underlying Risk

Abstract Adenovirus (AdV) can cause severe respiratory infections in children and immunocompromised patients, but less is known about severe AdV pneumonia in immunocompetent adults. In this retrospective study, we compared respiratory tract infections and pneumonia caused by AdV in immunocompromised and immunocompetent adult patients regarding clinical presentation and severity of infection. The results show that AdV can cause severe infections in both immunocompetent and immunocompromised patients, and the clinical presentation and need for hospitalisation, mechanical ventilation and antiviral treatment were equal in both groups. No underlying risk factors for severe AdV infection in healthy individuals were identified.

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