scholarly journals Pasteurella multocida Endocarditis with Septic Arthritis: Case Report and Review of the Literature

2021 ◽  
Author(s):  
E Carter ◽  
U Iroegbu ◽  
W Baig ◽  
JAT Sandoe
Keyword(s):  
Cardiac Surgery ◽  
Septic Arthritis ◽  
Pasteurella Multocida ◽  
Left Knee ◽  
Rapid Progression ◽  
First Case ◽  
Literature Reviews ◽  
Aortic Root Abscess ◽  
Mobile Mass ◽  
Grade 3

Background: There is a paucity of evidence regarding optimal management of Pasteurella spp. endocarditis. The authors report the first case of Pasteurella spp. endocarditis with septic arthritis and review the literature. Case Description: A 79-year-old patient with significant comorbidities, including prosthetic aortic valve, was admitted with left knee swelling, fever, and confusion, having been scratched by a cat 2-weeks prior. At presentation, there was a metallic click, a Grade 3 pan-systolic murmur and Grade 1 flow murmur audible on auscultation. Blood and synovial fluid cultures both isolated Pasteurella multocida, identified by matrix-assisted laser desorption ionisation–time of flight, which was sensitive to penicillin according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST); minimum inhibitory concentration: 0.094). The patient underwent joint washout and received intravenous piperacillin/tazobactam for 3 days before switching to benzylpenicillin once sensitivities were known. Due to continued pyrexia, a transthoracic echocardiogram was obtained, which revealed a small mobile mass on a thickened mitral valve suspicious for a vegetation. On review by the Infective Endocarditis team, conservative management was deemed best, given the presence of comorbidities. Despite requiring further joint washout due to persistent knee pain, the patient was successfully treated with 8 weeks of antibiotic therapy (24 days of benzylpenicillin monotherapy, 2 weeks of benzylpenicillin and ciprofloxacin, and 15 days ciprofloxacin monotherapy). Discussion: Previous literature reviews report a higher mortality of Pasteurella spp. endocarditis when managed without cardiac surgery, thus recommending surgery in all cases. The authors found these to have confounding factors, including inadequate duration of antimicrobials, aortic root abscess, and rapid progression to death. The authors’ case of Pasteurella spp. endocarditis, complicated by septic arthritis, showed successful therapy without cardiac surgery.

Septic arthritis caused by Pasteurella multocida

1982 ◽  
Vol 1 (3) ◽  
pp. 137-137 ◽  
Author(s):  
Heather Mitchell ◽  
Richard Travers ◽  
David Barraclough
Keyword(s):  
Septic Arthritis ◽  
Pasteurella Multocida

Effects of the use neuromuscular electrical stimulation of the lower extremities in the prehabilitation of patients in a before cardiac surgery

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
P Oleinik ◽  
AN Sumin ◽  
AV Bezdenezhnykh
Keyword(s):  
Cardiac Surgery ◽  
Handgrip Strength ◽  
Lower Extremities ◽  
Left Knee ◽  
Knee Extensors ◽  
Control Group ◽  
Elective Cardiac Surgery ◽  
Antagonist Muscles ◽  
Muscle Groups ◽  
Knee Flexors

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Research Institute for Complex Issues of Cardiovascular Diseases Aim To evaluate the effects of neuromuscular electrostimulation in the prehabilitation and prevention of muscle weakness in patients awaiting cardiac surgery. Materials and methods 122 patients waiting for elective cardiac surgery were included. Exclusion criteria: age less than 25 and more than 80 years; emergency and urgent surgical interventions; arthropathies; low pain threshold; rhabdomyolysis and other myopathies; cognitive dysfunction. Routine laboratory and instrumental examinations were performed in all patients upon admission to the hospital, as part of a standard examination. 62 patients were randomly selected for the preoperative NMES group, in addition to the standard preoperative preparation and treatment program. The standard program included 60 control patients. Patients of the NMES group underwent quadriceps stimulation for at least 5 sessions, lasting 90 minutes, daily before surgery. Results. The groups were comparable and did not have significant differences in gender and age characteristics, according to the main clinical and anamnestic data and types of operations. Initially, there were no differences in the state of the muscles of the lower extremities, the distance of the six-minute walking test (6MWT), and the strength of the hand grip. After NMES, there was an increase in muscle strength relative to the control group, both stimulated muscle groups and unstimulated antagonist muscles, as well as a greater 6MWT distance and hand compression force. All the differences were significant. Conclusions The course of pre-rehabilitation of NMES before surgery, allowed to maintain, and in some cases improve the condition of the muscle frame of the lower extremities. A positive effect was observed not only in stimulated muscle groups, but also in antagonist muscles Indicators of muscle status NMES (n = 62) Control group (n = 60) Baseline Discharge Baseline Discharge P-level Right knee extensors strength (kg) 24,4 [18,3; 31,4] 30,4 [23,8; 36,2]* 24,7 [20,1; 33,2] 22,25 [18,9; 30,4] <0,001 Left knee extensors strength (kg) 23,8 [19,3; 31,3] 29,2 [23,6; 35,4]* 25,75 [19,2; 31,3] 22,9 [18,9; 27,8] <0,001 Right knee flexors strength (kg) 18,9 [13,3; 24,0] 21,7 [16,6; 25,1] 19,55 [13,1; 26,0] 16,7 [12,1; 23,3] 0,006 Left knee flexors strength (kg) 19,3 [14,3; 24,5] 21,9 [17,3; 26,7] 19,5 [13,0; 24,3] 18,2 [13,4; 22,2] 0,005 6-MWT (m) 300,0 [261,0; 371,0] 331,0 [280,0; 375,0] 304,5 [253,0; 380,0] 285,5 [246,0; 342,0] 0,006 Right handgrip strength (kg) 28,5 [20,5; 34,0] 31,5 [22,0; 34,0] 29,0 [19,0; 34,0] 27,0 [19,0; 33,0] 0,054 Left handgrip strength (kg) 25,0 [18,0; 31,0] 25,0 [18,0; 32,0] 24,0 [15,0; 31,0] 22,0 [14,0; 28,0] 0,062 * - p-level from baseline data < 0,05 Abstract Figure. dynamics of stimulated muscles

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 Aspergillus aortitis in an immunocompetent patient presenting with acute endophthalmitis

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Joseph M. Rocco ◽  
Maggie K. Benson
Keyword(s):  
Cardiac Surgery ◽  
Early Recognition ◽  
Disease Process ◽  
Infectious Agent ◽  
Immunocompetent Patient ◽  
Endogenous Endophthalmitis ◽  
Laboratory Studies ◽  
Aortic Pseudoaneurysm ◽  
First Case ◽  
Ascending Aortic Pseudoaneurysm

Aspergillus is a common environmental mold most often recognized as an infectious agent in patients with severe immune compromise. We present a case of an immunocompetent patient presenting with endogenous endophthalmitis in the absence of other infectious symptoms. The search for a systemic source revealed an ascending aortic pseudoaneurysm. Surgical resection and pathology revealed angioinvasive aspergillus aortitis. Recent cardiac surgery has been noted to be a risk factor for angioinvasive aspergillosis. Diagnosis is difficult as symptoms are mild and laboratory studies are often normal. To our knowledge this is the first case of aspergillus aortitis presenting as endogenous endophthalmitis without systemic signs of inflammation. These patients have a high mortality rate therefore early recognition is essential. It is important to consider angioinvasive aspergillus infections in patients with prior cardiac surgery presenting with occult embolic phenomena. Only with early diagnosis and prompt treatment can we improve outcomes of this disease process.

scholarly journals Fatal Chromobacterium violaceum septicemia in a South Indian adult

2012 ◽  
Vol 6 (10) ◽  
pp. 751-755 ◽  
Author(s):  
Rajiv Karthik ◽  
Padmaja Pancharatnam ◽  
Veeraraghavan Balaji
Keyword(s):  
Mortality Rate ◽  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
High Mortality ◽  
South India ◽  
Chromobacterium Violaceum ◽  
Human Pathogen ◽  
Tropical Regions ◽  
First Case ◽  
South Indian

Chromobacterium violaceum is a rare human pathogen that causes potentially fatal infections especially in the tropical regions. Limited awareness about this pathogen and inappropriate antibiotic therapy are some of the factors contributing to the high mortality rate. To date there have been only eight cases reported from India of which only one is an adult. To the best of our knowledge, we report here the first case of a 40-year-old man from South India with septicemic C. Violaceum infection and septic arthritis.

Pasteurella Multocida: first case report of uterine abscess and septic metastasis

2020 ◽  
pp. 102003
Author(s):  
Manon Mangiardi-Veltin ◽  
Stéphanie Aicardi ◽  
Marjorie Vermeille ◽  
Joël Amblard ◽  
Denis Savary
Keyword(s):  
Case Report ◽  
Pasteurella Multocida ◽  
First Case ◽  
Uterine Abscess

scholarly journals Septic arthritis of the shoulder due to Ureaplasma urealyticum after emergency caesarean section: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jaad Mahlouly ◽  
Loic Lhopitallier ◽  
Véronique Suttels ◽  
Linda Mueller ◽  
Diane Wernly ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Septic Arthritis ◽  
Antibiotic Treatment ◽  
Ureaplasma Urealyticum ◽  
Post Partum ◽  
Emergency Caesarean Section ◽  
Mucosal Barrier ◽  
Emergency Caesarean ◽  
First Case ◽  
Operative Recovery

Abstract Background Ureaplasma urealyticum is an intra-cellular bacterium frequently found colonizing the genital tract. Known complications include localized infections, which can result in premature deliveries. Septic arthritis due to U. urealyticum in healthy patients is exceptionally rare, although opportunistic septic arthritis in agammaglobulinemic patients have been reported. However, there are no reports of septic arthritis due to U. urealyticum following caesarean section or in the post-partum period. Case presentation A 38-year-old immunocompetent woman presented with severe right shoulder pain, 1 month following emergency caesarean section at 26 weeks of gestation for pre-eclampsia and spontaneous placental disruption with an uncomplicated post-operative recovery. Our suspicion of septic arthritis was confirmed with abundant pus following arthrotomy by a delto-pectoral approach. Awaiting culture results, empirical antibiotic treatment with intravenous amoxicilline and clavulanic acid was initiated. In spite of sterile cultures, clinical evolution was unfavorable with persistent pain, inflammation and purulent drainage, requiring two additional surgical débridement and lavage procedures. The 16S ribosomal RNA PCR of the purulent liquid was positive for U. urealyticum at 2.95 × 106 copies/ml, specific cultures inoculated a posteriori were positive for U. urealyticum. Levofloxacin and azithromycine antibiotherapy was initiated. Susceptibility testing showed an intermediate sensibility to ciprofloxacin and clarithromycin. The strain was susceptible to doxycycline. Following cessation of breastfeeding, we started antibiotic treatment with doxycycline for 4 weeks. The subsequent course was favorable with an excellent functional and biological outcome. Conclusions We report the first case of septic arthritis due to U. urealyticum after caesarean section. We hypothesize that the breach of the genital mucosal barrier during the caesarean section led to hematogenous spread resulting in purulent septic arthritis. The initial beta-lactam based antibiotic treatment, initiated for a purulent arthritis, did not provide coverage for cell wall deficient organisms. Detection of 16S rRNA allowed for a correct microbiological diagnosis in a patient with an unexpected clinical course.

scholarly journals Is This Rapid Destructive Hip Osteoarthritis ?

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0007
Author(s):  
Tung HO Sheung ◽  
Yip Kan Yeung ◽  
Ming Yu Chiu ◽  
Yeung IP Hoi
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Septic Arthritis ◽  
Hip Arthroplasty ◽  
Frozen Section ◽  
Hip Osteoarthritis ◽  
Rapid Progression ◽  
Total Hip ◽  
Diagnosis By Exclusion ◽  
Rapid Destruction

Rapid destructive hip osteoarthritis is a diagnosis by exclusion. It should be differentiated from septic arthritis, osteonecrosis, neuropathic arthritis and other aetiologies causing rapid bone resorption or destruction around the hip. The present study aims to review the incidence of rapid destructive hip osteoarthritis among those patients who request total hip arthroplasty for end stage arthrosis. A retrospective review of radiographs of all patients who scheduled for total hip arthroplasty from January 2010 to March 2019 were analysed by 3 orthopaedic fellows. Of 174 hips of 146 patients, 35 hips of 29 patients were considered by at least 2 orthopaedic fellows to have rapid destructive hip osteoarthritis based on radiographic criteria of rapid joint space narrowing or rapid destruction of femoral head with or without acetabular involvement. Clinical history and physical finding, blood biochemistry, cultures and pathology with or without frozen section are reviewed. Early total hip arthroplasty, rather than routine operation in the long waiting list, is recommended for rapid destructive hip osteoarthritis to prevent technical difficulty in dealing with the bone loss or defect associated with rapid destructive hip osteoarthritis. However, one must exclude septic arthritis before proceeding to total hip arthroplasty. In clinically highly suspected cases, staged total hip arthroplasty was done despite of normal initial blood investigationsand negative hip aspiration with equivocal frozen section on table. In one such patient, the culture was initially negative, but became positive only after extended period of culture. On the other hand, rapid destruction of acetabulum requiring impaction bone grafting and acetabular augmentation for total hip arthroplasty was needed in one patient. Malignancy was suspected in another patient, but there was no evidence of malignancy or infection in the femoral head and tissue obtained by excisional arthroplasty of hip. One patient with hip pain and bilateral hip involvement was found to have Charcot joint. Rapid destruction hip osteoarthritis represents an uncommon subset of arthrosis with rapid progression. A delicate balance between correct diagnosis and timely early operation should be exercised to prevent rapid loss of bone stock making delayed total hip arthroplasty become technical difficult with possible compromised outcomes.

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