scholarly journals Pylephlebitis caused by a liver abscess

2019 ◽  
Vol 6 (4) ◽  
pp. 13
Author(s):  
Daniel Alcantar ◽  
Fanny Giron Galeano ◽  
Christine Junia
Keyword(s):  
Rare Complication ◽  
Hepatic Abscess ◽  
Left Lobe ◽  
Portal Venous System ◽  
Microbial Infection ◽  
Gram Negative ◽  
Liver Abscesses ◽  
Empiric Antibiotic ◽  
Loss Of Appetite ◽  
Antibiotic Coverage

Pylephlebitis is a rare complication associated with an intra-abdominal septic process in the portal venous system. It is defined as thrombophlebitis of the portal vein and is often reported in association with appendicitis and diverticulitis. We present a 64-yearold female who presented with fever, chills, myalgia, and loss of appetite. A computerized tomography (CT) chest/abdomen/pelvis was performed and the patient was found to have a low-density lesion within the left lobe of the liver suspicious for a hepatic abscess and a suspected left segmental plyephlebitis. The diagnosis of pylephlebitis can be challenging as there is a broad differential diagnosis to consider. When considering pylephlebitis, empiric antibiotic coverage for poly-microbial infection targeting both gram-negative aerobes and anaerobes should be initiated. Antimicrobial therapy is modified according to blood culture results and treatment can be extended for 4 to 6 weeks. To our knowledge, there are only a few cases identifying liver abscesses as an etiology for pylephlebitis. This case was atypical compared to other cases in that the diagnosis of pylephlebitiswas incidental.

scholarly journals Management of complex hepatic abscess by percutaneous catheter drainage: a case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2799
Author(s):  
Prashant Pareek ◽  
Priyanka Pareek ◽  
Pratish Kumar Singh
Keyword(s):  
Hepatic Abscess ◽  
Needle Aspiration ◽  
Percutaneous Catheter Drainage ◽  
Surgical Drainage ◽  
Catheter Drainage ◽  
Percutaneous Catheter ◽  
Liver Abscesses ◽  
The Right ◽  
Antibiotic Coverage

Liver abscesses are a commonly encountered pathology in the tropical setting. Most commonly these are secondary to amoebic infestation. Majority of liver abscesses present with abdominal pain confined to the right hypochondrium. Smaller abscesses are easily dealt with by needle aspiration or catheter drainage under image guidance. Larger and complex abscesses are commonly dealt with by surgical drainage. We deal here with a case of complex liver abscesses which even had perforated into the pleural cavity. Keeping a close watch on the patient’s general condition which was satisfactory, we did not rush into a major surgical procedure. Wide antibiotic coverage and pulmonary care were initiated. Two pig-tail catheters were placed in separate abscesses and metronidazole irrigation periodically done. The daily drain output gradually reduced and we could successfully remove the two catheters at an interval. The patient made a good recovery and continues to do well on follow-up. We see in this case that even large and multiple abscesses if meticulously managed, surgical drainage can be avoided and catheter drainage provides satisfactory results. Good antibiotic coverage must continue in the follow-up period too.

scholarly journals Fusobacterium nucleatum causing a pyogenic liver abscess: a rare complication of periodontal disease that occurred during the COVID-19 pandemic

2021 ◽  
Vol 14 (1) ◽  
pp. e240080
Author(s):  
Laurence Collins ◽  
Tom Diamond
Keyword(s):  
Liver Abscess ◽  
Antimicrobial Therapy ◽  
Literature Search ◽  
Rare Complication ◽  
Fusobacterium Nucleatum ◽  
Signs And Symptoms ◽  
Pyogenic Liver Abscess ◽  
Dental Services ◽  
Gram Negative ◽  
Liver Abscesses

Fusobacterium nucleatum is a periodontal commensal and pathogen. In rare cases, these anaerobic gram-negative bacilli have been reported to cause pyogenic liver abscesses (PLAs). We describe a patient who developed a periodontal abscess during the COVID-19 pandemic and was unable to access the restricted General Dental Services at this time. She subsequently developed a F. nucleatum bacteraemia and liver abscess. The non-specific signs and symptoms experienced meant the patient self-isolated due to suspected COVID-19 infection and presentation to hospital was delayed. We also include the results of a literature search of other cases of PLAs attributed to F. nucleatum. PLAs often develop insidiously. They require percutaneous drainage and prolonged antimicrobial therapy. Clinicians should be aware of this rare complication of a dentoalveolar infection in a patient who is systemically unwell.

scholarly journals 1554. Epidemiology of Adult Bacterial Hand Infections at Two Urban Hospitals

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S777-S778
Author(s):  
Arsheena Yassin ◽  
Christine Stavropoulos ◽  
Krystina L Woods ◽  
Jiashan Xu ◽  
Justin Carale ◽  
...  
Keyword(s):  
New York ◽  
Staphylococcus Aureus ◽  
Antibiotic Regimen ◽  
Gram Positive ◽  
Gram Negative ◽  
Streptococcus Species ◽  
Urban Hospitals ◽  
Haemophilus Parainfluenzae ◽  
Empiric Antibiotic ◽  
Gram Negative Organisms

Abstract Background Hand infections represent a major source of morbidity, which can result in hand stiffness and amputation. Early appropriate empiric antibiotic regimen may reduce the associated morbidity, hence the importance to examine local epidemiology. The aim of this study was to define the current epidemiology of adult hand infections at two urban hospitals in New York City. Methods We performed a double center, retrospective study of adult patients hospitalized from March 2018 to May 2020. Patients with positive cultures associated with the hand infections were included. Retrospectively, 100 patients were reviewed. Data on baseline demographic, clinical, surgical, microbiology, and treatment parameters were collected. Results Of the 100 patients, 76% were male, with median age of 47.5 years (35, 58.25) and average C-reactive protein (CRP) of 50.66 mg/L (± 64.64) on admission (see Table 1). Previous hospitalization within 1 year (38%), previous surgical procedures (39%) and recent IV medication use (26%) were common. 130 bacterial isolates were identified (see Table 2). The most frequent organisms were Gram-positive, with Methicillin susceptible Staphylococcus aureus (MSSA, 25.38%), Streptococcus species (20.08%), and Methicillin resistant Staphylococcus aureus (MRSA, 15.38%) being the most common. Gram-negative organisms were infrequent, with Haemophilus parainfluenzae (3.85%), Enterobacter cloacae (3.85) and Pseudomonas aeruginosa (3.08%) being the most prevalent. Of the 100 patients, 27% had polymicrobial infections, associated with trauma (6%), illicit IV use (6%) and unknown (7%) etiologies. Table 1: Baseline demographics and co-morbid conditions Table 2: Types and numbers of organisms in relation to etiologies Conclusion Within our population, the most common organisms associated with hand infections were Gram-positive, with Staphylococcus aureus and Streptococcus species being the most prevalent. Gram-negative pathogens were infrequently isolated. The results within this study can provide guidance to clinicians on assessing the appropriate empiric antibiotic regimen in patients with hand infections, and can serve as a basis for further studies identifying risk factors associated with isolation of organisms associated with hand infections. Disclosures All Authors: No reported disclosures

Bacterial community analysis of purulent material from liver abscesses of crossbred cattle and Holstein steers fed finishing diets with or without tylosin

2021 ◽  
Vol 99 (4) ◽  
Author(s):  
Raghavendra G Amachawadi ◽  
Wesley A Tom ◽  
Michael P Hays ◽  
Samodha C Fernando ◽  
Philip R Hardwidge ◽  
...  
Keyword(s):  
Bacterial Community ◽  
Community Composition ◽  
Bacterial Community Composition ◽  
Feedlot Cattle ◽  
Crossbred Cattle ◽  
Sequence Analyses ◽  
Gram Negative ◽  
Treatment Groups ◽  
Finishing Diets ◽  
Liver Abscesses

Abstract Liver abscesses in feedlot cattle are polymicrobial infections. Culture-based studies have identified Fusobacterium necrophorum as the primary causative agent, but a number of other bacterial species are frequently isolated. The incidence of liver abscesses is highly variable and is affected by a number of factors, including cattle type. Holstein steers raised for beef production have a higher incidence than crossbred feedlot cattle. Tylosin is the commonly used antimicrobial feed additive to reduce the incidence of liver abscesses. The objective of this study was to utilize 16S ribosomal RNA amplicon sequence analyses to analyze the bacterial community composition of purulent material of liver abscesses of crossbred cattle (n = 24) and Holstein steers (n = 24), each fed finishing diet with or without tylosin. DNA was extracted and the V3 and V4 regions of the 16S rRNA gene were amplified, sequenced, and analyzed. The minimum, mean, and maximum sequence reads per sample were 996, 177,070, and 877,770, respectively, across all the liver abscess samples. Sequence analyses identified 5 phyla, 14 families, 98 genera, and 102 amplicon sequence variants (ASV) in the 4 treatment groups. The dominant phyla identified were Fusobacteria (52% of total reads) and Proteobacteria (33%). Of the top 25 genera identified, 17 genera were Gram negative and 8 were Gram positive. The top 3 genera, which accounted for 75% of the total reads, in the order of abundance, were Fusobacterium, Pseudomonas, and Bacteroides. The relative abundance, expressed as percent of total reads, of phyla, family, and genera did not differ (P > 0.05) between the 4 treatment groups. Generic richness and evenness, determined by Shannon–Weiner and Simpson’s diversity indices, respectively, did not differ between the groups. The UniFrac distance matrices data revealed no clustering of the ASV indicating variance between the samples within each treatment group. Co-occurrence network analysis at the genus level indicated a strong association of Fusobacterium with 15 other genera, and not all of them have been previously isolated from liver abscesses. In conclusion, the culture-independent method identified the bacterial composition of liver abscesses as predominantly Gram negative and Fusobacterium as the dominant genus, followed by Pseudomonas. The bacterial community composition did not differ between crossbred and Holstein steers fed finishing diets with or without tylosin.

Cutaneous Amebiasis

PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 595-598
Author(s):  
Mary Ellen Rimsza ◽  
Robert A. Berg
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Wall ◽  
Entamoeba Histolytica ◽  
Liver Abscess ◽  
Rare Complication ◽  
Hepatic Abscess ◽  
Amebic Liver Abscess ◽  
Colostomy Site ◽  
Histolytica Infection ◽  
Laparotomy Incision

An infant with cutaneous amebiasis of the vulva and amebic liver abscess is described. Epidemiologic investigations and serologic studies were crucial in establishing the diagnosis. The vulvar amebic ulcers responded dramatically to metronidazole therapy. Cutaneous amebiasis is a rare complication of Entamoeba histolytica infection which should be considered in the differential diagnosis of perineovulvar or penile ulcers. Cutaneous amebiasis may also occur on the abdominal wall surrounding a draining hepatic abscess, colostomy site, or laparotomy incision.

scholarly journals Epidemiology of Inappropriate Empiric Antibiotic Therapy for Bacteremia Based on Discordant In vitro Susceptibilities: Risk factors and Taxon-level Variation in Burden and Outcome in 156 US hospitals, 2000–2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S13-S14
Author(s):  
Sameer S Kadri ◽  
Yi Ling Lai ◽  
Emily Ricotta ◽  
Jeffrey Strich ◽  
Ahmed Babiker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Empiric Antibiotic Therapy ◽  
In Vitro Susceptibility ◽  
Gram Negative ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Empiric Antibiotic

Abstract Background Discordance between in vitro susceptibility and empiric antibiotic therapy is inextricably linked to antibiotic resistance and decreased survival in bloodstream infections (BSI). However, its prevalence, patient- and hospital-level risk factors, and impact on outcome in a large cohort and across different pathogens remain unclear. Methods We examined in vitro susceptibility interpretations for bacterial BSI and corresponding antibiotic therapy among inpatient encounters across 156 hospitals from 2000 to 2014 in the Cerner Healthfacts database. Discordance was defined as nonsusceptibility to initial therapy administered from 2 days before pathogen isolation to 1 day before final susceptibility reporting. Discordance prevalence was compared across taxa; risk factors and its association with in-hospital mortality were evaluated by logistic regression. Adjusted odds ratios (aOR) were estimated for pathogen-, patient- and facility-level factors. Results Of 33,161 unique encounters with BSIs, 4,219 (13%) at 123 hospitals met criteria for discordant antibiotic therapy, ranging from 3% for pneumococci to 55% for E. faecium. Discordance was higher in recent years (2010–2014 vs. 2005–2009) and was associated with older age, lower baseline SOFA score, urinary (vs. abdominal) source and hospital-onset BSI, as well as ≥500-bed, Midwestern, non-teaching, and rural hospitals. Discordant antibiotic therapy increased the risk of death [aOR = 1.3 [95% CI 1.1–1.4]). Among Gram-negative taxa, discordant therapy increased risk of mortality associated with Enterobacteriaceae (aOR = 1.3 [1.0–1.6]) and non-fermenters (aOR = 1.7 [1.1–2.5]). Among Gram-positive taxa, risk of mortality from discordant therapy was significantly higher for S. aureus (aOR = 1.3 [1.1–1.6]) but unchanged for streptococcal or enterococcal BSIs. Conclusion The prevalence of discordant antibiotic therapy displayed extensive taxon-level variability and was associated with patient and institutional factors. Discordance detrimentally impacted survival in Gram-negative and S. aureus BSIs. Understanding reasons behind observed differences in discordance risk and their impact on outcomes could inform stewardship efforts and guidelines for empiric therapy in sepsis. Disclosures All authors: No reported disclosures.

Hepatic abscess: a rare complication after liver transplant

2016 ◽  
Vol 30 (10) ◽  
pp. 1230-1235 ◽  
Author(s):  
Oskar Kornasiewicz ◽  
Wacław Hołówko ◽  
Michał Grąt ◽  
Zuzanna Gorski ◽  
Krzysztof Dudek ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Rare Complication ◽  
Hepatic Abscess

scholarly journals Intraoperatively Diagnosed Tracheal Tear after Using an NIM EMG ETT with Previously Undiagnosed Tracheomalacia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Minal Joshi ◽  
Simon Mardakh ◽  
Joel Yarmush ◽  
H. Kamath ◽  
Joseph Schianodicola ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Endotracheal Tube ◽  
Total Thyroidectomy ◽  
Endotracheal Intubation ◽  
Multinodular Goiter ◽  
Rare Complication ◽  
Early Management ◽  
Tracheal Rupture ◽  
Tracheal Tear ◽  
Antibiotic Coverage

Tracheal rupture is a rare complication of endotracheal intubation. We present a case of tracheal rupture that was diagnosed intraoperatively after the use of an NIM EMG endotracheal tube. A 66-year-old female with a recurrent multinodular goiter was scheduled for total thyroidectomy. Induction of anesthesia was uncomplicated. Intubation was atraumatic using a 6 mm NIM EMG endotracheal tube (ETT). Approximately 90 minutes into the surgery, a tracheal tear was suspected. After confirming the diagnosis, conservative treatment with antibiotic coverage was favored. The patient made a full recovery with no complications. Diagnosis of the tracheal tear was made intraoperatively, prompting early management.

Sign in / Sign up

Export Citation Format

Share Document