scholarly journals Bacteremia after Bacillus clausii administration for the treatment of acute diarrhea: A case report

Biomédica ◽  
2021 ◽  
Vol 41 (Sp. 2) ◽  
pp. 13-20
Author(s):  
Juan Pablo García ◽  
Julián Andrés Hoyos ◽  
John Alexander Alzate ◽  
Edilberto Cristancho
Keyword(s):  
Acute Diarrhea ◽  
Pseudomembranous Colitis ◽  
Immunocompromised Patient ◽  
Systemic Infection ◽  
Hemodynamic Instability ◽  
Ionization Time ◽  
Ulcer Disease ◽  
Bacillus Clausii ◽  
Infectious Origin ◽  
Active Peptic Ulcer

Bacillus clausii is a gram-positive rod used as a probiotic to treat diarrhea and the side effects of antibiotics such as pseudomembranous colitis. We report a case of B. clausii bacteremia in a non-immunocompromised patient with active peptic ulcer disease and acute diarrhea. The probiotic was administered during the patient´s hospitalization due to diarrhea of infectious origin. B. clausii was identified in the bloodstream of the patient through Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) days after her discharge.Given the wide use of probiotics, we alert clinicians to consider this microorganism as a causative agent when signs of systemic infection, metabolic compromise, and hemodynamic instability establish after its administration and no pathogens have been identified that could explain the clinical course.

Early Surgical Intervention for Fulminant Pseudomembranous Colitis

2008 ◽  
Vol 74 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Syed O. Ali ◽  
John P. Welch ◽  
Robert J. Dring
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Pseudomembranous Colitis ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Case Series ◽  
Hemodynamic Instability ◽  
Blood Cell Count

The objective of this study of a retrospective case series was to determine factors associated with survival after surgical intervention in pseudomembranous colitis (PMC). The study was conducted at a tertiary care medical center and comprised 36 patients who underwent colectomy for fulminant PMC from 1995 to 2006. Patients including 21 females ranged from 40 to 89 years of age (mean, 70 years). Comorbidities included diabetes (39%), cardiovascular disease (77%), chronic obstructive pulmonary disease (47%), and intake of immunosuppressive medications (45%). Seventy-two per cent received antibiotics in the previous 2 months. Only patients with a confirmation of PMC on pathology specimens were included in the study. All patients underwent colectomy. Patients were stratified into two groups: survivors and nonsurvivors. Various clinical factors/parameters used in the management of patients with PMC were studied in these two groups. Survival was correlated with mean white blood cell count (23,000 survivors versus 40,000 nonsurvivors, P < 0.01); multisystem organ failure (16 per cent survivors versus 47 per cent nonsurvivors, P < 0.05); and preoperative pressors (16 per cent survivors versus 47 per cent nonsurvivors, P < 0.05). Overall mortality for the study period was 47 per cent. Mortality rate analysis revealed a lower rate for the more recent years (32 per cent for 2000 to 2006 versus 65 per cent for 1995 to 1999, P < 0.05). In the more recent years, the time elapsing before colectomy was also lower (1.4 days versus 2.5 days, nonsignificant), and patients had less preoperative hemodynamic instability (70 per cent versus 31 per cent, P < 0.03). In one institution, survival after surgery for PMC was found to be associated with a mean white blood cell count (<37,000), nondependence on preoperative vasopressors, and surgical intervention before the onset of hemodynamic instability.

ACUTE DIARRHEA IN INFANCY

PEDIATRICS ◽  
1948 ◽  
Vol 2 (5) ◽  
pp. 525-532
Author(s):  
ANÍBAL ARIZTÍA ◽  
CARLOS GARCÉS
Keyword(s):  
Acute Diarrhea ◽  
Intestinal Flora ◽  
Great Majority ◽  
Individual Case ◽  
Etiologic Factor ◽  
Intestinal Lesions ◽  
Infectious Origin ◽  
Enteric Infections ◽  
Good Nutritional State ◽  
The Individual

An analysis of acute diarrheas in infancy is made, based on the clinical study of two groups of patients: the first is made up of 1,505 infants who had 3,391 diarrheal episodes in a period of six years; and the second, of 199 infants who had a dysentery-like diarrhea in a period of one year's observation. Out of the 3,391 diarrheal episodes 3,020 showed an infection of parenteral origin, 210 enteral, and 161 no demonstrable infection. We consider every acute diarrhea in infancy as having an infectious origin either parenteral or caused by specifically enteric exogenous germs as well as the nonspecific intestinal flora. In the great majority of our diarrhea cases (2,060 or 60.7%) there was a coexisting metabolic impairment and this was almost general in the enteral infection group, having a mortality rate of 17%. The isolation of a specific enteric germ (salmonella, shigella) was only possible in approximately 30% in both groups, the first one with 210 cases of enteral infection, and the other of 199 children with dysentery-like diarrhea. The highest incidence of diarrhea in this country is in spring and summer seasons. Most of the affected children were previously undernourished. Postmortem examinations in fatal cases failed to show a relationship between the severity of intestinal lesions and the type and origin of the infection. Neither could we demonstrate a definite parallelism between cause and character of the diarrhea, although specific enteric infections had certain predominance of inflammatory stools (salmonella, shigella). From a diagnostic, therapeutic and prophylactic standpoint, we have indicated the importance of two main elements in any given case of diarrhea: its metabolic impairment and the infectious etiologic factor. We think neither element alone justifies the denomination and classification of acute diarrhea in infancy. The preservation of a good nutritional state and the sanitary control of food, water. sewage, etc., as well as the elimination of carriers, seem to be of the foremost prophylactic importance. In the individual case treatment should correct the metabolic impairment and infection.

scholarly journals Pulmonary Fungal Infection Caused by Neoscytalidium dimidiatum

2015 ◽  
Vol 53 (7) ◽  
pp. 2381-2384 ◽  
Author(s):  
Brandon Dionne ◽  
Luke Neff ◽  
Samuel A. Lee ◽  
Deanna A. Sutton ◽  
Nathan P. Wiederhold ◽  
...  
Keyword(s):  
Fungal Infection ◽  
Pulmonary Infection ◽  
Immunocompromised Patient ◽  
Systemic Infection ◽  
Previous Literature ◽  
Content Type ◽  
Neoscytalidium Dimidiatum ◽  
Susceptibility Data

Neoscytalidium dimidiatumis a mold known to cause onychomycosis and dermatomycosis; however, it is an extremely rare cause of systemic infection. We report a case of pulmonary infection withNeoscytalidium dimidiatumin an immunocompromised patient and discussin vitrosusceptibility data from this case and previous literature.

scholarly journals A case report of pseudomembranous colitis, not associated with prior antimicrobial drugs treatment

2019 ◽  
Vol 17 (3) ◽  
pp. 259-263
Author(s):  
I. Sirakov ◽  
Y. Yordanov ◽  
A. Marinkov ◽  
I. Trifonov ◽  
V. Velev ◽  
...  
Keyword(s):  
Case Report ◽  
Acute Diarrhea ◽  
Pseudomembranous Colitis ◽  
Antimicrobial Agents ◽  
Antimicrobial Drugs ◽  
Chemotherapy Drugs ◽  
Histological Data ◽  
History Of ◽  
Inflammatory Bowel ◽  
Inflammatory Drugs

Clostridium difficile associated colitis /CDAC/ is an inflammatory bowel disease with infectious etiology and specific endoscopic and histological data. It is the most common cause of acute diarrhea syndrome, occurring during hospitalization. CDAC usually appears after treatment with antimicrobial agents , such as Clindamycin, Glycopeptides, Fluoroquinolones, II-nd and III-rd gen. Cephalosporins . Sometimes CDAC is triggered by other factors – nonsteroid anti – inflammatory drugs (NSAIDs), chemotherapy drugs, ulcerative colitis, Crohn’s disease and others. The typical complaints of the patients with CDAC are : abdominal pain, diarrhea, fever, and leukocytosis. Since pseudomembranous colitis is associated with C. difficile infection, stool testing and empirical antibiotic treatment should be initiated when suspected. Тhe case report is about 83 years old woman with clinically, laboratory, endoscopic and histological data typical for pseudomembranous colitis, without a history of previous antibiotic therapy . The case shows that the CDAC may be atypical and the disease should be well – known and expected, especially in immunocompromised or comorbid people over 65 years old with history for NSAIDs or chemotherapy drugs treatment, with acute diarrhea.

scholarly journals CLINICAL EFFECTIVENESS OF BACILLUS CLAUSII AND LACTIC ACID BACILLUS IN ACUTE DIARRHEA

2020 ◽  
Vol 07 (03) ◽  
pp. 109-112
Author(s):  
Apurva C Shah ◽  
Dileep Kumar Goyal ◽  
Devendra Sareen
Keyword(s):  
Lactic Acid ◽  
Acute Diarrhea ◽  
Clinical Effectiveness ◽  
Bacillus Clausii

scholarly journals Active Peptic Ulcer Disease in Patients with Hepatitis C Virus-Related Cirrhosis: The Role ofHelicobacter pyloriInfection and Portal Hypertensive Gastropathy

2004 ◽  
Vol 18 (8) ◽  
pp. 521-524 ◽  
Author(s):  
Maria Dore ◽  
Daniela Mura ◽  
Stefania Deledda ◽  
Emmanouil Maragkoudakis ◽  
Antonella Pironti ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Peptic Ulcer Disease ◽  
Portal Hypertensive Gastropathy ◽  
Ulcer Disease ◽  
Compensated Cirrhosis ◽  
Breath Testing ◽  
Active Peptic Ulcer ◽  
H Pylori

BACKGROUND & AIM:The relationship betweenHelicobacter pyloriinfection and peptic ulcer disease in cirrhosis remains controversial. The purpose of the present study was to investigate the role ofH pyloriinfection and portal hypertension gastropathy in the prevalence of active peptic ulcer among dyspeptic patients with compensated hepatitis C virus (HCV)-related cirrhosis.METHODS:Patients undergoing upper endoscopy with compensated HCV-related cirrhosis were enrolled. Child-Pugh's score was determined at the entry. Variceal size was measured endoscopically and the severity of portal hypertensive gastropathy was graded.H pyloriinfection status was determined by urea breath testing and/or histology.RESULTS:A total of 178 patients positive for HCV (A and B Child-Pugh's score) were prospectively included. The prevalence ofH pyloriinfection was 43%. An active peptic ulcer was found in 14 patients (8%) and was significantly more common among those withH pyloriinfection (16% versus 2% inH pyloriuninfected patients, odds ratio: 8.0). No association was observed betweenH pyloriinfection and variceal size, or hypertensive gastropathy.CONCLUSIONS:Patients with compensated cirrhosis andH pyloriinfection showed higher risk of developing a peptic ulcer. Clinical relevance of this result would be that dyspeptic patients with HCV-related cirrhosis may benefit from preventive screening and eradication ofH pylori, especially those with features of insufficient hemostasis.

530 Case Report of Curling’s Ulcer in Convalescing Burn Patient

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S112-S113
Author(s):  
Lucas Hunter ◽  
Jeffrey W Williams ◽  
Christopher K Craig ◽  
Rachel McEathron ◽  
Anju Saraswat ◽  
...  
Keyword(s):  
Proton Pump ◽  
Burn Injury ◽  
Hemodynamic Instability ◽  
Small Bowel Resection ◽  
Right Hemicolectomy ◽  
Gastric Fundus ◽  
Stress Factors ◽  
Burn Patients ◽  
Ulcer Disease ◽  
Antacid Therapy

Abstract Introduction Although stress ulcer disease related to burn injury was noted previously, it was the report of a series of 10 cases by Curling which lent the name to the finding. Occurrence of the disease has been attributed to the stress factors of hemodynamic instability with resultant decrease in defense factors of the gastroduodenal epithelium noted as patients began to survive massive burns. At one time, the incidence was reported as high as 23% of hospitalized burn patients. However, with advances in supportive care and antacid therapy, some have wondered if Curlings ulcers may have become extinct. Methods We report the case of a 21-year-old male admitted after MVC with 53% TBSA burn (32% full-thickness) and multiple blunt trauma injuries. Early in his course he underwent splenectomy, small bowel resection, right hemicolectomy, and ORIF of an unstable lumbar fracture, and below-knee amputation. He underwent staged excision and grafting of burn wounds and had been autografted with exception of about 11%TBSA of the left lower extremity (wound controlled with allograft). On hospital day 38, the patient was noted to have melanotic colostomy output with a concomitant drop in hemoglobin level from 7.6 g/dl to 3.5 g/dl. Results The gastroenterology service was consulted, and they performed upper endoscopy on hospital day 39. A large amount of clotted blood was seen in the stomach, but the source of bleeding was not visualized. Subsequent endoscopy the following day showed an erosion of gastric mucosa in the gastric fundus consistent with ulcer, on which two clips were placed. The patient’s stool was tested for H. pylori antigen and the test was negative. The patient continued on a proton pump inhibitor, non-steroidal anti-inflammatory drugs were held, and his hemoglobin stabilized and melanotic ostomy output resolved. Conclusions Antacid therapy, H2-blockers, and proton pump inhibitors have historically been used in cases of large burns. However, in the care of other critically ill patients the association of this therapy with ventilator associated pneumonias has lead to new scrutiny. In addition, a renewed emphasis on multimodal pain management may be introducing a bias towards an increase in so-called aggressive factors, namely NSAIDS administered over longer periods. Advances in critical care of burn patients have made Curling’s ulcers rare, but not extinct.

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