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PubMedDate not supplied

Suppurative mediastinitis secondary to Burkholderia cepacia in a patient with cystic fibrosis.

Burkholderia cepacia is an important opportunistic pathogen among patients with cystic fibrosis (CF); it is associated with deterioration of lung function, poor outcome following lung transplantation and increased mortality. Fever, an elevated white blood cell count, weight loss and an often fatal deterioration in pulmonary function characterize a particular clinical course, termed "Cepacia syndrome". The present case report describes a 40-year-old man with CF who developed Cepacia syndrome complicated by suppurative mediastinitis, from which B cepacia was isolated. Despite optimal medical and surgical therapy, this patient succumbed to his illness. Those caring for patients with CF should be aware of this potentially catastrophic complication of B cepacia infection, especially in the setting of Cepacia syndrome.

Adult↗

PubMedDate not supplied

Acute suppurative necrotizing pancholangitis. A case report.

OBJECTIVE: To present a case of ascending cholangitis with resulting necrosis of the biliary system with perforation. CLINICAL PRESENTATION AND INTERVENTION: A 40-year-old male patient presented with upper abdominal pain, fever and jaundice assessed clinically and investigated by laboratory and radiological tests. Endoscopic retrograde cholangiogram and surgery were performed. However, because of extensive suppurative pancholangitis involving most of the intrahepatic radicles, sound surgical drainage could not be accomplished. Unfortunately, the patient died 2 days after surgery. CONCLUSION: In this case of severe cholangitis, endoscopic and surgical interventions were not successful and might have contributed to the worsening of the condition.

Acute Disease↗

PubMed1977

Treatment of chronic suppurated otitis with fosfomycin.

A group of 24 patients with suppurated chronic processes of the medial ear have been treated with fosfomycin. All the cases were studied bacteriologically, isolating in the pus or exudates pathogenic bacterial flora, in which P. aeruginosa (40%) of the isolations) and S. aureus (23%) predominated. The sensitiveness of the strains isolated to fosfomycin was 94%. The results obtained were 21 clinical cures accompanied by the sterility of the exudates and 3 failures, which represents 87.5% success and 12.5% failures. These results are considered very satisfactory in view of the complexity and chronicity of the processes treated. It is also pointed out that fosfomycin totally lacks ototoxicity, being, therefore, a suitable antibiotic for treating chronic infectious processes of the ear.

Adolescent↗

PubMed2006

Indoleamine 2,3-dioxygenase-expressing dendritic cells form suppurative granulomas following Listeria monocytogenes infection.

Control of pathogens by formation of abscesses and granulomas is a major strategy of the innate immune system, especially when effector mechanisms of adaptive immunity are insufficient. We show in human listeriosis that DCs expressing indoleamine 2,3-dioxygenase (IDO), together with macrophages, are major cellular components of suppurative granulomas in vivo. Induction of IDO by DCs is a cell-autonomous response to Listeria monocytogenes infection and was also observed in other granulomatous infections with intracellular bacteria, such as Bartonella henselae. Reporting on our use of the clinically applied anti-TNF-alpha antibody infliximab, we further demonstrate in vitro that IDO induction is TNF-alpha dependent. Repression of IDO therefore might result in exacerbation of granulomatous diseases observed during anti-TNF-alpha therapy. These findings place IDO(+) DCs not only at the intersection of innate and adaptive immunity but also at the forefront of bacterial containment in granulomatous infections.

Antigens, CD↗

PubMed2005

Effect of climate on the bacteriology of chronic suppurative otitis media.

OBJECTIVES: We evaluated the correlation between the microbial content of chronic suppurative otitis media (CSOM) and regional climatic parameters. METHODS: We assessed the interrelations between monthly mean records of temperature, maximum temperature, atmospheric pressure, and humidity and the aerobic microbial flora in CSOM. RESULTS: Forty-three bacteria of Enterobacteriaceae, 67 staphylococcal spp, 51 Pseudomonas aeruginosa, 9 Streptococcus pneumoniae, 1 alpha-hemolytic Streptococcus, 1 Enterococcus sp, and 2 Edwardsiella tarda strains were recovered from 173 patients with CSOM. There was a good relationship between enteric bacteria and monthly mean temperature (r = 0.501) and significant colonization rates due to increasing monthly mean temperature (p = .040) and monthly mean maximum temperature values (p = .048). CONCLUSIONS: When the weather warmed, the frequency of isolation of enteric bacteria increased significantly. Temperature changes may affect the enteric bacterial colonization of CSOM.

Atmospheric Pressure↗

PubMedDate not supplied

Open randomized study comparing doxycycline and co-amoxiclav in the treatment of acute suppurative tracheobronchitis in adults. The Collaborative Group of the Centre Universitaire de Medécine Générale de L'Université Libre de Bruxelles (CUMG-ULB) Investigators.

Doxycycline and co-amoxiclav were compared in a randomized clinical trial involving adult patients with acute suppurative tracheobronchitis. Patients were treated for 5 to 10 days with either antibiotic following three schemes: co-amoxiclav 500 mg three times daily, or doxycycline 200 mg on day 1 followed by 100 mg daily, or 200 mg daily. Assessment after 5-9 days was based only on clinical parameters. Patients with inadequate response to the initial treatment were crossed over to the alternative antibiotic. Of the 210 patients enrolled, 206 were available for evaluation of efficacy. Both antibiotic regimens proved equally efficacious, with rates of clinical response (cure or improvement) of 89% and 91% for doxycycline and coamoxiclav, respectively. Patients who were crossed over to the alternative antibiotic had a significantly lower cure rate after their second course of antibiotics (22% compared with 70%). Adverse effects, most often of gastro-intestinal origin, were more common in the co-amoxiclav group than in the doxycycline-treated group, but rarely caused cessation of treatment.

Acute Disease↗

PubMed1981

Non-suppurative encephalomyelitis in cats suggestive of a viral origin.

In 10 of 16 domestic cats with spontaneous non-suppurative encephalomyelitis, lesions were multifocal but relatively few and were considered nonspecific as to cause, although viral agents could not be excluded. Six cats had polioencephalomyelitis or polioencephalitis suggestive of viral infection. The clinical and morphological features are compared with those of previous reports of feline encephalitis possibly of viral origin. Some previously reported epidemiological and serological surveys suggest a possible role for arboviruses.

Animals↗

PubMed2003

Molecular and antigenic characterization of Bordetella bronchiseptica isolated from a wild southern sea otter (Enhydra lutris nereis) with severe suppurative bronchopneumonia.

Bordetella bronchiseptica was isolated in pure culture from the lung, abdomen, and intestine of a wild free-ranging southern sea otter (Enhydra lutris nereis) with severe, suppurative bronchopneumonia. Immunohistochemistry, using antiserum raised to B. bronchiseptica, revealed strong positive staining of bacteria attached to bronchial ciliated epithelia as well as scattered positive staining in affected alveoli. Western blot analysis demonstrated that virulence factors, filamentous hemagglutinin, pertactin, and adenylate cyclase toxin are produced by the sea otter B. bronchiseptica isolate. Ribotype analysis using Pvu II restriction digests indicated that this isolate is most similar to strains commonly obtained in domestic dogs and cats.

Animals↗

PubMed1994

Intracranial suppuration: a modern decade of postoperative subdural empyema and epidural abscess.

A retrospective study of subdural empyema and epidural abscess spanning 11 years and encompassing 41 patients was performed, demonstrating that the clinical characteristics of intracranial suppuration have changed over time. Sinusitis and otitis media, previously the predominant etiologies, were predisposing factors in only 29% of patients. A prior craniotomy had been performed in 66% of cases and was the most common risk factor for abscess development. The postoperative patients were subjected to detailed analysis. Patients who had undergone a prior craniotomy were notable for the following features: older age, lack of fever, evidence of wound infection, frequent false-negative computed tomographic scans, and a high percentage of Gram negative aerobic organisms or skin flora as pathogens. The population at highest risk for abscess development ranged from 50 to 60 years old, older than in previous series. Older age and an advanced degree of encephalopathy were indicative of a poor prognosis. Patients with subdural empyema had a worse prognosis as well. Hyponatremia was a frequent complicating factor. A much greater percentage of Gram-negative aerobic bacteria were isolated than in previous studies. Computed tomographic scans, half of which were performed with intravenous contrast material, were nondiagnostic in 30% of patients. The mortality rate was 18.5%, and delay in treatment correlated with increased risk of poor outcome. All patients were treated with a craniotomy. Repeated operations were required in three patients and were associated with the development of intraparenchymal abscess.

Adolescent↗

PubMed1975

Etiologic factors in non-suppurative otitis media.

Two observations in non-suppurative otitis media, namely the serous fluid and the tympanic membrane retraction, may have separate explanations as to the etiologic factors. The first is the obstruction of the collecting lymphatic tubules of the middle ear and eustachian tube as they drain to the retropharyngeal lymphatics. This leads to a transudation of fluid in the middle ear or serous fluid. The second observation, retraction of the tympanic membrane, may be due to an absence or significant reduction of the surface tension lowering substance (Surface Active Membrane) of the eustachian tube, preventing the transmission of air to the middle ear from the nasopharynx.

Air Pressure↗

PubMed1982

Acute suppurative thyroiditis in children.

The ability of the thyroid gland to withstand infection is a well known phenomenon. In this regard, inflammatory disease of the thyroid gland in children is an uncommon occurrence. The frequency with which this proceeds to abscess formation is rare. Review of the literature of the past 25 years reveals only 21 reported cases of acute suppurative thyroiditis in children, only one of which has been reported in the otolaryngologic literature. We report two cases of thyroid abscess in children initially presented as painful swellings in the lower neck. An overview of the management of these patients is detailed, including a discussion of the appropriate utilization of diagnostic studies. Demonstration of an internal fistula originating from the pyriform sinus underscores the need to consider a fourth branchial arch remnant as a possible source of infection. The importance of obtaining appropriate bacterial, fungal, and acid-fast cultures is stressed, as is the role of antibiotic therapy and definitive surgery once the diagnosis of thyroid abscess is made.

Abscess↗

PubMed1977

Studies on a case of suppurative thyroiditis.

A patient with suppurative thyroiditis due to infection with Escherichia coli is described. Serial studies of thyroid function were performed. Before the abscess was drained there was no uptake of radio-iodine by the thyroid and there was some spillage of iodinated compounds from the gland. Post-operatively circulating thyroid hormone concentrations declined but were restored at four weeks. Thyroid uptake of radio-iodine was re-established two weeks after operation but there was little secretion of thyroxine at this time. Four weeks after operation the uptake of radio-iodine was greater than normal and thyroxine was being secreted. These changes in thyroid function were not associated with any significant rise in the plasma thyrotrophin concentration.

Aged↗

PubMed2004

Treatment of suppurative facial cellulitis and panniculitis caused by Corynebacterium pseudotuberculosis in two horses.

Two horses were examined for large head wounds suspected to be the result of trauma and characterized by extensive necrosis of the skin and subcutaneous tissue, with abundant purulent exudate. Corynebacterium pseudotuberculosis was isolated from the facial wounds in both horses. Histopathologic examination revealed severe suppurative cellulitis and panniculitis with fistulous tracts and granulation tissue in 1 horse. Both horses were treated with local wound care, nonsteroidal anti-inflammatory drugs, and administration of antimicrobials. The concept of moist wound care was used in the second horse, with products that have recently become available for veterinary wound management. Outcome in both horses was good.

Administration, Topical↗

PubMed1989

Suppurative thrombophlebitis of the superior vena cava.

A 22-year-old woman, a neurosurgical comatose patient developed suppurative thrombophlebitis of the superior vena cava due to Klebsiella pneumoniae, as a complication of catheterisation for parenteral nutrition. The diagnosis was established by gallium scan, computed tomography and digital vascular imaging. Conservative treatment with antibiotics and heparin resulted in the emergence of a resistant mutant of the causative agent. The infection could only be eradicated after surgical thrombectomy.

Adult↗

PubMed1993

Intracranial suppuration caused by Micrococcus luteus.

Micrococcus spp. are commensal organisms colonizing the body surfaces of humans. In a few instances these organisms have been reported to colonize ventricular shunts. We report a patient, with no overt evidence of immunosuppression, in whom Micrococcus luteus was responsible for intracranial suppuration at multiple sites.

Adult↗

PubMed1987

Complex sorption therapy of locomotor system traumatic suppurative complications.

Complex sorption therapy efficacy in treating 271 patients with suppurative complications of extremity traumas is analyzed. All patients underwent 1-3 enterosorption courses, the wounds were treated with application of sorbents against the background of traditional therapy. In the event of aggravating intoxication, developing first symptoms of sepsic condition, or the desease chronic course 1-5 hemosorption sessions were performed. Clinical and laboratory-instrumental examination demonstrated positive effect of the complex of sorption methods on the patient' general state, temperature curve dynamics, blood indices, microcirculation, function of liver, kidneys, and immune system status. Pathogenic flora stability decreased, wound cleaning and healing was 1.5 times faster. The total therapeutic period was 28% shorter compared to the control group of patients, treated without sorption methods.

Administration, Oral↗

PubMed1980

A suppurative ovarian cyst in pregnancy due to Salmonella typhi.

A 23-year-old primigravida with suppurative ovarian dermoid cyst due to Salmonella typhi is presented. The organism could not be isolated from the blood, faeces or urine and it was felt that the patient was an example of non-excretory carrier in whom S. typhi was lying dormant in the ovarian tissue for a long time.

Adult↗

PubMed1981

Acute suppurative salmonella thyroiditis: clinical course and antibody response.

A previously healthy 72-year-old man, who had been treated with steroids for one month on a presumptive diagnosis of polymyalgia rheumatica, developed a suppurative thyreoiditis. Salmonella enteritidis was isolated from the thyroid aspirate. Although the bacterial strain was sensitive to ampicillin in vitro, the disease was not cured until treatment with trimethoprim-sulfamethoxazole was initiated. The patient developed a high antibody response of the IgM class against both salmonella serogroup B and D O-antigenic determinants, as estimated by enzyme-linked immunosorbent assay (ELISA). Absorption studies suggested that most of the antibody response was directed against salmonella 012 determinant(s), common to both salmonella serogroup B and D.

Acute Disease↗