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[Comparative clinico-morphological characteristics of peace-time anaerobic infections].

Altogether 26 cases of anaerobic infection (AI) of various etiology were analysed. Local tissue ischemia and operations on gastrointestinal organs in patients with secondary immunodeficit conditions are the factors facilitating the development of AI. The distinction is made between clostridial AI with a rapidly progressing gaseous gangrene and the non-clostridial AI with a slower course of a serous-purulent phlegmoma. Anaerobic myositis is observed in all forms of AI. Depending on the localisation of AI, anaerobic cellulitis and fasciitis are mentioned which occur mainly in non-clostridial AI. The treatment of AI and the mechanisms of death are discussed.

Adult↗

Current experience with clindamycin in the treatment of abdominal and female pelvic infections.

Clindamycin had been used in treatment of severe abdominal and female pelvic infections for over fifteen years. On the basis of several prospective trials, clindamycin has equivalent efficacy to other anti-anaerobe drugs such as cefoxitin and metronidazole. Clindamycin had proven to be superior to cephalothin, cefamandole and cefoperazone in intraabdominal infections. It also produces better results than various penicillins in a variety of obstetrical and gynecological infections. In one study, tubo-ovarian abscess healed significantly better on medical therapy when clindamycin was included in the regimen. Considering the long tract record of favorable results, clindamycin can be considered the "gold standard" by which other anti-anaerobe therapies of abdominal and female pelvic infections are judged.

Abdomen↗

Anaerobic orbital cellulitis.

A 10-year-old boy with orbital cellulitis died seven weeks after admission to the hospital despite intensive surgical intervention and medical therapy. We isolated many anaerobic bacteria from the orbit, frontal sinus, and epidural space. Orbital cellulitis, which often occurs by direct extension from infected paranasal sinuses, commonly affects children and young adults, and is a potentially lethal disease, if left untreated. Heightened awareness of the role of anaerobes in chronic sinusitis and of the possibility of an anaerobic orbital cellulitis may lead to the identification of more cases. Penicillin G appears to be the first drug of choice in cases with suspected anaerobic orbital cellulitis. Chloramphenicol and clindamycin should be considered, if treatment with penicillin fails. Antibiotics alone should not be considered as a panacea, and surgical drainage is often the most compelling consideration.

Anaerobiosis↗