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PubMed1982

Superinfection.

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Adult↗
PubMed1982

Septic polyarthritis due to Bacteroides fragilis in a patient with rheumatoid arthritis. A case report.

Gram-negative septic arthritis is an uncommon but serious complication of rheumatoid arthritis and is usually mono-articular. The present case is unusual in that a septic polyarthritis due to Bacteroides fragilis developed in nine joints. The organism was grown only in anaerobic synovial fluid and blood cultures. The patient recovered after treatment which included repeated needle aspirations of the joints under anaesthesia and oral metronidazole (Flagyl; Maybaker). Any patient with rheumatoid arthritis who develops an acute flare-up of disease in one or more joints should have these aspirated to exclude the possibility of septic arthritis. Both anaerobic and aerobic cultures of synovial fluid and blood should be done. Prompt antibiotic treatment and joint drainage are the cornerstones of treatment.

Arthritis, Infectious↗
PubMed1982

The role of Bacteroides fragilis in the pathogenesis of acute appendicitis.

The predominant bacteria from 50 inflamed human appendices were isolated. Anaerobic bacteria were isolated more frequently than aerobic bacteria ( 141 versus 96 isolates). E. coli was the most common aerobic genus (47 out of 50 patients). Bacteria belonging to the B. fragilis groups (B. Fragilis, B. ovatus, B. distasonis, B. thetaiotaomicron, B. vulgatus and B. uniformis) were the most frequently isolated anaerobic microorganisms (87 of 141 strains), and B. fragilis predominated within this group (24 out of 87 strains). There were no significant differences in the numbers and types of bacteria found in three patients groups (Group A--19 phlegmonous; Group B--19 gangrenous; and Group C--12 perforative appendicitis cases). Serological investigations of the humoral antibody responses (IFL) against the predominant bacteria in the three patient groups showed that a doubling, or more, of the titer was observed in the following cases: against B. fragilis, 3 out of 8 patients (Group A); 5 out of 7 patients (Group B); and 7 out of 7 patients (Group C). The corresponding figures for E. coli were 4 out of 18, 3 out of 17, and 5 out of 12 patients. Only minor responses against the remaining aerobic and anaerobic isolates were measured. From the bacteriological and immunological results we conclude that (1) the B. fragilis group were the predominant bacteria in diseased appendices; (2) that significant antibody responses were only observed against B. fragilis; (3) that the response increased with the degree of organ destruction and the length of time elapsed from the onset of the symptoms; (4) that B. fragilis is likely to play an important role in the pathogenesis of acute appendicitis, provided that other predisposing factors, such as a deterioration of the blood circulation in the appendiceal wall, are present.

Acute Disease↗
PubMed1981

Chloramphenicol.

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Anemia, Aplastic↗
PubMed1981

[Splenic abscess caused by Ristella fragilis : a case report of a 2 years-old boy (author's transl)].

This is a case report concerning a 2 years-old white boy who suffered sepsis fever with isolation in blood culture of an anaerobic bacteria (Ristella or Bacterioïdes fragilis). Despite continued specific therapy with clindamycine, a mass rapidly developed in the upper left portion of the abdomen which was investigated by plain film, barium enema, upper G.I. series and ultrasound study. The diagnosis of splenic abscess was only made at laparotomy. Splenectomy was a difficult procedure and needed an extension to the chest because of diaphragmatic adhesions. Culture of pus from the excised spleen grew bacteroides fragilis also, and metronidazole was added for therapy. Recover was uneventful with a 3 years follow-up. The authors emphasized the difficulty of clinical diagnosis of splenic abscess, the difficulty of bacteriological study of anaerobic bacteria and the scarceness of such cases, especially in pediatric literature. They ask the question about the legitimacy of splenectomy.

Abscess↗
PubMed1978

Activity of sulfamethoxazole trimethoprim against Bacteroides fragilis.

The author tested parallely 35 Bacteroides fragilis strains by the agar diffusion method and disk technique. A notable discrepancy appears between these two procedures. No regression line can be constructe and the inhibition diameter measurement is unable to class the strain in "susceptible" or "resistant". A literature review on this theme shows that the dissociation between these two techniques were more frequent with anaerobic strains than aerobic for SMX + TMP as others antibiotics. The MIC determination by an agar dilution is the only able to these studies.

Bacteroides Infections↗