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BMJ Case Rep ; 20152015 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-25564586

RESUMO

A 78-year-old woman presented to the acute medical unit with a productive cough, dyspnoea and decreased appetite of 4 days duration. Initial assessment supported a diagnosis of right-sided community-acquired pneumonia and she was started on antibiotics. In view of the clinical finding of splenomegaly, she had an ultrasound and, subsequently, a CT of the abdomen, which revealed a large splenic abscess. Pending cultures from a sample obtained from percutaneous drainage of the abscess, she was started on intravenous meropenem. The initial echocardiogram did not suggest any evidence of endocarditis. The pus drained from the abscess on cultures was subsequently positive for Staphylococcus aureus. An MRI of the spine excluded discitis as a source of infection. Owing to a high index of clinical suspicion a repeat echocardiogram was undertaken after 1-week, which confirmed acute endocarditis. The patient was treated with intravenous antibiotics for 6 weeks with improvement in clinical, radiological and biochemical parameters.


Assuntos
Abscesso Abdominal/microbiologia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico , Esplenopatias/microbiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Broncopneumonia/complicações , Endocardite Bacteriana/tratamento farmacológico , Feminino , Humanos , Esplenomegalia/microbiologia , Infecções Estafilocócicas/tratamento farmacológico
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