RESUMEN
Slackia exigua (S. exigua) is an obligatory anaerobic coccobacillus under the family of Coriobacteriaceae. It is a rare cause of pyogenic extraoral infections. We report a 58-year-old lady with good past health presented with fulminant community-acquired pneumonia causing acute respiratory distress syndrome caused by S. exigua requiring veno-venous extra-corporeal membrane oxygenation (VV-ECMO). Bacterial identification can be challenging and often require 16 S rRNA and MALDI-TOF MS. The patient was treated with amoxicillin-clavulanic acid according to sensitivity and made significant recovery.
Asunto(s)
Actinobacteria/patogenicidad , Infecciones Comunitarias Adquiridas/patología , Empiema/microbiología , Infecciones por Bacterias Grampositivas/patología , Neumonía/patología , Síndrome de Dificultad Respiratoria/microbiología , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Infecciones Comunitarias Adquiridas/microbiología , Empiema/patología , Empiema/terapia , Oxigenación por Membrana Extracorpórea , Femenino , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Persona de Mediana Edad , Neumonía/microbiología , Síndrome de Dificultad Respiratoria/patología , Síndrome de Dificultad Respiratoria/terapia , Resultado del TratamientoRESUMEN
Spontaneous chylothorax is rare in adults. We present an unusual case that was complicated by Prevotella bivia empyema. Full recovery was achieved with chest tube drainage and prompt treatment with intravenous clindamycin.
Asunto(s)
Infecciones por Bacteroidaceae/diagnóstico , Quilotórax/complicaciones , Quilotórax/diagnóstico , Empiema/diagnóstico , Prevotella/aislamiento & purificación , Administración Intravenosa , Anciano , Antibacterianos/uso terapéutico , Infecciones por Bacteroidaceae/microbiología , Infecciones por Bacteroidaceae/patología , Infecciones por Bacteroidaceae/terapia , Quilotórax/patología , Quilotórax/terapia , Clindamicina/uso terapéutico , Drenaje , Empiema/microbiología , Empiema/patología , Empiema/terapia , Humanos , Masculino , Radiografía Torácica , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Trichomonad is a type of flagellate that parasitizes the human oral cavity, intestine, or vagina. However, respiratory infection is rare. We report a patient with pyothorax related to Tetratrichomonas species, which is the first reported case in Japan. The patient was a 66-year-old female. She consulted the Emergency Outpatient Unit of our hospital with fever, dyspnea, and the retention of pleural effusion. The appearance of the pleural effusion collected by thoracic drainage was brown, fetid pus. On microscopy, Trichomonad was detected in the pleural effusion. On a gene test, Tetratrichomonas sp. was identified. Based on this experience, we propose that non-stained specimens should be examined to detect Trichomonad on a puncture fluid test. (Case report).
Asunto(s)
Empiema Pleural/patología , Empiema/patología , Derrame Pleural/patología , Infecciones por Protozoos/patología , Trichomonadida/aislamiento & purificación , Anciano , Diagnóstico Diferencial , Empiema/diagnóstico , Empiema Pleural/diagnóstico , Femenino , Humanos , Japón , Derrame Pleural/diagnóstico , Infecciones por Protozoos/diagnósticoAsunto(s)
Actinomicosis/patología , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Empiema/patología , Infecciones por Pasteurellaceae/patología , Derrame Pleural/etiología , Pared Torácica/patología , Traqueostomía/efectos adversos , Actinomyces/aislamiento & purificación , Actinomicosis/complicaciones , Niño , Diagnóstico Diferencial , Empiema/complicaciones , Empiema/diagnóstico por imagen , Femenino , Humanos , Inflamación/diagnóstico , Neoplasias/diagnóstico , Infecciones por Pasteurellaceae/complicaciones , Derrame Pleural/diagnóstico por imagen , Pared Torácica/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Tráquea/lesiones , Traqueítis/complicacionesRESUMEN
Mycoplasma salivarium infections outside the oral cavity are rare. We describe a 49-year-old man with laryngeal cancer and right pleural space infection with M. salivarium. To our knowledge, this is the first report of empyema due to Mycoplasma salivarium.
Asunto(s)
Empiema/diagnóstico , Empiema/microbiología , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/microbiología , Mycoplasma salivarium/aislamiento & purificación , Análisis por Conglomerados , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Empiema/patología , Humanos , Neoplasias Laríngeas/complicaciones , Masculino , Persona de Mediana Edad , Infecciones por Mycoplasma/patología , Mycoplasma salivarium/clasificación , Mycoplasma salivarium/genética , Filogenia , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADNRESUMEN
An infant had a subdural empyema caused by the rare Salmonella species enterica subspecies houtenae (IV) serotype 44:z4,z23:- after only indirect exposure to exotic reptiles in her foster home. Infants recovering from preexisting subdural hematoma are at risk for development of empyema.
Asunto(s)
Reservorios de Enfermedades , Empiema/microbiología , Hematoma Subdural Crónico/microbiología , Lagartos/microbiología , Infecciones por Salmonella/etiología , Salmonella enterica , Animales , Australia , Empiema/patología , Empiema/cirugía , Femenino , Cuidados en el Hogar de Adopción , Hematoma Subdural Crónico/patología , Hematoma Subdural Crónico/cirugía , Humanos , Iguanas/microbiología , Lactante , Imagen por Resonancia Magnética , New York , Infecciones por Salmonella/patología , Infecciones por Salmonella/cirugíaRESUMEN
Hydrocarbon poisoning such as that of benzene and petroleum usually occurs accidentally by inhalation or ingestion of these cytotoxic chemical compounds. Intravenous or subcutaneous injection of petroleum compounds with intent of suicide or abuse is an extraordinary event that can result in local damage or systemic toxicity such as tissue necrosis, abscess formation, respiratory system failure and partial damage to the kidneys, the brain and the nervous system. In this article, we describe a 31-year-old man who was admitted in the surgery ward of Besat Hospital. He had widespread necrosis and infection of the chest wall soft tissue and also had empyema after a suicidal attempt by injection of 40 ml of petroleum into the left hemithorax. The patient underwent repeated surgical debridement of the chest wall necrotic tissues. With segmentectomy and flap reconstruction of the chest wall wound, he recovered completely and was discharged. Our report supports early and aggressive surgical debridement of necrotic tissue, thoracotomy tube insertion and special care of respiratory system toxicity after chest wall injection of petroleum. Regarding the basis of clinical findings and paraclinical investigations that measure lung parenchymal necrosis with empyema and fistula formation, thoracotomy and decortication with or without lung tissue resection and also chest wall reconstruction are the standard treatment of these patients.
Asunto(s)
Empiema/etiología , Petróleo/envenenamiento , Intento de Suicidio , Pared Torácica/patología , Adulto , Empiema/diagnóstico por imagen , Empiema/patología , Humanos , Masculino , Necrosis , Cavidad Pleural/diagnóstico por imagen , Cavidad Pleural/patología , RadiografíaRESUMEN
OBJECTIVE: Empyema is the most common complication of pneumonia. Primary interventions include chest drainage and fibrinolytic therapy (CDF) or video-assisted thoracoscopic surgery (VATS). We describe disease trends, clinical outcomes and factors associated with reintervention. DESIGN/SETTING/PATIENTS: Retrospective cohort of paediatric empyema cases requiring drainage or surgical intervention, 2011-2018, admitted to a large Australian tertiary children's hospital. RESULTS: During the study, the incidence of empyema increased from 1.7/1000 to 7.1/1000 admissions (p<0.001). We describe 192 cases (174 CDF and 18 VATS), median age 3.0 years (IQR 1-5), mean fever duration prior to intervention 6.2 days (SD ±3.3 days) and 50 (26%) cases admitted to PICU. PICU admission increased during the study from 18% to 34% (p<0.001). Bacteraemia occurred in 23/192 (12%) cases. A pathogen was detected in 131/192 (68%); Streptococcus pneumoniae 75/192 (39%), S. aureus 25/192 (13%) and group A streptococcus 13/192 (7%). Reintervention occurred in 49/174 (28%) and 1/18 (6%) following primary CDF and VATS. Comparing repeat intervention with single intervention cases, a continued fever postintervention increased the likelihood for a repeat intervention (OR 1.3 per day febrile; 95% CI 1.2 to 1.4, p<0.0001). Younger age, prolonged fever preintervention and previous antibiotic treatment were not associated with initial treatment failure (all p>0.05). CONCLUSION: We report increasing incidence and severity of empyema in a large tertiary hospital. One in four patients required a repeat intervention after CDF. Neither clinical variables at presentation nor early investigations were able to predict initial treatment failure.
Asunto(s)
Empiema/etiología , Preescolar , Empiema/epidemiología , Empiema/patología , Empiema/terapia , Femenino , Humanos , Masculino , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Centros de Atención Terciaria/estadística & datos numéricos , Cirugía Torácica Asistida por Video , Terapia Trombolítica/métodos , Resultado del TratamientoRESUMEN
PURPOSE: The objective of this work was to present possible, though rare, complications of Neuro-Patch implantation after brain surgery. METHODS: Two patients, aged 62 and 63 years, who had a partial dural substitution with an artificial polyurethane graft after neurosurgical resection of a gross tumour, are presented. RESULTS: In the two patients, the a-vital tissue was infiltrated by either inflammatory or neoplastic tissue respectively. CONCLUSIONS: This report demonstrates a new pathological point of view in using synthetic materials for the reconstruction of dural defects.
Asunto(s)
Duramadre/cirugía , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Recurrencia Local de Neoplasia/fisiopatología , Recurrencia Local de Neoplasia/cirugía , Procedimientos Neuroquirúrgicos/efectos adversos , Prótesis e Implantes/efectos adversos , Movimiento Celular/fisiología , Senos Craneales/patología , Senos Craneales/cirugía , Duramadre/patología , Empiema/etiología , Empiema/patología , Empiema/fisiopatología , Encefalitis/etiología , Encefalitis/patología , Encefalitis/fisiopatología , Fiebre , Humanos , Imagen por Resonancia Magnética , Masculino , Membranas Artificiales , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/fisiopatología , Meningioma/patología , Meningioma/fisiopatología , Persona de Mediana Edad , Náusea , Metástasis de la Neoplasia/patología , Metástasis de la Neoplasia/fisiopatología , Recurrencia Local de Neoplasia/patología , Reoperación , VómitosRESUMEN
Clinical manifestations of extralymphatic disease caused by filariasis are varied and range from symptoms due to tropical pulmonary eosinophilia to hematuria, proteinuria, splenomegaly, and rarely arthritis. Disseminated microfilaremia in association with loculated lung cyst and empyema is of rare occurrence and to the best of our knowledge has not been documented in the literature so far. We report here a case of disseminated microfilaremia due to Wuchereria bancrofti infection accompanied by a lung cyst and empyema in a 21-year-old Indian man.
Asunto(s)
Quistes/parasitología , Filariasis Linfática/parasitología , Empiema/parasitología , Enfermedades Pulmonares/parasitología , Animales , Quistes/patología , Filariasis Linfática/patología , Empiema/patología , Resultado Fatal , Humanos , Enfermedades Pulmonares/patología , Masculino , Wuchereria bancrofti/aislamiento & purificación , Adulto JovenAsunto(s)
Empiema/etiología , Empiema/patología , Micosis/diagnóstico , Micosis/patología , Ustilaginales/aislamiento & purificación , Anciano de 80 o más Años , Femenino , Humanos , Técnicas Microbiológicas/métodos , Microscopía , Micología/métodos , Micosis/microbiología , Derrame Pleural , Análisis de Secuencia de ADN , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Ustilaginales/química , Ustilaginales/genéticaRESUMEN
Tuberculosis (TB) is the leading infectious cause of death worldwide, and the commonest cause of death in people living with HIV. Globally, pleural TB remains one of the most frequent causes of pleural exudates, particularly in TB-endemic areas and in the HIV positive population. Most TB pleural effusions are exudates with high adenosine deaminase (ADA), lymphocyte-rich, straw-coloured and free flowing, with a low yield on mycobacterial culture. TB pleurisy can also present as loculated neutrophil-predominant effusions which mimic parapneumonic effusions. Rarely, they can present as frank TB empyema, containing an abundance of mycobacteria. Up to 80% of patients have parenchymal involvement on chest imaging. The diagnosis is simple if M. tuberculosis is detected in sputum, pleural fluid or biopsy specimens, and the recent advent of liquid medium culture techniques has increased the microbiological yield dramatically. Where the prevalence of TB is high the presence of a lymphocyte-predominant exudate with a high ADA has a positive predictive value of 98%. In low prevalence areas, the absence of an elevated ADA and lymphocyte predominance makes TB very unlikely, and pleural biopsy should be performed to confirm the diagnosis. Pleural biopsy for liquid culture and susceptibility testing must also be considered where the prevalence of drug resistant TB is high. Treatment regimens are identical to those administered for pulmonary TB. Initial pleural drainage may have a role in symptom relief and in hastening the resolution of the effusion. Surgical intervention may be required in loculated effusions and empyemas.
Asunto(s)
Derrame Pleural/etiología , Tuberculosis Pleural/epidemiología , Tuberculosis Pleural/patología , Tuberculosis Pulmonar/epidemiología , Adenosina Desaminasa/metabolismo , Biopsia/métodos , Drenaje/métodos , Empiema/tratamiento farmacológico , Empiema/microbiología , Empiema/patología , Empiema/cirugía , Exudados y Transudados/enzimología , Exudados y Transudados/microbiología , Femenino , Humanos , Linfocitos/patología , Masculino , Mycobacterium tuberculosis/aislamiento & purificación , Neutrófilos/patología , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/microbiología , Derrame Pleural/patología , Prevalencia , Esputo/microbiología , Tuberculosis Pleural/tratamiento farmacológico , Tuberculosis Pleural/microbiología , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/microbiología , Tuberculosis Pulmonar/patologíaRESUMEN
In this case report we described a Bahraini male patient of twenty years of age, a smoker and diagnosed with stage IV B Hodgkin lymphoma. He presented with fever, nonproductive cough, upper back pain and shortness of breath due to right upper lobe pneumonia with right encysted pleural effusion. Salmonella enterica serotype Enteritidis was isolated from the sputum. He was successfully treated with 2 weeks of ceftriaxone followed by 2 weeks of oral cefixime. This was the first case of encysted empyema caused by Salmonella enterica serotype Enteritidis reported in the Kingdom of Bahrain. The different aspects of pulmonary Salmonella infections were discussed and the literature was reviewed.
Asunto(s)
Empiema/diagnóstico , Empiema/patología , Neumonía Bacteriana/complicaciones , Neumonía Bacteriana/diagnóstico , Infecciones por Salmonella/diagnóstico , Infecciones por Salmonella/patología , Salmonella enteritidis/aislamiento & purificación , Antibacterianos/administración & dosificación , Bahrein , Cefixima/administración & dosificación , Ceftriaxona/administración & dosificación , Empiema/tratamiento farmacológico , Empiema/microbiología , Enfermedad de Hodgkin/complicaciones , Humanos , Masculino , Neumonía Bacteriana/microbiología , Neumonía Bacteriana/patología , Infecciones por Salmonella/tratamiento farmacológico , Infecciones por Salmonella/microbiología , Salmonella enteritidis/clasificación , Esputo/microbiología , Adulto JovenRESUMEN
Diffusion-weighted imaging and in vivo proton magnetic resonance spectroscopy ((1)H magnetic resonance spectroscopy) have demonstrated great potential in differentiating intracranial lesions of various pathologies. This report describes a case of a 12-year-old child with cerebellitis and subdural empyema that manifested presence of succinate, acetate, lactate, and amino acids on in vivo (1)H magnetic resonance spectroscopy from a large area of restricted diffusion in the vermis on diffusion-weighted imaging, a finding specific for bacteria-induced infection. The child made a complete clinical and imaging recovery on conservative management.
Asunto(s)
Infecciones Bacterianas del Sistema Nervioso Central/patología , Cerebelo/patología , Imagen de Difusión por Resonancia Magnética , Niño , Empiema/patología , Femenino , Humanos , Protones , Espacio Subdural/patologíaAsunto(s)
Antirreumáticos/efectos adversos , Celulitis (Flemón)/inducido químicamente , Empiema/inducido químicamente , Proteína Antagonista del Receptor de Interleucina 1/efectos adversos , Antirreumáticos/administración & dosificación , Artritis Psoriásica/tratamiento farmacológico , Celulitis (Flemón)/patología , Celulitis (Flemón)/terapia , Empiema/patología , Empiema/terapia , Humanos , Inyecciones Subcutáneas , Proteína Antagonista del Receptor de Interleucina 1/administración & dosificación , Masculino , Persona de Mediana EdadRESUMEN
A 55-year-old man was admitted to the Department of Internal Medicine of our hospital with chief complaints of fever, cough, and right-sided chest pain. Plain radiography of the chest revealed widening of the mediastinum (attributed to esophageal achalasia), pneumonia, and right pleural effusion. According to the properties of the pleural fluid, empyema was diagnosed. Because the empyema was resistant to antibiotic treatment and was in the fibrinopurulent stage, it could not be drained effectively. Therefore, after treatment of the esophageal achalasia by balloon dilatation of the lower esophagus, the empyema was treated by video-assisted thoracoscopic surgery, i.e., by video-assisted thoracoscopic drainage and curettage of the empyema cavity, under local anesthesia.
Asunto(s)
Anestesia Local , Empiema , Acalasia del Esófago , Neumonía por Aspiración , Cirugía Asistida por Video/métodos , Empiema/etiología , Empiema/patología , Empiema/cirugía , Acalasia del Esófago/complicaciones , Acalasia del Esófago/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neumonía por Aspiración/complicaciones , Neumonía por Aspiración/etiología , Neumonía por Aspiración/cirugía , Radiografía Torácica , Toracoscopía , Tomografía Computarizada por Rayos XAsunto(s)
Empiema/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Absceso Pulmonar/microbiología , Micrococcaceae/aislamiento & purificación , Neumonía Bacteriana/microbiología , Neumonía Bacteriana/patología , Anciano , Antibacterianos/uso terapéutico , Empiema/tratamiento farmacológico , Empiema/patología , Infecciones por Bacterias Grampositivas/patología , Humanos , Inmunocompetencia , Absceso Pulmonar/tratamiento farmacológico , Absceso Pulmonar/patología , Masculino , Neumonía Bacteriana/tratamiento farmacológicoRESUMEN
OBJECTIVES: We report on the incidence, clinical characteristics, and bacterial genotype of group A streptococcal (GAS) meningitis in the Netherlands. METHODS: We assessed the incidence, clinical characteristics, and outcome of patients with GAS meningitis from a nationwide cohort study of adults with community-acquired bacterial meningitis in the Netherlands from 2006 to 2013. RESULTS: GAS was identified in 26 of 1322 patients with community-acquired bacterial meningitis (2%); 9 cases (35%) occurred in the first four months of 2013. GAS meningitis was often preceded by otitis or sinusitis (24 of 26 [92%]) and a high proportion of patients developed complications during clinical course (19 of 26 [73%]). Subdural empyema occurred in 8 of 26 patients (35%). Nine patients underwent mastoidectomy and in 5 patients neurosurgical evacuation of the subdural empyema was performed. Five of 26 patients (19%) died and 11 of 21 surviving patient had neurologic sequelae (52%). Infection with the emm1 and cc28 GAS genotype was associated with subdural empyema (both 4 of 6 [67%] vs. 2 of 14 [14%]; P = 0.037). CONCLUSIONS: GAS meningitis is an uncommon but severe disease. Patients are at risk for empyema, which is associated with infection with the emm1 and cc28 genotype.