RESUMEN
A case of bacterial endocarditis caused by Moraxella catarrhalis in an apparently immunocompetent Greek male is presented, which was diagnosed after a 2-month history of low-grade fever of unknown origin. The agent seems to be a rare pathogen, but due to the high mortality rate, it should always be considered in the differential diagnosis of relevant cases. Beta-lactamase production by many strains complicates the choice of antibiotic.
Asunto(s)
Endocarditis/microbiología , Moraxella catarrhalis/aislamiento & purificación , Infecciones por Neisseriaceae/microbiología , Adulto , Amoxicilina/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Bacteriemia/microbiología , Ácido Clavulánico/uso terapéutico , Endocarditis/tratamiento farmacológico , Humanos , Inmunocompetencia , Masculino , Pruebas de Sensibilidad Microbiana , Moraxella catarrhalis/efectos de los fármacos , Infecciones por Neisseriaceae/tratamiento farmacológico , Penicilinas/uso terapéutico , Literatura de Revisión como Asunto , Resultado del TratamientoRESUMEN
Micrococcus luteus was repeatedly isolated in blood cultures during a prolonged feverish syndrome in a patient who presented with multiple hepatic abscesses as well. In contrast to the literature, this case is not related to prosthetic devices; an untreated limb wound may have been the site of microbial entry.
Asunto(s)
Absceso Hepático/etiología , Micrococcus luteus/patogenicidad , Infecciones por Bacterias Grampositivas/diagnóstico por imagen , Infecciones por Bacterias Grampositivas/etiología , Infecciones por Bacterias Grampositivas/microbiología , Humanos , Absceso Hepático/diagnóstico por imagen , Absceso Hepático/microbiología , Masculino , Micrococcus luteus/aislamiento & purificación , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
Anaerobic arthritis due to Bacteroides fragilis was diagnosed in a 33-year-old patient with prolonged fever suffering from sickle cell/thalassaemia. The causative agent was isolated from blood and purulent synovial fluid from both knee joints. A combination of chloramphenicol plus metronidazole treatment proved effective. Anaerobic arthritis has not previously been described in patients with sickle cell disease, and may reflect the well-known susceptibility of these patients to pathogens.
Asunto(s)
Anemia de Células Falciformes/complicaciones , Artritis Infecciosa/microbiología , Infecciones por Bacteroides/complicaciones , Bacteroides fragilis , Talasemia/complicaciones , Adulto , Artritis Infecciosa/tratamiento farmacológico , Infecciones por Bacteroides/tratamiento farmacológico , Cloranfenicol/uso terapéutico , Quimioterapia Combinada , Humanos , Articulación de la Rodilla/microbiología , Masculino , Metronidazol/uso terapéutico , Líquido Sinovial/microbiologíaRESUMEN
The efficacy and safety of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections was evaluated in 72 patients suffering from upper urinary tract infection (19 patients), deep soft tissue infection (16), chronic osteomyelitis (12), abscess (7), chronic otitis media (6), otitis externa (3) and bronchopneumonia (9). Forty-eight patients received an oral dose of 500 mg or 750 mg b.i.d. and five patients an i.v. dose of 200 mg b.i.d., while 19 patients were given both oral and parenteral doses. The duration of therapy ranged from seven days to more than four months. The MICs of ciprofloxacin for the Pseudomonas aeruginosa strains isolated were in the range less than 0.06-2 mg/l; 36% of the strains were resistant to all other available antibiotics. At follow-up after a minimum of six months the clinical success rate was 75% and the infecting organism was permanently eradicated in 49% of the patients. In nine patients the organism developed resistance, particularly when the initial MIC was higher than 0.5 mg/l. No significant adverse reactions were observed. Ciprofloxacin is the first antipseudomonal antimicrobial agent which can be administered orally and therefore fulfills a need in chemotherapy.