RESUMEN
We present a case of renal abscess caused by Capnocytophaga canimorsus infection in a previously healthy middle-aged man. He presented with sepsis and an acute kidney injury, and although not identified on his initial assessment, he had sustained a dog bite 5 days prior to hospital admission. The patient developed left loin pain and imaging investigation revealed a renal abscess. Gram stain showed a gram-negative bacillus and C. canimorsus was identified by 16S PCR from these samples along with aspirate from the abscess. The patient responded to treatment with carbapenems but required a prolonged course. His clinical condition was further complicated by a pleural effusion and the development of fatigue symptoms consistent with a post-infection chronic fatigue syndrome. We present this case which we believe to be the first documented case of C. canimorsus causing renal abscess. We discuss the challenges relating to investigation, management and the importance of detailed diagnostic exposure histories in sepsis of unknown origin.
Asunto(s)
Mordeduras y Picaduras , Infecciones por Bacterias Gramnegativas , Sepsis , Masculino , Animales , Humanos , Perros , Absceso/diagnóstico , Absceso/tratamiento farmacológico , Absceso/complicaciones , Sepsis/diagnóstico , Sepsis/complicaciones , Capnocytophaga , Infecciones por Bacterias Gramnegativas/diagnóstico , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/complicaciones , Mordeduras y Picaduras/complicacionesRESUMEN
This brief report presents a series of 5 pregnant women treated for rifampicin-resistant tuberculosis with the novel drugs bedaquiline, delamanid, and linezolid as part of an optimized backbone regimen and reviews the outcomes of the children born to them. Although the case series is small, all children had excellent birth outcomes suggesting pregnant women should not be denied access to novel therapies for RR-TB.
Asunto(s)
Antituberculosos/uso terapéutico , Diarilquinolinas/uso terapéutico , Linezolid/uso terapéutico , Nitroimidazoles/uso terapéutico , Oxazoles/uso terapéutico , Mujeres Embarazadas , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Adulto , Salud Infantil , Preescolar , Femenino , Humanos , Lactante , Salud del Lactante , Embarazo , Resultado del Embarazo , Sudáfrica/epidemiología , Adulto JovenAsunto(s)
Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Masculinos/diagnóstico , Herpes Simple/diagnóstico , Reacción en Cadena de la Polimerasa Multiplex/métodos , Sífilis/diagnóstico , Treponema pallidum/aislamiento & purificación , Adolescente , Adulto , Niño , Preescolar , Femenino , Enfermedades de los Genitales Femeninos/microbiología , Enfermedades de los Genitales Femeninos/virología , Enfermedades de los Genitales Masculinos/microbiología , Enfermedades de los Genitales Masculinos/virología , Herpes Simple/virología , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Sífilis/microbiología , Treponema pallidum/genética , Úlcera , Adulto JovenRESUMEN
Background: Large sporting events have raised concerns about the effect on the sexual and reproductive health (SRH) of visiting and resident populations to the host city and increased demand on SRH services. However, there is little evidence to support these concerns. The aim of this study is to investigate if the 2014 XX Commonwealth Games had an effect on the service demands of a Glasgow city-wide integrated SRH service. Methods: Electronic patient records, city-wide pharmacy data and case note review was used to assess aspects of SRH; this included overall attendance at integrated services, clinic and community emergency contraception prescriptions, victims of sexual assault, acute sexually transmissible infections (STIs), post exposure prophylaxis after sexual exposure (PEPSE) prescriptions, condom distribution and termination of pregnancy. Results: There was a significant decrease in core sexual health attendances, total acute STIs and emergency hormonal contraception prescriptions. There was no change in PEPSE prescriptions or the number of reported sexual assaults throughout the city. Conclusions: This study found no evidence that the 2014 XX Commonwealth Games placed any increased demand on the local SRH services, and showed no increase in STIs, emergency hormonal contraception prescriptions or sexual assaults. These findings will help service planning in host cities hosting future large sporting events.