RESUMO
Murine typhus in the pediatric population has increased substantially in recent years. The most common clinical presentation of murine typhus includes fever, rash, headaches and myalgias. Murine typhus presenting with predominant myositis and/or encephalopathy is rare. It is important to recognize unusual clinical manifestations of murine typhus in children for early diagnosis and treatment.
Assuntos
Antifúngicos/uso terapêutico , Doenças Endêmicas , Histoplasmose/diagnóstico , Infecções Fúngicas Invasivas/diagnóstico , Fígado/patologia , Biópsia por Agulha , Insuficiência de Crescimento/diagnóstico , Insuficiência de Crescimento/etiologia , Feminino , Seguimentos , Histoplasma/isolamento & purificação , Histoplasmose/tratamento farmacológico , Humanos , Imuno-Histoquímica , Lactente , Infecções Fúngicas Invasivas/tratamento farmacológico , Fígado/fisiopatologia , Doenças Raras , Medição de Risco , Resultado do Tratamento , Vômito/diagnóstico , Vômito/etiologia , Redução de PesoAssuntos
Exantema/etiologia , Hanseníase/diagnóstico , Criança , Humanos , Hanseníase/complicações , MasculinoRESUMO
Stenotrophomonas maltophilia can present as bacteremia, respiratory tract infection, urinary tract infection, soft tissue and wound infections, bone and joint infections, meningitis, and endocarditis especially in immunosuppressed patients and those with underlying medical conditions. The incidence and impact of S. maltophilia in young children with heart disease are poorly defined. A single center retrospective observational study was conducted in infants <180 days of age with positive S. maltophilia cultures over a period of 5 years. The overall incidence for S. maltophilia infection was 0.8 % (n = 32/3656). Among 32 identified infants, there were 47 episodes of S. maltophilia infection 66 % of infants had prior exposure to broad spectrum antibiotics. 97 % of positive isolates were susceptible to trimethoprim/sulfamethoxazole and 91 % to levofloxacin as well as ticarcillin/clavulanate. Ventilator-free days and absolute lymphocyte count prior to acquiring infection were significantly lower in non-survivors than in survivors. 100 % of survivors had clearance of positive cultures compared to 50 % in non-survivors (p < 0.05). The crude all-cause mortality rate was 37.5 %. All non-survivors had increased length of ICU stay and duration of mechanical ventilation and had delayed clearance of infection and required longer duration of treatment.
Assuntos
Antibacterianos/administração & dosagem , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/mortalidade , Stenotrophomonas maltophilia/isolamento & purificação , Antibacterianos/uso terapêutico , Ácidos Clavulânicos/administração & dosagem , Feminino , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Unidades de Terapia Intensiva , Levofloxacino/administração & dosagem , Masculino , Estudos Retrospectivos , Fatores de Risco , Stenotrophomonas maltophilia/efeitos dos fármacos , Ticarcilina/administração & dosagem , Combinação Trimetoprima e Sulfametoxazol/administração & dosagemRESUMO
We report a case of a 5-year-old girl with invasive colitis and secondary bacteremia caused by group A beta-hemolytic streptococcus. Although group A beta-hemolytic streptococcus is occasionally isolated from stool, it is a rare cause of colitis. This is the first report of group A beta-hemolytic streptococcus pancolitis with secondary bacteremia.
