Clinical characteristics of Actinotignum schaalii bacteremia in a Japanese tertiary hospital.

We retrospectively analyzed seven patients with Actinotignum schaalii bacteremia in a tertiary hospital in Japan. Pyelonephritis was the most frequent source of bacteremia, followed by Fournier's gangrene and pyometra. All patients with pyelonephritis had underlying urological conditions, ureteral stents, nephrostomy, ureteral stones, or ureterocele.

Case Report: Emphysematous Pyelonephritis With a Congenital Giant Ureterocele.

A 14-year-old girl noticed malodorous urine and experienced left flank pain. The patient was presented to our hospital with gradually increasing pain. She had no underlying disease but had a history of pain on micturition for several days. Hematologic examination indicated low white blood cell and platelet counts and a high serum lactate level. Computed tomography showed that a part of the parenchyma of the left kidney had poor contrast and was deteriorated, with fluid and gas retention from the perirenal region to the retroperitoneal cavity. A left hydroureter and large ureterocele were observed in the bladder. She was diagnosed with emphysematous pyelonephritis (EPN) with a giant congenital ureterocele. Vasopressors and blood transfusion failed to maintain normal circulatory dynamics, and an open left nephrectomy and transurethral ureterocele fenestration were performed. The excised outer portion of the left kidney was dissolved by the infection and replaced with blood clots and necrotic tissue. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry identified the inflammatory, gas-producing bacteria Actinotignum schaalii, Peptoniphilus asaccharolyticus, and Actinomyces odontolyticus. Meropenem was administered for 4 days postoperatively and then de-escalated to sulbactam/ampicillin for another 10 days. The patient was discharged on day 17 of hospitalization, and the postoperative course remained favorable. EPN is extremely rare in pediatric patients, and it is believed that nephrectomy is sometimes necessary if the patient does not have normal circulatory dynamics despite the use of catecholamines.

Photocatalytic degradation of diuron in aqueous solution by platinized TiO2.

The photocatalytic degradation of diuron, which is one of phenylurea herbicides, was carried out in the presence of platinized TiO(2) photocatalyst. Platinization was found to increase the rate of diuron degradation. When 0.2wt.% of platinum was deposited onto the surface of TiO(2), an initial diuron concentration of 10 mg L(-1) was completely degraded after 20 min. Furthermore, the first-order rate constant for diuron degradation by Pt-TiO(2) was ca. 4 times higher than P-25 TiO(2). In addition, the photocatalytic activity of Pt-TiO(2) was appeared under visible light. The decrease of TOC as a result of mineralization of diuron was observed during the photocatalytic process. The degree of diuron mineralization was about 97% under UV irradiation after 8h. The formations of chloride, nitrate and ammonium ions as end-products were observed during the photocatalytic system. The decomposition of diuron gave four kinds of intermediate products. The degradation mechanism of diuron was proposed on the base of the evidence of the identified intermediates. Based on these results, the photocatalytic reaction by Pt-TiO(2) could be useful technology for the treatment of wastewater containing diuron.

[A case of primary pulmonary proteinosis with bilateral pneumothorax].

A 40-year-old man was admitted to our hospital because of chronic cough and mild exertional dyspnea. Radiographs of the chest showed diffuse infiltrative shadows in both lung fields. A diagnosis of pulmonary alveolar proteinosis (PAP) was made by examination with a flexible bronchoscope and bronchoalveolar lavage, with transbronchial biopsy. After diagnosis, the patient underwent whole-lung lavage with temporary improvement. Due to the recurrence of his illness, he needed a total of four whole-lung lavages over the course of his illness. However, the exertional dyspnea became progressively worse. Bilateral pneumothorax developed suddenly and led to his death. This case indicates the possibility that deterioration of PAP despite whole-lung lavage may sometimes be followed by pneumothorax.