Assuntos
Febre Q/complicações , Ruptura Esplênica/etiologia , Adulto , Humanos , Masculino , Ruptura EspontâneaRESUMO
AIM: to evaluate bacteremias caused during endoscopic examination of the digestive tract. PATIENTS AND METHODS: prospective study of randomly selected patients who underwent digestive system endoscopic examination. Emergency endoscopic examinations were excluded. RESULTS: a total of 102 patients were analyzed. Of 44 patients who underwent gastroscopy, 11 (25%) subsequently had positive blood culture, and Staphylococcus spp and Streptococcus spp were isolated. Of 30 patients who underwent colonoscopy, 3 (10%) had positive blood cultures, and Staphylococcus spp were isolated. Of 28 patients who underwent endoscopic retrograde cholangiopancreatography, 11 (39.2%) had positive blood cultures, and Escherichia coli, Morganella morganii, Staphylococcus spp and Streptococcus spp were isolated. No deaths, endocarditis or other septic phenomena were attributed to bacteremia. CONCLUSIONS: the incidence of bacteremia ranged from 10% to 39% depending on the type of endoscopy. The microorganisms that were isolated most frequently were Staphylococcus spp and Streptococcus spp. Gram-negative bacilli and enterobacteria were isolated in patients who had undergone endoscopic retrograde cholangiopancreatography.
Assuntos
Bacteriemia/etiologia , Endoscopia do Sistema Digestório/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/sangue , Bacteriemia/microbiologia , Bactérias/isolamento & purificação , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica/estatística & dados numéricos , Endoscopia do Sistema Digestório/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de TempoRESUMO
We report a case of rhombencephalitis with meningitis in a 36-years-old previously healthy man; neurological signs and symptoms were initially consistent with a diagnosis of Wallenberg syndrome. Analysis of cerebrospinal fluid showed predominantly lymphocytic pleocytosis and elevated protein levels. A CT brain scan was normal. MRI of the brain showed a hypertensive type lesion in T2, in the right pontomedullary region that suggested inflammation. A blood culture grew Listeria monocytogenes. The patient improved and fully recovered with appropriate antibiotic treatment. Listeria monocytogenes is a recognized cause of acute brainstem meningoencephalitis. Differential diagnoses that must be considered are other forms of purulent meningitis, viral meningoencephalitis, granulomatosis infections of the central nervous system and, occasionally, stroke.
