Hepatic portal venous gas associated with Klebsiella oxytoca infection in the absence of preceding antibiotic treatment.

Klebsiella oxytoca (K. oxytoca) is a causative organism for hemorrhagic antibiotic-associated colitis. K. oxytoca infection is a typical example of microbial substitution diseases caused by exposure to antibiotics prior to the onset of diarrhea. Here, we repot a case with ileitis associated with K. oxytoca infection in the absence of preceding antibiotic treatment. Interestingly, abdominal computed tomography revealed wall thickening of the ileum and hepatic portal venous gas (HPVG). K. oxytoca was isolated from the stool. This very elderly patient had been treated with azathioprine for long-standing history of ulcerative colitis. Immuno-compromised state of this patient was considered to allow overgrowth of K. oxytoca in the small bowel to cause not only ileitis but also HPVG.

[Emphisematous cystitis with multiorganic embolism: Case report.] / Cistitis enfisematosa con embolismo multiorgánico: a propósito de un caso.

OBJECTIVE: We present an unusual case of emphysematous cystitis with multiple septic embolisms to several organs. METHOD AND RESULTS: Case description and selection of related pictures. Review of the existing literature. CONCLUSIONS: Emphysematous cystitis is a rare condition but potentially severe. Prognosis depends on a rapid diagnosis and treatment.

Persistent portal venous gas.

This case report describes a patient diagnosed with ongoing portal venous gas, initiated by a rather common Campylobacter enterocolitis and maintained by septic thrombophlebitis and possibly by chronic cholecystitis. Cholecystectomy attenuated the patient's septic condition. The etiology of portal venous gas determines both the patient's prognosis and the choice for either conservative or surgical treatment. This report describes persistence of portal venous gas for a long period and a possible role for chronic cholecystitis as a cause.

Massive intracerebral air embolism associated with meningitis and lumbar spondylitis: case report.

BACKGROUND: Massive intracerebral air embolism is a rare pathologic state and never in association with meningitis and lumbar spondylitis. To the best of our knowledge, our presented case is the first of a massive intracerebral air embolism associated with meningitis and lumbar spondylitis of Klebsiella pneumonia. CASE DESCRIPTION: A 55-year-old man presented with a high fever and low back pain. Blood culture showed Klebsiella pneumonia. Lumbar computed tomography (CT) revealed discitis at L1-2 and L2-3 levels and paraspinal abscess in which air was found. Despite management with antibiotics, patient's consciousness deteriorated, and brain CT revealed diffuse intravenous air embolism and severe brain swelling. Cerebrospinal fluid (CSF) examination demonstrated bacterial meningitis, and the CSF culture showed Klebsiella pneumonia. Later, septic shock occurred and patient expired. CONCLUSION: Intracerebral air embolism can occur in the Klebsiella pneumonia meningitis that resulted from lumbar spondylitis and sepsis.