RESUMO
We present a case of endocarditis with embolic stroke and digital infarction due to the recently renamed Aggregatibacter aphrophilus. The isolation and identification of this organism can be problematic but was achieved in this case using both older phenotypic and newer genotypic methods. A benign tongue lesion is suggested as the likely portal of entry for this oropharyngeal organism. The patient made a good recovery with six weeks of intravenous ceftriaxone but will need cardiac valvular surgery at some point in the future.
Assuntos
Infarto Cerebral/microbiologia , Endocardite/microbiologia , Infecções por Haemophilus/complicações , Infecções por Haemophilus/diagnóstico , Haemophilus paraphrophilus/isolamento & purificação , Antibacterianos/uso terapêutico , Ceftriaxona/uso terapêutico , Dedos/irrigação sanguínea , Infecções por Haemophilus/tratamento farmacológico , Humanos , Infarto/microbiologia , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVES: Acute appendicitis is a common surgical emergency. The etiology and pathophysiology of appendicitis have been well investigated. Aggregatibacter aphrophilus is a fastidious gram-negative coccobacilli. Detection of this organism in clinical samples and its differentiation from Haemophilus aphrophilus or from Aggregatibacter actinomycetemcomitans in routine microbiology settings could be difficult. METHODS: In this rare case, we report the isolation of Aggregatibacter aphrophilus from the appendix of a 14-year-old boy presented with acute appendicitis. The genotypic method using 16S rRNA sequencing was used for identification of the organism at species level. CONCLUSION: This case highlights the importance of detecting fastidious and rare microorganisms such as Aggregatibacter aphrophilus that could be associated with acute appendicitis.
Assuntos
Apendicite/microbiologia , Apêndice/microbiologia , Haemophilus paraphrophilus/isolamento & purificação , Doença Aguda , Adolescente , Apendicectomia , Apendicite/cirurgia , Apêndice/cirurgia , DNA Bacteriano/isolamento & purificação , Haemophilus paraphrophilus/classificação , Haemophilus paraphrophilus/genética , Humanos , Masculino , RNA Ribossômico 16S/genética , RibotipagemRESUMO
The authors report a case of orbital cellulitis with abscess formation that developed after surgical management of canaliculitis. The patient developed pain, erythema, proptosis, and limited eye movements 3 days after canalicular debridement. She required urgent drainage of an orbital abscess and was treated with intravenous antibiotics for 2 weeks. Complications from surgical management of canaliculitis are unusual. Clinicians should be aware of the rare but serious risk of spread of the infection to the orbit.
Assuntos
Abscesso/microbiologia , Dacriocistite/cirurgia , Infecções Oculares Bacterianas/microbiologia , Infecções por Bactérias Gram-Negativas/microbiologia , Celulite Orbitária/microbiologia , Complicações Pós-Operatórias , Infecções Estreptocócicas/microbiologia , Antibacterianos/administração & dosagem , Terapia Combinada , Desbridamento , Drenagem , Eikenella corrodens/isolamento & purificação , Feminino , Infecções por Bactérias Gram-Negativas/diagnóstico por imagem , Infecções por Bactérias Gram-Negativas/terapia , Haemophilus paraphrophilus/isolamento & purificação , Humanos , Pessoa de Meia-Idade , Celulite Orbitária/diagnóstico por imagem , Celulite Orbitária/terapia , Infecções Estreptocócicas/diagnóstico por imagem , Infecções Estreptocócicas/terapia , Streptococcus anginosus/isolamento & purificação , Tomografia Computadorizada por Raios XRESUMO
We report on a 3-year-old boy presenting with left-sided eyelid myocloni due to an intracranial abscess harboring Haemophilus paraphrophilus. This is the first description of an intracranial infection with this pathogen in a child.
