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1.
Tidsskr Nor Laegeforen ; 139(16)2019 11 05.
Artigo em Norueguês | MEDLINE | ID: mdl-31686480

RESUMO

Nowadays severe illness in neonates is fortunately rare in Norway. However, newborns present with non-specific symptoms, making diagnostics in this age group challenging, and neonatologists need to think broadly in order not to overlook serious illness. We present the case of a nine-day-old who was severely ill when she arrived at hospital. She was born in gestational week 37 after a normal pregnancy. The birth was complicated by shoulder dystocia, rupture of the umbilical cord and fracture of the clavicle. Thereafter she had a normal stay in the maternity ward for three days. At home she appeared healthy and gained weight until she returned to hospital after thirteen hours of poor feeding, irritability and fever. The symptoms turned out to be caused by bacterial meningitis. During the first week of hospitalisation she developed ventriculitis, brain abscesses and sinus vein thrombosis. It was later discovered that she had severely impaired hearing, and thereafter she developed hydrocephalus requiring surgical drainage. The mortality from neonatal bacterial meningitis has dropped from almost 50 % in the 1970s to less than 10 % today, but the morbidity has remained unchanged. It is crucial that clinicians are alert to this diagnosis, as delayed treatment can worsen the prognosis.


Assuntos
Meningite devida a Escherichia coli , Abscesso Encefálico/microbiologia , Ventriculite Cerebral/microbiologia , Escherichia coli/isolamento & purificação , Feminino , Febre/microbiologia , Humanos , Hidrocefalia/microbiologia , Recém-Nascido , Imagem por Ressonância Magnética , Meningite devida a Escherichia coli/complicações , Meningite devida a Escherichia coli/diagnóstico , Meningite devida a Escherichia coli/tratamento farmacológico , Trombose dos Seios Intracranianos/microbiologia
2.
Georgian Med News ; (294): 10-16, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687941

RESUMO

Aim - to evaluate pathogens and their susceptibility to antibiotic therapy (ABT) in combat-related penetrating craniocerebral gunshot wound (PCGW) patients and develop recommendations for treatment of post-traumatic meningoencephalitis. We conducted a prospective analysis of examination and treatment results of 121 patients who were admitted to the Public Institution, Mechnikov Dnipropetrovsk Regional Clinical Hospital, Dnipro, Ukraine, from 25 May 2014, to 31 December 2017, and were successively enrolled in the study. Intracranial purulent-septic complications were diagnosed in 14 (11.6%) patients including eight cases of isolated meningoencephalitis, three cases of meningoencephalitis combined with ventriculitis, two cases of meningoencephalitis combined with ventriculitis and subdural empyema and one case of multiple brain abscesses. In most cases of combat-related craniocerebral wounds, infections are considered nosocomial and typically related to medical procedures and devices. In most cases, the effectiveness of first-line antibiotics was low, and it was often necessary to prescribe broad-spectrum ABT, including those related to second-line antibiotics and reserve drugs, according to the World Health Organisation classification. The use of initial de-escalation of empiric ABT with the broadest-spectrum drugs, mainly as a part of combination therapy for expected gram-positive and gram-negative aerobic and anaerobic infection pathogens, is recommended.


Assuntos
Antibacterianos/uso terapêutico , Bactérias/efeitos dos fármacos , Infecções Bacterianas/complicações , Abscesso Encefálico/tratamento farmacológico , Traumatismos Craniocerebrais/complicações , Infecção da Ferida Cirúrgica/complicações , Infecção dos Ferimentos/tratamento farmacológico , Ferimentos Penetrantes/complicações , Adulto , Bactérias/classificação , Bactérias/isolamento & purificação , Abscesso Encefálico/epidemiologia , Abscesso Encefálico/microbiologia , Traumatismos Craniocerebrais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/microbiologia , Ucrânia/epidemiologia , Infecção dos Ferimentos/diagnóstico , Infecção dos Ferimentos/epidemiologia , Infecção dos Ferimentos/microbiologia
3.
BMC Infect Dis ; 19(1): 863, 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31638913

RESUMO

BACKGROUND: Invasive meningococcal disease (IMD) presenting with meningitis causes significant mortality and morbidity. Suppurative complications of serogroup B meningococcal sepsis are rare and necessitate urgent multidisciplinary management to mitigate long-term morbidity or mortality. CASE PRESENTATION: We present a rare case of invasive meningococcal disease in a 28-month old boy complicated by multiple abscess formation within a pre-existing antenatal left middle cerebral artery territory infarct. Past history was also notable for cerebral palsy with right hemiplegia, global developmental delay and West syndrome (infantile spasms). Two craniotomies were performed to achieve source control and prolonged antimicrobial therapy was necessary. The patient was successfully discharged following extensive multidisciplinary rehabilitation. CONCLUSIONS: Longstanding areas of encephalomalacia in the left MCA distribution may have facilitated the development of multiple meningococcal serogroup B abscess cavities in the posterior left frontal, left parietal and left temporal lobes following an initial period of cerebritis and meningitis. A combination of chronic cerebral hypoperfusion and some degree of pre-existing necrosis in these areas, may also have facilitated growth of Neisseria meningitidis, leading ultimately to extensive cerebral abscess formation following haematogenous seeding during meningococcemia. In this case report we review similar cases of cerebral abscess or subdural empyema complicating serogroup B meningococcal meningitis.


Assuntos
Abscesso Encefálico/microbiologia , Meningite Meningocócica/complicações , Neisseria meningitidis Sorogrupo B/genética , Antibacterianos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/cirurgia , Infarto Cerebral/complicações , Paralisia Cerebral/complicações , Pré-Escolar , Craniotomia , Empiema Subdural/tratamento farmacológico , Empiema Subdural/microbiologia , Seguimentos , Hemiplegia/complicações , Humanos , Masculino , Meningite Meningocócica/prevenção & controle , Reação em Cadeia da Polimerase , Sepse/tratamento farmacológico , Sepse/microbiologia , Resultado do Tratamento , Vacinação
4.
BMC Oral Health ; 19(1): 200, 2019 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470835

RESUMO

BACKGROUND: Antibiotic prophylaxis before invasive treatments, including dental extractions, is still recommended for patients at high risk of infective endocarditis. However, the risk from self-extraction of teeth in daily life of patients with intellectual disabilities is uncertain. CASE PRESENTATION: A 6-year-old patient with Ebstein's anomaly developed cerebral abscess, which appeared associated with infective endocarditis of dental origin. Two weeks after self-extraction of his deciduous teeth, he began to experience pain in his ear and developed continuous fever, followed by vomiting, facial spasm, and a loss of consciousness. He was admitted into a hospital for 2 months, during which he received intravenously administered antibiotics and a drainage tube in his brain. CONCLUSIONS: Deciduous teeth can be self-extracted before root resorption and natural shedding in patients with intellectual disabilities. When they are at high risk of infective endocarditis and frequently touch mobile deciduous teeth, it seems to be an option to extract the teeth early with antibiotic prophylaxis, rather than to wait natural fall.


Assuntos
Abscesso Encefálico/diagnóstico , Anomalia de Ebstein/complicações , Endocardite/microbiologia , Deficiência Intelectual/complicações , Extração Dentária/efeitos adversos , Antibacterianos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/microbiologia , Criança , Pré-Escolar , Feminino , Febre/etiologia , Humanos , Lactente , Masculino , Infecções Estafilocócicas
5.
Drug Discov Ther ; 13(3): 175-176, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31327792

RESUMO

This is the first case of an angiosarcoma patient with brain abscess, and it might be responsible for skin defect and cranial bone necrosis by surgical excision and radiation. Our patient was treated with 10 courses of triweekly paclitaxel therapy, radical radiotherapy (70 Gy), and surgical excision (2 cm margin apart from a lesion) for angiosarcoma. At two years after the operation he was diagnosed as brain abscess. Brain abscess was managed with antibiotic drugs and drainage, his clinical symptoms improved by these treatments. He achieves replace free survival without the exacerbation of angiosarcoma and brain abscess for three years.


Assuntos
Infecções Bacterianas/diagnóstico , Abscesso Encefálico/diagnóstico , Neoplasias Encefálicas/terapia , Hemangiossarcoma/terapia , Idoso , Antibacterianos/uso terapêutico , Infecções Bacterianas/terapia , Abscesso Encefálico/microbiologia , Abscesso Encefálico/terapia , Neoplasias Encefálicas/complicações , Intervalo Livre de Doença , Drenagem , Firmicutes/isolamento & purificação , Hemangiossarcoma/complicações , Humanos , Masculino , Procedimentos Neurocirúrgicos , Radioterapia , Resultado do Tratamento
6.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(6): 438-443, 2019 Jun 12.
Artigo em Chinês | MEDLINE | ID: mdl-31189230

RESUMO

Objective: To study the clinical features and the diagnosis and treatment of endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae pneumonia. Methods: Three cases of endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae with microbiological evidence were studied. The related literatures published from January 2008 to June 2018 were reviewed with "pneumonia" , "endogenous endophthalmitis" and "Klebsiella pneumoniae" as the keywords in CNKI, Wanfang, PubMed and Web of Science databases. Results: The 3 patients, all males, aged 54 years, 82 years and 48 years respectively. They all had a history of type 2 diabetes mellitus. Endophthalmitis occurred in one eye in all of them, and the patients had eye symptoms including eye pain, progressive loss of vision, periorbital area inflammation, conjunctivitis, weakening or disappearance of pupil light reflex, corneal edema and anterior chamber effusion. All of 3 cases had multiple patchy pulmonary lesions, and Klebsiella pneumoniae was proven to be the pathogen by blood culture. Two cases had pulmonary abscess and liver abscess, and one of them had brain abscess. A total of 28 literatures with 81 cases of endogenous Klebsiella pneumoniae endophthalmitis associated with Klebsiella pneumoniae pneumonia were retrieved from CNKI, WanFang, PubMed and Web of Science database. Conclusions: Klebsiella pneumoniae was one of the most common pathogens of pneumonia and endogenous endophthalmitis, which would seriously damage the lung and the eye. The early clinical features were not specific. Misdiagnosis or missed diagnosis might cause serious consequences. Eye pain and visual disturbance symptoms, ophthalmic examination, chest imaging, blood and aqueous humor etiology were of great value in the diagnosis of this disease.


Assuntos
Abscesso Encefálico/microbiologia , Endoftalmite/microbiologia , Infecções por Klebsiella/diagnóstico por imagem , Klebsiella pneumoniae/isolamento & purificação , Abscesso Hepático/microbiologia , Pneumonia Bacteriana/diagnóstico por imagem , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Abscesso Encefálico/complicações , Diabetes Mellitus Tipo 2/complicações , Endoftalmite/complicações , Humanos , Infecções por Klebsiella/complicações , Infecções por Klebsiella/tratamento farmacológico , Abscesso Hepático/complicações , Masculino , Pessoa de Meia-Idade
7.
World Neurosurg ; 129: 188-189, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31176834

RESUMO

Tuberculous brain abscess is an extremely rare form of central nervous system tuberculosis. This lesion usually occurs in the supratentorial space. Cerebellar tubercular abscesses are rare. Most of these cases occur in immunocompromised patients. We report an immunocompetent individual with tuberculous abscess of the cerebellum and discuss the role of stereotactic aspiration in the management of these rare lesions.


Assuntos
Abscesso Encefálico/cirurgia , Doenças Cerebelares/cirurgia , Paracentese/métodos , Técnicas Estereotáxicas , Tuberculose do Sistema Nervoso Central/cirurgia , Abscesso Encefálico/microbiologia , Doenças Cerebelares/microbiologia , Feminino , Humanos , Pessoa de Meia-Idade
8.
Anaerobe ; 59: 68-71, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31132411

RESUMO

Brain abscess accounts for 8% of all intracranial insults in developing countries. Anaerobic infections are missed in most cases due to difficult isolation techniques. This study was done to determine the anaerobic bacteriological profile of brain abscess, their distribution according to sociodemographic variables, anatomical location, management and the outcome during the subjects' stay in a neurosciences' speciality hospital. We included 190 cases of confirmed anaerobic brain abscess from the year 1998-2017. The median age was 22 years with more males (73% of 190 cases) than females. The Bacteroides spp. were the most common (64%) anaerobic organisms isolated followed by Gram positive anaerobic cocci (51%). While 67% of the samples showed purely anaerobic bacteria on culture, remaining were mixed. Chronic suppurative otitis media (CSOM) was the most common predisposing factor.


Assuntos
Bactérias Anaeróbias/classificação , Bactérias Anaeróbias/isolamento & purificação , Abscesso Encefálico/microbiologia , Adolescente , Adulto , Idoso , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/patologia , Abscesso Encefálico/terapia , Criança , Pré-Escolar , Estudos Transversais , Demografia , Gerenciamento Clínico , Feminino , Humanos , Índia , Lactente , Masculino , Pessoa de Meia-Idade , Centros de Atenção Terciária , Adulto Jovem
9.
J Mycol Med ; 29(2): 180-184, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31056403

RESUMO

Emergence of saprophytic fungi thriving in dead plant material and soil as opportunistic human pathogens is of great concern. Cladosporium species are environmental saprophytes reported to cause various superficial and invasive fungal infections worldwide. C. sphaerospermum, a predominantly indoor fungus has been reported from cases of meningitis, subcutaneous and pulmonary fungal infections in the past. Herein we report the first case of cerebral abscess due to C. sphaerospermum in an immunocompetent host who was successfully managed by combined medical and surgical therapy.


Assuntos
Abscesso Encefálico/microbiologia , Cladosporium/isolamento & purificação , Cladosporium/patogenicidade , Micoses/diagnóstico , Adulto , Antifúngicos/farmacologia , Encéfalo/diagnóstico por imagem , Abscesso Encefálico/cirurgia , Humanos , Imunocompetência , Imagem por Ressonância Magnética , Masculino , Micoses/tratamento farmacológico , Resultado do Tratamento
10.
Korean J Gastroenterol ; 73(4): 230-234, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31030461

RESUMO

Anaerobic infections have been reported to be responsible for 3-10% of pyogenic liver abscesses in Korea, and reported anaerobes include Fusobacterium, Bacillus fragilis, and Bacteroides melaninogenicus. Parvimonas micra is an anaerobic, Gram-positive, non-spore-forming bacterial species and a constituent of normal flora on skin, vagina, gastrointestinal tract, and oral cavity that can cause opportunistic infections. However, it has only rarely been reported to be a cause of liver abscess; only one such case has been reported in Korea. We experienced a case of concomitant liver and brain abscesses caused by Parvimonas micra in a non-immunodeficient 65-year-old female patient without diabetes or periodontal disease. Parvimonas micra infection was confirmed by blood culture using VITEK® 2 cards and by bacterial 16s ribosomal RNA gene sequencing. We conclude that we should not overlook anaerobes as a cause of liver abscess.


Assuntos
Abscesso Encefálico/diagnóstico , Firmicutes/isolamento & purificação , Abscesso Hepático Piogênico/diagnóstico , Abdome/diagnóstico por imagem , Idoso , Abscesso Encefálico/microbiologia , Feminino , Firmicutes/genética , Humanos , Abscesso Hepático Piogênico/microbiologia , Imagem por Ressonância Magnética , RNA Ribossômico 16S/química , RNA Ribossômico 16S/metabolismo , Análise de Sequência de DNA , Tomografia Computadorizada por Raios X
12.
Transpl Infect Dis ; 21(3): e13082, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30892778

RESUMO

Burkholderia cepacia complex (Bcc) includes several phenotypically similar but genotypically distinct gram-negative bacteria (GNB) that can colonize the respiratory tract of Cystic Fibrosis (CF) patients. Pathogens are difficult to treat due to intrinsic resistance to multiple antibiotics and are associated to a more rapid decline in lung function and to increased mortality, particularly after lung transplantation. For all these reasons, chronic infection by Burkholderia (B) cenocepacia is presently considered a relative or absolute contraindication in almost all lung transplant centres. We report the case of a young adult CF patient chronically colonized by B multivorans genomovar II, with diabetes and end-stage renal disease treated with renal replacement therapy: a few months after lung transplantation, she developed post-surgery B multivorans bacteremia and multiple brain abscesses. This severe infection did not improve despite multiple standard antibiotic regimen. The introduction of ceftazidime-avibactam, a new ß-lactam/ ß-lactamase inhibitor combination resulted in clinical recovery and in radiological and biochemical improvement.


Assuntos
Compostos Azabicíclicos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Infecções por Burkholderia/tratamento farmacológico , Ceftazidima/uso terapêutico , Fibrose Cística/complicações , Transplante de Pulmão/efeitos adversos , Adulto , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Abscesso Encefálico/microbiologia , Infecções por Burkholderia/etiologia , Complexo Burkholderia cepacia/efeitos dos fármacos , Fibrose Cística/microbiologia , Complicações do Diabetes/microbiologia , Combinação de Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/microbiologia , Pulmão/microbiologia , Pulmão/patologia , Resultado do Tratamento
13.
Ann Biol Clin (Paris) ; 77(2): 184-186, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30882349

RESUMO

Streptococcus intermedius is considered as a commensal of the oropharynx, but can be a source of serious infections. We report a case of cerebral abscess in a young man of 18 years, who was admitted to the emergency room for consciousness disorder, and whose cerebral CT showed a frontal mass evoking the diagnosis of abscess. Diagnosis was confirmed by bacteriological examination of puncture fluid which was in favor of Streptococcus intermedius abscess.


Assuntos
Abscesso Encefálico/diagnóstico , Infecções Bacterianas do Sistema Nervoso Central/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus intermedius/isolamento & purificação , Adolescente , Antibacterianos/uso terapêutico , Abscesso Encefálico/líquido cefalorraquidiano , Abscesso Encefálico/microbiologia , Abscesso Encefálico/terapia , Infecções Bacterianas do Sistema Nervoso Central/líquido cefalorraquidiano , Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Infecções Bacterianas do Sistema Nervoso Central/terapia , Craniectomia Descompressiva , Drenagem , Humanos , Masculino , Infecções Estreptocócicas/líquido cefalorraquidiano , Infecções Estreptocócicas/terapia , Streptococcus intermedius/patogenicidade , Tomografia Computadorizada por Raios X
15.
Eur J Clin Microbiol Infect Dis ; 38(5): 811-818, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30796545

RESUMO

Methanogens are strictly anaerobic archaea metabolising by-products of bacterial fermentation into methane by using three known metabolic pathways, i.e. the reduction of carbon dioxide, the fermentation of acetate or the dismutation of methanol or methylamines. Methanogens described in human microbiota include only Euryarchaeota, i.e. Methanobrevibacter smithii, Methanobrevibacter oralis, Methanobrevibacter arbophilus, Methanobrevibacter massiliensis, Methanomassiliicoccus luminyensis, Methanosphaera stadtmanae and Ca. Methanomethylophilus alvus and Ca. Methanomassiliicoccus intestinalis. Methanogens are emerging pathogens associated with brain and muscular abscesses. They have been implicated in dysbiosis of the oral microbiota, periodontitis and peri-implantitis. They have also been associated with dysbiosis of the digestive tract microbiota linked to metabolic disorders (anorexia, malnutrition and obesity) and with lesions of the digestive tract (colon cancer). Their detection in anaerobic pus specimens and oral and digestive tract specimens relies on microscopic examination by fluorescence in situ hybridisation, specific DNA extraction followed by polymerase chain reaction (PCR)-based amplification of the 16S rRNA and mcrA gene fragments and isolation and culture in the supporting presence of hydrogen-producing bacteria. Diagnostic identification can be performed by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and can be further completed by genotyping through multi-spacer sequencing and, ultimately, whole genome sequencing (WGS). Ornidazole derivatives, fusidic acid and rifampicin are the compounds to be included in in vitro susceptibility testing to complete the clinical workflow. Clinical microbiology laboratories should work toward developing cheap and easy protocols for the routine detection and identification of methanogens in selected specimens in order to refine the diagnosis of infections, as well as to expand the knowledge about this group of intriguing microorganisms.


Assuntos
Abscesso/diagnóstico , Abscesso/microbiologia , Euryarchaeota/isolamento & purificação , Euryarchaeota/patogenicidade , Abscesso/patologia , Bactérias Anaeróbias/fisiologia , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/microbiologia , Abscesso Encefálico/patologia , Técnicas de Laboratório Clínico , Disbiose/microbiologia , Disbiose/patologia , Trato Gastrointestinal/microbiologia , Trato Gastrointestinal/patologia , Humanos , Microbiota , Músculos/microbiologia , Músculos/patologia
16.
Microb Pathog ; 128: 153-161, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30583023

RESUMO

The purpose of this study was to evaluate the effects of Bacillus subtilis 18 (BS-18) isolated from free-ranging Tibetan yaks in high altitude regions of Tibet (3600 m) on growth performance and gut microbial community in mice. In this study, mice (15-day-old) were used as an animal model and raised under standard conditions. A total of 20 KM mice were divided equally into two groups: control group (feed and drink freely), experimental group (feed and drink freely + 1 × 109 CFU/day BS-18). The intestines (duodenum, jejunum, ileum, cecum) and organs (liver, spleen, kidney) were collected from all the mice at day 18 for high throughput sequencing and HE staining. During the whole experiment, the mice treated by BS-18 displayed no abnormal behavior or macroscopic lesions on dissection. Meanwhile, there were no pathological changes observed using HE staining compared with the control group. The results show that BS-18 isolated from Tibetan yaks was safe and could increase average daily gain (ADG) and reduce feed conversion ratio (FCR). Furthermore, supplementation with BS-18 could improve the mucosal morphology and the ratio of villi to crypt cells (P < 0.05 or P < 0.01). The high-throughput sequencing results showed that the abundance and diversity of duodenum and jejunum in the experimental group were higher than control group. Lactobacillus in experimental group had higher abundance than control group. In addition, the quantity of Candidatus arthromitu was increased after BS-18 intake, which is associated with immune system activity. Acinetobacter induced brain abscess and bronchopneumonia were reduced in the experimental group. In conclusion, this study demonstrated that BS-18 isolated from Tibetan yaks was safe, beneficial and had the potential to serve as a probiotic.


Assuntos
Bacillus subtilis/isolamento & purificação , Bacillus subtilis/fisiologia , Bovinos/microbiologia , Microbioma Gastrointestinal , Probióticos/uso terapêutico , Ração Animal , Animais , Bacillus subtilis/genética , Biodiversidade , Abscesso Encefálico/microbiologia , Abscesso Encefálico/terapia , Broncopneumonia/terapia , Dieta , Modelos Animais de Doenças , Feminino , Microbioma Gastrointestinal/genética , Ensaios de Triagem em Larga Escala , Mucosa Intestinal/crescimento & desenvolvimento , Mucosa Intestinal/microbiologia , Intestinos/microbiologia , Rim/patologia , Lactobacillus , Masculino , Camundongos/crescimento & desenvolvimento , Camundongos/microbiologia , Baço/patologia , Tibet
18.
Folia Microbiol (Praha) ; 64(3): 383-388, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30368648

RESUMO

Cerebral abscesses caused by dark-pigmented Fonsecaea fungi are rare, especially in otherwise healthy individuals. In this case report, we present a 61-year-old man from Moldova, living in the Czech Republic, who had worked as a locksmith on oil platforms in Turkmenistan, Kazakhstan, Sudan, and Iraq since 1999, and was admitted to a neurology ward for a sudden motion disorder of the right leg, dysarthria, and hypomimia. Imaging revealed presence of expansive focus around the left lateral ventricle of the brain and a pronounced peripheral edema. The intracranial infectious focus was excised under intraoperative SonoWand guidance. Tissue samples were histologically positive for dark-pigmented hyphae, suggesting dematiaceous fungi. Therefore, liposomal amphotericin B therapy was initiated immediately. Fonsecaea monophora was provisionally identified using ITS rDNA region sequencing directly from brain tissue. The identification was subsequently confirmed by cultivation and DNA sequencing from culture. The strain exhibited in vitro sensitive to voriconazole (MIC = 0.016 µg/mL) and resistance to amphotericin B (MIC = 4 µg/mL); therefore, the amphotericin B was replaced with voriconazole. Postoperatively, a significant clinical improvement was observed and no additional surgery was required. Based on the literature review, this is the third documented case of cerebral infection due to this pathogen in patients without underlying conditions and the first such case in Europe.


Assuntos
Ascomicetos/isolamento & purificação , Abscesso Encefálico/microbiologia , Abscesso Encefálico/cirurgia , Micoses/diagnóstico , Anfotericina B/uso terapêutico , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Ascomicetos/efeitos dos fármacos , Ascomicetos/genética , Abscesso Encefálico/diagnóstico por imagem , República Tcheca , DNA Ribossômico/genética , Humanos , Imunocompetência , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico por imagem , Resultado do Tratamento
20.
Acta Chir Belg ; 119(2): 125-128, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29198174

RESUMO

BACKGROUND: Nasal dermoid cysts are common tumors in children. Due to anomalies in embryologic development of the nasal complex, sometimes an intracranial extension exists. When these cysts become infected they can lead to meningitis, brain abscess and death. METHODS: We report the case of a 1.5-year-old girl admitted to the paediatric intensive care unit after infection of a nasal dermoid cyst. RESULTS: The infant had a spiking fever and epileptic seizures. She was stabilized, intubated and a CT scan showed a subcutaneous mass with an adjacent zone of encephalitis and brain abscess formation. Neurosurgical interventions were necessary to lower intracranial pressure and control infectious spread. After a hospital stay of 69 days the child could be discharged. Due to her young age, irreversible brain damage is expected. CONCLUSION: Nasal midline dermoid cysts are considered benign swellings. When an intracranial extension exists, infection can lead to deleterious complications. It is important for health care practitioners to be aware of this imminent risk. Suspicion of a nasal midline dermoid cyst should prompt a careful clinical work-up with an ultrasound followed by CT or MRI imaging. The treatment is complete excision to avoid disastrous complications and recurrences.


Assuntos
Actinomicose/terapia , Abscesso Encefálico/etiologia , Cisto Dermoide/complicações , Encefalite/etiologia , Neoplasias Nasais/complicações , Infecções Estreptocócicas/terapia , Actinomicose/microbiologia , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/microbiologia , Abscesso Encefálico/terapia , Cisto Dermoide/diagnóstico , Encefalite/diagnóstico por imagem , Encefalite/microbiologia , Encefalite/terapia , Feminino , Humanos , Lactente , Neoplasias Nasais/diagnóstico , Infecções Estreptocócicas/microbiologia
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