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1.
Internist (Berl) ; 61(5): 518-521, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-32270231

RESUMO

A 33-year-old woman in a seriously ill state presented with hepatic abscesses. The proof of epitheloid-like reactions by biopsy and further serological analysis led to the final diagnosis of tularemia, which represents a rare disease in Germany. Thereafter targeted antibiotic therapy was successfully initiated. The contribution of simultaneously diagnosed celiac disease to the unusual manifestation of tularemia in the liver, remains uncertain.


Assuntos
Francisella tularensis/isolamento & purificação , Abscesso Hepático/microbiologia , Tularemia/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Biópsia , Doença Celíaca/diagnóstico , Feminino , Alemanha , Humanos , Resultado do Tratamento , Tularemia/tratamento farmacológico
2.
Medicine (Baltimore) ; 99(16): e19869, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32312012

RESUMO

INTRODUCTION: Klebsiella pneumoniae liver abscess (KPLA) is often associated with accompanying metastatic complications such as septic pulmonary embolism, brain abscess, and endophthalmitis. Pleural empyema secondary to a KPLA is a very unusual finding, made even more rare with the presence of a hepatopleural fistula. PATIENT CONCERNS: An 81-year-old woman presented with aggravated dyspnea. DIAGNOSIS: The patient was diagnosed with KPLA with empyema through computed tomography (CT) scan findings and pleural fluid culture. INTERVENTIONS: The empyema was drained by thoracostomy, and treatment with empirical antibiotics was initiated. After early removal of the chest tube, the liver abscess as well as the empyema increased. An additional liver abscess drainage procedure was performed. OUTCOMES: The fever resolved and dyspnea improved following drainage of effusion. Three days later, the follow-up chest radiograph showed decreased pleural effusion. CONCLUSION: Pleural empyema is a rare but fatal complication secondary to KPLA. Additionally, the discovery of a hepatopleural fistula on a CT scan (multiplanar reconstruction image) made this case even more rare. Both, the liver abscess and pleural empyema, were effectively drained through the fistula tract with drainage procedure, thoracostomy, and additional liver abscess drainage. Prompt diagnostic evaluation, using an imaging modality such as CT, and early drainage management with intravenous antibiotics can improve clinical outcome.


Assuntos
Empiema Pleural/etiologia , Klebsiella pneumoniae/isolamento & purificação , Abscesso Hepático/complicações , Abscesso Hepático/terapia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Tubos Torácicos/efeitos adversos , Drenagem/métodos , Dispneia/etiologia , Empiema Pleural/diagnóstico por imagem , Empiema Pleural/terapia , Feminino , Humanos , Abscesso Hepático/diagnóstico por imagem , Abscesso Hepático/microbiologia , Toracostomia/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
3.
Emerg Microbes Infect ; 9(1): 320-331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32037975

RESUMO

Background: Multidrug-resistant bacteria, especially those with high virulence, are an emerging problem in clinical settings.Methods: We conducted a multicentre epidemiological and comparative genomic analysis on the evolution, virulence and antimicrobial resistance of carbapenem-resistant Enterobacteriaceae in patients with bacterial liver abscesses from 2012 to 2016.Results: A total of 477 bacterial isolates were collected. Enterobacteriaceae were the main pathogen (89.3%) with K. pneumoniae (52.4%) predominating followed by Escherichia coli (26.8%). All CRKps (3.2%) were of sequence type (ST) 11 and serotypes K47 or K64, and simultaneously possessed acquired blaKPC-2/blaKPC-5 and blaCTX-M-65 together with the multidrug transporter EmrE. Seven Hv-CRKps (five ST11-K47, two ST11-K64) were confirmed by bacteriological test, neutrophil killing assay and Galleria mellonella infection model. Genomic analysis indicated that the emergence of one ST11-K64 Hv-CRKp strain was related to the acquisition of rmpA/rmpA2 genes and siderophore gene clusters, while ST11-K47 Hv-CRKp lacked these traditional virulence genes. Further complete genome analysis of one ST11-K47 Hv-CRKp strain, R16, showed that it acquired a rare plasmid (pR16-Hv-CRKp1) carrying blaKPC-2, blaSHV-12, blaTEM-1, blaCTX-M-65, rmtB and a predicted virulence gene R16_5486 simultaneously.Conclusion: The emergence of the ST11-K47/K64 Hv-CRKps, which are simultaneously multidrug-resistant and hypervirulent, requires urgent control measures to be implemented.


Assuntos
Enterobacteriáceas Resistentes a Carbapenêmicos/isolamento & purificação , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Abscesso Hepático/microbiologia , Idoso , Técnicas de Tipagem Bacteriana , Enterobacteriáceas Resistentes a Carbapenêmicos/classificação , China , Farmacorresistência Bacteriana Múltipla , Feminino , Humanos , Klebsiella pneumoniae/classificação , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Tipagem de Sequências Multilocus , Plasmídeos/genética , Sorogrupo , Virulência
4.
Microbiol Spectr ; 7(3)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31837132

RESUMO

Listeria monocytogenes is a Gram-positive pathogenic bacterium which can be found in soil or water. Infection with the organism can develop after ingestion of contaminated food products. Small and large outbreaks of listeriosis have been described. Listeria monocytogenes can cause a number of clinical syndromes, most frequently sepsis, meningitis, and rhombencephalitis, particularly in immunocompromised hosts. The latter syndrome mimics the veterinary infection in ruminants called "circling disease". Neonatal infection can occur as a result of maternal chorioamnionitis ("early onset" sepsis) or through passage through a birth canal colonized with Listeria from the gastrointestinal tract. ("late onset" meningitis). Treatment of listeriosis is usually with a combination of ampicillin and an aminoglycoside but other regimens have been used. The mortality rate is high, reflecting the combination of an immunocompromised host and an often delayed diagnosis.


Assuntos
Listeria monocytogenes/patogenicidade , Listeriose/epidemiologia , Listeriose/microbiologia , Listeriose/fisiopatologia , Animais , Doenças Biliares/microbiologia , Encefalite/microbiologia , Feminino , Doenças Transmitidas por Alimentos/microbiologia , Gastroenterite/microbiologia , Trato Gastrointestinal/microbiologia , Hepatite/microbiologia , Humanos , Listeriose/diagnóstico , Abscesso Hepático/microbiologia , Meningite/microbiologia , Meningoencefalite/microbiologia , Doenças Musculoesqueléticas/microbiologia , Peritonite/microbiologia , Gravidez , Sepse/microbiologia
5.
Medicine (Baltimore) ; 98(40): e17393, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577747

RESUMO

RATIONALE: Bacteremia caused by polymicrobial infections are rare but dangerous. We report a case of hepatic abscess combined with polymicrobial bacteremia in a 49-year-old male patient after surgery and transcatheter arterial chemoembolization (TACE). PATIENT CONCERNS: The patient was admitted to hospital with metastatic liver cancer for periodic chemotherapy and developed a high fever and tenderness to the liver following surgery and TACE. DIAGNOSIS: Hepatic abscess combined with polymicrobial bacteremia. INTERVENTIONS: The clinician formulated a therapy in accordance with the drug susceptibility test and the empirical drug use for anaerobic bacteria. A comprehensive treatment plan was adopted, on the basis of the combination of nitrazole and imipenem as anti-infection drugs as well as continuous abscess drainage. OUTCOMES: After comprehensive therapy, the patient was ultimately discharged without any residual symptoms. LESSONS: Bloodstream infection caused by multiple bacteria increases the difficulty of anti-infection treatments, leading to poor treatment outcome and high mortality. Therefore, a fast and accurate diagnosis of polymicrobial bacteremia is key for initiation of an effective antimicrobial treatment. Additionally, pre-operative prophylactic antibiotics are advisable when patients have a history of abdominal surgery and are immune-compromised.


Assuntos
Bacteriemia/etiologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Abscesso Hepático/etiologia , Neoplasias Hepáticas/terapia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Carcinoma Hepatocelular/cirurgia , Coinfecção , Drenagem , Humanos , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/microbiologia , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica
6.
J Anim Sci ; 97(11): 4567-4578, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31563955

RESUMO

Liver abscesses in feedlot cattle are detrimental to animal performance and economic return. Tylosin, a macrolide antibiotic, is used to reduce prevalence of liver abscesses, though there is variable efficacy among different groups of cattle. There is an increased importance in better understanding the etiology and pathogenesis of this condition because of growing concern over antibiotic resistance and increased scrutiny regarding use of antibiotics in food animal production. The objective of this study was to compare the microbiomes and antimicrobial resistance genes (resistomes) of feces of feedlot cattle administered or not administered tylosin and in their pen soil in 3 geographical regions with differing liver abscess prevalences. Cattle (total of 2,256) from 3 geographical regions were selected for inclusion based on dietary supplementation with tylosin (yes/no). Feces and pen soil samples were collected before harvest, and liver abscesses were identified at harvest. Shotgun and 16S rRNA amplicon sequencing were used to evaluate the soil and feces. Microbiome and resistome composition of feces (as compared by UniFrac distances and Euclidian distances, respectively) did not differ (P > 0.05) among tylosin or no tylosin-administered cattle. However, feedlot location was associated with differences (P ≤ 0.05) of resistomes and microbiomes. Using LASSO, a statistical model identified both fecal and soil microbial communities as predictive of liver abscess prevalence in pens. This model explained 75% of the variation in liver abscess prevalence, though a larger sample size would be needed to increase robustness of the model. These data suggest that tylosin exposure does not have a large impact on cattle resistomes or microbiomes, but instead, location of cattle production may be a stronger driver of both the resistome and microbiome composition of feces.


Assuntos
Antibacterianos/administração & dosagem , Doenças dos Bovinos/prevenção & controle , Suplementos Nutricionais/análise , Abscesso Hepático/veterinária , Microbiota/efeitos dos fármacos , Tilosina/administração & dosagem , Ração Animal/análise , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Farmacorresistência Bacteriana , Fezes/microbiologia , Feminino , Geografia , Abscesso Hepático/epidemiologia , Abscesso Hepático/microbiologia , Abscesso Hepático/prevenção & controle , Masculino , Metagenômica , Microbiota/genética , Modelos Estatísticos , Prevalência , Microbiologia do Solo
7.
BMC Infect Dis ; 19(1): 719, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31416426

RESUMO

BACKGROUND: Clostridium perfringens can cause various infections, including food poisoning, gas gangrene, cellulitis and fasciitis. C. perfringens septicemia is rare, but is a known cause of hemolysis by damaging red blood cell, and often proves rapidly fatal in emergency department (ED) situations. CASE PRESENTATION: A previously healthy 76-year-old man presented to the ED 8 h after onset of acute abdominal pain and diarrhea. Laboratory examination revealed a large discrepancy between the red blood cell count of 1.91 × 106/mm3 and the hemoglobin level of 10.3 g/dL, suggesting massive intravascular hemolysis. Computed tomography revealed liver abscesses with gas. During ED treatment, the state of the patient rapidly deteriorated and he entered cardiopulmonary arrest. Blood cultures finally identified C. perfringens. CONCLUSION: Intravascular hemolysis and red blood cell (RBC) / hemoglobin (Hb) discrepancy in the presence of infection should prompt ED physicians to consider C. perfringens septicemia and to act quickly to provide appropriate treatment.


Assuntos
Infecções por Clostridium/diagnóstico , Clostridium perfringens/patogenicidade , Gangrena Gasosa/diagnóstico , Hemoglobinas/análise , Abscesso Hepático/microbiologia , Idoso , Bacteriemia/microbiologia , Hemocultura , Infecções por Clostridium/etiologia , Gangrena Gasosa/etiologia , Parada Cardíaca , Hemólise , Humanos , Abscesso Hepático/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X
8.
Infect Immun ; 87(9)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31285251

RESUMO

Klebsiella pneumoniae-induced liver abscess (KLA) is emerging as a leading cause of pyogenic liver abscess worldwide. In recent years, the emergence of hypervirulent K. pneumoniae (hvKp) has been strongly associated with KLA. Unlike classical K. pneumoniae, which generally infects the immunocompromised population, hvKp can cause serious and invasive infections in young and healthy individuals. hvKp isolates are often associated with the K1/K2 capsular types and possess hypermucoviscous capsules. KLA is believed to be caused by K. pneumoniae colonizing the gastrointestinal tract of the host and translocating across the intestinal barrier via the hepatic portal vein into the liver to cause liver abscess. We optimized the isolation of the liver-resident macrophages called Kupffer cells in mice and examined their importance in controlling bacterial loads during hvKp infection in healthy mice. Our study reveals the high capability of Kupffer cells to kill hvKp in vitro despite the presence of the bacterial hypermucoviscous capsule, in contrast to other macrophages, which were unable to phagocytose the bacteria efficiently. Depletion of Kupffer cells and macrophages with liposome-encapsulated clodronate (liposomal clodronate) in both an intraperitoneal and an oral mouse infection model resulted in increased bacterial loads in the livers, spleens, and lungs and increased mortality of the infected mice. Thus, Kupffer cells and macrophages are critical for the control of hvKp infection.


Assuntos
Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/patogenicidade , Macrófagos do Fígado/imunologia , Abscesso Hepático/microbiologia , Macrófagos/imunologia , Animais , Cápsulas Bacterianas , Abscesso Hepático/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Virulência , Fatores de Virulência/imunologia
9.
BMC Infect Dis ; 19(1): 635, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315582

RESUMO

BACKGROUND: The outcomes of deep-seated abscesses attributed to chronic disseminated candidiasis (CDC) in patients with hematological malignancies have rarely been reported in recent years. METHODS: We retrospectively reviewed and analyzed the data of patients with hematological malignancies who received a diagnosis of CDC at a medical center in Taiwan between 2008 and 2013. RESULTS: Sixty-one patients (32 men and 29 women) were diagnosed with CDC. The median age was 51 years (range: 18-83). The overall incidence of CDC was 1.53 per 100 patient-years in patients with hematological malignancies between 2008 and 2013. The highest incidence of CDC was 4.3 per 100 patient-years for acute lymphoblastic leukemia, followed by 3.6 for acute myeloid leukemia. We detected 3 (4.9%) proven, 13 (21.3%) probable, and 45 (73.8%) possible cases of CDC. A total of 13 patients had positive blood cultures for Candida species: C. tropicalis (8), C. albicans (2), C. glabrata (2), and C. famata (1). The median duration of antifungal treatment was 96 days (range: 7-796 days). Serial imaging studies revealed that the resolution rate of CDC was 30.0% at 3 months and 54.3% at 6 months. Five patients (8.2%) had residual lesions that persisted beyond one year. A multivariate analysis of the 90-day outcome revealed that shock was the only independent prognostic factor of 90-day survival in patients with CDC. CONCLUSION: The incidence of CDC did not decrease between 2008 and 2013. Patients with acute leukemia had a higher risk of CDC than those with other hematological malignancies. Imaging studies conducted at 6 months after diagnosis revealed that only half of the patients showed complete resolution. CDC requires prolonged treatment, and serial imaging at 6 months interval is suggested. Shock is the only independent prognostic factor of 90-day survival in patients with CDC.


Assuntos
Candidíase/etiologia , Neoplasias Hematológicas/complicações , Abscesso Hepático/microbiologia , Esplenopatias/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antifúngicos/uso terapêutico , Candida/patogenicidade , Candidíase/diagnóstico por imagem , Candidíase/tratamento farmacológico , Candidíase/epidemiologia , Doença Crônica , Feminino , Neoplasias Hematológicas/microbiologia , Humanos , Abscesso Hepático/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Esplenopatias/etiologia , Taxa de Sobrevida , Taiwan/epidemiologia
10.
Medicine (Baltimore) ; 98(24): e15881, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192920

RESUMO

INTRODUCTION: Because of its infrequent and the lack of clinical data and image finding, the management of acute infections with the hepatosplenic brucella abscesses is challenging. METHODS: There were 10 serologically diagnosed cases with this brucella infection. All patients had fever, 50% patients had upper abdominal pain. Ninety percent patients lived in an urban environment. The localization of lesions included: 30% hepatosplenic, 30% liver, and 40% spleen. RESULTS: Abdominal computed tomography (CT) scans and magnetic resonance imaging (MRI) demonstrated hepatosplenomegaly, with multiple small abscess lesions of various sizes in the acute stage of brucellosis, with the largest diameter of 1.5 cm in the liver. After contrast-enhanced CT and MRI findings, the arterial phase in which the enhancing area of lesions was thick, revealed multifocal hypodense or hypointense lesions of various sizes. These lesions manifested distinct boundary, which was intensified obviously in portal venous phase. CONCLUSION: Our results indicate that early CT or MRI dynamic contrast enhancement of suspected cases could improve rapid diagnosis. However, diagnostic criteria remain problematic and diagnosis is mostly based on a combination of clinical suspicion, serologic markers, and radiologic findings.


Assuntos
Brucelose/diagnóstico por imagem , Abscesso Hepático/diagnóstico por imagem , Imagem Multimodal/métodos , Esplenomegalia/diagnóstico por imagem , Adolescente , Idoso , Brucelose/tratamento farmacológico , China/etnologia , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Feminino , Humanos , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/microbiologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rifampina/administração & dosagem , Rifampina/uso terapêutico , Esplenomegalia/tratamento farmacológico , Esplenomegalia/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
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
12.
J Infect Chemother ; 25(12): 1047-1049, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31196773
13.
Pol J Microbiol ; 68(2): 247-254, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31250595

RESUMO

Gastric microbiota provides a biological barrier against the invasion of foreign pathogens from the oral cavity, playing a vital role in maintaining gastrointestinal health. Klebsiella spp. of oral origin causes various infections not only in gastrointestinal tract but also in other organs, with Klebsiella pneumoniae serotype K1 resulting in a liver abscess (KLA) through oral inoculation in mice. However, the relationship between gastric microbiota and the extra-gastrointestinal KLA infection is not clear. In our study, a 454 pyrosequencing analysis of the bacterial 16S rRNA gene shows that the composition of gastric mucosal microbiota in mice with or without KLA infection varies greatly after oral inoculation with K. pneumoniae serotype K1 isolate. Interestingly, only several bacteria taxa show a significant change in gastric mucosal microbiota of KLA mice, including the decreased abundance of Bacteroides, Alisptipes and increased abundance of Streptococcus. It is worth noting that the abundance of Klebsiella exhibits an obvious increase in KLA mice, which might be closely related to KLA infection. At the same time, the endogenous antibiotics, defensins, involved in the regulation of the bacterial microbiota also show an increase in stomach and intestine. All these findings indicate that liver abscess caused by K. pneumoniae oral inoculation has a close relationship with gastric microbiota, which might provide important information for future clinical treatment.Gastric microbiota provides a biological barrier against the invasion of foreign pathogens from the oral cavity, playing a vital role in maintaining gastrointestinal health. Klebsiella spp. of oral origin causes various infections not only in gastrointestinal tract but also in other organs, with Klebsiella pneumoniae serotype K1 resulting in a liver abscess (KLA) through oral inoculation in mice. However, the relationship between gastric microbiota and the extra-gastrointestinal KLA infection is not clear. In our study, a 454 pyrosequencing analysis of the bacterial 16S rRNA gene shows that the composition of gastric mucosal microbiota in mice with or without KLA infection varies greatly after oral inoculation with K. pneumoniae serotype K1 isolate. Interestingly, only several bacteria taxa show a significant change in gastric mucosal microbiota of KLA mice, including the decreased abundance of Bacteroides, Alisptipes and increased abundance of Streptococcus. It is worth noting that the abundance of Klebsiella exhibits an obvious increase in KLA mice, which might be closely related to KLA infection. At the same time, the endogenous antibiotics, defensins, involved in the regulation of the bacterial microbiota also show an increase in stomach and intestine. All these findings indicate that liver abscess caused by K. pneumoniae oral inoculation has a close relationship with gastric microbiota, which might provide important information for future clinical treatment.


Assuntos
Biota , Disbiose/complicações , Mucosa Gástrica/microbiologia , Infecções por Klebsiella/complicações , Abscesso Hepático/complicações , Animais , Análise por Conglomerados , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Modelos Animais de Doenças , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/patologia , Abscesso Hepático/microbiologia , Abscesso Hepático/patologia , Camundongos , Filogenia , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
14.
BMJ Case Rep ; 12(6)2019 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-31229981

RESUMO

Mycobacterium tuberculosis complex disease (tuberculosis (TB)) of the liver is rare and liver abscesses as a result are even rarer. In an immunocompetent individual, the disease tends to be localised. To the best of our knowledge, we report one of the most severe TB involvements of the liver in an immunocompetent individual. A young woman with a history of previous TB infection, presented in septic shock. Scans showed a liver filled with possible abscesses, one of which was aspirated and confirmed TB. Multiple HIV tests were negative but she remained lymphopaenic. Although she improved substantially with anti-tuberculous treatment, she later developed non-tuberculous central nervous system disease that we were unable to fully explain. Despite a stormy recovery period, she continues to do well.


Assuntos
Abscesso Hepático/microbiologia , Fígado/microbiologia , Choque Séptico/etiologia , Tuberculose Hepática/microbiologia , Adolescente , Antibióticos Antituberculose/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Imunocompetência , Fígado/diagnóstico por imagem , Fígado/patologia , Abscesso Hepático/diagnóstico por imagem , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/patologia , Mycobacterium tuberculosis/isolamento & purificação , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Tuberculose Hepática/diagnóstico por imagem , Tuberculose Hepática/tratamento farmacológico
15.
Anaerobe ; 59: 35-37, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31103532

RESUMO

Dialister pneumosintes is an obligate anaerobic Gram-negative rod associated with infections of the oral cavity. We report on a previously healthy, 51-year-old woman who presented with a liver abscess caused by Dialister pneumosintes as a complication of a dental abscess. The microorganism was identified by using a broad-range bacterial 16S rRNA gene PCR in the liver exudate. The patient was cured after abscess drainage and 4-week antibiotic treatment. Our case highlights the importance of a good history and physical examination when taking care of patients admitted for pyogenic liver abscess.


Assuntos
Infecções por Bactérias Gram-Negativas/diagnóstico , Infecções por Bactérias Gram-Negativas/patologia , Abscesso Hepático/diagnóstico , Abscesso Hepático/patologia , Veillonellaceae/isolamento & purificação , Antibacterianos/administração & dosagem , DNA Bacteriano/química , DNA Bacteriano/genética , DNA Ribossômico/química , DNA Ribossômico/genética , Drenagem , Feminino , Infecções por Bactérias Gram-Negativas/microbiologia , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Abscesso Hepático/microbiologia , Abscesso Hepático/terapia , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , Doenças Estomatognáticas/complicações , Resultado do Tratamento
16.
Z Gastroenterol ; 57(5): 600-605, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-31083748

RESUMO

We report on a 40-year-old patient who presented with fever, right upper abdominal pain, right-sided chest pain and acute dyspnea. Imaging revealed several liver abscesses, as well as extensive right pleural empyema. Sixteen weeks previously, the patient underwent tooth extraction of the third molars (18, 28, 38, 48) and a first molar (46), and systematic closed periodontitis treatment. Four different species of the physiological microbiota of the oral cavity were detected in the pleura or liver abscess punctate (Streptococcus anginosus, Streptococcus constellatus, Actinomyces odontolyticus, Prevotella denticola). An underlying immune defect was ruled out. Ultrasound-guided drainage of liver abscesses and surgical treatment of pleural empyema by video-assisted thoracoscopy (VATS) and insertion of thoracic suction drains was performed, accompanied by targeted antibiotic therapy. Over a course of 6 weeks, the patient recovered completely. The case report illustrates severe infectious side effects of major dental interventions, and it critically summarizes current dental guideline recommendations on peri-interventional antimicrobial therapy. Therefore, a good clinical follow up after major tooth extractions is imperative.


Assuntos
Infecções Bacterianas/complicações , Empiema Pleural/diagnóstico por imagem , Abscesso Hepático/diagnóstico por imagem , Extração Dentária/efeitos adversos , Actinomyces viscosus/isolamento & purificação , Adulto , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Drenagem , Empiema Pleural/microbiologia , Empiema Pleural/cirurgia , Humanos , Abscesso Hepático/microbiologia , Abscesso Hepático/cirurgia , Masculino , Pleura/diagnóstico por imagem , Pleura/cirurgia , Complicações Pós-Operatórias , Prevotella intermedia/isolamento & purificação , Streptococcus anginosus/isolamento & purificação , Streptococcus constellatus/isolamento & purificação , Cirurgia Torácica Vídeoassistida , Toracoscopia , Resultado do Tratamento
17.
Anaerobe ; 57: 90-92, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30953694

RESUMO

We report the case of a patient with advanced gastric cancer and multiple liver metastases, who presented with bacteremia and hepatic gas gangrene caused by Clostridium novyi (C. novyi). The gas gangrene caused abscesses to form within metastatic lesions. This case highlights the antitumor effects of C. novyi in human.


Assuntos
Clostridium/isolamento & purificação , Gangrena Gasosa/diagnóstico , Gangrena Gasosa/patologia , Abscesso Hepático/diagnóstico , Abscesso Hepático/patologia , Neoplasias Hepáticas/complicações , Neoplasias Gástricas/complicações , Idoso de 80 Anos ou mais , Clostridium/classificação , Gangrena Gasosa/microbiologia , Humanos , Abscesso Hepático/microbiologia , Neoplasias Hepáticas/diagnóstico , Masculino , Neoplasias Gástricas/secundário
19.
BMJ Case Rep ; 12(3)2019 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-30904890

RESUMO

A 70-year-old man presented with acute wrist pain concerning for septic arthritis. Shortly thereafter, he developed acute monocular vision loss and was diagnosed with endogenous endophthalmitis. Subsequent imaging revealed numerous visceral abscesses and a mycotic abdominal aortic aneurysm. Cultures, in conjunction with the clinical syndrome, were strongly suggestive of hypervirulent Klebsiella pneumoniae syndrome (hvKP). hvKP syndrome may present with multiple sites of infection or subsequent metastatic spread may develop; the liver, lungs, central nervous system and eye are most commonly involved. Prompt source control and intravenous antibiotic therapy leads to a cure in the majority of patients. This case highlights the risk factors, presentation, management and prognosis of this disease as well as its increasing incidence in North America and Europe.


Assuntos
Ceftriaxona/administração & dosagem , Endoftalmite/microbiologia , Infecções por Klebsiella/diagnóstico , Klebsiella pneumoniae/isolamento & purificação , Abscesso Hepático/microbiologia , Administração Intravenosa , Idoso , Artrite Infecciosa , Ceftriaxona/farmacologia , Diagnóstico Diferencial , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Masculino , Resultado do Tratamento
20.
Anaerobe ; 56: 51-56, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30771459

RESUMO

Fusobacterium necrophorum is a Gram negative, rod-shaped and aero tolerant anaerobe. In animals, it is an opportunistic pathogen frequently associated with necrotic infections, generally called necrobacillosis, such as calf diphtheria, foot rot and liver abscesses in cattle. Two subspecies exist: subsp. necrophorum and subsp. funduliforme. Among several virulence factors, leukotoxin (Lkt) is considered to be a major factor and a protective antigen. The objective of the study was to utilize BL3 cells and measure the release of lactic dehydrogenase to quantify Lkt activity of F. necrophorum. The assay was used to examine the effects of storage and handling conditions, growth media, polymyxin B addition on the cytotoxicity and evaluate Lkt activities of F. necrophorum strains isolated from bovine liver abscesses and foot rot. The Lkt activity peaked at 9 h of incubation. There was a significant decrease in the cytotoxicity measured in the samples after each freeze and thaw cycle. No difference was observed in the cytotoxicity for the samples handled aerobically versus anaerobically. Lkt activities of strains grown in anaerobic Brain-Heart Infusion broth were higher compared to Vegitone broth. A small reduction in the cytotoxicity activity was observed after the addition of polymyxin. The Lkt activity was consistently higher in strains of subsp. necrophorum than subsp. funduliforme of liver abscess origin. Among the strains isolated from cattle foot rot, Lkt activities of subsp. necrophorum strains appear to be much more variable. Use of BL3 cells in combination of lactic acid dehydrogenase assay appears to be a simple and valid assay to measure Lkt activity of F. necrophorum.


Assuntos
Doenças dos Bovinos/microbiologia , Exotoxinas/toxicidade , Infecções por Fusobacterium/veterinária , Fusobacterium necrophorum/isolamento & purificação , Fusobacterium necrophorum/patogenicidade , Fatores de Virulência/toxicidade , Animais , Bovinos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Pododermatite Necrótica dos Ovinos/microbiologia , Infecções por Fusobacterium/microbiologia , L-Lactato Desidrogenase/análise , Abscesso Hepático/microbiologia , Abscesso Hepático/veterinária
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