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1.
BMC Infect Dis ; 20(1): 354, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429852

RESUMO

BACKGROUND: Mediastinitis caused by hematogenous spread of an infection is rare. We report the first known case of community-acquired mediastinitis from hematogenous origin in an immunocompetent adult. This rare invasive infection was due to Panton-Valentine Leucocidin-producing (PVL+) methicillin-susceptible Staphylococcus aureus (MSSA). CASE PRESENTATION: A 22-year-old obese man without other medical history was hospitalized for febrile precordial chest pain. He reported a cutaneous back abscess 3 weeks before. CT-scan was consistent with mediastinitis and blood cultures grew for a PVL+ MSSA. Intravenous clindamycin (600 mg t.i.d) and cloxacillin (2 g q.i.d.), secondary changed for fosfomycin (4 g q.i.d.) because of a related toxidermia, was administered. Surgical drainage was performed and confirmed the presence of a mediastinal abscess associated with a fistula between the mediastinum and right pleural space. All local bacteriological samples also grew for PVL+ MSSA. In addition to clindamycin, intravenous fosfomycin was switched to trimethoprim-sulfamethoxazole after 4 weeks for a total of 10 weeks of antibiotics. CONCLUSIONS: We present the first community-acquired mediastinitis of hematogenous origin with PVL+ MSSA. Clinical evolution was favorable after surgical drainage and 10 weeks of antibiotics. The specific virulence of MSSA PVL+ strains played presumably a key role in this rare invasive clinical presentation.


Assuntos
Toxinas Bacterianas/análise , Infecções Comunitárias Adquiridas/diagnóstico , Exotoxinas/análise , Imunocompetência , Leucocidinas/análise , Mediastinite/diagnóstico , Mediastinite/microbiologia , Infecções Estafilocócicas/diagnóstico , Staphylococcus aureus/metabolismo , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Abscesso/cirurgia , Antibacterianos/uso terapêutico , Anti-Infecciosos Urinários/uso terapêutico , Clindamicina/uso terapêutico , Infecções Comunitárias Adquiridas/tratamento farmacológico , Drenagem , Humanos , Masculino , Mediastinite/tratamento farmacológico , Mediastinite/imunologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/imunologia , Infecções Estafilocócicas/microbiologia , Resultado do Tratamento , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Adulto Jovem
2.
Int J Syst Evol Microbiol ; 70(6): 3614-3624, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32368999

RESUMO

A total of 34 Corynebacterium sp. strains were isolated from caseous lymph node abscesses of wild boar and roe deer in different regions of Germany. They showed slow growth on Columbia sheep blood agar and sparse growth on Hoyle's tellurite agar. Cellular fatty acid analysis allocated them in the C. diphtheriae group of genus Corynebacterium. MALDI-TOF MS using specific database extensions and rpoB sequencing resulted in classification as C. ulcerans. Their quinone system is similar to C. ulcerans, with major menaquinone MK-8(H2). Their complex polar lipid profile includes major lipids phosphatidylinositol, phosphatidylinositol-mannoside, diphosphatidylglycerol, but also unidentified glycolipids, distinguishing them clearly from C. ulcerans. They ferment glucose, ribose and maltose (like C. ulcerans), but do not utilise d-xylose, mannitol, lactose, sucrose and glycogen (like C. pseudotuberculosis). They showed activity of catalase, urease and phospholipase D, but variable results for alkaline phosphatase and alpha-glucosidase. All were non-toxigenic, tox gene bearing and susceptible to clindamycin, penicillin and erythromycin. In 16SrRNA gene and RpoB protein phylogenies the strains formed distinct brancheswith C. ulcerans as nearest relative.Whole genome sequencing revealed the unique sequence type 578, a distinctbranch in pangenomic core genome MLST, average nucleotide identities <91%, enhancedgenome sizes (2.55 Mbp) and G/C content (54.4 mol%) compared to related species.These results suggest that the strains represent a novel species, for which wepropose the name Corynebactriumsilvaticum sp. nov., based on their first isolation from forest-dwellinggame animals. The type strain isKL0182T (= CVUAS 4292T = DSM 109166T = LMG 31313T= CIP 111 672T).


Assuntos
Abscesso/microbiologia , Corynebacterium/classificação , Cervos/microbiologia , Linfonodos/microbiologia , Filogenia , Sus scrofa/microbiologia , Animais , Técnicas de Tipagem Bacteriana , Composição de Bases , Corynebacterium/isolamento & purificação , DNA Bacteriano/genética , Ácidos Graxos/química , Alemanha , Glicolipídeos/química , Linfonodos/patologia , Tipagem de Sequências Multilocus , Fosfolipídeos/química , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Suínos , Vitamina K 2/análogos & derivados , Vitamina K 2/química , Sequenciamento Completo do Genoma
4.
Gene ; 741: 144566, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32171826

RESUMO

Bacteria of the genusGlutamicibacterare considered ubiquitous because they can be found in soil, water and air. They have already been isolated from different habitats, including different types of soil, clinical samples, cheese and plants. Glutamicibacter creatinolyticus is a Gram-positive bacterium important to various biotechnological processes, however, as a pathogen it is associated to urinary tract infections and bacteremia. Recently,Glutamicibacter creatinolyticusLGCM 259 was isolated from a mare, which displayed several diffuse subcutaneous nodules with heavy vascularization. In this study, sequencing, genomic analysis ofG. creatinolyticusLGCM 259 and comparative analyseswere performedamong 4representatives of different members of genusfromdifferent habitats, available in the NCBI database. The LGCM 259 strain's genome carries important factors of bacterial virulence that are essential in cell viability, virulence, and pathogenicity. Genomic islands were predicted for 4 members of genusGlutamicibacter,showing ahigh number of GEIs,which may reflect a high interspecific diversity and a possible adaptive mechanism responsible for the survival of each species in its specific niche. Furthermore,G. creatinolyticusLGCM 259 sharessyntenicregions, albeit with a considerable loss of genes, in relation to the other species. In addition,G. creatinolyticusLGCM 259 presentsresistancegenes to 6 differentclasses ofantibiotics and heavy metals, such as: copper, arsenic, chromium and cobalt-zinc-cadmium.Comparative genomicsanalysescouldcontribute to the identification of mobile genetic elements particular to the speciesG. creatinolyticuscompared to other members of genus. The presence of specific regions inG. creatinolyticuscould be indicative of their rolesin host adaptation, virulence, and the characterization ofastrain that affects animals.


Assuntos
Abscesso/genética , Adaptação Fisiológica/genética , Variação Genética , Micrococcaceae/genética , Abscesso/microbiologia , Abscesso/veterinária , Animais , Genoma Bacteriano , Ilhas Genômicas/genética , Genômica , Cavalos/microbiologia , Masculino , Micrococcaceae/patogenicidade , Filogenia , Virulência/genética
5.
Rev. iberoam. fertil. reprod. hum ; 37(1): 0-0, ene.-mar. 2020.
Artigo em Espanhol | IBECS | ID: ibc-187706

RESUMO

Presentamos un caso de absceso pélvico en mujer de 48 años portadora de un DIU en el que se aisló un microogsnismo poco habitual en estos procesos como es Fusobacterium necrophorum. Aprovechamos el caso para ilustrar a la luz de los nuevos descubrimientos sobre el microbioma endometrial el viejo debate acerca de si el hallazgo en los cultivos de abscesos pélvicos de portadoras de DIUs de microorganismos anaerobios poco comunes indica o no un mayor riesgo de padecer estos procesos en estas mujeres


We present a case of pelvic abscess in a 48-year-old woman with an IUD and an unusual microognism isolated such as Fusobacterium necrophorum. We use it to illustrate on the new discoveries about the endometrial microbiome the old debate about whether the finding in cultures of pelvic abscesses of carriers of IUDs of rare anaerobic microorganisms indicates or not an increased risk of suffering these processes in long term IUD users


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Abscesso/diagnóstico , Abscesso/microbiologia , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/microbiologia , Dispositivos Intrauterinos , Fusobacterium necrophorum/isolamento & purificação , Infecções por Fusobacterium/diagnóstico , Abscesso/cirurgia , Doenças Ovarianas/cirurgia
7.
BMC Infect Dis ; 20(1): 47, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941460

RESUMO

BACKGROUND: Ureaplasma urealyticum is a fastidious bacteria which lacks a cell wall. Extragenital infections are rare in immunocompetent adults. There are few literature reports of perinephric abscess. We present a case of non-resolving multifocal "culture-negative" abscesses in a hypogammaglobulinemic adult female due to U. urealyticum. CASE PRESENTATION: 66-year-old female with a one-week history of fever, malaise and new right hip and leg pain. Past medical history was notable for chronic pancytopenia secondary to in remission B cell follicular lymphoma, ESRD on intermittent hemodialysis with bilateral nephrostomy tubes and Crohn's. CT abdomen/pelvis revealed a small left perinephric hematoma and proximal right femur fluid collection. Persistent right thigh pain led to additional ultrasound with anterior thigh collection and CT revealed an irregular rim-enhancing fluid collection in the left posterior pararenal space. Antimicrobial therapy included ertapenem and vancomycin followed by meropenem, trimethoprim-sulfamethoxazole, daptomycin and metronidazole in setting of persistent culture-negative results and clinical deterioration. Following detection of U. urealyticum by 16S rDNA PCR in both left pararenal and right trochanteric bursa abscesses doxycycline was started. Despite this, the patient died four days later. CONCLUSIONS: Disseminated infection by U. urealyticum has been documented in immunocompromised adult patients with few reports of perinephric abscess. We propose that ascending genitourinary route led to perinephric abscess. The multiple disseminated fluid collections make it highly suspicious for hematogenous spread given the lack of radiographic enhancement to suggest contiguous spread. Diagnosis and treatment of U. urealyticum-disseminated infection is extremely challenging as culture is laborious and not routinely performed. Furthermore, the lack of cell wall renders beta-lactams and vancomycin ineffective and therefore requirement for "atypical" coverage. Early diagnosis and treatment are key to prevent further complications and death.


Assuntos
Hospedeiro Imunocomprometido , Infecções por Ureaplasma/diagnóstico , Ureaplasma urealyticum/genética , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Idoso , Antibacterianos/uso terapêutico , DNA Bacteriano/análise , DNA Ribossômico/análise , Suscetibilidade a Doenças/imunologia , Doxiciclina/uso terapêutico , Evolução Fatal , Feminino , Humanos , Reação em Cadeia da Polimerase , Infecções por Ureaplasma/tratamento farmacológico , Infecções por Ureaplasma/microbiologia
8.
World Neurosurg ; 134: 67-75, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31629141

RESUMO

BACKGROUND: Central nervous system (CNS) melioidosis is rare. Clinical presentations depend on the region of endemicity. Despite treatment, neurologic disease has relatively high mortality rates. Less than 80 cases of CNS involvement have been reported. METHODS: A literature review was performed by searching online databases for melioidosis presenting as osteomyelitis or scalp/extra-axial abscess (OSEAA). In addition, 3 similar cases managed at my institute have been presented. RESULTS: Including this report of 3 cases, 20 additional cases have been reported. Of these, 12 cases (60%) were from India. The mean age of patients was 45.5 years (range, 29-74 years), and none were in the pediatric age group. Patients in the fifth to sixth decades were most frequently affected. The male to female ratio was 5.3:1. Eleven patients had predisposing factors. Fever, headache, and scalp swelling were the most common features. Five cases had history of previous melioid infection. Seven cases had systemic disease. Debridement was performed in 11 cases. The average intensive phase treatment duration was 4.6 weeks (range, 2-8 weeks) and 5.5 months (range, 3-12 months) for the maintenance phase. Mean follow-up duration was 13.5 months (range, 2 weeks-40 months). Two deaths (10%) were reported, and 1 case of residual frontal abscess had relapse. CONCLUSIONS: Cranial melioidosis presenting as OSEAA is associated with good outcome, in contrast with other neurologic presentations. Intensive phase for at least 2-3 weeks followed by maintenance phase for 3-6 months is the standard treatment, similar to other melioid presentations. A high degree of suspicion and accurate identification of the organism is crucial. Patients need to be monitored for recurrences, both clinically and radiologically.


Assuntos
Abscesso/microbiologia , Encefalopatias/microbiologia , Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Melioidose/patologia , Osteomielite/microbiologia , Abscesso/patologia , Adulto , Encefalopatias/patologia , Infecções Bacterianas do Sistema Nervoso Central/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/patologia
10.
Ann Otol Rhinol Laryngol ; 129(4): 376-379, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31762293

RESUMO

OBJECTIVES: Assess the outcome of Intravenous (IV) dexamethasone in the treatment of pediatric deep neck space infections (DNSI) in combination with IV antibiotics. METHODS: Retrospective chart review of pediatric patients admitted for a DNSI from March 2014 to June 2016. Patient characteristics including demographics, abscess type, antibiotic, dexamethasone, surgery, culture, and length of stay (LOS) were obtained. Patients treated with antibiotics alone versus antibiotics and dexamethasone were compared. Primary outcome measures were rate of surgical drainage and LOS. RESULTS: Overall 153 patients with DNSI were identified, including 62 lateral neck, 18 parapharyngeal, 40 peritonsillar, 32 retropharyngeal, and 1 submandibular. All patients received antibiotics. Dexamethasone was used in 35% of patients. The rate of surgical drainage in the dexamethasone and non-dexamethasone group was 36% and 53% respectively (P = .043). LOS was shorter for the dexamethasone group (2.9 days) compared to the non-dexamethasone group (3.8 days) but was non-significant, P-value-.09. The most common microorganisms cultured were MRSA (25), MSSA (11), and Streptococcus pyogenes (10). CONCLUSION: Dexamethasone use was associated with a decreased rate of surgical drainage in pediatric patients with DNSI. Further prospective study is needed to determine the role of dexamethasone in treatment.


Assuntos
Abscesso , Dexametasona/administração & dosagem , Drenagem , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Pescoço , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus pyogenes/isolamento & purificação , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Abscesso/cirurgia , Administração Intravenosa , Antibacterianos/uso terapêutico , Anti-Inflamatórios/administração & dosagem , Criança , Pré-Escolar , Drenagem/métodos , Drenagem/estatística & dados numéricos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Esvaziamento Cervical/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Estudos Retrospectivos , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/cirurgia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/cirurgia , Estados Unidos
11.
Indian J Tuberc ; 66(4): 433-436, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31813428

RESUMO

INTRODUCTION: WHO endorsed Xpert MTB/RIF assay has proven to be rapid with results obtained within 2h. The evidence base regarding the use of Xpert MTB/RIF in pulmonary TB is strong. Relatively few performance data have been published to date on detection of Mycobacterium tuberculosis in aspirated pus specimens from abscesses. OBJECTIVES: The aim of the study was to determine the sensitivity and specificity of Xpert MTB/RIF assay for the detection of M. tuberculosis and rifampicin resistance in aspirated pus specimens using culture on Lowenstein Jensen (LJ) medium and economic variant of proportion method (PM) for drug susceptibility testing (DST) as the reference standard. RESULTS: Xpert MTB/RIF assay in comparison to conventional reference method showed sensitivity and specificity of 76.19% and 68.75% for detection of M. tuberculosis and 71.4% and 100% for detection of rifampicin resistance respectively. CONCLUSION: The simplicity, sensitivity, speed and automation makes this assay a very promising diagnostic test for detection of M. tuberculosis and rifampicin resistance in aspirated pus specimens.


Assuntos
Antibióticos Antituberculose/farmacologia , Mycobacterium tuberculosis/efeitos dos fármacos , Rifampina/farmacologia , Tuberculose Pulmonar/tratamento farmacológico , Abscesso/microbiologia , Antibióticos Antituberculose/uso terapêutico , Testes Diagnósticos de Rotina , Humanos , Índia , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Rifampina/uso terapêutico , Sensibilidade e Especificidade , Supuração/microbiologia , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia
12.
BMC Endocr Disord ; 19(1): 130, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31791298

RESUMO

BACKGROUND: Abscess in the thyroid gland is a rare but severe infectious disease. The condition can have anatomic or iatrogenic underlying causes. If untreated it could be fatal. Pathogens vary considerably. Treatment is intravenous antibiotics, drainage, and sometimes surgery. METHODS: The electronic medical records of all adult patients with acute thyroiditis 2003-2017 treated at the Karolinska University Hospital (catchment area 2 million) in Sweden were systematically reviewed. RESULTS: Five patients were found in the catchment area. One patient from another region but known to us was also included. Thus, six patients (aged 28-73 years) were included in the study. Median length of hospital stay was 7.5 days (4-79 days). All were treated with antibiotics (intravenous n = 5, oral n = 1). Total antibiotic treatment duration was 13.5 days (10-41 days). Blood cultures were positive in three (streptococcus pneumonia, streptococci sanguineous, pepto streptococci), deep tissue culture in three (Escherichia coli, Candida, Hemophilic influenza) and no positive culture at all in two. Drainage was used in three patients. All patients recovered without recurrences. Surgery was performed twice in the acute phase in one. There was no recurrence during 7 years (3-12) of follow-up, but one patient died after three years (severe heart failure and pneumonia). CONCLUSION: Thyroid abscess in adults is extremely rare nowadays in the developed world. With prompt antibiotic therapy, drainage and in some cases thyroidectomy the prognosis seems favourable.


Assuntos
Abscesso/diagnóstico , Doenças da Glândula Tireoide/diagnóstico , Tireoidite Supurativa/diagnóstico , Abscesso/microbiologia , Abscesso/terapia , Doença Aguda , Adulto , Idoso , Antibacterianos/uso terapêutico , Biópsia por Agulha Fina , Candidíase/tratamento farmacológico , Drenagem , Infecções por Escherichia coli/tratamento farmacológico , Feminino , Infecções por Haemophilus/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Infecções Estreptocócicas/tratamento farmacológico , Doenças da Glândula Tireoide/microbiologia , Doenças da Glândula Tireoide/terapia , Tireoidectomia , Tireoidite Supurativa/microbiologia , Tireoidite Supurativa/terapia , Resultado do Tratamento
13.
Int J Mycobacteriol ; 8(4): 403-405, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31793514

RESUMO

Muscle's tuberculosis (TB) without coexistent active skeletal involvement is very rare. We presented a case of tuberculous abscess of longissimus muscle in a young immunocompetent female. Magnetic resonance imaging showed a well-circumscribed lesion in the longissimus muscle. No bony abnormality was noticed. An ultrasound-guided biopsy revealed the presence of granulomatous features on cytological pathology. A good response was seen with antitubercular treatment. TB should be considered in the differential diagnosis of any unexplained soft-tissue swelling in people born in tubercular endemic areas. To the best of our knowledge, our observation is the third reported case in immunocompetent patient.


Assuntos
Abscesso/microbiologia , Músculos Paraespinais/microbiologia , Tuberculose/complicações , Tuberculose/diagnóstico por imagem , Adulto , Antituberculosos/uso terapêutico , Diagnóstico Diferencial , Feminino , Humanos , Imunocompetência , Imagem por Ressonância Magnética , Mycobacterium tuberculosis/efeitos dos fármacos , Músculos Paraespinais/patologia , Coluna Vertebral/diagnóstico por imagem , Resultado do Tratamento
14.
BMJ Case Rep ; 12(12)2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31796455

RESUMO

Our case report describes a patient with a common presenting complaint yet an uncommon infection. Our patient presented with a fluctuant breast mass diagnosed as a breast abscess. An aspirate sample was sent for culture and sensitivities, which revealed the presence of Actinomyces turicensis and the anaerobe Peptoniphilus harei She was therefore prescribed several weeks of amoxicillin and metronidazole, and made a full recovery. There are only three case reports describing A. turicensis as a causative organism for breast abscess, one of which had also occurred in our department. One case also showed the additional presence of P. harei Our findings reveal a growing need for increasing clinician awareness of A. turicensis and the importance of aspirate sample culture and sensitivity.


Assuntos
Abscesso/microbiologia , Actinomycetaceae/isolamento & purificação , Doenças Mamárias/microbiologia , Firmicutes/isolamento & purificação , Abscesso/diagnóstico , Abscesso/tratamento farmacológico , Adulto , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Doenças Mamárias/diagnóstico , Doenças Mamárias/tratamento farmacológico , Feminino , Humanos , Metronidazol/administração & dosagem
15.
Am J Case Rep ; 20: 1961-1965, 2019 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-31884507

RESUMO

BACKGROUND Pseudopropionibacterium propionicum was called Propionibacterium propionicum until a recent taxonomy change in 2016. Diseases caused by P. propionicum resemble actinomycosis and thus differ dramatically from the infectious syndromes caused by common cutaneous Propionibacterium spp. However, if treating physicians are not familiar with P. propionicum and its clinical presentations, it is possible for them to regard it as a skin contaminant such as Cutibacterium acnes (formerly Propionibacterium acnes). CASE REPORT A 71-year-old man with past surgical history of right pneumonectomy was admitted with right chest wall abscess and right empyema. The chest wall abscess was drained surgically, and the empyema was drained via a chest tube. The abscess culture took 5 days to grow beaded branching Gram-positive rods, and 15 days to identify them as P. propionicum. The patient received 17 days of ceftriaxone and 4 weeks of doxycycline. However, he experienced a relapse of the chest wall abscess and right empyema 4 months after discontinuation of doxycycline. Cultures from the chest wall abscess and empyema grew P. propionicum again. We treated him with ceftriaxone for 6 months followed by minocycline for 7 months along with adequate drainage. CONCLUSIONS It is important to recognize that P. propionicum can cause thoracic actinomycosis and will likely require the prolonged treatment course typical for actinomycotic disease, which is 2 to 8 weeks of intravenous antibiotic therapy followed by 6 to 12 months of oral antibiotic therapy.


Assuntos
Abscesso/microbiologia , Actinomicose/microbiologia , Propionibacteriaceae/isolamento & purificação , Doenças Torácicas/microbiologia , Parede Torácica/microbiologia , Actinomicose/diagnóstico , Idoso , Humanos , Masculino
16.
BMC Infect Dis ; 19(1): 1052, 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31842764

RESUMO

BACKGROUND: The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. METHODS: In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher's exact test was used for comparisons between categorical variables, and student's t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. RESULTS: The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). CONCLUSIONS: Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.


Assuntos
Endocardite Bacteriana/microbiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/microbiologia , Estreptococos Viridans/isolamento & purificação , Abscesso/microbiologia , Adulto , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/microbiologia , Ecocardiografia , Endocardite Bacteriana/sangue , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Feminino , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/microbiologia , Sistema de Registros , Estudos Retrospectivos , Staphylococcus aureus/genética , Abuso de Substâncias por Via Intravenosa/microbiologia , Suécia , Resultado do Tratamento , Estreptococos Viridans/genética
17.
BMC Vet Res ; 15(1): 467, 2019 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-31864375

RESUMO

BACKGROUND: Listeria monocytogenes is a promising therapeutic vaccine vector for cancer immunotherapy. Although highly attenuated, three cases of systemic listeriosis have been reported in people following treatment with Listeria-based therapeutic vaccines. This complication has thus far not been reported in canine patients. CASE PRESENTATION: A dog previously diagnosed with osteoblastic osteosarcoma was presented for care following administration of three doses of the Canine Osteosarcoma Vaccine-Live Listeria Vector. On routine staging chest radiographs, mild sternal lymphadenopathy and a right caudoventral thoracic mass effect were noted. Further evaluation of the mass effect with computed tomography and ultrasound revealed a cavitated mass associated with the 7th right rib. Aspirates of the mass cultured positive for Listeria monocytogenes. The mass and associated ribs were surgically removed. Histopathology was consistent with metastatic osteoblastic osteosarcoma. Treatment was continued with doxorubicin chemotherapy and at the time of publication, the dog was alive over 1 year following diagnosis with no evidence of further disease progression. Genotyping of the abscess-derived L. monocytogenes was consistent with the vaccine strain. CONCLUSIONS: This case represents the first veterinary case to describe development of a Listeria abscess following administration of a Listeria-based therapeutic vaccine.


Assuntos
Abscesso/veterinária , Neoplasias Ósseas/veterinária , Listeria monocytogenes/isolamento & purificação , Listeriose/veterinária , Osteossarcoma/veterinária , Abscesso/microbiologia , Animais , Vacinas Bacterianas/efeitos adversos , Neoplasias Ósseas/prevenção & controle , Neoplasias Ósseas/secundário , Cães , Imunoterapia/efeitos adversos , Imunoterapia/veterinária , Listeria monocytogenes/genética , Listeriose/diagnóstico por imagem , Listeriose/microbiologia , Osteossarcoma/prevenção & controle , Osteossarcoma/secundário
18.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 30(6): 305-308, nov.-dic. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-186961

RESUMO

Presentamos el caso de una mujer de 52 años, sin antecedentes de interés, que fue derivada a nuestro centro tras ser diagnosticada de una lesión ocupante de espacio en el hemisferio cerebeloso derecho. La sospecha inicial era de metástasis. En la RMN cerebral, sin embargo, se apreciaba una marcada restricción en la secuencia de difusión concordante con un absceso cerebeloso. La paciente se había sometido a una limpieza dental tres semanas antes. El análisis microbiológico tras la evacuación quirúrgica de la lesión mostró la presencia de Streptococcus intermedius


A 52-year-old woman with no relevant previous medical history was diagnosticated of an infratentorial bulky cerebellar mass. The mass showed restricted diffusion on MR images, which was consistent with cerebellar abscess. The patient had undergone a minor dental procedure three weeks before. Microbiological analysis after surgical evacuation of the mass confirmed the presence of Streptococcus intermedius


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Profilaxia Dentária/efeitos adversos , Streptococcus intermedius/patogenicidade , Fossa Craniana Posterior/diagnóstico por imagem , Abscesso/microbiologia , Fossa Craniana Posterior/patologia , Cérebro/diagnóstico por imagem , Cérebro/patologia , Craniotomia/métodos , Neuroimagem/métodos , Abscesso/tratamento farmacológico
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