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1.
BMJ Case Rep ; 14(1)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495173

RESUMO

Surgery for prosthetic valve endocarditis in the mitral valve position is still challenging for surgeons. Reconstruction of the mitral annulus is useful for patients with a mitral annulus disputed by infection. Here, we report a redo mitral valve replacement using a collar-reinforced tissue valve, which was inserted into a mitral annulus reconstructed with a bovine patch. Though the preoperative blood culture detected Streptococcus anginosus, the intraoperative culture detected methicillin-resistant coagulase-negative staphylococci (MRCNS). MRCNS is rarely detected because of its indolent nature.


Assuntos
Antibacterianos/uso terapêutico , Endocardite Bacteriana/terapia , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Estenose da Valva Mitral/cirurgia , Infecções Relacionadas à Prótese/terapia , Infecções Estafilocócicas/terapia , Infecções Estreptocócicas/terapia , Idoso , Ampicilina/uso terapêutico , Hemocultura , Daptomicina/uso terapêutico , Desbridamento , Ecocardiografia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/etiologia , Imagem por Ressonância Magnética , Resistência a Meticilina/fisiologia , Infecções Relacionadas à Prótese/microbiologia , Procedimentos Cirúrgicos Reconstrutivos , Reoperação , Staphylococcus/isolamento & purificação , Staphylococcus/fisiologia , Streptococcus anginosus/isolamento & purificação , Streptococcus anginosus/fisiologia , Sulbactam/uso terapêutico
2.
Ann Agric Environ Med ; 27(4): 540-543, 2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33356058

RESUMO

INTRODUCTION: The role of fungi in infections in immunocompromised patients is a growing problem in both diagnosis and treatment. Candida species are the most common cause of fungal, endogenous endophthalmitis and infections of the cornea. CASE STUDY: A patient was admitted to hospital due to acute inflammation of the tissue of the left orbit, 1.5 years after the corneal penetrating transplantation of the left eye with intracapsular extraction of lens and simultaneous anterior vitrectomy. The microbiological system identified: Streptococcus pyogenes, Staphylococcus aureus, and Candida glabrata in the patient. CONCLUSIONS: The factors conducive to fungal infections are: patient's old age, immune disorders and diabetes, as well as the presence of a necrotic tissue or a foreign body. All these parameters were met in this case. Only antibiotic therapy and long-term antifungal therapy, together with surgical debridement of the site of the ongoing infection produces clinical effects in such severe cases.


Assuntos
Antifúngicos/uso terapêutico , Candida glabrata/isolamento & purificação , Candidíase/diagnóstico , Desbridamento , Infecções Oculares Fúngicas/diagnóstico , Panoftalmite/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Candidíase/microbiologia , Candidíase/fisiopatologia , Infecções Oculares Fúngicas/microbiologia , Feminino , Humanos , Panoftalmite/microbiologia , Polônia , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes/isolamento & purificação , Resultado do Tratamento
3.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33370943

RESUMO

A previously independent 56-year-old immunocompetent woman presented with septic shock in the setting of periorbital swelling and diffuse infiltrates on chest imaging. Blood cultures were positive for growth of group A Streptococcus (GAS). Broad spectrum antimicrobials were initiated with the inclusion of the antitoxin agent clindamycin. Necrosis of periorbital tissue was noted and surgical consultation was obtained. Débridement of both eyelids with skin grafting was performed. GAS was isolated from wound cultures and also observed on periorbital tissue microscopy. The final diagnosis was bilateral periorbital necrotising fasciitis (PONF) associated with invasive GAS infection. The patient had a prolonged intensive care unit course with input from multiple specialist teams. This case demonstrates the importance of early recognition and treatment of PONF, the profound systemic morbidity caused by these infections, and illustrates successful multidisciplinary teamwork.


Assuntos
Fasciite Necrosante/complicações , Choque Séptico/microbiologia , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/isolamento & purificação , Antibacterianos/uso terapêutico , Desbridamento , Quimioterapia Combinada , Pálpebras/microbiologia , Pálpebras/cirurgia , Fasciite Necrosante/diagnóstico , Fasciite Necrosante/microbiologia , Fasciite Necrosante/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Choque Séptico/diagnóstico , Choque Séptico/terapia , Transplante de Pele , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Resultado do Tratamento
4.
BMJ Case Rep ; 13(12)2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33370987

RESUMO

Cavernous sinus thrombosis (CST) is a rare and potentially fatal complication of acute sinusitis. Timely diagnosis and management is, therefore, essential in preventing death and neurological disability. Here, we describe the case of a paediatric patient with bilateral CST secondary to acute unilateral pansinusitis that presented with rapidly progressing bilateral periorbital oedema. Initial imaging was negative. This case serves to emphasise the importance of maintaining a high index of suspicion when managing paediatric patients with suspected CST with persistent symptoms. Expeditious investigation and management of our patient in this case resulted in a positive outcome, with resolution of symptoms and no residual neurological deficit.


Assuntos
Trombose do Corpo Cavernoso/diagnóstico , Seio Cavernoso/microbiologia , Cefaleia/etiologia , Sinusite/diagnóstico , Infecções Estreptocócicas/diagnóstico , Administração Intravenosa , Adolescente , Antibacterianos/administração & dosagem , Anticoagulantes/administração & dosagem , Seio Cavernoso/diagnóstico por imagem , Seio Cavernoso/patologia , Seio Cavernoso/cirurgia , Trombose do Corpo Cavernoso/líquido cefalorraquidiano , Trombose do Corpo Cavernoso/tratamento farmacológico , Trombose do Corpo Cavernoso/etiologia , Diagnóstico Diferencial , Quimioterapia Combinada/métodos , Endoscopia , Cefaleia/líquido cefalorraquidiano , Cefaleia/terapia , Humanos , Angiografia por Ressonância Magnética , Masculino , Sinusite/complicações , Sinusite/microbiologia , Sinusite/terapia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Streptococcus intermedius/isolamento & purificação , Tomografia Computadorizada por Raios X , Resultado do Tratamento
6.
PLoS One ; 15(6): e0235139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574205

RESUMO

Viral infections complicated by a bacterial infection are typically referred to as coinfections or superinfections. Streptococcus pyogenes, the group A streptococcus (GAS), is not the most common bacteria associated with influenza A virus (IAV) superinfections but did cause significant mortality during the 2009 influenza pandemic even though all isolates are susceptible to penicillin. One approach to improve the outcome of these infections is to use passive immunization targeting GAS. To test this idea, we assessed the efficacy of passive immunotherapy using antisera against either the streptococcal M protein or streptolysin O (SLO) in a murine model of IAV-GAS superinfection. Prophylactic treatment of mice with antiserum to either SLO or the M protein decreased morbidity compared to mice treated with non-immune sera; however, neither significantly decreased mortality. Therapeutic use of antisera to SLO decreased morbidity compared to mice treated with non-immune sera but neither antisera significantly reduced mortality. Overall, the results suggest that further development of antibodies targeting the M protein or SLO may be a useful adjunct in the treatment of invasive GAS diseases, including IAV-GAS superinfections, which may be particularly important during influenza pandemics.


Assuntos
Antígenos de Bactérias/imunologia , Proteínas da Membrana Bacteriana Externa/imunologia , Proteínas de Transporte/imunologia , Imunoterapia/métodos , Vírus da Influenza A/imunologia , Infecções por Orthomyxoviridae/imunologia , Infecções Estreptocócicas/imunologia , Streptococcus pyogenes/imunologia , Estreptolisinas/imunologia , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Antígenos de Bactérias/metabolismo , Proteínas da Membrana Bacteriana Externa/antagonistas & inibidores , Proteínas da Membrana Bacteriana Externa/metabolismo , Proteínas de Bactérias/antagonistas & inibidores , Proteínas de Bactérias/imunologia , Proteínas de Bactérias/metabolismo , Proteínas de Transporte/antagonistas & inibidores , Proteínas de Transporte/metabolismo , Coinfecção/microbiologia , Coinfecção/terapia , Coinfecção/virologia , Feminino , Interações Hospedeiro-Patógeno/efeitos dos fármacos , Interações Hospedeiro-Patógeno/imunologia , Humanos , Soros Imunes/imunologia , Soros Imunes/farmacologia , Vírus da Influenza A/fisiologia , Camundongos Endogâmicos BALB C , Infecções por Orthomyxoviridae/terapia , Infecções por Orthomyxoviridae/virologia , Coelhos , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes/metabolismo , Streptococcus pyogenes/fisiologia , Estreptolisinas/antagonistas & inibidores , Estreptolisinas/metabolismo , Superinfecção/microbiologia , Superinfecção/terapia , Superinfecção/virologia
7.
Jt Dis Relat Surg ; 31(2): 399-402, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584745

RESUMO

Streptococcus dysgalactiae (SD) is a common pathogen among elderly population. However, to our knowledge, there is no periprosthetic joint infection case reported that is infected with Streptococcus dysgalactiae subspecies equisimilis (SDSE) in the English literature. In this article, we report a 77-year-old male patient who had undergone total knee arthroplasty three years ago and had the diagnosis of cellulitis at his leg followed by swelling, pain and hyperemia localized at his knee. Three knee aspirations were performed and the SDSE was identified. There was no direct contact of patient to animals.


Assuntos
Artroplastia do Joelho , Cefalosporinas/administração & dosagem , Desbridamento/métodos , Infecções Relacionadas à Prótese , Infecções Estreptocócicas , Streptococcus/isolamento & purificação , Idoso , Antibacterianos/administração & dosagem , Artroplastia do Joelho/efeitos adversos , Artroplastia do Joelho/instrumentação , Artroplastia do Joelho/métodos , Humanos , Masculino , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/fisiopatologia , Infecções Relacionadas à Prótese/cirurgia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/etiologia , Infecções Estreptocócicas/fisiopatologia , Infecções Estreptocócicas/terapia , Resultado do Tratamento
8.
Postgrad Med ; 132(6): 526-531, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32379557

RESUMO

Background: Streptococcal Toxic Shock Syndrome (STSS) is a serious condition that can arise from streptococcal postpartum endometritis. It is associated with a substantial increase in mortality rate and can rarely result in multiorgan infarction. Early recognition plays a vital role in patients' outcome. Objective: To report a case of complicated STSS and review the literature for previous case reports of streptococcal postpartum endometritis to determine if STSS diagnostic criteria (published by the Centers for Disease Control and Prevention) were fulfilled. Case presentation: This is a 41-year-old woman who presented 5 days after an uncomplicated vaginal delivery with endometritis complicated by invasive group A ß-hemolytic streptococcus (GAS) infection and confirmed toxic shock syndrome. The patient was initially admitted to the critical care unit due to hemodynamic compromise requiring intravenous (IV) fluids, IV antibiotic therapy with penicillin and clindamycin, and IV immunoglobulin therapy. The patient subsequently developed multi-organ infarctions, acute respiratory distress syndrome requiring noninvasive respiratory support, and severe reactive arthritis. Literature review revealed 15 case reports of GAS postpartum endometritis, five met criteria for confirmed STSS. One patient died from severe septic shock leading to cardiopulmonary arrest. Thirteen out of 15 cases of postpartum endometritis occurred after uncomplicated vaginal delivery. Conclusion: STSS is a serious and possibly fatal medical condition that requires early diagnosis and treatment to prevent poor patient outcomes and death. Careful consideration to the patient's postpartum clinical presentation with the implementation of an intradisciplinary approach should be utilized.


Assuntos
Antibacterianos , Artrite Reativa , Endometrite , Rim , Infecção Puerperal , Infarto do Baço/diagnóstico por imagem , Infecções Estreptocócicas , Streptococcus pyogenes/isolamento & purificação , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/classificação , Artrite Reativa/etiologia , Artrite Reativa/terapia , Endometrite/microbiologia , Endometrite/fisiopatologia , Endometrite/terapia , Feminino , Hidratação/métodos , Humanos , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Oxigenoterapia/métodos , Infecção Puerperal/microbiologia , Infecção Puerperal/fisiopatologia , Infecção Puerperal/terapia , /terapia , Choque Séptico/microbiologia , Choque Séptico/fisiopatologia , Infecções Estreptocócicas/etiologia , Infecções Estreptocócicas/fisiopatologia , Infecções Estreptocócicas/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
10.
Am J Trop Med Hyg ; 102(6): 1208-1209, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32314699

RESUMO

The early shortage of novel coronavirus disease (COVID-19) tests in the United States led many hospitals to first screen for common respiratory pathogens, and only if this screen was negative to proceed with COVID-19 testing. We report a case of a 56-year-old woman with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) coinfection with group A Streptococcus. The initial testing strategy resulted in delays in both diagnosis and implementation of appropriate precautions. Underlined is the importance of testing for both SARS-CoV-2 and other common respiratory pathogens during the current pandemic.


Assuntos
Betacoronavirus/patogenicidade , Dor Crônica/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Hipertensão/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Infecções Estreptocócicas/diagnóstico por imagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Azitromicina/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/isolamento & purificação , Ceftriaxona/uso terapêutico , Chicago , Dor Crônica/imunologia , Dor Crônica/patologia , Dor Crônica/terapia , Coinfecção , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/terapia , Oxigenação por Membrana Extracorpórea , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Hipertensão/imunologia , Hipertensão/patologia , Hipertensão/terapia , Pulmão/efeitos dos fármacos , Pulmão/patologia , Pulmão/virologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/patologia , Pneumonia Viral/terapia , Infecções Estreptocócicas/imunologia , Infecções Estreptocócicas/patologia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes/efeitos dos fármacos , Streptococcus pyogenes/isolamento & purificação , Streptococcus pyogenes/patogenicidade , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
Ann Otol Rhinol Laryngol ; 129(7): 662-668, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32070112

RESUMO

OBJECTIVE: Cricoid chondronecrosis is a rare entity that has significant consequences for patients. Reports of its occurrence are scattered in the literature and currently there is no comprehensive review to help guide providers. METHODS: A case report from our institution is presented. A review of available literature is then provided with assessment of risk factors, signs and symptoms at presentation, laryngeal exam findings, radiologic findings, and surgical techniques. RESULTS: Twenty-four cases of cricoid chondronecrosis were reviewed from the literature. Patient age ranged from 8 months to 76 years. A history of endotracheal intubation for various reasons was present in all but two cases, and duration of intubation ranged from 6 hours to 28 days. Patients presented with airway compromise in all but two cases-one asymptomatic patient with prior tracheostomy and another with dysphagia after radiation. Dysphonia (n = 6) and dysphagia (n = 3) were less commonly present. Subglottic stenosis (n = 19) was the most common exam finding followed by vocal fold impairment (n = 11). When CT scan findings were reported, fragmentation of the cartilage and/or hypodensity of the central lamina were described in all but one case. Interventions ranged from observation on antibiotics and steroids to surgical therapies including tracheostomy, dilation, and posterior cricoid split, with or without stent placement. CONCLUSIONS: Cricoid chondronecrosis is a serious, rare entity that can occur even after a short period of endotracheal intubation. Providers must have a high level of suspicion in patients that present with upper airway dyspnea with a history of prior intubation. LEVEL OF EVIDENCE: Level 4.


Assuntos
Doenças das Cartilagens/diagnóstico , Cartilagem Cricoide/diagnóstico por imagem , Infecções por Haemophilus/diagnóstico , Laringoestenose/diagnóstico , Infecções Estreptocócicas/diagnóstico , Traqueostomia , Adulto , Alcoolismo/complicações , Antibacterianos/uso terapêutico , Doenças das Cartilagens/complicações , Doenças das Cartilagens/patologia , Doenças das Cartilagens/terapia , Cartilagem Cricoide/patologia , Depressão/complicações , Dispneia/etiologia , Infecções por Haemophilus/complicações , Infecções por Haemophilus/terapia , Humanos , Intubação Intratraqueal , Laringoscopia , Laringoestenose/etiologia , Masculino , Necrose , Procedimentos Cirúrgicos Otorrinolaringológicos , Sons Respiratórios/etiologia , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/terapia , Paralisia das Pregas Vocais/diagnóstico , Paralisia das Pregas Vocais/etiologia
15.
BMC Pulm Med ; 20(1): 43, 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066414

RESUMO

Descending necrotizing mediastinitis is a severe infection of the mediastinum. This syndrome manifests as fever and chest pain following cough and sputum production. A 49-year-old woman presented with fever and a 14-day history of pneumonia. CT showed mediastinal abscesses with a giant calcified mediastinal lymph node (21 × 18 mm) and pneumonia. Bronchoscopy by EBUS-TBNA under general anesthesia was performed. The pathogen found in the puncture culture was Streptococcus constellatus, and antibiotics (mezlocillin/sulbactam 3.375 IVGTT q8h) was administered. A proximal right main bronchial neoplasm, suspected lung cancer, was found and conformed to inflammatory granuloma. A total of 22 months post-discharge the patient was clinically stable. We also conducted a review of the literature for all Streptococcus constellatus descending necrotizing mediastinitis infections between 2011 and 2017.


Assuntos
Broncoscopia , Mediastinite/microbiologia , Pneumonia/complicações , Infecções Estreptocócicas/microbiologia , Streptococcus constellatus/isolamento & purificação , Antibacterianos/uso terapêutico , Drenagem/métodos , Feminino , Humanos , Imunocompetência , Linfonodos/patologia , Mediastinite/diagnóstico , Mediastinite/terapia , Pessoa de Meia-Idade , Pneumonia/diagnóstico , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/terapia , Tomografia Computadorizada por Raios X
16.
Nat Rev Nephrol ; 16(1): 32-50, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31399725

RESUMO

For over a century, acute 'post-streptococcal glomerulonephritis' (APSGN) was the prototypical form of bacterial infection-associated glomerulonephritis, typically occurring after resolution of infection and a distinct infection-free latent period. Other less common forms of infection-associated glomerulonephritides resulted from persistent bacteraemia in association with subacute bacterial endocarditis and shunt nephritis. However, a major paradigm shift in the epidemiology and bacteriology of infection-associated glomerulonephritides has occurred over the past few decades. The incidence of APSGN has sharply declined in the Western world, whereas the number of Staphylococcus infection-associated glomerulonephritis (SAGN) cases increased owing to a surge in drug-resistant Staphylococcus aureus infections, both in the hospital and community settings. These Staphylococcus infections range from superficial skin infections to deep-seated invasive infections such as endocarditis, which is on the rise among young adults owing to the ongoing intravenous drug use epidemic. SAGN is markedly different from APSGN in terms of its demographic profile, temporal association with active infection and disease outcomes. The diagnosis and management of SAGN is challenging because of the lack of unique histological features, the frequently occult nature of the underlying infection and the older age and co-morbidities in the affected patients. The emergence of multi-drug-resistant bacterial strains further complicates patient treatment.


Assuntos
Endocardite Bacteriana/epidemiologia , Glomerulonefrite/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estreptocócicas/epidemiologia , Distribuição por Idade , Antibacterianos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Endocardite Bacteriana/complicações , Endocardite Bacteriana/terapia , Hidratação , Glomerulonefrite/etiologia , Glomerulonefrite/microbiologia , Glomerulonefrite/terapia , Humanos , Imunossupressores/uso terapêutico , Rim/patologia , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Staphylococcus aureus , Staphylococcus epidermidis , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/terapia , Streptococcus pyogenes , Abuso de Substâncias por Via Intravenosa/epidemiologia , Fatores de Tempo
17.
J Infect Chemother ; 26(1): 128-131, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31300376

RESUMO

Streptococcus pyogenes is a rare pathogen that causes endogenous endophthalmitis (EE). A healthy 58-year-old woman was diagnosed with EE secondary to septic arthritis caused by S. pyogenes. She underwent enucleation after hospitalization for 14 days with appropriate antibiotic cover. A literature search for outcomes of this condition revealed reports on only 10 eyes among 8 cases identified: 8 eyes (80%) developed poor visual outcome and 5 eyes (50%) underwent enucleation. There were no cases with immunocompromise. Our case report and literature review suggest the importance of awareness of the occurrence of S. pyogenes infection in immunocompetent hosts, and thus early diagnosis and aggressive treatment may be required to improve visual outcome.


Assuntos
Artrite Infecciosa , Endoftalmite , Infecções Estreptocócicas , Streptococcus pyogenes , Antibacterianos/uso terapêutico , Artrite Infecciosa/complicações , Artrite Infecciosa/microbiologia , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Endoftalmite/terapia , Enucleação Ocular , Feminino , Humanos , Pessoa de Meia-Idade , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia
18.
Acta Chir Belg ; 120(1): 53-56, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30139299

RESUMO

Acute necrotizing gastritis, which appears to be a variant of phlegmonous gastritis is the rarest cause of gastric necrosis. We report a case of a 57-year-old female patient with an acute necrotizing gastritis caused by a Group A ß-hemolytic streptococcus. The case presented herein is of unusual interest because only a limited number of case reports on this etiology have been published. Diagnosing infectious necrotizing gastritis remains complex because of its rarity and nonspecific clinical presentation. Nevertheless, prompt diagnosis is of high importance because necrotizing gastritis can progress rapidly into a more advanced stage causing septic shock or even death. In our opinion, early resection of necrotic gastric wall combined with adequate antimicrobial therapy is the cornerstone in treatment of necrotizing gastritis. We will present a case in which adequate medical treatment was not successful.


Assuntos
Gastrite/microbiologia , Gastrite/terapia , Infecções Estreptocócicas/patologia , Infecções Estreptocócicas/terapia , Streptococcus pyogenes , Doença Aguda , Feminino , Gastrite/patologia , Humanos , Pessoa de Meia-Idade , Necrose
19.
Aust J Rural Health ; 28(1): 74-80, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31659821

RESUMO

OBJECTIVE: To determine the incidence, clinical presentation and progress of acute post-streptococcal glomerulonephritis in Central Australia. DESIGN: Retrospective observational analysis. SETTING: Paediatric inpatient admission at Alice Springs Hospital. PARTICIPANTS: Patients admitted to Alice Springs Hospital under 14 years of age meeting diagnostic criteria for acute post-streptococcal glomerulonephritis between January 2010 and December 2014. MAIN OUTCOME MEASURES: Incidence of acute post-streptococcal glomerulonephritis in central Australia. Biochemical abnormalities associated with acute post-streptococcal glomerulonephritis. Co-occuring conditions. RESULTS: Sixty-nine out of the 174 cases reviewed were identified as having either acute post-streptococcal glomerulonephritis (63) or probable acute post-streptococcal glomerulonephritis (6). We calculate the incidence of APSGN admission to be higher than previously reported and the highest reported incidence globally in children. Clinical evidence of skin infection was frequently documented. Co-occurring infections were common, including scabies/head lice, urinary tract infection and pneumonia. Fifty-three patients showed biochemical evidence of acute kidney injury. CONCLUSIONS: Aboriginal children in Central Australia have the highest incidence of acute post-streptococcal glomerulonephritis reported worldwide. Urgent action is required to improve housing and reduce overcrowding in Central Australian towns and communities to reduce the burden of disease of skin infection and Group A Streptococcus related diseases. Without effective change in living conditions, it is unlikely that there will be a significant change in the morbidity related to these conditions.


Assuntos
Doença Aguda/terapia , Glomerulonefrite/diagnóstico , Glomerulonefrite/terapia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/terapia , Doença Aguda/epidemiologia , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Feminino , Glomerulonefrite/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Infecções Estreptocócicas/epidemiologia
20.
BMJ Case Rep ; 12(12)2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31857289

RESUMO

A 26-year-old man who was previously well presented to the emergency in septic shock. He had a preceding history of fever, right upper abdominal pain and jaundice. On examination, there was tenderness over the right hypochondrium and epigastrium, without features of generalised peritonitis. His blood tests were suggestive of sepsis with deranged liver function tests. CT scan of the abdomen showed multiples abscesses in various segments of the liver and a thrombus in the inferior venacava, without any other intraabdominal focus of infection. The abscess was aspirated under sonographic guidance, and the cultures grew Streptococcus constellatus species of S. milleri group (SMG). He received crystalline penicillin, based on culture sensitivity and underwent drainage of the abscess. There was a clinical improvement and he was subsequently discharged in a stable condition. On 3 months follow-up, there was a complete resolution of the liver abscess and normalisation of the liver function tests.


Assuntos
Abscesso Hepático Piogênico/diagnóstico , Infecções Estreptocócicas/diagnóstico , Streptococcus constellatus/isolamento & purificação , Dor Abdominal/etiologia , Adulto , Antibacterianos/uso terapêutico , Terapia Combinada , Diagnóstico Diferencial , Drenagem , Febre/etiologia , Humanos , Icterícia/etiologia , Abscesso Hepático Piogênico/complicações , Abscesso Hepático Piogênico/diagnóstico por imagem , Abscesso Hepático Piogênico/terapia , Masculino , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/diagnóstico por imagem , Infecções Estreptocócicas/terapia , Tomografia Computadorizada por Raios X
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