ABSTRACT
Leuconostoc species are gram-positive cocci and they are rarely pathogenic in human. Leuconostoc infections are commonly associated with immunocompromised status and indwelling medical devices include intravenous catheter, tracheostomy, endotracheal intubation and percutaneous endoscopic gastrostomy. Clinical isolates of Leuconostoc were frequently misidentified, usually as viridans streptococci, but they possess inherent resistance to vancomycin despite sensitivity to most other antibiotics. We present a case of Leuconostoc peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD). A 48-year-old man with hypertensive nephropathy has been treated with peritoneal dialysis, developed peritonitis due to Leuconostoc species. The peritonitis was poorly responded to empirical antibiotics. He was successfully treated with intraperitoneal administration of ampicillin. The dialysis catheter was left in place, and continued to function. To our knowledge, this is the first case of Leuconostoc peritonitis reported in Korea.
Subject(s)
Humans , Middle Aged , Ampicillin , Anti-Bacterial Agents , Catheters , Dialysis , Gastrostomy , Gram-Positive Cocci , Intubation, Intratracheal , Korea , Leuconostoc , Peritoneal Dialysis , Peritoneal Dialysis, Continuous Ambulatory , Peritonitis , Tracheostomy , Vancomycin , Viridans StreptococciABSTRACT
Sodium picosulfate/magnesium citrate (Picolight Powder), which is used as a bowel preparation for the colon and the rectum, can cause a severe electrolyte imbalance like hyponatremia. When hyponatremia gets severe or occurs rapidly, it can lead to death due to associated complications. We have experienced a case of hyponatremia associated with seizure and loss of consciousness in a 76-year-old woman, who took sodium picosulfate/magnesium citrate as a bowel preparation for colonoscopy. She was taking thiazide and synthroid for the treatment of hypertension and hypothyroidism, respectively, and she had other underlying medical conditions such as a history of seizure and dementia. Following the diagnosis of hyponatremia, we used an intravenous injection of 3% NaCl to normalize the sodium level in her serum, and her associated symptoms soon disappeared.
Subject(s)
Aged , Female , Humans , Citric Acid , Colon , Colonoscopy , Dementia , Diagnosis , Hypertension , Hyponatremia , Hypothyroidism , Injections, Intravenous , Rectum , Seizures , Sodium , Thyroxine , UnconsciousnessABSTRACT
As the use of early coronary angiography and echocardiography become widely available in the setting of acute coronary syndrome, the gradual increase for variant forms of transient left ventricular (LV) apical ballooning syndrome have been recognized. This syndrome usually occurs in women and is frequently elicited by an intense emotional, psychological, and physical event. While the patients' characteristics between typical and non-typical LV ballooning syndrome seem to differ, the presentation, clinical features, and reversibility of LV wall motion abnormalities are similar. We present a middle-aged woman who experienced inverted takotsubo cardiomyopathy triggered by pulmonary embolism. To the best of our knowledge, this case is particularly unique and is rarely reported in the disease entity.