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1.
Rev. chil. infectol ; 37(4): 383-388, ago. 2020. tab
Article in Spanish | LILACS | ID: biblio-1138562

ABSTRACT

Resumen Introducción: Streptococcus grupo viridans (SGV) ha adquirido relevancia como microorganismo causante de neutropenia febril, asociándose a morbilidad significativa. Objetivo: Caracterizar episodios de bacteriemia causados por SGV en niños con cáncer que desarrollaron neutropenia febril de alto riesgo (NFAR) desde abril de 2004 a junio de 2018 en seis hospitales pediátricos de Santiago, Chile. Pacientes y Métodos: Análisis retrospectivo de bases de datos de cuatro proyectos FONDECYT sucesivos, prospectivos y multicéntricos, registrando características clínicas y de laboratorio de los pacientes, además de patrón de resistencia antimicrobiana de las cepas aisladas. Resultados: Se registraron 95 episodios de bacteriemia asociada a SGV en 91 niños con NFAR. Destacan: leucemia mieloide aguda como enfermedad de base, neutropenia profunda, hospitalización prolongada (15 días), uso extendido de antimicrobianos (14 días), uso de citarabina en esquemas de quimioterapia (86% episodios). Las manifestaciones clínicas más frecuentes fueron respiratoria y gastrointestinal, asociándose en 26% a síndrome de shock por Streptococcus grupo viridans. Hubo elevada resistencia a β lactámicos, sin cepas no susceptibles a vancomicina. Discusión: SGV es un patógeno relevante en niños con cáncer, fiebre y neutropenia en nuestro medio, asociado a casos de sepsis. La resistencia a β lactámicos es un aspecto que requiere vigilancia epidemiológica estricta en esta población.


Abstract Background: Viridans group streptococci (VGS) has acquired relevance as a microorganism causing febrile neutropenia, associated with significant morbidity. Aim: To characterize episodes of bacteremia caused by VGS in children with cancer who developed high-risk febrile neutropenia (HRFN) during the period from April 2004 to June 2018 in six pediatric hospitals of Santiago, Chile. Method: Database analysis of 4 successive, prospective and multicentric studies recording clinical and laboratory characteristics of patients, as well as antimicrobial susceptibility pattern of isolated strains. Results: 95 episodes of VGS bacteremia in 91 children with HRFN were analyzed. It emphasizes acute myeloid leukemia as cancer type, deep neutropenia, prolonged hospitalization (15 days), with extended use of antimicrobials (14 days) and use of cytarabine in chemotherapy schemes (86% episodes). The most frequent clinical manifestations were respiratory and gastrointestinal, associating up to 26% viridans group shock syndrome. There was high resistance to β lactams. As expected, there were not non-susceptible strains to vancomycin. Discussion: VGS is a relevant microorganism in children with cancer, fever and neutropenia, with a high percentage of sepsis. Resistance to β lactams is an issue that requires strict epidemiological surveillance in this population.


Subject(s)
Humans , Child , Streptococcal Infections/drug therapy , Bacteremia/drug therapy , Febrile Neutropenia/drug therapy , Neoplasms/complications , Neoplasms/drug therapy , Chile/epidemiology , Prospective Studies , Anti-Bacterial Agents/therapeutic use
2.
Arch. argent. pediatr ; 116(6): 769-772, dic. 2018. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-973695

ABSTRACT

La sepsis es la principal causa de mortalidad neonatal. La forma precoz, habitualmente, está relacionada con la colonización recto-vaginal u otros factores de riesgo materno. En la forma tardía, es difícil establecer su origen; por lo general, es nosocomial o de la comunidad. El Streptococcus agalactiae (Streptococcus beta-hemolítico del grupo B) es el germen implicado con más frecuencia en la sepsis neonatal en países desarrollados. La forma tardía, generalmente, se presenta con septicemia y meningitis, y, en ocasiones, pueden detectarse infecciones osteoarticulares o de piel y tejidos blandos. El síndrome celulitis-adenitis en la región cervical, forma poco frecuente de presentación, es causado por Staphylococcus aureus y, ocasionalmente, por Streptococcus agalactiae. Se reportan 2 casos de sepsis neonatal tardía con clínica de celulitis-adenitis cervical causados por Streptococcus beta-hemolítico del grupo B, con una evolución satisfactoria con terapia antibiótica de amplio espectro.


Septicemia is the main cause of neonatal mortality. The early-onset neonatal sepsis is usually related to maternal factor risks including recto-vaginal colonization. In the late-onset neonatal septicemia it is more difficult to establish the etiology because the majority of the cases are nosocomial or community related. The Streptococcus agalactiae (beta-hemolytic Streptococcus) is the most frequent germ associated with neonatal sepsis in developed countries. The late-onset form usually occurs with septic symptoms and meningitis and, in a few cases, with osteoarticular, skin and soft tissue infection. Adenitis-cellulitis syndrome is rarely seen, and its main cause is Staphylococcus aureus, followed by Streptococcus agalactiae. We report two cases of group B Streptococcus late-onset neonatal septicemia, both of them with adenitis-cellulitis syndrome. Patients recovered uneventfully after an adequate antibiotic therapy.


Subject(s)
Humans , Male , Infant , Streptococcal Infections/diagnosis , Cellulitis/diagnosis , Neonatal Sepsis/diagnosis , Lymphadenitis/diagnosis , Streptococcal Infections/microbiology , Streptococcal Infections/drug therapy , Streptococcus agalactiae/isolation & purification , Syndrome , Cellulitis/microbiology , Cellulitis/drug therapy , Neonatal Sepsis/microbiology , Neonatal Sepsis/drug therapy , Lymphadenitis/microbiology , Lymphadenitis/drug therapy , Anti-Bacterial Agents/administration & dosage
3.
Rev. chil. infectol ; 35(4): 424-430, ago. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978054

ABSTRACT

Resumen Introducción La infección por Streptococcus agalactiae (β-hemolítico del grupo B (SGB) continúa siendo una de las principales causas de sepsis precoz en países desarrollados a pesar de la implementación de profilaxis efectiva. Objetivos Describir la incidencia, características clínicas y mortalidad de sepsis precoz por SGB en recién nacidos del Centro Hospitalario Pereira Rossell (CHPR), y analizar las fallas de adherencia a las estrategias de prevención. Métodos Estudio retrospectivo de descripción de casos entre los años 2007 a 2015 identificados a partir de la base de datos del laboratorio de bacteriología. Resultados Se identificaron 15 casos de sepsis neonatal precoz a SGB con una incidencia en el período de estudio de 0,23‰. La quimioprofilaxis intraparto no fue realizada en caso alguno. Todos los recién nacidos se presentaron sintomáticos en las primeras 15 h de vida. La dificultad respiratoria fue el signo más frecuente (80%). En un caso se aisló SGB de líquido cefalorraquídeo. La mortalidad fue de 20%. Todas las muertes ocurrieron en las primeras 24 h de vida, siendo dos tercios prematuros. Conclusión La incidencia de sepsis precoz por SGB en el CHPR fue similar a la incidencia en centros donde se realiza quimioprofilaxis. Una mejor adherencia a las estrategias de prevención podría disminuir la incidencia.


Background: Group B Streptococcus (GBS) disease remains the leading cause of early-onset sepsis (EOS) in developed countries despite effective prophylaxis strategies. Aims: To describe the incidence, clinical features and mortality of GBS EOS in infants born at Centro Hospitalario Pereira Rossell (CHPR) and analyse failure of adherence to prevention strategies. Methods: Retrospective review of EOS cases between 2007 and 2015 collected from the bacteriology laboratory database. Results: Fifteen cases of GBS EOS were identified, with an incidence of 0.23% during the study period. Intrapartum antibiotic prophylaxis (IAP) was not administered in any of the cases. All infants were symptomatic within the first 15 hours of life, mainly due to respiratory signs (80%). In one case, GBS was isolated from spinal fluid. Mortality rate was 20%. All deaths occurred in the first 24 hours of life, corresponding two thirds to preterm infants. Conclusion: The incidence of GBS EOS at CHPR was similar to other centers where IAP is implemented. Better adherence to prophylaxis strategies could reduce the incidence.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Adolescent , Adult , Young Adult , Pregnancy Complications, Infectious/mortality , Streptococcal Infections/mortality , Streptococcal Infections/prevention & control , Sepsis/mortality , Sepsis/prevention & control , Infectious Disease Transmission, Vertical/statistics & numerical data , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/microbiology , Pregnancy Complications, Infectious/prevention & control , Streptococcal Infections/microbiology , Streptococcal Infections/drug therapy , Streptococcus agalactiae/isolation & purification , Retrospective Studies , Sepsis/diagnosis , Sepsis/drug therapy , Infectious Disease Transmission, Vertical/prevention & control , Antibiotic Prophylaxis , Anti-Bacterial Agents/therapeutic use
5.
Article in English | WPRIM | ID: wpr-173881

ABSTRACT

BACKGROUND: We determined the epidemiological characteristics of erythromycin (EM)-resistant Streptococcus pyogenes (group A streptococci, GAS) strains isolated from Korea and Japan, using emm genotyping and multilocus sequence typing (MLST). METHODS: Clinical isolates of GAS had been collected from 1992 to 2012 in Korea and from 2004 to 2009 in Japan. EM resistance was determined by the microdilution method, and resistance genotypes were assessed by PCR. The emm genotyping and MLST were performed by DNA sequencing. RESULTS: The emm genotypes and sequence types (STs) were concordant in 143 (85.1%) of 168 EM-resistant GAS strains from Korea. ST36/emm12 (35.1%), ST52/emm28 (22.6%), and ST49/emm75 (16.1%) were the most common types. Most of the ST36 (93.9%) and ST52 (95.8%) strains harbored erm(B), whereas strains ST49, ST42, and ST15 contained mef(A). The concordance between emm genotypes and STs was 41 (93.2%) among 44 EM-resistant GAS strains from Japan. ST36/emm12 (34.1%), ST49/emm75 (18.2%), and ST28/emm1 (15.9%) were the major types. ST36 isolates harbored either erm(B) (56.3%) or mef(A) (37.5%), whereas isolates ST28, ST49, and ST38 carried only mef(A). The proportion of erm(B) and mef(A) was 66.1% and 33.3% in Korea and 22.7% and 68.2% in Japan, respectively. CONCLUSIONS: The common STs in Korea and Japan were ST36 and ST49, whereas ST52 was present only in Korea and ST28 only in Japan. Genotype erm(B) was predominant in Korea, whereas mef(A) was frequent in Japan. There were differences between Korea and Japan regarding the frequencies of emm genotypes, STs, and EM resistance genes among the EM-resistant GAS.


Subject(s)
Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Bacterial Typing Techniques , Drug Resistance, Bacterial , Epidemiologic Studies , Erythromycin/pharmacology , Genotype , Humans , Japan/epidemiology , Microbial Sensitivity Tests , Multilocus Sequence Typing , Republic of Korea/epidemiology , Streptococcal Infections/drug therapy , Streptococcus pyogenes/drug effects
6.
Arch. argent. pediatr ; 113(4): 317-323, ago. 2015. tab
Article in English, Spanish | LILACS, BINACIS | ID: lil-757043

ABSTRACT

Introducción. La sepsis neonatal es una de las principales causas de muerte en recién nacidos. El tratamiento antimicrobiano empírico se sustenta en información epidemiológica y pruebas de susceptibilidad antimicrobiana. El objetivo del estudio fue describir los agentes etiológicos y su sensibilidad antimicrobiana enreciénnacidos con sepsis temprana (SNTe) o tardía (SNTa) de una Unidad de Terapia Intensiva Neonatal. Métodos. Estudio transversal realizado en un hospital de concentración del occidente de México. Se determinó la resistencia antimicrobiana de los gérmenes aislados en sangre o líquido cefalorraquídeo de pacientes con SNTe o SNTa nosocomial. Resultados. Se aislaron bacterias o levaduras en 235 cultivos de 67 eventos de SNTe y 166 eventos de SNTa. Del total de aislamientos, las bacterias más frecuentes fueron enterobacterias (51,5%), seguidas de Streptococcus spp. en SNTe y Staphylococcus spp. en SNTa. En cuanto a las enterobacterias de adquisición nosocomial, el 40% fueron productoras de betalactamasas de espectro extendido. En especies de Staphylococcus, la resistencia a oxacilina se registró en el 65,5%. En las enterobacterias (n: 121), la frecuencia de resistencia a amikacina, piperacilina-tazobactam y meropenem fue menor del 3%. En bacterias no fermentadoras, no se observó resistencia a amikacina, ciprofloxacino y cefepime; sin embargo, el número de aislamientos fue escaso. Conclusiones. Las bacterias identificadas con mayor frecuencia en SNTe fueron enterobacterias (67,6%) y Streptococcus spp. (17,6%), mientras que, en SNTa, fueron enterobacterias (44,9%) y Staphylococcus spp. (34,7%). El 40% de las enterobacterias de adquisición nosocomial fueron productoras de betalactamasas de espectro extendido y el 65,5% de Staphylococcus spp. mostraron resistencia a oxacilina.


Introduction. Neonatal sepsis is one of the main causes of death among newborn infants. Empirical antimicrobial treatment is based on epidemiological information and antimicrobial susceptibility tests. The objective of this study was to describe etiologic agents and their antimicrobial susceptibility among newborn infants with early-onset neonatal sepsis (EONS) or late-onset neonatal sepsis (LONS) at a Neonatal Intensive Care Unit. Methods. Cross-sectional study conducted at a tertiary referral hospital in Western Mexico. Determination of antimicrobial resistance of microorganisms isolated in blood or cerebrospinal fluid of patients with EONS or nosocomial LONS. Results. Yeasts and bacteria were isolated from 235 cultures corresponding to 67 events of EONS and 166 events of LONS. Of all isolates, the most common bacteria were Enterobacteriaceae (51.5%), followed by Streptococcus spp. in EONS, and by Staphylococcus spp. in LONS. Of all nosocomial Enterobacteriaceae, 40% were extended spectrum beta-lactamase producing bacteria. Among Staphylococcus species, resistance to oxacillin was recorded in 65.5%. Among Enterobacteriaceae (n: 121), resistance to amikacin, piperacillin-tazobactam, and meropenem was below 3%. Non-fermenting bacteria did not show resistance to amikacin, ciprofloxacin or cefepime; however, the number of isolates was scarce. Conclusions.The most commonly identified bacteria in EONS were Enterobacteriaceae (67.6%) and Streptococcus spp. (17.6%), and Enterobacteriaceae (44.9%) and Staphylococcus spp. (34.7%) in LONS. Forty percent ofnosocomial Enterobacteriaceae were extended spectrum beta-lactamase producing bacteria, and 65.5% of Staphylococcus spp. showed resistance to oxacillin.


Subject(s)
Humans , Infant, Newborn , Staphylococcal Infections/drug therapy , Staphylococcus/drug effects , Streptococcal Infections/drug therapy , Streptococcus/drug effects , Intensive Care Units, Neonatal , Microbial Sensitivity Tests , Cross-Sectional Studies , Drug Resistance, Bacterial , Enterobacteriaceae/drug effects , Enterobacteriaceae Infections/drug therapy , Neonatal Sepsis/etiology , Neonatal Sepsis/drug therapy , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology
7.
Mem. Inst. Oswaldo Cruz ; 109(7): 940-943, 11/2014. graf
Article in English | LILACS | ID: lil-728811

ABSTRACT

Endothelial dysfunction is a major component of the pathophysiology of septicaemic group B Streptococcus (GBS) infections. Although cytokines have been shown to activate human umbilical vein endothelial cells (HUVECs), the capacity of interferon (IFN)-γ to enhance the microbicidal activity of HUVECs against GBS has not been studied. We report that the viability of intracellular bacteria was reduced in HUVECs activated by IFN-γ. Enhanced fusion of lysosomes with bacteria-containing vacuoles was observed by acid phosphatase and the colocalisation of Rab-5, Rab-7 and lysosomal-associated membrane protein-1 with GBS in IFN-γ-activated HUVECs. IFN-γ resulted in an enhancement of the phagosome maturation process in HUVECs, improving the capacity to control the intracellular survival of GBS.


Subject(s)
Humans , Anti-Infective Agents/pharmacology , Human Umbilical Vein Endothelial Cells/microbiology , Interferon-gamma/pharmacology , Microbial Viability/drug effects , Streptococcal Infections/drug therapy , Streptococcus agalactiae/drug effects , Acid Phosphatase/metabolism , Bacterial Adhesion/drug effects , Endocytosis , Human Umbilical Vein Endothelial Cells/metabolism , Lysosomes/drug effects , Primary Cell Culture , Phagosomes/drug effects , Survival Analysis , Streptococcal Infections/prevention & control
8.
Rev. Soc. Bras. Med. Trop ; 47(4): 409-413, Jul-Aug/2014. tab
Article in English | LILACS | ID: lil-722313

ABSTRACT

Acute pharyngitis/tonsillitis, which is characterized by inflammation of the posterior pharynx and tonsils, is a common disease. Several viruses and bacteria can cause acute pharyngitis; however, Streptococcus pyogenes (also known as Lancefield group A β-hemolytic streptococci) is the only agent that requires an etiologic diagnosis and specific treatment. S. pyogenes is of major clinical importance because it can trigger post-infection systemic complications, acute rheumatic fever, and post-streptococcal glomerulonephritis. Symptom onset in streptococcal infection is usually abrupt and includes intense sore throat, fever, chills, malaise, headache, tender enlarged anterior cervical lymph nodes, and pharyngeal or tonsillar exudate. Cough, coryza, conjunctivitis, and diarrhea are uncommon, and their presence suggests a viral cause. A diagnosis of pharyngitis is supported by the patient's history and by the physical examination. Throat culture is the gold standard for diagnosing streptococcus pharyngitis. However, it has been underused in public health services because of its low availability and because of the 1- to 2-day delay in obtaining results. Rapid antigen detection tests have been used to detect S. pyogenes directly from throat swabs within minutes. Clinical scoring systems have been developed to predict the risk of S. pyogenes infection. The most commonly used scoring system is the modified Centor score. Acute S. pyogenes pharyngitis is often a self-limiting disease. Penicillins are the first-choice treatment. For patients with penicillin allergy, cephalosporins can be an acceptable alternative, although primary hypersensitivity to cephalosporins can occur. Another drug option is the macrolides. Future perspectives to prevent streptococcal pharyngitis and post-infection systemic complications include the development of an anti-Streptococcus pyogenes vaccine.


Subject(s)
Humans , Streptococcal Infections/diagnosis , Streptococcal Infections/microbiology , Streptococcal Infections/drug therapy , Pharyngitis/diagnosis , Pharyngitis/microbiology , Pharyngitis/drug therapy , Anti-Bacterial Agents/therapeutic use , Acute Disease
10.
Braz. dent. j ; 23(1): 36-38, 2012.
Article in English | LILACS | ID: lil-618002

ABSTRACT

This study evaluated the inhibitory activity of copaiba oil (Copaifera officinalis against the cariogenic microorganism, Streptococcus mutans. For such purpose, a minimum inhibition concentration test of copaiba oil against S. mutans was performed, using the serial dilution in broth technique, with a negative control, a positive control (0.12 percent chlorhexidine) and a 10 percent copaíba oil solution as a test. A minimum bactericidal concentration test with tubes presenting microbial inhibition was also conduced. In the minimum inhibitory concentration test, copaiba oil showed inhibition of bacterial growth at all concentrations tested up to 0.78 µL/mL of the 10 percent copaiba oil solution in the broth. In addition, the negative control had no inhibition, and the 0.12 percent chlorhexidine solution was effective up to 6.25 µL/mL in the broth. Copaiba oil showed a bacteriostatic activity against S. mutans at low concentrations, and could be a an option of phytotherapic agent to be used against cariogenic bacteria in the prevention of caries disease.


Este estudo avaliou a atividade inibitória do óleo de copaíba (Copaifera officinalis contra o microrganismo cariogênico, Streptococcus mutans. Para isso, foi realizado um teste de concentração mínima inibitória do óleo de copaíba contra S. mutans, utilizando a técnica de diluição seriada em caldo, com um controle negativo, um controle positivo (clorexidina a 0,12 por cento) e uma solução de óleo de copaíba 10 por cento como teste. Também foi conduzido um teste de concentração mínima bactericida com os tubos que apresentaram inibição microbiana. No teste de concentração inibitória mínima, o óleo de copaíba mostrou inibição do crescimento bacteriano em todas as concentrações testadas até 0,78 µL/mL da solução a 10 por cento do óleo de copaíba no caldo. Além disso, o controle negativo não teve nenhuma inibição, e a solução de clorexidina 0,12 por cento foi eficaz até 6,25 µL/mL no caldo. O óleo de copaíba mostrou uma atividade bacteriostática contra S. mutans em baixas concentrações, apresentando-se assim como uma opção de fitoterápico a ser utilizado contra bactérias cariogênicas na prevenção de cáries.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Chlorhexidine/pharmacology , Fabaceae/drug effects , Phytotherapy , Plant Oils/pharmacology , Streptococcal Infections/drug therapy , Streptococcus mutans/drug effects , Dental Caries/prevention & control , Microbial Sensitivity Tests , Plant Oils/therapeutic use
11.
Rev. méd. Chile ; 139(9): 1143-1149, set. 2011. ilus, tab
Article in Spanish | LILACS | ID: lil-612237

ABSTRACT

Background: Macrolide and lincosamide resistance in Streptococcus pyogenes is due to the acquisition of mef, ermB and ermA genes, which confer different resistance phenotypes, namely M, MLSBconstitutive and MLSBinducible respectively. The last report of resistance in Chile was done in the period 1990-1998, in which resistance to macrolides was 5.4 percent, with M phenotype as the predominant one. Aim: To characterize the evolution of erythromycin and clindamycin resistance and their associated genes in S. pyogenes strains isolated from patients with invasive and non-invasive infections in the period 1996 to 2005. Material and Methods: Resistance to erythromycin and clindamycin was determined in 1,282 clinical isolates using the disk diffusion test. Resistant isolates were analyzed by polymerase chain reaction (PCR) for the presence of the above mentioned resistance genes. Results: Global resistance to erythromycin and clindamycin was 3.5 and 0.7 percent respectively. Eighty percent of the resistant strains possessed the M. phenotype. Conclusions: Resistance levels of S. pyogenes have decreased in Chile in the last years. Most resistant strains have M phenotype in contrast to many countries in which the MLSB constitutive phenotype is the predominant one.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Clindamycin/pharmacology , Drug Resistance, Bacterial/genetics , Erythromycin/pharmacology , Pharyngitis/microbiology , Streptococcal Infections/microbiology , Streptococcus pyogenes/drug effects , Bacterial Proteins/genetics , Chile/epidemiology , Drug Resistance, Bacterial/drug effects , Genotype , Membrane Proteins/genetics , Methyltransferases/genetics , Phenotype , Poisson Distribution , Pharyngitis/drug therapy , Streptococcal Infections/drug therapy , Streptococcus pyogenes/genetics
12.
Rev. argent. microbiol ; 43(3): 195-197, jun.-set. 2011.
Article in Spanish | LILACS | ID: lil-634693

ABSTRACT

El objetivo del presente informe es describir un caso de queratopatía cristalina causada por microorganismos pertenecientes al grupo Streptococcus mitis en una paciente que concurrió a la consulta oftalmológica por molestias en su ojo derecho. Al examen oftalmológico presentó un punto de sutura interrumpida de nylon 10-0 sin tensión y con secreciones mucosas adheridas. El punto flojo fue retirado bajo normas de asepsia. Se indicó colirio de moxifloxacina al 0,5 %; el ojo tuvo una evolución adecuada, con una correcta epitelización. Sin embargo, luego de 15 días desarrolló un infiltrado blanquecino arboriforme. Se tomó una muestra en el quirófano, enhebrando el trayecto intraestromal de la sutura retirada con sutura de vicryl 7-0. Se indicaron colirios de vancomicina con 50 mg/ml. El infiltrado se mantuvo estable durante 45 días, luego se incrementó el tamaño y se produjo necrosis tisular con peligro de perforación corneal. Se realizó un recubrimiento conjuntival bipediculado. La paciente evolucionó favorablemente y luego de la retracción espontánea del recubrimiento, se observó leucoma cicatrizal y neovasos corneales.


Crystalline keratopathy: an infrequent corneal infection produced by the Streptococcus mitis group. The objective of this report is to describe a case of crystalline keratopathy caused by the Streptococcus mitis group corresponding to a patient who attended hospital for discomfort in his right eye. The ophthalmological examination showed an interrupted stitch of 10-0 nylon suture without tension and with attached mucus secretions. The loose suture was removed under aseptic conditions. Moxifloxacin 0.5 % eye drops were topically indicated. The treated eye successfully epithelialized and evolved favorably. However, after 15 days, a white tree-shaped infiltrate developed. A corneal sample was taken in the operating room, threading the intrastromal path of the removed stitch with a 7-0 vicryl suture. Vancomycin 50 mg/ml drops were indicated. The infiltrate, which was stable for 45 days, later increased its size and tissue necrosis occurred with danger of corneal perforation. A bipedicle conjunctival flap was performed in the affected corneal area, which evolved favorably. After spontaneous conjunctival flap retraction, only corneal scarring and neovascularization outside the visual axis were observed.


Subject(s)
Female , Humans , Middle Aged , Keratoplasty, Penetrating , Keratitis/microbiology , Streptococcal Infections/microbiology , Streptococcus mitis/isolation & purification , Surgical Wound Infection/microbiology , Sutures/adverse effects , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Conjunctiva/surgery , Equipment Contamination , Keratitis/diagnosis , Keratitis/drug therapy , Keratitis/surgery , Surgical Flaps , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Streptococcal Infections/surgery , Streptococcus mitis/drug effects , Surgical Wound Infection/diagnosis , Sutures/microbiology , Vancomycin/therapeutic use
13.
Arch. argent. pediatr ; 109(4): e85-e87, jul.-ago. 2011.
Article in Spanish | LILACS | ID: lil-633192

ABSTRACT

Actualmente, Streptococcus grupo A es una causa infrecuente de infección en el período neonatal. La descripción de casos de infección grave en el recién nacido es esporádica. Presentamos un recién nacido de 12 días de vida que acudió al servicio de urgencias por síndrome febril sin foco, que durante su ingreso desarrolló afectación neurológica y sistémica. Describimos la presentación clínica, la evolución y el tratamiento. El aislamiento de Streptococcus grupo A en el hemocultivo confrma la sepsis tardía por este germen con probable meningitis asociada.


Currently, the group A Streptococcus is a unusual cause of infection in the neonatal period. The description of cases of severe infection in the newborn is sporadic. We present a 12-days-old newborn attended at the emergency room for fever without focus, which developed neurological and systemic involvement during admission. Clinical presentation, evolution and treatment are described. Blood culture isolation of group A Streptococcus confrmed late sepsis by this bacteria, probably with associated meningitis.


Subject(s)
Humans , Infant, Newborn , Male , Streptococcal Infections , Streptococcus pyogenes , Sepsis/microbiology , Sepsis/diagnosis , Sepsis/drug therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy
14.
Arq. bras. cardiol ; 94(4): e113-e115, abr. 2010. ilus
Article in Portuguese | LILACS | ID: lil-546707

ABSTRACT

A endocardite bacteriana é uma grave doença infecciosa cujo tratamento é tradicionalmente feito com o paciente internado. recebendo medicação intravenosa. A possibilidade de tratamento domiciliar ou ambulatorial. em casos estritamente selecionados. é atraente tanto do ponto de vista social quanto do econômico. Apresentamos o relato de 6 pacientes com diagnóstico de endocardite bacteriana por Streptococcus. tratados parcial ou integralmente em regime ambulatorial. Todos evoluíram sem complicações e com resolução completa do quadro infeccioso.


Bacterial endocarditis is a severe infectious disease. of which treatment is traditionally carried out in hospitalized patients through intravenous medication. The possibility of at-home or ambulatory treatment. for stringently selected cases. is attractive from the social as well as from the economic point of view. We report 6 patients with a diagnosis of bacterial endocarditis caused by Streptococcus. treated partially or completely on an outpatient basis. All of them evolved without complications and presented complete resolution of the infection.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Ambulatory Care/standards , Endocarditis, Bacterial/drug therapy , Streptococcal Infections/drug therapy , Ambulatory Care/methods , Endocarditis, Bacterial/microbiology
16.
Evid. actual. práct. ambul ; 12(4): 156-157, dic. 2009.
Article in Spanish | LILACS | ID: lil-569796

ABSTRACT

A partir de la descripción de un caso clínico sobre la necesidad de administrar un tratamiento antibiótico a una niña con faringitis aguda estreptocóccica, se plantea la posible diferencia de eficacia entre dosis administradas cada seis u ocho horas, comparadas con la administración cada 12 o 24 horas. Se concluye que la indicación de penicilina o amoxicilina oral cada doce horas tiene eficacia similar a la indicación cada seis u ocho, para producir la resolución clínica y bacteriológica de la faringitis estreptocóccica en niños, con las ventajas de una mayor probabilidad de adherencia al tratamiento en la población infantil. No se evidenció el mismo efecto en el caso de la dosis única de penicilina, que disminuye su eficacia, sin embargo la amoxicilina así podría indicarse en una dosis única diaria.


Subject(s)
Humans , Female , Child , Anti-Bacterial Agents/administration & dosage , Pharyngitis/diagnosis , Pharyngitis/drug therapy , Pharyngitis/therapy , Streptococcal Infections/drug therapy , Case Reports
17.
Rev. chil. infectol ; 26(2): 152-155, abr. 2009. ilus
Article in Spanish | LILACS | ID: lil-518473

ABSTRACT

Necrotizing fasciitis (NF) is a serious infection that compromises subcutaneous tissue, fascia, and adipose tissue, with high mortality rate and sequelae. Extremities, trunk and pelvis are the most common body sites affected. Periorbital celullitis with necrotizing fasciitis of the eyelid is rare. We report the case of a three years old child with bilateral NF of the eyelids and toxic shock syndrome secondary to Streptococcus pyogenes infection ocurring after a minor skin trauma. Early recognition leading to intensive care treatment and prompt surgical debridement were critical in the favourable outcome of the child.


La fascitis necrosante (FN) es una infección grave de los tejidos subcutáneos, localizada más frecuentemente en extremidades, tronco y pelvis. El compromiso de la cara y la región palpebral es inusual. Reportamos el curso clínico de un niño de tres años, previamente sano, que presentó una FN palpebral bilateral asociado a shock tóxico por Streptococcus pyogenes, secundaria a un trauma localizado. El paciente requirió tratamiento en cuidado intensivo con resucitación enérgica, antimicrobianos, inmunoglobulina intravenosa y desbridamiento quirúrgico precoz, lo que permitió su evolución favorable.


Subject(s)
Child, Preschool , Humans , Male , Eyelid Diseases/therapy , Fasciitis, Necrotizing/therapy , Streptococcus pyogenes , Shock, Septic/therapy , Streptococcal Infections/drug therapy , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Debridement , Eyelid Diseases/diagnosis , Eyelid Diseases/microbiology , Fasciitis, Necrotizing/diagnosis , Fasciitis, Necrotizing/etiology , Immunoglobulins, Intravenous/therapeutic use , Severity of Illness Index , Shock, Septic/diagnosis , Shock, Septic/microbiology , Streptococcal Infections/diagnosis , Streptococcus pyogenes/isolation & purification , Treatment Outcome
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