Résumé
Chromobacterium violaceum causes a rare infection in human, usually in tropical or subtropical areas. We report a fatal case of C. violaceum infection affecting a 40-year-old previously healthy man in Hong Kong. He presented with a wound infection and lymphadenitis. Despite multiple antibiotic treatment, including ciprofloxacin, he succumbed shortly after admission to the hospital. We report the epidemiological investigation findings and discuss the possible sources of infection. Physicians should be alert to this rare but fatal infection. Injury prevention and proper wound care should be emphasized to the public.
Sujets)
Adulte , Chromobacterium/effets des médicaments et des substances chimiques , Coagulation intravasculaire disséminée/microbiologie , Multirésistance bactérienne aux médicaments , Issue fatale , Hong Kong , Humains , Lymphadénite/diagnostic , Mâle , Sepsie/diagnostic , Infection de plaie/microbiologieRésumé
Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites (chiggers). A prospective study was conducted in septic shock patients in Maharat Hospital, Nakhon Ratchasima Province, Thailand, from 12 November 2001 to 5 January 2002. Of the 51 septic shock patients studied during the 7 week period, 18 (35.3%) were found to have evidence of scrub typhus infection; 3 patients (16.7%) died. In this study, septic shock caused by Orientia tsutsugamushi is the most prominent (35.3%) in endemic area of scrub typhus. Scrub typhus with septic shock patients results in organ failure: respiratory failure, DIC were predominant, followed by renal and hepatic involvement. Two deaths were due to respiratory failure and one death was as a result of combined respiratory and renal failure. Fever was the most common symptom, followed by headache, myalgia and dyspnea; lymphadenophathy and eschar are common signs. Laboratory findings revealed that almost all of the patients had a mild leukocytosis, reduced hematocrit and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77.8% of patients had abnormal chest X-rays.
Sujets)
Adulte , Sujet âgé , Animaux , Vecteurs arachnides/microbiologie , Aspartate aminotransferases/sang , Bilirubine/sang , Azote uréique sanguin , Créatinine/sang , Coagulation intravasculaire disséminée/microbiologie , Dyspnée/microbiologie , Maladies endémiques/statistiques et données numériques , Femelle , Fièvre/microbiologie , Céphalée/microbiologie , Hématocrite , Hospitalisation/statistiques et données numériques , Humains , Hypoalbuminémie/microbiologie , Hyperleucocytose/microbiologie , Maladies lymphatiques/microbiologie , Mâle , Adulte d'âge moyen , Mites (acariens)/microbiologie , Défaillance multiviscérale/microbiologie , Études prospectives , Insuffisance respiratoire/microbiologie , Fièvre fluviale du Japon/sang , Choc septique/sang , Thaïlande/épidémiologie , Thrombopénie/microbiologieRésumé
Vibrio vulnificus is a lactose positive Gram negative rod that lives in warm seas and can infect wounds and produce sepsis. Its infection is acquired after eating oysters or other filtering marine organisms. We report a 53 years old diabetic male who started with fever after a voyage to Central America. He was admitted febrile, hipotense, dehydrated and polypneic. Painful erythematous lesions and lumps were observed in his upper and lower limbs. After 72 hours of evolution, the lesions became violaceous, with crepitating vesicles full of hemorrhagic exudate. He developed a renal failure and a disseminated intravascular coagulation. Blood cultures demonstrated the presence of Vibrio vulnificus and the patient died 68 hours after admission