ABSTRACT
Ascitic and pleural fluids infection by Listeria monocytogenes is uncommon. The association of spontaneous bacterial peritonitis and empyema caused by this microorganism has been seldom reported. A 61 year-old male with an alcoholic cirrhosis and an upper right ¡obectomy for a lung cáncer, consulted because of an exacerbation of dyspnea, abdominal pain and fever. Listeria monocytogenes was isolated from ascitic and pleural fluids and from blood cultures. He was successfully treated with ampicillin and a chest tube for drainage.
Subject(s)
Humans , Male , Middle Aged , Ascitic Fluid/microbiology , Empyema, Pleural/microbiology , Listeriosis/diagnosis , Peritonitis/microbiology , Pleural Effusion/microbiology , Empyema, Pleural/diagnosis , Peritonitis/diagnosisABSTRACT
Fournier's gangrene is a form of necrotizing fasciitis of the perineal region that frequently affects immunocompromised patients. In most cases the point of entry of the infecting microorganisms goes undetected. A case of necrotizing fasciitis was diagnosed in a 77-year-old male with diabetes mellitus following an injection of botulinum toxin in the anal sphincter to treat an anal fissure.
Subject(s)
Anti-Dyskinesia Agents/administration & dosage , Botulinum Toxins/administration & dosage , Fasciitis, Necrotizing/etiology , Fournier Gangrene/etiology , Aged , Anti-Dyskinesia Agents/therapeutic use , Bacteroides fragilis , Botulinum Toxins/therapeutic use , Debridement , Fasciitis, Necrotizing/diagnostic imaging , Fasciitis, Necrotizing/microbiology , Fissure in Ano/drug therapy , Humans , Injections/adverse effects , Male , RadiographyABSTRACT
Ascitic and pleural fluids infection by Listeria monocytogenes is uncommon. The association of spontaneous bacterial peritonitis and empyema caused by this microorganism has been seldom reported. A 61-year-old male with an alcoholic cirrhosis and an upper right lobectomy for a lung cancer, consulted because of an exacerbation of dyspnea, abdominal pain and fever. Listeria-monocytogenes was isolated from ascitic and pleural fluids and from blood cultures. He was successfully treated with ampicillin and a chest tube for drainage.
Subject(s)
Ascitic Fluid/microbiology , Empyema, Pleural/microbiology , Listeriosis/diagnosis , Peritonitis/microbiology , Pleural Effusion/microbiology , Empyema, Pleural/diagnosis , Humans , Male , Middle Aged , Peritonitis/diagnosisSubject(s)
Neck Muscles/pathology , Pectoralis Muscles/pathology , Pyomyositis/pathology , Anti-Bacterial Agents/therapeutic use , Cloxacillin/therapeutic use , Humans , Immunocompetence , Male , Middle Aged , Pyomyositis/drug therapy , Shoulder Joint/diagnostic imaging , Shoulder Joint/pathology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Wegener's granulomatosis is a systemic necrotizing vasculitis that affects medium size and small vessels. Neurological involvement occurs in 22% to 54% of patients, mainly in the form of mononeuritis multiplex. Central nervous system involvement is reported in only 2% to 8% of the cases. We report a 42-year-old male who presented with headache, diplopia, third and sixth cranial nerve palsies and left eye amaurosis associated to mass located in the Meckel cavum and diffuse meningeal involvement. A biopsy of the mass disclosed a chronic granulomatous necrotizing inflammation with Langhans giant cells. A chest CAT scan showed three cavitated lung nodules and ANCA antibodies were positive in a titer of 1:80. Treatment with steroid and cyclophosphamide was started and cranial nerve palsies resolved and the number and size of lung nodules decreased. The patient was lost from follow up.
Subject(s)
Granulomatosis with Polyangiitis/complications , Meningitis, Aseptic/etiology , Adult , Cranial Nerve Diseases/etiology , Humans , MaleABSTRACT
Wegener's granulomatosis is a systemic necrotizing vasculitis that affects medium size and small vessels. Neurological involvement occurs in 22 percent to 54 percent of patients, mainly in the form of mononeuritis multiplex. Central nervous system involvement is reported in only 2 percent to 8 percent of the cases. We report a 42-year-old male who presented with headache, diplopia, third and sixth cranial nerve palsies and íeft eye amaurosis associated to mass located in the íeft Meckel cavum and diffuse meningeal involvement. A biopsy of the mass disclosed a chronic granulomatous necrotizing inflammation with Langhans giant cells. A chest CAT scan showed three cavitated lung nodules and ANCA antibodies were positive in a titer of 1:80. Treatment with steroid and cyclophosphamide was started and cranial nerve palsies resolved and the number and size of lung nodules decreased. The patient was lost from follow up.
Subject(s)
Adult , Humans , Male , Meningitis, Aseptic/etiology , Granulomatosis with Polyangiitis/complications , Cranial Nerve Diseases/etiologyABSTRACT
OBJECTIVES: To report one case of unilateral acute orchiepididymitis due to Brucella and to review its diagnosis and treatment in the related literature. METHOD: We report the case of a 37-year-old-male with undulant fever, scrotal pain and swelling and osteoarticular involvement. Diagnosis was obtained by anamnesis, blood cultures and specific serologic tests for Brucella. RESULTS: Antibiotic therapy with orally administered Doxycycline (6 weeks) and im-administered Streptomycin (3 weeks). Complete clinical resolution was achieved. CONCLUSIONS: We must perform an exhaustive anamnesis looking for a history of contact with animals or ingestion of contaminated dairy products in endemic areas of Brucella when facing the case of orchiepididymitis resistant to usual antibiotic therapy. The diagnosis is based on Brucella spp. isolation in blood cultures and on positive serologic tests (Rose Bengal test, standard seroagglutination test, anti-Brucella Coombs test, Brucellacapt test). Doxycycline with Streptomycin or Rifampin for 6 weeks seems to be the most adequate combinations of antibiotics. Surgical treatment only in exceptional cases.
Subject(s)
Brucellosis , Epididymitis/microbiology , Orchitis/microbiology , Adult , Brucellosis/diagnosis , Epididymitis/complications , Epididymitis/diagnosis , Humans , Male , Orchitis/complications , Orchitis/diagnosisABSTRACT
OBJETIVOS: Presentar un caso de orquiepididimitisaguda unilateral secundaria a brucella y revisar aspectos diagnóstico-terapéuticos en la literatura relacionada. MÉTODO: Presentamos el caso de un varón de 37 añoscon fiebre ondulante, dolor, tumefacción escrotal y afectación osteoarticular. Diagnóstico mediante anamnesis, hemocultivos y serologías específicas para brucella. RESULTADOS: Tratamiento antibiótico con Doxiciclina víaoral (6 semanas) y Estreptomicina intramuscular (3 semanas). Completa resolución clínica del cuadro. CONCLUSIONES: En áreas endémicas de brucella oante la refractariedad al tratamiento antibiótico habitualde una orquiepididimitis debemos realizar una detalladaanamnesis en busca de posibles contactos con ganado oingesta de productos lácteos contaminados. El diagnósticose basa en el aislamiento de brucella spp. en hemocultivos y en la positividad de pruebas serológicas (test rosa de Bengala, test de seroaglutinación estándar, test deCoombs anti-Brucella y test Brucellacapt). Doxiciclina asociadaa Estreptomicina o Rifampicina durante 6 semanasparecen las combinaciones antibióticas de elección.Tratamiento quirúrgico sólo en casos excepcionales
OBJECTIVES: To report one case of unilateral acute orchiepididymitis due to Brucella and to review its diagnosis and treatment in the related literature. METHOD: We report the case of a 37-year-old-male with undulant fever, scrotal pain and swelling and osteoarticular involvement. Diagnosis was obtained by anamnesis, blood cultures and specific serologic tests for Brucella. RESULTS: Antibiotic therapy with orally administered Doxycycline (6 weeks) and im-administered Streptomycin (3 weeks). Complete clinical resolution was achieved. CONCLUSIONS: We must perform an exhaustive anamnesis looking for a history of contact with animals or ingestion of contaminated dairy products in endemic areas of Brucella when facing the case of orchiepididymitis resistant to usual antibiotic therapy. The diagnosis is based on Brucella spp. isolation in blood cultures and on positive serologic tests (Rose Bengal test, standard seroagglutination test, anti-Brucella Coombs test, Brucellacapt test). Doxycycline with Streptomycin or Rifampin for 6 weeks seems to be the most adequate combinations of antibiotics. Surgical treatment only in exceptional cases
