ABSTRACT
We report the case of a 28-year-old intravenous drug abuser under quadritherapy for stage C3 AIDS and with past history of infectious endocarditis. He was admitted with a diminished general condition, weight loss, progressive unbearable abdominal pain and vomiting, without fever. An inflammatory syndrome is noted and imaging reveals a voluminous splenic abscess. Conservative treatment is initiated with repetitive drainages and intravenous antibiotics. Aetiologies, diagnosis and possible therapeutics of splenic abscesses are discussed.
Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Abdominal Abscess/diagnosis , Bacterial Infections/diagnosis , Splenic Diseases/diagnosis , AIDS-Related Opportunistic Infections/therapy , Abdominal Abscess/therapy , Adult , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/therapy , Combined Modality Therapy , Drainage , Enterobacter cloacae , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/therapy , Enterococcus , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/therapy , Humans , Illicit Drugs , Male , Splenic Diseases/therapy , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Substance Abuse, Intravenous/complications , Tomography, X-Ray ComputedABSTRACT
Several authors, mainly from the United States, have reported on the microbiology and interpretation of positive blood cultures. We conducted a retrospective study over a 2 years period to address this issue in a medium-size swiss hospital: two hundred and thirty-two episodes of positive blood culture were recorded, with 403 microorganisms; Escherichia coli (22%), Staphylococcus aureus (21%) and coagulase-negative staphylococci (110%) were the most frequent isolates. The latter were considered as contaminants in 38% of cases. Half the episodes were nosocomial, 23% originated from the urinary tract and 18% were linked to a vascular catheter. Attributable mortality of bacteremia/fungemia was 9%, significantly higher for fungi (36%) than for bacteria (8%; p 0.009).
Subject(s)
Bacteremia/epidemiology , Fungemia/epidemiology , Bacteremia/diagnosis , Bacteremia/etiology , Cross Infection , Fungemia/diagnosis , Fungemia/etiology , Hospitals/statistics & numerical data , Humans , Incidence , Retrospective Studies , Risk Factors , Switzerland/epidemiologyABSTRACT
The management of a liver abscess suspected on the basis of clinical and radiological findings is radically different depending on its amoebic or pyogenic etiology. Medical management is usually enough to treat amoebic abscess, the prognosis of which is excellent while percutaneous aspiration puncture, drainage and antibiotics is the rule in pyogenic abscess, the prognosis of which depends on the quickness of diagnosis and risk factors associated. This article first relates a case of liver abscess we had in our service and then propose, on the basis of a literature review, a synthesis of the different characteristics, diagnostic and therapeutic approaches and follow-up of amoebic and pyogenic liver abscesses.
