ABSTRACT
OBJECTIVE: This study was conducted to investigate the clinical characteristics of patients with Aeromonas peritonitis, particularly secondary peritonitis. METHODS: Patients with Aeromonas peritonitis treated between July 2004 and December 2011 were identified from the computerized database of a regional hospital in southern Taiwan. The medical records of these patients were retrospectively reviewed. RESULTS: A total of 50 patients with Aeromonas peritonitis were identified. Nine cases were classified as spontaneous bacterial peritonitis, and 41 cases were classified as secondary peritonitis. The most common etiology of secondary peritonitis was acute appendicitis (n=26), followed by small bowel perforation (n=7) and colon perforation (n=6). The patients with spontaneous bacterial peritonitis were more likely to be immunocompromised (p=0.0013) and more frequently had an initial presentation of shock (p=0.0129), an abnormal liver function (p<0.05) and concomitant bacteremia (p=0.0024) than the patients with secondary peritonitis. Although the patients with secondary peritonitis had higher levels of inflammatory parameters, including leukocytes and C-reactive protein, and more frequent polymicrobial infections, their survival outcome rates, such as in-hospital mortality, were significantly lower (p=0.0007). The overall in-hospital mortality rate was 20%, and initial shock was the only independent prognostic factor for mortality (p=0.012). CONCLUSION: The clinical characteristics, including outcomes, of patients with spontaneous and secondary Aeromonas peritonitis differ. In-hospital mortality is significantly associated with the initial presentation of shock.
Subject(s)
Aeromonas/pathogenicity , Gram-Negative Bacterial Infections/microbiology , Peritonitis/microbiology , Adolescent , Adult , Aeromonas/isolation & purification , Aged , Female , Gram-Negative Bacterial Infections/diagnosis , Hospitals, Municipal , Humans , Male , Middle Aged , Peritonitis/diagnosis , Prognosis , Taiwan , Young AdultABSTRACT
Empyema thoracis with concomitant bacteremia caused by nontuberculous mycobacterium is rare. Herein, we report a case of disseminated Mycobacterium abscessus in a patient with liver cirrhosis and diabetes mellitus. M. abscessus was isolated from the specimen of pleural fluid and blood. The patients clinical condition gradually improved after antibiotic use and drainage.
Subject(s)
Bacteremia/diagnosis , Bacteremia/pathology , Empyema, Pleural/diagnosis , Empyema, Pleural/pathology , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium Infections, Nontuberculous/pathology , Mycobacterium/isolation & purification , Adult , Anti-Bacterial Agents/therapeutic use , Bacteremia/complications , Bacteremia/therapy , Blood/microbiology , Diabetes Complications/diagnosis , Diabetes Complications/pathology , Drainage , Empyema, Pleural/complications , Empyema, Pleural/therapy , Exudates and Transudates/microbiology , Humans , Liver Cirrhosis/complications , Male , Mycobacterium/classification , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/therapy , Radiography, Thoracic , Treatment OutcomeABSTRACT
Strains of Aeromonas species are prevalent bacteria in coastal areas of southern Taiwan. Aeromonad is known as a cause of epidemic diarrheal disease, and the most common clinical manifestation is acute gastroenteritis. Extra-intestinal infections by Aeromonas species, such as pleural cavity, are rare. Herein, we described the six patients who developed Aeromonas spp.-related empyema, and was successfully treated with antimicrobial agent and drainage.
Subject(s)
Aeromonas/pathogenicity , Empyema/microbiology , Gram-Negative Bacterial Infections/complications , Adult , Aged , Female , Gram-Negative Bacterial Infections/microbiology , Humans , Male , Middle Aged , TaiwanABSTRACT
Vibrio cholerae is known as a common etiology of epidemic diarrheal disease and rarely causes extra-intestinal infections. In this report, we described a cirrhotic patient with hepatocellular carcinoma who developed spontaneous bacterial empyema due to non-O1, non-O139 V. cholerae. The patient was successfully treated with antimicrobial agents and percutaneous drainage.
Subject(s)
Carcinoma, Hepatocellular/complications , Empyema/diagnosis , Empyema/microbiology , Liver Cirrhosis/complications , Liver Neoplasms/complications , Vibrio cholerae/isolation & purification , Anti-Bacterial Agents/administration & dosage , Cholera/diagnosis , Cholera/microbiology , Cholera/pathology , Cholera/therapy , Drainage , Empyema/pathology , Empyema/therapy , Humans , Male , Middle Aged , Radiography, Thoracic , Vibrio cholerae/classificationSubject(s)
Carcinoma, Hepatocellular/complications , Liver Abscess/diagnosis , Liver Cirrhosis/complications , Liver Neoplasms/complications , Vibrio Infections/diagnosis , Vibrio cholerae non-O1/isolation & purification , Aged , Humans , Liver Abscess/microbiology , Male , Radiography, Abdominal , Tomography, X-Ray Computed , Vibrio Infections/microbiologyABSTRACT
Shewanella algae, mainly found in marine environments, is a rare pathogen in humans, especially in healthy children. Here we report a previously healthy boy presenting with acute exudative tonsillitis after traveling to the coast, and S. algae was isolated from the throat swab culture.
