ABSTRACT
Escherichia coli infection is very common cause of early onset septicemia especially in very low-birth-weight newborns, but E. coli endocarditis has not been described in newborns. E. coli endocarditis, even in the adult population, is a rare and not well-characterized disease and is associated with high mortality. We report a very unusual presentation of persistent E. coli infection associated with endocarditis.
Subject(s)
Staphylococcal Scalded Skin Syndrome/diagnosis , Staphylococcus epidermidis , Diagnosis, Differential , Exanthema/etiology , Female , Humans , Infant, Newborn , Skin/microbiology , Skin/pathology , Staphylococcal Scalded Skin Syndrome/therapy , Staphylococcus epidermidis/isolation & purification , Stevens-Johnson Syndrome/diagnosisSubject(s)
Aneurysm, Infected/diagnosis , Blepharoptosis/etiology , Carotid Artery Diseases/diagnosis , Carotid Artery, Internal , Cavernous Sinus Thrombosis/diagnosis , Intracranial Aneurysm/diagnosis , Streptococcal Infections/diagnosis , Adolescent , Aneurysm, Infected/complications , Carotid Artery Diseases/complications , Cavernous Sinus Thrombosis/complications , Humans , Intracranial Aneurysm/complications , Magnetic Resonance Angiography , Male , Streptococcal Infections/complications , Streptococcus milleri Group/isolation & purificationABSTRACT
OBJECTIVES: To determine risk factors in children for the acquisition of Brucella, clinical presentation, treatment, and disease outcomes. METHODS: A retrospective multicenter chart review was undertaken of children identified with brucellosis from 1986 to 2008 at three tertiary care centers in Chicago, Illinois, USA. The charts were reviewed for data regarding risk factors for acquisition, clinical presentation, and outcomes. RESULTS: Twenty-one charts were available for review. The median age was 6.5 years (range 2-14 years); 62% were female. Ethnic background was 67% Hispanic and 24% Arabic. Risk factors included travel to an endemic area (86%), particularly Mexico, and consumption of unpasteurized milk products (76%). Common findings included fever (95%), bacteremia (86%), elevated liver transaminases (80%), constitutional symptoms (76%), splenomegaly (60%), and hepatomegaly (55%). Relapse occurred in three of six subjects started on single drug treatment, but in only one of 15 subjects who started on two or more drugs (p=0.053). No relapses occurred in children whose initial therapy included rifampin or those administered three-drug regimens. CONCLUSIONS: Brucella is an infrequent pathogen but should be considered in children with compatible epidemiologic and clinical characteristics. Blood cultures should be obtained, and initial therapy with two or more drugs may decrease the risk of relapse.
