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1.
Fetal Pediatr Pathol ; 31(1): 1-6, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22506968

ABSTRACT

We report an unusual variant of Lemierre's Syndrome (LS) in a 10-year-old-girl admitted to the intensive care unit for septic shock with meningitis. The primary infection was otitis media. A gram negative bacillus was identified in the direct exam of the purulent ear discharge and the cerebrospinal fluid but cultures were negative. Computerized tomography of the neck revealed a thrombus in the internal jugular vein. Septic shock improved rapidly under supportive treatment. The patient recovered without sequellae after a prolonged duration of parenteral antibiotherapy and hospital stay. Neurologic variants of LS with meningitis, previously reported in the literature, are reviewed.


Subject(s)
Lemierre Syndrome/physiopathology , Meningitis/physiopathology , Otitis Media, Suppurative/complications , Child , Female , Humans , Lemierre Syndrome/etiology , Meningitis/etiology
2.
J Microbiol Immunol Infect ; 44(5): 394-6, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21524967

ABSTRACT

Group milleri streptococci that colonize the mouth and the upper airways are generally considered to be commensal. In combination with anaerobics, they are rarely responsible for brain abscesses in patients with certain predisposing factors. Mortality in such cases is high and complications are frequent. We present a case of fatal subdural empyema caused by Streptococcus constellatus and Actinomyces viscosus in a previously healthy 7-year-old girl.


Subject(s)
Actinomyces viscosus/isolation & purification , Actinomycosis/complications , Actinomycosis/diagnosis , Empyema, Subdural/diagnosis , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Streptococcus constellatus/isolation & purification , Actinomycosis/microbiology , Actinomycosis/pathology , Child , Coinfection/diagnosis , Coinfection/microbiology , Coinfection/pathology , Empyema, Subdural/microbiology , Empyema, Subdural/pathology , Fatal Outcome , Female , Head/diagnostic imaging , Humans , Streptococcal Infections/microbiology , Streptococcal Infections/pathology , Tomography, X-Ray Computed
3.
Tunis Med ; 84(11): 730-3, 2006 Nov.
Article in French | MEDLINE | ID: mdl-17294901

ABSTRACT

A total of 23 invasive strains of Neisseria meningitidis were isolated between March 1998 and February 2004. 19 strains were recovered from cerebrospinal fluid (CSF) and 4 from blood. The majority of these strains were recovered from children with an age less to 4 years (86.9%). The antigenic formula'study (serogroup:serotype:serosubtype) of the strain's collection have shown there great diversity. The sero-group B was the most frequent (83%) followed by serogroup C (17%). The B:NT:NST phenotype was major among strains of the serogroup B and the C:4:P1-14 phenotype among strains of the serogroup C. No beta-lactamase activity was detected. 30.4% of the strains were of diminished susceptibility to penicillin G (CM190 = 0.38 Ig/ml). No resistance to amoxicillin (CMI90 = 0.19 microg/ml), to cefotaxime (CMI90 = 0.016 microg/ml) and to rifampin (CMI90-0.125 microg/ml) was detected; whereas 8.7% of strains-were resistant to chloramphenicol (CMI90=2 Ig/ml) and 65.2% to spiramycin.


Subject(s)
Anti-Bacterial Agents/pharmacology , Hospitals, Pediatric , Neisseria meningitidis/drug effects , Antibiotics, Antitubercular/pharmacology , Child , Child, Preschool , Drug Therapy, Combination , Female , Humans , Infant , Male , Meningococcal Infections/blood , Meningococcal Infections/cerebrospinal fluid , Microbial Sensitivity Tests/methods , Neisseria meningitidis/classification , Neisseria meningitidis/isolation & purification , Phenotype , Retrospective Studies , Serotyping , Tunisia
4.
Tunis Med ; 81(6): 390-4, 2003 Jun.
Article in French | MEDLINE | ID: mdl-14534944

ABSTRACT

E. coli is the most frequently isolate species in community as well as in nosocomial acquired urinary tract infections (UTI). Trimethoprim-sulfamethoxazole (TMP-SMX), is commonly used as empiric treatment for managing uncomplicated UTI whereas the rate of resistance to amoxicilline is increasing. A multicentric retrospective study was conducted from January 1st 1999 to December 31st 2000 to evaluate the prevalence of E. coli isolates from UTI and to guide empiric therapies. Among 6994 urinary isolates, 62.6% were resistant to amoxicilline, this rate fell to 33.6% when amoxicilline was associated to clavulanic acide, 2.7% were producing extended spectrum b-lactamases (BLSE), higher than reported in France and USA. 37.3% were resistant to TMP-SMX. The high prevalence of antimicrobial resistance among UTI E. coli isolates emphasizes the necessity to review the empiric therapies. Fluoroquinolones can be considered as an alternative therapy according to their excellent tissue penetration and their wide spectrum of activity.


Subject(s)
Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Escherichia coli Infections/drug therapy , Urinary Tract Infections/drug therapy , Urinary Tract Infections/microbiology , Anti-Bacterial Agents/therapeutic use , Escherichia coli/isolation & purification , Humans , Retrospective Studies , Tunisia
5.
Tunis Med ; 81(3): 167-71, 2003 Mar.
Article in French | MEDLINE | ID: mdl-12793066

ABSTRACT

We report the results of a multicenter tunisian study, performed over a two-year period (1998-1999), to determine the susceptibility pattern of Streptococcus pneumoniae in our country. A total of 146 S. pneumoniae were collected during the study period. 76 were recovered from adults and 70 from children. 53% of isolates have decreased susceptibility to penicillin, 24% with low level resistance, and 11% with high level resistance. Amoxicillin and cefotaxime decreased susceptibility rates were: 12% (low level resistance exclusively). and 14% (10% with low level resistance and 4% with high level resistance) respectively. Strains isolated from children, showed higher resistance to b lactams than those isolated from adults. Resistance rates to other antibiotics were as follow: erythromycin 28%, choramphenicol 14%, cyclins 23%, thrimethoprim-sulfamethoxazole 28% and rifampin 1%. No vancomycin resistant strain was found. The acquire resistance rates of Streptococcus pneumoniae in Tunisia are worrying, essentially for penicillin and erythomycin. Amoxicillin and cefotaxime have conserved a good activity.


Subject(s)
Anti-Bacterial Agents/pharmacology , Streptococcus pneumoniae/drug effects , Adult , Age Factors , Amoxicillin/pharmacology , Cefotaxime/pharmacology , Child , Chloramphenicol/pharmacology , Drug Resistance, Bacterial , Erythromycin/pharmacology , Humans , Microbial Sensitivity Tests , Penicillin G/pharmacology , Penicillin Resistance , Penicillins/pharmacology , Retrospective Studies , Streptococcus pneumoniae/isolation & purification , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , Tunisia
6.
Tunis Med ; 80(8): 469-72, 2002 Aug.
Article in French | MEDLINE | ID: mdl-12703127

ABSTRACT

Haemophilus influenzae, a commensal bacteria, is frequently incriminated in broncho--pulmonary surinfections and severe diseases as meningitis, pneumonia and septic arthritis, particularly in young children. A multicenter study was conducted to establish the epidemiological profile of Haemophilus influenzae diseases, to determine the rate of antibiotics resistance for guide therapeutic and preventive strategies. The identification was based on the requirements for X and V factors, and the serotype b determined by agglutination. The betalactamase production was done by nitrocefin test. Antimicrobial susceptibility testing was determined on Muller Hinton chocolate agar with isovitalex. During the two year period, (January 1998 December 1999), 192 isolates of H. Influenzae were collected, 61% were recovered from invasive infections (44 meningitis, 8 bacteremia, 2 arthritis). The serotype b was identified in 55.7% of cases, 67.3% were invasive strains. 24.5% of isolates were producing betalactamase particularly invasive serotype b strains. All isolates of H. influenzae were susceptible to cefotaxim and to ofloxacin. Resistance rates to other antibiotics were: erythromycin 56.2%, tetracyclin 10.3%, rifampin 12%, chloramphénicol 1%, cotrimoxazole 16.5%, 11.5% amikacin and 20% gentamicin. The incidence of meningitis remained frequent in our country, involving the introduction of the vaccination in official calendar. Nevertheless, the surveillance of H. influenzae invasives infections and the serotyping of isolates were necessary to evaluate the impact of the immunization.


Subject(s)
Haemophilus Infections/epidemiology , Haemophilus influenzae/pathogenicity , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Drug Resistance, Microbial , Haemophilus Vaccines/administration & dosage , Haemophilus influenzae/drug effects , Humans , Incidence , Meningitis, Haemophilus/epidemiology , Seasons , Tunisia/epidemiology
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