Perinephric abscess caused by Fusarium chlamydosporum in an immunocompetent child: case report and identification of the morphologically atypical fungal strain.

Fusarium infections are important problem worldwide, cause a broad spectrum of infections in human including superficial infections as well as locally invasive and disseminated infections. We report a rare case of perinephric abscess caused by Fusarium chlamydosporum in a child who had a recent episode of pyelonephritis. This case illustrates the ever increasing spectrum of rare but offending pathogenic fungi in an immunocompetent host. Fungal infections should always be suspected in patients having one or the other underlying risk factor or who are unresponding to antibacterial therapy. Early diagnosis of infection with a specific pathogen may lead to changes in antifungal therapy and may be critical for an improved outcome.

Perinephric abscess from insulin syringe reuse.

Perinephric abscess is a rare and often missed diagnosis. Diabetes mellitus and injection drug use are often considered among the predisposing factors for perinephric abscess. Diabetic patients are taught to discard insulin syringes after a single use. Described here is a patient who developed perinephric abscess from contaminated insulin syringes. Physicians are often unaware of the high prevalence of disposable insulin syringe reuse in the community.

Desensitization of vascular and platelet alpha 2-adrenoceptors in rabbits with perinephritis hypertension.

The effects of infusion of alpha-adrenoceptor agonists on blood pressure, pressor responses to bolus doses of agonists and to platelet aggregation were examined in rabbits with perinephritis hypertension and in sham-operated controls. Pressor responses to bolus doses and infusions of phenylephrine, an alpha 1-selective agonist, were greater in hypertensive rabbits. In contrast, responses to boluses but not infusions of alpha-methylnoradrenaline, a selective alpha 2-agonist, were increased in hypertensives. During alpha-methylnoradrenaline infusions pressor responses to bolus doses of alpha-methylnoradrenaline and the aggregatory response of platelets to adrenaline were attenuated in all rabbits, consistent with alpha 2-adrenoceptor desensitization. Attenuation and recovery were observed within minutes of commencing and ceasing infusion. The extent of attenuation and rate of change were generally increased in hypertensive animals. This could explain the apparent increase in pressor responses to bolus doses but not infusions of alpha-methylnoradrenaline in the hypertensive rabbits. It might also contribute to the lability in blood pressure observed in these animals.

Bacteroides fragilis perinephric abscess.

Although urinary tract infection caused by Bacteroides fragilis has been recognized since the turn of the century it is not frequently recognized in clinical practice. Only a small number of significant upper urinary tract infections in which Bacteroides fragilis has had a significant pathogenic role have been reported previously. The use of systemic metronidazole in the treatment of this rare and unusually refractory form of urinary tract infection is described.

Perinephric abscess in patients with polycystic kidney disease undergoing chronic hemodialysis.

5 patients with polycystic kidney disease undergoing chronic hemodialysis who developed perinephric abscesses are described. Gallium-67 scintigraphy was helpful in making a diagnosis in 2 of these patients. All 5 patients initially presented with urinary tract infections. Perinephric abscess became evident over a variable period of time (2--28 days) following completion of antibiotic therapy for their urinary tract infection. Gallium-67 scintigraphy appears useful in detecting this complication, and nephrectomy should be considered once the diagnosis is confirmed.

[Clinical study with Spectacillin on patients with infections of the urogenital system (author's transl)]. / Klinische Untersuchungen mit Spectacillin bei Infektionen des Urogenitalsystems

Report is given of clinical experiences gained with the new developed semi-syntheticpenicillin "Spectacillin" on 75 patients suffering from an urological disease. The drug has been applied for therapy of acute and chronic forms of inflammations of the bladder and the urethra, additionally the prostatitis, the epididymitis, but first of all the pyelonephritis (caused bacterially). Within the germ spectrum of these diseases, germs of the coli-type, streptococcus faecalis (enterococcus), staphylococcus aureus, Neisseria gonorrhoeae, proteus, pseudomonas and aerobacter were found. Patients with acute/subacute diseases have been treated 8 to 9 days (3-4 grams per day) on an average; in case of chronic diseases, the patients received initially 1 gram a day and thereupon during 3 to 4 weeks 3 to 4 grams per day. The well-succeeded results have been documentated by means of the clinical course, the germ-elimination and the laboratory findings. The exanthematous quote may be demonstrated as remarkably low, considering the good universal compatibility of the substance. For this reason "Spectacillin" not finally is suitable for treatment of acute and chronic infections of the urogenital systems.