[Sepsis with staphylococcal vegetation on tricuspid valve. Differential diagnosis with Wegener's granulomatosis]. / Posocznica gronkowcowa z wegetacja bakteryjna na zastawce trójdzielnej. Trudnosci w róznicowaniu z ziarniniakowatoscia Wegenera.

Acute, febrile disease in a young person with no previous medical history is most often caused by infection. If disease progresses despite antimicrobial treatment vascular and collagen diseases should be taken into account in differential diagnosis We present a case of a young man, with lung infiltrations and cavities in the course of febrile illness. He was referred to our hospital with a suspicion of Wegener's granulomatosis after few days of ineffective antimicrobial therapy. Positive blood culture for S. aureus and demonstration of tricuspid valve vegetation on echocardiographic examination enabled to make a final diagnosis of infective endocarditis with multiple lung abscessus.

[Etiologic factors of pleural empyema as a potential source of nosocomial infections]. / Czynniki etiologiczne ropniaków oplucnej jako potencjalne zródlo zakazen szpitalnych.

Pleural empyema still comprises an important therapeutic problem despite the availability of effective antibiotic therapy. This disorder is characterised by 20% mortality rate. Moreover, the involvement of multi-drug resistant bacterial strains may pose a risk of a nosocomial spread to other hospitalised patients. In the present study we have analysed 184 bacterial strains isolated from 63 patients with pleural empyema. A predominance of aerobic bacteria was detected, both Gram-positive cocci and Gram-negative bacilli. Staphylococci isolated from the clinical samples were characterised by a high percentage of strains resistant to gentamicin (86.3%) and methicillin (38.2%). The other important etiological agents were Pseudomonas aeruginosa and Gram-negative enteric rods of the Enterobacteriaceae family. Only 1 strain of anaerobic bacteria was detected. The enteric bacilli were characterised by a low percentage of isolates susceptible to most of the tested antibiotics (< 60%), with an exception of ciprofloxacin (68%) and imipenem (100%). These multi-drug resistant strains may spread nosocomially to other patients.