RESUMO
Raoultella (R.) ornithinolytica is a gram-negative, encapsulated aerobe or facultative anaerobe belonging to the family Enterobacteriaceae. It is distinguished from other members in the family with a negative indole test, growth at 10oC, production of histamine, a negative D-melezitose test, and metabolism of ornithine. R. ornithinolytica is a versatile organism found in different habitats, including soil, water, and plants, as well as colonizing the human gastrointestinal tract and throat. It was considered to cause opportunistic infection in humans but is increasingly being implicated in infections in immunocompetent individuals. Raoultella ornithinolytica causes infection in different clinical settings. Sepsis from Raoultella ornithinolytica is increasing among humans, and it is considered an emerging infectious agent in both immunocompromised and immunocompetent people. There is an increasing level of antibiotic resistance among isolates with reports of multidrug resistance. We report the case of a 95-year-old man with multidrug-resistant R. ornithinolytica multisystem infection and review the literature.
RESUMO
Spontaneous intracranial bleed in sickle cell disease is a rare presentation and complication of the disease, with a few cases presenting with epidural hematoma. We present an 18-year-old boy with sickle cell, hemoglobin FS, who presented with non-traumatic scalp swelling, headaches, and vomiting six days following an episode of vaso-occlusive crisis with bone pain. A head CT scan showed extensive epidural hematoma with mass effect and acute corpus callosum bleed. The patient, however, had a cardiac arrest with unsuccessful resuscitation before neurosurgical interventions could be instituted. Of all reported cases, none has reported associated bleeding in the corpus callosum, making our case the firstwith such a combination, possibly worsening the outcome.