RESUMO
A case of bacterial endocarditis caused by Moraxella catarrhalis in an apparently immunocompetent Greek male is presented, which was diagnosed after a 2-month history of low-grade fever of unknown origin. The agent seems to be a rare pathogen, but due to the high mortality rate, it should always be considered in the differential diagnosis of relevant cases. Beta-lactamase production by many strains complicates the choice of antibiotic.
Assuntos
Endocardite/microbiologia , Moraxella catarrhalis/isolamento & purificação , Infecções por Neisseriaceae/microbiologia , Adulto , Amoxicilina/uso terapêutico , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Ácido Clavulânico/uso terapêutico , Endocardite/tratamento farmacológico , Humanos , Imunocompetência , Masculino , Testes de Sensibilidade Microbiana , Moraxella catarrhalis/efeitos dos fármacos , Infecções por Neisseriaceae/tratamento farmacológico , Penicilinas/uso terapêutico , Literatura de Revisão como Assunto , Resultado do TratamentoRESUMO
Micrococcus luteus was repeatedly isolated in blood cultures during a prolonged feverish syndrome in a patient who presented with multiple hepatic abscesses as well. In contrast to the literature, this case is not related to prosthetic devices; an untreated limb wound may have been the site of microbial entry.
Assuntos
Abscesso Hepático/etiologia , Micrococcus luteus/patogenicidade , Infecções por Bactérias Gram-Positivas/diagnóstico por imagem , Infecções por Bactérias Gram-Positivas/etiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Abscesso Hepático/diagnóstico por imagem , Abscesso Hepático/microbiologia , Masculino , Micrococcus luteus/isolamento & purificação , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Anaerobic arthritis due to Bacteroides fragilis was diagnosed in a 33-year-old patient with prolonged fever suffering from sickle cell/thalassaemia. The causative agent was isolated from blood and purulent synovial fluid from both knee joints. A combination of chloramphenicol plus metronidazole treatment proved effective. Anaerobic arthritis has not previously been described in patients with sickle cell disease, and may reflect the well-known susceptibility of these patients to pathogens.
Assuntos
Anemia Falciforme/complicações , Artrite Infecciosa/microbiologia , Infecções por Bacteroides/complicações , Bacteroides fragilis , Talassemia/complicações , Adulto , Artrite Infecciosa/tratamento farmacológico , Infecções por Bacteroides/tratamento farmacológico , Cloranfenicol/uso terapêutico , Quimioterapia Combinada , Humanos , Articulação do Joelho/microbiologia , Masculino , Metronidazol/uso terapêutico , Líquido Sinovial/microbiologiaRESUMO
The efficacy and safety of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections was evaluated in 72 patients suffering from upper urinary tract infection (19 patients), deep soft tissue infection (16), chronic osteomyelitis (12), abscess (7), chronic otitis media (6), otitis externa (3) and bronchopneumonia (9). Forty-eight patients received an oral dose of 500 mg or 750 mg b.i.d. and five patients an i.v. dose of 200 mg b.i.d., while 19 patients were given both oral and parenteral doses. The duration of therapy ranged from seven days to more than four months. The MICs of ciprofloxacin for the Pseudomonas aeruginosa strains isolated were in the range less than 0.06-2 mg/l; 36% of the strains were resistant to all other available antibiotics. At follow-up after a minimum of six months the clinical success rate was 75% and the infecting organism was permanently eradicated in 49% of the patients. In nine patients the organism developed resistance, particularly when the initial MIC was higher than 0.5 mg/l. No significant adverse reactions were observed. Ciprofloxacin is the first antipseudomonal antimicrobial agent which can be administered orally and therefore fulfills a need in chemotherapy.
