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15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of Staphylococcus aureus subcutaneous abscess centered over the Jizhong acupuncture point (DU 6) which lies along the Du (Back midline) meridian after acupuncture at the corresponding acupuncture point for low back pain. The patient recovered after surgical debridement and drainage and 5 weeks of cloxacillin therapy. Among the 16 anecdotal case reports of pyogenic bacterial infections complicating acupuncture described in the English literature (MEDLINE Search 1996-2002), S. aureus was documented to be the causative agent in 9 (56%). Three patients had septic arthritis, 2 had chronic osteomyelitis, 2 had abscess formation, 1 had chondritis, and 1 had infective endocarditis. Five patients had S. aureus bacteremia. All patients who recovered required prolonged antibiotic treatment of 5-6 weeks, and 6 required drainage and/or debridement. Overall, 3 patients (30%) died. S. aureus causes significant morbidity and mortality in patients who receive acupuncture treatment. More resources should be spent on implementation of proper infection control guidelines, as the money lost due to prolonged hospitalization and medication would far exceed that used for implementation.
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PMID:Staphylococcus aureus subcutaneous abscess complicating acupuncture: need for implementation of proper infection control guidelines. 1273 99

This article describes the microbiology, diagnosis, and management of human and animal bite wound infections. Various organisms can be recovered from bite wounds that generally result from aerobic and anaerobic microbial flora of the oral cavity of the biting animal, rather than the victim's own skin flora. The role of anaerobes in bite wound infections has been increasingly appreciated. Anaerobes were isolated from more than two thirds of human and animal bite wound infections, especially those associated with abscess formation. This article describes several of the organisms found in the bites of various species. In addition to local wound infection, other complications may occur, including lymphangitis, local abscess, septic arthritis, tenosynovitis, and osteomyelitis. Rare complications include endocarditis, meningitis, brain abscess, and sepsis with disseminated intravascular coagulation, especially in immunocompromised individuals. Wound management includes the administration of proper local care and the use of proper antimicrobial agents when needed.
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PMID:Microbiology and management of human and animal bite wound infections. 1282 49

Staphylococcus aureus is a virulent pathogen that is currently a major cause of community-acquired infections, as well as infections in hospitalized patients. Morbidity and mortality due to S. aureus infections, such as sepsis, osteomyelitis, septic arthritis and infective endocarditis, remain high despite the use of newer antibiotics. Of major concern, methicillin resistance in S. aureus isolates has increased dramatically worldwide, especially among nosocomial isolates; this phenotype may be associated with resistance to other antistaphylococcal compounds, including vancomycin. This increase in prevalence of multiantibiotic resistance in S. aureus is a major public health concern. Currently, there is an intense focus on the development of novel vaccines for the prevention of S. aureus infections in high-risk populations and on new antimicrobial classes for the therapy of established S. aureus infections.
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PMID:New approaches to the prevention and treatment of severe S. aureus infections. 1284 79

The most important complications of endocarditis are congestive heart failure, paravalvular abscess formation, and embolism, especially stroke. In addition, endocarditis may be complicated by septic arthritis, vertebral osteomyelitis, pericarditis, metastatic abscesses and an array of renal problems ranging from immune-complex glomerulonephritis to renal abscesses. Adverse reactions associated with medical treatment of endocarditis can also result in significant complications such as ototoxicity and nephrotoxicity, skin rashes, and serum sickness. This review focuses on the cardiac, embolic, neurologic and renal complications of endocarditis and discusses how these complications influence the clinical management of individual cases in daily practice.
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PMID:Current best practices and guidelines. Assessment and management of complications in infective endocarditis. 1287 98

We present a case of bacteremia and septic arthritis due to Streptococcus bovis biotype I after shock, in a patient with liver cirrhosis of enolic etiology. Diagnosis was made based on a clinical setting of fever and a painful shoulder. The presence of colonic neoplasia was ruled out in this patient and the bacteremia developed without endocarditis.
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PMID:Septic arthritis due to Streptococcus bovis in a patient with cirrhosis of enolic etiology. 1295 12

An exceptional case of microbiologically confirmed oral infection with Kingella kingae in an immunocompetent adult (30-year-old woman) is presented and the pathogenesis is discussed and related to known literature data.K. kingae is a rather common but yet relatively unknown commensal corroding bacterium from the oro- and nasopharynx in healthy children, which might turn into a human pathogen causing osteomyelitis, arthritis, spondylitis, endocarditis and intervertebral diskitis in young children and rarely endocarditis, septic arthritis, meningitis, epiglottitis, diskitis and bacteraemia in adults. Sofar K. kingae associated stomatitis was reported in children and a few adults, however, with concomitant herpes simplex virus infections, and without microbiological confirmation. In the described case no viral infection was found. The proven K. kingae stomatitis represents an extension of the pathogenic spectrum and suggests that the breach of the oral mucosal barrier can be caused by the bacterial pathogen itself. Whether a concomitant viral infection is necessary forK. kingae to actually invade the bloodstream remains to be considered.
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PMID:An adult case of oral infection with Kingella kingae. 1469 Jun 66

Although infections caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility (SA-RVS) have been reported from a number of countries, including Australia, the optimal therapy is unknown. We reviewed the clinical features, therapy, and outcome of 25 patients with serious infections due to SA-RVS in Australia and New Zealand. Eight patients had endocarditis, 9 had bacteremia associated with deep-seated infection, 6 had osteomyelitis or septic arthritis, and 2 had empyema. All patients had received vancomycin before the isolation of SA-RVS, and glycopeptide treatment had failed for 19 patients (76%). Twenty-one patients subsequently received active treatment, which was effective for 16 patients (76%). Eighteen patients received linezolid, which was effective in 14 (78%), including 4 patients with endocarditis. Twelve patients received a combination of rifampicin and fusidic acid. Surgical intervention was required for 15 patients (60%). Antibiotic therapy, especially linezolid with or without rifampicin and fusidic acid, in conjunction with surgical debulking is effective therapy for the majority of patients with serious infections (including endocarditis) caused by SA-RVS.
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PMID:Treatment outcomes for serious infections caused by methicillin-resistant Staphylococcus aureus with reduced vancomycin susceptibility. 1476 45

Kingella kingae is a fastidious gram-negative coccobacillus that colonizes the respiratory and oropharyngeal tract in children. K. kingae occasionally causes invasive disease, primarily osteomyelitis/septic arthritis in young children, bacteremia in infants, and endocarditis in school-aged children and adults. Although diagnosis of this organism frequently is missed, invasive disease is uncommon. Only sporadic, non-epidemiologically linked cases have been reported previously. In October 2003, the Minnesota Department of Health (MDH) investigated a cluster of two confirmed cases and one probable case of osteomyelitis/septic arthritis caused by K. kingae among children aged 17-21 months attending the same toddler classroom in a day care center. All reported within the same week with onset of fever, preceding or concurrent upper respiratory illness (URI), and refusal to bear weight on the affected limb. This report summarizes these cases and describes the epidemiologic investigation of the day care center. The findings underscore the need for clinicians and laboratorians to consider K. kingae infection in young children with Gram stain--negative or culture-negative skeletal infections.
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PMID:Osteomyelitis/septic arthritis caused by Kingella kingae among day care attendees--Minnesota, 2003. 1504 52

A 7-year-old castrated male German Shepherd Dog was evaluated for lethargy, icterus, and sepsis. Porcupine quills had been removed from the dog's face 1 month prior to examination; progressive right forelimb lameness had developed soon after removal of the quills. Septic arthritis of the right elbow joint was diagnosed and was unresponsive to antimicrobial and anti-inflammatory treatments. At the time of referral, the dog had developed endocarditis, septicemia, and disseminated intravascular coagulation. Via ultrasonography, a foreign body consistent with a porcupine quill was detected in the medial portion of the right humeroradial joint. The dog did not respond to initial supportive treatment and died as a result of cardiac arrest. Postmortem examination confirmed the presence of a quill in the medial compartment of the right elbow joint and severe acute endocarditis with septic emboli to the kidneys and spleen. Ultrasonographic examination should be considered as a diagnostic tool when septic arthritis secondary to a foreign body is suspected in dogs.
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PMID:Ultrasonographic diagnosis of septic arthritis secondary to porcupine quill migration in a dog. 1512 88

In recent years, Kingella kingae has emerged as an important cause of invasive infections in young children, especially septic arthritis, osteomyelitis, spondylodiscitis, bacteraemia, and endocarditis, and less frequently lower respiratory tract infections and meningitis. The organism is part of the pharyngeal flora of young children and is transmitted from child-to-child. The clinical presentation of invasive K kingae disease is often subtle and laboratory tests are frequently normal. A substantial fraction of children with invasive K kingae infections have a recent history of stomatitis or symptoms of upper-respiratory-tract infection. The organism is susceptible to a wide array of antibiotics that are usually given empirically to young children including beta lactams, and with the exception of cases of endocarditis, the disease runs a benign clinical course. Although isolation and recognition of the organism is not difficult, clinicians and microbiologists should be aware of its fastidious nature. To optimise the recovery of K kingae, inoculation of synovial fluid specimens into blood culture vials is strongly recommended.
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PMID:Kingella kingae: from medical rarity to an emerging paediatric pathogen. 1517 44


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