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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Early reports associated Candida parapsilosis with endocarditis in intravenous narcotic addicts. More recently, this species has emerged as an important nosocomial pathogen, with clinical manifestations including fungemia, endocarditis, endophthalmitis, septic arthritis, and peritonitis, all of which usually occur in association with invasive procedures or prosthetic devices. Outbreaks of C. parapsilosis infections have been caused by contamination of hyperalimentation solutions, intravascular pressure monitoring devices, and ophthalmic irrigating solution. Experimental studies have generally shown that C. parapsilosis is less virulent than Candida albicans or Candida tropicalis. However, characteristics of C. parapsilosis that may relate to its increasing occurrence in nosocomial settings include frequent colonization of the skin, particularly the subungual space, and an ability to proliferate in glucose-containing solutions, with a resultant increase in adherence to synthetic materials. Recently developed molecular techniques may facilitate the continued exploration of the epidemiology and pathogenesis of C. parapsilosis infections.
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PMID:Candida parapsilosis: epidemiology, pathogenicity, clinical manifestations, and antimicrobial susceptibility. 801 46

During a 50-month period, we identified 91 episodes of fungal infection in 72 liver transplant recipients (23.8%). Candida species accounted for 83.5% of cases. Clinical patterns of fungal infections included disseminated infection (19), peritonitis (17), pneumonitis (15), multiple sites of colonization (13), fungemia (11), and other sites (16). The diagnosis of fungal infection was usually made in the first 2 months (84.7% of cases), at a mean time of 16 days after transplantation. Risk factors for fungal infections included retransplantation, Risk score, intraoperative transfusion requirement, urgent status, Roux limb biliary reconstruction (in adults), steroid dose, bacterial infections and antibiotic therapy, and vascular complications. Fungal infections were successfully treated with amphotericin B in 63 cases (74.1%) but were associated with diminished patient survival (50% vs 83.5%). Fungal infection is a frequent source of early morbidity and can be related to well-defined risk factors, suggesting the need for effective prophylaxis.
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PMID:Clinical spectrum of fungal infections after orthotopic liver transplantation. 199 92

We have reported a case of neonatal Torulopsis glabrata peritonitis and ventriculitis associated with a ventriculoperitoneal shunt. Treatment of fungemia and ventriculitis with amphotericin B and 5-fluorocytosine was successful.
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PMID:Systemic Torulopsis glabrata infection in a neonate. 219 97

The growing problem of candidemia and systemic candidiasis reflects the enormous increase in the pool of patients at risk as well as the increased opportunity that exists for Candida sp to invade tissues normally resistant to invasion. Candida sp, as truly opportunistic pathogens, exploit recent technological advances to gain access to the circulation and deep tissues. The increased prevalence of local and systemic disease caused by Candida organisms has resulted in new clinical syndromes, the expression of which depends upon the immune status of the host. These new syndromes include the focal hepatosplenic candidiasis, Candida peritonitis and systemic candidiasis. Management of serious and life-threatening invasive candidiasis remains severely hampered by the lack of reliable diagnostic methods that would allow early detection of both fungemia and tissue invasion by Candida organisms. Amphotericin B remains the cornerstone of effective antifungal therapy in systemic candidiasis. Over the last decade, new principles have emerged, including shorter and lower dosage regimens for catheter-related candidemia. The newer oral azoles may play a useful role in the management of invasive candidiasis.
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PMID:Candidemia and systemic candidiasis. 224 7

Mycotic peritonitis can be demonstrated by microbiological, histological and serological tests. The disease can be proved histologically by a deep invasion of fungi. Initially, the mycotic peritonitis can be caused by polymicrobial infections and also by genuine mycotic invasion after perforation of the gastrointestinal tract. In the final phase of the disease only these fungi are of relevance. In most of the cases candida albicans can be verified. In the procedure of programmed peritoneal lavage the mycotic peritonitis provides a severe complication. Untreated, it would cause death by dissemination, fungemia and candida sepsis. 8 out of 12 patients with candida peritonitis died. Most of the patients had been severely ill previously and had shown several risk factors promoting mycotic disease. Antimycotic treatment has to be initiated as soon as possible, in order to diminish the high lethality.
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PMID:[Fungal peritonitis]. 228 9

We report a retrospective analysis of 75 children with hepatic portoenterostomies hospitalized because of fever. Bacterial cholangitis was the most commonly defined cause of fever within 3 months of surgery. Pneumonia and upper respiratory infections were more common 3 months to 2 years following the procedure; however, cholangitis continued to occur during this time period. Twenty percent of hospitalizations were associated with bacteremia or fungemia. Streptococcus pneumoniae was the most common pathogen isolated from the blood. Three children with presumed cholangitis continued to have fever until effective antipseudomonal antibiotic coverage was implemented. The findings in this study lead to the following suggestions: vaccinate all children with pneumococcal vaccine at 2 years of age; a chest radiograph and dental evaluation should be obtained when evaluating the febrile child; empiric treatment for possible cholangitis should include an antipseudomonal penicillin derivative with an aminoglycoside; and if signs of peritonitis are present antibiotic treatment should also include antimicrobials effective against Haemophilus influenzae.
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PMID:Diagnosis and treatment of the febrile child following hepatic portoenterostomy. 404 60

Tobramycin in combination with clindamycin or lincomycin were used as systemic antibiotics in the treatment of 20 consecutive patients with septic peritonitis or intraabdominal sepsis, 10 of which were in septic shock. Doses were: tobramycin 1.5 mg/kg body weight every 8 hours, with prolonged dosage interval in patients with reduced renal function, clindamycin 0.9 g every 8 hours and lincomycin 1.2 g every 8 hours. Therapy was monitored by means of tobramycin serum concentration determinations and renal function tests. Eventual cure of the infection was obtained in 19 patients. In 2 of these, the effects of the antibiotics were doubtful. Side effects were observed on 8 occasions: One patient had a slight and temporary subjective hearing loss, coinciding with raised trough levels of tobramycin. Diarrhoea occurred in 3 cases and skin reactions in 3 cases. Superinfection with Candida albicans fungemia occurred in one patient. From the overall results it is concluded that the antibiotic regimen is of value in serious life-threatening infections. Although the tobramycin dose was higher than customarily used in Scandinavia at the time, 0 hour and 1 hour serum concentrations remained stable during therapy in patients whose renal function was normal at onset of therapy. Serum creatinine (S-Cr) levels in these patients were also essentially unchanged. Temporary reductions in osmolality (Osm) ratio Osm-urine/Osm-serum occurred in 11 patients despite normal S-Cr, but it was hard to attribute these impairments of renal function to tobramycin specifically. It was also doubtful whether tobramycin further aggravated renal function in those patients where it was impaired at onset of therapy. Thus, no conclusive evidence of clinically important tobramycin-induced nephrotoxicity were found. We suggest that the dosage schedule of tobramycin used in this study is applied when treating serious intraabdominal infections.
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PMID:High-dose tobramycin combined with clindamycin or lincomycin in the treatment of septic peritonitis and intraabdominal sepsis. 732 60

Flavimonas oryzihabitans is rarely reported as a pathogen in humans. Twelve cases of F. oryzihabitans bacteremia were diagnosed at National Taiwan University Hospital over a 3-year period. The clinical features of these patients were analyzed, and antimicrobial susceptibilities and random amplified polymorphic DNA (RAPD) patterns of the 12 isolates were studied. Among these 12 patients, eight (67%) had underlying neoplastic diseases and all acquired F. oryzihabitans bacteremia while hospitalized. The clinical syndromes included primary bacteremia in 5 patients (42%), biliary tract infection in 3 (25%), and peritonitis, subdural empyema, infusion-related bacteremia, and pneumonia in 1 each. Polymicrobial bacteremia or concomitant fungemia was seen in three patients (25%). All the patients survived after antibiotic treatment. All isolates were susceptible to piperacillin, third-generation cephalosporins, aminoglycosides, and quinolones but resistant to cephalothin, cefuroxime, and trimethoprim. Susceptibility to aztreonam was variable (25%). The RAPD patterns differed among the isolates, indicating the epidemiological unrelatedness of these infections. F. oryzihabitans should be included as an etiology of severe nosocomial infection in patients with underlying debilitating diseases.
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PMID:Flavimonas oryzihabitans bacteremia: clinical features and microbiological characteristics of isolates. 914 84

The purpose of this prospective, open-label, noncomparative, multicentre study was to evaluate the efficacy and safety of fluconazole in the treatment of hospitalised patients with mycoses. A total of 587 patients with diagnosed fungal infections were enrolled. Fluconazole was given orally or intravenously in a 200 or 400 mg loading dose, followed by 100 or 200 mg once daily. The most common candidal infections were fungemia, esophageal candidiasis, bronchopulmonary candidiasis, peritonitis, oropharyngeal candidiasis, urinary tract infection and deep wound infection. Meningitis was the most common cryptococcal infection. Of the 291 evaluable patients with candidiasis, 96% (70/73) of AIDS patients and 79% (171/218) of non-AIDS patients were clinically cured or improved. Of the 36 evaluable patients with cryptococcosis, 69% (20/29) of AIDS patients and 100% (7/7) of non-AIDS patients responded clinically. The overall mycological eradication rate was 85%; eradication was similar in patients with and without AIDS. Most adverse events during fluconazole therapy were mild to moderate in severity. This investigation confirms the results of previous studies demonstrating high response rates to fluconazole therapy in AIDS and non-AIDS patients with fungal infections. Even during long-term therapy treatment-limiting adverse events were uncommon with fluconazole.
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PMID:Large-scale multicentre study of fluconazole in the treatment of hospitalised patients with fungal infections. Multicentre European Study Group. 917 62

Although there is a 20% yeast colonization in the gastrointestinal tract of the population, fungal infections appear only rarely in secondary peritonitis. The risk of severe mycosis increases after a major operation and when a patient is taking broad-spectrum antibiotics, is on total parenteral nutrition, is catheterized, and/or is immune-suppressed. In the past years the incidence of nosocomial fungal infections (usually Candida spp.) has risen significantly. Five percent of CAPD-related peritonitis is caused by fungi. In enteral anastomosis breakdown, invasive mycosis occurs more often, with an accompanying lethality of up to 80%. In severe pancreatitis, up to 5% of peripancreatic necrosis is infected with fungi. The clinical course of severe mycosis, like the septic syndrome, is associated with fungemia in up to 50% of cases. As most of the facultative pathogenic fungi are part of the physiological flora, it is difficult to interpret mycological cultures. In order to diagnose invasive fungal infections, histopathological techniques and serologic tests for antigens and antibodies are available. Three antifungal agents (amphotericin B, flucytosine, fluconazole) are available for intravenous administration. Amphotericin B is given at doses of up to 1 mg/kg per day, in liposomal galenism up to 3 mg/kg per day. Combining amphotericin B with flucytosine (150-200 mg/kg per day) a synergistic effect is reached. Fluconazole at a dosage of 200-800 mg per day represents an alternative with similar antifungal activity and lower side effects.
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PMID:[Importance of mycoses in intra-abdominal infections]. 933 8


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