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Query: UMLS:C0341503 (bacterial peritonitis)
 1,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pasteurella multocida, a small, gram-negative coccobacillus , is part of the normal oral flora of many animals, including the dog and cat. P. multocida is the etiologic agent in a variety of infectious disease syndromes. We have reported 34 cases of infection caused by P. multocida and have reviewed the English literature. P. multocida infections may be divided into three broad groups: 1. Infections resulting from animal bites and scratches : The most common infections caused by P. multocida are local wound infections following animal bites or scratches . Cats are the source of infection in 60 to 80% of cases and dogs in the great majority of the remainder. Local infections are characterized by the rapid appearance of erythema, warmth, tenderness, and frequently purulent drainage. The most common local complications are abscess formation and tenosynovitis. Serious local complications include septic arthritis proximal to bites or scratches , osteomyelitis resulting from direct inoculation or extension of cellulitis, and the combination of septic arthritis and osteomyelitis, most commonly involving a finger or hand after a cat bite. 2. Isolation of P. multocida from the respiratory tract: The isolation of P. multocida from the respiratory tract must be interpreted differently than its isolation from other systemic sites. Most commonly P. multocida found in the respiratory tract is a commensal organism in patients with underlying pulmonary disease, but serious respiratory tract infections including pneumonia, empyema, and lung abscesses may develop. Most patients with respiratory tract colonization or infection have a history of animal exposure. 3. Other systemic infections: P. multocida is recognized as a pathogen in a variety of systemic infections including bacteremia, meningitis, brain abscess, spontaneous bacterial peritonitis, and intra-abdominal abscess. P. multocida often acts as an opportunistic pathogen with a predilection for causing bacteremia in patients with liver dysfunction, septic arthritis in damaged joints, meningitis in the very young or elderly, and pulmonary colonization or invasion in patients with underlying respiratory tract abnormalities.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Pasteurella multocida infections. Report of 34 cases and review of the literature. 637 40

Sepsis due to Streptococcus pneumoniae has a high mortality. We report a retrospective review of 40 episodes of S pneumonia sepsis in adult patients during a two year period in a general hospital, that represented 11.3% of all sepsis observed in such hospital. Ninety two percent of infections were community acquired and in 95%, the portal of entry was the respiratory tract. Eighty five percent of patients had at least one risk factor such as alcohol abuse, unconsciousness or chronic pulmonary disease. Nine patients had suppurative complications (empyema in 4 cases, spontaneous bacterial peritonitis in 2, septic arthritis in 2 and meningitis in 1 case) and 12 (30%) died. The potential benefit of antipneumococcal vaccine as prevention should be considered in high risk subjects.
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PMID:[Streptococcus pneumoniae septicemia. Analysis of 40 cases]. 765 13

Fifty-seven patients with decompensated cirrhosis were studied prospectively to assess the sensitivity and specificity of early clinical or biological signs of bacterial infection. Among them, 19 had proven infection on admission (7 spontaneous bacterial peritonitis, 5 bacteraemia, 3 urinary tract infections, 2 pneumonia, 1 dental abscess and 1 cholangitis). Fever, polymorphonuclear cell count, fibrinogen and C-reactive protein levels were found to be of little or no help in diagnosing bacterial infection on admission. Interleukin-6 plasma levels were, however, significantly different between infected (median: 1386 pg/ml, range: 237-20,000) and non-infected patients (median: 34 pg/ml, range: 0-4500, p < 0.00001). Levels above 200 pg/ml were always found in infected patients, giving a sensitivity of 100% and a specificity of 74%. C-reactive protein correlated weakly with interleukin-6 levels, indicating a defective acute-phase response in cirrhosis. Tumor necrosis factor alpha plasma levels were less sensitive (95%) and specific (68%) for the diagnosis of bacterial infection at a threshold of 50 pg/ml, but were more closely related to a poor patient outcome. In decompensated cirrhosis, interleukin-6 plasma levels on admission provided the most sensitive and specific tool for the diagnosis of bacterial infection.
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PMID:Interleukin-6: an early marker of bacterial infection in decompensated cirrhosis. 793 Apr 84

One hundred and seventy hospitalized patients with cirrhosis were included in a prospective and sequential study, to verify the prevalence and most frequent causes of bacterial infection. The differences in clinical and laboratory data between the two groups were analyzed: group I--80 patients who developed bacterial infection and group II--90 patients without bacterial infection. The prevalence or cumulative frequency of the development of bacterial infection during one hospitalization was 47.06%. Among these, the most frequent types of infection were: spontaneous bacterial peritonitis (SBP): 31.07%, urinary tract infection (UTI): 25.24% and pneumonia: 21.37%. Community infections were more frequent (56.25%) than nosocomial infections (32.50%) and they occurred sequentially in 11.25% of the cases. The agents responsible were gram negative bacteria in 72.34% of the cases. Clinical and biochemical parameters in bacterial infection were generally correlated with the severity of liver disease. Child-Pugh classification showed a predominance of class C in infected cirrhotic patients compared to non-infected ones. During hospitalization, the mortality rate of group I was 30% whereas in group II it was 5.55% (P = 0.0001). SBP and pneumonia were the most severe types of infection, with high mortality rates, 31.25% and 40.91%, respectively. These results indicate that bacterial infection is a severe complication in the course of cirrhosis.
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PMID:A prospective study of bacterial infections in patients with cirrhosis. 822 17

Seven patients with decompensated posthepatitis B cirrhosis were treated with low doses of interferon alpha. The initial plasma level of HBV-DNA ranged from 3.0 to 189.3 pg/ml, and that of ALT from 37 to 156 IU/l. Liver biopsies demonstrated ongoing piecemeal necrosis. In sera of all but one patient, HBV-DNA became undetectable by hybridisation techniques within 10 to 28 weeks. Plasma HBeAg became negative in four and HBe-antibodies positive in three patients. Serum transaminase levels showed a marked initial rise 3 to 13 weeks after onset of therapy; they dropped to normal values later in all except one patient. Therapy was initiated at 1 MU (million units) three times a week for 2 weeks and was increased to 2.5 MU for 16 weeks. Later, this dosage was raised to 5 MU three times a week in some patients. Complications included variceal haemorrhage, aggravation of ascites or of encephalopathy, development of pneumonia, recurrence of spontaneous bacterial peritonitis or of gastric ulcer bleeding. One year after stopping the therapy, three patients are well and without any feature of liver decompensation. Three patients died before they could undergo a liver transplantation. In one patient treatment was interrupted because of marked exacerbation of liver cell necrosis. It thus seems possible to suppress HBeAg and HBV-DNA in patients with decompensated cirrhosis. This is important to prepare them for possible liver transplantation. Interferon should be initiated at low doses and the patients be very carefully monitored. Prophylactic therapy for bacterial peritonitis and for variceal haemorrhage is warranted.
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PMID:Treatment of decompensated viral hepatitis B-induced cirrhosis with low doses of interferon alpha. 845 21

Although Taiwan is not an area where cholera is endemic, from October 1988 to October 1997 30 episodes of non-O1, non-O139 Vibrio cholerae infection were noted at the National Cheng Kung University Hospital in Taiwan. Infections generally occurred in hot seasons, and two episodes were concomitant with Vibrio vulnificus infection. Three major clinical presentations were found: bacteremia with concurrent spontaneous bacterial peritonitis or invasive soft-tissue infections that occurred solely in cirrhotic patients; self-limited acute febrile gastroenteritis that occurred in patients with no underlying medical disease; and necrotizing fasciitis or cellulitis that often resulted from a wound on extremities. Other manifestations included fatal pneumonitis in a drowned man and acute pyosalpinx. The differential diagnosis of invasive infections in cirrhotic patients should include infections due to non-O1 V. cholerae or V. vulnificus, and a third-generation cephalosporin and a tetracycline analogue or a fluoroquinolone alone is recommended for treatment of severe vibrio infections.
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PMID:Infections due to non-O1 Vibrio cholerae in southern Taiwan: predominance in cirrhotic patients. 979 33

Within a 6-year period from January 1991 to December 1996, 19 patients with Salmonella choleraesuis bacteremia were enrolled for clinical and microbiological analysis. Young children, the elderly and patients with hematological malignancy (36.8%), liver cirrhosis (26.3%), systemic lupus erythematosus (10.5%), chronic renal impairment (10.5%), and peptic ulcer (10.5%) were at high risk of this infection. The ratio of male to female was 3:1. Three cases (15.8%) were nosocomially acquired. Fever (89.5%), chills (57.9%) and anorexia (52.6%) were the most common clinical manifestations. Seven patients (36.8%) presented no gastrointestinal manifestations. Normal white blood cell count was noted in seven patients (36.8%), and neutropenia caused by underlying diseases or severe infection was found in six cases (31.6%). Various types of metastatic focal infections were found, such as septic arthritis, cutaneous infection, spontaneous bacterial peritonitis, and pneumonia. The severe immunocompromised status of patients and the high virulence of this pathogen may contribute to the high case fatality rate (21%). Higher resistance rate to commonly used antimicrobial agents was noted in ampicillin (94.7%), chloramphenicol (89.5%), and TMP/SMZ (63.8%). All strains of S. choleraesuis were susceptible to third-generation cephalosporins and fluoroquinolones. Generally, S. choleraesuis bacteremia should be taken into account in the differential diagnosis of sepsis in immunocompromised patients, even without gastrointestinal manifestations. The third-generation cephalosporins and fluoroquinolones may be the first choice for treatment of this invasive infections.
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PMID:Salmonella choleraesuis bacteremia in southern Taiwan. 1033 Jul 99

Liver diseases are an important cause of high morbidity and mortality in HIV-infected patients, and liver cirrhosis is the commonest cause of ascites in this population. We describe the case of a 38-year-old HIV-positive male (CDC stage B3, CD4 cell count 199/mm3) with a history of hepatitis C-associated liver cirrhosis. Following pneumonia he developed spontaneous bacterial peritonitis due to Streptococcus constellatus. Clinically noticeable was the gradually worsening course with few symptoms, despite the initially high ascitic fluid leucocyte count of over 11,000/microliter, but a favourable response to betalactam antibiotics.
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PMID:[Spontaneous bacterial peritonitis with Streptococcus constellatus in an HIV positive patient]. 1068 83

This is a retrospective study of Streptococcus suis infection in humans submitted to the National Streptococcal Referrence Center of Thailand from 1994 to 2001. There were 11 men and 6 women whose mean age was 46.24 years (range 1 month to 75 years). Among the men, two had known occupational and behavioral exposure to pork or meat products. Among the women, one was a butcher and three were housewives. Half of the patients had underlying diseases. One patient had congenital hydrocephalus, three patients had rheumatic heart disease and three were alcoholics. Two of these patients had a history of skin injury before infection. Nine patients had evidence of acute bacterial meningitis, four patients had infective endocarditis, two had the sepsis syndrome and two suffered from pneumonia and spontaneous bacterial peritonitis. The authors suspected that many cases are not reported particularly where pig-rearing or pork consumption are common. In the absence of an effective vaccine, prevention by public health surveillance is important. Prompt treatment of any cuts and wounds among pork-handlers is a sensible precaution. Furthermore, a high index of suspicion and early detection in order to identify and apply effective antimicrobial agents is necessary to successfully treat S. suis infection.
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PMID:Streptococcus suis infection in Thailand. 1218

Infections in patients affected with liver cirrhosis are frequent, recurrent and associated to unfavorable outcome. They are facilitated by acquired and progressive defects on the innate immune and reticuloendothelial system that are aggravated by alcohol consumption. Infections in patients with cirrhosis are typically bacterial or viral in origin and have in most cases a stereotyped clinical presentation, although diagnosis may be difficult in some cases. Pneumonia, urinary tract infection, bacteremia and spontaneous bacterial peritonitis explain more than 90% of the cases. The latter requires a high clinical suspicion and a standardized diagnostic work up. Preventive strategies are important in the management of these patients and include chemoprophylaxis against spontaneous bacterial peritonitis in selected cases, vaccines against pneumococcal and influenza infections, and hepatitis A and B vaccine in susceptible patients. Due to limited seroconversion, active immunization should be applied as earlier as possible, before clinical deterioration ensues.
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PMID:[Diagnosis, management and prevention of infections in cirrhotic patients]. 1579 72


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