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Efficacy of the combination imipenem and ofloxacin for the treatment of a nocardiosis revealed by a subcutaneous abscess in a HIV-infected patient.
To report an unique case of subcutaneous infection due to Nocardia (N.) asteroides apparently subsequent to a Pulmonary fistulized lesion in a HIV infected patient and the rapid and lasting efficacy of a combination of imipenem and ofloxacin. A 38 year-old hiv infected man with a history of aortic prosthesis, diabetes mellitus and thrombocytopenia treated with corticosteroids presented a subcutaneous painful thoracic abscess persisting despite antistaphylococcal therapy with oxacillin. Laboratory tests performed on admission revealed ESR of 109/ hr and CD4 cell count of 47/ mm3. The chest roentenogram showed a cavitating lesion of the right middle lobe and a contiguous pleural effusion. The direct examination of the subcutaneous sample revealed many colonies of N. asteroides. The search of N. in sputum, blood samples and liquid from broncho-alveolar washing was negative. Computed tomography (C.T) of chest revealed a communicating way between Pulmonary and subcutaneous lesions. A rapid improvement was obtained with a 3-week course of imipenem in combination with ofloxacin, followed by a single treatment with ofloxacin for 2 weeks. No recurrence was noted one year after completion of therapy. CONCLUSION: 1) the hematogenous way is the most common mode of dissemination for nocardiosis but, because of similar properties to mycobacteria, fistulization can be possible, so a subcutaneous abscess associated to Pulmonary lesions must lead to look for Nocardia. 2) The combination of imipenem and ofloxacin which produced a synergistic effect against N. asteroides in vitro was confirmed to be effective in vivo.
PULMONARY ABSCESS—AN EXPERIMENTAL STUDY
Pulmonary ABSCESS—AN EXPERIMENTAL STUDY
MedlinePlus
Medical Encyclopedia: Pulmonary aspergilloma (mycetoma)
Aspergillomas are formed when the fungus aspergillus grows in a clump in a pre-existing Pulmonary (lung) cavity or when the organism invades previously healthy tissue, causing an abscess .
Rhodococcus equi brain abscess in AIDS patients: case report and review of the literature.
Introduction: Pulmonary infections caused by Rhodococcus equi (RE) in AIDS patients are being increasingly recognized. There is increased potential for hematogenous spread in immunosuppressed patients. Objective: To present a case and review the literature on brain abscess caused by RE, discuss risk factors, diagnosis and treatment. Case: A 36-year old male with AIDS presented with confusion. Two months prior, he finished a six month course of therapy for Pulmonary abscess due to RE with vancomycin, erythromycin and rifampin. MRI scan revealed ring enhancing lesions of (R) temporoparietal and bilateral frontal lobes. Toxoplasma serologies were negative. Patient succumbed despite therapy with clindamycin, primaquine, vancomycin, ceftriaxone, and erythromycin. Autopsy studies of the brain abscess revealed RE exclusively. Discussion: Four other cases of brain abscess due to RE have been reported in AIDS patients. All had previous Pulmonary infections due to RE and were treated on average for 2-12 months. Brain abscess developed while still on therapy in 2 patients. Diagnosis was made by brain biopsy in all cases and the majority (4/ 5) succumbed despite antibiotic therapy. Conclusion: RE should be suspected as a cause of brain abscess in AIDS patients with a previous history of Pulmonary disease due to this organism. Antibiotic therapy alone appears to be ineffective.
Disease Listing, Nocardiosis, Technical Information | CDC Bacterial, Mycotic Diseases
Disease Listing, Nocardiosis, Technical Information | CDC Bacterial, Mycotic Diseases
MedlinePlus
Medical Encyclopedia: Pulmonary actinomycosis
MedlinePlus
Medical Encyclopedia: Pulmonary actinomycosis
Energy Citations Database (ECD) - - Document #5272644
Magnetic resonance (MR) imaging was performed in 10 children with intrathoracic disease.^Entities imaged included mediastinal lymphoma and neuroblastoma, Pulmonary metastases from hepatoblastoma and osteogenic sarcoma, hemorrhagic pleural effusion, and nonmalignant disease such as abscess, cystic fibrosis, and bronchogenic cyst.^MR imaging was particularly valuable in delineating mediastinal and parenchymal masses from adjacent vascular structures without the need for contrast material enhancement.^However, MR was insensitive to lesion calcification.^Since Pulmonary vessels give very low signal, differentiation of high-intensity Pulmonary nodules from vessels is readily apparent.^For similar reasons, MR was excellent in distinguishing endobronchial mucus plugs from peripheral Pulmonary vessels.
CDC - Community-Acquired Klebsiella pneumoniae Bacteremia: Global Differences in Clinical Patterns
Second, a striking clinical finding concerning a new manifestation of community-acquired K. pneumoniae infections has been documented. An unusual invasive presentation of K. pneumoniae infection, primary bacteremic liver abscess, has been described by numerous investigators in Asia; >900 patients with Klebsiella liver abscess have been reported from Taiwan in the last 10 years ( 5-22 ). In addition, case reports and small series from Korea, Singapore, Japan, India, and Thailand have been published ( 23-32 ). The Taiwanese patients with K. pneumoniae liver abscess have no history of hepatobiliary disease. Seventy percent of such patients have diabetes mellitus ( 5 , 13,18,19 ); 11% to 12% of the reported patients with Klebsiella liver abscess have other septic metastatic lesions, including Pulmonary emboli or abscess, brain abscess, pyogenic meningitis, endophthalmitis, prostatic abscess, osteomyelitis, septic arthritis, or psoas abscess (5,13,19).
PULMONARY ABSCESS—POSTOPERATIVE
Pulmonary ABSCESS—POSTOPERATIVE
Emergency Data
Emergency Data
Acute chest pain - no ECG or enzyme evidence of myocardial ischemia/infarction.
Acute chest pain - no ECG or enzyme evidence of myocardial ischemia/ infarction.
OIICS Section 4
OIICS Section 4
FloridaHealthFinder.gov | Health Encyclopedia | Chest x-ray
FloridaHealthFinder.gov | Health Encyclopedia | Chest x-ray
FloridaHealthFinder.gov | Health Encyclopedia | P Index
FloridaHealthFinder.gov | Health Encyclopedia | P Index
Scimitar Syndrome
Scimitar Syndrome
Search of: "Suppuration" - List Results - ClinicalTrials.gov
Search of: "Suppuration" - List Results - ClinicalTrials.gov
NIDA - Diagnosis and Treatment of Drug Abuse in Family Practice - Introduction
NIDA - Diagnosis and Treatment of Drug Abuse in Family Practice - Introduction
Congestive heart failure.
The chest radiograph is also useful for diagnosing diseases other than CHF in patients with dyspnea. The radiographic distinction of CHF from increased permeability edema, of which the adult respiratory distress syndrome is the prototype, may be difficult. Findings that favor CHF are an enlarged cardiac silhouette, Kerley lines, and pleural effusions. Lobar pneumonia and abscess, Pulmonary infarction, lung masses or nodules, and focal pleural disease are usually readily distinguishable from CHF.
Emergency Data
Emergency Data
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