- Prevalence of enteric bacteria and their antimicrobial susceptibility patterns among food handlers in Gondar town, Northwest Ethiopia. [Journal Article]
- ARAntimicrob Resist Infect Control 2019; 8:111
- CONCLUSIONS: Our study showed high prevalence of enteric bacterial pathogens among food handlers. All isolates were susceptible to ciprofloxacin. However, a substential number of isolates were resistant to commonly prescribed antibiotics and the prevalence of MDR was high.
- Curious CXR. [Journal Article]
- EMEmerg Med J 2019; 36(7):442-450
- A 98-year-old man with 2 days of headache, nausea, malaise and unsteadiness was referred to the ED by his GP with a suspicion of an intracranial bleed. His medical history included atrial fibrillatio…
A 98-year-old man with 2 days of headache, nausea, malaise and unsteadiness was referred to the ED by his GP with a suspicion of an intracranial bleed. His medical history included atrial fibrillation (AF) (taking warfarin). Observations were SpO2 95% on air, RR24, HR88, BP210/104, GCS14, Temp 34.3. On examination he had bilateral creps and was sleepy but not confused. A septic screen was undertaken and intravenous ceftriaxone given. His CTH was essentially normal. His CXR is shown in figure 1 emermed;36/7/442/F1F1F1Figure 1Anteropsterior(AP) CXR at presentation. QUESTION: What is the diagnosis?Acute collapse and consolidation secondary to pneumonia.Spontaneous haemothorax.Acute consolidation with underlying old TB.Traumatic lung contusions.
- [Clinical characteristics and drug sensitivity in children with invasive pneumococcal disease: a multicenter study]. [Journal Article]
- ZDZhongguo Dang Dai Er Ke Za Zhi 2019; 21(7):644-649
- CONCLUSIONS: IPD is more common in children under 5 years old, especially in those under 2 years old. Some children with IPD have underlying diseases, and most of the patients have various risk factors for drug resistance. Pneumonia with sepsis is the most common infection type. The isolated Streptococcus pneumoniae strains are highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin, ertapenem, and ceftriaxone in children with IPD.
- Prevalence and etiological agents for chronic suppurative otitis media in a tertiary hospital in Tanzania. [Journal Article]
- BRBMC Res Notes 2019 Jul 17; 12(1):429
- Chronic suppurative otitis media is among the most common otological condition reported in otorhinolaryngology practice commonly attributing to preventable hearing loss. The aim of this study was to …
Chronic suppurative otitis media is among the most common otological condition reported in otorhinolaryngology practice commonly attributing to preventable hearing loss. The aim of this study was to determine the prevalence and etiological agents for chronic suppurative otitis media in our department.
- Agranulocytosis from Outpatient Antimicrobial Treatment with Ceftriaxone: A Case Report. [Journal Article]
- PJPerm J 2019; 23
- CONCLUSIONS: Serious adverse effects of ceftriaxone therapy, such as agranulocytosis, must be monitored for, especially in patients who are receiving prolonged therapy or high doses. Once this cause of agranulocytosis is identified, ceftriaxone therapy should be stopped; if the patient is febrile, an infectious disease workup should be performed and antibiotics should be started; and granulocyte colony-stimulating factor should be administered with daily monitoring of the absolute neutrophil count.
- Changes in the patterns and microbiology of spontaneous bacterial peritonitis : analysis of 200 cirrhotic patients. [Journal Article]
- AGActa Gastroenterol Belg 2019 Apr-Jun; 82(2):261-266
- CONCLUSIONS: Changes in the patterns and microbiology of SBP are evident in our region with increasing prevalence of culture negative SBP, extended spectrum beta-lactamases resistant E.Coli, and increased resistance rate to first line antibiotics. Our data argue for relying on periodic hospital based antibiotic susceptibility data whenever SBP is treated.
- Nonbacterial Thrombotic Endocarditis Due to Primary Gallbladder Malignancy with Recurrent Stroke Despite Anticoagulation: Case Report and Literature Review. [Journal Article]
- JGJ Gen Intern Med 2019 Jul 16
- Nonbacterial thrombotic endocarditis (NBTE) associated with malignancy is rare; its infrequency and similarity to other diagnoses make it a significant diagnostic challenge. A 63-year-old woman on ri…
Nonbacterial thrombotic endocarditis (NBTE) associated with malignancy is rare; its infrequency and similarity to other diagnoses make it a significant diagnostic challenge. A 63-year-old woman on rivaroxaban for prior deep vein thrombosis presented with left upper extremity weakness and left facial droop with imaging demonstrating multiple strokes. Echocardiograms revealed mitral and aortic valve vegetations. The patient was switched to apixaban and started on vancomycin and ceftriaxone for presumed culture-negative endocarditis. Despite continuing apixaban, her hospital course was complicated by new acute embolic infarcts. Workup confirmed non-mucinous metastatic biliary adenocarcinoma. The patient was placed on a heparin drip then switched to low molecular weight heparin without further embolic events and was discharged to a rehabilitation facility in stable condition with plans for chemotherapy as an outpatient. These clinical, imaging, and histologic findings were consistent with a rare case of NBTE associated with primary non-mucinous gallbladder malignancy complicated by recurrent strokes in which direct oral anticoagulants did not provide adequate anticoagulation.
- Streptococcus viridans Endocarditis Affecting All Four Valves. [Case Reports]
- CCureus 2019 May 10; 11(5):e4635
- Infective endocarditis (IE) affecting all four valves is rare. We describe an interesting clinical scenario of a 47-year-old female, with an underlying, unrepaired atrial septal defect (ASD) and hype…
Infective endocarditis (IE) affecting all four valves is rare. We describe an interesting clinical scenario of a 47-year-old female, with an underlying, unrepaired atrial septal defect (ASD) and hypertrophic obstructive cardiomyopathy (HOCM), who presented with a five-week history of worsening lower extremity rash and New York Heart Association (NYHA) class IV symptoms. She was febrile to 101.3°F at the time of presentation. Examination revealed dental caries and track mark on hands. Her extremities demonstrated palpable purpura and pitting edema. Chest auscultation revealed bibasilar crackles and a grade III pan-systolic murmur, best heard over the apex, with radiation to the axilla. The blood gram stain resulted positive for gram-positive cocci in chains, prompting the initiation of ceftriaxone. Transthoracic echocardiography (TTE) did not reveal any new valvular regurgitation or vegetation. Transesophageal echocardiography (TEE) showed vegetation on all four valves and underlying ASD with HOCM. Blood cultures grew Streptococcus viridians. She had evidence of extensive septic emboli to the brain, lungs, spleen, and intestines. Given the extent of valvular involvement, intracranial hemorrhage, and tenuous hemodynamic status, a decision was taken to manage her conservatively followed by elective surgical management. She, however, went into cardiogenic shock further complicated by lower gastrointestinal bleed and passed away.
- [Ocular syphilis, a re-emergent pathology: Series of 12 patients in one Hospital, 2017]. [Journal Article]
- RMRev Med Interne 2019 Jul 10
- CONCLUSIONS: Ophtalmic cases of syphilis have become more frequent over the past few years in France. The diagnosis should be suspected in cases of eye inflammation even in the absence of favourable clinical presentation or anamnesis. Search for HIV co-infection should be systematic. Our study shows that ceftriaxone remains an effective alternative to penicillin G.
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- Subcutaneously administered antibiotics. [Review]
- MMMed Mal Infect 2019 Jul 09
- The subcutaneous route is a widely used route of administration in routine clinical practice, particularly in elderly patients, when the intravenous route cannot be used. This review of the literatur…
The subcutaneous route is a widely used route of administration in routine clinical practice, particularly in elderly patients, when the intravenous route cannot be used. This review of the literature highlights the lack of randomized studies and the lack of pharmacokinetic data on the use of this route of administration. Three antibiotics administered subcutaneously can be used for severe infections, with acceptable pharmacokinetic and pharmacodynamic data, when the intravenous administration is not possible: ceftriaxone, ertapenem, and teicoplanin.