Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 2005
Case ReportsStaphylococcus saprophyticus causing native valve endocarditis.
Coagulase negative staphylococci are a rare cause of native valve endocarditis. Staphylococcus saprophyticus is a coagulase-negative Staphylococcus infrequently reported as a human pathogen, and most of the cases reported are urinary tract infections. We describe a case of native valve endocarditis attributed to this organism. The patient needed valve replacement due to heart failure.
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Scand. J. Infect. Dis. · Jan 2005
Successful management of severe group A streptococcal soft tissue infections using an aggressive medical regimen including intravenous polyspecific immunoglobulin together with a conservative surgical approach.
Intravenous polyspecific immunoglobulin G (IVIG) has been reported to be efficacious as adjunctive therapy in patients with toxic shock syndrome caused by a group A streptococci (GAS). GAS is also an important cause of necrotizing fasciitis, for which an early and extensive surgical intervention is currently advocated. Here we report on the use of an aggressive medical regimen including high-dose IVIG together with a conservative surgical approach in severe GAS soft tissue infection. ⋯ All patients survived. Immunostaining of tissue biopsies from 2 of the patients revealed high levels of GAS, superantigen and pro-inflammatory cytokines initially, which were dramatically reduced in a repeat biopsy of the initial operative site collected from 1 of the patients 66 h post-IVIG administration. The study suggests that the use of a medical regimen including IVIG in patients with severe GAS soft tissue infections may allow an initial non-operative or minimally invasive approach, which can limit the need to perform immediate wide debridements and amputations in unstable patients.
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Linezolid is a new synthetic antibiotic with a broad spectrum of activity against virtually all important Gram-positive infections. Lactic acidosis is a well known side-effect of metformin and nucleoside reverse-transcriptase inhibitors. We report a case in which lactic acidosis developed as an adverse effect of linezolid treatment.
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Scand. J. Infect. Dis. · Jan 2005
Case ReportsPseudomembranous tracheobronchitis caused by Aspergillus in immunocompromised patients.
We report 2 cases of Aspergillus pseudomembranous tracheobronchitis in patients with diabetes. The first patient succumbed to progressive obstructive respiratory failure despite mechanical ventilation and antifungal therapy. ⋯ Early bronchoscopy and histologic examination should be performed. Early, appropriate treatment may be life saving.
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Scand. J. Infect. Dis. · Jan 2005
Review Case ReportsPacemaker infection due to Mycobacterium fortuitum.
Pacemaker infection with Mycobacterium fortuitum has not been reported previously. We describe a case of pacemaker generator pocket infection and intravascular lead endocarditis due to Mycobacterium fortuitum. The entire pacing system was removed and the patient was treated successfully with a multidrug regimen for a total of 6 months.