Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 1998
Case ReportsFatal necrotizing fasciitis caused by a toothpick injury.
Necrotizing fasciitis is a severe life-threatening infection. The portal of entry is usually a site of disruption of the skin barrier. We report a case of fatal necrotizing fasciitis caused by an accidental toothpick injury--a unique injury mechanism not reported this far to cause necrotizing fasciitis. Although toothpick injuries are usually regarded as trivial, it should be kept in mind that they have the potential to cause such a lethal infection.
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Scand. J. Infect. Dis. · Jan 1998
The diagnostic value of gram stain of bronchoalveolar lavage samples in patients with suspected ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is one of the most common causes of morbidity and mortality in intensive care unit patients. However, the diagnosis is quite difficult. Gram stain (GS) of bronchoalveolar lavage (BAL) sample is a time-saving diagnostic method for VAP. ⋯ Accordingly, the sensitivity of BAL-GS for VAP diagnosis was 77%, the specificity 87%, the positive predictive value 71% and the negative predictive value 90%. Our data suggest that BAL-GS has good sensitivity and high specificity for VAP diagnosis. It could therefore constitute a useful complementary tool in the task of early diagnosis and treatment of VAP.
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Scand. J. Infect. Dis. · Jan 1997
Case ReportsCellulitis due to Streptococcus pneumoniae with diminished susceptibility to penicillin in an immunocompromised patient.
A 74-year-old man with multiple myeloma developed facial and cervical cellulitis and severe sepsis as a complication of surgery (alar region basal cell carcinoma). The etiological agent was, surprisingly, penicillin-resistant Streptococcus pneumoniae (PRSP). ⋯ Amoxicillin was given as monotherapy during the last 14 days of treatment. PRSP can be responsible not only for otitis media, pneumonia or meningitis, but also for various other types of infection in patients with predisposing factors.
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Scand. J. Infect. Dis. · Jan 1997
Case ReportsInterleukin-6 in the fever and multiorgan crisis of pheochromocytoma.
A 31-y-old black man with neurofibromatosis, alcoholism and hypertension was admitted because of abdominal pain, hematemesis and cough. In the hospital he had prolonged fever and developed a multiorgan crisis. Despite thorough investigation, no infectious cause for fever was found. ⋯ A diagnosis of pheochromocytoma was made, and as soon as treatment with phenoxybenzamine and propranolol was begun, the fever resolved. Serum interleukin-6 (IL-6) concentration was initially elevated, decreased after the start of adrenergic blockade, and gradually fell to an undetectable level after surgery. These observations suggest that interleukin-6 might have been causally related to the patient's fever and possibly the multiorgan crisis.
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Scand. J. Infect. Dis. · Jan 1997
Case ReportsSplenic abscess caused by Salmonella braenderup, treated with percutaneous drainage and antibiotics.
Splenic abscess is a rare condition and its optimal treatment is still debated. We report on a 17-year-old immunocompetent female patient, hospitalized with Salmonella braenderup gastroenteritis and splenic abscess, who was treated with ciprofloxacin, percutaneous catheter drainage and despite remaining drainage of 50 ml/24 h, the catheter was removed and the antibiotic treatment was stopped when the fluid was clear. Following removal a transient increase in the size of the splenic cavity was observed, but without any clinical symptoms or deterioration of laboratory parameters. At the 1-year follow-up, ultrasound examination of the spleen disclosed only a 8 mm scar.