Anaerobe
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Climate change is a current global concern and, despite continuing controversy about the extent and importance of causes and of its effects, it seems likely that it will affect the incidence and prevalence of both residual and imported infections in Europe. Climate affects mainly the range of infectious diseases, whereas weather affects the timing and intensity of outbreaks. Climate change scenarios include a change distribution of infectious diseases with warming and changes in outbreaks associated with weather extremes. ⋯ European action plans to affront climate changes related health and infection problems are developed by the EU Commission at different levels and jointly by different DGs. In a few words within the EU the following points on human, animal and plant health are considered a priority: * Strengthening cooperation between the services of these three branches of health (human, animals, plants); * Developing action plans in the event of extreme weather conditions, in order to be better prepared and to react in the best way; * Gathering more reliable information on the risks of climate change whilst maintaining international cooperation, in particular with the WHO, as cooperation beyond that between Member States will be required to be more effective; * Providing additional effort to identify the most effective measures; * Improving the surveillance and the control of the animal diseases. The European Commission has decided to consider climate change, and the consequences it has on health, with greater importance whilst being aware that it is at the root of numerous diseases.
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We report here a rare case of infection caused by Propionibacterium acnes following trauma surgery: a 36-year-old male, accident victim was admitted to the hospital because of polytrauma. He underwent a long-drawn-out surgical intervention and after a free-muscle transfer using the rectus femoris muscle, signs of inflammation were detected in the affected area. ⋯ Adequate antibiotic treatment with penicillin had been started right after the positive microbiological result. Our data confirm the pathogenic potential of P. acnes in late post-surgical infections, and suggest a proper therapeutic approach with intravenous antibiotics and surgical removal of the infected tissue.
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Review Case Reports
Fusobacterium necrophorum bacteremic tonsillitis: 2 Cases and a review of the literature.
Fusobacterium necrophorum can cause endemic pharyngitis and the Lemierre syndrome. Four previous case reports and one epidemiologic study have documented that some F. necrophorum pharyngitis patients develop bacteremia without developing the complete Lemierre syndrome. We report two more patients who have bacteremic F. necrophorum pharyngitis. ⋯ We speculate that prompt antibiotic treatment may have prevented the more serious Lemierre syndrome. Adolescents and young adults who present with significant pharyngotonsillitis and bacteremic symptoms should have blood cultures and receive antibiotic regimens that treat F. necrophorum. Recognition of such patients might prevent Lemierre syndrome.
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Review Case Reports
Peptostreptococcus infective endocarditis and bacteremia. Analysis of cases at a tertiary medical center and review of the literature.
Peptostreptococcus infective endocarditis is rare but associated with high morbidity. We report two cases and evaluate all positive blood cultures for Peptostreptococcus at our institution, followed by a review of the literature. This organism causes a subacute presentation and cardiac valve pathology is a risk factor. Penicillin remains the treatment of choice.
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Anaerobic bacteria remain an important cause of bloodstream infections and account for 1-17% of positive blood cultures. This review summarizes the epidemiology, microbiology, predisposing conditions, and treatment of anaerobic bacteremia (AB) in newborns, children, adults and in patients undergoing dental procedures. The majority of AB are due to Gram-negative bacilli, mostly Bacteroides fragilis group. ⋯ The predisposing conditions in children include: chronic debilitating disorders such as malignant neoplasm, hematologic abnormalities, immunodeficiencies, chronic renal insufficiency, or decubitus ulcers and carried a poor prognosis. Predisposing factors to AB in adults include malignant neoplasms, hematologic disorders, transplantation of organs, recent gastrointestinal or obstetric gynecologic surgery, intestinal obstruction, diabetes mellitus, post-splenectomy, use of cytotoxic agents or corticosteroids, and an undrained abscess. Early recognition and appropriate treatment of these infections are of great clinical importance.