Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
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J. Infect. Chemother. · Jun 2017
Case ReportsA case of descending mediastinitis caused by Streptococcus pyogenes harboring genotype emm25 and sequence type 660.
Descending mediastinitis caused by Streptococcus pyogenes (group A streptococcus, GAS) is rare among cases of invasive GAS infection. In this report, we describe a case of a cervical abscess and secondary descending mediastinitis in a previously healthy 39-year-old Japanese man. The patient presented with a 2-week history of a sore throat, and subsequently developed an abscess and descending mediastinitis. ⋯ Although we have reviewed the literature regarding the clinical and microbiological characteristics of descending mediastinitis cause by GAS, little is known regarding epidemiological and clinical characteristics of emm25/ST660 GAS. Furthermore, to best of our knowledge, this is the first reported case of descending mediastinitis caused by emm25/ST660 GAS. Therefore, physicians should be aware of case with a cervical abscess and secondary descending mediastinitis caused by GAS infection, even if the patient is immunocompetent.
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J. Infect. Chemother. · Apr 2017
Case ReportsEosinophilic pneumonia caused by daptomycin: Six cases from two institutions and a review of the literature.
Here we report six cases of daptomycin (DAP)-induced eosinophilic pneumonia (DIEP) encountered at two medical centers and present a review of 43 DIEP patients from 26 studies to compare the clinical characteristics and radiographic findings of acute and chronic eosinophilic pneumonia (AEP; CEP). Four of the six patients did not exhibit respiratory symptoms, and one patient with only fever was misdiagnosed with DAP-induced fever. According to our literature review and the present findings, male sex and old age were dominant risk factors for DIEP. ⋯ All patients showed prompt recovery after DAP withdrawal. Our results suggest that clinicians should consider DIEP as a differential diagnosis when patients receiving DAP therapy, particularly men and elderly patients, present with fever, even in the absence of respiratory symptoms. Furthermore, they should be aware that the occurrence of DIEP is independent of the DAP dose and administration duration, and allergic reaction.
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J. Infect. Chemother. · Apr 2017
Case ReportsPyomyositis caused by Streptococcus pneumoniae after allogeneic hematopoietic stem cell transplantation.
Pyomyositis is classified into two main types: tropical and non-tropical. Non-tropical pyomyositis occurs among various immunocompromised patients, and Staphylococcus aureus has been reported as the most common pathogen. Pyomyositis caused by Streptococcus pneumoniae is uncommon, and has not been previously reported after allogeneic hematopoietic stem cell transplantation (allo-HSCT). ⋯ The patient had an initial clinical response following the administration of intravenous benzylpenicillin potassium for 4 weeks. Although S. pneumoniae bacteremia is a rare bacterial infection after HSCT, the possibility of pyomyositis must be considered when a recipient develops S. pneumoniae bacteremia. Accurate diagnosis and the selection of appropriate antibiotics are necessary for the treatment of pyomyositis.
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J. Infect. Chemother. · Mar 2017
Observational StudyImpact of procalcitonin-guided therapy for hospitalized community-acquired pneumonia on reducing antibiotic consumption and costs in Japan.
This study aimed to investigate the usefulness of procalcitonin-guided therapy in hospitalized community-acquired pneumonia patients to reduce antibiotic duration and costs without worsening prognosis. ⋯ Procalcitonin-guided therapy may be useful in hospitalized community-acquired pneumonia patients to reduce antibiotic duration and costs without worsening the prognosis.
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J. Infect. Chemother. · Jan 2017
The diagnostic value of soluble urokinase plasminogen activator receptor (suPAR) compared to C-reactive protein (CRP) and procalcitonin (PCT) in children with systemic inflammatory response syndrome (SIRS).
The aim of the present study was to determine the diagnostic and prognostic values of suPAR and to compare them to CRP and PCT in pediatric patients with systemic inflammatory response syndrome (SIRS). ⋯ We conclude that suPAR does have diagnostic value in children with SIRS. Additionally, persistent high serum suPAR level predicts mortality in SIRS in children.