Japanese journal of infectious diseases
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Jpn. J. Infect. Dis. · Mar 2009
Carbapenem-resistant Acinetobacter baumannii producing OXA-23 in Thailand.
We investigated the resistance determinant of 13 clinical isolates of carbapenem-resistant Acinetobacter baumannii collected from a regional hospital in the north of Thailand. All isolates were multidrug resistant and produced the OXA-23 carbapenemase. ⋯ The bla(OXA-23) and bla(IMP) genes were plasmid-mediated according to the transformation assays. This is the first description of OXA-23-producing A. baumannii from Thailand.
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Jpn. J. Infect. Dis. · Mar 2009
Case ReportsLemierre's syndrome followed by acute respiratory distress syndrome successfully rescued by antibiotics and hemoperfusion with polymyxin B-immobilized fiber.
Lemierre's syndrome is characterized by a primary oropharyngeal infection in a young healthy person who subsequently develops septic thrombophlebitis of the internal jugular vein and metastatic abscesses. We here report an uncommonly severe case of Lemierre's syndrome with acute respiratory distress syndrome (ARDS), in which polymyxin B-immobilized fiber (PMX) was used as supportive therapy. A 30-year-old, previously healthy man presented with sore throat, fever, rigor, and dyspnea. ⋯ Isolation of Fusobacterium necrophorum from the blood culture and the contrast-enhanced scan revealed thrombosis and thrombophlebitis in the left internal jugular vein. The patient was diagnosed with Lemierre's syndrome, and an alternative treatment regimen with prolonged administration of ampicillin, clindamycin, and metronidazole resulted in improvement of the patient's respiratory function and general condition. Our case indicated that PMX might be an effective supportive therapy in severe cases of Lemierre's syndrome with ARDS that possessed no indication of surgical interventions.