The NAIS can be staged without compromising the efficacy of the procedure as evident by excellent long-term patency and control of the infection. By reducing the duration of the primary procedure, staging may be beneficial to both the patient and the surgeon.
Salmonella
is known to cause invasive illness. However, head and neck abscesses are an unusual presentation of extra-intestinal infection with this organism. We describe a case of
Salmonella
neck abscess in a diabetic patient. An 18 year old diabetic male was admitted with increasing left sided neck pain and swelling approximately four weeks after gastrointestinal illness. Imaging revealed a left sided neck abscess. Surgical drainage was undertaken. Cultures grew non-typhoid
Salmonella
species. He was treated with intravenous antibiotics and did well clinically.
Salmonella
infection should be considered in the differential diagnosis of patients with immunocompromising conditions presenting with neck abscess of unclear etiology.
Pyometra is an unusual presentation of uterine infection, this condition is characterized by purulent fluid within the uterine cavity. In this report we describe pyometra due to
Pseudomonas aeruginosa
in a 90-year-old woman who presented with abdominal pain, nausea with emesis and diarrhea. She was evaluated at an outside emergency department and computed tomography (CT) revealed a large, complex, cystic mass measuring 9.2 cm (cm) in greatest diameter. Given her age, the diagnosis of malignancy was entertained. She was referred to gynecologic-oncology service for evaluation and underwent exploratory laparotomy with total abdominal hysterectomy and lysis of adhesions. Intraoperative findings were consistent with pyometra. Cultures ultimately grew
Pseudomonas aeruginosa
. She initiated on antibacterial therapy and was discharged to a rehabilitation facility.
Summary An outbreak of pneumonia associated with Bordetella bronchiseptica in a breeding colony of guinea-pigs was studied. Infected animals were identified by the use of nasal swabbing and necropsy examination, and measures were taken to control the disease and establish a colony free of this pathogen.
BackgroundInvasive infections due to Candida were once thought to be rare, but have been increasing in incidence over the past two decades. The reason for the increase in fungal infections is likely multifactorial. Patients are living longer with chronic illnesses and often have frank or relative immunosuppression. The increased use of central venous catheters and antimicrobials are also felt to play a role. In addition, injection drug use has led to a concomitant increase in a variety of invasive infections including fungemia and osteomyelitis. This is particularly a problem in West Virginia as we have seen a sharp increase in injection drug use over the past decade. However, vertebral osteomyelitis due to Candida is still rare and can be difficult to diagnosis and treat. We evaluated the incidence of vertebral osteomyelitis due to Candida species at our facility to try to identify risk factors and determine outcomes.MethodsWe used our electronic record databases to search for patients with a diagnosis of osteomyelitis, and a positive fungal culture. From 2006 to 2018 our hospital had 14 cases of culture proven Candida vertebral osteomyelitis.Results
Candida albicans was the most frequently isolated organism, being cultured in 10/14 (71.4%) patients, followed by C. tropicalis (2/14), C. krusei (1/14), and C. parapsilosis (1/14). The two most common risk factors for infection were injection drug use (50%) and prior spinal surgery (35.7%). Almost all patients were treated with caspofungin followed by fluconazole. Ten patients (71.4%) required surgery. Short-term outcomes were favorable with no deaths.ConclusionThe incidence of vertebral osteomyelitis due to Candida may be increasing. In our state, injection drug use seems to be a factor in the increase rate of infection. We have seen a rise in injection drug use as prescription narcotics are becoming more difficult to obtain. Physicians must have a high index of suspicion for fungal disease when treating osteomyelitis in patients with these risk factors. Short-term outcomes seem favorable, but further studies are needed to evaluate long-term outcomes and to determine optimal management.Disclosures
All authors: No reported disclosures.
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