Proteus vulgaris Empyema and Increased Pleural Fluid pH

Isenstein, Douglas A.; Honig, Eric

doi:10.1378/chest.97.2.511b

Cited by 13 publications

(9 citation statements)

References 2 publications

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“…mirabilis has been implicated in bacteremia (3,106), neonatal meningoencephalitis (39), empyema (49), and osteomyelitis (63). P. penneri has been implicated in a case of bacteremia and concomitant subcutaneous thigh abscess in a neutropenic patient with acute lymphocytic leukemia (23) and in nosocomial urosepsis in a diabetic patient from whom the organism was also subsequently isolated from bronchoalveolar lavage fluid and a pulmonary artery catheter tip (60).…”

Section: Clinical Significancementioning

confidence: 99%

Classification, Identification, and Clinical Significance of Proteus, Providencia, and Morganella

O'Hara¹,

Brenner²,

Miller³

2000

Clinical Microbiology Reviews

405

266

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Section: Clinical Significancementioning

confidence: 99%

Classification, Identification, and Clinical Significance of Proteus, Providencia, and Morganella

O'Hara¹,

Brenner²,

Miller³

2000

Clinical Microbiology Reviews

405

266

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“…Their true role, however, remains unsubstantiated. P. mirabilis has been implicated in bacteremia (3,106), neonatal meningoencephalitis (39), empyema (49), and osteomyelitis (63). P. penneri has been implicated in a case of bacteremia and concomitant subcutaneous thigh abscess in a neutropenic patient with acute lymphocytic leukemia (23) and in nosocomial urosepsis in a diabetic patient from whom the organism was also subsequently isolated from bronchoalveolar lavage fluid and a pulmonary artery catheter tip (60).…”

Section: Clinical Significancementioning

confidence: 99%

Classification, Identification, and Clinical Significance ofProteus,Providencia, andMorganella

O'Hara¹,

Brenner

Miller³

2000

Clin Microbiol Rev

372

238

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SUMMARY This review presents the current taxonomy of the genera Proteus, Providencia, and Morganella, along with the current methods for the identification of each species within the three genera, incorporating both conventional biochemical and commercial methods. While all of these organisms are ubiquitous in the environment, individual case reports and nosocomial outbreak reports that demonstrate their ability to cause major infectious disease problems are presented. Lastly, anticipated antimicrobial susceptibility patterns are reviewed. Many of these organisms are easily controlled, but the advent of newer and more powerful antimicrobial agents has led to some problems of which laboratorians need to be aware.

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“…In this case, the pH was 8, which is 0.4 unit above the highest level in a study of 178 cases of pleural effusion reported by Light et al 44 This level is very unusual, although there have been a few case reports of a very high pH in pleural-fluid specimens due to the presence of proteus species. 45,46 Proteus is an uncommon cause of community-acquired pneumonia, however, and was not recovered from this patient's sputum.…”

Section: Pathological Discussionmentioning

confidence: 76%

Case 14-2000

Shapiro¹,

Mark²

2000

N Engl J Med

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A 60-year-old man was admitted to the hospital because of pneumonia.The patient had been well until 10 days earlier, when exertional dyspnea developed, with chills, fever, and night sweats. Two days later, his temperature rose to 40°C. Four days before being admitted to this hospital, he was admitted to another hospital, where a radiograph of the chest showed one area of consolidation in the left lower lobe, another area in the right upper lobe, and a small left pleural effusion. The white-cell count was 12,700 per cubic millimeter, with 60 percent neutrophils and 26 percent band forms. Specimens were obtained for culture. Cefuroxime therapy was begun, and cefuroxime was subsequently replaced by ceftriaxone, gentamicin, and erythromycin. The temperature rose to 40°C daily, and daily headache was reported. A sputum culture yielded gram-negative rods, which were suspected to be a species of haemophilus. By the fifth hospital day, the pleural effusion had enlarged. Microscopical examination of a sputum specimen revealed occasional gram-positive diplococci and a few gram-variable bacilli. The patient was transferred to this hospital.The patient worked on a farm on the island of Nantucket, Massachusetts, where he was exposed to chickens, turkeys, horses, sheep, and domestic rabbits; he was not aware of any exposure to wild rabbits or deer. Seven years before admission, he had been treated with an antibiotic for Lyme disease. He was allergic to amoxicillin. His father had died of psittacosis and cardiac disease, and his mother had died of sarcoidosis. There was no history of wheeze, productive cough, hemoptysis, pleuritic chest pain, nausea, vomiting, diarrhea, weight loss, recent trav-el, or exposure to persons with tuberculosis or other acute illnesses, and there were no risk factors for human immunodeficiency virus (HIV) infection.The temperature was 38.5°C, the pulse was 75, and the respirations were 22. The blood pressure was 100/80 mm Hg.On examination, the patient was slightly tachypneic. No skin lesions or enlarged lymph nodes were found. Dullness and crackles were present at the base of the left lung, with egobroncophony, and consolidation was detected at the apex of the right lung.Laboratory tests were performed (Tables 1 and 2).

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Proteus vulgaris Empyema and Increased Pleural Fluid pH

Cited by 13 publications

References 2 publications

Classification, Identification, and Clinical Significance of Proteus, Providencia, and Morganella

Classification, Identification, and Clinical Significance of Proteus, Providencia, and Morganella

Classification, Identification, and Clinical Significance ofProteus,Providencia, andMorganella

Case 14-2000

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