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Microbiological Findings (microbiological + finding)
Selected AbstractsMicrobiological findings and host response in patients with peri-implantitisCLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2002Margareta Hultin Abstract: The aim of the present study was to characterise microbiota and inflammatory host response around implants and teeth in patients with peri-implantitis. We included 17 partly edentulous patients with a total of 98 implants, of which 45 showed marginal bone loss of more than three fixture threads after the first year of loading. Nineteen subjects with stable marginal tissue conditions served as controls. Oral hygiene, gingival inflammation, and probing pocket depth were evaluated clinically at teeth and implants. Microbiological and crevicular fluid samples were collected from five categories of sites: 1) implants with peri-implantitis (PI), 2) stable implants (SI) in patients with both stable and peri-implantitis implants, 3) control implants (CI) in patients with stable implants alone, 4) teeth in patients (TP) and 5) controls (TC). Crevicular fluid from teeth and implants was analysed for elastase activity, lactoferrin and IL-1, concentrations. Elastase activity was higher at PI than at CI in controls. Lactoferrin concentration was higher at PI than at SI in patients with peri-implantitis. Higher levels of both lactoferrin and elastase activity were found at PI than at teeth in patients. The concentrations of IL-1, were about the same in the various sites. Microbiological DNA-probe analysis revealed a putative periodontal microflora at teeth and implants in patients and controls. Patients with peri-implantitis harboured high levels of periodontal pathogens, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteroides forsythus and Treponema denticola. These findings indicate a site-specific inflammation rather than a patient-associated specific host response. [source] Pyogenic liver abscesses: a comparison of older and younger patientsHPB, Issue 3 2001JA Alvarez Background Pyogenic liver abscess is a life-threatening disease. Few studies have specifically explored the way in which the clinical features and management of elderly patients with pyogenic liver abscess differ from those of younger individuals. Methods A retrospective study was undertaken to evaluate whether older patients with pyogenic liver abscess have distinctive presenting features or whether their management and outcome differ from that of younger patients. A total of 133 patients with liver abscess treated in five hospitals during 13 years comprised two groups: 78 patients aged 60 years or above (older group) and 55 patients below age 60 years (younger group). Clinical features, laboratory data, imaging and microbiological findings, management and outcome were determined in each group. Results The older group contained more patients with associated diseases (p = 0.03), nausea and vomiting at presentation (p = 0.02), higher APACHE II (Acute Physiological and Chronic Health Evaluation II scale) score (p < 0.001) and blood urea nitrogen (p < 0.001) and serum creatinine levels (p = 0.002). Multiple abscess (p = 0.05) and bilobar (p = 0.03) abscess were also commoner in this group. By contrast, in the younger group men predominated (p = 0.01), and there was a higher overall complication rate (p = 0.05). Time to diagnosis, hospital mortality rate and other variables analysed were similar in both groups. Discussion Elderly patients with pyogenic liver abscess have some subtle differences in clinical and laboratory presentation, but these do not appear to delay diagnosis. Active management is tolerated well, with a lower morbidity rate than in younger patients and no difference in the mortality rate. [source] Fournier's gangrene: Report of thirty-three cases and a review of the literatureINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2006LUTFI TAHMAZ Background:, Fournier's gangrene (FG) is an extensive fulminant infection of the genitals, perineum or the abdominal wall. The aim of this study is to share our experience with the management of this difficult infectious disease. Methods:, Thirty-three male patients were admitted to our clinic with the diagnosis of FG between February 1988 and December 2003. The patient's age, etiology and predisposing factors, microbiological findings, duration of hospital stay, treatment, and outcome were analyzed. The patients were divided into two groups. The first 21 patients (Group I) were treated with broad-spectrum triple antimicrobial therapy, broad debridement, exhaustive cleaning, and then they underwent split-thickness skin grafts or delayed closure as needed. The other 12 patients (Group II) were treated with unprocessed honey (20,50 mL daily) and broad-spectrum triple antimicrobial therapy without debridement. Their wounds were cleaned with saline and then dressed with topical unprocessed honey. The wounds were inspected daily and the honey was reapplied after cleaning with normal saline. Then, the patients' scrotum and penis were covered with their own new scrotal skin. Results:, The mean age of the patients was 53.9 ± 9.56 years (range = 23,71). The source of the gangrene was urinary in 23 patients, cutaneous in seven patients, and perirectal in three patients. The predisposing factors included diabetes mellitus for 11 patients, alcoholism for 10 patients, malnutrition for nine patients, and medical immunosuppression (chemotherapy, steroids, malignancy) for three patients. The mean duration of hospital stay was 41 ± 10.459 (range = 14,54) days. Two patients in Group I died from severe sepsis. The clinical and cosmetic results were better in Group II than Group I. Conclusions:, Necrotizing fasciitis of the perineum and genitalia is a severe condition with a high morbidity and mortality. Traditionally, good management is based on aggressive debridement, broad-spectrum antibiotics, and intensive supportive care but unprocessed honey might revolutionize the treatment of this dreadful disease by reducing its cost, morbidity, and mortality. [source] Blastomycosis-like pyoderma: Successful treatment with low-dose acitretinAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2005Roland TD Nguyen SUMMARY Blastomycosis-like pyoderma typically presents as verrucous plaque(s) with a purulent discharge through multiple sinuses. Two patients with blastomycosis-like pyoderma developing on significantly sun-damaged skin are presented: an 84-year-old man with multiple painful nodules and plaques, and a 92-year-old woman with a solitary plaque on the left calf. Histopathology showed pseudoepitheliomatous hyperplasia with dermal foci of suppuration. Staphylococcus aureus was isolated from a biopsy specimen in the first patient, whereas the latter patient had Prevotella and Corynebacterium species. Investigations for fungi and mycobacteria yielded negative results. These microbiological findings further supported the clinicopathological diagnosis. Both patients failed to respond to oral doxycycline despite the in vitro susceptibility of the organisms. Treatment with low-dose oral acitretin was successful in both patients after 3,4 months. [source] Mastitis in early infancyACTA PAEDIATRICA, Issue 2 2005T Stricker Abstract Aim: To evaluate the clinical features and microbiological findings in young infants with mastitis. Methods: Retrospective review of medical records of 18 infants with breast inflammation during the first 3 mo of life seen in the paediatric emergency department between 1992 and 2002. Results: All were full-term infants with female,male ratio of 3.5,1. The age ranged from 12 to 45 d, with a peak in the 4th and 5th weeks of life. Only five patients had systemic manifestations, and five were pretreated with oral antibiotics (amoxicillin-clavulanic acid). The latter as well as seven additional cases required incision and drainage due to abscess formation. Bacterial cultures grew Staphylococcus aureus in 10 cases including all pretreated infants. In four of these cases, Gram stain showed the pathogen. After antimicrobial treatment, no recurrence was observed in any of the patients. Conclusions: These findings suggest that mastitis in early infancy should be treated with parenteral antibiotics guided by Gram stain when available and informative. Otherwise, ,-lactamase-resistant antibiotics are a reasonable empirical initial treatment pending culture results. Optimizing the management of infants with mastitis is important especially since abscess formation requiring incision may be detrimental for later breast development. [source] | ||||||||||