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BMC Pulmonary Medicine Feb 2020Descending necrotizing mediastinitis is a severe infection of the mediastinum. This syndrome manifests as fever and chest pain following cough and sputum production. A... (Review)
Review
Descending necrotizing mediastinitis is a severe infection of the mediastinum. This syndrome manifests as fever and chest pain following cough and sputum production. A 49-year-old woman presented with fever and a 14-day history of pneumonia. CT showed mediastinal abscesses with a giant calcified mediastinal lymph node (21 × 18 mm) and pneumonia. Bronchoscopy by EBUS-TBNA under general anesthesia was performed. The pathogen found in the puncture culture was Streptococcus constellatus, and antibiotics (mezlocillin/sulbactam 3.375 IVGTT q8h) was administered. A proximal right main bronchial neoplasm, suspected lung cancer, was found and conformed to inflammatory granuloma. A total of 22 months post-discharge the patient was clinically stable. We also conducted a review of the literature for all Streptococcus constellatus descending necrotizing mediastinitis infections between 2011 and 2017.
Topics: Anti-Bacterial Agents; Bronchoscopy; Drainage; Female; Humans; Immunocompetence; Lymph Nodes; Mediastinitis; Middle Aged; Pneumonia; Streptococcal Infections; Streptococcus constellatus; Tomography, X-Ray Computed
PubMed: 32066414
DOI: 10.1186/s12890-020-1068-3 -
Infection and Drug Resistance 2022() is a well-known part of the normal flora in humans. Pyogenic spondylitis (PS) induced by is very rare. In this case, a 46-year-old male patient presented to our...
() is a well-known part of the normal flora in humans. Pyogenic spondylitis (PS) induced by is very rare. In this case, a 46-year-old male patient presented to our hospital with a 2-month history of low back pain and weakness in both legs. Based on his clinical manifestations, laboratory findings, blood culture results, imaging and histopathological findings, the patient was diagnosed with PS caused by . One unique aspect of this case is the acute and severe course of infection, which resulted in multiple organ dysfunction syndrome and septic shock in the first week and rapid vertebral destruction within 2 months of the patient's admission. His obese status may be relevant to his presentation. This case report suggests that infections should not be overlooked, especially in patients with known risk factors and predispositions to infectious diseases.
PubMed: 35971556
DOI: 10.2147/IDR.S371411 -
Journal of Bacteriology Apr 2019Cystic fibrosis (CF) is a genetic disease that causes patients to accumulate thick, dehydrated mucus in the lung and develop chronic, polymicrobial infections due to...
Cystic fibrosis (CF) is a genetic disease that causes patients to accumulate thick, dehydrated mucus in the lung and develop chronic, polymicrobial infections due to reduced mucociliary clearance. These chronic polymicrobial infections and subsequent decline in lung function are significant factors in the morbidity and mortality of CF. and spp. are among the most prevalent organisms in the CF lung; the presence of correlates with lung function decline, and the group (SMG), a subgroup of the viridans streptococci, is associated with exacerbations in patients with CF. Here we characterized the interspecies interactions that occur between these two genera. We demonstrated that multiple laboratory strains and clinical CF isolates promote the growth of multiple SMG strains and oral streptococci in an coculture system. We investigated the mechanism by which enhances growth of streptococci by screening for mutants of PA14 that are unable to enhance growth, and we identified the ::Tn mutant, which failed to promote growth of and Characterization of the Δ mutant revealed that this strain cannot promote growth. Our genetic data and growth studies support a model whereby the Δ mutant overproduces siderophores and thus likely outcompetes for limited iron. We propose a model whereby competition for iron represents one important means of interaction between and spp. Cystic fibrosis (CF) lung infections are increasingly recognized for their polymicrobial nature. These polymicrobial infections may alter the biology of the organisms involved in CF-related infections, leading to changes in growth, virulence, and/or antibiotic tolerance, and could thereby affect patient health and response to treatment. In this study, we demonstrate interactions between and streptococci using a coculture model and show that one interaction between these microbes is likely competition for iron. Thus, these data indicate that one CF pathogen may influence the growth of another, and they add to our limited knowledge of polymicrobial interactions in the CF airway.
Topics: Bacterial Proteins; Gene Deletion; Genetic Testing; Iron; Microbial Interactions; Mutagenesis, Insertional; Pseudomonas aeruginosa; Siderophores; Streptococcus milleri Group
PubMed: 30718303
DOI: 10.1128/JB.00014-19 -
Infection and Drug Resistance 2023Disseminated infection caused by was seldom occurred. We reported a case of infection, presenting as multiple pulmonary cavities, thoracic wall abscess and vertebral...
Disseminated infection caused by was seldom occurred. We reported a case of infection, presenting as multiple pulmonary cavities, thoracic wall abscess and vertebral destruction. The 37-year-old male had recurrent fever, chest wall swelling and pain, and lower limb numbness, he had weak physical condition and previously suffered from poorly controlled diabetes and severe periodontal disease for 3 years. Definite diagnosis of infection was made by metagenomic next‑generation sequencing (mNGS) in abscess drainage fluid. Systemic antibiotics and thoracic wall drainage were given, and the pulmonary cavity and the thoracic intermuscular abscess were significantly decreased. Few to no study reported the disseminated infection (pulmonary cavities, thoracic wall abscess and vertebral destruction) caused by . This case report highlighted the importance of mNGS for accurate diagnosis, as well as the timely drainage and antibiotics for effective treatment of infection.
PubMed: 37601557
DOI: 10.2147/IDR.S416483 -
European Journal of Oral Sciences Dec 2022Microbial biofilms play a dominant role in the failure of endodontic therapies. Bacterial adhesion is the first step in the establishment of biofilms, activating the...
Microbial biofilms play a dominant role in the failure of endodontic therapies. Bacterial adhesion is the first step in the establishment of biofilms, activating the host immune response leading to tissue damage. Biosurfactants are microbe-derived tensioactive molecules with latent anti-adhesive and anti-microbial activity. This study reports the extraction and characterization of a biosurfactant from Lactobacillus (L.) plantarum (Lp-BS) and investigates its anti-microbial and anti-adhesive properties compared to rhamnolipid, a commercially available biosurfactant. Lp-BS, extracted from L. plantarum during the growth phase, was characterized as a glycoprotein, able to reduce surface tension and emulsify non-polar liquids. Proteomic analysis of Lp-BS identified three bacterial adhesin-like proteins, suggesting roles in hindering bacterial adhesion. Lp-BS did not show significant anti-microbial activity against endodontic pathogens from the Streptococcus (Strep.) anginosus group or Enterococcus (Ent.) faecalis at 50 mg/ml. However, anti-adhesive activity on abiotic surfaces was observed against both Strep. anginosus and Strep. intermedius. Rhamnolipid exhibited strong anti-microbial activity, with minimum inhibitory concentrations of 0.097 mg/ml against Strep. anginosus, and 0.048 mg/ml against Strep. constellatus and Strep. intermedius, in addition to a marked anti-adhesive activity. These findings offer preliminary evidence for the potential application of biosurfactants as an anti-microbial and/or anti-adhesive pharmacotherapy in endodontics.
Topics: Proteomics
PubMed: 36326688
DOI: 10.1111/eos.12900 -
AIDS Research and Therapy Jan 2024Empyema caused by Streptococcus constellatus (S. constellatus) is rare in patients with HIV. To analyze the clinical data of a patient living with HIV (PLHIV), who got... (Review)
Review
BACKGROUND
Empyema caused by Streptococcus constellatus (S. constellatus) is rare in patients with HIV. To analyze the clinical data of a patient living with HIV (PLHIV), who got empyema caused by S. constellatus, investigating the diagnosis and treatment of this disease through literature review to improve the clinical understanding of this disease.
CASE PRESENTATION
We have reported here a 58-year-old male PLHIV with cough, wheezing, and fever for 20 days. He has a history type 2 diabetes, alcohol abuse, and a teeth extracted. Chest computed tomography revealed multiple encapsulated pleural effusions, pneumatosis, and partial compressive atelectasis in the right lung. Submission of pleural efusions timely, and then cultures revealed S. constellatus. After comprehensive treatment, including antibiotics, closed pleural drainage, and intrapleural injection of urokinase, the pleural efusion was absorbed, and chest computed tomography also confirmed the improvement.
CONCLUSIONS
S. constellatus should not be neglected as a pus pathogen in patients with HIV. comprehensive treatment is important for empyema of S. constellatus.
Topics: Male; Humans; Middle Aged; Streptococcus constellatus; Empyema, Pleural; Diabetes Mellitus, Type 2; HIV Infections; Drainage
PubMed: 38173032
DOI: 10.1186/s12981-023-00587-z -
Annals of Palliative Medicine Jul 2021Necrotizing fasciitis (NF) is a rare, fulminant, lethal soft-tissue infection result in fascial necrosis, it is rarer in the head and neck area. Infection caused by...
Necrotizing fasciitis (NF) is a rare, fulminant, lethal soft-tissue infection result in fascial necrosis, it is rarer in the head and neck area. Infection caused by Klebsiella oxytoca is much less common. Therefore, we reported a case of NF in the maxillofacial region, neck and upper mediastinum caused by Klebsiella oxytoca as the main cause recently treated in our department. The patient is a middle-aged male with a 10-year history of diabetes with unstable insulin control. The main symptoms were pain on left side with dysphagia and fever and the situation was getting worse. The patient had limited ability to have mouth open and had hyperemia, swelling on the left pharynx, maxillofacial area, and upper left neck and skin tenderness, and all symptoms were getting worse quick. The CT mainly found out that left oropharyngeal wall, parotid gland area, bilateral submaxilla, left neck, and superior mediastinum are swelling with gas. The blood test result: leukocytes count 16.64×109/L, neutrophils percentage 85.8%; C-Pr 320 mg/L; urinary routine: urine glucose (+++++), ketone bodies (+++++); fasting glucose metabolism: glucose 21.33 mmol/L, glycosylated albumin 47.67%. Three incisions of facial and neck were performed to drain pus. Result of bacteria culture: Klebsiella oxytoca and Streptococcus constellatus During treatment of DKA and reduce patient glucose level, we also treated patient with neck and trachea incisions to drain pus and cleaned daily wound area and used different antibiotics according to the bacteria culture and CT results. And finally, the patient was cured and discharged from hospital. This case of NF was very rare not only the bacteria in this case but also the pathological changes related (involving the mediastinum). The report of his diagnosis and treatment can provide experience for future treatments.
Topics: Fasciitis, Necrotizing; Humans; Klebsiella oxytoca; Male; Mediastinum; Middle Aged; Neck; Streptococcus constellatus
PubMed: 33977729
DOI: 10.21037/apm-20-2427 -
Diagnostics (Basel, Switzerland) Aug 2021Deep neck infection (DNI) is a serious disease that can lead to airway obstruction, and some patients require a tracheostomy to protect the airway instead of intubation....
Deep neck infection (DNI) is a serious disease that can lead to airway obstruction, and some patients require a tracheostomy to protect the airway instead of intubation. However, no previous study has explored risk factors associated with the need for a tracheostomy in patients with DNI. This article investigates the risk factors for the need for tracheostomy in patients with DNI. Between September 2016 and February 2020, 403 subjects with DNI were enrolled. Clinical findings and critical deep neck spaces associated with a need for tracheostomy in patients with DNI were assessed. In univariate and multivariate analysis, older age (≥65 years old) (OR = 2.450, 95% CI: 1.163-5.161, = 0.018), multiple spaces involved (≥3 spaces) (OR = 4.490, 95% CI: 2.153-9.360, = 0.001), and the presence of mediastinitis (OR = 14.800, 95% CI: 5.097-42.972, < 0.001) were independent risk factors associated with tracheostomy in patients with DNI. Among the 44 patients with DNI that required tracheostomy, ≥50% of patients had involvement of the parapharyngeal or retropharyngeal space (72.72% and 50.00%, respectively). (25.00%) was the most common pathogen in patients with DNI who required tracheostomy. In conclusion, requiring a tracheostomy was associated with a severe clinical presentation of DNI. Older age (≥65 years old), multiple spaces (≥3 spaces), and presence of mediastinitis were significant risk factors associated with tracheostomy in patients with DNI. The parapharyngeal and retropharyngeal spaces were the most commonly involved, and was the most common pathogen in the patients with DNI that required tracheostomy.
PubMed: 34573878
DOI: 10.3390/diagnostics11091536 -
Ear, Nose, & Throat Journal Nov 2023Pterygopalatine fossa (PPF) abscess is an exceedingly rare occurrence. Typically, it has been reported in association with odontogenic infections or hematogenous...
Pterygopalatine fossa (PPF) abscess is an exceedingly rare occurrence. Typically, it has been reported in association with odontogenic infections or hematogenous dissemination. In this report, we present the first case of PPF abscess where no obvious underlying cause or primary infection was evident. The patient initially presented with a 2-week history of left ptosis and persistent headaches, which were subsequently accompanied by fever and limited mouth opening. Based on elevated inflammatory markers and imaging findings, the diagnosis of a PPF abscess was established. Successful treatment was achieved through surgical drainage using an external cervical approach. Cultures from the aspirated pus identified as the causative agent. This case highlights the importance of considering PPF abscess in patients presenting with ptosis as an initial symptom. When diagnosed, surgical drainage should be considered as a viable therapeutic option.
PubMed: 38031416
DOI: 10.1177/01455613231212047 -
Open Respiratory Archives 2023
PubMed: 37842285
DOI: 10.1016/j.opresp.2023.100272