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BMJ Case Reports Jan 2022Torticollis in children can be a sign of a potentially dangerous disease; the correct diagnosis is not always obvious on history and physical examination. The use of...
Torticollis in children can be a sign of a potentially dangerous disease; the correct diagnosis is not always obvious on history and physical examination. The use of point-of-care ultrasound (POCUS) helps to limit the differential diagnosis and direct appropriate further laboratory and radiology-performed evaluation. We present a case of a 10-year-old child whose deep neck infection (DNI) was timely diagnosed in the paediatric emergency department by early use of POCUS and drained under POCUS guidance after admission to the hospital. The culture from the fluid grew This case demonstrates that DNIs occur in children with acute acquired torticollis, even without fever and demonstrates the importance of early use of POCUS in cases where DNI is a potential diagnosis. Moreover, this case emphasises the importance of microbiological identification of DNIs that can be the key to successful treatment.
Topics: Child; Emergency Service, Hospital; Humans; Neck; Point-of-Care Systems; Torticollis; Ultrasonography
PubMed: 34992062
DOI: 10.1136/bcr-2021-244331 -
Mayo Clinic Proceedings Nov 2021
Topics: Abscess; Adult; Anti-Bacterial Agents; Cautery; Deglutition Disorders; Dissection; Fistula; Humans; Male; Pharyngitis; Prevotella; Pyriform Sinus; Secondary Prevention; Thyroid Gland; Tomography, X-Ray Computed; Treatment Outcome; Viridans Streptococci
PubMed: 34736611
DOI: 10.1016/j.mayocp.2021.08.023 -
Biologia Futura Dec 2021More than 6 billion bacteria and other microorganisms live in the adult oral cavity. As a result of any deleterious effect on this community, some microorganisms will...
More than 6 billion bacteria and other microorganisms live in the adult oral cavity. As a result of any deleterious effect on this community, some microorganisms will survive better than others, which may trigger pathogenic processes like caries, halitosis, gingivitis or periodontitis. Oral dysbiosis is among the most frequent human health hazards globally. Quality of life of patients deteriorates notably, while treatments are often unpleasant, expensive and irreversible, e.g. tooth loss. In the experiments reported here, we investigated the individual interactions between 8 pathogenic and 8 probiotic strains and a commercially available probiotic product. Almost all pathogens, namely Fusobacterium nucleatum, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Streptococcus mutans, Streptococcus oralis, Streptococcus gordonii, Enterococcus faecalis and Prevotella buccae are pathogens frequently occurring in the oral cavity. The used probiotic strains were Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus delbrueckii, Bifidobacterium thermophilum and two Streptococcus dentisani isolates. Using a modified agar diffusion method, we investigated capability of the probiotic bacteria to prevent the growth of the pathogenic ones in order to identify candidates for future therapeutic treatments. The results indicated successful bacteriocin production, i.e. growth inhibition, against every pathogenic bacterium by at least 5 probiotic strains.
Topics: Antibiosis; Humans; Mouth; Periodontitis; Probiotics; Virulence Factors
PubMed: 34554489
DOI: 10.1007/s42977-021-00091-3 -
Journal of the American College of... Oct 2020Purulent pericarditis is an extremely rare disease accounting for <1% of pericarditis cases. Purulent pericarditis with hemodyamically unstable tamponade if untreated is...
Purulent pericarditis is an extremely rare disease accounting for <1% of pericarditis cases. Purulent pericarditis with hemodyamically unstable tamponade if untreated is fatal. Furthermore, although idiopathic polymicrobial disease is documented, a combination , , and have not been found in the literature by the authors. What follows is a case of a 58-year-old male who presented to the emergency department (ED) with these features and underwent emergent bedside pericardiocentesis and a brief review of current pericardiocentesis techniques in the emergency department.
PubMed: 33145514
DOI: 10.1002/emp2.12202 -
Mikrobiyoloji Bulteni Apr 2020Prevotella species, being members of the human microbiota, are obligate anaerobic gram-negative bacteria. These organisms may cause opportunistic infections, including...
Prevotella species, being members of the human microbiota, are obligate anaerobic gram-negative bacteria. These organisms may cause opportunistic infections, including specific oral infections, local or systemic infections. A significant increase of resistance to some antimicrobials has been detected among Prevotella species. The frequency of resistance vary among isolates from different infection sources and between geographic locations. The knowledge about the antimicrobial susceptibility patterns of different Prevotella species is limited in Turkey. Providing the antimicrobial susceptibility data of these bacteria is very important for effective empirical treatment. In this study, we aimed to determine susceptibility data for 12 antimicrobial agents against Prevotella strains originating from human infections, collected in two centers in Turkey. A total of 118 Prevotella strains, isolated from different clinical samples in Marmara University Faculty of Medicine Medical Microbiology and Istanbul University Faculty of Dentistry Oral Microbiology Laboratories between January 2014-December 2017, were tested. Organisms were identified by using MALDI-TOF MS and by 16S rRNA gene sequencing. Minimal inhibitor concentrations of ampicillin, ampicillin-sulbactam, piperacillin-tazobactam, cefoxitin, meropenem, imipenem, clindamycin, tetracycline, tigecycline, moxifloxacin and metronidazole were determined using gradiyent test methodology (E-test; bioMerieux, France) and the European Committee on Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute and Food and Drug Administration guidelines were used for interpretation. Thirteen different Prevotella species were identified, Prevotella bivia and Prevotella nigrescens were the most prevalent species (n= 21) followed by Prevotella buccae (n= 19). All Prevotella strains were susceptible to piperacillin-tazobactam, cefoxitin, meropenem, imipenem and tigecycline. A total of 2 (1.7%) isolates were resistant to metronidazole and 1 (0.8%) isolate was intermediately resistant to ampicillin/sulbactam. The frequency of resistant isolates against ampicillin, clindamycin, tetracycline and moxifloxacin were 57.6%, 36.4%, 18% and 16.3%, respectively. In conclusion, piperacillin/tazobactam, cefoxitin, and tigecycline displayed high in vitro activity against Prevotella spp. and they all remained good candidates for empiric therapy. Imipenem and meropenem were also found to be very active, but the usage of carbapenems should be reserved for serious mixed infections, potentially accompanied by other resistant organisms. Intermediate resistance to ampicillinsulbactam and the resistance against metronidazole emphasized the need of periodic monitoring of their susceptibility patterns. The high rates of non-susceptibility to ampicillin, clindamycin, tetracycline and moxifloxacin indicated that these antimicrobials should not be used for treatment of infections without prior antimicrobial susceptibility testing.
Topics: Anti-Bacterial Agents; Bacteria, Anaerobic; Bacteroidaceae Infections; Humans; Microbial Sensitivity Tests; Prevotella; RNA, Ribosomal, 16S; Turkey
PubMed: 32723280
DOI: 10.5578/mb.69309 -
BMJ Case Reports Jan 2020A 76-year-old man presented with neck swelling associated with pain and fever. On examination, there was a submental neck swelling. His initial CT scan showed...
A 76-year-old man presented with neck swelling associated with pain and fever. On examination, there was a submental neck swelling. His initial CT scan showed multiloculated abscess centred in the left submandibular gland. He remained febrile despite on intravenous ceftriaxone and metronidazole. A repeat CT scan revealed significant worsening with multiple pockets of fluids with gas locules in the deep neck spaces. He subsequently underwent neck exploration and drainage of neck abscess. Extensive necrotic tissue was found intraoperatively and thick pus was drained from the bilateral parapharyngeal, submental spaces and anterior mediastium. Pus culture profusely grew of species. Patient recovered well following further intravenous antibiotic therapy. Diabetes mellitus and odontogenic infections are the common risk factors in deep neck infections. Our patient is however non-diabetic and edentulous. Current case is presented to serve as a rare case of neck abscess with unusual cause in a non-diabetic patient.
Topics: Abscess; Actinobacteria; Aged; Anti-Bacterial Agents; Combined Modality Therapy; Diagnosis, Differential; Humans; Male; Neck; Prevotella; Tomography, X-Ray Computed
PubMed: 31919070
DOI: 10.1136/bcr-2019-233467 -
Journal of Medical Case Reports Sep 2019Rapid diagnosis and appropriate treatment of Munchausen syndrome is important not only for the patient but also for health care workers because a delay in diagnosis can...
BACKGROUND
Rapid diagnosis and appropriate treatment of Munchausen syndrome is important not only for the patient but also for health care workers because a delay in diagnosis can worsen patients' clinical outcomes, and result in a substantial medical cost.
CASE PRESENTATION
A young and previously healthy 24-year-old Japanese woman, a nurse, presented with complaints of refractory abscess on her left upper limb for 3 months. A physical examination on admission revealed low-grade fever and a subcutaneous abscess in her left forearm. Laboratory data suggested mild systemic inflammation and liver dysfunction, but no abnormalities of the immune system, including changes in the number of lymphocytes and neutrophils, neutrophil phagocytic capacity, and natural killer (NK) cell activity, were observed. A human immunodeficiency virus test was also negative. Multiple modalities, including positron emission tomography-computed tomography, failed to detect any cause and focus of infection except her left upper limb. Streptococcus mitis and Prevotella buccae were detected from the wound, but no microorganisms were detected in a blood culture. The cellulitis promptly resolved; however, exacerbation of the subcutaneous abscess with polymicrobial bacteremia repeatedly occurred unexpectedly. Because of this puzzling clinical course, the possibility of self-injury was finally suspected. Three syringes with needles, with a turbid liquid, were found in our patient's bag. Enterobacter cloacae and Enterococcus faecalis were detected in the liquid, and an analysis via repetitive element sequence-based polymerase chain reaction determined that Enterococcus faecalis in the wound and syringe contents were genetically identical. She was diagnosed as having Munchausen syndrome and treated with the collaboration of a psychiatrist. She finally confessed that she had injected her own saliva and toilet water into the drip line and wound.
CONCLUSIONS
This case report is valuable in that it is the first case in which this syndrome was diagnosed by a genetic method. Munchausen syndrome should not be neglected as a possible cause of refractory and recurrent infection.
Topics: Abscess; Bacteremia; Cellulitis; Enterococcus faecalis; Female; Forearm; Gram-Positive Bacterial Infections; Humans; Injections, Subcutaneous; Munchausen Syndrome; Nursing Staff, Hospital; Polymerase Chain Reaction; Sequence Analysis, DNA; Subcutaneous Tissue; Young Adult
PubMed: 31511062
DOI: 10.1186/s13256-019-2212-7 -
Anaerobe Feb 2020Mediastinitis is a well-known complication of open-heart surgery. Strictly anaerobic bacteria are rarely found in this condition, unlike in descending mediastinitis. We...
Mediastinitis is a well-known complication of open-heart surgery. Strictly anaerobic bacteria are rarely found in this condition, unlike in descending mediastinitis. We report the case of a mediastinitis due to Prevotella buccae after surgical replacement of the aortic valve and triple coronary artery bypass in an immunocompetent 76 year-old man. The bacteria were found in pure culture on blood samples and surgical samples. This case emphasizes the need to perform anaerobic cultures in case of sternal wound infection after open-heart surgery.
Topics: Aged; Anti-Bacterial Agents; Bacterial Infections; Biomarkers; Cardiac Surgical Procedures; Humans; Male; Mediastinitis; Postoperative Complications; Prevotella
PubMed: 31494261
DOI: 10.1016/j.anaerobe.2019.102097 -
Current Microbiology Sep 2019A novel Gram-negative, obligately anaerobic, non-motile, non-spore forming, and rod-shaped bacterium, designated strain JS262, was isolated from human subgingival plaque...
A novel Gram-negative, obligately anaerobic, non-motile, non-spore forming, and rod-shaped bacterium, designated strain JS262, was isolated from human subgingival plaque of periodontitis lesion and was characterized by polyphasic taxonomic analysis. Comparison of 16S ribosomal RNA gene (16S rDNA) sequence revealed that the strain belonged to the genus Prevotella. The percent similarity of 16S rDNA of strain JS262 was closest to those of Prevotella buccae ATCC 33574 (89.1%) and Prevotella shahii JCM 12083 (88.9%). The major fatty acids of strain JS262 were C (29.2%), iso-C (19.2%), and anteiso-C (16.9%). Complete genome of strain JS262 was 2,691,540 bp in length and the G+C content was 43.9 mol%. Average nucleotide identity and genome-to-genome distance values between strain JS262 and P. buccae ATCC 33574 or P. loescheii DSM 19665 were > 70.4% and > 30.1%, respectively. On the basis of these data, a novel Prevotella species is proposed: Prevotella koreensis sp. nov. The type strain of P. koreensis is JS262 (= KCOM 3155 = JCM 33298).
Topics: Bacterial Typing Techniques; Base Composition; Dental Plaque; Fatty Acids; Female; Genome, Bacterial; Humans; Middle Aged; Periodontitis; Phylogeny; Prevotella
PubMed: 31214821
DOI: 10.1007/s00284-019-01720-w