amoxicillin-potassium-clavulanate-combination and Chest-Pain

Syphilis is a sexually transmitted systemic infection caused by Treponema pallidum. We report a case of a heterosexual, HIV-positive man who presented with secondary syphilis and a lung abscess. A bacterial lung abscess was suspected and a computed tomography-guided percutaneous needle aspiration of the lung abscess was performed. Direct pulmonary involvement by T. pallidum was suggested by a positive PCR result on the aspirated fluid specimen. The clinical signs of secondary syphilis improved, and the lung abscess was resolved after treatment with benzathine penicillin G and amoxicillin-clavulanate. The final diagnosis was secondary pulmonary syphilis. Few reports of secondary syphilis with pulmonary involvement have been reported to date.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chest Pain; HIV Infections; Humans; Lung; Lung Abscess; Male; Penicillin G Benzathine; Polymerase Chain Reaction; Syphilis; Syphilis Serodiagnosis; Tomography, X-Ray Computed; Treatment Outcome; Treponema pallidum

Topics: Amoxicillin-Potassium Clavulanate Combination; Anaphylaxis; Chest Pain; Coronary Occlusion; Epinephrine; Humans; Hydrocortisone; Kounis Syndrome; Male; Middle Aged; Percutaneous Coronary Intervention

Staphylococcus lugdunensis, a strain of coagulase-negative staphylococci, is part of the normal flora of human skin but can cause multiple infections at various sites. This microorganism has emerged as a major human pathogen. However, no study has reported primary lung abscess caused by S. lugdunensis. A 54-year-old alcoholic man without relevant past medical history was admitted because of primary lung abscesses. Empirical amoxicillin/clavulanate therapy was initially administered; however, the patient had persistent pleuritic chest pain and fever. He subsequently underwent resection of the lung abscess and removal of exudative pleural effusion on the fourth hospital day. Histopathologic examination confirmed the diagnosis of lung abscess, and colonies of gram-positive bacteria were identified. The culture specimen from the abscess was positive for S. lugdunensis, which was susceptible to amoxicillin/clavulanate, cefazolin, ciprofloxacin, clindamycin, erythromycin, oxacillin, teicoplanin, tetracycline, and vancomycin. Following resection and 3 weeks of amoxicillin/clavulanate therapy, the patient eventually recovered well without relapse. This case report is the first to describe S. lugdunensis as a cause of primary lung abscess; this microorganism should be considered a potential monomicrobial pathogen in primary lung abscess.

Topics: Alcoholics; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chest Pain; Humans; Lung Abscess; Male; Middle Aged; Pleural Effusion; Pneumonectomy; Radiography; Staphylococcal Infections; Staphylococcus lugdunensis

A 38-year-old man presented with pleuritic chest pain that was present on waking and localised to the left costal margin with no radiation. He was otherwise asymptomatic and denied preceding trauma, heavy lifting, coughing or recent vomiting. Observations and examination were unremarkable; however, a chest radiograph showed a pneumomediastinum. Spontaneous pneumomediastinum (SPM) is a rare condition that tends to follow a benign clinical course. A CT of the chest is generally only indicated if the chest X-ray fails to show an SPM in patients for whom there is a high index of clinical suspicion. A contrast-enhanced swallow study is only indicated if there is suspicion of an oesophageal tear or rupture. Evidence suggests that patients with SPM can be managed conservatively and observed for 24 h.

Topics: Acute Disease; Adult; Amoxicillin-Potassium Clavulanate Combination; Analgesics; Chest Pain; Diagnosis, Differential; Emergency Service, Hospital; Humans; Male; Mediastinal Emphysema; Radiography, Thoracic; Risk Assessment; Severity of Illness Index; Treatment Outcome

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chest Pain; Female; Gastroesophageal Reflux; Gastroplasty; Humans; Laparoscopy; Obesity, Morbid; Pneumonia, Aspiration; Pneumonia, Bacterial; Postoperative Complications; Radiography