amoxicillin-potassium-clavulanate-combination and Liver-Abscess

Topics: Africa; Albendazole; Amoxicillin-Potassium Clavulanate Combination; Animals; Anthelmintics; Ascaris lumbricoides; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis; Common Bile Duct; Decompression, Surgical; Drainage; Female; Humans; Klebsiella pneumoniae; Liver; Liver Abscess; Liver Diseases, Parasitic; Middle Aged; Shock, Septic; Travel-Related Illness; Treatment Outcome

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Deferoxamine; Female; Glucosephosphate Dehydrogenase Deficiency; Humans; Injections, Subcutaneous; Jehovah's Witnesses; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess; Middle Aged; Thalassemia

Melioidosis caused by Burkholderia pseudomellei is an infection with protean clinical manifestations. Guillain-Barré syndrome [GBS] associated with melioidosis is very rare.. A 42-year-old woman with diabetes presented with abdominal pain, vomiting and intermittent fever for one month. Six months before presentation she had recurrent skin abscesses. Three months before presentation she had multiple liver abscesses which were aspirated in a local hospital. The aspirate grew "coliforms" resistant to gentamicin and sensitive to ceftazidime. On presentation she had high fever and tender hepatomegaly. Ultra Sound Scan of abdomen showed multiple liver and splenic abscesses. Based on the suggestive history and sensitivity pattern of the previous growth melioidosis was suspected and high dose meropenem was started. Antibodies to melioidin were raised at a titre of 1:10240. The growth from the aspirate of liver abscess was confirmed as Burkholderia pseudomellei by polymerase chain reaction [PCR]. After a week of treatment, patient developed bilateral lower limb weakness. Deep tendon reflexes were absent. There was no sensory loss or bladder/bowel involvement. Analysis of the cerebro-spinal fluid showed elevated proteins with no cells. There was severe peripheral neuropathy with axonal degeneration. A diagnosis of GBS was made and she was treated with plasmapharesis with marked improvement of neurological deficit. Continuation of intravenous antibiotics lead to further clinical improvement with normalization of inflammatory markers and resolution of liver and splenic abscess. Eradication therapy with oral co-trimoxazole and co-amoxyclav was started on the seventh week. Patient was discharged to outpatient clinic with a plan to continue combination of oral antibiotics for 12 weeks. At the end of 12 weeks she was well with complete neurological resolution and no evidence of a relapse.. Guillaine Barre syndrome is a rare complication of melioidosis and should be suspected in a patient with melioidosis who develop lower limb weakness. Plasmapharesis can be successfully used to treat GBS associated with active melioidosis.

Topics: Abdominal Pain; Administration, Oral; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Burkholderia pseudomallei; Ceftazidime; Drug Resistance, Bacterial; Female; Gentamicins; Guillain-Barre Syndrome; Humans; Injections, Intravenous; Liver Abscess; Melioidosis; Meropenem; Peripheral Nervous System Diseases; Polymerase Chain Reaction; Splenic Diseases; Thienamycins; Trimethoprim, Sulfamethoxazole Drug Combination

The case of cryptogenic Escherichia coli pyogenic liver abscess in a 59-year-old Human Immunodeficiency Virus (HIV) seropositive man is reported. The initial treatment was a percutaneous drainage. As the abscess did not reduce in size, surgical drainage was planned but during surgery a necrosectomy had to be performed resulting in a partial hepatectomy. After nine months of amoxicillin-clavulanic acid treatment, drainage and highly active antiretroviral therapy, the patient recovered completely. It is expected that because of highly active antiretroviral therapy, mortality rates of surgical interventions in patients with HIV infection will decrease. Because of the increased life expectancy in persons with HIV infection, the criteria for considering surgical interventions in these patients should be broadened.

Topics: Amoxicillin-Potassium Clavulanate Combination; Antiretroviral Therapy, Highly Active; Drainage; Drug Therapy, Combination; Escherichia coli Infections; Hepatectomy; HIV Seropositivity; Humans; Liver Abscess; Male; Middle Aged

A woman, aged 76, was admitted to the Internal Medicine Ward because of severe general state, marked dehydration and high pyrexia of ten-day duration. The executed diagnostics, among others USG and CT, allowed to give the diagnosis of single hepatic abscess. The patient did not consent to the lesion puncture and due to that conservative treatment was initiated. She was administered Augmentin, Gentamycin and Metronidazole parenterally. In consequence of the treatment complete recovery, confirmed in control USG and CT, was obtained.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents; Drug Therapy, Combination; Female; Gentamicins; Humans; Liver Abscess; Metronidazole; Treatment Outcome; Ultrasonography

Topics: Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Liver Abscess; Streptococcal Infections; Sulbactam; Time Factors; Tomography, X-Ray Computed