amoxicillin-potassium-clavulanate-combination and Lung-Abscess

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

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

Topics: Accidents, Traffic; Actinomycosis; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bone and Bones; Bronchi; Bronchoscopy; Foreign Bodies; Humans; Lung Abscess; Lung Diseases; Male; Maxilla; Middle Aged; Pneumonectomy; Time Factors; Treatment Outcome

Cavitary lung lesions in patients from developing countries are mostly caused by tuberculosis (TB). However, when TB cannot be confirmed, a primary lung abscess caused by anaerobic bacteria from the mouth should be considered, especially in patients with poor dentition. We present a case of a Sudanese woman with a cavitary lung lesion and severe gingivitis. Bulleidia extructa was isolated as a single pathogen from the pulmonary cavity.

Topics: Africa; Amoxicillin-Potassium Clavulanate Combination; Bacteria, Anaerobic; Female; Gingivitis; Humans; Lung Abscess; Middle Aged; Sudan; Tuberculosis

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacteria, Anaerobic; Bacterial Infections; Community-Acquired Infections; Drug Therapy, Combination; Empyema, Pleural; Humans; Lung Abscess; Lung Diseases, Obstructive; Microbial Sensitivity Tests; Pleurisy; Pneumonia, Bacterial; Respiratory Tract Infections