cefotaxime and Emphysema

An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Cefotaxime; Cholangiocarcinoma; Clostridium Infections; Clostridium perfringens; Emphysema; Escherichia coli; Escherichia coli Infections; Female; Hepatitis; Humans; Metronidazole; Pneumoperitoneum; Tomography, X-Ray Computed

Topics: Anti-Bacterial Agents; Cefazolin; Cefotaxime; Emphysema; Endocarditis; Endophthalmitis; Escherichia coli Infections; Fatal Outcome; Gentamicins; Humans; Male; Middle Aged; Oxacillin; Sepsis; Urinary Tract Infections

Emphysematous pyelonephritis in patients with diabetes mellitus is increasingly recognised as a disease requiring urgent and aggressive treatment. We present 3 cases of emphysematous pyelonephritis; 1 patient required percutaneous nephrostomy followed by nephroureterectomy but the other 2 were successfully managed with antibiotics and control of diabetes. Diagnosis was confirmed by sequential imaging techniques which demonstrated an inflammatory renal mass associated with gas and fluid.

Topics: Cefotaxime; Diabetes Complications; Diabetes Mellitus; Emphysema; Female; Humans; Kidney; Male; Middle Aged; Nephrectomy; Pyelonephritis; Ultrasonography

A 60-year-old woman with rheumatoid arthritis developed acute emphysematous septic arthritis of the knee due to Klebsiella pneumoniae. She was brought to the hospital in septic shock with disseminated intravascular coagulation and had striking physical signs and roentgenograms showing distention of the knee with gas. She also had an infection of the hand with subcutaneous gas. After surgical drainage and institution of antibiotic therapy, she remained critically ill for several days but gradually improved. Two months later, she was ambulating independently. Emphysematous septic arthritis is rare. Four cases have previously been reported, but none were caused by Klebsiella.

Topics: Arthritis, Infectious; Cefotaxime; Emphysema; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Knee Joint; Middle Aged; Radiography; Shock, Septic