cefotaxime and Empyema--Pleural

We aimed to identify the causative organisms and sensitivities in community-acquired paediatric empyema at Starship Children's Hospital and Christchurch Hospital and to determine if current antibiotic recommendations are appropriate.. Retrospective analysis was undertaken of all cases with clinical, radiological, and microbiological evidence of empyema at Starship Children's Hospital and Christchurch Hospital between June 2009 and March 2013 (3.8 years), and January 2009 and May 2014 (5.4 years) respectively.. Ninety-eight children were managed with empyema at Starship Children's Hospital and 30 children at Christchurch Hospital. Staphylococcus aureus was the most common pathogen identified at both sites followed by Streptococcus pneumoniae. A significant proportion had no pathogen identified. Amongst S.aureus isolates, 1/5th were methicillin-resistant, contributing 8% of all culture positive empyema cases. Māori and Pacific groups were over-represented. Cases occurred more often in boys and those <5 years. Blood cultures and S.pneumoniae pleural antigen were important in diagnosis.. Our audit confirms the important role of S.aureus in paediatric empyema in New Zealand and a high rate of this disease, particularly in the North Island. Antimicrobial susceptibilities of the pathogens of empyema demonstrate current initial antibiotic recommendation.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefotaxime; Cefuroxime; Child; Child, Preschool; Cohort Studies; Community-Acquired Infections; Empyema, Pleural; Ethnicity; Female; Floxacillin; Hospitals, Pediatric; Hospitals, Urban; Humans; Infant; Infant, Newborn; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; New Zealand; Pneumococcal Infections; Practice Guidelines as Topic; Retrospective Studies; Seasons; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus pneumoniae; Streptococcus pyogenes

Topics: Anti-Bacterial Agents; Bronchial Fistula; Cefotaxime; Chest Tubes; Combined Modality Therapy; Debridement; Drainage; Drug Therapy, Combination; Empyema, Pleural; Equipment Failure; Female; Humans; Infant; Lung Abscess; Male; Necrosis; Pleural Diseases; Pneumonia, Bacterial; Pneumothorax; Postoperative Complications; Radiography; Respiratory Tract Fistula; Therapeutic Irrigation; Thoracoscopy; Vancomycin

Occasionally, trivial odontogenic infections may develop into complex diseases. This may even result in an unrestrained phlegmonous spread causing life-threatening complications. These problems have decreased since the introduction of antibiotics and also due to improved oral hygiene and improved diagnostic measures resulting in optimized medical treatment. However, life-threatening forms are still seen, in particular if infections spread along the cervical fascial sheaths down towards to the mediastinum. Over the past decade the number of critical infections has increased in other medical specialties. This is usually explained by the development of multiresistant pathogens in the context of nosocomial infections.. We reviewed the patients' records of the past 15 years at the Department of Oral and Maxillofacial Surgery of the University Hospital Kiel to assess a possible increase of odontogenic infections with life-threatening complications. From 1990 to 2004, four patients with odontogenic infections exhibiting critical phlegmonous spread were treated in the intensive care unit. Two patients developed bacterial mediastinitis which could be controlled by intravenous antibiotics only. One patient progressed to general septic mediastinitis and eventually died of cardiorespiratory arrest. The last patient also had septic mediastinitis and developed right pleural empyema. Several operations were necessary before the disease could be controlled. This patient's case report is presented in detail.. The prognosis of patients with mediastinitis crucially depends on (a) early diagnosis including computed tomography of the neck and thorax, (b) early radical surgical intervention, and (c) optimized pathogen-oriented antibiotic treatment.

Topics: Abscess; Ampicillin; Cefotaxime; Cellulitis; Combined Modality Therapy; Critical Care; Disease Progression; Empyema, Pleural; Follow-Up Studies; Humans; Male; Mediastinitis; Middle Aged; Neck; Reoperation; Shock, Septic; Staphylococcal Infections; Staphylococcus epidermidis; Streptococcal Infections; Sulbactam; Therapeutic Irrigation; Thoracotomy; Tomography, X-Ray Computed; Vancomycin

Spontaneous bacterial empyema is a complication of hepatic hydrothorax in cirrhotic patients. The pathogen, clinical course and treatment strategy are different to the empyema secondary to pneumonia. A 54-year-old man, who was a cirrhotic patient with hepatic hydrothorax, was admitted to National Taiwan University Hospital for fever, dyspnea and right side pleuritic pain. The image study revealed massive right pleural effusion and no evidence of pneumonia. The culture of pleural effusion yielded Aeromonas veronii biotype sobria. The diagnosis of spontaneous bacterial empyema caused by Aeromonas veronii biotype sobria was established. To our best knowledge, Aeromonas veronii biotype sobria had never been reported in English literature as the causative pathogen of spontaneous bacterial empyema.

Topics: Aeromonas; Cefotaxime; Cephalosporins; Empyema, Pleural; Hepatitis B, Chronic; Humans; Hydrothorax; Liver Cirrhosis; Male; Microbial Sensitivity Tests; Middle Aged

Klaforan pharmacodynamics was studied up in pleural exudate and blood serum of the patients with purulent-destructive pulmonary diseases after its single endolymphatic and intravenous introduction in the dose 60 mg/kg of the body mass. Convalescence frequency in control group was 61.6%, in principal-82.9%, lethality-18.6 and 9.3% accordingly.

Topics: Adolescent; Adult; Aged; Cefotaxime; Cephalosporins; Empyema, Pleural; Female; Humans; Injections, Intralymphatic; Lung Diseases; Male; Middle Aged; Suppuration