cefotaxime and Liver-Abscess

Background Liver abscess is the most common extraintestinal manifestation of Entamoeba histolytica. Clinical manifestations could appear after returning from an endemic area or several years after the exposure. The diagnosis usually requires microbiological confirmation. Case presentation We present a case of a 55-year-old woman diagnosed with Crohn's disease treated with immunosuppressive drugs, who was admitted to the Emergency Service with liver parenchyma abscesses. Computed tomography (CT)-guided puncture showed pus, and both Gram staining and fresh parasite visualization were negative. Hepatic pus bacteriological culture was reported as negative and parasite multiplex polymerase chain reaction (PCR) was performed, being positive for E. histolytica. The same PCR was performed on blood, pleural fluid and stool samples, all of them being positive for E. histolytica. Conclusions Reviewing the clinical history of this patient, it was observed that parasite detection in three stool samples was negative 2 months before the current admission. Due to the lack of sensitivity of the microscopy techniques, we propose to routinely perform parasite detection in stools using molecular techniques, especially in immunocompromised patients.

Topics: Anti-Bacterial Agents; Antiprotozoal Agents; Cefotaxime; Entamoeba histolytica; Feces; Female; Humans; Immunocompromised Host; Intestinal Diseases, Parasitic; Liver Abscess; Metronidazole; Middle Aged; Paromomycin; Polymerase Chain Reaction; Punctures; Tomography, X-Ray Computed; Treatment Outcome

Topics: Adolescent; Anti-Bacterial Agents; Cefotaxime; Crohn Disease; Humans; Infliximab; Liver Abscess; Male; Remission Induction

Topics: Anti-Bacterial Agents; Brain Abscess; Cefotaxime; Cephalosporins; Cerebellar Ataxia; Diagnosis, Differential; Diverticulitis; Drug Therapy, Combination; Dysarthria; Humans; Linezolid; Liver Abscess; Lung Abscess; Magnetic Resonance Angiography; Male; Metronidazole; Middle Aged; Paraneoplastic Syndromes; Vasculitis

Topics: Aged; Anti-Bacterial Agents; Cefotaxime; Ceftriaxone; Diabetes Mellitus; Fermentation; Glucose; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver; Liver Abscess; Male; Taiwan; Tomography, X-Ray Computed

The outcome of children with liver abscess (LA) depends upon prompt diagnosis and intervention. We evaluated the etiology, clinical profile, various interventional modalities of management and outcome of children with LA. A total of 39 hospitalized children (mean age 7.2 ± 3.9 years) with radiologically proven LA were analyzed. Parenteral antibiotics, percutaneous drainage (PD) or open surgical drainage (OSD) was done as required. Cases with ruptured or impending rupture of LA, upper gastrointestinal bleed, jaundice, pleural effusion or consolidation were labeled as "high risk" cases. Triad of fever, pain and hepatomegaly was the most common presentation. Single abscess was present in 66.7% and right lobe was involved in 69.2% of cases. Majority of LA were pyogenic (PLA, 25/39). Amebic liver abscess (ALA) and PLA had similar clinical and laboratory profile except that multiloculated abscess on ultrasonography was a feature of PLA (12/25 vs. 0/11; p = 0.006). Cases with ALA settled significantly more often with antibiotics alone (5/11 vs. 3/25; p = 0.04) than PLA and none required surgery (0/11 vs. 7/25; p = 0.03). Subjects with "high-risk" LA (n - 26) had significantly larger abscesses, more polymorphonuclear leucocytosis (74 ± 15% vs. 61 ± 13%; p = 0.01) in peripheral blood and need of drainage (24/26 vs. 7/13; p = 0.03) than patients with average-risk LA. Based on the results, 38/39 children recovered, with complete abscess resolution in 28, over 48 ± 63.8 days. In conclusion, ALA, although similar in presentation, are uniloculated, and patients with ALA recover more often without drainage than patients with PLA. Patients with "high risk" LA are more common and have a good outcome with drainage. PD, being safe, efficacious and less invasive than OSD, should be the preferred drainage procedure.

Topics: Adolescent; Anti-Infective Agents; Cefotaxime; Child; Child, Preschool; Cloxacillin; Drainage; Drug Therapy, Combination; Female; Humans; Leukocytosis; Liver Abscess; Male; Metronidazole; Neutrophils; Retrospective Studies; Risk Assessment; Treatment Outcome; Vancomycin

Lactococcus lactis cremoris infections are very rare in humans. We experienced liver abscess and empyema due to L. lactis cremoris in an immunocompetent adult. A 42-yr-old man was admitted with fever and abdominal pain. Abdominal computed tomography (CT) revealed a liver abscess and chest CT showed loculated pleural effusion consistent with empyema. L. lactis cremoris was isolated from culture of the abscess material and blood. The patient was treated with pus drainage from liver abscess, video-assisted thoracoscopic decortications for empyema, and antibiotics including cefotaxime and levofloxacin. The patient was completely recovered with the treatment. To our knowledge, this is the first report of a L. lactis cremoris infection in Korea.

Topics: Adult; Anti-Bacterial Agents; Cefotaxime; Drainage; Empyema; Gram-Positive Bacterial Infections; Humans; Lactococcus lactis; Levofloxacin; Liver Abscess; Male; Microbial Sensitivity Tests; Ofloxacin; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed

An 8 year old boy presented with fever of unknown origin in whom the diagnosis of liver abscess was made. He also had palmoplantar keratoderma and premature loss of teeth, consistent with the diagnosis of Papillon Lefevre syndrome.

Topics: Amikacin; Anti-Bacterial Agents; Cefotaxime; Child; Dermatologic Agents; Humans; Isotretinoin; Liver Abscess; Male; Papillon-Lefevre Disease; Periodontitis; Skin Diseases; Sulbactam

Neisseria sicca is rarely associated with clinical infections and to the authors' knowledge this organism has not been reported as a causative agent of infected biloma (liver abscess). A case of a diabetic man with infected biloma due to N. sicca after repeated transcatheter arterial embolization for hepatocellular carcinoma is reported. The patient was successfully treated with intravenous cefotaxime and metronidazole. The biochemical profile and 16S rRNA gene partial sequencing results of the isolate were in agreement with those of N. sicca.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Catheterization; Cefotaxime; Embolization, Therapeutic; Humans; Liver Abscess; Male; Metronidazole; Middle Aged; Neisseria sicca; Neisseriaceae Infections; Radiography, Abdominal

To study the differences between the clinical presentation and complications of amoebic and pyogenic liver abscess. To correlate the diagnostic significance of Entamoeba Indirect Haemagglutination test (E.IHA) in establishing the diagnosis of amoebic liver abscess.. Open cohort observational study.. Department of Medicine (Medical Unit II) Jinnah Postgraduate Medical Centre, Karachi.. Fifty two patients aged 13-70 years admitted in Medical Unit II and diagnosed to have liver abscess.. Group A comprised of patients clinically diagnosed to have amoebic liver abscess and received Metronidazole 500mg iv x 8 hourly for atleast 10 days or more if patient developed complications. Group B comprised of patients diagnosed to have pyogenic abscess and received Cefotaxime 1g iv x 8 hourly for the same duration or more if complicated (antibiotic reviewed in accordance with culture and sensitivity report).. Differences in the clinical presentation, complications and diagnostic parameters between the two groups of patients.. It was not possible to differentiate between amoebic and pyogenic liver abscess on clinical grounds, routine investigations and imaging techniques. Aspiration of pus, especially if the abscess was multiple, was most helpful in differentiating the two types of abscesses. Serological test of E.IHA was highly specific and sensitive for amoebic liver abscess.. Majority of liver abscesses in Karachi are due to Entamoeba Histolytica. Pyogenic abscess though less frequent, must be excluded by pus aspiration and culture and sensitivity. E.IHA is a good rapid method of discriminating between the two types of abscesses.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antiprotozoal Agents; Cefotaxime; Cohort Studies; Diagnosis, Differential; Female; Humans; Jaundice; Liver Abscess; Liver Abscess, Amebic; Male; Metronidazole; Middle Aged; Treatment Outcome

Pyogenic liver abscess are macroscopic collections of pus within the hepatic parenchyma after a bacterial infection. These infections are usually polymicrobial in nature, and in most occasions due to biliary tract diseases or cryptogenetic in origin. Monomicrobial hepatic abscess caused by Klebsiella pneumoniae are uncommon lesions in western countries. These lesions are associated with underlying diseases, particularly diabetes mellitus, and are frequently complicated with septic metastasis. We report here three cases of monomicrobial liver abscess caused by Klebsiella pneumoniae in diabetic patients, without septic metastasis and a favourable outcome.

Topics: Aged; Cefotaxime; Cephalosporins; Diabetes Complications; Follow-Up Studies; Gentamicins; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess; Male; Middle Aged; Time Factors; Tomography, X-Ray Computed

Topics: Anti-Infective Agents; Cefotaxime; Cephalosporins; Ciprofloxacin; Female; Humans; Liver Abscess; Middle Aged; Tomography, X-Ray Computed; Ultrasonography; Yersinia Infections

Cat-scratch disease is considered in the differential diagnosis of benign regional lymphadenopathy. We describe a case of cat-scratch disease in a 12-year-old boy with multiple bony, hepatic and splenic lesions which resolved with chemotherapy. The present case with simultaneous multiorgan involvement supports the view of a systemic nature of the disease.

Topics: Abscess; Cat-Scratch Disease; Cefotaxime; Child; Humans; Liver Abscess; Male; Osteolysis; Splenic Diseases

Topics: Acquired Immunodeficiency Syndrome; Adult; Cefotaxime; Humans; Liver Abscess; Male; Salmonella Infections; Salmonella typhimurium

We report a rare case of Klebsiella pneumoniae meningitis associated with liver abscess, which was successfully treated with cefotaxime (CTX), one of the third-generation cephalosporins. A 53-year-old man was admitted to Keio University Hospital on June 13, 1988, because of a fever and a headache. On June 3, he suddenly started shivering and his temperature rose to 39 degrees C. He then began to complain of polydipsia, polyuria, and a weight loss of 4 kg a week. On June 11, he developed a severe headache. Four years prior to this incident, he had been diagnosed as having diabetes after a routine medical examination, but had neglected to undergo medical treatment. On admission, laboratory data showed leukocytosis, hyperglycemia (394 mg/dl) and ketonuria (4+). A lumbar puncture yielded cloudy cerebrospinal fluid (CSF) containing 500/3 cells/mm8, of which about 70% were neutrophils. A diagnosis of diabetic ketoacidosis and purulent meningitis was made. A treatment with ampicillin (ABPC) and CTX, (12 g/day, each) was begun. On the third day, cultures of a blood specimen and CSF yielded both K. pneumoniae. The MICs of CTX to K. pneumoniae isolated from blood and CSF were both 0.05 microgram/ml. ABPC was discontinued, gentamicin was administered for 2 days, CTX was continued at the same dosage level and an administration of prednisolone 40 mg daily was begun.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Cefotaxime; Humans; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess; Male; Meningitis; Middle Aged; Sepsis

In an eighteen-year-old boy with a high fever, an intra-hepatic infectious hematoma following blunt hepatic trauma was treated twice with intrahepatic arterial injection chemotherapy in an attempt to prevent conversion of the hematoma to an abscess. A decrease in body temperature occurred after the arterial injections, and the hematoma was gradually diminished in size. In selected patients with blunt hepatic trauma, intrahepatic arterial injection chemotherapy seems to be an effective treatment for prevention of liver abscess formation.

Topics: Adolescent; Cefmetazole; Cefoperazone; Cefotaxime; Cefotiam; Cephalothin; Cephamycins; Dibekacin; Hematoma; Humans; Injections, Intra-Arterial; Liver; Liver Abscess; Liver Diseases; Male; Wounds, Nonpenetrating