meropenem and Alcoholism

Calciphylaxis is a rare complication that occurs in 1% of patients with end-stage renal disease (ESRD) each year. Extensive microvascular calcification and occlusion/thrombosis lead to violaceous skin lesions, which progress to nonhealing ulcers with secondary infection, often leading to sepsis and death. The lower extremities are predominantly involved (roughly 90% of patients). Although most calciphylaxis patients have abnormalities of the calcium-phosphate axis or elevated levels of parathyroid hormone, these abnormalities do not appear to be fundamental to the pathophysiology of the disorder. We report on a case of histologically proven calciphylaxis in a 54-year-old woman with normal renal function and normal calcium-parathyroid homeostasis. She had a history of alcoholic cardiomyopathy, and was treated with warfarin anticoagulation. She has been successfully treated with antibiotics, i.v. biophosphonates and intensive local wound care. We recorded a complete wound healing in contrast to what is reported in other series.

Topics: Alcoholism; Anti-Bacterial Agents; Anticoagulants; Calciphylaxis; Clindamycin; Diphosphonates; Female; Heart Diseases; Humans; Kidney Failure, Chronic; Meropenem; Middle Aged; Risk Factors; Thienamycins; Vancomycin; Warfarin

Meningitis caused by Campylobacter jejuni is rare, we describe a case following neurosurgery for intra-cranial haematoma in a chronic alcoholic patient. Conventional culture of CSF and blood was supplemented by polymerase chain reaction (PCR) detection of Campylobacter jejuni.

Topics: Adult; Alcoholism; Brain; Campylobacter Infections; Campylobacter jejuni; Humans; Male; Meningitis, Bacterial; Meropenem; Polymerase Chain Reaction; Thienamycins