meropenem and Colitis--Ulcerative

Bordetella bronchiseptica is a gram-negative, obligate aerobic coccobacillus known to cause disease in domesticated animals and pets. In humans, B. bronchiseptica commonly leads to respiratory infections like pneumonia or bronchitis, and animal contact usually precedes the onset of symptoms.. We report a case of post-traumatic B. bronchiseptica meningitis without recent surgery in the setting of immunosuppression with a monoclonal antibody. Our case concerns a 77-year-old male with ulcerative colitis on infliximab who sustained a mechanical fall and developed a traumatic cerebrospinal fluid leak complicated by meningitis. He received meropenem then ceftazidime during his hospital course, and temporary neurosurgical drain placement was required. His clinical condition improved, and he was discharged at his baseline neurological status.. B. bronchiseptica is an unusual cause of meningitis that may warrant consideration in immunocompromised hosts with known or suspected animal exposures. To better characterize this rare cause of meningitis, we performed a systematic literature review and summarized all previously reported cases.

Topics: Aged; Animals; Anti-Bacterial Agents; Bordetella bronchiseptica; Bordetella Infections; Ceftazidime; Cerebrospinal Fluid Leak; Colitis, Ulcerative; Drainage; Humans; Immunocompromised Host; Immunosuppressive Agents; Infliximab; Male; Meningitis; Meropenem; Neurosurgical Procedures; Treatment Outcome

Clostridium difficile (CD) infection is almost always confined to the colon causing a spectrum of illness ranging from diarrhoea to fulminant colitis. CD infection of the small intestine has been described but the identification of CD toxin in the stoma effluent of a patient with an end ileostomy is rare. We describe a 91-year-old woman, with a history of proctocolectomy for ulcerative colitis, presenting with profuse ileostomy diarrhoea after a course of antibiotics. Ileostomy effluent was positive for CD toxin but the patient died despite appropriate treatment. This suggests that the small intestine is susceptible to CD infection in antibiotic-treated patients many years after a colectomy. CD enteritis should be considered in all patients with increased ileostomy diarrhoea despite the absence of a colon.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Colectomy; Colitis, Ulcerative; Enterocolitis, Pseudomembranous; Fatal Outcome; Female; Humans; Ileostomy; Infusions, Intravenous; Intestine, Small; Meropenem; Postoperative Complications; Staphylococcal Infections; Thienamycins