meropenem and Emphysema

Gas is rarely found within the viscera outside the lumen of the gastrointestinal tract. Emphysematous gastritis is a rare form of infection of the stomach wall by gas producing organisms.. A 45-year-old Chinese lady underwent hepatectomy for hepatocellular carcinoma. Postoperatively, she turned septic and encephalopathic with worsening liver function. Computed tomography scan revealed a thickened, oedematous stomach wall with air pockets within.. The patient was started on a course of broad spectrum antibiotics.. She responded and was discharged well.. Emphysematous gastritis is a rare condition with high mortality. There is however, still no preferable approach of treatment despite therapeutic advances.

Topics: Anti-Bacterial Agents; Emphysema; Female; Gastritis; Humans; Meropenem; Middle Aged; Portal Vein; Radiography; Thienamycins; Ultrasonography; Venous Thrombosis

Emphysematous gastritis is a life-threatening disease. It is characterized by the presence of gas within the wall of the stomach. The etiology includes firstly infections with gas-forming organisms; other predisposing causes are the ingestion of corrosive substances and alcohol abuse. Diagnosis is based on radiological techniques, mainly computed tomographic scan (CT). The election treatment is antibiotics and surgery. The evolution is generally fatal. We present the first known case reported, which is associated with aplastic anemia with immunosuppressive therapy, its evolution with medical treatment and a literature review.

Topics: Anemia, Aplastic; Antilymphocyte Serum; Cholelithiasis; Cyclosporine; Emphysema; Female; Gastritis; Granulocyte Colony-Stimulating Factor; Humans; Immunosuppressive Agents; Meropenem; Methylprednisolone; Metronidazole; Middle Aged; T-Lymphocytes; Thienamycins; Tomography, X-Ray Computed

Topics: Abdominal Pain; Anti-Bacterial Agents; Diabetes Mellitus, Type 2; Diagnosis, Differential; Drainage; Emphysema; Humans; Hypertension; Klebsiella Infections; Klebsiella pneumoniae; Liver Abscess; Male; Meropenem; Middle Aged

Infective endocarditis (IE) is a life-threatening disease, mostly caused by gram-positive bacteria. Gram-negative bacteria were identified as a causative organism in relatively small number of cases. Although, antibiotic-resistant Escherichia coli is common cause of gram-negative endocarditis, AmpC beta-lactamase (BL)-harboring E coli is very rare cause of IE. Furthermore, emphysematous endocarditis is also a very rare manifestation of E coli infection.. We report a case of 80-year-old female patient presenting with dizziness, fever, and altered mental status, who was finally diagnosed with emphysematous endocarditis caused by E coli harboring an AmpC BL gene.. Her chest computed tomography revealed air bubbles surrounding the annulus of a mitral valve and a transesophageal echocardiogram revealed a hyperechogenic mass fixed on the posteromedial side of the mitral annulus with 2 eccentric mitral regurgitation jets. Blood cultures grew E coli which harbored the DHA-type AmpC BL. The organism belonged to a B2 phylogenic group, and multilocus sequence typing analyses revealed that the strains were of ST-95.. She was treated with meropenem following the resistant profiles, and surgery was recommended by the healthcare professional, but denied by the patient's guardians. She was transferred to another hospital due to a refusal for further treatment.. Emphysematous endocarditis is an uncommon complication of E coli bacteremia. Certain phylogenetic groups may be associated with development of E coli endocarditis.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bacterial Proteins; Bacterial Typing Techniques; beta-Lactamases; Echocardiography, Transesophageal; Emphysema; Endocarditis, Bacterial; Escherichia coli; Escherichia coli Proteins; Female; Humans; Meropenem; Microbial Sensitivity Tests; Patient Care Management; Thienamycins; Tomography, X-Ray Computed; Treatment Outcome

Topics: Anti-Bacterial Agents; Emphysema; Escherichia coli Infections; Humans; Male; Meropenem; Middle Aged; Polycystic Kidney, Autosomal Dominant; Thienamycins

Emphysematous cystitis is a potentially life-threatening condition characterized by the amassing of gas within the wall of the bladder, as a result of infection by gas-forming organisms. However, the amassing of gas in the wall of the bladder does not always result from an infectious etiology. Here we report the case of a patient diagnosed with lung cancer and treated with chemotherapy, where there was air within the bladder wall accompanied by pneumoperitoneum. The presence of an infectious etiology was not clear, and the patient responded successfully to medical treatment. Although emphysematous cystitis is the most common diagnosis, the presence of gas within the wall of the bladder is a sign and not a disease per se. In our opinion, the case displays similar characteristics to those of pneumatosis cystoides intestinalis, and for this reason we refer to it as bladder pneumatosis.

Topics: Aged; Anti-Bacterial Agents; Cystitis; Emphysema; Female; Granulocyte Colony-Stimulating Factor; Humans; Leukopenia; Lung Neoplasms; Meropenem; Pneumoperitoneum; Radiography; Thienamycins

Emphysematous pyelonephritis (EPN) is a rare, life threatening, upper urinary tract infection with high mortality rate.. We report a type-2 diabetes mellitus patient presenting with persistent fever, vomiting and pyuria despite appropriate treatment, diagnosed as a case of EPN, recovered without any surgical intervention.. Suspicion of EPN should be entertained in diabetes mellitus patient with persistent pyuria and deteriorating condition despite adequate treatment with antibiotics.

Topics: Anti-Infective Agents; Diabetes Mellitus, Type 2; Diagnosis, Differential; Emphysema; Escherichia coli; Escherichia coli Infections; Female; Follow-Up Studies; Humans; Hypoglycemic Agents; Meropenem; Metronidazole; Middle Aged; Pyelonephritis; Thienamycins; Tomography, X-Ray Computed; Treatment Outcome; Urinary Tract Infections

Topics: Abdominal Abscess; Anti-Bacterial Agents; Drainage; Emphysema; Escherichia coli Infections; Female; Humans; Meropenem; Middle Aged; Portal Vein; Portography; Pyelonephritis; Thienamycins; Tomography, X-Ray Computed; Treatment Outcome

Emphysematous pyelonephritis most often presents as an acute medical emergency, typically in a septic diabetic patient with acute renal failure. The management of this condition has traditionally been surgical, with nephrectomy. However, some recent reports have described successful medical interventions. We describe a case of acute bilateral emphysematous pyelonephritis in a frail patient not suitable for bilateral nephrectomy and long-term dialysis. This condition was managed medically, not surgically, with intensive antibiotic and circulatory support. The outcome was complete recovery after months of hospital-based treatment. We discuss the management of this rare but important condition in detail.

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Combined Modality Therapy; Diabetes Mellitus, Type 2; Emphysema; Hemofiltration; Humans; Male; Meropenem; Middle Aged; Pyelonephritis; Sepsis; Thienamycins; Treatment Outcome; Vancomycin