meropenem and Influenza--Human

Ecthyma gangrenosum is a cutaneous infection, most commonly occurring during sepsis evolution with Pseudomonas aeruginosa on an immunocompromised background. There have been rare case reports in previously healthy children and rarer are the cases with double etiology.. We present the case of a female Caucasian patient, aged 1 year and 8 months, who developed severe sepsis during flu evolution with predominant respiratory and cerebral manifestations. On admission, at skin level, there was noticed a necrotic coccygeal ulceration (with rapid increasing dimensions 0.5/0.5 cm in 24 hours), and with the transformation from a dry necrosis in a sphacelus at the periphery and progression of necrosis in depth.. The patient was diagnosed with ecthyma gangrenosum from which Pseudomonsa aeruginosa and Enterococcus faecalis were isolated from the samples that were harvested intraoperatively, decision that was taken considering the appearance of CT scan and the extremely rapid expansion of necrosis. Excisional debridement with necrectomy, lavage, and dressing being performed. The invasion of the fascia was excluded intraoperatively.. Treatment with Meropenem for 14 days was initiated, as well as amikacin and linezolid, the latter being replaced with teicoplanin for 14 days. Red blood cells transfusion, intravenous immunoglobulins, anticonvulsants were also administered.. Under treatment the evolution was favorable.. This case brings into discussion a double etiology of ecthyma gangrenosum, in a previously healthy child that occurred in the evolution of influenza. The evolution was favorable under broad-spectrum antibiotic treatment and surgical excision.

Topics: Anti-Bacterial Agents; Debridement; Ecthyma; Enterococcus faecalis; Female; Gram-Positive Bacterial Infections; Humans; Immunocompromised Host; Infant; Influenza, Human; Meropenem; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis

Cystic fibrosis is an autosomal recessive disorder characterized by chronic progressive multisystem involvement. AH1N1 virus infections caused classic influenza symptoms in the majority of cystic fibrosis patients while others experienced severe outcomes.. We report a case of late incidental cystic fibrosis diagnosis in a young Caucasian man suffering from respiratory failure following infection due to AH1N1 influenza virus. The patient was admitted to our department with fever, cough, and dyspnea at rest unresponsive to antibiotics CONCLUSIONS: Late diagnosis of cystic fibrosis in uncommon. This report highlights the importance of early cystic fibrosis diagnosis to minimize risk of occurrence of potential life-threatening complications.

Topics: Anti-Bacterial Agents; Ceftazidime; Colistin; Cystic Fibrosis; Delayed Diagnosis; Drainage, Postural; Genetic Testing; Humans; Incidental Findings; Influenza A Virus, H1N1 Subtype; Influenza, Human; Male; Meropenem; Pneumonia; Referral and Consultation; Sweat; Thienamycins; Tomography, X-Ray Computed; Young Adult

The spectrum of disease with pandemic novel H1N1 influenza A (2009) virus ranges from non-febrile, mild upper respiratory tract infection to severe or fatal pneumonia. We report the bronchoscopic findings associated with a fatal case of H1N1 influenza A associated with co-infection with methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy child, which were more severe than those previously described as associated with seasonal influenza infection alone. The severity of the airway pathology seen on bronchoscopy in this patient may be due to a unique effect of the H1N1 influenza A virus or may be as a result of a destructive synergism between this virus and bacteria such as MRSA.

Topics: Anti-Bacterial Agents; Bronchoscopy; Child; Fatal Outcome; Female; Fibrinolytic Agents; Humans; Influenza A Virus, H1N1 Subtype; Influenza, Human; Lung; Meropenem; Methicillin-Resistant Staphylococcus aureus; Oseltamivir; Respiratory Distress Syndrome; Respiratory Insufficiency; Staphylococcal Infections; Thienamycins; Tissue Plasminogen Activator; Vancomycin