meropenem and Necrosis

Bacillus cereus (B. cereus) is a Gram-positive rod that is widely distributed in the environment and can be a cause of food poisoning. We herein present a case of B. cereus necrotizing pneumonia in a patient with nephrotic syndrome under corticosteroid treatment after developing transient gastroenteritis symptoms. B. cereus was isolated from bronchial lavage fluid and transbronchial biopsy specimens. A multiplex polymerase chain reaction analysis of the toxin genes revealed a strain possessing enterotoxicity. The patient recovered after one week of intravenous meropenem followed by a combination of oral moxifloxacin and clindamycin. B. cereus is a pathogen that causes necrotizing pneumonia in immunocompromised hosts.

Topics: Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Aza Compounds; Bacillus cereus; Biopsy, Needle; Bronchoalveolar Lavage Fluid; Clindamycin; Drug Therapy, Combination; Fluoroquinolones; Follow-Up Studies; Gram-Positive Bacterial Infections; Humans; Immunocompromised Host; Immunohistochemistry; Male; Meropenem; Moxifloxacin; Necrosis; Nephrotic Syndrome; Pneumonia, Bacterial; Quinolines; Radiography, Thoracic; Risk Assessment; Severity of Illness Index; Thienamycins; Tomography, X-Ray Computed; Treatment Outcome

Topics: Acute Disease; Amikacin; Anemia, Aplastic; Antilymphocyte Serum; Combined Modality Therapy; Cyclosporine; Drug Therapy, Combination; Escherichia coli Infections; Gastric Mucosa; Gastritis; Granulocyte Colony-Stimulating Factor; Immunosuppressive Agents; Meropenem; Methylprednisolone; Necrosis; Neutropenia; Omeprazole; Parenteral Nutrition, Total; T-Lymphocytes; Thienamycins

Necrotizing otitis externa resolves best with antimicrobial treatment. How to care for these patients and monitor their resolution remains a problem. Our protocol in Bangalore can manage these patients inexpensively and well.. Patients who were referred to our patients became the subjects for this paper. They were managed through our protocol, which consists of IV ciprofloxacin and meropenem, weekly labs, weekly examinations, and photodocumention.. Fifty-one people presented with necrotizing otitis externa (NOE) between October 2015 and November 2017 and completed our entire protocol. Forty-six had complete resolution of their disease, while 5 had to undergo surgical removal of necrotic bone. Six of 8 patients with facial weakness had improvement in their House-Brackmann scores. Reduction of self-reported nocturnal pain, dissolution of ear canal granulations, and normalization of the erythrocyte sedimentation rate (ESR) proved to be the most accurate indicators of disease regression.. Patients are monitored closely with review of their otalgia, examination of their canal, repeated ESRs, effective control of their diabetes, and radiological imaging. All this can be done in a resource-poor country, which in turn serves as a model for the wealthier nations.

Topics: Anti-Bacterial Agents; Ciprofloxacin; Earache; Female; Humans; India; Male; Meropenem; Middle Aged; Necrosis; Osteomyelitis; Otitis Externa; Skull Base; Treatment Outcome

Topics: Abdominal Abscess; Anti-Bacterial Agents; Cellulitis; Clindamycin; Combined Modality Therapy; Common Variable Immunodeficiency; Debridement; Drug Substitution; Female; Humans; Immunoglobulin G; Immunoglobulins, Intravenous; Infusions, Subcutaneous; Meropenem; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Necrosis; Pyoderma Gangrenosum; Reoperation; Staphylococcal Infections; Thienamycins; Vancomycin; Wound Infection

Topics: Amikacin; Facial Dermatoses; Fatal Outcome; Female; Gangrene; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Meropenem; Necrosis; Neutropenia; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis; Skin Diseases, Bacterial; Skin Ulcer; Thienamycins

We recently experienced the case of an intramuscular chloroma with infection in a 7-year-old boy diagnosed with acute myeloid leukemia. Conventional magnetic resonance imaging (MRI) showed that the lesion mimicked an abscess, but diffusion-weighted imaging showed no diffusion restriction. These results suggested that the interior cystic portion was serous. On histopathological findings, a chloroma was diagnosed on the wall of a mass. Culture of the interior fluid revealed that Klebsiella pneumoniae was present. MRI differentiation is difficult even with diffusion-weighted images.

Topics: Anti-Bacterial Agents; Antimetabolites, Antineoplastic; Child; Contrast Media; Cytarabine; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Gentamicins; Humans; Image Enhancement; Klebsiella Infections; Klebsiella pneumoniae; Leg; Leukemia, Myeloid, Acute; Magnetic Resonance Imaging; Male; Meropenem; Muscle Neoplasms; Necrosis; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Sarcoma, Myeloid; Teicoplanin; Thienamycins; Treatment Outcome

Extensive peristomal skin necrosis is an unusual complication, which is difficult to manage because of frequent contamination from the stoma site. This wound leads to difficulty in applying the stoma appliance. This case report describes the successful use of the vacuum-assisted closure system in the management of a patient who developed peristomal skin necrosis after emergency Hartmann's procedure.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bandages; Colon, Sigmoid; Colostomy; Debridement; Diverticulitis; Drainage; Female; Humans; Meropenem; Necrosis; Surgical Wound Dehiscence; Surgical Wound Infection; Thienamycins; Vacuum

Topics: Acute Disease; Anti-Bacterial Agents; C-Reactive Protein; Humans; Imipenem; Meropenem; Necrosis; Pancreatitis; Thienamycins