piperacillin--tazobactam-drug-combination and Abdominal-Pain

Infectious suppurative thrombophlebitis of the portal venous system, referred to as pylephlebitis, is a rare complication of intra-abdominal inflammatory processes. Advances in diagnostics and antibiotics have improved survival, but mortality remains remarkably high even in the most recent literature. The majority of patients have concomitant bacteraemia on presentation most commonly with typical gastrointestinal (GI) organisms. On rare occasion, patients have culture positive

Topics: Abdominal Pain; Anti-Bacterial Agents; Anticoagulants; beta-Lactams; Endoscopy, Gastrointestinal; Ertapenem; Fever; Fusobacterium Infections; Fusobacterium necrophorum; Heparin; Humans; Lemierre Syndrome; Male; Penicillanic Acid; Phlebitis; Piperacillin; Piperacillin, Tazobactam Drug Combination; Portal Vein; Treatment Outcome

Topics: Abdominal Pain; Adult; Analgesics; Anti-Bacterial Agents; Diagnosis, Differential; Emergency Nursing; Emergency Treatment; Female; Fluid Therapy; Gastric Bypass; Humans; Intussusception; Jejunal Diseases; Pain Measurement; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Risk Factors; Tomography, X-Ray Computed; Vomiting

Topics: Abdominal Abscess; Abdominal Pain; Aged; Cholangiopancreatography, Magnetic Resonance; Cholecystectomy, Laparoscopic; Female; Gallstones; Humans; Piperacillin, Tazobactam Drug Combination

A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew

Topics: Abdominal Pain; Adult; Anti-Bacterial Agents; Betacoronavirus; Coronavirus Infections; COVID-19; Critical Care; Diagnosis, Differential; Diarrhea; Humans; Lung; Male; Pandemics; Piperacillin, Tazobactam Drug Combination; Pneumonia, Viral; SARS-CoV-2; Sputum; Tomography, X-Ray Computed; Treatment Outcome; Yersinia enterocolitica

Liver abscess secondary to a migrated ingested foreign body is an uncommon condition where early diagnosis helps management and improves prognosis. Abscess drainage with removal of the foreign body is the recommended management. We report the successful management of a patient with a liver abscess from a migrated fishbone that was treated medically with the foreign body left in situ.

Topics: Abdominal Pain; Animals; Anti-Bacterial Agents; Bone and Bones; Diagnosis, Differential; Drug Therapy, Combination; Female; Foreign Bodies; Foreign-Body Migration; Humans; Liver Abscess; Metronidazole; Middle Aged; Piperacillin, Tazobactam Drug Combination; Seafood; Tomography, X-Ray Computed

Topics: Abdominal Pain; Anti-Bacterial Agents; Anti-Ulcer Agents; Emphysema; Foreign Bodies; Gastritis; Humans; Male; Melena; Middle Aged; Pantoprazole; Piperacillin, Tazobactam Drug Combination; Tomography, X-Ray Computed

A man in his late 50s presented to the emergency room with a 1-month history of severe abdominal pain and an endoscopic fishbone retrieval from his rectum. Serial CT scans revealed a fishbone located in the patient's upper abdomen, which had migrated through the stomach wall, into the periportal space, causing a contained gastric perforation, development of a porta hepatis abscess and secondary portal vein thrombosis. Furthermore, the sharp tip of the fishbone lay 5 mm from the patient's hepatic artery. He was transferred to a hepatobiliary centre where he underwent urgent exploratory laparotomy, with surgical exploration of the porta, drainage of the abscess and retrieval of the fishbone. Postoperatively, he received further treatment with antibiotics and anticoagulation and recovered without further sequelae.

Topics: Abdominal Abscess; Abdominal Pain; Aged; Anticoagulants; Diagnosis, Differential; Enterobacteriaceae Infections; Foreign-Body Migration; Heparin; Humans; Male; Piperacillin, Tazobactam Drug Combination; Portal Vein; Streptococcal Infections; Thrombosis; Tomography, X-Ray Computed

Health information found on open access Internet platforms is often unscrutinized, unreliable, and can lead to considerable morbidity for patients and their presentation to the emergency department. Currently, home treatments for constipation and other gastrointestinal ailments featuring the use of hydrogen peroxide (H. We present a case of a 48-year-old female with a history of fibroids who presented to the emergency department with acute abdominal pain after self-administering a 3% H

Topics: Abdominal Pain; Colitis; Emergency Service, Hospital; Enema; Female; Humans; Hydrogen Peroxide; Middle Aged; Occult Blood; Piperacillin, Tazobactam Drug Combination; Radiography; Self Care; Tomography, X-Ray Computed

Acute appendicitis is one of the most common surgical emergencies, and it is treated definitively with appendectomy. Recurrent appendicitis is a rare entity, being reported after approximately 1 in 50,000 appendectomies. It is typically caused by inflammation of the appendiceal stump. Inflammation of a retained appendiceal tip is a unique entity that can also cause recurrent appendicitis and presents similarly to primary appendicitis.. We present a case of a 50-year-old man who had undergone laparoscopic appendectomy 1 year earlier and who subsequently presented with a chief complaint of right lower quadrant abdominal pain. The diagnosis of recurrent appendicitis caused by a retained appendiceal tip was made after a computed tomography scan. The patient underwent successful laparoscopic removal of the retained appendiceal fragment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The etiology of recurrent appendicitis is separate from the stump appendicitis that has been well described in the literature. Retained tip appendicitis poses a diagnostic dilemma because it is uncommon and, if missed, can lead to complications, such as perforation and severe sepsis. Recurrent appendicitis must be in the differential diagnosis for patients who are post-appendectomy and who present with right lower quadrant abdominal pain.

Topics: Abdominal Pain; Appendicitis; Emergency Service, Hospital; Humans; Laparoscopy; Male; Middle Aged; Piperacillin, Tazobactam Drug Combination; Postoperative Complications; Recurrence; Tomography, X-Ray Computed

Topics: Abdominal Pain; Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Fusobacterium Infections; Fusobacterium necrophorum; Humans; Liver Abscess; Male; Metronidazole; Middle Aged; Nausea; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Sepsis; Treatment Outcome; Vomiting

We report a case of a rare complication of acute appendicitis with perforation through the abdominal wall. The case points out that an intraabdominal origin should be considered in patients presenting with rapidly spreading soft tissue infections of the trunk.. A 58-year-old European woman presented to our hospital with a 1-week history of severe abdominal pain accompanied by rapidly spreading erythema and emphysema of the lower abdomen. On admission, the patient was in septic shock with leukocytosis and elevation of C-reactive protein. Among other diagnoses, necrotizing fasciitis was suspected. Computed tomography showed a large soft tissue infection with air-fluid levels spreading through the lower abdominal wall. During the operation, we found a perforated appendicitis breaking through the fascia and causing a rapidly progressive soft tissue infection of the abdominal wall. Appendicitis was the origin of the soft tissue infection. The abdominal wall was only secondarily involved.. Even though perforated appendicitis as an etiology of a rapidly progressive soft tissue infection of the abdominal wall is very rare, it should be considered in the differential diagnosis of abdominal wall cellulitis. The distinction between rapidly spreading subcutaneous infection with abscess formation and early onset of necrotizing fasciitis is often difficult and can be confirmed only by surgical intervention.

Topics: Abdominal Pain; Abdominal Wall; Anti-Bacterial Agents; Appendectomy; Appendicitis; Emphysema; Escherichia coli Infections; Female; Humans; Middle Aged; Penicillanic Acid; Peritonitis; Piperacillin; Piperacillin, Tazobactam Drug Combination; Reoperation; Soft Tissue Infections; Tomography, X-Ray Computed; Treatment Outcome

To analyze the clinical characteristics of continuous ambulatory peritoneal dialysis (CAPD) associated peritonitis in the tertiary hospitals and to discuss the preventive and therapeutic strategy.
 Methods: The clinical characteristics, pathogens, resistance and outcomes of 126 CAPD associated peritonitis in 104 patients from Jan, 2013 to June, 2016, were retrospectively analyzed.
 Results: Among the patients, the incidence rates of abdominal pain, fever, diarrhea and emesis were 104 (82.54%), 56 (44.44%), 49 (38.89%), and 31 (23.60%), respectively. Among them, 88 patients suffered peritonitis once, other 16 patients suffered multiple peritonitis or recurrent peritonitis for 38 times. Among the 38 times, the numbers for recurrent, repeated or catheter-associated peritonitis were 2, 2, or 3, respectively. Peritoneal fluids from 103 cases were cultured, and 64 cases were positive in bacteria, with a rate of 62.14%. A total of 70 strains of bacteria were separated, including 42 strains of gram-positive bacteria, 21 strains of gram-negative bacteria, and 7 strains of fungus. The most common gram-positive pathogens were Staphylococcus epidermidis, Enterococcus faecalis and Staphylococcus haemolyticus, while Escherichia coli, Klebsiella pneumoniae and Klebsiella pneumoniae were the most common gram-negative bacteria. Candida albicans was the major fungal pathogens. Gram-positive cocci showed resistance to gentamycin, levofloxacin, moxifloxacin, vancomycin and linezolid, with a rate at 20.00%, 36.11%, 5%, 0%, and 0%, respectively. The gram-negative bacilli were resistent to cefoperazone/sulbactam, gentamycin, cephazolin, and ceftazidime, with a rate at 6.25%, 10.53%, 64.29%, and 15.38%, respectively. There were no imipenem, amikacin, piperacillin/tazobactam-resistant strains were found.
 Conclusion: The most common pathogen causing CAPD associated peritonitis is gram-positive bacteria. It is crucial to take the anti-infection therapy for CAPD associated peritonitis early. The positive rates for bacterial culture need to be enhanced through improvement of methods. At the same time, doctors could improve the outcome of CAPD associated peritonitis by adjusting the medication according to the drug sensitivity results.. 目的：探讨某三甲医院持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis，CAPD)相关性腹膜炎临床特点、致病菌分布及耐药性情况，为临床防治CAPD相关性腹膜炎总结经验。方法：回顾性调查该院2013年1月至2016年6月42个月中，104人126例次CAPD相关性腹膜炎患者的临床特点、致病菌分布、耐药性等情况。
结果：在126例次CAPD相关性腹膜炎中，患者出现腹痛104例次(82.54%)，发热56例次(44.44%)，腹泻49例次(38.89%)，呕吐31例次(23.60%)。126例次CAPD相关性腹膜炎中，发生一次腹膜炎的88人次，多次和反复发作的腹膜炎16人38例次，其中复发性腹膜炎2例，腹膜炎重现2例，导管相关性腹膜炎3例。在103例送检的腹水标本中，培养阳性64例次，阳性率达62.14%。共分离出致病菌70株，其中革兰阳性细菌42株，革兰阴性细菌21株，真菌7株。主要的革兰阳性菌包括表皮葡萄球菌、粪肠球菌、溶血葡萄球菌；主要的革兰阴性菌包括大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌；真菌以白假丝酵母菌为主。革兰阳性菌对庆大霉素、左氧氟沙星、莫西沙星、万古霉素、利奈唑胺的耐药率分别为20.00%，36.11%，5.00%，0%，0%；革兰阴性菌对头孢哌酮/舒巴坦、庆大霉素、头孢唑啉、头孢他啶的耐药率分别为6.25%，10.53%，64.29%，15.38%，对亚胺培南、阿米卡星、哌拉西林/他唑巴坦的耐药率均为0%。结论：革兰阳性菌是CAPD相关性腹膜炎的主要致病菌，临床不仅应尽早开始经验性治疗，而且要考虑如何通过改善培养方法以提高阳性检出率；可以根据药敏结果调整用药，以促进患者CAPD相关性腹膜炎的治愈和腹膜功能的恢复。.

Topics: Abdominal Pain; Anti-Bacterial Agents; Bacteria; Bacterial Infections; Candidiasis; Catheters; Diarrhea; Drug Resistance, Bacterial; Enterococcus faecalis; Escherichia coli; Fever; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Imipenem; Klebsiella pneumoniae; Microbial Sensitivity Tests; Mycoses; Penicillanic Acid; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Piperacillin; Piperacillin, Tazobactam Drug Combination; Recurrence; Retrospective Studies; Staphylococcus epidermidis; Staphylococcus haemolyticus; Vomiting

Initial antibiotics with planned interval appendectomy (interval AP) have been used to treat patients with complicated perforated appendicitis; however, little experience exists with this approach in children with suspected acute perforated appendicitis (SAPA). We sought to determine the outcome of initial antibiotics and interval AP in children with SAPA.. Over an 18-month period, 751 consecutive patients underwent appendectomy including 105 patients with SAPA who were treated with initial intravenous antibiotics and planned interval AP ≥ 8 weeks after presentation. All SAPA patients had symptoms for ≤ 96 hours. Primary outcome variables were rates of readmission, abscess formation, and need for interval AP prior to the planned ≥ 8 weeks.. Intraabdominal abscess rate was 27%. Appendectomy prior to planned interval AP was 11% and readmission occurred in 34%. All patients underwent eventual appendectomy with pathologic confirmation confirming the previous appendiceal inflammation. White blood cell (WBC) count >15,000, WBC >15,000 plus fecalith on imaging, and WBC >15,000 plus duration of symptoms >48 hours were all significantly associated with higher rates of readmission (p=0.01, p=0.04, p=0.02) and need for interval AP prior to the planned ≥ 8 weeks (p=0.003, p=0.05, p=0.03).. Treatment of SAPA with antibiotics and planned interval AP is successful in the majority of patients; however, complications such as abscess formation and/or readmission prior to planned interval AP occur in up to one-third of patients. Certain clinical variables are associated with increased treatment complications.

Topics: Abdominal Abscess; Abdominal Pain; Anti-Bacterial Agents; Appendectomy; Appendicitis; Child; Critical Pathways; Drug Administration Schedule; Drug Combinations; Fever; Humans; Intestinal Perforation; Patient Readmission; Penicillanic Acid; Peritonitis; Piperacillin; Piperacillin, Tazobactam Drug Combination; Prospective Studies; Suction; Time Factors; Treatment Outcome

Topics: Abdominal Pain; Aged; Anti-Bacterial Agents; Diagnosis, Differential; Duodenitis; Endoscopy, Gastrointestinal; Female; Gastrointestinal Hemorrhage; Humans; Inflammatory Bowel Diseases; Penicillanic Acid; Peptic Ulcer; Piperacillin; Piperacillin, Tazobactam Drug Combination; Streptococcal Infections; Streptococcus pyogenes