piperacillin--tazobactam-drug-combination and Diabetes-Mellitus--Type-2

Topics: Adenocarcinoma; Aged; Cefazolin; Cefepime; Diabetes Mellitus, Type 2; Drug Resistance, Microbial; Drug Resistance, Multiple, Bacterial; Flavobacteriaceae; Gram-Negative Bacterial Infections; Humans; Immunocompromised Host; Kidney Failure, Chronic; Male; Pancreatic Neoplasms; Pancreatitis; Peritoneal Dialysis; Piperacillin, Tazobactam Drug Combination; Sleep Apnea Syndromes

Topics: Antifungal Agents; Aspergillus niger; Chest Pain; Diabetes Mellitus, Type 2; Empyema, Pleural; Female; Hemoglobin A; Humans; Middle Aged; Piperacillin, Tazobactam Drug Combination; Streptococcus agalactiae; Tomography, X-Ray Computed; Vancomycin; Voriconazole

We present the case of infected wet gangrene of right foot in the setting of poorly controlled type 2 diabetes in a 71-year-old woman. This patient presented with improved infection condition after intravenous piperacillin-tazobactam (PTZ) 2.25 gm every 6 hours treatment and below knee amputation surgery on day 3. However, neutropenia and thrombocytopenia developed on day 13. We consulted a haematologist and performed a series of examinations. However, no significant findings were noted thereafter. PTZ was suspected to be the most likely cause of neutropenia and thrombocytopenia and was hence terminated on day 14 (cumulative dose of PTZ: 126 g) following stabilisation of the infection condition. A transfusion was performed with two units of single donor platelets on day 14 and treated with intravenous dexamethasone 5 mg every 8 hours from day 14 to 16. Her white blood cell and platelet counts increased on day 15 and continued to recover thereafter.

Topics: Aged; Anti-Bacterial Agents; Diabetes Mellitus, Type 2; Diabetic Foot; Diagnosis, Differential; Female; Humans; Neutropenia; Piperacillin, Tazobactam Drug Combination; Thrombocytopenia

Topics: Aged; Anti-Bacterial Agents; Ciprofloxacin; Diabetes Mellitus, Type 2; Diabetic Foot; Humans; Male; Osteomyelitis; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Treatment Outcome

Topics: Abscess; Anti-Bacterial Agents; Debridement; Diabetes Mellitus, Type 2; Disease Susceptibility; Empyema, Pleural; Hematoma; Humans; Male; Middle Aged; Obesity, Morbid; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pleural Effusion; Smoking; Streptococcal Infections; Streptococcus agalactiae; Thoracic Injuries; Wound Infection; Wounds, Nonpenetrating

Piperacillin/tazobactam (PTZ) is frequently used in patients with diabetic foot infections. Herein, we report a patient who developed severe neutropenia, thrombocytopenia, and fever while receiving PTZ for a diabetic foot infection. We recommend vigilance when long-term PTZ use is planned in patients with diabetic foot infections.

Topics: Aged; Anti-Bacterial Agents; Diabetes Mellitus, Type 2; Diabetic Foot; Fever; Humans; Male; Neutropenia; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Thrombocytopenia

Topics: Anti-Bacterial Agents; Daptomycin; Diabetes Mellitus, Type 2; Diabetic Foot; Hearing Loss, Sudden; Humans; Male; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination

Melioidosis is an infection caused by Burkholderia pseudomallei. The disease is known as a remarkable imitator due to the wide and variable clinical spectrum of its manifestations. Septic arthritis is rare but well-recognized manifestation of this disease. We report a case of melioidosis in a 52 year male with uncontrolled diabetes mellitus (DM) presenting with a rare combination of septic arthritis and abscesses in the chest wall, liver and subcutaneous tissue. The patient responded to prolonged treatment of intravenous ceftazidime followed by oral co-trimoxazole.

Topics: Ankle Joint; Anti-Bacterial Agents; Arthritis, Infectious; Burkholderia pseudomallei; Diabetes Mellitus, Type 2; Humans; Knee Joint; Male; Melioidosis; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Recurrence; Synovial Fluid

Bordetella bronchiseptica rarely causes disease in man, and is an unusual pathogen in animals. It causes a pertussis-like syndrome, but pneumonia and sepsis have been described in the immunocompromised as well as in the immunocompetent. A 53-year-old man with adult-onset diabetes and healed pulmonary tuberculosis presented with lobar pneumonia and rapidly developed septic shock with adult respiratory distress syndrome. He responded well to the combination of piperacillin-tazobactam.

Topics: Bordetella bronchiseptica; Bordetella Infections; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Humans; Male; Middle Aged; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia, Bacterial