piperacillin--tazobactam-drug-combination and Emphysema

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

Emphysematous gastritis (EG) is a rare disease of the stomach that is caused by gas-forming bacteria, and it can be lethal. There have been <70 reported cases in the English literature of this disease which carries a mortality rate up to 60%. Early recognition and treatment through conservative management have been a popular and successful choice in today's medicine. Studies have shown that surgical intervention does not confer a statistical benefit on mortality in this condition. We present another case of EG in a 33-year-old woman who was successfully managed conservatively.

Topics: Adult; Anti-Bacterial Agents; Conservative Treatment; Emphysema; Female; Fluid Therapy; Gastric Mucosa; Gastritis; Humans; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Tomography, X-Ray Computed; Vancomycin

Topics: Anti-Bacterial Agents; Comorbidity; Diabetes Mellitus; Diabetic Ketoacidosis; Drug Therapy, Combination; Emphysema; Humans; Hypertension; Kidney Transplantation; Male; Middle Aged; Norepinephrine; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Postoperative Complications; Pyelonephritis; Tomography, X-Ray Computed; Transplantation, Homologous; Vancomycin

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