rifampin and Abdominal-Abscess

Splenic abscess due to acute brucellosis is a rare event. We report a case of multiple splenic abscesses caused by Brucella melitensis in a 45-year-old woman and review the English language literature based on a PubMed/MEDLINE search of the last 50 years. The majority of the cases published in the literature were due to B. melitensis and a splenectomy was required in half of the cases. Antibiotics alone without surgical intervention can be successful in the treatment of patients with splenic brucellosis in the early stages of the disease.

Topics: Abdominal Abscess; Administration, Oral; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Doxycycline; Female; Humans; Middle Aged; Rifampin; Splenectomy; Splenic Diseases; Treatment Outcome

Topics: Abdominal Abscess; Adult; Anti-Bacterial Agents; Cefotaxime; Humans; Male; Pelvis; Pneumococcal Infections; Pristinamycin; Retroperitoneal Space; Rifampin; Streptococcus pneumoniae; Young Adult

Brucellosis which is a systemic infection, is seen endemically in Turkey. Although there a lot of complications related to brucellosis, soft tissue involvement is rare. In this case report a patient with mature cystic teratoma and a Brucella related obturatory abscess, was presented. A 21-year-old female patient with bilateral pelvic pain was admitted to the hospital with complaints of weakness, backache and ab- dominal swelling. Pelvic examination revealed bilateral adnexial sensitive masses. There were no history of systemic complaints or other organ involvement. The patient had no history of contact with infected animals, intramuscular injections or consumption of non-pasteurized foods. A mass of 56 x 63 mm with regular margins and hyperechogenic segments at the left side was detected at ultrasonographic examination. Left ovarian cystectomy and mass excision at the left side were performed during laparotomy. Histopathological examination of the mass revealed chronic granulomatous inflammation characterized by central necrosis, histiocyte and lymphocyte infiltration and formation of giant cells, compatible with brucellosis. Brucella melitensis was isolated from the capsule of pelvic mass on the fifth day of culture in BacT/ALERT Selectlink (Organon Teknika, U.S.A.) system. Brucella Wright agglutination titer which was 1:80 at the admittance, rose to 1:2560 at the sixth week of the follow-up. The patient was treated successfully with the excision of the abscess and 6 weeks course of oral doxycycline and rifampicin. Brucellosis should be considered in the differential diagnosis of pelvic pain and obturatory abscess, especially in endemic areas for brucellosis.

Topics: Abdominal Abscess; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Diagnosis, Differential; Doxycycline; Drug Therapy, Combination; Female; Humans; Pelvic Pain; Rifampin; Young Adult

Splenic abscess due to Brucella spp. is extremely rare. We report a case of a splenic abscess due to Brucella spp. in a 61-year-old male patient. Brucella slide and tube agglutination tests (Wright) were positive while blood culture and culture from splenic tissue yielded negative results. The abdominal ultrasonography revealed a hypoechoic intrasplenic mass 15x12 mm in diameter at the middle portion of the spleen. The splenic lesions disappeared after prolonged treatment for 7 months with a combination of doxycycline, and rifampicin, followed by TMP-SXT. Brucella spp. should be considered in the differential diagnosis of splenic abscess in countries where brucellosis is endemic. The results of this case and literature review shows that a conservative approach using optimum antibiotics alone without surgical intervention can be successful in the treatment of patients with splenic brucellosis.

Topics: Abdominal Abscess; Agglutination Tests; Anti-Infective Agents; Brucellosis; Doxycycline; Drug Therapy, Combination; Enzyme Inhibitors; Humans; Male; Middle Aged; Rifampin; Spleen; Splenic Diseases; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography

A 3-month-old female Arabian horse was evaluated because of fever, respiratory distress, lethargy, and decreased appetite of 5 days' duration. Pleural effusion was diagnosed on the basis of ultrasonographic and radiographic examinations. Cytologic examination of pleural fluid collected via thoracocentesis revealed septic inflammation; bacteriologic culture of a sample of that fluid yielded Rhodococcus equi. A large intra-abdominal mass adjacent to the body wall was identified ultrasonographically. A specimen of the mass was collected via aspiration; the specimen was identified cytologically as purulent exudate that contained large numbers of rod-shaped bacteria, which confirmed abdominal abscess formation. Bacteriologic culture of a sample of the exudate also yielded R. equi. The foal was treated with azithromycin (10 mg/kg [4.5 mg/lb], PO, q 24 h for 5 days then q 48 h) and rifampin (5 mg/kg [2.3 mg/lb], PO, q 12 h) for 8 weeks and metronidazole (15 mg/kg [6.8 mg/lb], PO, q 8 h) for 3 weeks. Clinically, the foal responded to antimicrobial treatment within 2 weeks. At 8 weeks after the initial evaluation, ultrasonographic examination of the foal revealed resolution of the pleural effusion and abdominal abscess. In foals, R. equi infection typically results in pyogranulomatous pneumonia, and pleural effusion is an uncommon clinical sign. The combination of azithromycin and rifampin appears to be an effective treatment for R. equi infection in foals.

Topics: Abdominal Abscess; Actinomycetales Infections; Animals; Animals, Newborn; Anti-Bacterial Agents; Azithromycin; Drug Resistance, Bacterial; Female; Horse Diseases; Horses; Pneumonia, Bacterial; Rhodococcus equi; Rifampin; Treatment Outcome; Ultrasonography

Brucellosis may lead to complications that affect different organ systems, including the liver and spleen. In acute disease, hepatosplenic abscess is a rare complication. We report herein a woman with splenic abscess due to acute Brucella melitensis infection who was successfully treated with antibiotics alone.

Topics: Abdominal Abscess; Aged; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Doxycycline; Female; Humans; Rifampin; Splenic Diseases; Streptomycin