rifampin and Abscess

Mycobacterium Avium Complex (MAC) is an established microbiologic cause of pulmonary disease, lymphadenitis, and disseminated disease in cases of advanced immune suppression. However, MAC manifesting as vertebral osteomyelitis is less common, and is particularly rare in the absence of Acquired Immunodeficiency Syndrome (AIDS). Prompt diagnosis of MAC vertebral osteomyelitis is challenging, but necessary to prevent serious morbidity or mortality.. We report a case of MAC osteomyelitis of the lumbar spine in a 70-year-old woman on extended duration corticosteroid therapy for systemic lupus erythematosus who presented with progressive back pain. Upon presentation, imaging revealed osteomyelitis of the lumbar spine with associated paraspinal abscess. Cultures from the surgical evacuation of the paraspinal abscess yielded no pathogen growth and she was therefore treated with empiric antibacterial therapy. Two weeks after her initial hospital discharge she represented with severe back pain and radiologic evidence of progressive disease in her lumbar spine. Two additional vertebral biopsies were required during her first 2 weeks of admission. MAC eventually grew from culture 14 days after collection. She was treated with ethambutol and rifampin and her symptoms resolved in 2 weeks, though therapy was continued for 12 months.. MAC is an unusual cause of vertebral osteomyelitis in patients with AIDS, but is exceedingly rare in those without severe immune compromise. Despite its rarity, it must be considered in cases of vertebral osteomyelitis that do not respond to empiric antibiotic therapy. Multiple biopsies may be necessary to obtain a diagnosis and avoid destructive infectious complications of an untreated infection.

Topics: Abscess; Aged; Anti-Bacterial Agents; Drug Therapy, Combination; Ethambutol; Female; Humans; Lumbosacral Region; Mycobacterium avium Complex; Mycobacterium avium-intracellulare Infection; Osteomyelitis; Rifampin

Bacillus Calmette-Guerín (BCG) is a live attenuated vaccine to prevent tuberculosis, routinely administered at birth as part of the World Health Organization global expanded immunisation programme. Given intradermally, it can cause adverse reactions, including local, regional, distant and disseminated manifestations that may cause parental distress. Rarely, it can cause serious illness and even death. Among those patients with immunocompromised conditions, such as the human immunodeficiency virus (HIV) infection, the complication rate is even higher.. To assess the effects of different interventions for treating BCG-induced disease in children.. The following databases were searched: the Cochrane Infectious Diseases Group Specialized Register and Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library (The Cochrane Library 2012, Issue 4); MEDLINE (1966 to November 2012); EMBASE (1947 to November 2012); and LILACS (1980 to November 2012). The metaRegister of Controlled Trials (mRCT) and the WHO trials search portal. Conference proceedings for relevant abstracts and experts were also contacted to identify studies. No language restrictions were applied.. Randomized controlled trials (RCTs) comparing any medical or surgical treatment modality for BCG-induced disease in children.. Two authors independently evaluated titles, applied inclusion criteria, and assessed the risk of bias of studies. The primary outcomes were the failure rate of therapies for all types of BCG vaccine-induced complications and the time to resolution of illness measured in months. The secondary outcomes were death from BCG vaccine-induced disease and the all-cause mortality. Risk ratios (RRs) were used as measure of effect for dichotomous outcomes and mean differences for continuous outcomes.. Five RCTs analysing 341 children addressed the primary outcomes and were included. Four arms compared oral antibiotics to no intervention or placebo, one arm evaluated needle aspiration compared to no intervention, and another evaluated the use of locally instilled isoniazid versus oral erythromycin.Two small studies evaluated oral isoniazid; we are uncertain of whether this intervention has an effect on clinical failure (RR 1.48; 95% Confidence Interval (CI) 0.79 to 2.78; 54 participants, two studies, very low quality evidence). Similarly, for oral erythromycin, we are uncertain if there is an effect (clinical failure RR 1.03; 95% CI 0.70 to 1.53; 148 participants, three studies, very low quality evidence), and for oral isoniazid plus rifampicin (clinical failure, RR 1.20; 95% CI 0.51 to 2.83; 35 participants, one study, very low quality evidence).In patients with lymphadenitis abscess, needle aspiration may reduce clinically persistent BCG-induced disease at 6 to 9 months of follow-up (RR 0.13; 95% CI 0.03 to 0.55; 77 participants, one study, low quality evidence). In another study of patients with the same condition, aspiration plus local instillation of isoniazid reduces time to clinical cure compared to aspiration plus oral erythromycin (mean difference 1.49 months less; 95% CI 0.82 to 2.15 less; 27 participants, one study).No RCTs of HIV-infected infants with a BCG-induced disease evaluated the use of antibiotics or other therapies for reducing the rate of clinical failure or the time to clinical resolution. No data on mortality secondary to the interventions for treating BCG-induced disease were reported.. It is unclear if oral antibiotics (isoniazid, erythromycin, or a combination of isoniazid plus rifampicin) are effective for the resolution of BCG-induced disease. Most non-suppurated lymphadenitis will resolve without treatment in 4 to 6 months. Patients with lymphadenitis abscess might benefit from needle aspiration and possibly local instillation of isoniazid could shorten recovery time. Included studies were generally small and could be better conducted. Further research should evaluate the use of needle aspiration and local instillation of isoniazid in fluctuant nodes. Therapeutic and preventive measures in HIV-infected infants could be important given the higher risk of negative outcomes in this group.

Topics: Abscess; Adjuvants, Immunologic; Antibiotics, Antitubercular; BCG Vaccine; Child; Child, Preschool; Erythromycin; Humans; Infant; Isoniazid; Lymphadenitis; Mycobacterium bovis; Randomized Controlled Trials as Topic; Rifampin; Suction

Topics: Abscess; Adolescent; Antitubercular Agents; Biopsy; Combined Modality Therapy; Diagnosis, Differential; Drainage; Drug Therapy, Combination; Ethambutol; Female; Humans; Immunocompetence; Isoniazid; Mycobacterium tuberculosis; Pyrazinamide; Rifampin; Sternum; Thoracic Neoplasms; Thoracic Wall; Tomography, X-Ray Computed; Tuberculosis, Cutaneous; Tuberculosis, Osteoarticular

To focus on the need of including tuberculosis among differential diagnoses of any epidymo-testicular mass, especially if its evolution is torpid.. A 73-year-old man who presented with scrotum abscess underwent surgical drainage and antibiotic treatment, but suppuration relapsed through cutaneous fistulae. A epipidymectomy was then performed, which demonstrated tuberculous granulomas. Torax Rx showed a cystic apical pulmonary wound which was treated with 3 antituberculostatics for 12 months. Sputum culture was positive for Micobacterium Bovis.. Aspirative punction under sonographic control is a valuable technique to avoid mutilating surgeries and to permit an almost always effective treatment, before the appearance of permanent lesions which lead to sterility.

Topics: Abscess; Aged; Animal Husbandry; Animals; Anti-Bacterial Agents; Antitubercular Agents; Cattle; Drug Therapy, Combination; Epididymitis; Humans; Isoniazid; Male; Mycobacterium bovis; Occupational Diseases; Pyrazinamide; Rifampin; Scrotum; Tuberculosis, Bovine; Tuberculosis, Male Genital

We report a case of human infection caused by Mycobacterium lentiflavum and review the literature for infections caused by this bacterium. The patient was a 19-month-old boy with involvement of a cervical lymph node. Surgical removal of the lymphadenopathy was both diagnostic and curative.

Topics: Abscess; Amoxicillin-Potassium Clavulanate Combination; Humans; Infant; Isoniazid; Lymph Nodes; Male; Mycobacterium; Mycobacterium Infections; Pyrazinamide; Rifampin; Tuberculosis, Lymph Node

Tuberculosis, with its varied presentations and numerous complications, is a relatively common disease in developing countries like India. Amongst its many presentations, pulmonary tuberculosis is the commonest. A tubercular laryngeal abscess is an extremely rare entity. We report a 37-year-old male, diagnosed with a tubercular laryngeal abscess which was successfully treated under local anaesthesia by incision and drainage and in whom a tracheostomy could be avoided.

Topics: Abscess; Adult; Antitubercular Agents; Cefotaxime; Diclofenac; Drainage; Ethambutol; Humans; Hydrocortisone; Isoniazid; Laryngoscopy; Male; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Laryngeal

Although rare, paradoxical subcutaneous abscesses may develop during appropriate treatment of miliary tuberculosis. While the pathogenesis of this phenomenon is not clear, some theories have been postulated. A case of a 37-y-old woman diagnosed as having miliary tuberculosis who developed subcutaneous abscesses within the 5 months of antituberculous treatment is described and all 6 similar cases published in English from 1954 to 1999 are discussed.

Topics: Abscess; Adolescent; Adult; Antibiotics, Antitubercular; Antitubercular Agents; Female; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Polymerase Chain Reaction; Radiography; Rifampin; Tuberculosis, Cutaneous; Tuberculosis, Miliary

Two patients with a history of intravenous drug abuse developed a pancreatic abscess due to mycobacterial infection as their initial evident opportunistic infection in association with the acquired immunodeficiency syndrome (AIDS). This presentation of mycobacterial infection has been previously reported in nine patients. The two patients reported here are the second and third reported cases in association with AIDS. As this entity should be considered a cause of a pancreatic lesion in immunosuppressed patients, fluid drained from a pancreatic abscess should have histologic stains and cultures for mycobacteria.

Topics: Abscess; Acquired Immunodeficiency Syndrome; Adult; Amikacin; Female; Gentamicins; Humans; Isoniazid; Middle Aged; Mycobacterium Infections; Nafcillin; Pancreatic Diseases; Penicillins; Rifampin; Tomography, X-Ray Computed; Ultrasonography

Topics: Abscess; Carrier State; Cloxacillin; Drug Interactions; Drug Therapy, Combination; Endocarditis, Bacterial; Furunculosis; Humans; Methicillin; Oxacillin; Penicillin Resistance; Phagocytes; Rifampin; Staphylococcal Infections

There is an ever-expanding number of antimicrobial agents available for the clinician to use to combat infections. We review the majority of such agents that are currently available relative to their theoretical or proven efficacy in the treatment of CNS infections. Due to the unique ability of the CNS to exclude many agents delivered via the blood stream, easily administered and efficacious therapy remains a problem. Based on the pharmacokinetics of anti-infective drugs and their antimicrobial spectrum, at present a penicillin derivative or chloramphenicol should be used whenever possible because parenteral therapy will usually achieve the desired results. In many neurosurgery-associated infections, intrathecal or intraventricular antibiotics may be required to supplement parenteral treatment and/or surgical intervention. Some of the more promising agents (such as rifampin, trimethoprim-sulfamethoxazole, and metronidazole) await further clinical trials to establish their place in the therapeutic armamentarium. Careful, randomized, prospective studies of prophylactic antibiotics must be performed in the neurosurgical setting. A group of tables are included that summarize the expected spinal fluid levels, the sensitivities of organisms commonly causing neurosurgical infections, doses of drugs given intrathecally or intraventricularly, and recommended regimens for certain infections.

Topics: Abscess; Anti-Bacterial Agents; Anti-Infective Agents; Central Nervous System Diseases; Cephalosporins; Cephamycins; Chloramphenicol; Erythromycin; Humans; Infections; Lincomycin; Meningitis; Metronidazole; Penicillins; Polymyxins; Rifampin; Sulfonamides; Tetracyclines; Trimethoprim; Vancomycin

Gamithromycin is active in vitro against the bacterial agents most commonly associated with bronchopneumonia in older foals. However, the clinical efficacy and safety of this drug have not been investigated.. Gamithromycin is effective for the treatment of bronchopneumonia in foals.. One hundred and twenty-one foals on a farm endemic for infections caused by Rhodococcus equi.. In a controlled, randomized, and double blinded clinical trial, foals with ultrasonographic evidence of pulmonary abscesses (abscess score 8.0-20 cm) were randomly allocated in 3 treatment groups: (1) gamithromycin IM q7 days (n = 40); (2) azithromycin with rifampin, PO q24h (n = 40); or (3) no antimicrobial treatment (controls; n = 41). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were removed from the study.. The proportion of foals that recovered without the need to be removed from the study was significantly higher for foals treated with gamithromycin (38 of 40) or azithromycin with rifampin (39 of 40) than for controls (32 of 41). Treatment with gamithromycin or with azithromycin-rifampin resulted in a significantly faster decrease in the clinical score and abscess score compared to the controls. Adverse reactions characterized by colic (n = 18) and hind limb lameness (n = 14) were observed only in foals treated with gamithromycin.. Gamithromycin was noninferior to azithromycin with rifampin for the treatment of bronchopneumonia in the study population but had a higher frequency of adverse reactions.

Topics: Abscess; Actinomycetales Infections; Animals; Anti-Bacterial Agents; Azithromycin; Bronchopneumonia; Double-Blind Method; Drug Therapy, Combination; Female; Horse Diseases; Horses; Macrolides; Male; Rhodococcus equi; Rifampin

The results of treatment for postvaccination complications were compared in 287 children (125 patients with regional lymphadenitis and 162 patients with cold abscesses). The treatment included local applications of rifampicin and dimexide solutions. Postvaccination lymphadenitis occurred significantly more frequently in children receiving BCG vaccine versus those receiving BCG-M vaccine with diminished antigenic load. Local applications of rifampicin+dimexide solution as an adjuvant treatment to isoniazid therapy of abscessed lymphadenitis permit the physician to reduce the number of puncture administration of 5% saluzid solution and decrease 2-fold the treatment duration. Similar results were obtained for cold abscess treatment. Rifampicin+dimexide applications to treat postvaccination complications in the form of lymphadenitis and cold abscesses in infiltration phase do not require local administration of saluzid, oral isoniazid. The complete resorption is reached within 1-2 months.

Topics: Abscess; BCG Vaccine; Child; Dimethyl Sulfoxide; Drug Combinations; Humans; Infant, Newborn; Isoniazid; Lymphadenitis; Rifampin; Solutions; Time Factors

MRI was performed at three centres in Bombay on 24 patients clinically suspected of tuberculosis of the spine but with normal radiographs. There were 11 males and 13 females and their average age was 24 years (11 to 60). 99mTc bone scans were done in 16 patients before MRI. Eleven patients had the diagnosis confirmed by biopsy and the remainder all responded rapidly to specific antituberculous chemotherapy. On T1-weighted images there was a decrease in signal intensity of the involved bone and soft tissues; on T2-weighted images there was increased signal intensity. Depending on the stage of the disease, three different patterns of infection were revealed: osteitis, osteitis with an abscess, and osteitis with or without an abscess plus discitis. The anatomical pattern of involvement, particularly of the soft tissues and the discs, is specific for tuberculous disease. The ability of MRI to detect tuberculosis of the spine earlier than other techniques could reduce bone destruction and deformity and diminish the need for surgical intervention. Despite the specificity of the patterns revealed by MRI, biopsy is recommended during the stage of osteitis to confirm the diagnosis.

Topics: Abscess; Adolescent; Adult; Biopsy, Needle; Cervical Vertebrae; Child; Discitis; Drainage; Female; Humans; Image Interpretation, Computer-Assisted; Isoniazid; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Osteitis; Reproducibility of Results; Rifampin; Thoracic Vertebrae; Time Factors; Tuberculosis, Spinal

Methicillin-resistant. This retrospective study was conducted from January 2016-December 2021 on patients at eleven ISPED-group hospitals.. From 2016-2021, a total of 13024 MRSA isolates were obtained from children. The most common age group for patients with MRSA infection was less than 3 years old, and newborns were an important group affected by MRSA infection. MRSA was most commonly isolated from the lower respiratory, an abscess, a secretion, or blood in neonates and from the lower respiratory, an abscess, or the upper respiratory in non-neonates. All isolates were susceptible to vancomycin and linezolid and resistant to penicillin; additionally, 76.88%, 54.97%, 22.30%, 5.67%, 5.14%, 3.63%, and 1.42% were resistant to erythromycin, clindamycin, tetracycline, levofloxacin, sulfamethoxazole-trimethoprim (TMP-SMX), gentamicin, and rifampin, respectively. Between 2016 and 2021, a significant increase was seen in the levofloxacin- and TMP-SMX-resistance rates (from 5.45% to 7.14% and from 4.67% to 6.50%, respectively) among MRSA isolates, along with a significant decrease in the rates of resistance to erythromycin (from 82.61% to 68.08%), clindamycin (from 60.95% to 46.82%), tetracycline (from 25.37% to 17.13%), gentamicin (from 4.53% to 2.82%), and rifampin (from 1.89% to 0.41%).. The antibiotic-resistance rates varied among MRSA isolated from different sources. Because of the high antibiotic resistance rate to clindamycin, this antibiotic is not recommended for empirical treatment of MRSA infections, especially in osteomyelitis.

Topics: Abscess; Anti-Bacterial Agents; Child; Child, Preschool; Clindamycin; Communicable Diseases; Drug Resistance, Bacterial; Erythromycin; Gentamicins; Humans; Infant, Newborn; Levofloxacin; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Retrospective Studies; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination

The objective is to determine whether a medical treatment, the combination of cefotaxime and rifampicin, is effective in avoiding surgery for managing deep cervical abscesses in children and to determine prognostic factors in the efficacy of this medical treatment. This is a retrospective analysis of all patients under 18 presenting with para- or retro-pharyngeal abscess over the period 2010-2020 in two hospitals' pediatric otorhinolaryngology departments. One hundred six records were included. Multivariate analyses were performed to study the relationship between the prescription of the Cefotaxime-rifampicin protocol at the onset of the management and the use of surgery and to evaluate the prognostic factors of its efficacy. The 53 patients who received the cefotaxime-rifampicin protocol as first-line treatment (vs. 53 patients receiving a different protocol) required surgery less frequently: 7.5% versus 32.1%, validated by a Kaplan-Meier survival curve and a Cox model analysis adjusted for age and abscess size (Hazard Ratio = 0.21). This good outcome of the cefotaxime-rifampicin protocol was not demonstrated when it was instituted as a second-line treatment after the failure of a different protocol. An abscess larger than 32 mm at hospitalization was significantly associated with more frequent use of surgery in multivariate analysis adjusted for age and sex (Hazard Ratio = 8.5).    Conclusions: The cefotaxime-rifampicin protocol appears to be an effective first-line treatment in managing non-complicated deep cervical abscesses in children. What is Known: • Nowadays, medical treatment is preferred for managing deep neck abscesses in children. There has yet to be a consensus on the antibiotic therapy to be proposed. • Staphylococcus aureus and streptococci are the most frequent causative organisms. What is New: • The cefotaxime-rifampicin protocol introduced at first intention is effective, with only 7.5% of patients requiring drainage surgery. • The only risk factor for failure of the medical treatment is the initial size of the abscess.

Topics: Abscess; Anti-Bacterial Agents; Cefotaxime; Child; Drainage; Humans; Neck; Retrospective Studies; Rifampin

81-year-old man with a history of Bio-Bentall surgery presented to the emergency department with fever, chills and back pain. Initial physical examination was inconclusive apart from sudden onset of delirium.. Elevated white blood cells, anemia, and neutrophilia. Further studies revealed gram-positive cocci on the initial blood culture, which was then confirmed to be Methicillin Sensitive Staph Aureus bacteremia. Subsequently, a transesophageal echocardiography showed a periaortic abscess, moderate aortic regurgitation and severe aortic stenosis with no evidence of endocarditis.. Antibiotics were started and urgent abscess drainage was planned. In a hybrid operative setting, a multidisciplinary team of cardiology, and cardiac surgery managed the periaortic graft abscess drainage through a median sternotomy and transcatheter aortic valve replacement. Postoperatively, the complications included bradycardia, and right heart failure. Six-week course of IV Rifampin, Probenecid, and Cefazolin was initiated, and patient was to remain on lifelong Cefadroxil.. A hybrid approach should be considered for patients with high morality risks in the field of cardiovascular medicine as it offers the best available combination of treatments.

Topics: Abscess; Aged, 80 and over; Anti-Bacterial Agents; Aortic Valve; Aortic Valve Stenosis; Cefadroxil; Cefazolin; Drainage; Heart Valve Prosthesis; Humans; Male; Methicillin; Probenecid; Rifampin; Transcatheter Aortic Valve Replacement

Bacillus Calmette-Guérin (BCG)-associated osteomyelitis is a rare adverse event following BCG vaccination, and there have been no previous reports of BCG-associated cervical spondylitis. Here, we describe the case of a 3-year-old immunocompetent girl who developed BCG-associated cervical spondylitis and was successfully treated by prompt surgical drainage of the abscess and administration of isoniazid and rifampicin for 9 months without sequelae.

Topics: Abscess; Antitubercular Agents; BCG Vaccine; Cervical Vertebrae; Child, Preschool; Female; Humans; Immunocompetence; Isoniazid; Mycobacterium bovis; Osteomyelitis; Rifampin; Spondylitis; Tuberculosis

WHO endorsed Xpert MTB/RIF assay has proven to be rapid with results obtained within 2h. The evidence base regarding the use of Xpert MTB/RIF in pulmonary TB is strong. Relatively few performance data have been published to date on detection of Mycobacterium tuberculosis in aspirated pus specimens from abscesses.. The aim of the study was to determine the sensitivity and specificity of Xpert MTB/RIF assay for the detection of M. tuberculosis and rifampicin resistance in aspirated pus specimens using culture on Lowenstein Jensen (LJ) medium and economic variant of proportion method (PM) for drug susceptibility testing (DST) as the reference standard.. Xpert MTB/RIF assay in comparison to conventional reference method showed sensitivity and specificity of 76.19% and 68.75% for detection of M. tuberculosis and 71.4% and 100% for detection of rifampicin resistance respectively.. The simplicity, sensitivity, speed and automation makes this assay a very promising diagnostic test for detection of M. tuberculosis and rifampicin resistance in aspirated pus specimens.

Topics: Abscess; Antibiotics, Antitubercular; Diagnostic Tests, Routine; Humans; India; Microbial Sensitivity Tests; Mycobacterium tuberculosis; Retrospective Studies; Rifampin; Sensitivity and Specificity; Suppuration; Tuberculosis, Pulmonary

In Denmark, Q fever has previously been considered a rare and imported disease; however, recent testing of antibodies in cattle as well as humans has indicated that the infection is widespread. A 76-year-old Danish man was diagnosed with infective endocarditis and underwent open surgical aortic valve replacement with insertion of a biological valve. Due to paravalvular leakage, destruction of the aortic annulus, and an aortic root abscess, the patient underwent re-operation 3 weeks later, with replacement of the biological valve and insertion of an aortic prosthetic tube. Despite treatment with various broad-spectrum antibiotic regimes, the patient died 3.5 months after initial hospital admission.. The causative agent was probed by PCR amplification of bacterial DNA on the removed prosthetic aortic valve using broad range primers targeting the variable regions V1-V3 of the 16S RNA gene. After identification of Coxiella burnetii, multispacer sequence typing (MST) was performed by PCR amplification of 10 intergenic sequences.. BLAST analysis of DNA from prosthetic valve material identified a 16S rRNA gene fragment almost identical to the type strain of C. burnetii (462/463 nt). Molecular typing allocated the strain to MST_18.. Molecular methods are increasingly used to characterize isolates and to determine relationships between isolates that cause disease in different contexts and geographical areas. The present case demonstrates that identification and typing of C. burnetii is achievable without access to biosafety level 3 containment and highlights the first molecular characterization of an uncultured strain of C. burnetii causing infective endocarditis.

Topics: Abscess; Aged; Aortic Valve; Coxiella burnetii; Denmark; DNA, Bacterial; Doxycycline; Echinocandins; Endocarditis, Bacterial; Fatal Outcome; Gentamicins; Heart Valve Prosthesis; Humans; Male; Meropenem; Metronidazole; Multilocus Sequence Typing; Rifampin; RNA, Ribosomal, 16S; Vancomycin

Up to 1.3 million children from the former Soviet Union (fSU) and Eastern Europe have been placed in institutional care worldwide. With the hope of ensuring the child's health in the immediate post-adoption period, these children are known to receive many injections of vaccines, vitamins, and medications, many unnecessary and often administered with unsafe technique. This practice can lead to formation of suppurative granulomas in these children. Though rare, dermatologists should be aware of these conditions in adoptees from Eastern Europe.

Topics: Abscess; Child, Adopted; Clarithromycin; Europe, Eastern; Female; Granuloma; Humans; Infant; Injections, Intramuscular; Rifampin; Risk Assessment; Russia; Skin Diseases; USSR

A 56-year-old man sought care from a primary care physician (PCP) 5 days after lifting a heavy box produced acute, isolated lumbar pain. The PCP diagnosed a lumbar disc herniation and referred the patient to physical therapy without diagnostic imaging. Due to the presence of multiple red flags leading up to and during examination, the patient was transferred to the emergency department for further evaluation. Magnetic resonance imaging revealed a spinal epidural abscess with an associated multiloculated abscess within the adjacent left paraspinal muscles.

Topics: Abscess; Anti-Bacterial Agents; Diagnosis, Differential; Humans; Low Back Pain; Male; Middle Aged; Oxacillin; Paraspinal Muscles; Rifampin; Staphylococcal Infections; Staphylococcus aureus

Topics: Abscess; Anti-Bacterial Agents; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Humans; Lymphadenitis; Male; Middle Aged; Minocycline; Mycobacterium Infections, Nontuberculous; Rifampin; Skin Diseases, Bacterial

Infections to the peritoneal catheter are common in Peritoneal Dialysis (PD). We report the clinical case of a 49-year-old male patient in PD, who showed an atypical manifestation of tunnel infection caused by Staphylococcus aureus. The infection was characterized by a little abscess, on the left pararectal abdominal line, 6 cm far from exit-site of the peritoneal catheter. The diagnosis was made using ultrasonography (US), which showed a fistulous communication from subcutaneous cuff to the skin. We treated the infection conservatively by performing cuff-shaving and drainage of the abscess, associated to antibiotic therapy (teicoplanin). Due to the persistence of the infection, we added oral and topical rifampicin, and advanced medication with freez-dried collagen plant impregnated with extended-release gentamicin. The complete resolution of the infection allowed us to avoid removing the catheter.

Topics: Abdominal Wall; Abscess; Anti-Bacterial Agents; Catheter-Related Infections; Combined Modality Therapy; Drainage; Gentamicins; Humans; Male; Middle Aged; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Polycystic Kidney, Autosomal Dominant; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Teicoplanin; Ultrasonography

Tuberculosis affects one-third of the world's population. The incidence of extrapulmonary tuberculosis including cutaneous and skeletal manifestations has increased in the last decades. The authors report a clinical case of concomitant metastatic cutaneous abscesses and Pott disease in an immunocompetent patient, a rare presentation of tuberculosis.

Topics: Abscess; Adult; Antitubercular Agents; Arthrodesis; Debridement; Ethambutol; Humans; Immunocompetence; Isoniazid; Magnetic Resonance Imaging; Male; Pyrazinamide; Rifampin; Tuberculosis, Cutaneous; Tuberculosis, Spinal

We aimed to evaluate the GeneXpert® MTB/RIF test for the diagnosis of extrapulmonary tuberculosis. The test simultaneously detects Mycobacterium tuberculosis complex and resistance to rifampicin.. We analyzed 153 clinical samples collected in a tertiary hospital in Sfax, Tunisia, between 2013 and 2014. We performed the GeneXpert® test, a Ziehl-Neelsen and auramine-rhodamine staining, conventional culture on MGIT 960 and LJ media, and we tested the resistance to anti-tuberculosis drugs on MGIT 960 and LJ media for each sample. Diagnosis was based on clinical, radiological, microbiological, pathological, and therapeutic data.. We considered that 59 patients out of 153 presented with tuberculosis. PCR was positive in 50 samples and all of these samples were susceptible to rifampicin. Sensitivity, specificity, positive predictive value, and negative predictive value of the GeneXpert® test were 84.7%, 96.8%, 94.3%, and 91%, respectively, compared with diagnosis. We observed a statistically significant difference between the direct test and the GeneXpert® test, and between culture and the GeneXpert® test. No statistically significant difference was observed between pathological results and the GeneXpert® test. Sensitivity of the GeneXpert® test was 87.5% in biopsies, 80% in pus and abscesses, and 66.7% in biological fluids. All strains were susceptible to rifampicin with culture and GeneXpert® test.. The GeneXpert® test helped detect a higher proportion of M. tuberculosis complex. It does not replace conventional diagnostic methods but it is a useful addition to achieve better sensitivity and obtain rapid results.

Topics: Abscess; Antitubercular Agents; Biopsy; Body Fluids; DNA, Bacterial; Drug Resistance; Female; HIV Seronegativity; Humans; Male; Mycobacterium tuberculosis; Polymerase Chain Reaction; Predictive Value of Tests; Retrospective Studies; Rifampin; Sensitivity and Specificity; Staining and Labeling; Suppuration; Tuberculosis; Tuberculosis, Multidrug-Resistant

We report the case of an 83-year-old man who presented with swelling of his left lower leg. Subsequent investigations revealed that the swelling was due to a Mycobacterium tuberculosis abscess in the tibialis anterior muscle.

Topics: Abscess; Aged, 80 and over; Antibiotics, Antitubercular; Antitubercular Agents; Diagnosis, Differential; Diagnostic Imaging; Edema; Humans; Isoniazid; Leg; Male; Muscle, Skeletal; Mycobacterium tuberculosis; Recurrence; Rifampin; Tuberculosis

Topics: Abscess; BCG Vaccine; Humans; Infant; Isoniazid; Lymphadenitis; Male; Mycobacterium tuberculosis; Polymerase Chain Reaction; Radiography, Thoracic; Rifampin; Sequence Analysis, DNA; Thoracic Wall; Tomography, X-Ray Computed; Tuberculin Test

Topics: Abscess; Adolescent; Allografts; Aorta; Aortic Rupture; Aortic Valve; Aortic Valve Insufficiency; Bicuspid Aortic Valve Disease; Cardiac Surgical Procedures; Chest Pain; Drug Resistance, Bacterial; Dyspnea; Endocarditis; Gentamicins; Heart Murmurs; Heart Valve Diseases; Humans; Male; Nafcillin; Pericardial Effusion; Rifampin; Staphylococcal Infections; Staphylococcus lugdunensis; Vancomycin; Vascular Grafting

We evaluated the efficacy and tolerability of antibiotic regimens and optimal duration of therapy in complicated and uncomplicated forms of spinal brucellosis. This is a multicentre, retrospective and comparative study involving a total of 293 patients with spinal brucellosis from 19 health institutions. Comparison of complicated and uncomplicated spinal brucellosis was statistically analysed. Complicated spinal brucellosis was diagnosed in 78 (26.6%) of our patients. Clinical presentation was found to be significantly more acute, with fever and weight loss, in patients in the complicated group. They had significantly higher leukocyte and platelet counts, erythrocyte sedimentation rates and C-reactive protein levels, and lower haemoglobulin levels. The involvement of the thoracic spine was significantly more frequent in complicated cases. Spondylodiscitis was complicated, with paravertebral abscess in 38 (13.0%), prevertebral abscess in 13 (4.4%), epidural abscess in 30 (10.2%), psoas abscess in 10 (3.4%) and radiculitis in 8 (2.7%) patients. The five major combination regimens were: doxycycline 200 mg/day, rifampicin 600 mg/day and streptomycin 1 g/day; doxycycline 200 mg/day, rifampicin 600 mg/day and gentamicin 5 mg/kg; doxycycline 200 mg/day and rifampicin 600 mg/day; doxycycline 200 mg/day and streptomycin 1 g/day; and doxycycline 200 mg/day, rifampicin 600 mg/day and ciprofloxacin 1 g/day. There were no significant therapeutic differences between these antibiotic groups; the results were similar regarding the complicated and uncomplicated groups. Patients were mostly treated with doxycycline and rifampicin with or without an aminoglycoside. In the former subgroup, complicated cases received antibiotics for a longer duration than uncomplicated cases. Early recognition of complicated cases is critical in preventing devastating complications. Antimicrobial treatment should be prolonged in complicated spinal brucellosis in particular.

Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Aminoglycosides; Anti-Bacterial Agents; Brucellosis; Doxycycline; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Retrospective Studies; Rifampin; Spondylitis; Treatment Outcome; Young Adult

Endocarditis due to Propionibacterium acnes is a rare disease. Scant data on treatment of these infections is available and is based on case reports only. If the disease is complicated by abscess formation, surgical intervention combined with an antibiotic therapy might improve clinical outcome. In some cases, cardiac surgeons are reluctant to perform surgery, since they consider the intervention as high risk. Therefore, a conservative therapy is required, with little, if any evidence to choose the optimal antibiotic. We report the first case of a successfully treated patient with P. acnes prosthetic valve endocarditis without surgery.. We report the case of a 29-year-old patient with a prosthetic valve endocarditis and composite graft infection with abscess formation of the left ventricular outflow tract due to P. acnes. Since cardiac surgery was considered as high risk, the patient was treated intravenously with ceftriaxone 2 g qd and rifampin 600 mg bid for 7 weeks and was switched to an oral therapy with levofloxacin 500 mg bid and rifampin 600 mg bid for an additional 6 months. Two sets of blood cultures collected six weeks after completion of treatment remained negative. The patient is considered to be cured based on absence of clinical signs and symptoms, normal laboratory parameters, negative radiology scans and negative blood cultures, determined at site visits over two years after completion of treatment.. To our knowledge, this is the first successfully managed patient with P. acnes prosthetic valve endocarditis with abscess formation of the left ventricular outflow tract who was treated with antibiotics alone without a surgical intervention. A six month treatment with a rifampin and levofloxacin combination was chosen, based on the excellent activity against stationary-phase and adherent bacteria.

Topics: Abscess; Adult; Anti-Bacterial Agents; Ceftriaxone; Communicable Diseases; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Heart Valve Prosthesis; Humans; Levofloxacin; Male; Middle Aged; Propionibacterium acnes; Prosthesis-Related Infections; Rifampin; Treatment Outcome

Involvement of the renal parenchyma in the acute phase of brucellosis is very rare. Only two cases of renal brucelloma have been reported in the English language literature to date. We report a case of renal abscess caused by Brucella in the acute phase. A 45-year-old Chinese man presented with a high fever, urine occult blood, and a low density lesion in the right kidney. Ultrasound-guided aspiration was done. Brucella melitensis was isolated from both blood and puncture fluid culture. Minocycline combined with moxifloxacin was prescribed for 4 months. The infection relapsed at 6 months after discontinuation. Minocycline combined with rifampin was administered for another 2 months. The brucellosis had not relapsed at more than 20 months later. It is possible to cure renal brucelloma with antibiotics and ultrasound-guided aspiration. Treatment should not be discontinued until the abscess has disappeared and two consecutive blood cultures taken 1 month apart are negative.

Topics: Abscess; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Drug Therapy, Combination; Fluoroquinolones; Humans; Kidney Diseases; Male; Middle Aged; Minocycline; Moxifloxacin; Rifampin

This paper presents a rare case of facial soft tissue infection caused by the bacterial strain of Rothia mucilaginosa. Odontogenic background of infection and initial clinical presentation suggested the presence of typical bacterial flora and uncomplicated course of treatment. However, despite surgical intervention and broad-spectrum antibiotic therapy, the expected improvement of a clinical status was not achieved. Only detailed bacteriological examination allowed to establish a bacterial pathogen and start a targeted antibiotic therapy. The unusual clinical course was monitored by imaging CT examination and further surgical interventions. A significant improvement was obtained in the third week of hospitalization and further antibiotic therapy was continued by means of outpatient treatment. Rothia mucilaginosa infection together with dental intervention is a rare case, since most of the reports in the literature concern the patients with decreased immunity. In such patients, the most common areas of infection were: the peritoneum, lung tissue and meningeal spaces of the brain and the presence of a foreign body. 

Topics: Abscess; Adult; Anti-Bacterial Agents; Cheek; Drug Administration Schedule; Female; Gram-Positive Bacterial Infections; Humans; Micrococcus; Rifampin; Soft Tissue Infections; Tooth Extraction; Toothache; Trismus; Young Adult

A 31-year-old HIV-negative man presented to our clinic with a 6-month history of back pain and a swelling at the back. Radiological studies revealed lumbar vertebral destruction. Ultrasound of the mass showed a septated cystic mass with turbid fluid. Diagnostic aspiration revealed thick pus and smear microscopy detected acid-fast bacilli. Xpert MTB/RIF assay detected Mycobacterium tuberculosis with no rifampicin resistance.

Topics: Abscess; Adult; Diagnosis, Differential; Diagnostic Imaging; Drug Resistance, Bacterial; Fatal Outcome; Humans; Lumbar Vertebrae; Male; Nucleic Acid Amplification Techniques; Rifampin; Rural Population; Spondylitis; Tanzania; Tuberculosis, Spinal

Brucellosis is an important cause of spondylodiscitis in endemic areas. Brucellar spondylodiscitis is a serious complication because of its association with abscess formation. Prospective studies comparing patients with and without abscesses are lacking. The objective of this study was to determine the frequency and demographic, clinical, laboratory, and radiological features of brucellar spondylodiscitis and to compare patients with and without abscesses regarding treatment and outcome. Out of 135 consecutive patients with brucellosis, 31 patients with spondylodiscitis were recruited for the study. Patients were grouped according to magnetic resonance imaging findings. The frequency of spondylodiscitis was 23.0 %. Sites of involvement were lumbar (58.1 %), lumbosacral (22.6 %), cervical (9.7 %), thoracolumbar (6.5 %), and thoracic (3.2 %). Abscesses occurred in 19 (61.3 %) patients and were associated with low hemoglobin levels. Medical treatment included a combination of streptomycin (for the first 3 weeks), doxycycline, and rifampin. The total duration of treatment was 12-39 (mean 17.0 ± 8.5 SD) weeks. By 12 weeks of treatment, evidence of clinical improvement (67 vs. 28 %) and radiological regression (92 vs. 50 %) was significantly greater in patients without abscesses. The duration of treatment was longer if an abscess was present. Two female patients with abscesses required surgical intervention. Both patients presented with high fever, neurologic deficit, and high Brucella standard tube agglutination test titers. Each patient should be evaluated individually, based on clinical findings, laboratory data, and radiological results, when undergoing treatment for brucellar spondylodiscitis. If abscesses are found, a longer course of treatment and even surgical intervention may be needed.

Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Brucellosis; Discitis; Doxycycline; Drug Therapy, Combination; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Rifampin; Streptomycin; Treatment Outcome

Brucellosis is an endemic disease in Turkey, and testicular abscess is a rare and frequently misdiagnosed complication of brucellosis. In the literature there are only seven reported cases, and all were treated with both medical and surgical therapy. We report a case of brucellar testicular abscess treated with medical therapy only. Although the patient recovered clinically at the end of 6 weeks, the regression of the testicular lesion could not be observed until after 5 months.

Topics: Abscess; Adult; Anti-Bacterial Agents; Brucellosis; Doxycycline; Epididymitis; Humans; Male; Orchitis; Rifampin; Testicular Diseases; Turkey

The authors report a rare case of piriformis pyomyositis, in a teenage rugby player, who was initially feverish and presented to us with low back pain, sciatica and inability to mobilise due to pain. Subsequent imaging investigations (MRI scan) revealed abscess formation in the piriformis muscle with compression effect on the ipsilateral sciatic nerve. A course of intravenous antibiotic therapy followed by oral antibiotics fully resolved his symptoms and returned inflammatory markers back to normal.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Floxacillin; Football; Humans; Low Back Pain; Magnetic Resonance Imaging; Male; Meropenem; Pain; Piriformis Muscle Syndrome; Pyomyositis; Rifampin; Sciatica; Staphylococcal Infections; Staphylococcus aureus; Thienamycins; Vancomycin

Topics: Abscess; Adult; Antibiotics, Antitubercular; Antitubercular Agents; Female; Humans; Isoniazid; Mycobacterium tuberculosis; Rifampin; Skin Ulcer; Tuberculosis, Cutaneous

Pelvic abscesses occurring after gynecologic pelvic surgery are uncommon. We describe the case of a woman who, after undergoing such a procedure, was found to have pelvic abscesses infected with methicillin-resistant Staphyloccocus aureus. The purpose of this report is to raise awareness of a life-threatening complication of gynecologic pelvic surgery.

Topics: Abscess; Anti-Bacterial Agents; Female; Genital Diseases, Female; Gynecologic Surgical Procedures; Humans; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Pelvic Organ Prolapse; Rifampin; Staphylococcal Infections; Treatment Outcome; Vancomycin

Topics: Abscess; Adult; AIDS-Related Opportunistic Infections; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Antitubercular Agents; Axilla; Clarithromycin; Darunavir; Dideoxynucleosides; Enfuvirtide; Ethambutol; HIV Envelope Protein gp41; HIV-1; Humans; Immune Reconstitution Inflammatory Syndrome; Isoniazid; Lamivudine; Lymph Node Excision; Lymphadenitis; Male; Mycobacterium avium-intracellulare Infection; Peptide Fragments; Pyrazinamide; Rifampin; Ritonavir; Streptomycin; Sulfonamides

Topics: Abscess; Adult; Albania; Anti-Bacterial Agents; Biopsy, Needle; Brucellosis; Cervical Vertebrae; Discitis; Doxycycline; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Female; Greece; Humans; Magnetic Resonance Imaging; Nerve Compression Syndromes; Rifampin; Spinal Nerve Roots; Streptomycin; Tomography, X-Ray Computed

Bacillus Calmette-Guérin (BCG) vaccine has a good safety profile in immune competent children and considerable risks such as disseminated BCG disease in individuals with immune deficiencies. However, some complications including local subcutaneous infection, regional suppurative lymphadenitis may occur after BCG vaccination in immune competent children. A 17-month-old female child was admitted with a painless protruding mass on the anterior chest wall. There was no evidence of previous tuberculous infection and contact with a tuberculosis patient. Chest-computed tomography revealed an oval shaped low attenuated 1.8 x 1.0 cm mass at subcutaneous and muscle layers just below sternum, but the pulmonary parenchyma seemed to be normal. We excised the mass and the histopathologic examination revealed granulomatous lesions that suggestive of mycobacterial disease process. We considered that the chest wall abscess was a complication of BCG vaccination occurred by hematogenous dissemination of the inoculated mycobacteria. She recovered without any complications and was treated with isoniazid (150 mg/day) and rifampin (150 mg/day) for 6 months as an outpatient, not directly observed therapy but monthly follow-up.

Topics: Abscess; Antitubercular Agents; BCG Vaccine; Female; Humans; Infant; Isoniazid; Mycobacterium Infections; Rifampin; Thoracic Wall; Tomography, X-Ray Computed; Treatment Outcome

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Brucellosis; Cefuroxime; Child; Doxycycline; Female; Gentamicins; Humans; Immunoglobulin G; Joint Diseases; Kidney Diseases; Lyme Disease; Male; Methicillin-Resistant Staphylococcus aureus; Pain; Rifampin

Topics: Abscess; Aged; Amoxicillin; Anti-Bacterial Agents; Aortic Valve; Bacteremia; Combined Modality Therapy; Device Removal; Endocarditis, Bacterial; Gentamicins; Gram-Positive Bacterial Infections; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Pacemaker, Artificial; Propionibacterium acnes; Prosthesis-Related Infections; Reoperation; Rifampin

Soft tissue involvement is an uncommon complication of brucellosis. We report a rare case of gluteal abscesses caused by brucellosis. The patient was a housewife living in a city. There was no history of systemic complaints or other organ involvement. Diagnosis was made by positive pus culture and serological tests. Histopathological examination of the abscess wall revealed granulomatous inflammatory reaction. The patient was treated successfully with abscess drainage and a 6-week course of oral doxycycline and rifampicin. Brucellosis should be kept in mind in the diagnosis of gluteal abscess, especially in endemic areas.

Topics: Abscess; Adult; Anti-Bacterial Agents; Brucella; Brucellosis; Buttocks; Doxycycline; Female; Humans; Rifampin; Treatment Outcome

Dental infections are associated with a range of serious complications. The orofacial region provides potential spaces in the tissue that infections of dental origin can occupy. We describe the subtemporal extension of a dental infection, the late development of cranial osteomyelitis, and its surgical management.

Topics: Abscess; Anti-Bacterial Agents; Bacteroides fragilis; Bacteroides Infections; Cephradine; Drainage; Female; Focal Infection, Dental; Humans; Middle Aged; Osteomyelitis; Rifampin; Temporal Bone

The adequate treatment of methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis has intrigued clinicians for some time. As the resistance of these pathogens, coupled with the increase in community-acquired cases, continues steadily to rise, clinicians are finding it useful to employ multi-modal approaches for efficacious treatment. The authors present a single case report of a patient with recurrent MRSA osteomyelitis, lumbar paraspinal and epidural abscess. He was found to have decreased muscle strength and was hyporeflexic in the involved extremity. Serum testing demonstrated MRSA bacteremia. Neuroimaging studies revealed evidence of paraspinal abscess and a presumed herniated nucleus pulposus at the L5/S1 interspace with significant nerve root compromise. Despite antimicrobials, his symptoms persisted, necessitating surgical exploration. At surgery, paraspinal and epidural abscesses were encountered and debrided; however, no herniated disc was visualized. This case demonstrates the diagnostic and therapeutic dilemmas with which these lesions present. We postulate that the MRSA osteomyelitis/discitis pathogens were walled off in the disc space and subsequently inoculated the soft tissues with ensuing bacteremia. We concur that antimicrobial treatment should be the first line of therapy for these patients; however, surgical debridements and cautious spinal instrumentation should be employed where appropriate.

Topics: Abscess; Acetamides; Adult; Anti-Bacterial Agents; Bacteremia; Debridement; Drug Therapy, Combination; Humans; Intervertebral Disc Displacement; Laminectomy; Linezolid; Lumbar Vertebrae; Male; Methicillin Resistance; Osteomyelitis; Oxazolidinones; Recurrence; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Time Factors; Treatment Outcome; Vancomycin

Infective sacro-ileitis is due to common bacteria, 25% being tuberculosis and 10% brucellosis. Slow progression characterizes joint tuberculosis, an uncommon variant of this disease. The onset is usually insidious, and early diagnosis requires a high index of clinical suspicion. We report two cases with tuberculous sacro-ileitis which initially mimicked brucellosis infiltration. Diagnosis of tuberculosis of the sacroiliac joint was established by fine-needle aspiration of joint and radiological imaging methods such as computerized tomography, magnetic resonance and three-phase bone scan. The current diagnosis and treatment of this condition is discussed based on these cases and a literature review.

Topics: Abscess; Adult; Antitubercular Agents; Arthritis, Infectious; Brucellosis; Diagnosis, Differential; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Male; Pyrazinamide; Radiography; Rifampin; Sacroiliac Joint; Tuberculosis, Osteoarticular; Tuberculosis, Pulmonary; Ultrasonography

Topics: Abscess; Adult; Anti-Bacterial Agents; Cloxacillin; Endocarditis, Bacterial; Fever; Humans; Levofloxacin; Male; Methicillin Resistance; Ofloxacin; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Tricuspid Valve

Topics: Abscess; Actinomycetales Infections; Animals; Anti-Bacterial Agents; Azithromycin; Diagnosis, Differential; Horse Diseases; Horses; Lung; Male; Pneumonia, Bacterial; Radiography, Thoracic; Rhodococcus equi; Rifampin; Ultrasonography

To present the clinical, histopathological, and molecular biologic findings in fifteen cases of ocular tuberculosis (TB) in patients with acquired immune deficiency syndrome (AIDS).. Retrospective, observational, noncomparative case series of HIV-infected patients with ophthalmic complaints and/or with advanced disease (CD4+ cell count < 200), seen between the years 1993 to 2005 at tertiary care ophthalmic and AIDS care hospitals.. Each patient underwent a complete ophthalmic examination and relevant laboratory and radiologic investigations and was treated accordingly. The study was carried out in this cohort to describe the ocular manifestations of TB. The main outcome measures were to describe the clinical course histopathologic and molecular biologic features of ocular lesions attributable to tuberculosis in AIDS patients in our center.. Ocular TB was seen in 15 (1.95%) out of 766 consecutive cases of HIV/AIDS. Nineteen eyes of 15 patients were affected. Four cases (26.66%) had bilateral presentation. Presentations of ocular TB included choroidal granulomas in 10 eyes (52.63%), subretinal abscess in seven eyes (36.84%), worsening to panophthalmitis in three eyes, conjunctival tuberculosis, and panophthalmitis each in one eye (5.26%). All cases had evidence of pulmonary tuberculosis. Coexistent central nervous system (CNS) tuberculosis was seen in two cases and one case had abdominal tuberculosis. CD4+ cell counts were done in 14 patients; the count ranged from 14 to 560 cells/microl--mean 160.85 cells/microl.. Ocular TB in AIDS is relatively rare and can occur even at CD4+ cell counts greater than 200 cells/microl. It can have varied presentations with severe sight-threatening complications.

Topics: Abscess; Adolescent; Adult; AIDS-Related Opportunistic Infections; Antitubercular Agents; CD4 Lymphocyte Count; Child; Conjunctival Diseases; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Panophthalmitis; Pyrazinamide; Retinal Diseases; Retrospective Studies; Rifampin; Tuberculosis, Central Nervous System; Tuberculosis, Ocular; Tuberculosis, Pulmonary

A 21 year old man, previously healthy, presented with subcutaneous nodes consistent with gummas. Ultrasonography disclosed multiple subcutaneous abscesses and images suitable with piomiositis, pleural and pericardium effusion. A puncture-aspirate with fine-needle was performed and produced purulent material, with isolate of Staphylococcus aureus. Antimicrobial susceptibility testing by disk diffusion showed resistant to cefalotin, erythromycin and clindamycin, and susceptibility to trimethoprim-sulfamethoxazole, ciprofloxacin and rifampicin. Methicilin-resistance was confirmed by Staphyslide agglutination testing (Biomérieux). The patient was treated with ciprofloxacin and rifampicin during four weeks, with a good clinical response. The frequency of CA-MRSA infections is increasing, and these are reported in patients without identified predisposing risks leading to failure on empiric therapy for community infections presumed to be due to staphylococcal agents.

Topics: Abscess; Adult; Anti-Infective Agents; Ciprofloxacin; Community-Acquired Infections; Humans; Male; Methicillin Resistance; Rifampin; Risk Factors; Staphylococcal Infections; Staphylococcal Skin Infections; Staphylococcus aureus

Erythema nodosum rarely occurs in childhood and can be caused by cat scratch disease, as a result of agent Bartonella henselae. We report the case of a teenager who presented erythema nodosum and bilateral inguinal adenitis. Cat scratch disease diagnosis was confirmed by anti-Bartonella henselae serologies. Despite an appropriate antibiotic therapy, evolution was unfavourable with adenitis abcédation requiring surgical drainage.. Erythema nodosum in children must let think to cat scratch disease among others etiologies.

Topics: Abscess; Administration, Oral; Adolescent; Anti-Bacterial Agents; Antibodies, Bacterial; Bartonella henselae; Cat-Scratch Disease; Drainage; Erythema Nodosum; Fluorescent Antibody Technique, Indirect; Follow-Up Studies; Groin; Humans; Immunoglobulin G; Male; Rifampin; Time Factors; Treatment Outcome

Brucellosis is a zoonosis that affects several organs and has a protean presentation. The authors report the case of a 61-year-old male patient with brucellar spondylodiscitis involving several vertebrae and a paravertebral abscess localized in the erector spinae muscle. Diagnosis was made by positive blood culture and MRI. No relapse was seen with a combined treatment (doxycycline/rifampin) for 3 months, followed by doxycycline alone for 6 months. Almost all radiologic findings disappeared at the end of a 1-year follow-up without any further treatment.

Topics: Abscess; Anti-Bacterial Agents; Brucella; Brucellosis; Discitis; Doxycycline; Drug Therapy, Combination; Fever; Humans; Low Back Pain; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Rifampin; Thoracic Vertebrae; Treatment Outcome

A 68-year old man with fever chills and a diastolic murmur was diagnosed with aortic-valve endocarditis caused by coagulase-negative Staphylococcus lugdunensis. The clinical condition initially improved with antibiotic therapy. On day seven, transoesophageal echocardiography revealed large abscesses extending from the aortic root to the left ventricular wall. Emergency cardiac surgery was performed successfully and a stentless bioprosthetic valve was inserted. S. lugdunensis endocarditis is known for its aggressive clinical course with valve destruction, abscess formation and embolic complications despite appropriate antibiotics. Antibiotic treatment alone is associated with a high mortality rate which can be reduced by early valve replacement.

Topics: Abscess; Aged; Aorta, Thoracic; Aortic Valve; Cefuroxime; Disease Progression; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Echocardiography; Echocardiography, Transesophageal; Endocarditis, Bacterial; Humans; Male; Microbial Sensitivity Tests; Pericardial Effusion; Rifampin; Staphylococcal Infections; Staphylococcus; Vancomycin

We report a case of borderline tuberculoid leprosy complicated by a median nerve abscess, acute renal failure secondary to rifampicin-induced haemolysis and duodenal ulceration secondary to steroid use. Rifampicin induced hameolysis is a rare and probably under-reported complication of leprosy multi-drug therapy. It should be considered when patients complain of flu-like symptoms after taking their monthly rifampicin.

Topics: Abscess; Acute Kidney Injury; Adult; Female; Hemolysis; Humans; Leprostatic Agents; Leprosy, Borderline; Magnetic Resonance Imaging; Median Nerve; Peptic Ulcer; Rifampin

A retrospective descriptive assessment of the clinical and radiologic outcomes of 11 patients who underwent transpedicular decompression for thoracic spine tuberculosis.. To study the neurologic and radiologic outcomes in patients who underwent transpedicular decompression for thoracic spine tuberculosis.. Several approaches have been used in the management of thoracic spine tuberculosis to achieve the goals of decompression of the cord followed by immobilization and antituberculous therapy. These range from conservative regimens of computed tomography-guided biopsy followed by bed rest and drug therapy to radical surgeries that involve extensive debridement of the vertebral body followed by instrumentation. The authors report their experience with a "middle path" regimen of transpedicular decompression followed by external immobilization and antituberculous therapy.. The charts of 11 patients were reviewed retrospectively for clinical outcome, and kyphotic angle was measured on the follow-up radiographs to ascertain progression of kyphosis.. There was no worsening of the neurologic status in any patient, and 10 of the 11 patients returned to functional activity. There was no significant progression of kyphosis.. Our results show that the transpedicular approach is a viable and safe surgical option for ventral decompression in thoracic spine tuberculosis, followed by chemotherapy for 18 months and immobilization in an alkathene shell for 3 months.

Topics: Abscess; Adolescent; Adult; Aged; Antitubercular Agents; Braces; Combined Modality Therapy; Curettage; Debridement; Decompression, Surgical; Disease Progression; Drainage; Ethambutol; Female; Follow-Up Studies; Humans; Immobilization; Isoniazid; Kyphosis; Male; Middle Aged; Movement Disorders; Pyrazinamide; Radiography; Recovery of Function; Retrospective Studies; Rifampin; Severity of Illness Index; Spinal Cord Compression; Thoracic Vertebrae; Treatment Outcome; Tuberculosis, Spinal

Topics: Abscess; Disinfection; Drug Resistance, Multiple; Family Health; Humans; Methicillin Resistance; Microbial Sensitivity Tests; Rifampin; Staphylococcal Infections; Staphylococcal Skin Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Concentrations of the calcium-binding proteins of the S100 family, myeloid-related proteins 8 and MRP 14 (MRP8/14), are elevated in chronic infections, yet the role of these proteins is not clearly defined. Using commercial and developed enzyme immunoassays, we assayed for MRP8/14 in sterile-filtered abscess fluid from tissue-cage-implanted rats and rabbits. Staphylococcus aureus abscesses were created 6 weeks after the intraperitoneal implantation of tissue cages. Leukocytes, bacteria, and non-protein-bound calcium and zinc were measured in the infection exudate at day 3 or 5 of infection and after 8 days of treatment with antimicrobials beta-lactams (18 rabbits, 35 rats) and fluoroquinolone-rifampin (6 rabbits). Half of the infected rats were depleted of neutrophils; these rats exhibited significantly lower MRP 8/14 concentrations on all days sampled, regardless of the level of infection. The level of abscess MRP 8/14 is high early in the course of infection but decreases with effective antimicrobial treatment by as much as 100-fold. Thirty-day-old abscesses with log 6 bacterial counts and low neutrophil counts showed low concentrations of MRP 8/14 in these models. In abscess fluid, interleukin-6, as a representative marker of inflammation, correlated with MRP8/14, whereas ionized calcium and zinc did not. Our data suggest that infection and inflammation are not equal stimuli for MRP 8/14. The neutrophil appears to be the main source of MRP8/14 in this model.

Topics: Abscess; Animals; Anti-Bacterial Agents; Anti-Infective Agents; Calcium; Calgranulin A; Calgranulin B; Cations, Divalent; Chlorides; Disease Models, Animal; Exudates and Transudates; Fluoroquinolones; Immunoenzyme Techniques; Inflammation; Interleukin-6; Lactams; Leukocyte Count; Neutrophils; Rabbits; Rats; Rifampin; Staphylococcal Infections; Zinc

The case of a 25-y-old woman with brucellar ovarian abscess is reported. Cultures of blood, ascites and a pus specimen yielded Brucella melitensis. The possibility of ovarian abscess being caused by Brucella melitensis should be considered in countries where the infection is endemic.

Topics: Abscess; Adult; Anti-Bacterial Agents; Ascites; Brucella melitensis; Brucellosis; Doxycycline; Female; Humans; Laparoscopy; Ovarian Diseases; Rifampin

We report a patient with lepromatous leprosy who developed a rare variant of type-2 lepra reaction, characterized by pustular lesions, on switching from WHO multi drug therapy (MDT) to ofloxacin-aided MDT.

Topics: Abscess; Adult; Drug Resistance, Bacterial; Drug Therapy, Combination; Erythema Nodosum; Humans; Leprostatic Agents; Leprosy, Lepromatous; Macrophages; Male; Melanins; Minocycline; Mycobacterium tuberculosis; Neutrophils; Ofloxacin; Rifampin; Tumor Necrosis Factor-alpha; Vasculitis

This report describes the case of a 45-year-old woman with a 5-month history of fever, generalized malaise, myalgia, lower back pain and difficulty in walking. Serodiagnosis for brucella, carried out at the onset of symptoms 5 months previously, was negative. When the patient was admitted to our hospital there was contracture of the paraspinal muscles but no peripheral nerve damage. Laboratory tests showed positive agglutination for Brucella and an increase in the rate of dilution from 1/160 to 1/640 over 2 weeks. Radiographs and a computed tomography scan of the spine revealed bone erosion in the posterior borders of the L4-L5 vertebral end plates and a soft tissue mass surrounding the interposed disc and protruding into the spinal canal. Magnetic resonance imaging confirmed the presence of a paraspinal abscess around the affected disc and tissue edema. Culture tests of the blood and abscess tissue, taken by biopsy, were negative. Rifampicin treatment (600 mg daily), combined with a bust cast to immobilize the spine, led to clinical healing without the need for surgery. Because onset symptoms are nonspecific and insidious, in nonrisk subjects a diagnosis of brucellosis may sometimes be suspected only if there are local symptoms. The phenomenon of the absence of positivity in patients with a high antibody titer should also be considered Cases such as that described herein demonstrate the need for culture tests and serodiagnosis, even in nonrisk patients with persistent fever and arthralgia, to prevent the later complications of brucellosis.

Topics: Abscess; Antibiotics, Antitubercular; Brucella melitensis; Brucellosis; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Reverse Transcriptase Polymerase Chain Reaction; Rifampin; RNA, Ribosomal, 16S; Spinal Diseases; Spine; Spondylitis

We report the case of a 44-year-old obese diabetic woman admitted for fever. Blood cultures grew Staphylococcus Aureus and antibiotherapy was started. Iliac abscess was diagnosed and surgical drainage done. Clinical evolution was marked by metastatic dissemination: sacroiliac osteolysis, right shoulder osteoarthritis, spondylitis of the third lumbar vertebra and pulmonary localizations. This case-report shows diagnosis and treatment difficulties of an iliac muscle abscess with metastatic localization in a diabetic patient.

Topics: Abscess; Adult; Anti-Bacterial Agents; Diabetes Complications; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Obesity; Rifampin; Staphylococcal Infections; Treatment Outcome

Human brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations, and its complications can affect almost all organs and systems with varying incidence. Soft-tissue infection due to Brucella species is a rare complication of brucellosis. This report presents a case of a 30-y-old previously healthy woman whose right buttock abscess culture grew Brucella spp. The patient was treated successfully with abscess drainage and antibiotic therapy.

Topics: Abscess; Adult; Brucellosis; Buttocks; Doxycycline; Female; Humans; Rifampin; Treatment Outcome

We report a case of chronic wound infection (abscess, fistula) after a Lichtenstein repair of inguinal hernia. After surgical treatment (mesh explantation), a small-colony variant (SCV) of Staphylococcus aureus was cultured microbiologically. SCV represent subpopulations of Staphylococcus aureus which are associated with chronic infections and which respond poorly to usual treatment regimes. In this case surgery and specific antibiotic treatment with flucloxacillin and rifampicin were successful.

Topics: Abscess; Chronic Disease; Combined Modality Therapy; Cutaneous Fistula; Floxacillin; Hernia, Inguinal; Humans; Male; Middle Aged; Postoperative Complications; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Surgical Wound Infection

Corynebacterium minutissimum, known as the causative agent of erythrasma, has recently been reported as a clinically significant pathogen in the immunocompromised host. We report for the first time the possible involvement of a multidrug-resistant C. minutissimum strain in a costochondral abscess occurring in an HIV-infected patient.

Topics: Abscess; Adult; AIDS-Related Opportunistic Infections; Amikacin; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents; Antibiotics, Antitubercular; Ciprofloxacin; Corynebacterium; Corynebacterium Infections; Drug Resistance, Microbial; Drug Resistance, Multiple; HIV Infections; HIV-1; Humans; Male; Penicillins; Ribs; Rifampin; Tomography, X-Ray Computed; Vancomycin

Topics: Abscess; Adult; Antitubercular Agents; Chronic Disease; Drug Therapy, Combination; Ethambutol; Female; Graft Rejection; Humans; Isoniazid; Kidney Transplantation; Nephrectomy; Pyrazinamide; Reoperation; Rifampin; Tuberculosis

Topics: Abscess; Adult; Anti-Infective Agents; Brain Diseases; Brucellosis; Drug Therapy, Combination; Endoscopy; Female; Humans; Pituitary Diseases; Rifampin; Sulfamethoxazole; Trimethoprim

Treatment of aortic graft infection with graft excision and axillofemoral bypass may carry an increased risk of limb loss, aortic stump blowout, and pelvic ischemia. A review of patients with aortic graft infection treated with in situ prosthetic graft replacement was undertaken to determine if mortality, limb loss, and reinfection rates were improved with this technique.. The clinical data of 25 patients, 19 males and 6 females, with a mean age of 68 years (range 35 to 83), with aortic graft infection, treated between January 1, 1989, and December 31, 1998, by in situ prosthetic graft replacement were reviewed. Follow-up was complete in the 23 surviving patients and averaged 36 months (range 4 to 103).. Twenty aortofemoral, 3 aortoiliac, and 2 straight aortic graft infections were treated with excision and in situ replacement with standard polyester grafts in 16 patients (64%), or with rifampin-soaked collagen or gelatin-impregnated polyester grafts in 9 patients (36%). Fifteen patients (60%) had aortic graft enteric fistulas, 8 patients (32%) had abscesses or draining sinuses, and 2 patients (8%) had bacterial biofilm infections. Thirty-day mortality was 8% (2 of 25). There were no early graft occlusions or amputations. There was one late graft occlusion. There were no late amputations. The reinfection rate was 22% (5 grafts). All reinfections occurred in patients operated upon for occlusive disease. Only one reinfection occurred in the rifampin-soaked graft group (11% versus 29%, P = NS). Reinfection tended to be lower in patients with aortoenteric fistulas and without abscess. Autogenous tissue coverage provided statistically significant protection against reinfection. There were no late deaths related to in situ graft infection.. Patients treated with in situ graft replacement had an 8% mortality and 100% limb salvage rate. Reinfection rates were similar to those of extra-anatomic bypass, but a trend of lower reinfection rates with rifampin-impregnated grafts was apparent. Patients with aortoenteric fistula and without abscess appear to be well treated by the technique of in situ prosthetic grafting and autogenous tissue coverage.

Topics: Abscess; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Aorta; Biofilms; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Collagen; Female; Femoral Artery; Follow-Up Studies; Gelatin; Graft Occlusion, Vascular; Humans; Iliac Artery; Intestinal Fistula; Male; Middle Aged; Polyesters; Postoperative Complications; Prosthesis-Related Infections; Recurrence; Reoperation; Retrospective Studies; Rifampin; Survival Rate; Treatment Outcome

Thyroid tuberculosis is rare. In the last decade, however, the incidence of extrapulmonary forms of tuberculosis has increased. We report on 2 cases of thyroid tuberculosis. In case 1, a tubercular abscess mimicking acute thyroiditis was found which was correctly diagnosed by fine-needle aspiration biopsy (FNAb). No evidence of active disease was noticed. Pleural thickening on chest X-ray was the only sign compatible with a previous infection. In case 2, tubercular thyroiditis with lymph node enlargement was also diagnosed by FNAb in a reevaluation setting. In both cases treatment with antitubercular drugs resulted in complete recovery. Thyroid tuberculosis should be kept in mind in the differential diagnosis of thyroid nodules, notably in patients with a history of tuberculous disease. FNAb represents the main approach to making the diagnosis.

Topics: Abscess; Aged; Aged, 80 and over; Antitubercular Agents; Biopsy, Needle; Ethambutol; Female; Humans; Isoniazid; Lymph Nodes; Mycobacterium tuberculosis; Rifampin; Thyroid Diseases; Tuberculosis, Endocrine

Report of a rare case of spinal actinomycosis in a young immunocompetent woman.. To show the difficulties in diagnosing spinal actinomycosis.. Spinal actinomycosis is rare and usually occurs as a result of a contiguous (abdominal, pelvic, or thoracic) spread of the infection. This localization represents less than 5% of the infectious sites and was mainly, before the penicillin era, a postmortem discovery.. A case is reported of a 34-year-old Algerian woman who had fever, persistent cough, right-side thoracic pain, and progressive severe back pain. Radiographs, computed tomographic scan, and magnetic resonance imaging demonstrated lytic areas on the vertebral bodies of T11 and T12 and a paravertebral mass, without disk involvement. A surgical biopsy of T12 and the paravertebral abscess was performed.. Presence of characteristic sulfur granules and gram-positive filamentous bacteria in surgical biopsy tissues and isolation of Actinobacillus actinomycetemcomitans in cultures led to the diagnosis of vertebral actinomycosis. The patient was virtually free of pain and fever after a 3-month regimen of ofloxacin and rifampicin (Rifadine, Marion-Merell, France) and was without recurrence after 18 months of follow-up.. Actinomycosis of the spine, caused by the spread of a paraspinal abscess, is extremely rare. The previously poor prognosis has been transformed by antibiotics.

Topics: Abscess; Actinomycosis; Adult; Anti-Infective Agents; Drug Combinations; Female; Humans; Magnetic Resonance Imaging; Ofloxacin; Rifampin; Spinal Diseases; Spine; Spondylitis

Pharmacokinetics of INH, RFP and OFLX in serum and cold abscesses of patients with spinal tuberculosis was analyzed to provide reference to choosing clinical therapeutic regimen.. The aspiration specimens of abscesses and venous blood were collected from 8 patients with spinal tuberculosis at 0.5, 0.75, 1.0, 1.5, 2.0, 4.0, 6.0, 9.0, 12.0, 16.0 and 24.0 h after administration of antituberculous drugs. The specimens were assessed by high performance liquid chromatography (HPLC). The data were processed with software 3P87.. The Cmax of INH, RFP and OFLX in serum were 10.87 +/- 7.09 micrograms/ml, 9.98 +/- 3.53 micrograms/ml, and 5.29 +/- 0.72 micrograms/ml, while the Cmax of INH, RFP and OFLX in cold abscesses were 2.84 +/- 1.63 micrograms/ml, 0.57 +/- 0.26 microgram/ml and 3.19 +/- 1.29 micrograms/ml respectively.. After administration, the Cmax of INH and OFLX in the cold abscesses of patients with spinal tuberculosis, reached the level beyond their MIC and appeared and disappeared more slowly than that in the serum; RFP was not easy to permeate into the cold abscesses, the Cmax of RFP in the cold abscesses just reached its MIC.

Topics: Abscess; Adult; Anti-Infective Agents; Antitubercular Agents; Female; Humans; Isoniazid; Male; Ofloxacin; Rifampin; Tuberculosis, Spinal

We studied the efficacies of ofloxacin, rifampin, and clindamycin in a Staphylococcus aureus abscess model and seven antimicrobial regimens in an intracellular killing assay. Ofloxacin plus rifampin was the most effective regimen in the abscess model, and rifampin and ofloxacin were the most active regimens in the intracellular killing assay.

Topics: Abscess; Animals; Anti-Infective Agents; Antibiotics, Antitubercular; Clindamycin; Microbial Sensitivity Tests; Models, Biological; Ofloxacin; Rabbits; Rats; Rifampin; Staphylococcal Infections; Staphylococcus aureus

Thirty nine cases of borderline tuberculoid leprosy having nerve abscesses (15 with sinuses) were treated with daily dose of rifampicin and isoniazid for six months along with standard multidrug therapy. The patients were followed up for three to five years. No recurrence of abscess or sinus was observed. Observations indicate that medical approach is required at times to supplement surgical intervention for management of these cases.

Topics: Abscess; Adult; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Isoniazid; Leprostatic Agents; Leprosy, Borderline; Leprosy, Tuberculoid; Male; Nervous System Diseases; Rifampin; Treatment Outcome

A 33-year-old woman with a history of right tuberculous pleuritis was successfully treated in December 1992 by administration of anti-tuberculous drugs, she demonstrated residual localized pleural thickening on chest computed tomography (CT) and gradually developed a subcutaneous mass in the right chest which became apparent in March 1993. In September, chest CT revealed a periocostal abscess in the right anterior chest wall close to the localized pleural thickening. The patient was diagnosed with tuberculous abscess in the right chest wall on confirmation of acid-fast bacilli in a needle aspiration material of the abscess, and was referred to our hospital. Anti-tuberculous chemotherapy was continued but the chest abscess grew, so on January 28, 1994 she underwent a resection of the abscess, the third costal cartilage and bone, and the parietal pleural lesion connected to the abscess. Histopathological examination showed that the abscess and parietal pleural lesion were compatible with tuberculosis, i.e. both lesions consisted of caseous necrosis and epitheloid cell granuloma, but acid-fast bacilli were not demonstrated in both lesions. After one year of postoperative anti-tuberculous chemotherapy, she was followed without any therapy for 3 years and there has been no recurrence to date. When a localized thickening pleural lesion remains after tuberculous pleuritis, complication of tuberculous abscess in the chest wall should be considered.

Topics: Abscess; Adult; Antitubercular Agents; Female; Humans; Isoniazid; Rifampin; Thoracic Diseases; Tuberculosis; Tuberculosis, Pleural

The authors report a case of tuberculosis of the breast in a patient aged 71. The case described is an example of a rare form of extra pulmonary tuberculosis whose diagnosis can pose problems. In view of the recent increase in the incidence of tuberculosis in certain developed countries and the growth in the proportion of cases of extra pulmonary tuberculosis especially in HIV sero-positive individuals an observation such as this is useful in that it recalls for clinicians the fact that tuberculosis may present in very unusual forms which are easily forgotten.

Topics: Abscess; Aged; Antibiotics, Antitubercular; Antitubercular Agents; Breast Diseases; Female; Follow-Up Studies; Humans; Isoniazid; Mammography; Prognosis; Radiography, Thoracic; Rifampin; Time Factors; Tomography, X-Ray Computed; Tuberculosis

A study conducted in 74 TT/TB patients, with gross thickening of nerves together with nerve abscess, showed calcification in 8 patients. Calcification was most common in the ulnar nerve followed by the lateral popliteal nerve. All eight patients were males with significantly longer duration of illness before start of treatment. Patients with late onset of nerve abscess were found to be more prone to calcium deposition in the nerves. Caseous pus of the abscess had high lipid content with raised cholesterol and cholesterol ester ratio to total lipids suggesting a dystrophic nature of calcification.

Topics: Abscess; Adolescent; Adult; Aged; Calcinosis; Child; Cholesterol; Cholesterol Esters; Dapsone; Female; Follow-Up Studies; Humans; Leprostatic Agents; Leprosy, Tuberculoid; Lipids; Male; Middle Aged; Peripheral Nervous System Diseases; Rifampin; Suppuration; Ulnar Nerve

Topics: Abscess; Anti-Bacterial Agents; Antibiotics, Antitubercular; Child, Preschool; Clarithromycin; Combined Modality Therapy; Drainage; Drug Therapy, Combination; Face; Female; Humans; Microbial Sensitivity Tests; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Rifampin; Soft Tissue Infections; Tuberculin Test

Splenic tuberculosis is a rare entity. The case of an 18-year old patient admitted for fever and general malice is described. Echography and abdominal CT showed a hypodense image localized in the spleen. Splenic tuberculosis was diagnosed upon observation of alcohol acid resistant bacilli (AARB) in the biopsy obtained by punction of the abscess. Correct tuberculostatic treatment led to disappearance of the splenic abscess with no further therapeutic measures being required.

Topics: Abscess; Adolescent; Ethambutol; Female; Humans; Isoniazid; Rifampin; Time Factors; Tomography, X-Ray Computed; Tuberculosis, Splenic

Topics: Abscess; Cyclosporine; Cytochrome P-450 Enzyme System; Drug Interactions; Heart Transplantation; Humans; Mediastinal Diseases; Middle Aged; Rifampin; Staphylococcal Infections

Primary tuberculosis of the chest wall is rare and its clinical presentation may resemble pyogenic abscess or tumour. The diagnosis is difficult, since smears or cultures of aspirate frequently fail to show tubercle bacilli. Seven cases of primary chest-wall tuberculosis treated between 1973 and 1992 are described. All presented with a progressively enlarging mass. The diagnosis was based on bacteriologic and histologic findings, but definitive diagnosis was obtained before treatment in only two cases. Satisfactory results were obtained with surgical debridement and specific chemotherapy in six cases and with chemotherapy alone in one case. From this limited experience, we suggest that primary chest-wall tuberculosis should initially be treated with a combination regimen of antituberculous chemotherapy, which should take more than 9 months. If the lesion progressively enlarges or secondary infection occurs, however, adequate surgical debridement is also required.

Topics: Abscess; Adult; Antibiotics, Antitubercular; Antitubercular Agents; Combined Modality Therapy; Debridement; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Male; Middle Aged; Pyrazinamide; Retrospective Studies; Rifampin; Suppuration; Thoracic Diseases; Thoracic Neoplasms; Treatment Outcome; Tuberculosis

A patient with indolent, non-Hodgkin's lymphoma developed a pretibial soft tissue abscess caused by a fastidious mycobacterium. Because the organism could not be definitively identified by standard microbiologic testing, whole cell fatty acid analysis and 16S rDNA sequencing were performed. These procedures identified the organism as Mycobacterium haemophilum. We review the diagnostic considerations with regard to this pathogen.

Topics: Abscess; Aged; Ciprofloxacin; DNA, Bacterial; DNA, Ribosomal; Drug Therapy, Combination; Fatty Acids; Humans; Lymphoma, Non-Hodgkin; Male; Mycobacterium haemophilum; Mycobacterium Infections; Rifampin

We are currently witnessing a worldwide return of tuberculosis. An extremely rare form is tuberculosis of the spine which is reported above all in extra-European studies. The authors report a case of Pott's disease in a child aged 3 years and 3 months who was referred to their attention due to the appearance of left inguinal swelling, fever and anemia. Diagnostic tests (ETG, CT, MR) showed an abscess involving the L5-S1 intersomatic space, the intervertebral disc and osteolytic lesions of S1, with impairment of the left psoas muscle and diffusion as far as the inguinal region. Chemotherapy was commenced using isoniazid, ethambutol, rifampicin, and streptomycin and lasted 24 months associated with drainage of the ileopsoas abscess. Conservative orthopedic treatment lasting for one year initially took the form of decubitus in bed with hyperdistension of the vertebral column, followed by the creation of a plaster-cast cot on the back and lastly a glass-reinforced resin orthopedic jacket. The follow-up of 2 years and 10 months showed recovery with reconstruction of the vertebral elements and the preservation of intervertebral space.

Topics: Abscess; Child, Preschool; Humans; Isoniazid; Magnetic Resonance Imaging; Male; Mycobacterium tuberculosis; Rifampin; Spinal Cord; Streptomycin; Tomography, X-Ray Computed; Tuberculosis, Spinal

The AA. present a report about a patient having a cold tuberculous abscess which symptomatologic manifested through dysphagia and cervico-brachialgia. Comments on the most remarkable aspects of these conditions.

Topics: Abscess; Brachial Plexus Neuritis; Deglutition Disorders; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Neck; Rifampin; Tuberculosis

A rabbit perforated-capsule model was utilized to study antimicrobial efficacy in treating 2-week-old Staphylococcus aureus abscesses. Animals received either ciprofloxacin (30 mg/kg), cefazolin (100 mg/kg), or ciprofloxacin (30 mg/kg) plus rifampin (20 mg/kg) every 8 h for 8 days or no antibiotic. Antibiotic levels within the abscess exceeded the MIC for the test organism. At the end of treatment, ciprofloxacin was no more effective than the control, animals receiving cefazolin had a mean log10 fall of 2.41 CFU/ml, and animals receiving ciprofloxacin plus rifampin had a mean log10 reduction of 5.06 CFU/ml (P = less than 0.01). Six days after completion of therapy, all abscesses in animals receiving ciprofloxacin plus rifampin were culture negative. Surviving organisms in animals receiving ciprofloxacin or rifampin did not develop resistance to the treatment antibiotics. In vitro time-kill curves performed with logarithmic- and stationary-phase organisms in broth, serum, and abscess fluid supernatants did not correlate with the in vivo results. Neutrophil killing studies of S. aureus pretreated with antibiotics revealed greater killing of organisms pretreated with ciprofloxacin plus rifampin than of those pretreated with cefazolin or ciprofloxacin alone. In conclusion, ciprofloxacin plus rifampin was effective therapy in this staphylococcal abscess model, compared with the moderate efficacy of cefazolin and no effect observed with ciprofloxacin alone. Enhanced neutrophil killing of S. aureus pretreated with antibiotics may be an important mechanism by which bacteria are killed in suppurative infections.

Topics: Abscess; Animals; Cefazolin; Ciprofloxacin; Humans; In Vitro Techniques; Microbial Sensitivity Tests; Neutrophils; Rabbits; Rifampin; Staphylococcal Infections; Staphylococcus

A 25-year-old male patient was diagnosed as a case of borderline lepromatous (BL) type of leprosy in erythema nodosum leprosum type reaction. He was put on multidrug treatment. He took regular treatment. Approximately a year after the beginning of the treatment he developed multiple cold abscesses and later tuberculosis of the left hip joint. He was given antitubercular treatment with 4 drugs and the abscesses were treated surgically. He showed good response. This unusual case and the role of intermittent rifampicin is discussed.

Topics: Abscess; Adult; Clofazimine; Dapsone; Drug Therapy, Combination; Ethambutol; Hip Joint; Humans; Isoniazid; Leprosy, Borderline; Leprosy, Lepromatous; Male; Rifampin; Tuberculosis, Osteoarticular

Topics: Abscess; Adrenal Gland Diseases; Amphotericin B; Aspergillosis; Aspergillus fumigatus; Diagnosis, Differential; Drainage; Drug Therapy, Combination; Humans; Ketoconazole; Male; Middle Aged; Opportunistic Infections; Rifampin; Sarcoidosis

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.

Topics: Abscess; Adult; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Corneal Diseases; Female; Humans; Keratitis; Male; Middle Aged; Rifampin; Tetracycline

A case of psoas abscess occurring during treatment of tuberculous lymphadenopathy is described. There was no evidence of a bony origin for this abscess. It appears likely that it arose from involved glands on the posterior abdominal wall.

Topics: Abscess; Adult; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Male; Muscular Diseases; Retroperitoneal Space; Rifampin; Time Factors; Tuberculosis, Lymph Node

A 32-year-old man with systemic lupus erythematosus controlled by steroid therapy developed multifocal cutaneous abscesses caused by Mycobacterium scrofulaceum. The distribution and evolution of the lesions suggested hematogenous dissemination, but he exhibited no pulmonary or other visceral manifestations of systemic mycobacterial disease. The patient completed nine months of therapy with isoniazid and rifampin, and the lesions resolved within five months of presentation.

Topics: Abscess; Adult; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Isoniazid; Lupus Erythematosus, Systemic; Male; Mycobacterium avium; Rifampin; Tuberculosis, Cutaneous

Experimental intraabdominal abscesses were produced in mice by intraperitoneal injection of Bacteroides fragilis and Pseudomonas aeruginosa. The therapeutic efficacy of rifampicin and cefsulodin alone, and in combination was investigated in this in-vivo experimental mixed intraabdominal abscess model. Treatment with rifampicin at 10, and 25 mg/kg or cefsulodin at 50, and 100 mg/kg singly or in combinations prevented mortality as compared to 68% mortality rate occurring in the untreated mice. Rifampicin, at 25 mg/kg dose, was very effective in preventing abscess formation and produced bacterial eradication. It prevented abscess formation in 80% of the mice and eradicated both Bacteroides and Pseudomonas in 100% and 75% of the abscesses of the mice. Cefsulodin failed to reduce the incidence of abscess formation, and to eradicate Bact. fragilis from the abscesses, although it significantly decreased Ps. aeruginosa in the abscesses. The combination of rifampicin at 10 mg/kg and cefsulodin at 100 mg/kg was more effective than either of the antibiotics alone and was as effective as rifampicin alone at 25 mg/kg levels. This combination was bactericidal against both organisms in the infected mice.

Topics: Abscess; Animals; Bacteroides fragilis; Bacteroides Infections; Cefsulodin; Dose-Response Relationship, Drug; Drug Therapy, Combination; Female; Mice; Peritoneal Diseases; Pseudomonas aeruginosa; Pseudomonas Infections; Rifampin

Most of the successful non-surgical management of abdominal abscesses is based upon the presence of therapeutic amounts of effective antibiotics within the collection. However few data are currently available concerning antimicrobial levels in human purulent lesions. To study the relationship between serum and pus concentrations of rifampicin, 11 patients with deep-seated abscesses were given 900 mg intravenously of rifampicin daily; after 3, 8 and 20 h from injection, an ultrasound-guided percutaneous aspiration of the collection was performed. Samples were obtained on the first day of therapy in six cases, while in other six the aspiration took place on the third day. Rifampicin levels of therapeutic value were present after 8 h from the first injection. From this time antibiotic amounts in pus, ranging from 1.6 to 5.8 mg/l, were consistent with a long persistence of rifampicin in abscesses, without any evidence of accumulation.

Topics: Abscess; Humans; Infusions, Parenteral; Kinetics; Liver Abscess; Rifampin; Saliva; Suppuration

The efficacy of rifampicin in treating a Bacteroides fragilis infection was investigated and compared to clindamycin and metronidazole in an experimental model of intra-abdominal abscess in mice. Rifampicin, when given subcutaneously, showed activity superior to that of clindamycin in reducing the incidence of abscess formation as well as the number of Bacteroides organisms recovered from the abscess, and rifampicin was comparable in efficacy to metronidazole when given orally at the same dose level. The comparative pharmacokinetic properties of rifampicin and clindamycin demonstrated that the peak serum and abscess levels reached with rifampicin were significantly higher than those of clindamycin. The half-life of rifampicin in serum and in the abscess was longer than that of clindamycin.

Topics: Abscess; Administration, Oral; Animals; Bacteroides fragilis; Bacteroides Infections; Clindamycin; Female; Injections, Subcutaneous; Kinetics; Metronidazole; Mice; Mice, Inbred Strains; Peritoneal Diseases; Rifampin

A thrush-like oral infection with subsequent alveolar abscess formation and a positive blood culture due to Trichosporon capitatum developed in a patient with acute myelogenous leukaemia. Later T. capitatum was identified by indirect immunofluorescence in multiple splenic abscesses. The infection was controlled by immediate aggressive treatment with amphotericin B, flucytosine and rifampicin and by splenectomy. This case of systemic T. capitatum infection resembles somewhat the invasive mycosis due to candida.

Topics: Abscess; Adult; Amphotericin B; Blood; Female; Flucytosine; Humans; Leukemia, Myeloid, Acute; Mitosporic Fungi; Mycoses; Rifampin; Splenic Diseases

The efficacy of modern drugs in the treatment of tuberculosis of the spine has been evaluated by a personal follow-up for three to ten years. Operation on the vertebral lesion was done only for those patients with or without neural complications who failed to respond favourably to drug therapy and rest. Thus absolute indications for operation were present in only 6 per cent of cases without neural involvement and in 60 per cent of patients with neural deficit. Of patients who responded to drug therapy alone, only 19 per cent revealed increase of kyphosis by more than 10 degrees. The diseased area showed radiological evidence of osseous replacement of 29-6 per cent of cases, of fibro-osseous union in 50 per cent and of fibrous replacement in 20-2 per cent. The overall results of this regime compare favourably with those of radical operation. It is suggested that treatment should in the first place be by modern antitubercular drugs.

Topics: Abscess; Aminosalicylic Acids; Antitubercular Agents; Convalescence; Debridement; Drug Therapy, Combination; Ethambutol; Follow-Up Studies; Humans; Isoniazid; Postoperative Care; Recurrence; Rest; Rifampin; Spinal Cord Compression; Spinal Fusion; Streptomycin; Thioacetazone; Tuberculosis, Spinal

Topics: Abscess; Ethambutol; Humans; Intervertebral Disc; Isoniazid; Paraplegia; Rifampin; Spinal Fusion; Tuberculosis, Spinal

Topics: Abscess; Adult; Diagnosis, Differential; Ethambutol; Fluorescent Antibody Technique; Histoplasma; Histoplasmosis; Humans; Isoniazid; Male; Rifampin; Skin Tests; Thorax; Tuberculosis

Topics: Abscess; Animals; Leukocytes; Mice; Microbial Sensitivity Tests; Phagocytosis; Rifampin; Staphylococcal Infections; Staphylococcus

Topics: Abscess; Administration, Oral; Adult; Diffusion; Exudates and Transudates; Female; Humans; Injections; Male; Middle Aged; Rifampin; Time Factors; Tuberculosis, Osteoarticular

Topics: Abscess; Adult; Aged; Female; Humans; Male; Middle Aged; Respiratory Tract Infections; Rifampin; Tonsillitis; Tuberculosis; Urinary Tract Infections

Topics: Abscess; Bronchopneumonia; Empyema; Enteritis; Humans; Pharyngitis; Pneumonia; Respiratory Tract Infections; Rhinitis; Rifampin; Skin Diseases

Topics: Abscess; Adult; Aged; Arm; Buttocks; Cellulitis; Cheek; Female; Focal Infection, Dental; Foot Diseases; Furunculosis; Hand; Humans; Male; Middle Aged; Osteitis; Piperazines; Rifampin