rifampin and Rupture--Spontaneous

One of the most dreaded complications after cochlear implantation is infection. These infections are a challenge due to lack of any data regarding optimal methods of investigation and management. More often than not, these patients have to undergo explantation and revision surgery. This paper presents a case report and literature review which focuses on the role of antibiotics and the need for early explantation in most biofilm-related infections of cochlear implants.

Topics: Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Biofilms; Child, Preschool; Cochlear Implants; Device Removal; Humans; Infusions, Intravenous; Male; Prosthesis-Related Infections; Recurrence; Reoperation; Rifampin; Rupture, Spontaneous; Staphylococcal Infections; Surgical Flaps; Tomography, X-Ray Computed

Appendicitis is a common cause of acute abdominal pain in children and is treated by an open or laparoscopic appendicectomy. Well documented post-operative complications include wound infection, intra-abdominal collection, and adhesional bowel obstruction. We present the rare case of right sacro-iliitis and iliac bone osteomyelitis in a 13 year old boy following an open appendicectomy for a perforated appendicitis.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Appendectomy; Appendicitis; Ascitic Fluid; Ciprofloxacin; Clindamycin; Gram-Negative Bacteria; Humans; Laparotomy; Magnetic Resonance Imaging; Male; Metronidazole; Osteomyelitis; Rifampin; Rupture, Spontaneous; Sacroiliitis

Tuberculous aortitis is a rare entity and its association with necrosis and perforation is even more unusual. Our pulmonary medicine service originally evaluated an elderly woman with a right pleural effusion and upper lobe infiltrate thought to be tuberculosis. An abdominal CT scan performed at that time showed extensive periaortic adenopathy. Isoniazid and rifampin were started, but both were stopped by the patient after less than 6 months of therapy. The patient later had night sweats, a left pleural effusion, and a tender abdominal mass thought to be a symptomatic aneurysm. At operation, the aorta was necrotic and had an inflammatory mass and perforation on the left side. Infrarenal aortic ligation and resection were performed to control infection. A previously placed axillofemoral graft obviated the need for concomitant revascularization. The patient was treated postoperatively with isoniazid and rifampin until hyperbilirubinemia developed, which necessitated alternate therapy with ethambutol and streptomycin. The patient died one month after operation of a presumed pulmonary embolus.

Topics: Aged; Aortitis; Combined Modality Therapy; Female; Humans; Isoniazid; Necrosis; Rifampin; Rupture, Spontaneous; Tuberculosis, Cardiovascular