ro13-9904 and Actinobacillus-Infections

Aggregatibacter actinomycetemcomitans is considered a major pathogen in localized and generalized aggressive periodontitis. A. actinomycetemcomitans has been found in various extra oral infections and most frequently in endocarditis. We report a patient with multiple brain abscesses due to infection with A. actinomycetemcomitans and review the English language literature related to this subject.. A 42-year-old patient with no underlying medical conditions presented with multiple brain lesions initially thought to be metastatic lesions of a tumour of unknown origin. Findings during drainage and subsequent histopathological conclusions made infection more likely. Culture of drained material remained negative; however, 16S rDNA polymerase chain reaction and sequence analysis on direct material revealed A. actinomycetemcomitans as the causative agent of the infection. The most likely source of infection was the poor dentition of the patient. After repeated drainage of the lesions and antibiotic treatment the patient gradually improved, although cognitive impairment remained.. Our report illustrates that a poor dental condition, notably destructive periodontal disease, can be a risk for life-threatening extra oral disease, and thus contributes to the total inflammatory burden of the body.

Topics: Actinobacillus Infections; Adult; Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Anti-Infective Agents; Biopsy; Brain Abscess; Ceftriaxone; Dental Caries; Drainage; Focal Infection, Dental; Humans; Male; Metronidazole; Periodontal Diseases

Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis.. Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain.. Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement.. Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.

Topics: Actinobacillus Infections; Adult; Aged; Aggregatibacter actinomycetemcomitans; Alcoholism; Animals; Anti-Bacterial Agents; Antibodies, Bacterial; Aortic Valve; Bartonella henselae; Bartonella Infections; Blood; Cardiomyopathy, Hypertrophic; Cat-Scratch Disease; Cats; Ceftriaxone; Chlamydia; Ciprofloxacin; Combined Modality Therapy; Disease Susceptibility; Doxycycline; Endocarditis, Bacterial; Endocarditis, Subacute Bacterial; False Negative Reactions; Female; Gentamicins; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; Spain; Vancomycin

Endophthalmitis due to gram-negative bacilli has been associated with a high degree of vision loss. We report three cases due to the nonenteric gram-negative bacilli Moraxella nonliquefaciens, Haemophilus paraphrophilus, and multidrug-resistant Haemophilus influenzae. The features of these cases are compared with those of other reported cases of endophthalmitis due to unusual nonenteric gram-negative bacilli. Fifty-eight percent of patients had no vision in the affected eye after treatment. Early surgical intervention with vitrectomy and intravitreous antibiotics in addition to parenteral antibiotics should be included in the treatment of endophthalmitis due to gram-negative bacilli.

Topics: Actinobacillus Infections; Adult; Aged; Aggregatibacter actinomycetemcomitans; Ampicillin; Ceftriaxone; Endophthalmitis; Female; Gentamicins; Haemophilus Infections; Haemophilus influenzae; Humans; Male; Middle Aged; Moraxella; Neisseriaceae Infections; Postoperative Complications; Vitrectomy

Topics: Actinobacillus Infections; Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Aortic Valve; Ceftriaxone; Ciprofloxacin; Drug Therapy, Combination; Edema; Endocarditis, Subacute Bacterial; Fingers; Gentamicins; Hand Dermatoses; Heart Valve Prosthesis; Hemorrhage; Humans; Male; Middle Aged; Nail Diseases; Rheumatic Heart Disease; Ultrasonography

Cerebral hemorrhage occurs rarely in endocarditis caused by Actinobacillus actinomycetemcomitans. A 51-year-old man with a prosthetic mitral valve, who had been prophylactically treated (7 years) with warfarin, presented with intermittent fever. On admission, a Levine grade II/VI systolic cardiac murmur was detected. A transthoracic echocardiogram was negative for valve vegetation. Cefepime (1 g every 8 hours) was administered intravenously. On day 4, culturing of Gram-negative bacilli from blood and a transesophageal echocardiogram revealed a small oscillating filament attached to lateral mitral prosthetic ring on the atrial side. Ceftriaxone (2 g once daily) was started. Gait instability and left-side weakness developed abruptly 2 weeks later; brain magnetic resonance imaging revealed a hematoma over the right parietal-occipital lobe. Ceftriaxone was adjusted to 2 g every 12 hours. Actinobacillus actinomycetemcomitans was identified 3 weeks later. Recovery was achieved, with significant interval improvement and resolution of the cerebral lesions evident on CT.

Topics: Actinobacillus Infections; Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Anticoagulants; Ceftriaxone; Cerebral Hemorrhage; Endocarditis; Humans; Male; Middle Aged; Warfarin

Topics: Actinobacillus Infections; Adult; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Drug Therapy, Combination; Endocarditis, Bacterial; Follow-Up Studies; Haemophilus Infections; Haemophilus parainfluenzae; Humans; Male; Middle Aged; Pleural Effusion; Rifampin; Time Factors; Treatment Outcome

Actinobacillus actinomycetemcomitans is a microaerophilic, fastidious Gram-negative rod that most commonly causes periodontitis and odontogenic infections. We report the first case of an epidural abscess and osteomyelitis due to this organism resulting from self-extraction of carious teeth. The patient responded to surgical debridement and prolonged antimicrobial therapy with intravenous ceftriaxone.

Topics: Actinobacillus Infections; Aged; Aggregatibacter actinomycetemcomitans; Anti-Bacterial Agents; Ceftriaxone; Epidural Abscess; Humans; Male; Osteomyelitis

Topics: Actinobacillus Infections; Adult; Aggregatibacter actinomycetemcomitans; Anti-Infective Agents; Ceftriaxone; Cephalosporins; Ciprofloxacin; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Humans

Topics: Actinobacillus Infections; Adult; Aggregatibacter actinomycetemcomitans; Ceftriaxone; Cholelithiasis; Endocarditis, Bacterial; Female; Humans