ro13-9904 and Chest-Pain

A 35-year-old man was hospitalized with fever, chest pain, and cough of 2 weeks' duration. These symptoms persisted despite 4 days of antibiotic treatment with IV ceftriaxone sodium 2 g/d. The patient was a nonsmoker with an unremarkable medical history who worked as a herdsman and lived in the Shigate region of Tibet, China.

Topics: Adult; Anti-Bacterial Agents; Ceftriaxone; Chest Pain; Cough; Diagnosis, Differential; Fever; Humans; Male

Isolated pulmonary valve endocarditis (PVE) is a rare condition. Known risk factors in previous case reports were intravenous drug abuse and congenital heart disease. Epidemiology of PVE has been changing. It is now being reported specially following invasive healthcare-related procedures even in patients with structurally normal heart. Vast majority of patients present with respiratory symptoms and diagnosis of endocarditis may be challenging unless there is high index of suspicion. Various microorganisms had been isolated as aetiological agents; however,

Topics: Anti-Bacterial Agents; C-Reactive Protein; Ceftriaxone; Chest Pain; Echocardiography; Endocarditis, Bacterial; Enterococcus faecalis; Fever of Unknown Origin; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Pulmonary Valve

We report the case of a 17-year-old adolescent girl with systemic lupus erythematosus with disseminated pneumococcal infection leading to purulent pericarditis with cardiac tamponade. Although pericarditis is not an uncommon entity in autoimmune diseases such as systemic lupus erythematosus, purulent pericarditis is a rare cause (<1%) of this presentation.

Topics: Acute Pain; Administration, Intravenous; Adolescent; Anti-Bacterial Agents; Cardiac Tamponade; Ceftriaxone; Chest Pain; Echocardiography; Electrocardiography; Female; Humans; Lupus Erythematosus, Systemic; Pericardiocentesis; Pericarditis; Pneumococcal Infections; Streptococcus pneumoniae; Tomography, X-Ray Computed; Treatment Outcome

Spondylodiscitis, which is most commonly caused by Staphylococcus aureus, is an uncommon infection in adults. The diagnosis of spondylodiscitis is often delayed by its vague and non-specific presentations. As part of the normal flora in human mouth and sinuses, Streptococcus mitis is a very rare cause of spondylodiscitis. We report a case of thoracic spondylodiscitis caused by S. mitis in a patient with chronic sinusitis. The patient atypically presented with a sharp chest pain that radiated to the back and the imaging studies were initially negative. He failed outpatient pain management and the diagnosis of spondylodiscitis was confirmed by bone biopsy 6 weeks later. Treatment with antibiotics completely alleviated the pain. Increased awareness and a high index of suspicion are essential for early diagnosis of spondylodiscitis with an atypical presentation.

Topics: Anti-Bacterial Agents; Biopsy, Needle; Ceftriaxone; Chest Pain; Chronic Disease; Diagnosis, Differential; Discitis; Emergency Service, Hospital; Humans; Immunohistochemistry; Infusions, Intravenous; Magnetic Resonance Imaging; Male; Middle Aged; Pain Measurement; Severity of Illness Index; Sinusitis; Streptococcal Infections; Streptococcus mitis; Thoracic Vertebrae; Treatment Outcome; Vancomycin

Atrial flutter (AFL) is a common arrhythmia that is associated with postpericardiotomy and pericarditis. The relationship of AFL with tamponade has rarely been reported. A case of AFL with acute pericarditis and cardiac tamponade is thus presented here.

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Atrial Flutter; Cardiac Tamponade; Ceftriaxone; Chest Pain; Female; Humans; Pericarditis; Treatment Outcome; Vancomycin

This case report describes Nocardia pericarditis in a newly diagnosed human immunodeficiency virus (HIV) patient as an initial manifestation. Previously, two cases of Nocardia pericarditis were reported in patients with established HIV infection. To our knowledge this is the first case of Nocardia pericarditis as an initial manifestation of HIV infection. This case substantiates and emphasizes the importance of identifying Nocardia as an infectious cause of pericarditis in patients with acquired immunodeficiency. Long-term survival may be achieved with a combined medical and surgical approach.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Ceftriaxone; Cephalosporins; Chest Pain; Combined Modality Therapy; Cough; Drug Therapy, Combination; Dyspnea; Humans; Male; Minocycline; Nocardia asteroides; Nocardia Infections; Pericardial Effusion; Pericardial Window Techniques; Pericarditis