ro13-9904 and Diabetes-Mellitus--Type-2

We describe an unusual case of a 58-year-old man with type 2 diabetes mellitus (T2DM) developing sepsis secondary to a prevertebral neck abscess. Following cross-sectional imaging, the patient underwent surgical drainage.

Topics: Abscess; Ceftriaxone; Ciprofloxacin; Diabetes Mellitus, Type 2; Drainage; Humans; Male; Metronidazole; Middle Aged; Neck; Salmonella enterica; Salmonella Infections; Sepsis; Treatment Outcome

Bilateral emphysematous pyelonephritis is a life threatening condition usually occurring in diabetics. Management of this condition has traditionally been aggressive and surgery is considered mandatory. However, this is itself a hazardous intervention in a septic, unstable patient with circulatory or liver failure. When bilateral disease is present, the need for long-term dialysis is obviously unavoidable.. We herein report one of the few cases of bilateral emphysematous pyelonephritis successfully managed by non-surgical treatment.

Topics: Adult; Amikacin; Cardiotonic Agents; Ceftriaxone; Diabetes Mellitus, Type 2; Dopamine; Emphysema; Female; Fluid Therapy; Humans; Hypoglycemic Agents; Insulin; Pyelonephritis; Radiography; Treatment Outcome

A 65-year-old diabetic (requiring insulin during the last year) was admitted as an emergency because of a septic temperature rising to 40 degrees C with rigor, tachycardia (up to 120/min) and dyspnoea. On examination there was local reddening and swelling of the skin over the right thenar eminence and along the lower arm. Two days before admission a bad scratch had been inflicted on his right hand by a cat. He had first noticed the reddening and swelling 10 hours after the incident; 1 1/2 days after the scratch and 9-10 hours before hospitalization the first bouts of fever had occurred.. The chest radiogram showed interstitial pneumonia. The clinical findings, the laboratory tests (white cell count 21 750/microliters, platelets 140,000/microliters, C-reactive protein 35 mg/l and positive blood cultures pointed to early septicaemia. The germ was identified as Pasteurella multocida two days after blood had been taken for culturing. HbA1c was 11.38%.. From the time of hospitalization the patient had been treated with ceftriaxon, 2 g daily intravenously, and also with erythromycin because atypical pneumonia had been the suspected diagnosis at first and acute chlamydia infection had at first not been excluded. The patient's general condition quickly improved and the fever started to go down a few hours after onset of treatment. Blood cultures became negative after the first administration of antibiotics. He was discharged in a good state on optimal insulin dosage.. Pasteurella multocida is present in a high percentage of domestic animals and can be the cause of systemic infections in immunocompromised patients (e. g. poorly controlled diabetes mellitus).

Topics: Aged; Animals; Bites and Stings; Cats; Ceftriaxone; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Emergencies; Erythromycin; Humans; Lung Diseases, Interstitial; Male; Pasteurella Infections; Pasteurella multocida; Pneumonia, Bacterial; Sepsis

The risk of wound contamination in diabetic patients after abdominal operations is well known. Preincisional intraparietal injection of antibiotics is used for the prophylaxis of postoperative surgical infections. Whether topically injected antibiotics remain primarily in the surgical wound or are systematically absorbed is uncertain, however. The pharmacokinetics of a preincisional, intraparietal injection of 2 g ceftriaxone was studied in 50 consecutive diabetic (type I and II) patients undergoing abdominal surgery, with determination of serum, wound tissue, and wound fluid antibiotic concentrations. Preincisional intraparietal injection of ceftriaxone resulted in high antibiotic concentrations in the wound fluid. The highest plasma concentrations were achieved at 1.5 h (98.45 microg/ml, SD = 14.54). Plasma concentrations exceeded the minimal inhibitory concentrations of most aerobic gram positive and gram negative organisms with the exception of Pseudomonas aeruginosa, Acinetobacter species, and Streptococcus faecalis for 24 h (10.35 microg/ml, SD = 4.10). No long-lasting or general complications arose in any of the diabetic patients. Our results suggest that preincisional intraparietal administration of ceftriaxone for prophylaxis of wound sepsis in diabetic patients with high risk of infection is effective.

Topics: Abdomen; Adult; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Ceftriaxone; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Humans; Middle Aged; Preoperative Care; Prospective Studies; Surgical Wound Infection

Topics: Ceftriaxone; Diabetes Mellitus, Type 2; Female; Humans; Middle Aged; Pharmaceutical Preparations; Streptococcus; Thrombocytopenia

Topics: Abscess; Administration, Oral; Aged; Anti-Bacterial Agents; Ceftriaxone; Diabetes Mellitus, Type 2; Diagnosis, Differential; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Prostatic Diseases; Prostatic Hyperplasia; Tomography, X-Ray Computed

Currently, several studies propose that the dominant intestinal bacteria are core flora. Besides keeping the homeostasis of the intestinal environment, the intestinal microflora also plays a role in body metabolism, production of some vitamins, and control of barrier function. The study aimed to investigate the jejunum microbiota in diabetic rats as well as it's the relationship with Ceftriaxone sodium-mediated gut dysbiosis, diabetic parameters, and intestinal permeability. Thirty-two Wistar rats (Male) were enrolled and divided into four groups (A, B, C, and D; N = 8). Subsequently, T2DM was induced in C and D groups by HFD/STZ model and then gut dysbiosis in B and D groups via intragastric administration of Ceftriaxone sodium for two weeks. The food-water intake, body weight, fasting blood glucose, plasma insulin, HOMA-IR, intestinal permeability, and jejunum microbiota and it's histology were investigated. In this study, T2DM was associated with a significant decrease in the richness and diversity of jejunum microbiota, elevation in the intestinal permeability, and higher abundance of some opportunistic pathogens. Ceftriaxone sodium-induced gut dysbiosis declined food-water intake, damagedthe villi of jejunum tissue, increased intestinal permeability, and affected the diversity of jejunum microbiota. In diabetic rats, Ceftriaxone sodium-mediated gut dysbiosis also declined the abundance of someSCFAs bacteria and raised the abundant of some opportunistic bacteria such as Staphylococcus_sciuri. Interestingly, we found that several bacteria were negatively correlated with HOMA-IR, fasting blood glucose, body weight, and intestinal permeability. Overall, the study highlighted the jejunum microflora alterations in HFD/STZ diabetic rats and assessed the effect of Ceftriaxone sodium-induced gut dysbiosis on diabetic parameters, jejunum microbiota and histology, and intestinal permeability, which are of potential for further studies.

Topics: Animals; Anti-Bacterial Agents; Bacteria; Ceftriaxone; Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 2; Diet, High-Fat; Dysbiosis; Gastrointestinal Microbiome; Intestinal Absorption; Jejunum; Male; Permeability; Rats, Wistar; Streptozocin

The worldwide incidence of coronavirus disease 2019 (COVID-19) infection is rapidly increasing, but there exists limited information on coronavirus disease 2019 in pregnancy. Here, we present our experience with 7 confirmed cases of coronavirus disease 2019 in pregnancy presenting to a single large New York City tertiary care hospital. Of the 7 patients, 5 presented with symptoms of coronavirus disease 2019, including cough, myalgias, fevers, chest pain, and headache. Of the 7 patients, 4 were admitted to the hospital, including 2 who required supportive care with intravenous hydration. Of note, the other 2 admitted patients who were asymptomatic on admission to the hospital, presenting instead for obstetrically indicated labor inductions, became symptomatic after delivery, each requiring intensive care unit admission.

Topics: Acute Kidney Injury; Adult; Anesthesia, General; Anti-Bacterial Agents; Antihypertensive Agents; Azithromycin; Bronchial Spasm; Carrier State; Ceftriaxone; Cesarean Section; COVID-19; Diabetes Mellitus, Type 2; Enzyme Inhibitors; Female; Fever; Health Personnel; Hospitalization; Humans; Hydroxychloroquine; Hypertension; Intensive Care Units; Intubation, Intratracheal; Labor, Induced; New York City; Nicardipine; Occupational Exposure; Oxygen Inhalation Therapy; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Complications, Infectious; Pregnancy in Diabetics; Respiration, Artificial; SARS-CoV-2; Uterine Inertia

Topics: Aged; Anti-Bacterial Agents; Anticonvulsants; Ceftriaxone; Diabetes Mellitus, Type 2; Electroencephalography; Female; Humans; Levetiracetam; Meningitis, Bacterial; Seizures; Streptococcal Infections; Streptococcus agalactiae

Panspinal epidural abscesses are an extremely rare yet potentially fatal condition. Whether cases are best managed surgically or medically is currently controversial. A 63-year-old patient with diabetes presented initially with abdominal pain, back pain, urinary retention and constipation. He subsequently developed fevers, radicular pain and new-onset weakness in the right leg. MRI confirmed a panspinal epidural abscess extending from C7 to L5, with group B

Topics: Anti-Bacterial Agents; Ceftriaxone; Diabetes Mellitus, Type 2; Epidural Abscess; Gram-Positive Bacterial Infections; Humans; Linezolid; Magnetic Resonance Imaging; Male; Middle Aged; Treatment Outcome

Topics: Adult; Animals; Anti-Bacterial Agents; Bays; Brachyura; Ceftriaxone; Diabetes Mellitus, Type 2; Doxycycline; Drug Therapy, Combination; Hepatitis B; Humans; Male; Mid-Atlantic Region; Middle Aged; Occupational Exposure; Recreation; Restaurants; Shellfish; Tigecycline; Vibrio Infections

To compare 3 prophylactic regimens to assess their impact on postbiopsy sepsis incidence.. Data were reviewed for 829 consecutive patients who underwent prostate biopsy in a community practice setting between January 2013 and October 2017. Group 1 patients received ciprofloxacin 500 mg two times a day orally for 4 days starting the day prior to biopsy and gentamicin 80 mg intramuscularly 20 minutes prior to biopsy. From April 2015 to October 2017, 2 groups of patients were followed in parallel in a randomized manner. Group 2 received ciprofloxacin 500 mg two times a day orally for 4 days starting the day prior to biopsy and ceftriaxone 1 g intramuscularly 20 minutes prior to biopsy. Group 3 received the same antibiotic regimen as group 2 and also underwent isopropyl alcohol needle washing.. All study groups were demographically equivalent. Microscopic bacterial counts were substantially decreased after isopropyl alcohol needle washing. Incidence of postbiopsy sepsis in groups 1 (n = 313), 2 (n = 259), and 3 (n = 257) was 3.8%, 2%, and 0%, respectively (analysis of variance; P = .006). Risk factors for sepsis included elevated body mass index, Charlson Comorbidity Score, and presence of type 2 diabetes mellitus.. There was a significant reduction in the incidence of sepsis after prostate biopsy using a combination of a ciprofloxacin-ceftriaxone antibiotic regimen and isopropyl alcohol needle washing. The technique for needle washing is inexpensive and quick, and can be easily adopted into current biopsy protocols.

Topics: 2-Propanol; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Biopsy; Body Mass Index; Ceftriaxone; Ciprofloxacin; Comorbidity; Diabetes Mellitus, Type 2; Disinfection; Drug Therapy, Combination; Gentamicins; Humans; Incidence; Male; Middle Aged; Needles; Prostate; Random Allocation; Risk Factors; Sepsis

Topics: Anti-Bacterial Agents; Ceftriaxone; Diabetes Mellitus, Type 2; Humans; Leptospirosis; Magnetic Resonance Imaging; Male; Middle Aged; Myocarditis; Pancreatitis

Topics: Adenocarcinoma; Adrenal Cortex Hormones; Aged; Anti-Bacterial Agents; Antineoplastic Agents; Arthritis, Infectious; Arthritis, Rheumatoid; Ceftriaxone; Colonic Neoplasms; Diabetes Mellitus, Type 2; Female; Gram-Negative Bacterial Infections; Hip Joint; Humans; Immunocompromised Host; Immunosuppressive Agents; Paracoccus; Ribotyping; RNA, Bacterial; RNA, Ribosomal, 16S; Synovial Fluid

Topics: Aged; Anti-Bacterial Agents; Arthroplasty, Replacement, Knee; Bacteremia; Ceftriaxone; Cross Infection; Diabetes Mellitus, Type 2; Endocarditis, Bacterial; Female; Gentamicins; Humans; Klebsiella Infections; Klebsiella pneumoniae; Mitral Valve; Prosthesis-Related Infections; Ultrasonography

Topics: Aged; Anti-Bacterial Agents; Bile Duct Diseases; Ceftriaxone; Cholangiopancreatography, Magnetic Resonance; Diabetes Mellitus, Type 2; Diagnosis, Differential; Escherichia coli Infections; Hamartoma; Humans; Magnetic Resonance Imaging; Male; Tomography, X-Ray Computed; Ultrasonography

Topics: Adrenal Cortex Hormones; Adrenergic Agonists; Anaphylaxis; Anti-Bacterial Agents; Atropine; Bronchodilator Agents; Ceftriaxone; Diabetes Mellitus, Type 2; Epinephrine; Fatal Outcome; Humans; Intubation, Intratracheal; Male; Malpractice; Middle Aged; Multiple Trauma; Obesity; Skin Tests

Transrectal biopsy of the prostate (TBP) is the most accurate method of diagnosing prostate cancer. Although debate remains, prophylactic antibiotic therapy is most frequently used to prevent infectious complications after TBP. Here, we present a case of Escherichia coli meningitis after TBP despite quinolone prophylaxis.

Topics: Acute Disease; Aged; Antibiotic Prophylaxis; Biopsy, Needle; Ceftriaxone; Ciprofloxacin; Diabetes Mellitus, Type 2; Disease Susceptibility; Drug Resistance, Bacterial; Escherichia coli; Humans; Male; Meningitis, Escherichia coli; Prostate; Rectum; Urinary Tract Infections

Renal abscesses in patients with end stage renal disease are quite rare, and misdiagnosis or delaying in diagnosis is frequent. This report examines a case of renal abscess in a patient with end stage renal disease on maintenance hemodialysis and diabetes mellitus, which presented with a prolonged fever. An infected diabetic foot was impressed initially. Purulent urine, pyuria, bacteriuria, and bacteremia were noted after admission. Renal abscess was diagnosed by percutaneous needle aspiration under computerized tomography guidance. The patient was treated with parenteral antibiotics and percutaneous aspiration of the abscess. Follow-up ultrasonography showed renal abscess resolution. This case demonstrated that nephrectomy was not required in selected uremic patients with renal abscess.

Topics: Abscess; Aged; Anti-Bacterial Agents; Biopsy, Fine-Needle; Ceftriaxone; Diabetes Mellitus, Type 2; Drainage; Female; Gentamicins; Humans; Kidney; Kidney Failure, Chronic; Renal Dialysis; Staphylococcal Infections; Tomography, X-Ray Computed

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents; Ceftriaxone; Central Nervous System Bacterial Infections; Cephalosporins; Ciprofloxacin; Diabetes Mellitus, Type 2; Gentamicins; Humans; Male; Middle Aged; Salmonella enteritidis; Salmonella Infections; Salmonella typhimurium

We present a case of endocarditis caused by Salmonella in a patient with newly diagnosed diabetes and preexisting rheumatic heart disease. Despite sterilization of the blood with a fluoroquinolone and a third-generation cephalosporin, the patient required surgical intervention.

Topics: Aged; Anti-Infective Agents; Cardiac Catheterization; Ceftriaxone; Cephalosporins; Combined Modality Therapy; Diabetes Mellitus, Type 2; Drug Therapy, Combination; Echocardiography, Transesophageal; Endocarditis, Bacterial; Fatal Outcome; Fever; Headache; Heart Valve Prosthesis Implantation; Humans; Male; Nausea; Ofloxacin; Rheumatic Heart Disease; Salmonella Infections; Vomiting

The objectives of this pilot study were to identify the bacterial flora of neurotrophic ulcers, and to determine whether treatment with ceftriaxone improves the clinical picture. Twenty-five patients (15 male, 10 female, mean age 70 +/- 11 years) with mal perforant were treated with 2 g ceftriaxone once daily until the ulcer was healed, or for a period of 6 weeks. Biopsies were taken from the ulcer floor before and after therapy. Initially, the following bacteria were found, in order of frequency: Staphylococcus aureus, enterobacteria, coagulase-negative staphylococci, enterococci and streptococci as well as Pseudomonas aeruginosa. Under therapy with ceftriaxone, the lesions of 11 patients were healed; in 5 patients improvement > 50% was observed and in 4 patients improvement was < 50%. In 3 patients there was no change in the condition. Two patients had to stop treatment due to diarrhea. Asepsis was achieved in 5 patients despite persistence of the ulcer. The control group (25 patients without antibiotic therapy) showed the following results: healing in 6, improvement > 50% in 5, improvement < 50% in 10, and no change in 4. The results for the treatment group have to be compared with a historical control group since, for ethical reasons, the implementation of a double-blind study would not be feasible.

Topics: Aged; Aged, 80 and over; Bacteria; Ceftriaxone; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Female; Foot Ulcer; Humans; Male; Pilot Projects