sultamicillin and Kidney-Failure--Chronic

P. multocida (Pasteurella multocida) is animal-sourced gram-negative coccobacillus which can be transmitted to human through many animals including household pets. P. multocida induced peritoneal dialysis-related peritonitis has rarely been reported. In recent years, there has been an increase in the incidence of P. multocida induced peritoneal dialysis-related peritonitis, for the reason that patients with PD at home bred household pets. In this study, we present a case of a P. multocida induced peritoneal dialysis-related peritonitis, which is suspected to be caused through intimate contact with a household cat and we have reviewed 28 cases reported before and give suggestions for treatment and the way of prevention.. A 75-year-old man with end-stage renal disease (ESRD) for nearly 5 years on continuous ambulatory peritoneal dialysis (CAPD) was admitted to the nephrology department with a 1-week history of abdominal pain and a cloudy peritoneal dialysis effluent. Based on the history, physical examination and laboratory results with the findings in the peritoneal dialysis fluid, a diagnosis of peritoneal dialysis-related peritonitis was confirmed. The final culture of initial peritoneal effluent results indicated the organism was P. multocida. After a 12-day antibiotic treatment, the condition of patient was not improved. The patient was switched to ampicillin/sulbactam (3 g intravenously) twice every day and the condition was improved significantly. On further inquiring, the patient reported that he had had a cat at home and when the patient did CAPD, the cat was usually playing with the tubing or contacting the patient during CAPD.. In our case and reviewed cases, P. multocida induced peritoneal dialysis-related peritonitis could be cured by proper antibiotic treatment. If individuals keep the pet away from the PD process, the infection route may be severed. P. multocida induced peritoneal dialysis-related peritonitis does not need catheter removal and exchange with hemodialysis except long-time intractable peritonitis.

Topics: Aged; Ampicillin; Animals; Anti-Bacterial Agents; Bacterial Zoonoses; Cats; Humans; Kidney Failure, Chronic; Male; Pasteurella Infections; Pasteurella multocida; Peritoneal Dialysis, Continuous Ambulatory; Peritonitis; Pets; Sulbactam

A 73-year old man was brought to our hospital because of acute onset of fever and consciousness disturbance. He had been hemodialyzed three times a week because of chronic renal failure since 13 years ago. Neurological examination revealed deteriorated consciousness and neck stiffness. A lumbar puncture yielded clouded fluid with a WBC 7,912/mm³ (polymorphonuclear cells 88%, mononuclear cells 12%), 786 mg/dl of protein and 4 mg/dl of glucose (blood glucose 118 mg/dl). Brain CT and MRI were unremarkable. He was treated with ceftriaxone and ampicillin. Streptococcus salivarius was isolated from the blood sample, but not from cerebrospinal fluid. The patient responded promptly to antibiotics therapy (ampicillin 3g/day, ceftriaxone 1g/day), and within several days he became lucid and afebrile. Isolated S. salivarius was sensitive for ampicillin and ceftriaxone. We diagnosed this case as S. salivarius bacteremia/meningoencephalitis. A gastrointestinal diagnostic workup revealed an asymptomatic gastric adenocarcinoma. S. salivarius is a common inhabitant of the oral mucosa that has been associated with infection in different sites. Meningeal infection by S. salivarius generally related to neoplasia of colon or iatrogenia, has been described on few occasions. This is the first report of S. salivarius bacteremia/meningoencephalitis associated with gastric neoplasm. Neurologist should be aware of the association of S. salivarius bacteremia/meningoencephalitis and gastrointestinal disease.

Topics: Aged; Ampicillin; Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Early Diagnosis; Gastroscopy; Humans; Kidney Failure, Chronic; Male; Meningoencephalitis; Renal Dialysis; Stomach Neoplasms; Streptococcal Infections; Sulbactam

Pasteurella multocida is a Gram-negative bacillus that is part of the normal oral flora of cats and dogs. Most infections involving P. multocida are soft tissue infections after animal bites or scratches. We present a case of P. multocida urinary tract infection in a 13-year-old boy with end-stage renal disease receiving peritoneal dialysis. He was successfully treated with intravenous ampicillin-sulbactam followed by oral amoxicillin-clavulanate. Thirteen additional cases of P. multocida urinary tract infection (12 adults and one pediatric patient) reported in the literature were reviewed. Underlying medical illnesses and structural urologic abnormalities are risk factors.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Humans; Kidney Failure, Chronic; Male; Pasteurella Infections; Pasteurella multocida; Peritoneal Dialysis; Risk Factors; Sulbactam; Urinary Tract Infections

A case of listeriosis in a patient undergoing long-term hemodialysis is reported. The 69-year-old man with chronic renal failure due to polycystic renal dysplasia had received hemodialysis treatment for 10 years. Renal anemia and iron overload developed within this time. In the course of a hemodialysis the patient presented with malaise, chills and fever to 38.7 degrees C. Blood culture specimens were obtained and the patient received ampicillin-sulbactam. Blood culture specimens subsequently showed growth of Listeria monocytogenes. During therapy the patient improved rapidly and was free from fever on day 5. The relation of iron overload and Listeria infection is discussed.

Topics: Aged; Ampicillin; Anemia; Anti-Bacterial Agents; Bacteremia; Humans; Iron Overload; Kidney Failure, Chronic; Listeriosis; Male; Opportunistic Infections; Polycystic Kidney Diseases; Renal Dialysis; Sulbactam

A case of beta-lactam antibiotic-induced pseudoporphyria is presented. A 24-year-old African American woman with systemic lupus erythematosus and end-stage renal disease on hemodialysis developed tense bullae on her forehead and cheeks after exposure to ampicillin-sulbactam and cefepime. Histologically, the lesions were similar to porphyria cutanea tarda, but without the associated porphyrin abnormalities. The lesions resolved spontaneously on cessation of the antibiotics.

Topics: Abdominal Abscess; Ampicillin; Anemia, Hemolytic, Autoimmune; Anti-Bacterial Agents; Biopsy; Fallopian Tube Diseases; Female; Forehead; Humans; Kidney Failure, Chronic; Leukocyte Count; Lupus Erythematosus, Systemic; Middle Aged; Ovarian Diseases; Pruritus; Renal Dialysis; Sickle Cell Trait; Skin; Skin Diseases, Vesiculobullous; Sulbactam; Thrombocytopenia