Although there have been a few reported cases of Enterococcal endophthalmitis, this is an unusual case of endophthalmitis complicated with corneal ulcer caused by Enterococcus faecalis. A 67-year-old male patient with diabetes mellitus underwent secondary intraocular lens implantation. Post-operative recovery was uneventful until a wound rupture was noted 3 weeks after the operation. On day 12 after the repair of the wound, endophthalmitis accompanied by wound necrosis and a fullthickness corneal ulcer was detected. His vision was light perception, and Enterococcus faecalis was identified by culture in samples of conjunctival sac, anterior chamber and vitreous humor. After 3 rounds of intravitreal antibiotics injection, the vitreous opacity disappeared on ultrasonographic finding but corneal opacity and corneal neovascularization still remained.
Aged ; Anti-Bacterial Agents/administration & dosage ; Corneal Ulcer/diagnosis/drug therapy/*microbiology ; Endophthalmitis/diagnosis/drug therapy/*microbiology ; Enterococcus faecalis/drug effects/*isolation & purification ; *Eye Infections, Bacterial/diagnosis/drug therapy/microbiology ; Gram-Positive Bacterial Infections/diagnosis/drug therapy/*microbiology ; Humans ; Lens Implantation, Intraocular ; Male ; Microbial Sensitivity Tests ; Surgical Wound Infection/diagnosis/drug therapy/*microbiology ; Treatment Outcome

We report a case of spontaneous bacterial peritonitis from Ochrobactrum anthropi. O. anthropi is recognized as an emerging pathogen in immunocompromised patients. In contrast to most previously described cases, the patient reported here had no indwelling catheter. To our knowledge, no case of O. anthropi spontaneous bacterial peritonitis has been reported in the medical literature until now.
Treatment Outcome ; Rare Diseases/diagnosis/drug therapy/microbiology ; Peritonitis/*diagnosis/drug therapy/*microbiology ; Ochrobactrum anthropi/drug effects/*isolation & purification ; Middle Aged ; Male ; Humans ; Gram-Negative Bacterial Infections/*diagnosis/drug therapy/*microbiology ; Anti-Bacterial Agents/administration & dosage

We describe the first case of primary peritonitis in Korea of a healthy person due to Streptococcus pyogenes. In the absence of comorbid conditions, such as liver cirrhosis, immunosuppression, or nephrotic syndrome, primary peritonitis is uncommon in a young healthy woman. Abdomen computed tomography revealed ascites in the lower abdomen and peritoneal enhancement suggesting peritonitis. In diagnostic laparoscopy, purulent ascites was found in the pelvic cavity but both ovaries and fallopian tubes were intact. There were no intra-abdominal abnormalities such as bowel perforation, appendicitis, or necrosis. The reports of blood culture, ascites culture, and cervical swab culture confirmed S. pyogenes. After use of antibiotics, the patient was cured and discharged without sequelae.
Adult ; Anti-Bacterial Agents/therapeutic use ; Female ; Humans ; Laparoscopy ; Peritonitis/*diagnosis/drug therapy/microbiology ; Streptococcal Infections/*diagnosis/drug therapy/microbiology ; Streptococcus pyogenes/*isolation & purification ; Tomography, X-Ray Computed

Anti-Bacterial Agents ; therapeutic use ; Bacterial Infections ; diagnosis ; drug therapy ; etiology ; microbiology ; Breast Implants ; microbiology ; Clinical Laboratory Techniques ; Early Diagnosis ; Humans ; Microbiological Techniques

A 52 year-old, contact lens-wearing man presented with progressive right eye pain and redness for one month. He had been evaluated and treated for necrotizing scleritis by multiple eye care specialists prior to presentation. He underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis, including a culture. The culture revealed heavy growth of Nocardia asteroides complexes. The patient was treated with topical amikacin and oral Bactrim. Following several weeks of antibiotic treatment, the patient's infection resolved completely, and his visual acuity returned to baseline status. Nocardia is a rare but potentially devastating cause of necrotizing scleritis that may affect contact lens wearers without an associated keratitis. Prompt recognition and early treatment with appropriate antimicrobial agents are critical to achieve a favorable outcome.
Anti-Bacterial Agents/therapeutic use ; Contact Lenses/*adverse effects/*microbiology ; Humans ; Male ; Middle Aged ; Nocardia Infections/*diagnosis/drug therapy ; Nocardia asteroides/*isolation & purification ; Scleritis/drug therapy/*microbiology

INTRODUCTIONKlebsiella pneumoniae septic arthritis and osteomyelitis, albeit uncommon in adults, are important sites of disseminated infection. Many case reports have shown K. pneumoniae as a cause of nosocomial transmitted septic arthritis in neonates and children. We report a rare case of an elderly patient with K. pneumoniae genitourinary infection spreading to the liver and other extra hepatic sites like the prostate and peripheral joint.

CLINICAL PICTUREThe patient presented with a short history of general malaise, fever and urinary symptoms, associated with an acute monoarthritis of the ankle. On admission, he was in septic shock. Investigations suggested an infective cause, as evidenced by raised total white cell count and pyuria. K. pneumoniae was cultured from both urine and ankle synovial fluid. Imaging confirmed multiple liver and prostatic abscesses, as well as osteomyelitis of the foot bones adjacent to the ankle.

TREATMENTTreatment in this case included surgical drainage of the affected joint and surrounding soft tissue structures, in addition to a 6-week course of systemic antibiotics.

OUTCOMEThe patient had good clinical response following treatment. In addition, we noted a normalisation of his laboratory parameters and resolution of the intraabdominal and pelvic abscesses.

CONCLUSIONThis case emphasises the importance of timely and accurate diagnosis followed by appropriate treatment in disseminated K. pneumoniae infection to prevent significant morbidity and mortality.

Aged ; Ankle Joint ; microbiology ; surgery ; Anti-Bacterial Agents ; therapeutic use ; Arthritis, Infectious ; diagnosis ; microbiology ; therapy ; Combined Modality Therapy ; Drainage ; Foot Bones ; microbiology ; Humans ; Klebsiella Infections ; diagnosis ; therapy ; Klebsiella pneumoniae ; Liver Abscess ; microbiology ; Magnetic Resonance Imaging ; Male ; Osteomyelitis ; drug therapy ; epidemiology ; microbiology ; surgery ; Prostatic Diseases ; microbiology ; Synovial Fluid ; microbiology ; Tomography, X-Ray Computed ; Urinary Tract Infections ; drug therapy ; microbiology

The incidence of pulmonary disease caused by nontuberculous mycobacteria (NTM) appears to be increasing worldwide. In Korea, M. avium complex and M. abscessus account for most of the pathogens encountered, whilst M. kansasii is a relatively uncommon cause of NTM pulmonary diseases. NTM pulmonary disease is highly complex in terms of its clinical presentation and management. Because its clinical features are indistinguishable from those of pulmonary tuberculosis and NTMs are ubiquitous in the environment, the isolation and identification of causative organisms are mandatory for diagnosis, and some specific diagnostic criteria have been proposed. The treatment of NTM pulmonary disease depends on the infecting species, but decisions concerning the institution of treatment are never easy. Treatment requires the use of multiple drugs for 18 to 24 months. Thus, treatment is expensive, often has significant side effects, and is frequently not curative. Therefore, clinicians should be confident that there is sufficient pathology to warrant prolonged, multidrug treatment regimens. In all of the situations, outcomes can be best optimized only when clinicians, radiologists, and laboratories work cooperatively.
Anti-Bacterial Agents/therapeutic use ; Female ; Humans ; Korea ; Lung Diseases/*diagnosis/drug therapy/microbiology ; Male ; Mycobacterium Infections, Atypical/*diagnosis/drug therapy/microbiology ; Mycobacterium avium-intracellulare Infection/diagnosis/drug therapy/microbiology ; Research Support, Non-U.S. Gov't

OBJECTIVETo explore the influence of non-gonococcal Neisseria on the diagnosis and treatment of male genitourinary infection.

METHODSThe samples of urethral exudates, prostatic secretions or/and semen were collected from 8 cases of male patients with acute urethritis or chronic prostatitis, then inoculated into gonococcal agar medium, blood agar medium, Sabouraud agar medium and Mycoplasma agar medium, respectively. Neisseria gonorrhoeae, Mycoplasmae, fungi and other bacteria were isolated, Chlamydiae examined by Gemenez staining, and the gram-negative diplococci from the samples identified by oxidase test, biochemical examination and drug sensitivity test. The PCR products of the cryptic plasmid pJD1 gene of the isolated strains were amplified for the identification of Neisseria gonorrhoeae. Based on the results of drug sensitivity tests, intravenous or oral antibiotics were selected for treatment.

RESULTSEight strains of gram-negative diplococci were isolated in this study, 3 identified as N. mucosa, 4 as N. cinerea and the other 1 as N. lactamica. The PCR identification test of the cryptic plasmid pJD1 gene showed the same positive results in all the strains as in N. gonorrhoeae. The non-gonococcal Neisseria isolated from the male genital tract secretions exhibited a multidrug resistance, especially to quinolones and fosfomycin. All the symptoms disappeared and no pathogens were detected in the patients after a 7-day treatment with Cephalosporins or/and Minocycline.

CONCLUSIONSome Neisseria species normally parasitizing the upper respiratory tract can also cause male genitourinary infections, such as gonorrhea-like urethritis and chronic prostatitis. Neisseria gonorrhea could be clinically and etiologically misdiagnosed through such conventional methods as morphological examination, oxidase test and PCR identification test of cryptic plasmid and other nonspecific genes. Intravenous and/or oral antibiotic medication based on the results of drug sensitivity tests can cure acute urethritis and chronic prostatitis induced by non-gonococcal Neisseria in males. Drug resistance of non-gonococcal Neisseria directly affects the success of treatment.

Adult ; Anti-Bacterial Agents ; therapeutic use ; Humans ; Male ; Middle Aged ; Neisseria ; isolation & purification ; Neisseriaceae Infections ; diagnosis ; drug therapy ; microbiology ; Prostatitis ; diagnosis ; drug therapy ; microbiology ; Urethritis ; diagnosis ; drug therapy ; microbiology

PURPOSE: To report a case of an acute onset of delayed postoperative endophthalmitis that was caused by Sphingomonas paucimobilis. METHODS: This case demonstrates an acute onset of delayed postoperative endophthalmitis at 3 months after uneventful cataract extraction and posterior chamber intraocular lens implantation. We performed vitrectomy, intraocular lens and capsular bag removal, and intravitreal antibiotics injection. On the smear stains from the aspirated vitreous humor, gram-negative bacilli were detected and S. paucimobilis was found in culture. RESULTS: At three months after vitrectomy, the best corrected visual acuity was 20/300. Fundus examination showed mild pale color of optic disc and macular degeneration. CONCLUSIONS: Vitrectomy with intravitreal ceftazidime injection had contributed to the favorable result in case of an acute onset of delayed postoperatire endophthalmitis caused by S. paucimobilis.
Anti-Bacterial Agents/therapeutic use ; Ceftazidime/therapeutic use ; Combined Modality Therapy ; Endophthalmitis/diagnosis/drug therapy/*microbiology ; Eye Infections, Bacterial/diagnosis/drug therapy/*microbiology ; Gram-Negative Bacterial Infections/diagnosis/drug therapy/*microbiology ; Humans ; Lens Implantation, Intraocular ; Male ; Middle Aged ; *Phacoemulsification ; *Postoperative Complications ; Sphingomonas/*isolation & purification ; Visual Acuity ; Vitrectomy ; Vitreous Body/microbiology

PURPOSE: To report a case of an acute onset of delayed postoperative endophthalmitis that was caused by Sphingomonas paucimobilis. METHODS: This case demonstrates an acute onset of delayed postoperative endophthalmitis at 3 months after uneventful cataract extraction and posterior chamber intraocular lens implantation. We performed vitrectomy, intraocular lens and capsular bag removal, and intravitreal antibiotics injection. On the smear stains from the aspirated vitreous humor, gram-negative bacilli were detected and S. paucimobilis was found in culture. RESULTS: At three months after vitrectomy, the best corrected visual acuity was 20/300. Fundus examination showed mild pale color of optic disc and macular degeneration. CONCLUSIONS: Vitrectomy with intravitreal ceftazidime injection had contributed to the favorable result in case of an acute onset of delayed postoperatire endophthalmitis caused by S. paucimobilis.
Anti-Bacterial Agents/therapeutic use ; Ceftazidime/therapeutic use ; Combined Modality Therapy ; Endophthalmitis/diagnosis/drug therapy/*microbiology ; Eye Infections, Bacterial/diagnosis/drug therapy/*microbiology ; Gram-Negative Bacterial Infections/diagnosis/drug therapy/*microbiology ; Humans ; Lens Implantation, Intraocular ; Male ; Middle Aged ; *Phacoemulsification ; *Postoperative Complications ; Sphingomonas/*isolation & purification ; Visual Acuity ; Vitrectomy ; Vitreous Body/microbiology