Acute focal bacterial nephritis (AFBN), synonymous with acute lobar nephronia (ALN) or focal pyelonephritis, is an inflammatory mass without liquefaction caused by severe acute bacterial infection of kidney. Unless treated effectively, progression to a renal abscees may ensue. Clinically, AFBN presents as acute pyelonephritis, and radiologically, as focal swelling or mass. The distinction between AFBN and renal abceess or even tumor may be confusing and difficult. Ultrasonography and computerized tomography(CT) aid in establishing the correct diagnosis. However, the appearance of AFBN on sonography and CT is by no means pathognomonic. Benign or malignant renal tumors may have a similar appearance. With the clinical history, a high index of suspicion, and follow-up studies after institution of medical treatment may further aid in the differentiation. Herein we report 2 cases of AFBN, which were presented as renal masses.
Bacterial Infections ; Diagnosis ; Kidney ; Nephritis* ; Pyelonephritis ; Ultrasonography

Bacterial Infections ; diagnosis ; drug therapy ; etiology ; Drug Resistance, Bacterial ; Humans ; Peritonitis ; diagnosis ; drug therapy ; etiology

Necrotizing fasciitis is a rapidly progressing soft-tissue infection that affects the subcutaneous fascia and dermis, and characteristically spares the underlying muscle. Most cases represent a synergistic or mixed bacterial infection of aerobes and anaerobes. A variety of etiologies have been reported. Herein, two cases of necrotizing fasciitis of the right thigh secondary to perforated appendicitis, an extremely rare complication, are reported. Both cases recovered following aggressive surgical and medical therapies. The delay in diagnosis and radical surgical excision are frequent and significant contributory factors in the high reported mortality rate. A high index of suspicion, followed by prompt surgical intervention with broad-spectrum antibiotic therapy, seems to be the most important prognostic factor in these difficult cases.
Appendicitis* ; Bacterial Infections ; Dermis ; Diagnosis ; Fascia ; Fasciitis, Necrotizing* ; Mortality ; Thigh

BACKGROUND: Blood culture has been used for finding the etiology of bacteremia. The results of its susceptibility test can be an important tool for deciding the direction of treatment. However, the rate of positive blood culture is very low; it, most of all, is because of the abuse of antimicrobials. Especially under the condition which allows anyone to get antimicrobials at any pharmacies and hospitals without antimicrobial susceptibility test as in Korea, the abuse of antimicrobials be brought about, but there is no concrete information about it. METHODS: The rate of antimicrobial abuse and the serum antimicrobial activities of 106 patients, whose blood was requested for diagnosis of bacteremia, were investigated, and the results were compared with blood culture results. Thirteen mililiters of blood was as eptically extracted; 10 ml out of it was used for blood culture and the serum separated from 3ml of blood was used for serum antibacterial activities. For the test of serum antimicrobial activities, standard strain of bacteria, Staphylococcus aureus ATCC 25923, which are susceptible to every antibiotics was used. And for the blood culture, blood samples were inoculated to aerobic and anaerobic culture broth, and incubated in the automated blood culture system. The abuse of antimicrobials were investigated by the interview with patients and the medical records at admission. RESULTS: The antimicrobial abuse rate was 78.3%(83/106), and the rate of positive blood culture was as low as 6.6%(7/106). The rate of positive serum antibacterial activity was 47.2%(50/106). The rate of positive blood culture in the group of positive serum antimicrobial activity was only 4%(2/50) and that in the group of negative serum antimicrobial activity was 8.9%(5/56). And in the group of positive blood culture, the rate of positive serum antimicrobial activity was 28.6%(2/7) and the rate of negative activity was 71.4%(5/7). CONCLUSIONS: The antimicrobial abuse rate in Korea was considerably high, and the rate of positive blood culture was very low. The rate of positive blood culture in the group of positive serum antibacterial activity was conspicuously lower than that in the group of negative ones. According to these results, the use of antimicrobials before blood culture should be carefully considered for the diagnosis and treatment of bacterial infection.
Anti-Bacterial Agents ; Bacteremia ; Bacteria ; Bacterial Infections ; Diagnosis ; Humans ; Korea ; Medical Records ; Pharmacies ; Staphylococcus aureus

Phlegmonous gastritis is a rare disorder caused by suppurative bacterial infection of the gastric wall. The mortality rate remains extremely high and the gastrectomy has been thought to be an effective form of treatment. We report a case of acute phlegmonous gastritis developed in a patient with advanced alcoholic liver cirrhosis, and recovered with early endoscopic diagnosis and antibiotics alone.
Anti-Bacterial Agents* ; Bacterial Infections ; Cellulitis* ; Diagnosis ; Gastrectomy ; Gastritis* ; Humans ; Liver Cirrhosis, Alcoholic ; Mortality

Anti-Bacterial Agents ; Clostridium Infections ; diagnosis ; microbiology ; Clostridium difficile ; genetics ; Drug Resistance, Bacterial ; genetics ; Humans

Advances in the antimicrobials lower the mortality rate in most infectious diseases. But bacterial infections of the CNS is still one of the life-threatening infections. Untreated acute bacterial meningitis is fatal in 70% to 100% of patients. With appropriate antibacterial therapy, the case-fatality rate had been greatly reduced with death occurring principally in the very young the very old, or those with potentially lethal underlying diseases. Early recognition and antimicrobial therapy is mostly desirable. The causes of acute bacterial meningitis vary with age and the clinical setting under which the infection occurs. Empirical antibiotic treatment was started immediately on suspicion of the bacterial meningitis prior to etiologic diagnosis. The most effective and least toxic bactericidal drugs should be selected on the basis of known or predicted susceptibility of the bacterial cause of the disease. After the identification of the specific organism and determination of susceptibilities, effective antimicrobial was administered parenterally at maximum dose. The third-generation cephalosporins(cefotaxime, ceftriaxone, and ceftzidime) offer new advantages in the treatment of meningitis because they are active at the CSF concentraions obtainable. Newer antimicrobials(monobactam and newer quinolones) with improved access and an appropriately focused spectrum for CNS infections will become available.
Bacterial Infections* ; Ceftriaxone ; Central Nervous System* ; Communicable Diseases ; Diagnosis ; Humans ; Meningitis ; Meningitis, Bacterial ; Mortality

BACKGROUND: Severe neutropenia is defined as an absolute neutrophil count (ANC) less than 0.5×109/L, which is known to increase the risk of serious bacterial infections. The aim of this study was to investigate characteristics, etiology and differences between transient and chronic severe neutropenia in children.METHODS: 204 children, who were diagnosed with severe neutropenia at the Ajou University Hospital during a 5-year period, were included in the study. Clinical and laboratory features were analyzed. The patients were classified as having transient severe neutropenia (TSN) if recovery occurred within 6 months of diagnosis, and chronic severe neutropenia (CSN) if the neutropenia persisted for 6 months or more.RESULTS: 184 (90.2%) patients with TSN and 20 (9.8%) patients with CSN were identified. Most of the TSN occurred in patients less than 2 year of age (75.5%) and rarely occurred in patients 5 years or older (5.4%). The most common cause of TSN was infection-related neutropenia (82.6%), and most of the associated infections were respiratory infections (44.6%). Compared to TSN, CSN patients were younger at diagnosis (1.00 vs. 0.71, P < 0.001), had a lower ANC at diagnosis (364.8 vs. 214.9, P < 0.001), lower ANC at nadir (356.0 vs. 50.0, P < 0.001), and higher platelet count (188×10⁹ vs. 308×10⁹, P < 0.001), monocyte count (491.5×10⁶ vs. 832.9×10⁶, P=0.010) and CRP (0.22 vs. 0.85, P=0.036).CONCLUSION: Most of the severe neutropenia occurred in children younger than 2 years of age, and virus infection was the most common cause of TSN.
Bacterial Infections ; Child ; Diagnosis ; Humans ; Monocytes ; Neutropenia ; Neutrophils ; Platelet Count ; Respiratory Tract Infections

Bacterial Infections ; diagnosis ; therapy ; Humans ; Liver Cirrhosis ; diagnosis ; microbiology ; therapy ; Peritonitis ; diagnosis ; therapy

Enterococcus ; Gram-Positive Bacterial Infections ; diagnosis ; drug therapy ; Humans ; Infant, Newborn ; Male ; Meningitis, Bacterial ; diagnosis ; drug therapy