Infectious conjunctivitis is a very common presentation to medical professional and ophthalmologist all over the world. Although its typically self-limiting and treatable in almost all of the cases, but we need to be aware of the rare and potentially life threatening if the cause is not promptly identified and treated accordingly. In our case report, we highlighted the rare case of Neisseria meningitidis as a primary cause of keratoconjunctivitis. Neisseria meningitidis is a rare etiology of keratoconjunctivitis and its ocular presentations are quite similar with other bacterial or viral infection. The infection may potentially fatal if systemic invasion occurred, however with immediate and proper treatment the outcome is satisfactory. Early diagnosis and proper antibiotic treatment are critical to prevent systemic spread of the infection. Public health intervention is needed to prevent outbreak of the disease.
Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Ceftriaxone ; administration & dosage ; therapeutic use ; Child, Preschool ; Humans ; Keratoconjunctivitis ; Male ; Meningococcal Infections ; Neisseria meningitidis

The present study was planned to investigate the pharmacokinetics of ceftriaxone in experimentally induced febrile buffalo calves (n = 5). The fever was induced by intravenous injection of E.coli lipopolysaccaride (1 microgram/kg). To study the pharmacokinetics, ceftriaxone was administered at the dose rate of 10 mg/kg body wt. in all animals. At 1 min, the peak concentration of ceftriaxone was 79.4 +/- 2.37 microgram/ml and the drug was detected up to 6 h. The elimination rate constant was 0.35 +/- 0.02 /h and elimination half-life was 2.04 +/- 0.14 h. The apparent volume of distribution (Vd(area)) and total body clearance (ClB) were 1.21 +/- 0.15 l/kg and 0.41 +/- 0.03 l/kg/h, respectively. To maintain a minimum therapeutic concentration of 1 microgram/kg, a satisfactory dosage regimen of cefriaxone in febrile buffalo calves is 19 mg/kg followed by 18 mg/kg at 8 h intervals.
Animals ; Anti-Bacterial Agents/administration&dosage/*pharmacokinetics ; Area Under Curve ; Buffaloes/*metabolism ; Ceftriaxone/administration&dosage/*pharmacokinetics ; Drug Administration Schedule/veterinary ; Fever/drug therapy/*metabolism/*veterinary ; Half-Life ; Lipopolysaccharides/administration&dosage ; Male ; Metabolic Clearance Rate

BACKGROUNDTo observe the effects of short-term antibiotic treatment in patients with hepatic failure and spontaneous bacterial peritonitis (SBP).

METHODSIn this prospective study short-term antibiotic treatment was given to 67 cases diagnosed as hepatic failure with spontaneous bacterial peritonitis. Ceftriaxone 2 g, iv drip, q12h for 10 d or ofloxacin 0.2 g, iv drip, q12h for 10 d was given to the patients at random and the efficacy was evaluated on the basis of clinical symptoms, medical examination and ascites after 3, 7, 10 days of therapy.

RESULTSSeven cases (10.44%) were cured and 57 cases (85%) were improved after 3 days therapy, the total effective rate was 95.52%, but in 3 cases the therapy had no effect. The results of ascites bacterial culture and drug susceptibility test showed that one case had drug resistance to ceftriaxone and two cases had drug resistance to ofloxacin, so antibiotics were changed in time. After 7 days therapy, the results showed that 65 cases (97.01%) cured and 2 cases (2.99%) were improved, the total effective rate was 100%. When the therapy lasted for 10 days, all patients were cured. One patient had oral mucous membrane. Candida albicans infection after 3 days therapy; two cases got thrush and one patient got fungal intestinal infection after 7 days therapy; when the therapy lasted for 10 days, 4 cases had thrush and 2 cases had fungal infection of intestines and one patient had pulmonary fungal infection.

CONCLUSIONThe optimal period of antibiotic treatment of hepatic failure with SBP should be from 7 days to 10 days.

Adult ; Anti-Bacterial Agents ; administration & dosage ; Bacterial Infections ; drug therapy ; etiology ; Ceftriaxone ; administration & dosage ; Drug Therapy, Combination ; Female ; Humans ; Liver Failure ; complications ; Male ; Middle Aged ; Ofloxacin ; administration & dosage ; Peritonitis ; drug therapy ; etiology ; Prospective Studies ; Treatment Outcome

OBJECTIVETo compare the efficacy and safety of a single ceftriaxone injection with 10-day oral amoxicillin in the treatment for children's acute otitis media.

METHODSThis study was a prospective, comparative, open randomized, multicenter trial. In the ceftriaxone group, a single dose sodium ceftriaxone (50 mg/kg, total dose < 1 g) was injected. In the amoxicillin group, the oral amoxicillin [40 mg/(kg.d), tid] was used for 10 days. Totally 236 cases aged from 0.5 to 12 years were enrolled and 212 cases completed the study. These patients were followed up twice and clinical signs and symptoms were recorded, otoscopy, peripheral blood WBC count, hearing test (pure tone test) and tympanography were performed.

RESULTSIn the ceftriaxone group, 103/106 cases were cured or improved (97.17%), while in the amoxicillin group 96/106 cases were cured or improved (90.57%) (P < 0.05). Ceftriaxone was significantly better than amoxicillin in the treatment. Totally 4 cases had side effects such as papular skin rash, urticaria around mouth, skin pigmentation, two cases in the ceftriaxone group and other two cases in the amoxicillin group. There was no significant difference between the 2 groups in side effects.

CONCLUSIONCeftriaxone injection was significantly better than ten-day oral amoxicillin for treatment of acute otitis media in children. The single dose regimen with ceftriaxone seems to be a good choice for children, particularly for.

Acute Disease ; Administration, Oral ; Amoxicillin ; adverse effects ; therapeutic use ; Anti-Bacterial Agents ; adverse effects ; therapeutic use ; Ceftriaxone ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Otitis Media ; drug therapy ; Prospective Studies ; Treatment Outcome

We present a case report of brain death caused by Salmonella enterica serovar Enteritidis bacteremia. A 53-year-old diabetic male was admitted to our hospital with stupor mentality and fever. No evidence of meningitis was found upon cerebrospinal fluid analysis, but diffuse brain edema was shown by magnetic resonance imaging. S. Enteritidis phage type 7 was isolated from blood cultures. We diagnosed the patient with encephalopathy associated with S. Enteritidis bacteremia and treated him by intravenous administration of ceftriaxone and dexamethasone. Fifteen days after admission, the patient was diagnosed with brain death and became a cadaveric donor. Although encephalopathy associated with S. Enteritidis bacteremia is rare, it should be considered as a serious and potentially lethal complication.
Administration, Intravenous ; Bacteremia ; Bacteriophages ; Brain ; Brain Death ; Brain Edema ; Cadaver ; Ceftriaxone ; Dexamethasone ; Fever ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis ; Middle Aged ; Salmonella ; Salmonella enterica ; Salmonella enteritidis ; Stupor ; Tissue Donors

We present a case report of brain death caused by Salmonella enterica serovar Enteritidis bacteremia. A 53-year-old diabetic male was admitted to our hospital with stupor mentality and fever. No evidence of meningitis was found upon cerebrospinal fluid analysis, but diffuse brain edema was shown by magnetic resonance imaging. S. Enteritidis phage type 7 was isolated from blood cultures. We diagnosed the patient with encephalopathy associated with S. Enteritidis bacteremia and treated him by intravenous administration of ceftriaxone and dexamethasone. Fifteen days after admission, the patient was diagnosed with brain death and became a cadaveric donor. Although encephalopathy associated with S. Enteritidis bacteremia is rare, it should be considered as a serious and potentially lethal complication.
Administration, Intravenous ; Bacteremia ; Bacteriophages ; Brain ; Brain Death ; Brain Edema ; Cadaver ; Ceftriaxone ; Dexamethasone ; Fever ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis ; Middle Aged ; Salmonella ; Salmonella enterica ; Salmonella enteritidis ; Stupor ; Tissue Donors

OBJECTIVETo compare the effects and pharmacoeconomics of single-dose of ceftriaxone versus 3-day cefuroxime prophylaxis in patients undergoing gastric or colorectal resection.

METHODSThree hundred and five consecutive patients with gastric or colorectal cancer from 5 medical centers were randomly divided into ceftriaxone group (n = 153, receiving intravenously 1 g ceftriaxone 0.5 - 1 h prior to operation only) and cefuroxime group (n = 152, receiving 0.75 g cefuroxime preoperatively and the same dose q8h for 3 d). The patients' intra- and postoperative status, adverse responses and infectious complications were observed and documented, and pharmacoeconomic parameters were analyzed.

RESULTSThe disease distribution, operative procedures and patients' conditions in the 2 groups were comparable. No adverse responses to the test antibiotics were observed. Postoperative infectious complications occurred in 7 cases in the ceftriaxone group (4.58%) and 14 cases in the cefuroxime group (9.21%), respectively (P = 0.992), among which, 12 cases were surgical site infections (incisional, intra-abdominal): 2 cases in the ceftriaxone group (1.31%), and 10 cases in the cefuroxime group (6.58%), (chi(2) = 5.607, P = 0.018). The direct cost related to prevention and treatment of surgical site infections was 283.5 RMB in the ceftriaxone group and 811.1 RMB in the cefuroxime group (Z = 14.51, P = 0.000).

CONCLUSIONBoth ceftriaxone and cefuroxime are safe and effective for prevention of surgical site infections. Single-dose ceftriaxone prophylaxis is sufficient for gastric and colorectal operations, with a better cost-effectiveness ratio.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; economics ; therapeutic use ; Antibiotic Prophylaxis ; economics ; Ceftriaxone ; administration & dosage ; economics ; therapeutic use ; Cefuroxime ; administration & dosage ; economics ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Surgical Wound Infection ; prevention & control ; Treatment Outcome ; Young Adult

A 48-year-old man presented with visual dimness in the right eye that had developed 2 weeks previously. Dilated fundus examination showed few vitreous cells and numerous yellow, placoid lesions in both eyes. His right eye had more severe serous retinal detachment involving the macula. Fluorescein angiography demonstrated early irregular hypofluorescence with late staining in the areas of the yellow placoid lesions. He started a regimen of 60 mg of oral prednisone daily. Two weeks later, a serologic fluorescent treponemal antigen absorption test was positive for Ig G and Ig M. He was referred to an infectious disease specialist for antibiotic therapy. A week later, he returned, having stayed on prednisone only and not having taken the internist's antibiotic prescription. Meanwhile, the chorioretinitis in his right eye, which had initially been at a more advanced stage, was resolved with the use of steroids. The chorioretinitis in his left eye, which was aggravated at an earlier stage, ultimately recovered. Our case had atypical courses such that one eye improved and the other worsened during the same steroid treatment period. This result was inconsistent with that of previous reports showing that oral steroid influences the clinical course of acute syphilitic posterior placoid chorioretinitis.
Acute Disease ; Anti-Bacterial Agents/administration & dosage ; Ceftriaxone/administration & dosage ; Chorioretinitis/diagnosis/drug therapy/*microbiology ; Diagnosis, Differential ; Eye Infections, Bacterial/diagnosis/drug therapy/*microbiology ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Injections, Intravenous ; Male ; Middle Aged ; Syphilis/diagnosis/drug therapy/*microbiology

OBJECTIVETo analyze the treatment of acute renal failure caused by irrational drug use.

METHODData of 41 cases of acute renal failure seen from July 2008 to June 2012 in our hospital were reviewed. Bilateral renal parenchymas diffuse echo was found enhanced by ultrasound in all cases. Calculus image was not found by X-ray. All children had medical history of using cephalosporins or others. Alkalinization of urine and antispasmodic treatment were given to all children immediately, 17 children were treated with hemodialysis and 4 children accepted intraureteral cannula placement.

RESULTIn 24 children who accepted alkalinization of urine and antispasmodic treatment micturition could be restored within 24 hours, in 11 children micturition recovered after only one hemodialysis treatment and 2 children gradually restored micturition after hemodialysis twice, 4 children who accepted intraureteral cannula immediately restored micturition. In all children micturition recovered gradually after a week of treatment. Ultrasound examination showed that 39 children's calculus disappeared totally and renal parenchymas echo recovered to normal. The residual calculi with diameter less than 5 mm were found in 2 children, but they had no symptoms. The children received potassium sodium hydrogen citrate granules per os and were discharged from hospital. Ultrasound showed calculus disappeared totally one month later.

CONCLUSIONIrrational drug use can cause children urolithiasis combined with acute renal failure, while renal dysfunction can reverse by drug withdrawal and early alkalinization of urine, antispasmodic treatment, intraureteral cannula or hemodialysis when necessary, most calculus can be expelled after micturition recovered to normal.

Acute Kidney Injury ; chemically induced ; diagnosis ; therapy ; Ceftriaxone ; administration & dosage ; adverse effects ; Child ; Child, Preschool ; Diuretics ; therapeutic use ; Female ; Fluid Therapy ; Humans ; Infant ; Kidney ; pathology ; physiopathology ; Male ; Potassium Citrate ; therapeutic use ; Renal Dialysis ; Retrospective Studies ; Treatment Outcome ; Urinary Calculi ; chemically induced ; diagnosis ; therapy