No abstract available.
Arthritis ; Bacteremia* ; Female* ; Humans ; Knee Joint* ; Knee* ; Listeria monocytogenes* ; Listeria*

In the article cited above, upper part page in title page has an error. Ending page of the article should be 268, not 269.

BACKGROUND/AIMS: Acute pyelonephritis (APN) is the most common cause of community-onset bacteremia in hospitalized elderly patients. The objectives of this study were to investigate the differences in the clinical and microbiological data of hospitalized elderly and non-elderly women with community-onset APN. METHODS: Women with community-onset APN as a discharge diagnosis were identified from January 2004 to December 2013 using an electronic medical records system. We compared the clinical and microbiologic data in elderly and non-elderly women with community-onset APN due to Enterobacteriaceae. RESULTS: Of the 1,134 women with community-onset APN caused by Enterobacteriaceae, 443 were elderly and 691 were non-elderly women. The elderly group had a lower frequency of upper and lower urinary tract symptoms/signs than the non-elderly. The incidence of bacteremia, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, patients with a C-reactive protein (CRP) level > or = 15 mg/dL, and patients with a leukocyte count > or = 15,000/mm3 in the blood, were significantly higher in the elderly group than in the non-elderly group. The proportion of patients requiring hospitalization for 10 days or more was significantly higher in the elderly group compared to the non-elderly group (51.5% vs. 26.2%, p < 0.001). The clinical cure rates at 4 to 14 days after the end of therapy were 98.3% (338/344) and 97.4% (519/533) in the elderly and non-elderly groups, respectively (p = 0.393). CONCLUSIONS: Elderly women with APN exhibit higher serum CRP levels, a higher frequency of bacteremia, a higher proportion of ESBL-producing uropathogens, and require a longer hospitalization than non-elderly women, although these patients may not complain of typical urinary symptoms.
Acute Disease ; Adult ; Age Factors ; Aged ; Anti-Bacterial Agents/therapeutic use ; Community-Acquired Infections/*diagnosis/drug therapy/microbiology ; Electronic Health Records ; Enterobacteriaceae Infections/*diagnosis/drug therapy/microbiology ; Female ; Hospitalization ; Hospitals, University ; Humans ; Middle Aged ; Pyelonephritis/*diagnosis/drug therapy/microbiology ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Sex Factors ; Time Factors ; Treatment Outcome ; Urinary Tract Infections/*diagnosis/drug therapy/microbiology

No abstract available.
Acute Disease ; Adult ; Anti-Bacterial Agents/therapeutic use ; Choristoma/*complications/radiography ; Escherichia coli Infections/diagnosis/drug therapy/*microbiology ; Female ; Hernias, Diaphragmatic, Congenital/*complications/radiography ; Humans ; *Kidney ; Predictive Value of Tests ; Pyelonephritis/diagnosis/drug therapy/*microbiology ; Thoracic Diseases/*complications/radiography ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: This study examined the clinical effectiveness of parenteral cefuroxime and cefotaxime as empirical antibiotics for treating hospitalized women with uncomplicated acute pyelonephritis (APN). MATERIALS AND METHODS: This study was based on the clinical and microbiologic data of 255 hospitalized women with APN. Of these 255 women, 144 patients received cefuroxime and 111 received cefotaxime. RESULTS: There were no marked differences in the demographic features, clinical characteristics, and treatment duration between the populations of the cefuroxime and cefotaxime groups. The rates of defervescence showed no significant differences in the two groups at 48, 72, 96, and 120 hours. The clinical cure rates observed at the follow-up visit 4 to 14 days after the completion of antimicrobial therapy were not statistically different between the cefuroxime and cefotaxime groups [94.9% (129 of 136) versus 98.0% (100 of 102), respectively; p=0.307], and the microbiological cure rates were also not significantly different [88.3% (91 of 103) versus 95.0% (76 of 80), respectively; p=0.186]. The median hospitalization periods in the cefuroxime and cefotaxime groups were 7 (6-8) and 7 (6-8) days (p=0.157), respectively. Microbiological success rates after 72-96 hours of initial antimicrobial therapy were also not statistically different in the cefuroxime and cefotaxime groups, 89.4% (110 of 123) versus 94.9% (93 of 98; p=0.140). CONCLUSION: Cefuroxime, a second-generation cephalosporin, is an appropriate antibiotic option for the initial treatment of uncomplicated APN and its efficacy does not differ from cefotaxime, a third-generation cephalosporin, in the initial parenteral therapy for community-onset APN.
Administration, Intravenous ; Adult ; Aged ; Anti-Bacterial Agents/administration & dosage/*therapeutic use ; Cefotaxime/administration & dosage/*therapeutic use ; Cefuroxime/administration & dosage/*therapeutic use ; Community-Acquired Infections/*drug therapy ; Escherichia coli/drug effects ; Female ; Humans ; Infusions, Parenteral ; Length of Stay ; Male ; Middle Aged ; Pyelonephritis/*drug therapy/microbiology ; Retrospective Studies ; Treatment Outcome

BACKGROUND/AIMS: Efforts to decrease the use of extended-spectrum cephalosporins are required to prevent the selection and transmission of multi-drug resistant pathogens, such as extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. The objectives of this study were to assess the clinical efficacy of intravenous cefuroxime as an empirical antibiotic for the treatment of hospitalized women with acute pyelonephritis (APN) caused by Escherichia coli. METHODS: We analyzed the clinical and microbiologic database of 328 hospitalized women with community-onset APN. RESULTS: Of 328 women with APN, 22 patients had cefuroxime-resistant E. coli APN, and 306 patients had cefuroxime-susceptible E. coli APN. The early clinical success rates were significantly higher (p = 0.001) in the cefuroxime-susceptible group (90.8%, 278/306) than in the cefuroxime-resistant group (68.2%, 15/22) at 72 hours. The clinical cure rates at 4 to 14 days after completing antimicrobial therapy were not significantly different in the cefuroxime-resistant or -susceptible groups, with 88.2% (15/17) and 97.8% (223/228; p = 0.078), respectively. The microbiological cure rates were not significantly different and were 90.9% (10/11) and 93.4% (128/137), respectively (p =0.550). The median duration of hospitalization in the cefuroxime-resistant and -susceptible groups was 10 days (interquartile range [IQR], 8 to 13) and 10 days (IQR, 8 to 14), respectively (p =0.319). CONCLUSIONS: Cefuroxime, a second-generation cephalosporin, can be used for the initial empirical therapy of community-onset APN if tailored according to uropathogen identification and susceptibility results, especially in areas where the prevalence rate of ESBL-producing uropathogens is low.
Administration, Intravenous ; Aged ; Anti-Bacterial Agents/administration & dosage/adverse effects/*therapeutic use ; Cefuroxime/administration & dosage/adverse effects/*therapeutic use ; Community-Acquired Infections/diagnosis/*drug therapy/microbiology/urine ; Databases, Factual ; *Drug Resistance, Bacterial ; Escherichia coli/*drug effects/isolation & purification ; Escherichia coli Infections/diagnosis/*drug therapy/microbiology/urine ; Female ; Hospitalization ; Humans ; Microbial Sensitivity Tests ; Middle Aged ; Pyelonephritis/diagnosis/*drug therapy/microbiology/urine ; Remission Induction ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Urinalysis ; Urinary Tract Infections/diagnosis/*drug therapy/microbiology/urine ; Urine/microbiology

Nasopharyngeal tuberculosis is an uncommon disease, and isolated nasopharyngeal tuberculosis is an even rarer condition. An 18-year-old male came to our clinic with left nasal obstruction. Upon physical examination, there was no cervical lymphadenopathy. Nasal endoscopic examination revealed an isolated 2.0x1.5 cm sized pedunculated mass at the midline of the nasopharynx. Histopathological findings of the nasopharyngeal mass showed a caseating granuloma with multinucleated giant cells. He was diagnosed with nasopharyngeal tuberculosis and treated with antituberculous agents. We herein report a case of isolated nasopharyngeal tuberculosis without cervical lymphadenopathy with review of the literature.
Adolescent ; Giant Cells ; Granuloma ; Humans ; Lymphatic Diseases* ; Male ; Nasal Obstruction ; Nasopharynx ; Physical Examination ; Tuberculosis*

BACKGROUND: Scrub typhus is caused by Orientia tsutsugamushi and can become severe and potentially life-threatening. It is suggested that specific host factors can modify the host response during O. tsutsugamushi infection. It is known that susceptibility and outcome of infectious disease are associated with genetic polymorphisms of some cytokines. MATERIALS AND METHODS: Peripheral blood of 144 patients who were diagnosed with scrub typhus and of 311 unrelated healthy subjects were collected. A diagnosis of scrub typhus was made upon demonstration of a fourfold rise in antibody titer to O. tsutsugamushi in paired serum specimens in an indirect immunofluorescent (IFA) test. Genomic DNAs were extracted from peripheral mononuclear cells and genotypings for IL-1 (-511C/T), IL-1beta (+3953T/C), IL-2 (-330T/G), IL-4 (-590C/T), IL-4R(-1902G/A), IL-10 (-1082G/A), IL-10 (-819C/T), TNF-alpha (-238G/A) and TNF-alpha (-308G/A) were performed simultaneously using PCR-SSP (sequence specific polymorphisms) assay. RESULTS: The frequency of IL-1 (-511T/T) (OR=0.53, P<0.01) and IL-2 (-330T/T) (OR=0.56, P<0.01) were significantly decreased, but that of IL-2(-330G/G) (OR=4.49, P<0.01) was increased, in the scrub typhus patients compared to the healthy controls. And, there were no statistically significant differences in the genetic polymorphisms of IL-4 (-590C/T), IL-4Ralpha (-1902G/A), IL-10 (-1082G/A), IL-10 (-819C/T), TNF-alpha (-238G/A), TNF-alpha (-308G/A) genes, in the scrub typhus patients compared to the unrelated healthy controls. CONCLUSIONS: Cytokine polymorphisms in the IL-1 (-511T/T) and the IL-2 genes may influence the host response to O. tsutsugamushi.
Communicable Diseases ; DNA ; Humans ; Interleukin-1 ; Interleukin-10 ; Interleukin-2 ; Interleukin-4 ; Orientia tsutsugamushi ; Polymorphism, Genetic ; Scrub Typhus ; Tumor Necrosis Factor-alpha

Nasopharyngeal tuberculosis is an uncommon disease, and isolated nasopharyngeal tuberculosis is an even rarer condition. An 18-year-old male came to our clinic with left nasal obstruction. Upon physical examination, there was no cervical lymphadenopathy. Nasal endoscopic examination revealed an isolated 2.0x1.5 cm sized pedunculated mass at the midline of the nasopharynx. Histopathological findings of the nasopharyngeal mass showed a caseating granuloma with multinucleated giant cells. He was diagnosed with nasopharyngeal tuberculosis and treated with antituberculous agents. We herein report a case of isolated nasopharyngeal tuberculosis without cervical lymphadenopathy with review of the literature.
Adolescent ; Giant Cells ; Granuloma ; Humans ; Lymphatic Diseases* ; Male ; Nasal Obstruction ; Nasopharynx ; Physical Examination ; Tuberculosis*