Adenocarcinoma ; surgery ; Candidiasis ; etiology ; Cardiac Tamponade ; diagnosis ; etiology ; Echocardiography ; Electrocardiography ; Esophageal Fistula ; complications ; diagnostic imaging ; Fever ; etiology ; Gastrectomy ; Haemophilus Infections ; etiology ; Heart Diseases ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pericardial Effusion ; diagnostic imaging ; etiology ; Pericarditis ; diagnostic imaging ; etiology ; Postoperative Complications ; diagnostic imaging ; Staphylococcal Infections ; etiology ; Stomach Neoplasms ; surgery ; Streptococcal Infections ; etiology ; Tomography, X-Ray Computed

Humans ; Infant ; Male ; Meningitis, Bacterial ; etiology ; Streptococcal Infections ; complications ; Streptococcus agalactiae

OBJECTIVETo study the clinical characteristics, antibiotics sensitivity and outcome of group B streptococcus (GBS) meningitis in neonates in order to provide the guide for early diagnosis and appropriate treatment.

METHODA retrospective review was performed and a total of 13 cases of neonatal purulent meningitis caused by GBS were identified in the Neonatal Intensive Care Unit of Yuying Children's Hospital of Wenzhou Medical University from January 1, 2005 to May 31, 2013. The clinical characteristics, antibiotics sensitivity test results and outcome were analyzed.

RESULTFever, poor feeding, seizure and lethargy were common clinical signs of neonatal purulent meningitis caused by GBS. Three cases of early onset GBS meningitis received prepartum antibiotics. All 13 cases had abnormal C-reactive protein (CRP) level, and 11 cases had increased CRP within hours after admission. Of the 13 patients, 7 were cured, 4 discharged with improvement, 2 patients died during hospitalization after being given up because of serious complication. The average length of stay for recovered patients was (47 ± 21)d. Acute complications mainly included hyponatremia (5 cases), intracranial hemorrhage (3 cases) , ventriculomegaly (3 cases) , subdural collection (2 cases) , hydrocephalus (2 cases), septic shock (2 cases), cerebral hernia (1 case), encephalomalacia (1 case). One preterm patient with early onset GBS meningitis died 1 month after hospital discharge. Among 7 survivors with 10-24 months follow-up, 3 were early onset GBS meningitis, 2 with normal results of neurologic examination, 1 with delayed motor development, 4 were late onset GBS meningitis, 1 with normal results of neurologic examination, 3 were neurologically impaired with manifestations including delayed motor development (2 cases) and seizures (1 case). All the GBS strains were sensitive to penicillin and linezolid (13/13, 10/10), the susceptibility to levofloxacin, ampicillin and vancomycin were 11/12, 9/10, 8/13 respectively.

CONCLUSIONThe clinical manifestations of neonatal purulent meningitis caused by GBS are usually non-specific. It is associated with long hospitalization, neurological impairments and sequelae. Monitoring of serum CRP level is valuable for early diagnosis. Antepartum prophylaxis, early diagnosis and therapy are vital. Large dose penicillin is the priority choice to treat the neonatal purulent meningitis caused by GBS, linezolid should be used in intractable cases.

Anti-Bacterial Agents ; therapeutic use ; C-Reactive Protein ; analysis ; Drug Resistance, Bacterial ; Female ; Fever ; diagnosis ; drug therapy ; pathology ; Follow-Up Studies ; Humans ; Hyponatremia ; etiology ; Infant, Newborn ; Leukocyte Count ; Male ; Meningitis, Bacterial ; diagnosis ; drug therapy ; pathology ; Microbial Sensitivity Tests ; Penicillins ; therapeutic use ; Pregnancy ; Pregnancy Complications, Infectious ; Retrospective Studies ; Streptococcal Infections ; diagnosis ; drug therapy ; pathology ; Streptococcus agalactiae

Group B Streptococcus (GBS) is responsible for two distinct clinical syndromes in the newborn period categorised as either early- or late-onset GBS disease. Maternal GBS colonization of gastrointestinal tract or vaginal is the major risk factor for GBS diseases. There are two main strategies for identifying women at risk of giving birth to a GBS-infected infant: universal screening strategy and risk-based assessment. In the United States and other countries, the implementation of maternal intrapartum antibiotic prophylaxis policies has significantly reduced the incidence of early-onset neonatal GBS disease, but has little effect on the incidence of late-onset GBS disease. Penicillin is the first choice for antibiotic prophylaxis treatment. GBS strains which are isolated from pregnant women who are allergic to penicillin should undergo antibiotic susceptibility testing. Antibiotic prophylaxis measures have some disadvantages, so researchers should actively develop other precautions to prevent GBS infection.
Antibiotic Prophylaxis ; Female ; Humans ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious ; Streptococcal Infections ; etiology ; prevention & control ; Streptococcus agalactiae

BACKGROUND: To investigate the risk factors for vaginal infections and antimicrobial susceptibilities of vaginal microorganisms among women who experienced preterm birth (PTB), we compared the prevalence of vaginal microorganisms between women who experienced preterm labor (PTL) without preterm delivery and spontaneous PTB. METHODS: Vaginal swab specimens from 126 pregnant women who experienced PTL were tested for group B streptococcus (GBS), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex virus (HSV) I and II, and bacterial vaginosis. A control group of 91 pregnant women was tested for GBS. Antimicrobial susceptibility tests were performed for GBS, M. hominis, and U. urealyticum. RESULTS: The overall detection rates for each microorganism were: U. urealyticum, 62.7%; M. hominis, 12.7%; GBS, 7.9%; C. trachomatis, 2.4%; and HSV type II, 0.8%. The colonization rate of GBS in control group was 17.6%. The prevalence of GBS, M. hominis, and U. urealyticum in PTL without preterm delivery and spontaneous PTB were 3.8% and 8.7% (relative risk [RR], 2.26), 3.8% and 17.3% (RR, 4.52), and 53.8% and 60.9% (RR, 1.13), respectively, showing no significant difference between the 2 groups. The detection rate of M. hominis by PCR was higher than that by culture method (11.1% vs. 4.0%, P=0.010). The detection rates of U. urealyticum by PCR and culture method were 16.7% and 57.1%, respectively. CONCLUSIONS: There was no significant difference in the prevalence of GBS, M. hominis, and U. urealyticum between the spontaneous PTB and PTL without preterm delivery groups.
Female ; Humans ; Microbial Sensitivity Tests ; Mycoplasma Infections/complications/microbiology ; Mycoplasma hominis/isolation & purification ; Obstetric Labor, Premature/*epidemiology/etiology ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology/microbiology ; Premature Birth/*epidemiology/etiology ; Prevalence ; Risk Factors ; Streptococcal Infections/complications/microbiology ; Streptococcus agalactiae/isolation & purification ; Ureaplasma Infections/complications/microbiology ; Ureaplasma urealyticum/isolation & purification ; Vagina/*microbiology

Spontaneous rupture of colon cancer, combined with psoas abscess formation, is rare. A 44-year-old male visited for back pain and left buttock mass. Abdominal computed tomography and magnetic resonance image revealed a large abscess in the left psoas muscle and in the left lower quadrant area. Ten days after incision and drainage, a skin defect around the left anterior superior iliac spine remained. A local flap was performed using a superficial skin graft. Ten days after the stitches had been removed, fecal discharge was observed around the anterior superior iliac spine at the flap site. An operation was performed by a general surgeon who had diagnosed this as a case of enterocutaneous fistula. Operative findings included a ruptured tumor mass in the descending colon, which was connected to a retroperitoneal abscess. Pathologic report findings determined adenocarcinoma of the resected colon. Herein, we report a case of psoas abscess resulting from perforating colon cancer.
Adult ; Colonic Neoplasms/*complications ; Humans ; Male ; Psoas Abscess/*etiology ; Rupture, Spontaneous/complications ; Streptococcal Infections/*etiology

No abstract available.
Animals ; Biopsy ; Female ; Glomerulonephritis/*etiology ; Hemorrhage/*etiology ; Humans ; Kidney/pathology ; Lung Diseases/etiology ; Mice ; Middle Aged ; *Pulmonary Alveoli ; Streptococcal Infections/*complications

Child, Preschool ; Female ; Humans ; Male ; Shock, Septic ; etiology ; microbiology ; Streptococcal Infections ; complications ; pathology

Acute post-streptococcal glomerulonephritis (PSGN) is characterized by an abrupt onset of edema, hypertension, and hematuria. Life-threatening diffuse alveolar hemorrhage (DAH) is rarely associated with acute PSGN. There have been only two reported cases worldwide, and no case has been reported previously in Korea. Here, we present a patient who clinically presented with pulmonary-renal syndrome; the renal histology revealed post-infectious glomerulonephritis of immune complex origin. A 59-yr-old woman was admitted with oliguria and hemoptysis two weeks after pharyngitis. Renal insufficiency rapidly progressed, and respiratory distress developed. Chest radiography showed acute progressive bilateral pulmonary infiltrates. The clinical presentation suggested DAH with PSGN. Three days after treatment with high-dose steroids, the respiratory distress and pulmonary infiltrates resolved. Electron microscopy of a renal biopsy specimen sample revealed diffuse proliferative glomerulonephritis with characteristic subendothelial deposits of immune complex ("hump''). The renal function of the patient was restored, and the serum creatinine level was normalized after treatment.
Biopsy ; Female ; Glomerulonephritis/*etiology ; Hemorrhage/*etiology ; Humans ; Kidney/pathology ; Lung Diseases/etiology ; Middle Aged ; *Pulmonary Alveoli ; Streptococcal Infections/*complications

The M protein and streptococcus pyrogenic exotoxin (SPE A) are important virulence factors in group A streptococci (GAS) infections. The emm types of GAS strains isolated from patients with sepsis were determined by sequencing the 5' N-terminus of the emm gene, encoding the M protein, and clonality analysis using pulsed-field gel electrophoresis. The presence of speA and production of SPE A were also examined. There were no predominant GAS clones. The emm genotypes were variable, and the most common genotype was emm13 (17.9%). The production prevalence of SPE A was 21.4%. The low mortality rate (7.1%) of GAS sepsis might be attributable to the low incidence of virulent strains such as emm1 (10.7%) and emm3 (7.1%), as well as to low production rate of SPE A.
Virulence/genetics ; Variation (Genetics) ; Streptococcus pyogenes/*genetics/*pathogenicity ; Streptococcal Infections/*etiology/microbiology ; Sepsis/*etiology/microbiology ; Middle Aged ; Membrane Proteins/*biosynthesis/*genetics ; Male ; Infant ; Humans ; Genotype ; Female ; Exotoxins/*biosynthesis/*genetics ; DNA, Bacterial/genetics/isolation & purification ; Child, Preschool ; Child ; Bacterial Proteins/*biosynthesis/*genetics ; Aged ; Adult ; Adolescent