scholarly journals On a Boat: A Case in Australia of Endophthalmitis and Pyogenic Liver, Prostatic, and Lung Abscesses in a Previously Well Patient due toKlebsiella pneumoniae

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Alecia Vandevelde ◽  
Bojana Stepanovic
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Case Reports ◽  
Young Male ◽  
The Elderly ◽  
Significant Morbidity ◽  
Global Spread ◽  
Tract Infections

This is a case report about a patient who arrived in our emergency department in Western Australia to the care of the urologists having just gotten off a ship with a bacterial infection that would result in a 44-day stay in hospital and have quite devastating lasting effects for the young male. His story was in fact reflective of an emerging global phenomenon. Once thought to generally be a bacterium of threat only to the elderly and alcoholics, causing pneumonia and urinary tract infections, this case report describes the potentially devastating consequences of what is now becoming recognized as a hypervirulent form ofKlebsiella pneumoniaewith the potential to spread throughout the system rapidly seeding abscesses and causing significant morbidity in nonimmunocompromised patients. Initially noticed in Asia increasingly case reports are emerging in Western countries suggesting a global spread.

scholarly journals Ovarian Torsion in a 5-Year Old: A Case Report and Review

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Matthew F. Ryan ◽  
Bobby K. Desai
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Urinary Tract ◽  
Clinical Suspicion ◽  
Ovarian Torsion ◽  
Surgical Emergencies ◽  
High Clinical Suspicion ◽  
Tract Infections ◽  
Prompt Diagnosis

Ovarian torsion represents a true surgical emergency. Prompt diagnosis is essential to ovarian salvage, and high clinical suspicion is important in this regard. Confounding the diagnosis in general are more commonly encountered abdominal complaints in the Emergency Department (ED) such as constipation, diarrhea, and urinary tract infections and more common surgical emergencies such as appendicitis. Prompt diagnosis can be further complicated in low-risk populations such as young children. Herein, we describe the case of a 5-year-old girl with a seemingly benign presentation of abdominal pain who was diagnosed in the ED and treated for acute ovarian torsion after two prior clinic visits. A brief discussion of evaluation, treatment, and management of ovarian torsion follows.

scholarly journals Septic shock caused by community-acquired urinary tract infection caused by Klebsiella pneumoniae ESBL+: A case report

2020 ◽  
Author(s):  
Małgorzata Braczkowska ◽  
Lidia Glinka ◽  
Marcin Mieszkowski ◽  
Bułat Tuyakov ◽  
Aleksandra Gutysz-Wojnicka
Keyword(s):  
Septic Shock ◽  
Case Report ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Organ Failure ◽  
Diagnostic Procedures ◽  
Multiple Organ ◽  
The Body ◽  
Diagnostic Methods ◽  
Tract Infections

Introduction: Septic shock is defined as a life-threatening organ failure caused by an abnormal response of the body to infection. Urinary tract infections (UTIs) constitute about 10%–20% of all community-acquired infections and about 40%–50% of hospital-acquired infections. In patients with impaired immunity they may lead to sepsis. Strains of Klebsiella pneumoniae are often multidrug resistant, and therapeutic chances are limited where they occur. Aim: The aim of this paper is to discuss the most recent guidelines in diagnosing and treating sepsis, referring to a clinical case report. Case study: The study presents a case of septic shock in a 44-year-old female patient in a community-acquired UTI caused by K. pneumoniae extended-spectrum β-lactamases (ESBL+). Results and discussion: The course of septic shock proved fatal. As the stay in the intensive care unit (ICU) was short, this precluded implementing full diagnostic procedures and identifying the source of infection. A post mortem examination was performed to establish the cause of death and aetiology of the infection. Conclusions: K. pneumoniae ESBL+ has become a growing epidemiological problem in Poland and all over the world. This pathogen increasingly often leads to community-acquired infections and its multidrug resistance makes the applied therapies ineffective. Diabetes, one of the modern lifestyle diseases, impairs resistance and accelerates rapidly progressing septic shock with multiple organ failure. Late diagnosis of sepsis, because of considerable metabolic and cellular changes, brings about tragic results. Despite implementing new diagnostic methods and therapies, the mortality rate in sepsis still remains very high.

Age-related Trends in Adults with Urinary Tract Infections Presenting to the Emergency Department: A 5-Year Experience

2019 ◽  
Vol 14 (2) ◽  
pp. 147-156 ◽  
Author(s):  
Silvia Cardone ◽  
Carmine Petruzziello ◽  
Alessio Migneco ◽  
Barbara Fiori ◽  
Teresa Spanu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Young Adults ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Oldest Old ◽  
The Elderly ◽  
The Other ◽  
Care Hospital ◽  
Age Related ◽  
Tract Infections

Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections, affecting 150 million people worldwide each year. Importantly, the incidence of UTI increases markedly with age. The increasing resistance to empirically prescribed antimicrobial agents complicates the management of this disease. This makes UTI an important issue in increasingly aging population and updated epidemiological investigation is advisable. : To understand the epidemiological variation in UTI resistance patterns among differently aged populations, we conducted a retrospective study among patients presenting to the emergency department (ED) of a large tertiary-care hospital in Italy during January 2013 and June 2017. Methods: 1281 patients who presented with UTI symptoms to the ED, were stratified into four age categories: young adults (18-44 years old;), adults (45-64), the elderly (65-84), and the oldest old (≥ 85). Inclusion criteria were urine collected in ED patients with UTI symptoms and first positive culture from one given patient in a given year. Results: 362 (28.2%) patients had a urine culture with positive result, leading to a total of 459 germs isolated, stratified into four categories: young adults (58 isolates, 12.6%), adults (98, 21.4%), the elderly (174, 37.9%), and the oldest old (129, 28.1%). : Escherichia coli represents the 60% of all monomicrobial infections, followed in frequency by Klebsiella pneumoniae (15%), and Enterococcus faecalis (5%). The other 20% of the infections are caused by various germs. : The most common association of germs in polymicrobial is E. coli + E. faecalis, accounting for the 28% of all infections. : Overall, we found a peak of susceptibility to amoxicillin (AMX) in the oldest old ( 81%), significantly higher compared to young adults (54%), adults (47%) and elderly (35%) (p<0,001). : For ciprofloxacin (CIP) there is a greater susceptibility in the young adult (55.5%), but not so marked compared to the other three groups; for fosfomicin (FOS) the susceptibility was greater in the group of adults (60%) compared to young adults, elderly and the oldest old. Also for trimethoprim/ sulfamethoxazole (TMP-SMX) we found greater susceptibility in the adult group (60%), followed by the oldest old (57,6%), young adults (49%) and elderly (47%). Conclusion: Age-related differences in antimicrobial-resistant microorganisms were evident for adults with UTI, and could potentially contribute to the risk of inappropriate empirical therapy in elderly patients. Thus, different empirical antimicrobial regimens should be considered for distinct age groups.

scholarly journals Association between non-typhoidal Salmonella urinary tract infection and Klebsiella pneumoniae lung empyema

2020 ◽  
pp. 201010582096452
Author(s):  
Samuel Zheng Fong Goh ◽  
Boon Hian Tan ◽  
Simon Stacey
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Salmonella Enteritidis ◽  
The Elderly ◽  
Common Cause ◽  
Tract Infections

Non-typhoidal Salmonella is a known but rare cause of urinary tract infections (UTI). It has been associated with the elderly, urological abnormalities and immunocompromised states. Klebsiella pneumoniae is a common cause of lung empyema, and is typically associated with diabetes and malignancy. Here, we report a patient who was found to have a Salmonella enteritidis bacteriuria as well as a lung empyema secondary to K. pneumoniae.

scholarly journals 1675. Epidemiology of Urinary Tract Infections in the United States, 2009 - 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S823-S823
Author(s):  
Kendra Foster ◽  
Linnea A Polgreen ◽  
Brett Faine ◽  
Philip M Polgreen
Keyword(s):  
United States ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Urinary Tract Infections ◽  
Proteus Mirabilis ◽  
Antibiotic Use ◽  
The United States ◽  
Drug Resistant ◽  
E Coli ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are one of the most common bacterial infections. There is a lack of large epidemiologic studies evaluating the etiologies of UTIs in the United States. This study aimed to determine the prevalence of different UTI-causing organisms and their antimicrobial susceptibility profiles among patients being treated in a hospital setting. Methods We used the Premier Healthcare Database. Patients with a primary diagnosis code of cystitis, pyelonephritis, or urinary tract infection and had a urine culture from 2009- 2018 were included in the study. Both inpatients and patients who were only treated in the emergency department (ED) were included. We calculated descriptive statistics for uropathogens and their susceptibilities. Multi-drug-resistant pathogens are defined as pathogens resistant to 3 or more antibiotics. Resistance patterns are also described for specific drug classes, like resistance to fluoroquinolones. We also evaluated antibiotic use in this patient population and how antibiotic use varied during the hospitalization. Results There were 640,285 individuals who met the inclusion criteria. Females make up 82% of the study population and 45% were age 65 or older. The most common uropathogen was Escherichia Coli (64.9%) followed by Klebsiella pneumoniae (8.3%), and Proteus mirabilis (5.7%). 22.2% of patients were infected with a multi-drug-resistant pathogen. We found that E. Coli was multi-drug resistant 23.8% of the time; Klebsiella pneumoniae was multi-drug resistant 7.4%; and Proteus mirabilis was multi-drug resistant 2.8%. The most common antibiotics prescribed were ceftriaxone, levofloxacin, and ciprofloxacin. Among patients that were prescribed ceftriaxone, 31.7% of them switched to a different antibiotic during their hospitalization. Patients that were prescribed levofloxacin and ciprofloxacin switched to a different antibiotic 42.8% and 41.5% of the time, respectively. Conclusion E. Coli showed significant multidrug resistance in this population of UTI patients that were hospitalized or treated within the ED, and antibiotic switching is common. Disclosures All Authors: No reported disclosures

scholarly journals Dysuria, Rebound Tenderness, and a Palpable Mass—A Ticking Time Bomb

2021 ◽  
Author(s):  
Tyler Miklovic ◽  
Philip Davis
Keyword(s):  
Emergency Department ◽  
Case Reports ◽  
Pubic Symphysis ◽  
Subsequent Treatment ◽  
Urachal Cyst ◽  
Significant Morbidity ◽  
Palpable Mass ◽  
Rebound Tenderness ◽  
Patient Reported ◽  
Middle Aged Adult

ABSTRACT A 37-year-old male presented to the emergency department with the complaint of periumbilical abdominal pain, radiating to just above pubic symphysis. The patient reported that the pain was worse with urination and associated with chills and nausea. This case reports discusses the Emergency Department (ED) course and subsequent treatment of a patient found to have an infected urachal cyst, a previously asymptomatic embryological anomaly in an otherwise healthy middle-aged adult male. This is a crucial diagnosis to make in order to avoid the potential for significant morbidity and/or mortality, given the unlikely symptomatic source.

Urinary Tract Infections in Febrile Infants Younger Than 8 Weeks of Age

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 363-367 ◽  
Author(s):  
Ellen F. Crain ◽  
Jeffrey C. Gershel
Keyword(s):  
Emergency Department ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
White Blood Cells ◽  
Laboratory Data ◽  
Pediatric Emergency ◽  
Urine Specimen ◽  
High Power Field ◽  
Tract Infections

In this prospective study of 442 infants younger than 8 weeks of age who attended a pediatric emergency department with temperature ≥100.6°F (38.1° C), urinary tract infections (UTIs) were found in 33 patients (7.5%), 2 of whom were bacteremic. Clinical and laboratory data were not helpful for identifying UTIs. Of the 33 patients with UTIs, 32 had urinalyses recorded; 16 were suggestive of a UTI (more than five white blood cells per high-power field or any bacteria present). Of the 16 infants with apparently normal urinalysis results, three had an emergency department diagnosis suggesting an alternative bacterial focus of infection. If the physician had decided on the basis of apparently normal urinalysis results to forgo obtaining a urine culture, more than half of the UTIs would have been missed. Bag-collected specimens were significantly more likely to yield indeterminate urine culture results than either catheter or suprapublic specimens. In addition, uncircumcised males were significantly more likely to have a UTI than circumcised boys. These results suggest that a suprapubic or catheter-obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants younger than 8 weeks of age, regardless of the urinalysis findings or another focus of presumed bacterial infection.

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