scholarly journals A Woman with Unilateral Rash and Fever: Cellulitis in the Setting of Lymphedema

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Melissa Joseph ◽  
Marissa Camilon ◽  
Tarina Kang

Cellulitis in the setting of lymphedema is an uncommon but clinically important presentation to the emergency department. Stagnant lymph is an ideal medium for bacterial growth and progression can be rapid due to decreased ability to fight infection in the affected area. Infections are commonly caused by gram-positive cocci, though blood cultures are often negative. Treatment should be aimed at rapid initiation of antibiotics targeting these species. There may be a role for antibiotic prophylaxis in recurrent cases.

2005 ◽  
Vol 43 (12) ◽  
pp. 6144-6146 ◽  
Author(s):  
N. K. Shrestha ◽  
M. J. Tuohy ◽  
R. A. Padmanabhan ◽  
G. S. Hall ◽  
G. W. Procop

2013 ◽  
Vol 24 (4) ◽  
pp. e113-e116 ◽  
Author(s):  
Kanchana Manickam ◽  
Andrew Walkty ◽  
Philippe RS Lagacé-Wiens ◽  
Heather Adam ◽  
Barbara Swan ◽  
...  

INTRODUCTION:Staphylococcus aureusbacteremia is associated with considerable morbidity and mortality. In theory, reducing the turnaround time in reporting of methicillin-resistantS aureus(MRSA) among patients with bactermia could assist with the rapid optimization of antimicrobial therapy.OBJECTIVE: To evaluate the sensitivity and specificity of MRSASelect(Bio-Rad Laboratories, USA), a chromogenic medium, in the early detection of MRSA from blood cultures growing Gram-positive cocci in clusters, and to confirm that routine use of this medium would, in fact, reduce turnaround time for MRSA identification.METHODS: The present study was conducted at three microbiology laboratories in Manitoba. Between April 2010 and May 2011, positive blood cultures with Gram-positive cocci in clusters visualized on Gram stain were subcultured to both MRSASelectand routine media. MRSA isolates were identified using conventional microbiological methods from routine media and using growth with the typical colony morphology (pink colony) on MRSASelectmedium.RESULTS: A total of 490 blood cultures demonstrating Gram-positive cocci in clusters on Gram stain were evaluated.S aureuswas recovered from 274 blood cultures, with 51S aureusisolates (51 of 274 [18.6%]) identified as MRSA. MRSASelectmedium had a sensitivity of 98%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 99.8% for the recovery and identification of MRSA directly from positive blood culture bottles. In addition, use of MRSASelectmedium was found to improve turnaround time in the detection of MRSA by almost 24 h relative to conventional methods.DISCUSSION: These data support the utility of MRSASelectmedium for the rapid identification of MRSA from positive blood cultures. Further clinical studies are warranted to determine whether the improvement in turnaround time will result in a measurable reduction in suboptimal antimicrobial therapy and/or improvement in patient outcome.


2005 ◽  
Vol 11 (3) ◽  
pp. 478-484
Author(s):  
M. Rahbar

Ina 2-year retrospective study, the database of the microbiology laboratory of the Imam Khomeini Hospital was reviewed to identify patients who had nosocomial bacteraemia between 1 May 1999 and 31 May 2001 and identify the pathogen responsible and its resisitance to antibiotics. Of 6492 patients in various wards, 593 [9.1%] had positive blood cultures; 85 of those [14.3%] had signs of potential skin contamination. Gram-positive cocci, including coagulase-negative staphylococci, Staphylococcus aureus, Streptococcus pneumoniae and other Gram-positive cocci, accounted for 42.3% of isolates. Gram-negative bacilli were responsible for another 42.3% of isolates; Pseudomonas aeruginosa was the predominant isolate. Patterns of drug resistance varied according to species of bacteria but were generally quite high


2018 ◽  
Vol 56 (9) ◽  
Author(s):  
Paul A. Granato ◽  
Melissa M. Unz ◽  
Raymond H. Widen ◽  
Suzane Silbert ◽  
Stephen Young ◽  
...  

ABSTRACT The iC-GPC Assay (iCubate, Huntsville, AL) is a qualitative multiplex test for the detection of five of the most common Gram-positive bacteria (Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Enterococcus faecalis, and Enterococcus faecium) responsible for bacterial bloodstream infections, performed directly from positive blood cultures. The assay also detects the presence of the mecA, vanA, and vanB resistance determinants. This study comparatively evaluated the performance of the iC-GPC Assay against the Verigene Gram-positive blood culture (BC-GP) assay (Luminex Corp., Austin, TX) for 1,134 patient blood culture specimens positive for Gram-positive cocci. The iC-GPC Assay had an overall percent agreement with the BC-GP assay of 95.5%. Discordant specimens were further analyzed by PCR and a bidirectional sequencing method. The results indicate that the iC-GPC Assay together with the iCubate system is an accurate and reliable tool for the detection of the five most common Gram-positive bacteria and their resistance markers responsible for bloodstream infections.


2003 ◽  
Vol 9 (1-2) ◽  
pp. 185-190
Author(s):  
N. M. Kaplan

Blood cultures submitted to the Clinical Microbiology Laboratory, Queen Alia Military Hospital, Amman during 1999-2001 were examined to evaluate thermonuclease testing for identifying Staphylococcus aureus in blood culture broths growing gram-positive cocci. Of 170 cultures studied, 129 yielded gram-positive staphylococci and 41 yielded other gram-positive cocci. Toluidine blue-deoxynucleic acid agar plates were used to test for thermonuclease activity. St and ard tube coagulase tests were performed on the isolates. Direct detection of thermonuclease activity in 76 blood culture broths containing gram-positive staphylococci showed 100% correlation with subsequent tube coagulase tests. The thermonuclease test provides a fast, specific and reliable confirmation of S. aureus bacteraemia by direct examination of blood culture broths that contain gram-positive cocci. This allows for timely, optimal antibiotic therapy


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