scholarly journals Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Ali Ridha ◽  
Njideka Oguejiofor ◽  
Sarah Al-Abayechi ◽  
Emmanuel Njoku

Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms.

2020 ◽  
pp. 16-18
Author(s):  
V. M. Lykhman ◽  
O. M. Shevchenko ◽  
Ye. O. Bilodid ◽  
Igor Vladimirovich Volchenko ◽  
I. A. Kulyk ◽  
...  

Among urgent surgical diseases of abdominal cavity, an acute intestinal obstruction is the most difficult to be diagnosed and treated. Leading factor, determining the development of pathophysiological processes is considered to be the progressive manifestations of enteric insufficiency syndrome, resulting in intestinal barrier impairment, negative changes in ecology of intestinal flora, increased endotoxins. To identify the small intestine microflora in acute intestinal obstruction and determine the role of dysbiotic disorders in clinical manifestations of main pathological process, a study was conducted in 60 patients with mechanical intestinal obstruction. The small intestine has a relatively rare microflora, consisting mainly of gram−positive facultative aerobic microorganisms, streptococci, lactobacilli. The distal ileum in nearly 30−55 % of healthy people contains scanty microflora, and yet the flora of this area differs from the microbial population of the higher gastrointestinal tract due to higher concentration of gram−negative bacteria. Optional−anaerobic coliform bacilli, anaerobic bifidobacteria and fusobacteria, bacteroids, the number of which starts exceeding the one of gram−positive species, are presented in significant quantities. Distal to the ileocecal valve there are significant changes in the microflora quantitative and species composition. Obligatory anaerobic bacteria become the predominant part of microflora, exceeding the number of aerobic and facultative anaerobic bacteria. The bacterial flora in different parts of gastrointestinal tract has its own specifics and is quite constant, as a result of the interaction of many factors, regulating the bacterial population in small intestine. The most important among them are: acidity of gastric juice, normal peristaltic activity of the intestine, bacterial interactions and immune mechanisms. Disorders of the intestine motor and evacuation function with its obstruction lead to slow passage of the chyme and contamination of the upper gastrointestinal tract with new types of microbes. There is a syndrome of small intestine excessive colonization, which means an increased concentration of bacterial populations in it, similar in species composition to the colon microflora. Pathological intra−intestinal contents become a source of endogenous infection and re−infection of the patient, leads to internal digestive disorders, which is manifested by syndrome of malabsorption of proteins, carbohydrates and vitamins. Key words: acute intestinal obstruction, small intestinal microflora, conditionally pathogenic microorganisms, intestinal biocenosis.


2021 ◽  
Vol 158 ◽  
pp. S210
Author(s):  
F. Walter ◽  
A.S. Duque ◽  
H. Weingandt ◽  
J. Well ◽  
R. Shpani ◽  
...  

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Kędzia ◽  
Andrzej W. Kędzia

Introduction. Abies whitebark (Abies sibirica L.) belonging to the family Pinaceae. The tree grown in Mongol, China and Siberian taiga. Produced the pichtae oil, which is obtained by hydrodistillation method. It contain: α-pinene, β-pinene, β-caryophyllene, bornyl acetate, camphene, mircene and cineole. The oil exhibiting expectorant, analgesic, anti-inflammatory, antialergic, liver restorative, adaptogenic and antioxidant properties. It has antimicrobial activity. Aim. The aim of the date was to determine the susceptibility of anaerobic bacteria isolated from patients to pichtae oil. Material and methods. The investigated 49 strains of bacteria isolated from patients from genus Bacteroides (7 strains), Parabacteroides (1), Prevotella (8), Porphyromonas (5), Tannerella (1), Fusobacterium (6), Finegoldia (4), Parvimonas (2), Peptostreptococcus (4), Actinomyces (4), Bifidobacterium (1), Propionibacterium (6), and 10 reference strains. The concentrations the oil were the following: 2.5, 5.0, 7.5, 10.0, 15.0 and 20.0 mg/ml. The pichtae oil was added to Brucella agar with 5% defibrynated sheep blood, menadione and hemin. Inoculum containing 106 CFU/ml was seeded with Steers replicator upon the agar with oil or without oil (strains growth control). The incubation was carried out in anaerobic jars containing 10% C02 , 10% H2 and 80% N2 , palladic catalyst and anaerobic indicator, at 37°C for 48 hrs. The MIC was defined as the lowest concentration of the pichtae oil that completely inhibited growth the anaerobic bacteria. Results. The results investigation indicated that from Gram-negative rods Tannerella forsythia (MIC = 5.0 mg/ml), Bacteroides fragilis and Bacteroides uniformis (MIC = 7.5 mg/ml) were the most susceptible to pichtae oil. The growth of Prevotella strains were inhibited by concentrations in ranges 5.0-15.0 mg/ml. The Prevotella bivia (MIC 10.0-15.0 mg/ml) and Prevotella buccalis (MIC = 15.0 mg/ml) were the most resistant. The tested oil was active on account genus of Fusobacterium strains in concentrations 5.0-10.0 mg/ml. The Gram-positive cocci were the more sensitive then rods. The growth was inhibited by concentrations in ranges ≤ 2.5-10.0 mg/ml. The oil was equally effective against Gram-positive rods (MIC ≤ 2.5-10.0 mg/ml). From this bacteria the more susceptible were the strains of Actinomyces (MIC ≤ 2.5-7.5 mg/ml) and the least a rods from genus of Bifidobacterium (MIC = 10.0 mg/ml). The date indicated, that the Gram-positive anaerobes were the more susceptible to pichtae oil than Gram-negative rods. Conclusions. From among the Gram-negative bacteria the more susceptible to pichtae oil were the rods from genus Tannerella forsythia, Bacteroides fragilis and Bacteroides uniformis. Gram-positive anaerobic cocci were the more susceptible then Gram-positive rods. The pichtae oil was the more active towards Gram-positive bacteria then Gram-negative anaerobic rods.


2021 ◽  
pp. 1-14
Author(s):  
J.B. Zhang ◽  
Y. Meng ◽  
J. Xu ◽  
C. Rensing ◽  
D. Wang

The effects of four antibiotics (metronidazole (M) levofloxacin (L), sodium ampicillin (A), and streptomycin sulphate (S)) and their pair-wise combinations at three doses on the development and intestinal bacterial diversity of the black soldier fly (BSF; Hermetia illucens) larvae were studied. At a low dose M and L were able to inhibit larval growth. At a high dose, all antibiotics were shown to inhibit larval growth. However, the pair-wise combinational use of the antibiotics did not effectively enhance the inhibitory effect. The gut bacterial diversity of the normal control (NC) was significantly higher than the antibiotic-treated groups with 737 operational taxonomic units (OTUs) from the larval guts of NC, compared to 305 and 227 from ML and AS. The number of anaerobic bacteria in ML was significantly lower than in NC and AS, with the relative abundance of OTUs from larval guts of ML being only about 0.01, compared to 0.4 for NC and 0.15 for AS. These results indicated that antibiotics at the experimental concentration did not affect the palatability of food for insects, but they would affect the diversity of food and intestinal microorganisms of BSF larvae, and the inhibitory effect of antibiotics on growth and development of BSF larvae displayed in this study was a complex effect.


2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Shiara Ramdath ◽  
John Mellem ◽  
Londiwe Simphiwe Mbatha

Health issues involving inadequate treatment of diseases such as cancer and microbial infections continue to be the subject of much ongoing recent research. Biosynthesized silver nanoparticles (AgNPs) were characterized using Transmission Electron Microscopy (TEM), Zeta Sizer, Ultraviolet (UV), and Fourier Transform Infrared (FTIR) spectroscopy. Their antimicrobial activity was evaluated on selected Gram-positive and Gram-negative bacterial strains, using the disc diffusion and broth dilution assays. Cell viability profiles were evaluated using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and apoptosis studies on selected human noncancer and cancer cells. The biosynthesized AgNPs were evaluated to be spherical clusters, with sizes between 40 and 70 nm. The absorption peak at 423 nm and the presence of polyphenols confirmed the synthesis and stabilization of these tested AgNPs. The AgNPs showed a good stability of −23.9 ± 1.02 mV. Good antimicrobial activity (6.0–18.0 mm) was seen on all tested bacteria at a minimum inhibitory concentration (MIC) ranging from 5 to 16 μg/ml, with the highest activity seen against Gram-negative Escherichia coli (18 ± 0.5 mm), and the lowest activity was seen against Gram-positive Listeria monocytogenes (6.0 ± 0.4 mm) after treatment with the AgNPs. These NPs showed a concentration-dependent and cell-specific cytotoxicity with low IC50 values (41.7, 56.3, and 63.8 μg/ml). The NPs were well tolerated by tested cells as indicated by a more than 50% cell viability at the high dose tested and low apoptotic indices (<0.2). These findings indicated that these biosynthesized AgNPs showed great potential as effective antibacterial agents and anticancer drug delivery modalities.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S144-S145
Author(s):  
Jasmine R Marcelin ◽  
Mackenzie R Keintz ◽  
Jihyun Ma ◽  
Erica J Stohs ◽  
Bryan Alexander ◽  
...  

Abstract Background No established guidelines exist regarding the role of oral antibiotic therapy (OAT) to treat uncomplicated bloodstream infections (uBSIs) and practices may vary depending on clinician specialty and experience. Methods An IRB-exempt web-based survey was emailed to Nebraska Medicine clinicians caring for hospitalized patients, and widely disseminated using social media. The survey was open access and once disseminated on social media, it was impossible to ascertain the total number of individuals who received the survey. Chi-squared analysis for categorical data was conducted to evaluate the association between responses and demographic groups. Results Of 275 survey responses, 51% were via social media, and 94% originated in the United States. Two-thirds of respondents were physicians, 16% pharmacists, and infectious diseases clinicians (IDC) represented 71% of respondents. The syndromes where most were comfortable using OAT routinely for uBSI were urinary tract infection (92%), pneumonia (82%), pyelonephritis (82%), and skin/soft tissue infections (69%). IDC were more comfortable routinely using OAT to treat uBSIs associated with vertebral osteomyelitis and prosthetic joint infections than non-infectious diseases clinicians (NIDC), but NIDC were more likely to report comfort with routine use of OAT to treat uBSIs associated with meningitis and skin/soft tissue infections. IDC were more likely to report comfort with routine use of OAT for uBSIs due to Enterobacteriaceae and gram-positive anaerobes, while NIDC were more likely to be comfortable with routinely using OAT to treat uBSIs associated with S. aureus, coagulase-negative staphylococci and gram-positive bacilli. In one clinical vignette of S. aureus uBSI due to debrided abscess, 11% of IDC would be comfortable using OAT vs 28% of NIDC; IDC were more likely to report routinely repeating blood cultures (99% vs 83%, p&lt; 0.05). Figure 1: Clinician comfort using oral antibiotic therapy to treat uncomplicated bacteremia due to specific syndromes Figure 2: Clinician comfort using oral antibiotic therapy to treat uncomplicated bacteremia due to specific organisms Conclusion Considerable variation in comfort using OAT for uBSIs among IDC vs NIDC exists, highlighting opportunities for IDC to continue to demonstrate their value in clinical practice. Understanding the reasons for variability may be helpful in creating best practice guidelines to standardize decision making. Disclosures All Authors: No reported disclosures


2019 ◽  
Vol 20 (2) ◽  
Author(s):  
Anna Kędzia ◽  
Elżbieta Hołderna-Kędzia

Introduction. Cypress (Cupressus sempervirens L.) belongs to the family Cupressaceae. It is evergreen, and grows in Mediterranean region. The Cypress leaves and young branches are utilized to produce the essential oil. Cypress oil contain a number of components, in it α-pinene, Δ3-carene, α-terpinyl acetate, cedrol, α-terpinolene, β-myrcene, limonene, α-terpineolene, terpinen-4-ol, β-pinene, δ-cadinene and sabinene. The oil is used in therapy different diseases. It to have antimicrobial activity. Aim. The aim of the date was evaluation the susceptibility of anaerobic bacteria to Cypress oil. Material and methods. The anaerobic bacteria were isolated from patients. The 62 microorganisms, in it 36 strains of Gram-negative rods, 14 Gram-positive cocci and 12 Gram-positive rods, and 7 reference strains were tested. Susceptibility (MIC) was determined by means of plate dilution technique in Brucella agar supplemented with 5% defibrynated sheep blood, menadione and hemin. The Cypress oil was dissolved in DMSO and distilled water to obtain final following concentrations: 2.5, 5.0, 7.5, 10.0, 15.0 and 20.0 mg/ml. Inoculum containing 106 CFU per 1 ml was seeded with Steers replicator upon the agar with oil or without the oil (strains growth control). The agar plates was incubated in anaerobic condition in anaerobic jar in 37°C for 48 hrs. The MIC was interpreted as the lowest concentration of Cypress oil inhibiting the growth of tested bacteria. Results. The results indicated that from among Gram-negative rods the most susceptible to Cypress oil was the strains from genus Tannerella forsythia (MIC < 2.5-5.0 mg/ml), Bacteroides uniformis (MIC = 5.0 mg/ml), Bacteroides vulgatus and Porphyromonas asaccharolytica (MIC 5.0-7.5 mg/ml) and Porphyromonas levii (MIC = 7.5 mg/ml). The strains from genera Fusobacterium and of Bacteroides fragilis were the susceptible to 2.5-≥ 20.0 mg/ml. The Cypress oil was least active towards Prevotella and Parabacteroides strains (MIC ≥ 20.0 mg/ml).The tested Gram-positive cocci were more susceptible. The growth of the strains were inhibited by concentrations in ranges ≤ 2.5-7.5 mg/ml. The oil was minor active towards Gram-positive rods (MIC ≤ 2.5-20.0 mg/ml). Among the strains the genus of Actinomyces odontolyticus (MIC = 5.0 mg/ml) and Actinomyces viscosus (MIC ≤ 2.5-7.5 mg/ml) were the most susceptible. The growth of rods of Bifidobacterium breve was inhibited by concentrations 10.0 mg/ml. The data indicates that the Gram-negative rods were the less susceptible than Gram-positive bacteria to cypress oil. Conclusions. Among Gram-negative rods the most susceptible were the strains Tannerella forsythia, Bacteroides uniformis, Bacteroides vulgatus, Porphyromonas asaccharolytica and Porphyromonas levii. The oil was more active against Gram-positive cocci. Gram-positive anaerobic bacteria demonstrate the more susceptible to Cypress oil then Gram-positive rods.


EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Lee ◽  
M Bates ◽  
E Shepherd ◽  
A Thornley ◽  
N Kelland ◽  
...  

Abstract OnBehalf United Kingdom Cardiac SABR consortium Background Stereotactic Ablative Body Radiotherapy (SABR) is a novel non-invasive treatment for Ventricular Tachycardia (VT) refractory to standard catheter ablation. 3 UK hospitals have started compassionate use cardiac SABR programmes, and are working in close collaboration. Purpose To report initial UK experience for treatment of refractory VT with cardiac SABR. Methods All patients had undergone prior unsuccessful invasive ablation with VT recurrence despite anti-arrhythmic drug (AAD) use. High-resolution CT imaging with 3D reconstruction was combined with 12 lead ECGs of VT and prior invasive +/- non-invasive electrophysiology mapping data to define a cardiac target. Treatment margins were modified to account for cardiac/respiratory motion and to minimise off target treatment to other organs as per clinical SABR practice. Single fraction high dose treatment (20-25 Gy) was delivered by CT guided Linear Accelerator. Patients were assessed regularly with clinical review and remote device monitoring. Results 3 patients have been treated so far with aetiologies of prior myocarditis, non-ischaemic dilated cardiomyopathy and ischaemic cardiomyopathy. All patients successfully received planned SABR treatment in &lt;1 hour with no peri-procedural complications. Current follow up is to 4 months. Clinical course was variable – patient 1 had a flare of VT post-SABR requiring temporary escalation of AADs before VT was suppressed, patient 2 had initial suppression of VT but died from decompensated heart failure with further VT after 4 weeks, patient 3 had further VT with a different exit site and underwent repeat invasive ablation and escalated AAD use to achieve VT suppression. Conclusions Cardiac SABR shows promise for VT control, but further experience and trials are needed. Integration of imaging and electrophysiology data to generate accurate targets appears critical. The effect of SABR seems to develop over several weeks after therapy. Patient selection and timing of SABR delivery is important with acknowledgement that competing causes of death exist in patients with refractory VT entering a compassionate use program. Abstract Figure. Example SBRT plan


2019 ◽  
pp. 28-35 ◽  
Author(s):  
Helena Rosengren ◽  
Clare Heal ◽  
Petra Buettner

Background: Surgical site infection (SSI) rates for below-knee dermatological surgery are unacceptably high, particularly following complex flap and graft closures. The role of antibiotic prophylaxis for these surgical cases is uncertain. Objective: To determine whether SSI following complex dermatological closures on the leg could be reduced by antibiotic prophylaxis administered as a single oral preoperative dose. Methods: A total of 115 participants were randomized to 2 g of oral cephalexin or placebo 40-60 minutes prior to surgical incision in a prospective, randomized, double-blind, placebo-controlled trial at a primary care skin cancer clinic in North Queensland, Australia. Results: Overall 17/55 (30.9%) controls and 14/55 (25.5%) intervention participants developed infection (P = 0.525). There was no difference between the study groups in adverse symptoms that could be attributed to high-dose antibiotic administration (P = 1).


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