Bacterial Endocarditis of the Pulmonic Valve in a Dog

2018 ◽  
Vol 54 (5) ◽  
Author(s):  
Grace K. Clark ◽  
Alan Spier ◽  
Derek Nestor ◽  
Scott Rizzo
Keyword(s):  
Oral Therapy ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Bacterial Endocarditis ◽  
Blood Cultures ◽  
Oral Antibiotic ◽  
Pulmonic Valve ◽  
Intravenous Antibiotics ◽  
Pulmonic Regurgitation

ABSTRACT An 11 yr old female spayed golden retriever weighing 30.3 kg presented for evaluation of progressive lethargy, anorexia, tachypnea, stiff gait, and nonlocalized pain. On physical exam, the patient was febrile and tachycardic, and an arrhythmia with pulse deficits was noted. Clinicopathological abnormalities included thrombocytopenia, leukocytosis, nonregenerative anemia, and mild hypoalbuminemia. The patient progressed overnight to develop a productive cough, and an echocardiogram performed the next morning revealed irregular proliferative lesions of the pulmonic valve with moderate pulmonic regurgitation. Subsequent blood cultures grew two organisms: alpha-hemolytic streptococci spp. and Empedobacter brevis. The dog was treated with appropriate intravenous antibiotics for 2 wk and then switched to oral therapy. The clinicopathologic abnormalities, fever, and clinical signs resolved with oral antibiotic treatment. To the authors' knowledge, this case report represents the first detailed published case of bacterial endocarditis with E brevis bacteremia involving the pulmonic valve. The clinical presentation, diagnosis, treatment, and follow-up are discussed.

Short Oral Antibiotic Treatment of Osteomyelitis Questioned

1980 ◽  
Vol 2 (1) ◽  
pp. 18-18
Keyword(s):  
Antimicrobial Therapy ◽  
Oral Therapy ◽  
Initial Period ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Oral Route ◽  
Antimicrobial Treatment ◽  
Blood Levels ◽  
Oral Antibiotic ◽  
Cortical Destruction

Dr. Rothman of Haverhill, MA questioned the short duration of antimicrobial treatment and use of oral route for the patient with osteomyelitis presented by Bennett in PIR 1:153, November 1979. He noted that the traditional regimen for osteomyelitis calls for six weeks of intravenous antimicrobial therapy. Dr. Bennett quotes from Telzlaff et al (J Pediatr 92:485, 1978). In this report good results were found when antimicrobial regimens for patients with osteomyelitis and suppurative arthritis consisted of a brief initial period of parenteral therapy of only one to seven days followed by oral antimicrobial therapy begun when there was a definitive decrease in clinical signs of inflammation and continued for three weeks or longer. It is important to note that surgical drainage of pus was carried out, that antimicrobial blood levels were obtained after initiation of oral therapy to ensure adequate levels, that therapy was continued until all signs and symptoms had subsided, that there was no evidence of cortical destruction or sequestrum formation on roentgenogram, and the erythrocyte sedimentation rate was less than 20 mg/hr. When these conditions are met it is clear that oral therapy can be an adequate substitute for prolonged intravenous therapy for osteomyelitis in children.

Clinical presentation of pulmonary hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2495-2497
Author(s):  
Marion Delcroix
Keyword(s):  
Pulmonary Hypertension ◽  
Congenital Heart ◽  
Clinical Presentation ◽  
Heart Diseases ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Right Heart Failure ◽  
Clinical Feature ◽  
Associated Conditions

No clinical feature is pathognomonic for pulmonary hypertension. Signs and symptoms are quite unspecific and can be observed in other lung or heart diseases. This explains why the diagnosis is usually late. Dyspnoea, fatigue, syncope, and angina are the most frequent symptoms. Late in the disease course, signs of right heart failure may also appear, such as hepatomegaly, peripheral oedema, and jugular distension. The clinical presentation is also influenced by the associated conditions, with signs suggestive for systemic sclerosis, portal hypertension, or congenital heart disease. Evaluation of the clinical signs is an important part of patient risk stratification at diagnosis and in the follow-up of patients with pulmonary hypertension.

Oral Management for Pediatric Lyme Meningitis

2018 ◽  
Vol 8 (3) ◽  
pp. 272-275
Author(s):  
Santiago M C Lopez ◽  
Brian T Campfield ◽  
Andrew J Nowalk
Keyword(s):  
Oral Therapy ◽  
Chart Review ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Case Series ◽  
Parenteral Therapy ◽  
Oral Antibiotics ◽  
Serious Adverse Events ◽  
Parenteral Route

Abstract Background Guidelines for pediatric Lyme meningitis recommend treatment with parenteral therapy [1, 2]. Adult studies suggest that Lyme meningitis can be successfully treated with oral therapy. Our objective was to evaluate the clinical response, side effects and outcome of oral therapy for Lyme meningitis in the pediatric population compared with parenteral therapy in an area endemic for Lyme disease. Methods We conducted a case series chart review from January 2012 to May 2017 of pediatrics patient diagnosed and treated for Lyme meningitis. We recorded clinical presentation, laboratory values, antimicrobial therapy and follow up after therapy to compare the efficacy of oral versus parenteral route of therapy. Results We identified 38 patients diagnosed with Lyme meningitis. Thirty-two patients were discharge with exclusively oral therapy with: doxycycline and amoxicillin. We had only 2 patients developed potential adverse effects from oral doxycycline therapy. All patients treated with oral antibiotics had resolution of symptoms on follow up appointments. Conclusions Oral therapy for Lyme meningitis yields no serious adverse events, was well tolerated and showed resolution of symptoms.

scholarly journals Bilateral antrochoanal polyps: a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar cherrabi ◽  
Nabil Touihem ◽  
Ismail Nakkabi ◽  
Karim Nadour
Keyword(s):  
Maxillary Sinus ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Lateral Wall ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Case Presentation ◽  
Nasal Vestibule ◽  
Excellent Outcome

Abstract Background Antrochoanal or Killian polyp is a rare polyp of the maxillary sinus in adults. It is generally unilateral, implanted on the lateral wall of the maxillary sinus upon the uncinate process. Bilateral cases are very rare; only 14 cases have been cited from 1980 to 2020. Case presentation Our patient presented with a complete bilateral nasal obstruction, this symptom persisted for more than 10 years, with a perceived prolapse in his throat in the last 4 months. Anterior rhinoscopy showed a polyp that took up the totality of his nasal vestibule. Posterior rhinoscopy showed a polyp bulging behind the uvula. The challenge in this case is related to diagnosis decision; conditions with the same clinical presentation are several. Diagnosis was established through the clinical, radiological, and endoscopic aspects, and confirmed by histological findings. Management was obtained through functional endoscopic sinus surgery; no recurrence was noted in the 12-month follow-up, and clinical signs had completely subsided. Conclusion Diagnosis in bilateral forms of Killian polyp is perplexing; however, its management is generally simple, with excellent outcome. We report the case of the 15th patient along with a systematic literature review discussing bilateral Killian polyps, illustrated by a rare case of enormous bilateral antrochoanal polyps.

Leucocytoclastic vasculitis due to acute bacterial endocarditis resolves with antibiotics

2021 ◽  
Vol 14 (1) ◽  
pp. e239961
Author(s):  
Jeffrey Spindel ◽  
Ishan Parikh ◽  
Merryl Terry ◽  
Rodrigo Cavallazzi
Keyword(s):  
Infective Endocarditis ◽  
Female Patient ◽  
Clinical Signs ◽  
Bacterial Endocarditis ◽  
Blood Cultures ◽  
Right Atrial ◽  
Pacemaker Lead ◽  
Significant Morbidity ◽  
Leucocytoclastic Vasculitis ◽  
High Index Of Suspicion

Infective endocarditis is associated with a variety of clinical signs, but its association with multisystem vasculitis is rarely reported. A high index of suspicion is necessary to differentiate a primary autoimmune vasculitis from an infectious cause as the wrong treatment can lead to significant morbidity and mortality. We present a 71-year-old female patient with negative blood cultures, on antibiotics for recent bacteraemia, who presented with cutaneous and renal leucocytoclastic vasculitis. Workup revealed a vegetation adjacent to her right atrial pacemaker lead consistent with infective endocarditis and her vasculitis completely resolved with appropriate antibiotics.

scholarly journals Antibiotic treatment for bone infection after debridement: 2 weeks or 6 weeks?

2019 ◽  
Author(s):  
Xiaohua Wang ◽  
Li Fang ◽  
Shulin Wang ◽  
Huan Ma ◽  
Hongwen Zhao ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Antibiotic Treatment ◽  
Bone Infection ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Intravenous Antibiotics ◽  
Abnormal Rate ◽  
Oral Group ◽  
Liver And Kidney

Abstract Purpose: Our aim was to investigate the clinical efficacy and complications of antibiotics treatment duration for the patients of bone infection. Methods: We retrospectively analyzed the patients with bone infection admitted to our hospital between March 2013 and October 2018. The surgical debridement was performed and the patients were divided into three groups: IV group (Intravenous antibiotics for 2 weeks); Oral group (Intravenous antibiotics for 2 weeks followed by oral antibiotics for 4 weeks); Rifampicin group (Intravenous antibiotics for 2 weeks followed by oral antibiotics plus rifampicin for 4 weeks). The infection control rate and complications were compared. Results ： A total of 902 patients were enrolled, the infection sites included 509 tibias, 228 femurs, 32 humeri, 23 radii and ulnae, 40 calcanei, 23 multiple-site infections and the other sites 47 cases. After at least 6 months of follow-up, 148 (16.4%) patients had recurrence of infection. The recurrence rate of IV group was 17.9%, which was no significant higher than that of Oral group (10.1%) or Rifampicin group (10.5%). The abnormal rate of Glutamic-pyruvic transaminase(ALT) in IV group was 15.1%, which was lower than that of Oral group (18.0%) and Rifampicin group (27.4%), P=0.026. The positive rates of proteinuria in the three groups were 3.2%, 4.5%, and 9.3%, respectively, P=0.020. Conclusion: After debridement of bone infection, the additional oral antibiotic treatment may increase the damage of liver and kidney, and can not significantly reduce the infection recurrence rate. Therefore, it is recommended to adopt short-term systemic antibiotic treatment after debridement.

Aseptic Suppurative Meningitis in Juvenile Boxer Dogs: Retrospective Study of 12 Cases

2006 ◽  
Vol 42 (4) ◽  
pp. 277-282 ◽  
Author(s):  
Sebastien Behr ◽  
Laurent Cauzinille
Keyword(s):  
Complete Resolution ◽  
Clinical Presentation ◽  
Immunosuppressive Treatment ◽  
Clinical Signs ◽  
Central Nervous System Inflammation ◽  
Immune Mediated ◽  
Long Term Follow Up ◽  
Boxer Dogs

Immune-mediated central nervous system inflammation is described in a series of 12 juvenile boxer dogs. A diagnosis of steroid-responsive meningitis-arteritis was made based on the clinical presentation and on diagnostic findings. The boxer breed was at a higher risk for this inflammatory condition than other breeds. Long-term follow-up (>2 years) confirmed a better prognosis in this breed than in the beagle and the Bernese mountain dog. Complete resolution of clinical signs without significant deficits or recurrences was obtained in all cases. Early clinical recognition and immunosuppressive treatment resulted in a better response and complete resolution of the disorder.

Feline sialocoele: clinical presentation, treatment and outcome in 19 cases

2021 ◽  
pp. 1098612X2110461
Author(s):  
Diego Bobis-Villagrá ◽  
Matteo Rossanese ◽  
Daniela Murgia ◽  
Guido Pisani ◽  
Rosario Vallefuoco ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Signs ◽  
Good Prognosis ◽  
Case Selection ◽  
Parotid Duct ◽  
Duct Ligation ◽  
Referral Hospitals ◽  
Stab Incision ◽  
Clinical Records

Objectives The aim of this retrospective observational study was to describe the clinical presentation, treatment and outcome of cats with sialocoele. Methods Clinical records from seven referral hospitals were retrospectively searched to identify cats with sialocoele between 2007 and 2021. Results Nineteen cats were identified. The most common clinical signs were ptyalism, dysphagia and anorexia. Localisation of the sialocoele was cervical (n = 6), sublingual (n = 6), cervical/sublingual (n = 3), facial (n = 2), cervical/pharyngeal (n = 1) and zygomatic (n = 1). The affected salivary glands were mandibular–sublingual (n = 15), mandibular–sublingual/parotid (n = 1), zygomatic/parotid (n = 1) and parotid (n = 2). The aetiology of the sialocoele was traumatic in two cases, neoplastic in one cat and unknown in 16 cats. Sialoadenectomy was performed in 11 cats. Other treatments included ranula marsupialisation (n = 3), needle drainage (n = 2), single stab incision (n = 2) and parotid duct ligation (n = 1). The median follow-up time was 399 days (range 15–1460). Postoperative seroma was the only complication observed in one cat. No recurrence was reported. Conclusions and relevance Feline salivary sialocoele are relatively rare and have a good prognosis. They can be managed successfully with sialoadenectomy; however, a more conservative approach can be used with appropriate case selection.

Oral Antibiotic Therapy of Skeletal Infections in Children

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 867-871 ◽  
Author(s):  
E. Kolyvas ◽  
G. Ahronheim ◽  
M. I. Marks ◽  
R. Gledhill ◽  
H. Owen ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Prospective Study ◽  
Oral Therapy ◽  
Clinical Course ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Oral Antibiotic Therapy ◽  
Erythrocyte Sedimentation

Oral and intravenous (IV) antibiotic regimens were compared in 15 children with etiologically defined osteomyelitis and/or septic arthritis. On admission all children were started on standard IV therapy; seven were changed to oral antibiotics within 72 hours and the remaining eight continued on IV therapy for four weeks. Oral antibiotic doses were adjusted to achieve a peak serum bactericidal titer of [unknown]1:8 against the patient's own pathogen. All patients were treated in hospital for four weeks; therapy continued for a minimum of six weeks or until the erythrocyte sedimentation rate (ESR) fell below 20 mm/hr. The clinical course and outcome were similar in both groups. There were no treatment failures nor any relapses during a 12-month follow-up period. This prospective study supports, with controlled data, the concept that acute skeletal infections can be safely and successfully treated with carefully monitored oral therapy.

scholarly journals Tegumentary leishmaniasis in Northern Argentina: distribution of infection and disease, in three municipalities of Salta, 1990-1992

2000 ◽  
Vol 33 (6) ◽  
pp. 573-582 ◽  
Author(s):  
Sergio Sosa-Estani ◽  
Elsa Leonor Segura ◽  
Oscar Daniel Salomón ◽  
Adolfo Gómez ◽  
Mario Peralta ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Asymptomatic Infection ◽  
Epidemic Outbreak ◽  
Cross Sectional ◽  
Tegumentary Leishmaniasis ◽  
Epidemiological Pattern ◽  
Area North

This work describes the epidemiological pattern of tegumentary leishmaniasis in an area north of Salta, Argentina. The prevalence and incidence were estimated by means of a cross-sectional study and two follow-up studies during two consecutive years. The Montenegro Skin Test (MST) was administered to 7336 subjects at baseline. The prevalence and incidence between 1990 and 1992 of infection (MST reactive) was 38‰ persons and 4.5‰ persons/year respectively. The prevalence and incidence of tegumentary leishmaniasis (presence of clinical signs) was 1.8‰ and 0.8‰ persons/year, respectively. A physical examination performed on 264 patients with MST reactive during three years revealed that 130 cases (49.2%) had some evident sign of infection (scar and/or lesion), with a clinical presentation compatible with leishmaniasis. Our study demonstrated that after the epidemic outbreak of 1985 the transmission in the study area returned to endemic levels in 1992, and also demonstrated the presence of the asymptomatic infection in the area.

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