MyMedR

Fulltext A review of haematogenous osteomyelitis in children in Kuala Lumpur Hospital

Razak M, Ismail MM, Omar A

Med J Malaysia, 1998 Sep;53 Suppl A:83-5.

We review 81 cases of acute haematogenous osteomyelitis from 1983 to 1990 to establish current pattern of clinical presentation, modes of treatment and success of therapy. Majority of the patient (70%) presented within a week of symptom and significant number of them came with fever and swelling of the affected limb. Sedimentation rate was found to be raised in all of them. Fifty-four (55%) of them were treated surgically. The average antibiotic time was one week by intravenous administration followed by additional oral therapy for period up to four weeks. Average follow-up was 9 months. Six of them (7.5%) end up with various complication which was believed to be due to delay in getting medical treatment.

Matched MeSH terms: Bacteremia/complications*

Fulltext Septicaemic pulmonary melioidosis with cutaneous pustules

Liam CK

Med J Malaysia, 1993 Jun;48(2):248-9.

PMID: 8350807

Matched MeSH terms: Bacteremia/complications*

Septicaemic melioidosis: a review of 50 cases from Malaysia

Puthucheary SD, Parasakthi N, Lee MK

Trans R Soc Trop Med Hyg, 1992 11 1;86(6):683-5.

PMID: 1287945

Fifty cases of septicaemic melioidosis were reviewed. There was a preponderance of disease among males (male:female ratio 3.2:1) and those aged over 30 years. The presenting clinical features were very varied and not pathognomonic, ranging from fever, cough and septicaemia to fulminant septicaemia and shock. Pulmonary involvement was recorded in 58% of the patients. Skin and soft tissue sepsis was seen in 24%, but many had signs and symptoms of multiorgan involvement. Associated underlying illness was identified in 76% of patients, diabetes mellitus being the commonest (38%), while 34% had more than one predisposing factor. The mortality of 65% in our series is a reflection of the less than satisfactory status of the diagnosis and therapy of septicaemic melioidosis. Only 24% of our patients received appropriate empirical antibiotic therapy. A high index of suspicion of melioidosis in endemic areas and the use of appropriate empirical antimicrobial therapy would be a step towards reducing the high mortality rate.

Matched MeSH terms: Bacteremia/complications*

Fulltext Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis--a case report

Shaharuddin NR, Leong CL, Chidambaram SK, Lee C

Med J Malaysia, 2012 Jun;67(3):337-9.

PMID: 23082432

Paraspinal abscess and spondylodiscitis due to Citrobacter koseri is a very rare condition. We report a remarkable case of Citrobacter koseri bacteraemia complicated by paraspinal abscess and spondylodiscitis in a patient who has successfully been treated in our hospital. Our patient demonstrates one of the common challenges in the practice of infectious disease medicine, wherein an innocuous presentation may and often underlie a serious infection. This case report elucidates to us that the diagnosis of a paraspinal abscess and spondylodiscitis requires a high index of suspicion in at risk patient presenting with compatible signs and symptoms.

Matched MeSH terms: Bacteremia/complications

Fulltext The association of Streptococcus bovis/gallolyticus with colorectal tumors: the nature and the underlying mechanisms of its etiological role

Abdulamir AS, Hafidh RR, Abu Bakar F

J Exp Clin Cancer Res, 2011;30:11.

PMID: 21247505 DOI: 10.1186/1756-9966-30-11

Streptococcus bovis (S. bovis) bacteria are associated with colorectal cancer and adenoma. S. bovis is currently named S. gallolyticus. 25 to 80% of patients with S. bovis/gallolyticus bacteremia have concomitant colorectal tumors. Colonic neoplasia may arise years after the presentation of bacteremia or infectious endocarditis of S. bovis/gallolyticus. The presence of S. bovis/gallolyticus bacteremia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine. In addition, serological relationship of S. gallolyticus with colorectal tumors and direct colonization of S. gallolyticus in tissues of colorectal tumors were found. However, this association is still under controversy and has long been underestimated. Moreover, the etiological versus non-etiological nature of this associationis not settled yet. Therefore, by covering the most of up to date studies, this review attempts to clarify the nature and the core of S. bovis/gallolyicus association with colorectal tumors and analyze the possible underlying mechanisms.

Matched MeSH terms: Bacteremia/complications

Development of Aeromonas hydrophila bacteremia in a patient recovering from cholera

Riley PA, Parasakthi N, Liam CK

Clin Infect Dis, 1996 May;22(5):867-8.

PMID: 8722957

Matched MeSH terms: Bacteremia/complications*

Fulltext Non-O1, non-O139 Vibrio cholerae bacteraemia in splenectomised thalassaemic patient from Malaysia

Deris ZZ, Leow VM, Wan Hassan WM, Nik Lah NA, Lee SY, Siti Hawa H, et al.

Trop Biomed, 2009 Dec;26(3):320-5.

PMID: 20237446

Vibrio cholerae infection is mainly caused acute diarrhoea disease. Bacteraemia due to non-O1 V. cholerae is rare and mainly reported in liver cirrhotic patients. We report one case of non-O1 V. cholerae bacteraemia in splenectomised thalassaemic patient who presented with septic shock secondary to abdominal sepsis. She had undergone emergency laporatomy and was managed in the intensive care unit for nine days. She was treated with meropenem and doxycyline and discharged well after fourteen days of admission. The V. cholerae was identified by API 20NE, serotype and polymerase chain reaction showed as non-O1, non-O139 strain. Besides known cholera-like toxin and El Tor hemolysin, with increasing reported cases of V. cholerae bacteraemia, there is possibility of other virulence factors that allow this organism to invade the bloodstream.

Matched MeSH terms: Bacteremia/complications

Non-tuberculous mycobacterium bacteraemia in a pregnant systemic lupus erythematosus (SLE) patient: a case review and pooled case analysis

Shaharir SS, Sulaiman Sahari N, Mohamed Fuad Z, Zukiman WZHW, Mohd Yusof NH, Sulong A, et al.

Clin Rheumatol, 2018 Mar;37(3):837-847.

PMID: 28971307 DOI: 10.1007/s10067-017-3855-7

Non-tuberculous mycobacteria (NTM) are recognized as an important cause of human diseases and infections. It is commonly known to cause infections of the skin, soft tissue infections, and pulmonary infection as well as bacteraemia. We report a challenging case of severe mycobacterium abscessus bacteraemia in a pregnant lady with active systemic lupus erythematous (SLE). A comprehensive literature review of NTM infection among SLE patients was also performed, and pooled analysis of the reported cases, including our case, was done to determine the clinical characteristics and factors associated with poor outcome of NTM infection.

Matched MeSH terms: Bacteremia/complications*

Fulltext Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate

Rajahram GS, Barber BE, William T, Menon J, Anstey NM, Yeo TW

Malar J, 2012;11:284.

PMID: 22905799 DOI: 10.1186/1475-2875-11-284

The simian parasite Plasmodium knowlesi is recognized as a common cause of severe and fatal human malaria in Sabah, Malaysia, but is morphologically indistinguishable from and still commonly reported as Plasmodium malariae, despite the paucity of this species in Sabah. Since December 2008 Sabah Department of Health has recommended intravenous artesunate and referral to a general hospital for all severe malaria cases of any species. This paper reviews all malaria deaths in Sabah subsequent to the introduction of these measures. Reporting of malaria deaths in Malaysia is mandatory.

Matched MeSH terms: Bacteremia/complications

Mortality impact of empirical antimicrobial therapy in ESBL- and AmpC-producing Enterobacteriaceae bacteremia in an Australian tertiary hospital

Lim CL, Spelman D

Infect Dis Health, 2019 08;24(3):124-133.

PMID: 30928569 DOI: 10.1016/j.idh.2019.02.001

BACKGROUND: Treatment of ESBL- and AmpC-producing Enterobacteriaceae bacteremia is often complicated by lack of appropriate antibiotics. We aimed to determine the predictors of mortality and impact of empirical antibiotics.

METHODS: A retrospective observational study was performed on consecutive adult cases of ESBL and AmpC bacteremia at the Alfred Hospital from 2014 through April 2018.

RESULTS: Among 110 patients with ESBL (88.2%) and AmpC (14.5%) bacteremia episodes, 96.4% had comorbidities such as hematological malignancy (30%). Approximately 45% were on immunosuppressive drugs, while 69% had recent antibiotic exposure. Over 84% of bacteremias were hospital acquired or healthcare associated. Urinary tract was the main source of infection (40%) with E. coli being the commonest organism (66.4%). The isolates were least resistant to gentamicin (21.8%), which was often appropriately used in empirical therapy. About 34% of patients presented with severe sepsis or shock. The 30-day mortality rate was 20% with no correlation with inappropriate empirical antibiotics (52%). There was no significant mortality difference between carbapenem use in empirical and definitive therapy. Respiratory source [OR 11.77, 95% CI 1.30-106.85; p = 0.03], severe sepsis or shock [OR 5.17, 95% CI 1.37-19.55; p = 0.02] and inappropriate definitive therapy [OR 27.93, 95%CI 3.69-211.35; p = 0.001] were independent predictors for mortality.

CONCLUSION: The choice and appropriateness of empirical therapy were not associated with mortality in ESBL and AmpC bacteremia. Prudent use of carbapenem is reasonable with gentamicin as alternative. Emphasis should be on prompt resuscitation in severe sepsis and early detection of ESBL and AmpC to facilitate appropriate switch to definitive therapy.

Matched MeSH terms: Bacteremia/complications

Clinical characteristics and outcomes of bacteraemic melioidosis in a teaching hospital in a northeastern state of Malaysia: a five-year review

Deris ZZ, Hasan H, Siti Suraiya MN

J Infect Dev Ctries, 2010 Aug 04;4(7):430-5.

PMID: 20818090

BACKGROUND: Melioidosis is an important public health problem causing community acquired sepsis in the northeastern part of Malaysia.

METHODOLOGY: From January 2001 to December 2005, we reviewed case reports of all bacteraemic melioidosis admitted to a tertiary teaching hospital, Hospital Universiti Sains Malaysia.

RESULTS: Thirty-five patients had positive blood culture for meliodosis and 27 case reports were traceable for further analysis. The mean age was 46.8 + 20.0 years. Twenty patients (74.1%) were male. The main clinical presentation was fever that occurred in 23 (85.2%) patients. Eighteen patients (66.7%) had lung involvement and three patients had liver abscess. Two patients presented with scrotal swelling, one of whom further developed Fournier's Gangrene. Nineteen (70.4%) patients had underlying diabetes, five of whom were newly diagnosed during the admission. Thirteen (48.1%) patients were treated with high-dose ceftazidime and six (22.2%) patients were treated with imipenem. Eight (29.6%) patients were not given anti-melioidosis therapy because the causative agents were not identified until after the patients died. The patients were admitted 16.8 days + 18.1. Seventeen patients (63.0%) died in this series, 13 patients of whom died within four days of admission.

CONCLUSIONS: The wide range of clinical presentations and the fatal outcomes of melioidosis require a high level of suspicion among physicians to develop an early appropriate therapy and reduce the mortality rate.

Matched MeSH terms: Bacteremia/complications

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