RESUMEN
We report a unique case of neonatal mycotic internal iliac artery aneurysm managed non-operatively. The child had multifocal osteomyelitis and no history of umbilical artery catheterisation. The aneurysm was regularly scanned and monitored until its obliteration by thrombus 17 days after initial detection. Contingency plans for either interventional radiological coiling or open surgical repair were in place had the aneurysm grown or the child deteriorated.
Asunto(s)
Aneurisma Infectado/terapia , Aneurisma Ilíaco/terapia , Infecciones Estafilocócicas/terapia , Aneurisma Infectado/congénito , Antibacterianos/uso terapéutico , Infecciones por Bacillaceae/congénito , Infecciones por Bacillaceae/terapia , Bacillus , Terapia Combinada , Humanos , Aneurisma Ilíaco/congénito , Recién Nacido , Masculino , Osteomielitis/congénito , Osteomielitis/terapia , Infecciones Estafilocócicas/congénitoRESUMEN
Se presenta el caso clínico de una paciente de 28 años de edad, que fuera remitida al Servicio de Neumología del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba por presentar síntomas respiratorios (tos húmeda y expectoración mucosa) durante un período aproximado de 6 meses, además de síndrome general y, en ocasiones, febrícula. Posteriormente manifestó una disnea progresiva, que se volvió moderada ante los pequeños esfuerzos, unido a dolor torácico agudo en el lado izquierdo. Se determinó clínica y radiológicamente la existencia de hidroneumotórax; por lo que se le realizó una pleurotomía mínima baja y se inició el tratamiento antibacilar. Igualmente se efectuó la prueba de esputo para la búsqueda de bacilos ácido-alcohol resistentes, y se obtuvo codificación 8, de modo que fue confirmado el diagnóstico de tuberculosis pulmonar(AU)
The case report of a 28 year-old patient is presented who was remitted to the Pneumology Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba for presenting breathing symptoms (humid cough and mucous expectoration) during an approximate period of 6 months, besides general syndrome and, in occasions, slight fever. Later on she complained of progressive dyspnea which became moderate when making other small efforts, together with acute thoracic pain in the left side. It was determined clinically and radiologically the existence of an hydropneumothorax; for which a low minimum pleurotomy was carried out and the antibacillar treatment was applied. Equally the sputum test was carried out for finding acid-alcohol resistant bacilli, and code 8 was obtained, so the diagnosis of lung tuberculosis was confirmed(AU)
Asunto(s)
Humanos , Masculino , Adulto Joven , Hidroneumotórax , Tuberculosis Pulmonar , Enfermedades Respiratorias , Infecciones por Bacillaceae/terapiaRESUMEN
Bacillus species are biofilm-forming organisms that are associated with Bacillus catheter-related bloodstream infections (CRBSIs). The optimal treatment of Bacillus CRBSIs is not known. Therefore, in the current study, we determined the role of long-term central venous catheter (CVC) removal and treatment with vancomycin compared with other agents in Bacillus CRBSIs by retrospectively reviewing the medical records of cancer patients with Bacillus bacteremia who had been treated at our institution from December 1990 to March 2008. True bacteremia was defined as a positive blood culture (>15 colony-forming units/mL) with signs and symptoms of infection (such as fever and chills). Bacillus CRBSI was defined in accordance with the Infectious Diseases Society of America guidelines as probable or definite. There were 94 Bacillus bacteremia episodes, 93 of which (99%) were Bacillus CRBSIs (28% definite and 71% probable). Neutropenia during bacteremia occurred in 29%. Almost all bacteremia patients (99%) had been treated with antibiotics; 63% had received vancomycin. Sepsis with hypotension occurred in 6%, and endocarditis in 1%. Bacillus isolates were susceptible to linezolid (100%), vancomycin (98%), tetracycline (77%), and rifampin (67%). All 4 recurrences occurred in patients in whom the CVC had not been removed (12%), whereas no recurrences occurred in patients whose CVC had been removed (p = 0.028). Patient outcome, in terms of fever and hospitalization duration after the infection, was similar in patients who had received < or =10 days of systemic antibiotics compared with patients who had received >10 days. In conclusion, catheter retention in patients with Bacillus CRBSIs is associated with a significantly higher recurrence rate. If the CVC is retained, treatment with non-vancomycin antibiotics is associated with significantly shorter hospitalization duration after the infection, which may be because glycopeptide antibiotics have poor activity against bacilli embedded in biofilm.
Asunto(s)
Infecciones por Bacillaceae/terapia , Bacillus , Bacteriemia/terapia , Infecciones Relacionadas con Catéteres/terapia , Cateterismo Venoso Central/efectos adversos , Remoción de Dispositivos , APACHE , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Infecciones por Bacillaceae/diagnóstico , Infecciones por Bacillaceae/microbiología , Bacteriemia/diagnóstico , Bacteriemia/microbiología , Infecciones Relacionadas con Catéteres/diagnóstico , Infecciones Relacionadas con Catéteres/microbiología , Niño , Preescolar , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Vancomicina/uso terapéutico , Adulto JovenRESUMEN
Our patient was a 37-year-old man with diabetes mellitus and hepatopathy as underlying diseases. Swelling, erythema and pain appeared in the left upper limb on the day before the initial examination. On examination, diffuse purpura was noted on the left upper limb, and, as it rapidly extended to the left upper trunk, emergency surgery was performed. Intraoperatively, gas-producing necrosis was observed not only in subcutaneous tissues but also from the fascia to muscle tissues, and the condition resembled clostridial gas gangrene. However, as the culturing of samples from the lesion yielded Bacillus cereus, a diagnosis of necrotizing fasciitis and myonecrosis (synergistic necrotizing cellulitis) due to B. cereus was made. While the patient developed a serious condition due to sepsis and disseminated intravascular coagulation, he could be saved by early debridement and intensive treatment with an appropriate selection of antibiotics.
Asunto(s)
Infecciones por Bacillaceae/diagnóstico , Bacillus cereus/patogenicidad , Celulitis (Flemón)/diagnóstico , Fascitis Necrotizante/diagnóstico , Miositis/diagnóstico , Adulto , Infecciones por Bacillaceae/microbiología , Infecciones por Bacillaceae/terapia , Bacillus cereus/aislamiento & purificación , Celulitis (Flemón)/microbiología , Celulitis (Flemón)/terapia , Fascitis Necrotizante/microbiología , Fascitis Necrotizante/terapia , Humanos , Masculino , Miositis/microbiología , Miositis/terapia , NecrosisRESUMEN
Although Bacillus cereus is a ubiquitous bacterium, the incidence of neonatal infections is very low with only a few cases of B. cereus infections in neonates reported in the literature. We report the case of a premature infant with multiple intestinal perforations and an abdominal B. cereus infection. The initial course was characterized by severe cardiovascular shock, anemia, thrombocytopenia and disseminated intravascular coagulation, leading to periventricular leukomalacia, alopecia capitis and toxic epidermal necrolysis. The possible role of B. cereus-associated enterotoxins for the clinical manifestations are discussed. Our case confirms previous reports of severe clinical symptoms in B. cereus infection in premature neonates. We speculate that the systemic complications of B. cereus infection are at least partly related to the effect of B. cereus-associated enterotoxins.
Asunto(s)
Anomalías Múltiples/diagnóstico , Infecciones por Bacillaceae/diagnóstico , Bacillus cereus/aislamiento & purificación , Bacteriemia/diagnóstico , Enterotoxinas/metabolismo , Recién Nacido de muy Bajo Peso , Perforación Intestinal/diagnóstico , Antibacterianos/uso terapéutico , Infecciones por Bacillaceae/terapia , Bacteriemia/terapia , Terapia Combinada , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Estudios de Seguimiento , Humanos , Recién Nacido , Recien Nacido Prematuro , Unidades de Cuidado Intensivo Neonatal , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Masculino , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
OBJECTIVE: To study the clinical presentation, microscopic and organismal culture correlation of vitreous, and species-specific outcome in Bacillus endophthalmitis DESIGN: Retrospective noncomparative case series. INTERVENTION: Thirty-one culture proven Bacillus endophthalmitis patients between January 1991 and February 1998 underwent vitrectomy and intravitreal antibiotic injection. Lensectomy was combined when considered essential, and on a few occasions intravitreal dexamethasone was added. The patients also received topical and systemic antibiotics. The undiluted vitreous biopsy was the source for microbiologic evaluation (microscopy and culture sensitivity). MAIN OUTCOME MEASURES: The duration of symptoms, the presenting visual acuity, and influence of intravitreal dexamethasone with intravitreal antibiotics were examined for any statistical correlation with the final visual acuity. RESULTS: Trauma was the major cause of infection. Vitreous biopsy microscopy demonstrated gram-positive bacillus in 28 of 31 cases, and polymicrobial infection was seen in 12 instances. All Bacillus species were sensitive to gentamicin, followed by vancomycin and ciprofloxacin. Clinical treatment within 7 days of symptoms, use of intravitreal vancomycin, and absence of polymicrobial infection were associated with better visual outcome. CONCLUSIONS: With appropriate treatment that essentially consists of vitrectomy and intravitreal antibiotics, patients with Bacillus endophthalmitis are likely to benefit in many instances. Gram-positive bacilli detected on vitreous microscopy should be empirically treated as Bacillus species unless otherwise proved.
Asunto(s)
Infecciones por Bacillaceae/microbiología , Bacillus/aislamiento & purificación , Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo/microbiología , Adolescente , Adulto , Anciano , Antibacterianos , Infecciones por Bacillaceae/diagnóstico , Infecciones por Bacillaceae/terapia , Niño , Preescolar , Dexametasona/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Endoftalmitis/diagnóstico , Endoftalmitis/terapia , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/terapia , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza Visual , Vitrectomía , Cuerpo Vítreo/microbiologíaRESUMEN
PURPOSE: To examine the clinical and microbiological profile of Bacillus keratitis. METHODS: A retrospective review was done of all medical and laboratory records of patients with infectious keratitis in an urban tertiary level eye-care center in South India between January 1991 and June 1997. RESULTS: Nineteen eyes of 17 patients having microbiologically proven Bacillus keratitis were reviewed. The mean age of the patients was 32.64 years (range, 3-70). The duration of symptoms ranged from 1 day to 3 months, with 11 eyes seen within a week of onset of symptoms. Trauma (five eyes), lagophthalmos (two eyes), topical corticosteroid therapy (one eye), bullous keratopathy (two eyes), previous corneal scars (two eyes), and diabetes (one eye) were identified as predisposing factors. Severe corneal features, disproportionate to the duration of symptoms, were present in most of the eyes. Gram stain of corneal scrapings showed variably stained bacilli in eight (42.1%) cases. Polymicrobial infection was present in six eyes (two fungal, four bacterial). Of the 16 isolates tested for in vitro antibiotic susceptibility, 100% were sensitive to gentamicin, 15 (93.75%) were sensitive to ciprofloxacin and norfloxacin, 14 (87.5%) were sensitive to chloramphenicol, and 10 (62.5%) were sensitive to cefazolin. Whereas 12 (63.1%) eyes required only medical therapy, adjunctive procedures were required in seven (36.8%) eyes. The ulcers healed (mean time to healing, 37.4+/-28.6 days) in 16 eyes (lost to follow-up, three). Visual acuity had improved after treatment in 10 (71.4%) of 14 eyes in whom vision could be recorded. CONCLUSION: Bacillus is an unusual pathogen in the clinical setting of infectious keratitis. The infection is mostly amenable to treatment with commonly used antibiotics, and the final outcome is often satisfactory.
Asunto(s)
Infecciones por Bacillaceae/microbiología , Bacillus/aislamiento & purificación , Úlcera de la Córnea/microbiología , Infecciones Bacterianas del Ojo/microbiología , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Infecciones por Bacillaceae/diagnóstico , Infecciones por Bacillaceae/terapia , Bacillus/patogenicidad , Niño , Preescolar , Córnea/microbiología , Córnea/patología , Úlcera de la Córnea/diagnóstico , Úlcera de la Córnea/terapia , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/terapia , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza VisualRESUMEN
OBJECTIVE: To report the clinical outcome of chronic Bacillus endophthalmitis after cataract surgery. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Five eyes of five patients with late-onset or recurrent inflammation after exposure to bacteria-contaminated viscoelastic material were studied. INTERVENTION: Repeated vitrectomies, wide excision of the remnant posterior capsule, and intravitreal injections of antibiotics in five patients. Eventual explantation of the intraocular lens in four patients. MAIN OUTCOME MEASURES: Final visual acuities and results of microbiologic studies of aqueous and vitreous specimens as well as pathologic studies using hematoxylin-eosin, Gram, and periodic acid-Schiff (PAS) stain of explanted capsular remnants were obtained. RESULTS: Final visual acuity of 20/40 or better was obtained in three patients. Bacillus species were grown from two cases. PAS- and Gram-positive microorganisms were identified in the capsular tissue in three of four patients who had explantation of the intraocular lens. CONCLUSIONS: A chronic form of Bacillus endophthalmitis is described for the first time. The clinical outcome is similar to chronic endophthalmitis caused by other organisms.
Asunto(s)
Infecciones por Bacillaceae , Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo , Facoemulsificación/efectos adversos , Anciano , Anciano de 80 o más Años , Cámara Anterior/microbiología , Antibacterianos/uso terapéutico , Infecciones por Bacillaceae/etiología , Infecciones por Bacillaceae/terapia , Bacillus/aislamiento & purificación , Enfermedad Crónica , Endoftalmitis/terapia , Infecciones Bacterianas del Ojo/etiología , Infecciones Bacterianas del Ojo/terapia , Femenino , Humanos , Implantación de Lentes Intraoculares , Masculino , Persona de Mediana Edad , Recurrencia , Reoperación , Estudios Retrospectivos , Resultado del Tratamiento , Vancomicina/uso terapéutico , Agudeza Visual , Vitrectomía , Cuerpo Vítreo/microbiologíaRESUMEN
In recent years manufacturers have developed several products containing saprophytic bacteria, previously believed to be of minimal pathogenicity. We describe the first case of persistent Bacillus licheniformis bacteremia occurring after intentional injection of a consumer product that includes B. licheniformis spores. We postulate that these spores remained in the tissue, unaffected by antimicrobials, ultimately necessitating soft-tissue debridement of the area surrounding the injection site. On the basis of this case and a review of the literature, we submit that some consumer products contain bacteria with demonstrated pathogenicity. Manufacturers should study these bacteria in detail in order to rapidly provide information such as bacteriologic data and antimicrobial susceptibility data to clinicians.
Asunto(s)
Infecciones por Bacillaceae/etiología , Bacillus/aislamiento & purificación , Bacteriemia/etiología , Celulitis (Flemón)/inducido químicamente , Detergentes/envenenamiento , Adulto , Antibacterianos , Infecciones por Bacillaceae/terapia , Bacteriemia/diagnóstico , Celulitis (Flemón)/terapia , Desbridamiento/métodos , Quimioterapia Combinada/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intravenosas , Recurrencia , Intento de Suicidio , Resultado del TratamientoRESUMEN
PURPOSE: Bacillary endophthalmitis occurring after penetrating ocular trauma with an intraocular foreign body is always associated with poor visual outcome. Bacilli cause fulminant infection associated with tissue damage in the intraocular structures. CASE REPORTS: Our series consisted of four patients with penetrating ocular trauma and endophthalmitis caused by B. cereus or B. licheniformis. Three eyes ultimately developed phtisis. Only on eye recovered good vision (2.5/10 P4). DISCUSSION: Recommended early treatment includes topical, subconjunctival, parenteral antibiotics. A review of the literature indicates that intravitreal antibiotic infusion is crucial for sufficient concentration to control infection. Early vitrectomy is recommended in the management of endophthalmitis. Vitreous and intraocular foreign bodies should be cultured to identify pathogens and ascertain antibiotic susceptibilities.
Asunto(s)
Infecciones por Bacillaceae/etiología , Infecciones por Bacillaceae/terapia , Bacillus cereus , Endoftalmitis/etiología , Endoftalmitis/terapia , Lesiones Oculares Penetrantes/complicaciones , Administración Tópica , Adulto , Antibacterianos/uso terapéutico , Infecciones por Bacillaceae/diagnóstico , Niño , Terapia Combinada , Endoftalmitis/diagnóstico , Femenino , Humanos , Infusiones Parenterales , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza Visual , Vitrectomía , Cuerpo VítreoRESUMEN
Bacillus cereus is a ubiquitous organism that often contaminates microbiological cultures but rarely causes serious infections. Reports of B. cereus endocarditis are infrequent. Infection in patients with valvular heart disease is associated with significant mortality and morbidity. We describe a case of B. cereus endocarditis involving a mechanical mitral prosthesis that resolved after replacement of the prosthetic valve. We also review the previous cases reported in the literature.
Asunto(s)
Infecciones por Bacillaceae/diagnóstico , Bacillus cereus , Endocarditis Bacteriana/diagnóstico , Implantación de Prótesis de Válvulas Cardíacas , Válvula Mitral/cirugía , Infecciones por Bacillaceae/terapia , Endocarditis Bacteriana/terapia , Femenino , Humanos , Persona de Mediana Edad , ReoperaciónAsunto(s)
Infecciones por Bacillaceae/diagnóstico , Bacillus , Inmunodeficiencia Combinada Grave/diagnóstico , Enfermedades Cutáneas Bacterianas/diagnóstico , Infecciones por Bacillaceae/etiología , Infecciones por Bacillaceae/terapia , Terapia Combinada , Ligamiento Genético , Humanos , Lactante , Masculino , Inmunodeficiencia Combinada Grave/complicaciones , Inmunodeficiencia Combinada Grave/genética , Inmunodeficiencia Combinada Grave/terapia , Enfermedades Cutáneas Bacterianas/etiología , Enfermedades Cutáneas Bacterianas/terapia , Cromosoma XRESUMEN
OBJECTIVE: The purpose of the study is to report the clinical outcome of acute Bacillus endophthalmitis after cataract surgery. DESIGN: The study design is a cohort study. PARTICIPANTS: Fourteen eyes of 14 patients with epidemic acute postoperative inflammation after exposure to bacteria-contaminated viscoelastic material were studied. INTERVENTION: Three patients with milder clinical presentations were treated without vitrectomy or antibiotics. Eleven patients with more severe infection were treated with vitrectomy as well as intravitreous and topical fortified antibiotics. MAIN OUTCOME MEASURES: Final visual acuities were obtained in all 14 study patients. Results of microbiologic studies of aqueous and vitreous specimens from 11 vitrectomized eyes also were analyzed. RESULTS: One patient with late presentation had severe inflammation and had phthisis bulbi develop with no light perception. The remaining 13 patients had successful resolution of inflammation after treatment by 1 month of follow-up. Twelve of these 13 patients, including 1 nonvitrectomized patient, had final visual acuities of 20/100 or better at 6 months' follow-up. Six patients, including two patients with nonvitrectomized eyes, had outcomes of 20/40 or better visual acuity. Bacillus species were grown from all 11 (100%) vitreous and 7 (88%) of 8 aqueous specimens obtained from vitrectomized patients, as well as from the contaminated viscoelastic material remaining in the operating room. CONCLUSIONS: Postoperative Bacillus endophthalmitis need not result in poor outcome. Results depend on factors including bacterial load, specific bacterial species, timing of treatment, and immune status of the patient.
Asunto(s)
Infecciones por Bacillaceae/etiología , Bacillus/aislamiento & purificación , Extracción de Catarata/efectos adversos , Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo/etiología , Complicaciones Posoperatorias/microbiología , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos , Humor Acuoso/microbiología , Infecciones por Bacillaceae/terapia , Estudios de Cohortes , Contaminación de Medicamentos , Quimioterapia Combinada/uso terapéutico , Endoftalmitis/terapia , Infecciones Bacterianas del Ojo/terapia , Femenino , Estudios de Seguimiento , Humanos , Ácido Hialurónico , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/terapia , Resultado del Tratamiento , Agudeza Visual , Vitrectomía , Cuerpo Vítreo/microbiologíaRESUMEN
PURPOSE: Bacillus cereus endophthalmitis occurring after penetrating ocular trauma has been almost always associated with a poor visual outcome. The purpose of our study was to review and report patients who had useful visual acuity outcomes. METHODS: The study group consisted of five patients from a single medical center with penetrating ocular trauma and endophthalmitis caused by B. cereus. The study population was derived from a review of the microbiology records, clinical records, and operative reports of patients with culture-proven, post-traumatic endophthalmitis over a 15-year period. Patients were only included if the final visual acuity outcomes were 20/200 or better. RESULTS: All five patients had penetrating ocular injuries, and four patients had a retained intraocular foreign body. Endophthalmitis was diagnosed preoperatively in three patients and intraoperatively in two patients. All patients underwent pars plana vitrectomy and injection of intravitreal and periocular antibiotics. Postoperatively, a rhegmatogenous retinal detachment developed in three patients between 4 weeks and 12 months after the injury (average, 19 weeks); all retinal detachments were reattached with additional vitreoretinal surgery. Final postoperative visual acuities were 20/200 (two patients), 20/30 (one patient), and 20/25 (two patients). The postoperative follow-up time interval ranged from 12 months to 30 months (average, 19.2 months). CONCLUSION: The current series adds further support to the observation that certain eyes with post-traumatic B. cereus endophthalmitis may be associated with preservation of anatomic integrity and restoration of useful visual acuity.
Asunto(s)
Infecciones por Bacillaceae/terapia , Bacillus cereus/aislamiento & purificación , Endoftalmitis/terapia , Infecciones Bacterianas del Ojo/terapia , Agudeza Visual , Adolescente , Adulto , Antibacterianos/uso terapéutico , Humor Acuoso/microbiología , Infecciones por Bacillaceae/microbiología , Infecciones por Bacillaceae/fisiopatología , Endoftalmitis/microbiología , Endoftalmitis/fisiopatología , Cuerpos Extraños en el Ojo/microbiología , Cuerpos Extraños en el Ojo/fisiopatología , Cuerpos Extraños en el Ojo/terapia , Infecciones Bacterianas del Ojo/microbiología , Infecciones Bacterianas del Ojo/fisiopatología , Lesiones Oculares Penetrantes/microbiología , Lesiones Oculares Penetrantes/fisiopatología , Lesiones Oculares Penetrantes/terapia , Femenino , Humanos , Masculino , Desprendimiento de Retina/etiología , Desprendimiento de Retina/cirugía , Agudeza Visual/fisiología , Vitrectomía , Cuerpo Vítreo/microbiologíaRESUMEN
Non-anthracis Bacillus species associated with clinical infections are usually dismissed as contaminants or nonpathogens. As opportunists, however, Bacillus organisms can cause significant systemic infections including bacteremia, endophthalmitis, and pneumonia. Osteomyelitis with non-anthracis Bacillus organisms has been described in adults, although to our knowledge it has been described only once in a child. We report a case of chronic osteomyelitis due to Staphylococcus aureus and superinfection with Bacillus cereus in a 13-year-old adolescent. A Bacillus isolate should be considered a true pathogen in children with chronic osteomyelitis who have a poor clinical response to antistaphylococcal therapy.
Asunto(s)
Infecciones por Bacillaceae/etiología , Bacillus cereus , Osteomielitis/etiología , Sobreinfección/etiología , Adolescente , Infecciones por Bacillaceae/terapia , Trasplante Óseo , Terapia Combinada , Femenino , Fémur/diagnóstico por imagen , Fémur/cirugía , Humanos , Osteomielitis/diagnóstico por imagen , Osteomielitis/terapia , Radiografía , Infecciones Estafilocócicas/complicaciones , Sobreinfección/terapia , Vancomicina/uso terapéuticoRESUMEN
Eighteen cases of culture-proven Bacillus endophthalmitis were reviewed. The majority (13/18) were secondary to penetrating ocular trauma. Others were secondary to corneal ulcer (1), postoperative (1), and endogenous (3). Bacillus cereus was the most commonly identified species (12/18). Antibiotic sensitivities demonstrated uniform sensitivity to vancomycin and the aminoglycosides. Visual prognosis was generally poor; only two patients maintained 20/200 or better in the affected eye. Fourteen eyes were enucleated or eviscerated. The remaining two eyes had light perception vision at the last follow-up examination.