Tags: Bone infections

Other Mycobacteria

  Essentials of Diagnosis • Demonstration of the acid-fast bacillus. • Infections more common in immunocompromised hosts. • Infections mainly pulmonary or soft tissue. General Considerations The increasingly relative importance of the atypical mycobacteria, many of which are ubiquitous in the environment, was recognized with the decline in tuberculous disease. Generally, atypical mycobacteria are unusual causes of disease in patients who are immunocompetent but can in immunocompromised hosts such as AIDS and cancer patients. Most infections caused by atypical mycobacteria are skin and soft tissue abscesses, sometimes following pulmonary infection or implantation of prosthetic devices. There have been a few reports of epidemics of iatrogenic infection with atypical mycobacteria, associated with …

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Important Anaerobes

Essentials of Diagnosis • Foul odor of draining purulence. • Presence of gas in tissues. • No organism growth on aerobic culture media. • Infection localized in the proximity of mucosal surface. • Presence of septic thrombophlebitis. • Tissue necrosis and abscess formation. • Association with malignancies (especially intestinal). • Mixed organism morphologies on Gram stain. General Considerations A. Epidemiology and Ecology. Anaerobic bacteria are the predominant component of the normal microbial flora of the human body. The following sites harbor the vast majority of them: • Skin: Mostly gram-positive bacilli such as Propionibacterium acnes • Gastrointestinal tract: In the oral cavity Prevotella spp., Porphyromonas spp., Peptostreptococcus spp., microaerophillic streptococci, and …

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Important Anaerobes: Clinical Syndromes

Box 1 summarizes different clinical syndromes associated with anaerobic bacteria. The sections that follow describe the various syndromes, including clinical findings. For some syndromes, specific diagnosis and treatment information is included as well. For other syndromes, see summary diagnosis and treatment sections at the end of the chapter. HEAD & NECK 1. EAR & PARANASAL SINUSES The flora in as many as two-thirds of chronic sinusitis and otitis cases includes B fragilis, Prevotella spp., Peptostreptococcus spp., and Porphyromonas spp. It is not surprising that ~50% of patients with chronic otitis media are infected with anaerobic bacteria, B fragilis being the most common. Mastoiditis may arise as a complication in some of …

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Other Bacillus Species

General Considerations Bacillus species other than B anthracis are found in soil, decaying organic matter, and water, but they are rare causes of disease. Risk factors associated with Bacillus infection include the presence of intravascular catheters, intravenous drug use, sickle cell disease, and immunosuppression — particularly corticosteroid use, transplantation, AIDS, and neutropenia secondary to chemotherapy. The hardy growth characteristics of Bacillus spp. cause them to arise as common laboratory contaminants; however, they are also capable of causing severe invasive illness. B cereus and B subtilis are the most frequent Bacillus spp. to cause invasive infection. Pneumonia, meningoencephalitis, endocarditis (native and prosthetic valves), and intravascular catheter infection have been well described. High-grade …

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Osteomyelitis

Clinical Findings A. Signs and Symptoms. Osteomyelitis is divided into two subcategories based on the acuity of onset. Acute osteomyelitis, more commonly seen in children, is associated with sudden onset of bony pain, fever, and malaise. Acute disease is often the result of seeding of the bone during S aureus bacteremia, with the most common anatomic locations corresponding to highly vascularized osseous areas such as the metaphyses of long bones. Chronic osteomyelitis is a more indolent process, characterized by low-grade fevers and chronic nonhealing ulcers or draining sinus tracts in the skin overlying the infected bone. Bony necrosis is pathognomonic for chronic osteomyelitis. Chronic osteomyelitis commonly affects the feet and lower …

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Specific Anti-Infective Agents

Antibiotics Before prescribing a specific antibiotic, clinicians should be able to answer these questions: •  How does the antibiotic kill or inhibit bacterial growth? •  What are the antibiotic’s toxicities and how should they be monitored? •  How is the drug metabolized, and what are the dosing recommendations? Does the dosing schedule need to be modified in patients with renal dysfunction? •  What are the indications for using each specific antibiotic? •  How broad is the antibiotic’s antimicrobial spectrum? •  How much does the antibiotic cost? Clinicians should be familiar with the general classes of antibiotics, their mechanisms of action, and their major toxicities. The differences between the specific antibiotics in …

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Antituberculosis Agents General Statement

Aminosalicylic Acid, Aminosalicylate Sodium, Capreomycin Sulfate, Clofazimine, Cycloserine, Ethambutol Hydrochloride, Ethionamide, Isoniazid, Kanamycin Sulfate, Pyrazinamide, Rifabutin, Rifampin, Rifapentine, Streptomycin Sulfate • General Principles in Antituberculosis Therapy Antituberculosis agents are antibiotics and synthetic anti-infectives used in the treatment of tuberculosis and other diseases caused by organisms of the genus Mycobacterium. Isoniazid, rifampin, ethambutol, and pyrazinamide are the drugs used most frequently in the treatment of tuberculosis and are considered first-line agents for use in antituberculosis regimens. Rifapentine and rifabutin, like rifampin, are rifamycin derivatives; these drugs also are considered first-line agents and are used as alternatives to rifampin in antituberculosis regimens. Other antituberculosis agents currently available in the US are considered second-line …

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Tobramycin Sulfate

• Tobramycin is an aminoglycoside antibiotic. Uses • Parenteral Tobramycin sulfate is used parenterally for the treatment of serious infections, including septicemia, lower respiratory tract infections, CNS infections (meningitis), intraabdominal infections (including peritonitis), bone infections, skin and skin structure infections, and complicated and recurrent urinary tract infections caused by susceptible bacteria. (For information on parenteral uses of tobramycin, see Uses: Parenteral, in the Aminoglycosides General Statement 8:12.02.) • Oral Inhalation Commercially available tobramycin solution for oral inhalation is administered via nebulization in the management of bronchopulmonary Pseudomonas aeruginosa infections in cystic fibrosis patients 6 years of age or older. Use of tobramycin oral inhalation solution can be considered for suppressive therapy …

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Gentamicin Sulfate

(US Adopted Name, rINN) Drug Nomenclature International Nonproprietary Names (INNs) in main languages (French, Latin, Russian, and Spanish): Synonyms: Gentamicin Sulphate; Gentamicin sulfát; Gentamicin-szulfát; Gentamicina, sulfato de; Gentamicini Sulfas; Gentamicino sulfatas; Gentamicinsulfat; Gentamisiinisulfaatti; NSC-82261; Sch-9724 BAN: Gentamicin Sulphate [BANM] USAN: Gentamicin Sulfate INN: Gentamicin Sulfate [pINNM (en)] INN: Sulfato de gentamicina [pINNM (es)] INN: Gentamicine, Sulfate de [pINNM (fr)] INN: Gentamicini Sulfas [pINNM (la)] INN: Гентамицина Сульфат [pINNM (ru)] CAS: 1403-66-3 (gentamicin); 1405-41-0 (gentamicin sulfate) ATC code: D06AX07; J01GB03; S01AA11; S02AA14; S03AA06 Note. GNT is a code approved by the British Pharmacopoeia 2008 for use on single unit doses of eye drops containing gentamicin sulfate where the individual container may be …

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