by admin Posted in Anti-Infectives
Cystitis is an inflammatory process of the bladder that is nearly always due to a bacterial infection. Acute uncomplicated cystitis can be defined as cystitis in a healthy, young, non-pregnant woman. Acute uncomplicated cystitis is caused by bowel flora that colonizes periurethral tissues and ascends through the urethra, infecting the bladder. About 80% of cases of acute uncomplicated cystitis are caused by Escherichia со//and 10% by Staphylococcus saprophyticus. Most of the remaining infections are caused by Proteus mirabilis, Klebsiella pneumoniae, Entero-bacter species, and beta-hemolytic streptococi.
Asymptomatic bacteriuria is a common occurrence among young, sexually active women. In one study, monthly cultures were performed for 6 months in asymptomatic women, and more than 20% of the women in the study had at least one positive culture finding. However, only 8% of these positive cultures were followed by a symptomatic UTI. This finding supports the practice of treating bacteriuria only in symptomatic individuals. Only under special circumstances (e.g., pregnancy, preceding urologic procedures) is it appropriate to treat asymptomatic bacteriuria.
*139/348/5*
by admin Posted in Anti-Infectives
Splenic abscesses are uncommon lesions that are usually the result of hematogenous dissemination, as a result of bacteremia or septic embolization. Infected splenic infarcts and contiguous spread of infection are also potential mechanisms.
Patients often present with fever, chills, and left upper quadrant abdominal pain. Irritation of the diaphragm may lead to pleuropulmonary symptoms and referral of pain to the left shoulder. A quarter of cases involve a polymicrobial infection. Causative organisms include S. aureus and Streptococcus species (usually in cases of bacterial endocarditis), as well as Salmonella species and other enteric bacteria, including anaerobes. Fungi, especially Candida species, are important causes of splenic abscesses in immunocompromised hosts.
Broad-spectrum empiric antimicrobial therapy, as recommended for secondary peritonitis, is required. Although the treatment of choice is generally splenectomy, percutaneous drainage may be considered in some cases.
*99/348/5*
SPLENIC ABSCESSSplenic abscesses are uncommon lesions that are usually the result of hematogenous dissemination, as a result of bacteremia or septic embolization. Infected splenic infarcts and contiguous spread of infection are also potential mechanisms.Patients often present with fever, chills, and left upper quadrant abdominal pain. Irritation of the diaphragm may lead to pleuropulmonary symptoms and referral of pain to the left shoulder. A quarter of cases involve a polymicrobial infection. Causative organisms include S. aureus and Streptococcus species (usually in cases of bacterial endocarditis), as well as Salmonella species and other enteric bacteria, including anaerobes. Fungi, especially Candida species, are important causes of splenic abscesses in immunocompromised hosts.Broad-spectrum empiric antimicrobial therapy, as recommended for secondary peritonitis, is required. Although the treatment of choice is generally splenectomy, percutaneous drainage may be considered in some cases.*99/348/5*