Abstract Introduction: Trueperella bernardiae is a gram-negative coccobacilli that was initially categorized as coryneform bacteria, and thus frequently, it was not further investigated as a pathogenic organism. Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) has revolutionized the identification of bacteria, including T. bernardiae. Now case reports for T. bernardiae infections are starting to be reported, but it remains a rare pathogen for infections. Case Presentation: Here we are reporting a rare case of T. bernardiae bacteremia, presenting with sepsis and imaging finding showing pelvic septic arthritis, micro-abscesses, and osteomyelitis. It would have likely started as urinary tract infection, followed by osteomyelitis and bacteremia. The patient was managed with intravenous vancomycin. The follow-up clinic visit showed clinical improvement. This article also provides a brief literature review of T. bernardiae infections. Conclusion: T. bernardiae infections are rare but have clinical significance. This case adds another case to the literature regarding T. bernardiae infections and especially highlights the point that they can present with a more serious presentation like sepsis. MALDI-TOF helps in the identification of these rare pathogens.
{"title":"A Case Report of Trueperella bernardiae Pelvic Osteomyelitis and Sepsis: Literature Review of Trueperella bernardiae Infections","authors":"Saliha Saleem, William Roland, Abdullah Lodhi","doi":"10.1159/000539826","DOIUrl":"https://doi.org/10.1159/000539826","url":null,"abstract":"Abstract Introduction: Trueperella bernardiae is a gram-negative coccobacilli that was initially categorized as coryneform bacteria, and thus frequently, it was not further investigated as a pathogenic organism. Matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) has revolutionized the identification of bacteria, including T. bernardiae. Now case reports for T. bernardiae infections are starting to be reported, but it remains a rare pathogen for infections. Case Presentation: Here we are reporting a rare case of T. bernardiae bacteremia, presenting with sepsis and imaging finding showing pelvic septic arthritis, micro-abscesses, and osteomyelitis. It would have likely started as urinary tract infection, followed by osteomyelitis and bacteremia. The patient was managed with intravenous vancomycin. The follow-up clinic visit showed clinical improvement. This article also provides a brief literature review of T. bernardiae infections. Conclusion: T. bernardiae infections are rare but have clinical significance. This case adds another case to the literature regarding T. bernardiae infections and especially highlights the point that they can present with a more serious presentation like sepsis. MALDI-TOF helps in the identification of these rare pathogens.","PeriodicalId":501334,"journal":{"name":"Case Reports in Acute Medicine","volume":"128 4","pages":"30 - 37"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141681998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marc Sylva, A. Abdulla, Birgit C.P. Koch, Jaap Mulder
Introduction: We describe a child with meningococcal sepsis who suffered cephalosporin-related neurotoxicity. Case Presentation: A four-year-old girl was treated with intravenous ceftriaxone and supportive therapy. After rapid improvement, inotropic and respiratory support was stopped within 2 days. However, she developed renal failure and, on day four, deteriorated neurologically. Research into the cause of her encephalopathy revealed supra-therapeutic ceftriaxone concentrations with greatly increased unbound fractions leading to the diagnosis of cephalosporin-related neurotoxicity. Ceftriaxone treatment was discontinued, and renal replacement therapy was initiated on day six. With both discontinuation of ceftriaxone and renal replacement therapy, the girl’s condition improved rapidly. Conclusion: We postulate that in the described case both renal impairment and hypoalbuminemia played an important role in the development of high unbound ceftriaxone serum levels. We advocate therapeutic drug monitoring for ceftriaxone in critically ill children with renal failure or hypoalbuminemia.
{"title":"Cephalosporin-Related Neurotoxicity in a Ceftriaxone-Treated Critically Ill Child: A Case Report","authors":"Marc Sylva, A. Abdulla, Birgit C.P. Koch, Jaap Mulder","doi":"10.1159/000534890","DOIUrl":"https://doi.org/10.1159/000534890","url":null,"abstract":"Introduction: We describe a child with meningococcal sepsis who suffered cephalosporin-related neurotoxicity. Case Presentation: A four-year-old girl was treated with intravenous ceftriaxone and supportive therapy. After rapid improvement, inotropic and respiratory support was stopped within 2 days. However, she developed renal failure and, on day four, deteriorated neurologically. Research into the cause of her encephalopathy revealed supra-therapeutic ceftriaxone concentrations with greatly increased unbound fractions leading to the diagnosis of cephalosporin-related neurotoxicity. Ceftriaxone treatment was discontinued, and renal replacement therapy was initiated on day six. With both discontinuation of ceftriaxone and renal replacement therapy, the girl’s condition improved rapidly. Conclusion: We postulate that in the described case both renal impairment and hypoalbuminemia played an important role in the development of high unbound ceftriaxone serum levels. We advocate therapeutic drug monitoring for ceftriaxone in critically ill children with renal failure or hypoalbuminemia.","PeriodicalId":501334,"journal":{"name":"Case Reports in Acute Medicine","volume":" 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138962274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 68-year-old male was found unconscious in a hot bathtub on a cold winter’s day and was brought to our hospital. On arrival, the patient’s systolic blood pressure was 65 mm hg, heart rate was 134 beats per min, and rectal temperature was 40.5°C. A large volume infusion of acetated Ringer’s solution and vasopressors were administered as an immediate treatment for circulatory failure due to heatstroke. Although the circulatory failure temporarily improved, the blood pressure dropped almost to the point of cardiac arrest. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was implemented and the hemodynamics were soon stabilized. Subsequently, VA-ECMO was withdrawn on the third hospital day. The patient recovered enough to feed normally on the 40th hospital day and was transferred to another hospital on the 116th hospital day. Based on this case study, we consider that VA-ECMO implementation before cardiac arrest might be a suitable strategy. Case Rep Acute Med 2021;4:76–79
在一个寒冷的冬日，一名68岁的男性被发现在一个热浴缸里失去知觉，被送到我们医院。到达时，患者收缩压为65 mm hg，心率为134次/分，直肠温度为40.5℃。大量输注醋酸化林格氏液和血管加压药作为中暑引起的循环衰竭的即时治疗。虽然循环衰竭暂时得到改善，但血压几乎下降到心脏骤停的程度。静脉-动脉体外膜氧合(VA-ECMO)实施后，血流动力学很快稳定。随后，VA-ECMO于住院第三天撤销。患者于住院第40天恢复正常进食，并于住院第116天转院。基于本病例研究，我们认为在心脏骤停前实施VA-ECMO可能是一种合适的策略。病例报告急诊医学2021;4:76-79
{"title":"Veno-Arterial Extracorporeal Membrane Oxygenation for Severe Heatstroke with Refractory Hemodynamic Failure","authors":"Masahide Fujita, Keita Miyazaki, Momoko Horiguchi, Kouji Yamamoto, Shingo Ito, Hidetada Fukushima","doi":"10.1159/000517681","DOIUrl":"https://doi.org/10.1159/000517681","url":null,"abstract":"A 68-year-old male was found unconscious in a hot bathtub on a cold winter’s day and was brought to our hospital. On arrival, the patient’s systolic blood pressure was 65 mm hg, heart rate was 134 beats per min, and rectal temperature was 40.5°C. A large volume infusion of acetated Ringer’s solution and vasopressors were administered as an immediate treatment for circulatory failure due to heatstroke. Although the circulatory failure temporarily improved, the blood pressure dropped almost to the point of cardiac arrest. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was implemented and the hemodynamics were soon stabilized. Subsequently, VA-ECMO was withdrawn on the third hospital day. The patient recovered enough to feed normally on the 40th hospital day and was transferred to another hospital on the 116th hospital day. Based on this case study, we consider that VA-ECMO implementation before cardiac arrest might be a suitable strategy. <br />Case Rep Acute Med 2021;4:76–79","PeriodicalId":501334,"journal":{"name":"Case Reports in Acute Medicine","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138521766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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