BACKGROUND Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii(A.baumannii)is one of the most severe complications associated with craniotomy.However,limited therapeutic options exist f...BACKGROUND Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii(A.baumannii)is one of the most severe complications associated with craniotomy.However,limited therapeutic options exist for the treatment of A.baumannii ventriculitis due to the poor penetration rate of most antibiotics through the blood-brain barrier.CASE SUMMARY A 68-year-old male patient with severe traumatic brain injury developed pyogenic ventriculitis on postoperative day 24 caused by extensively drug-resistant A.baumannii susceptible to tigecycline only.Successful treatment was accomplished through multi-route administration of tigecycline,including intravenous combined with continuous ventricular irrigation plus intraventricular administration.The pus was cleared on the 3rd day post-irrigation,and cerebrospinal fluid cultures were negative after 12 d.CONCLUSION Our findings suggest that multi-route administration of tigecycline can be a therapeutic option against pyogenic ventriculitis caused by extensively drugresistant A.baumannii.展开更多
Pseudomonas aeruginosa (P. aeruginosa) frequently causes various infections, some of which are serious and require prompt medical detection and appropriate antibiotic selection. Although P. aeruginosa commonly exists ...Pseudomonas aeruginosa (P. aeruginosa) frequently causes various infections, some of which are serious and require prompt medical detection and appropriate antibiotic selection. Although P. aeruginosa commonly exists within the nasal cavity, meningitis or ventriculitis following transsphenoidal surgery to relieve P. aeruginosa has been reported only occasionally. However, as the endoscopic transnasal approach is more widely utilized for the suprasellar lesions, nosocomical P. aeruginosa infection associated with cerebrospinal fluid (CSF) leakage becomes more common in patients with panhypopituitarism who undergo transsphenoidal surgery. We report a case of a 36-year-old man with an intrasellar craniopharyngioma presenting with an acute obstructive hydrocephalus caused by P. aeruginosa ventriculitis following transsphenoidal surgery. Treatment with optimal antibiotics was initiated immediately after P. aeruginosa was recognized as the pathogen, and was continued for 3 months. After removal of the infected fascia and fat graft used for the closure of CSF leakage and sellar floor reconstruction, endoscopic third ventriculostomy was successfully performed to treat the obstructive hydrocephalus induced by the occlusion of the fourth ventricle outlet, resulting in a positive outcome. Although the obstructive hydrocephalus caused by P. aeruginosa is extremely rare, prompt detection and appropriate treatment should be required once P. aeruginosa ventriculitis happens.展开更多
Objectives To study the effects of AT1 antagonist on MMP2, MMP9 expression and collagen remodeling in left ventricle of rabbit undergoing chronic pressure overload. Methods 30 rabbits were randomly divided into 3 grou...Objectives To study the effects of AT1 antagonist on MMP2, MMP9 expression and collagen remodeling in left ventricle of rabbit undergoing chronic pressure overload. Methods 30 rabbits were randomly divided into 3 groups ( n = 10, each group), including sham operation group, abdominal aorta banded group (banded group), abdominal aorta banded +valsartan group (valsartan group). Twelve weeks after operation, hemodynamic parameters were acquired, then collagen volume fraction (CVF) and MMP2, MMP9 expression of left ventricle were measured by using VG and immunohistochemical stain. Results Compared with sham operation group, both MMP2 and MMP9 expression were enhanced in banded group; meanwhile, LVW/BW, LVEDP and CVF increased significantly. Compared with banded group, both MMP2 and MMP9 expression were weakened in valarstan group; simultaneously, LVW/BW, LVEDP and CVF decreased significantly. Conclusions Expression of MMP2 and MMP9 was enhanced in left ventricle of rabbit undergoing chronic pressure overload, which may be associated with collagen proliferation, ventricule remodeling and impaired heart function; Valsartan could inhibit collagen proliferation, prevent ventricule remodeling and preserve heart function by inhibiting abnormal expression of MMP2 and MMP9.展开更多
Salmonella enterica serovar Apeyeme is a rare pathogen that primarily affects poultry.However,there are limited data about this infection in humans.In this case,a 7-month-old infant presented with high-grade fever wit...Salmonella enterica serovar Apeyeme is a rare pathogen that primarily affects poultry.However,there are limited data about this infection in humans.In this case,a 7-month-old infant presented with high-grade fever without diarrhea for 12 hours prior to admission.Upon admission,he developed seizures and was referred for further intervention.He was diagnosed with meningoencephalitis with complications of subdural effusion,empyema,and abscesses.Salmonella Apeyeme was found in cerebrospinal fluid culture,but no growth was detected in either blood or stool cultures.He was given meropenem,vancomycin,and ciprofloxacin,but later developed disseminated intravascular coagulation.His clinical condition deteriorated over time,and he died 18 days after admission.To conclude,Salmonella Apeyeme infection should be considered if a patient is diagnosed with meningoencephalitis and has a history of poultry exposure.展开更多
文摘BACKGROUND Pyogenic ventriculitis caused by extensively drug-resistant Acinetobacter baumannii(A.baumannii)is one of the most severe complications associated with craniotomy.However,limited therapeutic options exist for the treatment of A.baumannii ventriculitis due to the poor penetration rate of most antibiotics through the blood-brain barrier.CASE SUMMARY A 68-year-old male patient with severe traumatic brain injury developed pyogenic ventriculitis on postoperative day 24 caused by extensively drug-resistant A.baumannii susceptible to tigecycline only.Successful treatment was accomplished through multi-route administration of tigecycline,including intravenous combined with continuous ventricular irrigation plus intraventricular administration.The pus was cleared on the 3rd day post-irrigation,and cerebrospinal fluid cultures were negative after 12 d.CONCLUSION Our findings suggest that multi-route administration of tigecycline can be a therapeutic option against pyogenic ventriculitis caused by extensively drugresistant A.baumannii.
文摘Pseudomonas aeruginosa (P. aeruginosa) frequently causes various infections, some of which are serious and require prompt medical detection and appropriate antibiotic selection. Although P. aeruginosa commonly exists within the nasal cavity, meningitis or ventriculitis following transsphenoidal surgery to relieve P. aeruginosa has been reported only occasionally. However, as the endoscopic transnasal approach is more widely utilized for the suprasellar lesions, nosocomical P. aeruginosa infection associated with cerebrospinal fluid (CSF) leakage becomes more common in patients with panhypopituitarism who undergo transsphenoidal surgery. We report a case of a 36-year-old man with an intrasellar craniopharyngioma presenting with an acute obstructive hydrocephalus caused by P. aeruginosa ventriculitis following transsphenoidal surgery. Treatment with optimal antibiotics was initiated immediately after P. aeruginosa was recognized as the pathogen, and was continued for 3 months. After removal of the infected fascia and fat graft used for the closure of CSF leakage and sellar floor reconstruction, endoscopic third ventriculostomy was successfully performed to treat the obstructive hydrocephalus induced by the occlusion of the fourth ventricle outlet, resulting in a positive outcome. Although the obstructive hydrocephalus caused by P. aeruginosa is extremely rare, prompt detection and appropriate treatment should be required once P. aeruginosa ventriculitis happens.
文摘Objectives To study the effects of AT1 antagonist on MMP2, MMP9 expression and collagen remodeling in left ventricle of rabbit undergoing chronic pressure overload. Methods 30 rabbits were randomly divided into 3 groups ( n = 10, each group), including sham operation group, abdominal aorta banded group (banded group), abdominal aorta banded +valsartan group (valsartan group). Twelve weeks after operation, hemodynamic parameters were acquired, then collagen volume fraction (CVF) and MMP2, MMP9 expression of left ventricle were measured by using VG and immunohistochemical stain. Results Compared with sham operation group, both MMP2 and MMP9 expression were enhanced in banded group; meanwhile, LVW/BW, LVEDP and CVF increased significantly. Compared with banded group, both MMP2 and MMP9 expression were weakened in valarstan group; simultaneously, LVW/BW, LVEDP and CVF decreased significantly. Conclusions Expression of MMP2 and MMP9 was enhanced in left ventricle of rabbit undergoing chronic pressure overload, which may be associated with collagen proliferation, ventricule remodeling and impaired heart function; Valsartan could inhibit collagen proliferation, prevent ventricule remodeling and preserve heart function by inhibiting abnormal expression of MMP2 and MMP9.
文摘Salmonella enterica serovar Apeyeme is a rare pathogen that primarily affects poultry.However,there are limited data about this infection in humans.In this case,a 7-month-old infant presented with high-grade fever without diarrhea for 12 hours prior to admission.Upon admission,he developed seizures and was referred for further intervention.He was diagnosed with meningoencephalitis with complications of subdural effusion,empyema,and abscesses.Salmonella Apeyeme was found in cerebrospinal fluid culture,but no growth was detected in either blood or stool cultures.He was given meropenem,vancomycin,and ciprofloxacin,but later developed disseminated intravascular coagulation.His clinical condition deteriorated over time,and he died 18 days after admission.To conclude,Salmonella Apeyeme infection should be considered if a patient is diagnosed with meningoencephalitis and has a history of poultry exposure.
