Liver and brain abscess caused by Aggregatibacter paraphrophilus in association with a large patent foramen ovale: a case report

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Introduction Aggregatibacter paraphrophilus (former name Haemophilus paraphrophilus) is a normal commensal of the oral flora. It is a rare cause of hepatobiliary or intracerebral abscesses. Case presentation We report a case of a 53-year-old Caucasian man with a liver abscess and subsequent brain abscesses caused by Aggregatibacter paraphrophilus. The probable source of the infection was the oral flora of our patient following ingestion of a dental filling. The presence of a large patent foramen ovale was a predisposing factor for multifocal abscesses. Conclusion In this case report, we describe an unusual case of a patient with both liver and brain abscesses caused by an oral commensal Aggregatibacter paraphrophilus that can occasionally show significant pathogenic potential.Published versio

A patient with bacteraemia and possible endocarditis caused by a recently-discovered genomospecies of Capnocytophaga: Capnocytophaga genomospecies AHN8471: a case report

<p>Abstract</p> <p>Introduction</p> <p><it>Capnocytophaga </it>are a genus of bacteria that have been found to be the causative organisms in a range of infections, including serious conditions such as bacteraemia, endocarditis and meningitis. This has been especially true amongst those with serious comorbidities and the immunocompromised populations. Although several species are known to cause human disease, historically, laboratories have often not identified isolates to species level due to the unreliable, laborious techniques needed. With the advent of Polymerase Chain Reaction-Restriction Fragment Length Polymorphism Analysis, identification to species level is now frequently possible and desirable, as it may provide clues as to the source of infection and its treatment.</p> <p>Case presentation</p> <p>Here we describe a case of bacteraemia and possible endocarditis in a 64-year-old white British man caused by a newly identified genomospecies of <it>Capnocytophaga </it>in a patient subsequently diagnosed with metastatic adenocarcinoma of the oesophagus. The source of the bacteraemia was presumed to be from the patient's own oral flora.</p> <p>Conclusion</p> <p>Our case further confirms the potential for <it>Capnocytophaga </it>to cause systemic infections, highlights the availability and need for identification of isolates to species level and re-emphasises the difficulty in diagnosing <it>Capnocytophaga </it>infections due to their slow growth in the laboratory.</p

Mortality in Hospitalized Older Adults Associated with Clostridium difficile Infection at a District Hospital

Clostridium difficile is the most common cause of hospital acquired infectious diarrhea in the developed world and has re-emerged in recent years with apparent greater morbidity and mortality. Despite this, there is little recent published data from the UK concerning associated mortality. We performed a case control study at a UK district general hospital of 66 hospitalized patients over the age of 65 years with C. difficile infection compared to 3-5 controls matched for age, sex and minimum length of stay. We found a significant excess mortality of 11.5% at seven days, 26.2% at 30 days, 38.1% at 90 days and 41.4% at 180 days. C. difficile infection in hospitalized elderly patients may contribute to long-term mortality or be a marker of poor prognosis and cases may require more intensive long-term follow up to improve mortality

Clostridium difficile infection

adults associated wit

Pseudomonas aeruginosa bacteraemia in two UK district hospitals

<em>Pseudomonas aeruginosa</em> bacteraemia is associated with significant morbidity and mortality. We retrospectively studied the epidemiology of bacteraemia due to <em>P. aeruginosa</em> in two UK district hospitals so as to determine prevention strategies and assess the efficacy and compliance with local hospital antibiotic guidelines. Eighty six episodes occurred in 85 patients over the 3 year period. There was a year on year increase in bacteraemias, due predominantly to an increased proportion of community-onset episodes. Urinary catheterisation was a significant risk factor, along with anaemia, renal disease, malignancy and diabetes. The antibiotic guidelines were adequate for 92.8% of episodes but only 73.8% of patients received adequate therapy. Failure to follow the guidelines was principally due to unwillingness to use gentamicin due to concerns about nephrotoxicity. The antibiotic guidelines may need reviewing to accommodate this problem and further work is required to address urinary catheter care in both the hospital and community. <em>Pseudomonas aeruginosa</em> should be considered a significant pathogen when patients are admitted with features of sepsis