Successful Treatment of Pasteurella multocida -Related Invasive Infections with a Beta-Lactamase Inhibitor-Sparing Combination Antibiotic Regimen: A Case Series

Pasteurella multocida , a Gram-negative, penicillin-sensitive coccobacillus that is frequently a member of the normal respiratory microbiota of different animals, remains a clinically important pathogen with the ability to cause severe disease. Few case reports have involved P. multocida infections without animal bites. Moreover, few reports have identified P. multocida as the causative agent of septic shock, which usually occurs in patients with cirrhosis and/or immunocompromised patients. To our knowledge, a human submandibular salivary gland abscess caused by P. multocida has not been reported. Pasteurella spp. are resistant to benzylpenicillin, and human isolates of beta-lactamase-producing resistant strains of P. multocida resistant have also been documented. The noteworthy findings of the current study were as follows: (i) the combination of ceftriaxone and ciprofloxacin successfully treated two patients infected with P. multocida ; (ii) the first reported case of a septicemic patient with no history of animal bites and a submandibular P. multocida infection; and (iii) an immunocompetent patient in septic shock due to a P. multocida systemic infection

Turicella otitidis central venous-related bacteremia during pediatric acute lymphoblastic leukemia

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Spontaneous bacterial peritonitis by Listeria monocytogenes. A rare case and literature review

Spontaneous bacterial peritonitis (SBP) is a bacterial infection of ascites and a common complication in patients with cirrhosis, associated with a high morbidity and mortality rate. Gram-negative Enterobacteriaceae bacteria are usually the major pathogens involved in SBP, with Klebsiella pneumoniae accounting for 50% of these. Individuals with chronic liver and /or kidney disease associated with long-standing ascites are predisposed to SBP. Nosocomial SBP presents most commonly a poorer outcome. Although Listeria monocytogenes peritonitis is a relatively rare focal manifestation of Listeria infection, its incidence is increasing. It is associated with a mortality rate approaching 30% in cases of systemic involvement, despite first-line therapy. To our knowledge, this is the first case of L.monocytogenes-associated SBP described in Italy. Clinicians should be aware of the uncommon agents of SBP, such as Listeria, because, if diagnosed early, early antibiotic administration is crucial in minimizing adverse outcomes.

Intrathecal tigecycline is a safe and effective treatment for central nervous system infections

Both the safety and effectiveness of intrathecal tigecycline (TGC) for treatment of infections of the central nervous system (CNS) are discussed using the clinical findings from a study of a recent patient who came to our attention, along with a literature review. Although penetration into the CNS is low (approximately 11%), intraventricular TGC could help treat patients with severe post-neurosurgical CNS infections. The use of multiple routes of TGC administration appears to be encouraging and should be considered in managing life-threatening intraventricular infections

Lambliasis-associated Schönlein-Henoch purpura in an Italian traveller: first case report in Italy

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Lambliasis-associated Schönlein-Henoch purpura in an Italian traveller: first case report in Italy

A unique report of Schönlein-Henoch purpura (SHP) associated with a recent Giardia lamblia enteric infectionis described and discussed on the ground of the available literature. Tinidazole plus an appropriateprobiotic therapy, including Lactobacillus reuteri and vitamin D, proved to be effective in the condition.SHP is an immunocomplex-mediated disorder characterised by a number of differently associated signsand symptoms, leading to the possible involvement of the skin, joints, abdomen and kidneys. Recentbacterial, viral, or protozoan infections may trigger the disease onset in patients of all ages. The paper describesthe first case of SHP triggered by a giardiasis. Tinidazole plus an appropriate probiotic therapy, i.e.L. reuteri and vitamin D proved to be effective in this condition. To our knowledge, this is the first reportedcase of lambliasis-associated SHP described in an international traveller

Candida guilliermondii Peritonitis During Peritoneal Dialysis. Case Report and Literature Review

Peritonitis is the most frequent complication of peritoneal dialysis (PD) and 3–6% of episodes have fungal origin. Candida guilliermondii is an uncommon species of Candida with invasive behavior in patients affected by severe underlying disorders or using indwelling vascular devices. Here we report the case of an 84-year-old woman undergoing outpatient PD for 4 years who had fever, chills, and diffuse increasing abdominal pain. After empiric antimicrobial therapy, based on teicoplanin in the dialytic circuit plus oral ciprofloxacin plus fluconazole, the patient was hospitalized. Afterwards, the culture from the peritoneal fluid showed the presence of C. guilliermondii. PD-related fungal peritonitis is an infrequent event, but the morbidity and mortality rates are significant. In this scenario, appropriate prevention strategies including antifungal prophylaxis during antibiotic treated bacterial peritonitis should be evaluated

Indirect hyperbilirubinemia and jaundice during chronic hepatitis C in an HIV-infected patient treated with glecaprevir/pibrentasvir (GLE/PIB) and antiretroviral therapy (ART). The first reported case in Italy

Glecaprevir (GLE)/pibrentasvir (PIB) is a pangenotypic direct- acting antiviral regimen approved for treating chronic hepatitis C virus. Primary treatment and re-treatment with GLE/PIB are effective and safe for patients without decompensated liver cirrhosis and chronic hepatitis C in a real-world clinical setting. However, in the context of compensated cirrhosis and concomitant adminis- tration of inhibitors of cytochromes, a careful monitoring of liver biomarkers, as well as therapeutic drug monitoring (TDM), may be advisable during GLE/PIB therapy. The GLE / PIB combination is very effective and safe in achieving a sustained virological response, but it can be associated with the development of severe hepatic adverse events, which require virological and serum con- centration monitoring of the two drugs to prevent a serious liver damage. The possible onset of hyperbilirubinemia must not neces- sarily lead to the suspension of therapy, because the phenomenon may be transient. We report what is likely the first known case of severe jaundice after treatment with GLE/PIB in Italy in a patient with compensated chronic hepatitis in the context of HIV disease