PubMed · 367503
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T Kalager, A Digranes. 1979-01-13. Unusual complication after suprapubic bladder puncture.. https://doi.org/10.1136/bmj.1.6156.91-a
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Six infants 8 weeks of age or younger had lung abscesses treated in our medical center during the 20-year period of from 1957 to 1977. The duration of symptoms prior to diagnosis, the etiologic organisms, and the therapeutic approach differ from those in older children and adults. The pathogenic organisms were Escherichia coli, group B streptococcus, and Klebsiella pneumoniae, initial therapy with a penicillin and an aminoglycoside are indicated until identification and susceptibility results are available on the organism isolated from the abscess cavity. Previously undiagnosed cystic malformations of the lung were seen in two of the six patients. Surgical intervention is usually required in this age group.
Microbial infections reportedly have a favorable effect on the course of certain malignant diseases. Intralesional inoculation of micro-organisms can bring about tumor regression in certain clinical and experimental situations. In order to evaluate the influence of immediate postoperative wound infection on the course of Stage II melanomas, a retrospective study was undertaken of 211 patients who had undergone axillary or groin dissection. None had any antibiotic, steroid, chemoimmunotherapy, or cryosurgery and there was no history of a second primary neoplasm, pregnancy, immunodeficiency, or administration of immunosuppressive drugs. Forty of these patients developed significant postoperative wound infections. Although their representation according to sex, tumor location, number of nodes involved, and other parameters was comparable to that of the remaining 171 patients who did not develop wound infections, the incidence of local recurrence in the group with infections was significantly lower (p less than 0.01). Patient survival and disease-free interval following node dissection were not influenced by infection. Postoperative infections in the groin or axilla offered only local protection from tumor recurrence; the ultimate course of the disease was not affected.
A review of the literature reveals only one case of neonatal Escherichia coli pericarditis. This is a case report of Escherichia coli pericarditis occurring in a two day old infant. The infant initially presented with lethargy and jaundice but this rapidly progressed into shock. Despite vigorous resuscitative efforts, the infant succumbed and at autopsy 30 cc of purulent fluid were obtained. Cultures of the admission blood and post-mortem pericardial effusion grew Escherichia coli. The clinical diagnosis of pericarditis is often difficult because of vague, nonspecific symptoms and signs. The symptoms are usually those of sepsis plus those of impaired circulation due to mechanical embarrassment by accumulating pericardial effusion. It is difficult to differentiate pericarditis with effusion from myocarditis and pericardial effusion secondary to congestive heart failure. The use of pericardiocentesis as a diagnostic tool and echocardiography are the most helpful techniques presently available for diagnosis. Management consists of vigorous supportive efforts, antibiotics, and drainage of the pericardial effusion. Because of the very high mortality associated with this disorder, a high index of suspicion with a vigorous diagnostic and therapeutic approach to the patient is indicated.