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Boisen AB, Ostenfeldt EB, Erikstrup LT, Bay B. [Genital actinomycosis and pelvic abscesses in a woman with a 13-year-old intrauterine device]. Ugeskr Laeger 2017; 179:V11160846. [PMID: 28397653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A 55-year-old woman who had had the same intrauterine device (IUD) for 13 years was referred to the gynaecology outpatient clinic due to constitutional symptoms, abdominal pain and vaginal discharge. Diagnostic imaging showed multiple pelvic abscesses, and severe chronic endometritis with Actinomyces was found in an endometrial biopsy. The patient underwent surgical drainage of the accessible abscesses and started long-term antibiotic treatment. This case report illustrates that actinomycosis is an important differential diagnosis in symptomatic women with IUD and suspected gynaecologic malignancy.
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Badri T, Jaada N, Debbiche A, Mokhtar I. Pelvic actinomycosis fistulised to the skin, treated with doxycycline. Tunis Med 2017; 95:224-225. [PMID: 29446822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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3
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Compton F, Everett J, Wanger A, Zhang S. Coccidioidomycosis Presented as a Pelvic Mass in an Otherwise Healthy Female. Ann Clin Lab Sci 2015; 45:585-587. [PMID: 26586713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We present a case of a 32 year old female with a past medical history of hypertension who presented with several years of chronic back pain and was ultimately diagnosed with isolated pelvic coccidioidomycosis. She was initially seen by gynecologic oncology for assessment of possible metastatic cancer by image study, but a cytopathologic diagnosis of coccidioidomycosis lead to a cancellation of the planned surgery and extensive antifungal treatment managed by the infectious disease team. She had no known previous pulmonary disease or immunodeficiency. Pelvic coccidioidomycosis without known pulmonary disease is very rare, and disseminated infection typically only occurs in those who are severely immunocompromised. Our case presented with several years of back pain and a pelvic mass mistaken for possible malignancy by image study.
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Affiliation(s)
- Frances Compton
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jamie Everett
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Audrey Wanger
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Songlin Zhang
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Wang S, Cunha BA, Hamid NS, Amato BM, Feuerman M, Malone B. Metronidazole Single versus Multiple Daily Dosing in Serious Intraabdominal/Pelvic and Diabetic Foot Infections. J Chemother 2013; 19:410-6. [PMID: 17855185 DOI: 10.1179/joc.2007.19.4.410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The purpose of the study was to compare the clinical efficacy of once-daily versus multiple dose regimens of metronidazole in inpatients with serious/systemic Bacteroides fragilis infections, i.e., intraabdominal/pelvic and diabetic foot infections. A retrospective chart review was performed on 145 adult inpatients who received combination therapy with metronidazole for B. fragilis abdominal/pelvic infection or diabetic (deep) foot infections/osteomyelitis. Exclusion criteria included metronidazole given for indications other than those mentioned, patients who received only one dose of metronidazole, and patients who received oral metronidazole only. The 145 patients were in two groups: 66 patients in the metronidazole 1 g (i.v.) q24h (Group A) and 79 patients who received metronidazole 500 mg (i.v./p.o.) q6-8h dosing (Group B). Patient demographics included age, gender, indications of metronidazole, concomitant, antibiotics, and co-morbidities. Data collection also included length of stay (LOS), antibiotic days, and clinical outcomes. The 145 patients in our study had a mean age of 66 years, 61% were female and 39% male. Most patients were being treated for definitive intraabdominal/pelvic infections (82%), or probable intraabdominal/pelvic infections (22%). Only 6% had deep diabetic foot infections of osteomyelitis (percentages exceed 100% since a patient can have more than one indication) and were included since B. fragilis is also and important pathogen in diabetic osteomyelitis. Group A patients had more concomitant antibiotics and co-morbidities (p < 0.0001 and p < 0.05 respectively, chi-square test for trend) than Group B patients. There were no statistically significant differences between groups A and B for LOS and antibiotic days (p = 0.42 and p = 0.92 respectively, by rank-sum test), but after adjusting for concomitant antibiotics and co-morbidities Group A patients had clinically shorter LOS and fewer antibiotic days. Unadjusted mortality and failure rates were non-significantly higher in group A (relative ratios of 12.1%/6.3% = 6.3% = 1.91 and 18.2%/ 10.1% = 1.80 respectively), but after adjusting for concomitant antibiotics and co-morbidities with stratification analysis, groups A and B were virtually the same (risk differences of </= 1%). The authors conclude that for B. fragilis infections, as part of combination therapy, metronidazole 1 g (i.v.) q 24h appears to eb as efficacious and not inferior to multiply-dosed metronidazole regimens. Once daily metronidazole, i.e., 1 g (i.v.) q24h for the treatment of serious systemic infections where B. fragilis is an important co-pathogen (intraabdominal/pelvic and deep diabetic foot infections) has pharmacokinetic and pharmaco-economic advantages.
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Affiliation(s)
- S Wang
- Department of Pharmacy, Winthrop-University Hospital, Mineola, NY 11501, USA.
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5
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Turner J, Brand MI, Saclarides TJ. Pelvic sepsis after transanal endoscopic microsurgical excision of rectal polyps. Am Surg 2011; 77:E154-E155. [PMID: 21944497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Jacquelyn Turner
- Section of Colon & Rectal Surgery, Department of General Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Affiliation(s)
- Zishan Sheikh
- Department of Cardiology, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
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Gorisek NM, Oresković S, But I. Salmonella ovarian abscess in young girl presented as acute abdomen--case report. Coll Antropol 2011; 35:223-225. [PMID: 21661376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Ovarian abscess in young sexually non-active girls can represent a diagnostic challenge. 15-years old girl was admitted to the Clinic for Gynaecology and Obstetrics under the suspicion of torsion of an ovarian cyst. Her clinical status deteriorated after the admission with development of acute abdomen. Laparoscopic exploration was performed and unilateral ovarian abscess was found without involvement of other pelvic structures. The surgical procedure was minimal invasive for a young girl and Salmonella staleyville was isolated from pus. Solitary ovarian abscess can be of hematogenous origin and the causative pathogens are different from pathogens usually involved in pelvic inflammatory disease. To avoid later fertility problems it is of great importance to treat infections in pelvic region correctly according to the isolated microorganism and that surgery is the least invasive.
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Affiliation(s)
- Nina Miksić Gorisek
- Maribor University Medical Center, Department of Infectious Diseases, Maribor, Slovenia
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8
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Ma L, Zhang YZ, Zheng YL, Wang ZH, Xu YD, Kong LN. [Multicenter randomized controlled clinical study on levornidazole and sodium chloride injection in the treatment of pelvic anaerobic infections]. Zhonghua Fu Chan Ke Za Zhi 2010; 45:754-756. [PMID: 21176556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE to evaluate clinical efficacy and safety of levornidazole in the treatment of pelvic anaerobic infections. METHODS a multicenter randomized controlled clinical study was conducted to evaluate clinical efficacy and safety of levornidazole. One hundred and fourty-three patients with pelvic anaerobic bacteria infection were classified into 70 cases treated by levornidazole in study group and 73 cases treated by Ornidazole in control group. Those patients in two groups were both administered at a dose of 0.5 g twice daily for 5 - 7 days. The rate of clinical efficacy, bacteria clearance and adverse effect were recorded and compared between two groups. RESULTS at the endpoint, the rate of clinical efficacy were 80% (56/70) in study group and 81% (59/73) in control group, which did not reach significant difference (P > 0.05). The rate of bacteria clearance were 97% (36/37) in study group and 92% (22/24) in control group, which also did not reach significant difference (P > 0.05). The rate of adverse reaction of 3% (20/70) in study group was significantly lower than 22% (16/73) in control group (P < 0.05). CONCLUSION it is effective and safe to treat pelvic anaerobic infections with levornidazole and sodium chloride injection.
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Affiliation(s)
- Ling Ma
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
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Brezean I, Aldoescu S, Catrina E, Vâlcu M, Ionuţ I, Predescu G, Degeratu D, Pantea I. Pelvic and abdominal-wall actinomycotic infection by uterus gateway without genital lesions. Chirurgia (Bucur) 2010; 105:123-125. [PMID: 20405693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We hereby aim to account on a case of actinomycotic infection occurred in a female patient with an intrauterine contraceptive device (IUCD). The infection occurred as a pseudo-tumour which raised differential diagnosis issues with a malignant tumour. The diagnosis has been eventually established following the pathologic examination of paraffin-embedded tissues. Although the infection's gateway was the uterus, the subsequent invasion of the parietal, urinary bladder and lateral rectal walls did not seem to affect the fallopian tubes or the ovaries.
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Affiliation(s)
- I Brezean
- Clinica de Chirurgie Generală "Ion Juvara", Spitalul Clinic "Dr. I. Cantacuzino", Bucureşti.
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10
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Rementería B, Hernández I, Salinas U, Aguilera L. [Primary pyomyositis in a postoperative recovery unit]. Rev Esp Anestesiol Reanim 2009; 56:265-267. [PMID: 19537275 DOI: 10.1016/s0034-9356(09)70390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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11
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Hasan A, McMullan P, Mustafa H, Salmon S. Pelvic actinomycosis 17 years after hysterectomy. Eur J Obstet Gynecol Reprod Biol 2008; 137:119-20. [PMID: 17335956 DOI: 10.1016/j.ejogrb.2006.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2005] [Revised: 11/12/2006] [Accepted: 11/14/2006] [Indexed: 10/23/2022]
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12
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Trutnovsky G, Tamussino K, Reich O. Short-term antibiotic treatment of pelvic actinomycosis. Int J Gynaecol Obstet 2007; 101:203-4. [PMID: 18164011 DOI: 10.1016/j.ijgo.2007.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Revised: 10/30/2007] [Accepted: 10/30/2007] [Indexed: 11/17/2022]
Affiliation(s)
- Gerda Trutnovsky
- Department of Obstetrics and Gynecology, Medical University of Graz, Austria.
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Abstract
Pelvic osteomyelitis is unusual in children. We retrospectively reviewed charts of patients with this infection seen at our institution. From 1998 to 2005, 31 patients with pelvic osteomyelitis were identified: 19 males and 12 females with an age range of 1.5 months to 17 years 9 months. Duration of illness prior to admission ranged from 1 day to 2.5 months. Chief complaints included nonspecific pain, fever, limp, and decreased weight bearing. Microorganisms isolated included Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella, Enterobacter cloacae, and Kingella kingae. Bones involved were acetabulum/ilium (22 patients), ischium (7 patients), and pubis (4 patients); 2 patients had several bones involved. Imaging studies performed included magnetic resonance imaging (21 patients), computed tomography (14 patients), and nuclear bone scan (25 patients). Our study, the largest contemporary series of pediatric pelvic osteomyelitis from one institution, highlights the consequences of prolonged duration of illness and delayed diagnosis.
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Affiliation(s)
- Joel D Klein
- Division of Infectious Diseases, Alfred I. duPont Hospital for Children, Wilmington, Delaware 19899, USA.
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Abstract
The actynomyces infection is a rare cause of chronic pelvic inflammation, which can be manifested in multiple ways. It is caused by the actynomyces bacteria, usually by the israelii type, which can be a part of the normal flora of the genital tract in patients who use intrauterine device (IUD). There is a discussion about the importance of considering this infection disease as part of the differential diagnosis in patients using the IUD, with atypical manifestations and bizarre presentation of infections of the genital tract, severe pelvic adherent syndromes, tubo-ovarian complexes (abscesses) barely symptomatic, and in the case of intraoperatory suspicion of pelvic carcinomatosis among others.
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Affiliation(s)
- Sergio Urbina
- Department of Gynecology and Obstetrics, Hospital of
San José, Bogotá, Colombia
- *Sergio Urbina:
| | - Hernando Ruiz
- Department of Gynecology and Obstetrics, Hospital of
San José, Bogotá, Colombia
| | - Sofia Parejas
- Department of Gynecology and Obstetrics, Hospital of
San José, Bogotá, Colombia
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Desnica B, Beus A, Skuhala T, Topic MB, Vickovic N, Makek N. Myalgia and swelling of interphalangeal joints as side-effect of prolonged azithromycin therapy in patient with pelvic actinomycosis: case report. ACTA ACUST UNITED AC 2007; 39:186-7. [PMID: 17366044 DOI: 10.1080/00365540600810018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bosko Desnica
- University Hospital of Infectious Diseases Dr. Fran Mihaljevic, Zagreb, Croatia
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Guettrot-Imbert G, Letranchant L, Gallot D, Romaszko C, Laurichesse H. [Multiorgan failure due to gonococcal peritonitis in an HIV-HCV co-infected female patient]. Med Mal Infect 2005; 34:231-2. [PMID: 16235602 DOI: 10.1016/j.medmal.2004.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- G Guettrot-Imbert
- Service des maladies infectieuses et tropicales, Hôtel-Dieu, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Solomkin J, Teppler H, Graham DR, Gesser RM, Meibohm AR, Roy S, Woods GL. Treatment of polymicrobial infections: post hoc analysis of three trials comparing ertapenem and piperacillin-tazobactam. J Antimicrob Chemother 2004; 53 Suppl 2:ii51-7. [PMID: 15150183 DOI: 10.1093/jac/dkh206] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The efficacy of ertapenem 1 g once a day for the treatment of polymicrobial complicated intra-abdominal, complicated skin/skin-structure and acute pelvic infections was compared with piperacillin-tazobactam 3.375 g every 6 h in a post hoc analysis of data from three large randomized double-blind trials. Of the 1,558 treated patients in the three trials, no pathogen was identified in 345 (22.1%), 423 (27.2%) had a monomicrobial infection and 790 (50.7%) had a polymicrobial infection. At the test-of-cure assessment, there were no significant differences in outcome between the two treatment groups for any of the three infections. Cure rates (clinical and microbiological for intra-abdominal infection, clinical for skin/skin-structure and pelvic infections) in microbiologically evaluable patients for ertapenem and piperacillin-tazobactam, respectively, were 85.6% (154/180 evaluable patients) and 82.5% (127/154) for polymicrobial intra-abdominal infection, 80.3% (53/66) and 78.7% (48/61) for polymicrobial skin/skin-structure infection, and 95.7% (88/92) and 92.6% (88/95) for polymicrobial pelvic infection. Respective cure rates for all evaluable patients in the original trials were: 83.6% and 80.4% for intra-abdominal, 83.9% and 85.3% for skin/skin-structure, and 93.9% and 91.5% for pelvic infections. These data show that in the three trials, ertapenem 1 g once a day was highly effective for the treatment of polymicrobial infections and as effective as piperacillin-tazobactam 3.375 g every 6 h.
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Affiliation(s)
- Joseph Solomkin
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Pedersen BW, Petersen IR, Hansen BM. [Genital actinomycosis--diagnosis and treatment]. Ugeskr Laeger 2004; 166:472-5. [PMID: 15045712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Tellado J, Woods GL, Gesser R, McCarroll K, Teppler H. Ertapenem versus piperacillin-tazobactam for treatment of mixed anaerobic complicated intra-abdominal, complicated skin and skin structure, and acute pelvic infections. Surg Infect (Larchmt) 2003; 3:303-14. [PMID: 12697078 DOI: 10.1089/109629602762539535] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Anaerobes are an important component of many serious, deep tissue infections, especially complicated intra-abdominal (IAI), complicated skin and skin structure (SSSI), and acute pelvic (PI) infections. This study compares the efficacy of ertapenem, 1 g once a day, in the treatment of adults with anaerobic IAI, SSSI, and PI to piperacillin-tazobactam, 3.375 g every 6 hours. METHODS Three randomized, double-blind trials comparing ertapenem to piperacillin-tazobactam for treatment of IAI, SSSI, and PI were conducted. This subgroup analysis included 623 patients, whose baseline culture grew one or more anaerobic pathogens, from these three studies. RESULTS Anaerobes most commonly isolated were Bacteroides fragilis group (IAI) and peptostreptococci (SSSI and PI). The median duration of ertapenem and piperacillin-tazobactam therapy, respectively, in these subgroups was 6 and 7 days for IAI, 7 and 8 days for SSSI, and 4 and 5 days for PI. Cure rates for all evaluable patients with anaerobic infection were 89.3% (242/271) for ertapenem and 85.9% (220/256) for piperacillin-tazobactam (95% CI for the difference, adjusting for infection, -2.6% to 9.3%), indicating that the two treatments were equivalent. Cure rates by infection, for ertapenem and piperacillin-tazobactam, respectively, were as follows: IAI, 86.4% (133/154) and 82.4% (117/142); SSSI, 84.4% (27/32) and 82.4% (28/34); PI, 96.5% (82/85) and 93.8% (75/80). The frequency and severity of drug-related adverse experiences were comparable in both treatment groups. CONCLUSION In this subgroup analysis, ertapenem was as effective as piperacillin-tazobactam for treatment of adults with moderate to severe anaerobic IAI, SSSI, and PI, was generally well tolerated, and had a similar safety profile.
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Teppler H, McCarroll K, Gesser RM, Woods GL. Surgical infections with enterococcus: outcome in patients treated with ertapenem versus piperacillin-tazobactam. Surg Infect (Larchmt) 2003; 3:337-49. [PMID: 12697080 DOI: 10.1089/109629602762539553] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The pathogenicity of Enterococcus in polymicrobial surgical infections is controversial. The objective of this analysis was two-fold. The impact of Enterococcus on clinical outcome was assessed in adults with complicated intra-abdominal (IAI), complicated skin and skin structure (CSSSI), or acute pelvic (PI) infection treated with ertapenem or piperacillin-tazobactam, which is more active in vitro against enterococci than ertapenem. Baseline characteristics were identified that were associated with Enterococcus infection and with treatment failure. METHODS This analysis included 1,558 patients treated in three randomized, triple-blind studies. Of these patients, 223 had Enterococcus in initial cultures: 125 of 623 (20%) with IAI, 28 of 529 (5%) with CSSSI, and 70 of 406 (17%) with PI. Logistic regression models were fit to assess each objective. RESULTS The cure rates for the two treatment groups were similar in each of the three studies, regardless of the presence or absence of Enterococcus. Cure rates for both treatment groups combined were significantly lower in patients with Enterococcus than without Enterococcus for IAI (76% [69/91] versus 87% [264/305], OR 2.3 [95% CI, 1.2-4.1], P = 0.009) and CSSSI (58% [11/19] versus 84% [241/287], OR 3.8 [95% CI, 1.5-10.0], P = 0.010); but for PI, rates were similar (96% [50/52] versus 92% [188/205], OR 0.4 [95% CI, 0.1-1.9], P = 0.220). Characteristics predictive of the presence of Enterococcus were Pseudomonas aeruginosa as a baseline pathogen for IAI, older age, and the presence of a complicating underlying disease for CSSSI, and infection severity rated moderate rather than severe for PI. The strongest predictors of treatment failure were >2 days postoperative infection at study entry for patients with IAI and older age for patients with CSSSI. CONCLUSION Choice of antimicrobial therapy did not affect cure rates in patients with or without Enterococcus. The strongest predictors of failure were postoperative infection at study entry in patients with IAI and older age in patients with CSSSI.
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Affiliation(s)
- Hedy Teppler
- Merck Research Laboratories, West Point, Pennsylvania 19422, USA
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Tedeschi A, Di Mezza G, D'Amico O, Ermann A, Montone L, Siciliano M, Cobellis G. A case of pelvic actinomycosis presenting as cutaneous fistula. Eur J Obstet Gynecol Reprod Biol 2003; 108:103-5. [PMID: 12694981 DOI: 10.1016/s0301-2115(02)00361-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Actinomycosis of the female genital tract has greatly increased over the last two decades. A pelvic form of the disease, associated with the use of Intra-uterine Devices (IUD), can severely damage pelvic organs and even can lead to death. We report a case of pelvic actinomycosis presenting as cutaneous fistula.
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Affiliation(s)
- Amando Tedeschi
- II University of Naples, Department of Gynecology and Obstetrics, SMDP Incurabili, A.S.L. 1, Via M. Longo, 38, Naples 80132, Italy.
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Roy S, Higareda I, Angel-Muller E, Ismail M, Hague C, Adeyi B, Woods GL, Teppler H. Ertapenem once a day versus piperacillin-tazobactam every 6 hours for treatment of acute pelvic infections: a prospective, multicenter, randomized, double-blind study. Infect Dis Obstet Gynecol 2003; 11:27-37. [PMID: 12839630 PMCID: PMC1852268 DOI: 10.1155/s1064744903000048] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare ertapenem therapy with piperacillin-tazobactam therapy for the management of acute pelvic infections. METHODS In a multicenter, double-blind study, 412 women with acute pelvic infection were assigned to one of two strata, namely obstetric/postpartum infection or gynecologic/postoperative infection, and were then randomized to ertapenem, 1 g once a day, or piperacillin-tazobactam, 3.375 g every 6 hours, both administered intravenously. RESULTS In total, 163 patients in the ertapenem group and 153 patients in the piperacillin-tazobactam group were clinically evaluable. The median duration of therapy was 4.0 days in both treatment groups. The most common single pathogen was Escherichia coli. At the primary efficacy endpoint 2-4 weeks post therapy, 93.9% of patients who received ertapenem and 91.5% of those who received piperacillin-tazobactam were cured (95% confidence interval for the difference, adjusting for strata, -4% to 8.8%), indicating that cure rates for both treatment groups were equivalent. Cure rates for both treatment groups were also similar when compared by stratum and severity of infection. The frequency and severity of drug-related adverse events were generally similar in both groups. CONCLUSIONS In this study, ertapenem was as effective as piperacillin-tazobactam for the treatment of acute pelvic infection, was generally well tolerated, and had an overall safety profile similar to that of piperacillin-tazobactam.
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Affiliation(s)
- Subir Roy
- Keck School of Medicine at USCLos AngelesCAUSA
| | | | | | | | | | - Ben Adeyi
- Merck Research LaboratoriesWest PointPAUSA
| | - Gail L. Woods
- Merck Research LaboratoriesWest PointPAUSA
- Merck &Co., Inc.10 Sentry ParkwayBL 3-4Blue BellPA19422USA
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Abstract
We present a case of ureteral obstruction secondary to pelvic actinomycosis. Despite stenting, prolonged antibiotic therapy, and debridement, the patient required ureteral resection and reconstruction. This condition may simulate advanced malignancy, and diagnostic suspicion lessens the need for radical extirpative surgery.
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