Ricardo Figueroa Damián

Septicemia due to Aeromonas hydrophila in a Pregnant Woman" A Case Report and Review of the Literature

Background: In the late 1960s, the first isolates of Aeromonas were recovered from human specimens. Presently, there is sufficient evidence to suggest that the different isolates of the genus Aeromonas are human pathogens. The most frequent site of infection is the digestive tract, although extraintestinal infection also occurs. In those cases involving septicemia, most infections occur in individuals with underlying diseases. This report presents the case of a pregnant woman with no underlying disease or signs of immunodeficiency who developed A. hydrophila septicemia at 24 weeks gestation. Case: A 20-year-old pregnant woman was admitted with a history of 10 days of fever, chills, and diaphoresis. Three days before her hospitalization, she noted jaundice and choluria. Her liver was enlarged and her liver function tests were abnormal, with a moderate elevation of serum aminotransferases and direct serum bilirubin and a high serum alkaline phosphatase. Her blood and bone-marrow cultures revealed A. hydropkila. She was treated with parenteral ceftriaxone. She experienced a complete remission of her symptoms and laboratory abnormalities after therapy. The remainder of the pregnancy was normal. At 39.2 weeks gestation, she delivered a healthy male infant. Conclusion: An association was noted between pregnancy and A. hydrophila septicemia in a woman without immunodeficiency or underlying disease, possibly indicating another infectious complication in pregnancy.

Endometritis etiology : diagnosis and treatment experience of the Instituto Nacional de Perinatologia

Abstract Endometritis is one of the main causes of puerperal infection. To obtain information on the clinical characteristics, etiology, and evolution of this disease, a retrospective study was carried out involving patients who developed endometritis at the Instituto Nacional de Perinatologia from March 1, 1988 through May 31, 1991. During the 39 months included in the study, 180 cases were diagnosed, from which 150 medical records could be reviewed. In 92.6% of the patients, cesarean section was the resolution route of the pregnancy; 22% had a history of premature rupture of the membranes. The latency period for the development of postpartum endometritis was 120 ± 66 hours, whereas in the post-cesarean-section cases it was 56.2 ± 30 hours ( P Staphylococcus, Escherichia coli , and Peptostreptococcus sp. Bacteroides were mostly penicillin-resistant but sensitive to clindamycin. Two percent of the patients developed pelviperitonitis; one death occurred.

Selecting the appropriate antibiotic for respiratory tract infections

Abstract Respiratory tract infections are a significant public health problem in developing countries. The implementation of programs for the prevention, diagnosis, and treatment of these illnesses is necessary to reduce morbidity and mortality rates, especially in highly susceptible individuals, such as newborns, malnourished children, malnourished or immunologically depressed adults, and elderly patients. Before starting antimicrobial therapy for a patient with a respiratory tract infection, the clinician must consider whether the antibiotic is suitable. The most potent antimicrobial drug or the one with the broadest spectrum of activity may not necesarily be the most appropriate. The clinician must take into account whether the disease was acquired in the community or a hospital and whether it is acute or chronic. The site of infection, seriousness of the illness, possible causative agent, previous or concomitant treatments, and the patients age and immunologic status also must be considered. Experience indicates that this information is sufficient to start empiric treatment while in vitro sensitivity tests and cultures are performed. The best antimicrobial drug is one that has good absorption and distribution characteristics at the infection site, resists the inactivating mechanisms of the causative microorganisms, has the least possible toxic effects and adverse reactions, and is easily administered, well tolerated, and cost effective.