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16S ribosomal RNA identification of Prevotella nigrescens from a case of cellulitis.

Yang JJ, Kwon TY, Seo MJ, Nam YS, Han CS, Lee HJ - Ann Lab Med (2013)

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.

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Gram-negative anaerobes of the Prevotella intermedia/nigrescens group are usually isolated from polymicrobial infections of periodontal origin, although recovery from healthy individuals is also possible... The patient initially received acupuncture for his sprained ankle during a hiking trip in November 2012... As the symptoms did not improve, he visited a secondary hospital where he was diagnosed with cellulitis... The reference biochemical profile used for comparison with the API rapid ID32A result is described in Table 1... The results of antimicrobial susceptibility testing are described in Table 2... The antibiotic regimen was reverted to ampicillin and sulbactam... Discharge gradually decreased and the patient was discharged on February 15... Prevotella spp. infections are often polymicrobial, which is frequently more pathogenic than infections involving a single organism... The precise cause of infection is difficult to identify, although both a history of acupuncture and aspiration are possible causes... Indeed, there is one case report of Prevotella spp. infection in which a history of acupuncture was also present, and early detection and aggressive drainage were important for treatment in that case... Despite retrospective antimicrobial susceptibility testing, antimicrobial treatment using piperacillin and tazobactam seemed sufficient, as both agents were found to be effective, and had activity in this case with a low minimal inhibitory concentration... A high percentage of Prevotella spp. are known to produce β-lactamase, and therefore, antimicrobial susceptibility testing may be helpful in such cases, although it is not currently recommended as a routine procedure... Although P. nigrescens is a phenotypically similar pathogen to P. intermedia with an indistinguishable biochemical profile, a greater likelihood of suppurative infection has been suggested.

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Magnetic Resonance Imaging: T1-weighted image showing cellulitis associated with talus osteochondral lesions.
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Figure 1: Magnetic Resonance Imaging: T1-weighted image showing cellulitis associated with talus osteochondral lesions.

Mentions: A 52-yr-old man with a history of diabetes and hypertension was referred to the department of orthopedics on December 18 complaining of cellulitis of the left ankle. The patient initially received acupuncture for his sprained ankle during a hiking trip in November 2012. As the symptoms did not improve, he visited a secondary hospital where he was diagnosed with cellulitis. Magnetic resonance imaging (MRI) taken on December 1 showed cellulitis with talus osteochondral lesions and a low probability of abscess or osteomyelitis (Fig. 1). In spite of a week of antibiotic treatment with cefazedone followed by another week with ceftazidime, the patient was referred to our hospital with symptoms of swelling, redness, and aggravated pain. Ultrasound sonography (US) performed on December 18 revealed an abscess on the left ankle, as suggested by fluid accumulation and diffuse inflammation of soft tissue. Complete blood counts were as follows: hemoglobin, 12.7 g/dL; white blood cells, 12.48×109/L; platelets, 514×109/L; and erythrocyte sedimentation rate (ESR), 75 mm/hr. The C-reactive protein (CRP) level was 4.68 mg/dL and the procalcitonin level was 0.068 µg/L (reference range: ~0.046 µg/L).


16S ribosomal RNA identification of Prevotella nigrescens from a case of cellulitis.

Yang JJ, Kwon TY, Seo MJ, Nam YS, Han CS, Lee HJ - Ann Lab Med (2013)

Magnetic Resonance Imaging: T1-weighted image showing cellulitis associated with talus osteochondral lesions.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756247&req=5

Figure 1: Magnetic Resonance Imaging: T1-weighted image showing cellulitis associated with talus osteochondral lesions.
Mentions: A 52-yr-old man with a history of diabetes and hypertension was referred to the department of orthopedics on December 18 complaining of cellulitis of the left ankle. The patient initially received acupuncture for his sprained ankle during a hiking trip in November 2012. As the symptoms did not improve, he visited a secondary hospital where he was diagnosed with cellulitis. Magnetic resonance imaging (MRI) taken on December 1 showed cellulitis with talus osteochondral lesions and a low probability of abscess or osteomyelitis (Fig. 1). In spite of a week of antibiotic treatment with cefazedone followed by another week with ceftazidime, the patient was referred to our hospital with symptoms of swelling, redness, and aggravated pain. Ultrasound sonography (US) performed on December 18 revealed an abscess on the left ankle, as suggested by fluid accumulation and diffuse inflammation of soft tissue. Complete blood counts were as follows: hemoglobin, 12.7 g/dL; white blood cells, 12.48×109/L; platelets, 514×109/L; and erythrocyte sedimentation rate (ESR), 75 mm/hr. The C-reactive protein (CRP) level was 4.68 mg/dL and the procalcitonin level was 0.068 µg/L (reference range: ~0.046 µg/L).

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Gram-negative anaerobes of the Prevotella intermedia/nigrescens group are usually isolated from polymicrobial infections of periodontal origin, although recovery from healthy individuals is also possible... The patient initially received acupuncture for his sprained ankle during a hiking trip in November 2012... As the symptoms did not improve, he visited a secondary hospital where he was diagnosed with cellulitis... The reference biochemical profile used for comparison with the API rapid ID32A result is described in Table 1... The results of antimicrobial susceptibility testing are described in Table 2... The antibiotic regimen was reverted to ampicillin and sulbactam... Discharge gradually decreased and the patient was discharged on February 15... Prevotella spp. infections are often polymicrobial, which is frequently more pathogenic than infections involving a single organism... The precise cause of infection is difficult to identify, although both a history of acupuncture and aspiration are possible causes... Indeed, there is one case report of Prevotella spp. infection in which a history of acupuncture was also present, and early detection and aggressive drainage were important for treatment in that case... Despite retrospective antimicrobial susceptibility testing, antimicrobial treatment using piperacillin and tazobactam seemed sufficient, as both agents were found to be effective, and had activity in this case with a low minimal inhibitory concentration... A high percentage of Prevotella spp. are known to produce β-lactamase, and therefore, antimicrobial susceptibility testing may be helpful in such cases, although it is not currently recommended as a routine procedure... Although P. nigrescens is a phenotypically similar pathogen to P. intermedia with an indistinguishable biochemical profile, a greater likelihood of suppurative infection has been suggested.

Show MeSH
Related in: MedlinePlus