Moraxella (Branhamella) catarrhalis bacteremia: a case report and literature review

Article Abstract:

Moraxella catarrhalis, which was previously referred to as Branhamella catarrhalis, has traditionally been thought of as a harmless upper-airway commensal. A commensal is an organism which lives off another organism without helping, but without harming the host either. M. catarrhalis gained this reputation by being so common in cultures taken from patients that it was not considered to be the cause of any disease. Recently, however, it has come to be appreciated that in some cases the organism may be infectious, and may invade body tissues. A review of the medical literature since 1925 uncovered only 26 reports of M. catarrhalis being found in the blood of patients. A recent case involving a 71-year-old man brought the total number of cases to 27. The man developed bronchopneumonia, apparently due to M. catarrhalis, along with bacteremia, a bacterial infection of the blood. The disease progressed rapidly despite antibiotic therapy, and the man died of respiratory arrest. Many recorded cases of M. catarrhalis bacteremia involved patients who were immunocompromized in some way, indicating that the greatest likelihood is that the normally harmless organism is capable of invading a compromised host. However, in many of the cases no source of immune compromise could be identified; therefore, the possibility of M. catarrhalis infection is always present, even if not likely. If M. catarrhalis is identified upon culture of blood or a normally sterile site, the antibiotic treatment should be planned accordingly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Pneumonia, Branhamella catarrhalis, Moraxella catarrhalis

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Abnormalities in bilirubin and liver enzyme levels in adult patients with bacteremia: a prospective study

Article Abstract:

A study of 84 patients with bacteremia, a septic condition of a blood infection, was conducted to identify possible biochemical markers of liver damage. Levels of bilirubin, the pigment in liver bile, and the liver enzymes aminotransferase and alkaline phosphatase were evaluated. None of the patients in this study suffered from cancerous malignancies or diseases of the hepatobiliary system. Elevated liver enzyme levels, or liver biochemical abnormalities (LBA), were detected in about half of the patients, but the elevations were mild, of short duration, and common to a variety of bacterial infections. Results showed that the mortality rate, infection site, and overall health of the patients did not differ greatly when there was an elevation of liver enzymes or jaundice (a yellowish skin pigmentation often caused by obstruction of bile ducts and excess bilirubin in the blood or poor liver function). Results concur with other research indicating that liver enzyme and bilirubin levels were not useful for predicting the course of the bacteremia. The relationship of bacteremia and LBA is not fully understood; the pathogenesis of LBA during the course of a bacterial infection may be related to a number of factors and not to a single bacterial toxin acting alone.

Abnormalities, Measurement, Liver, Enzymes, Bilirubin

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Group A beta-hemolytic streptococcal bacteremia and intravenous substance abuse

Article Abstract:

Group A beta-hemolytic streptococci bacteria (GASB) generally infect the throats of children and the skin of adults. If left untreated the bacteria can travel to infect the blood (bacteremia) and heart. Although the advent of antibiotics has reduced blood infections with group A beta-hemolytic streptococci, bacterial blood infections are still reported and the incidence may even be increasing, particularly among cancer patients, diabetics and intravenous drug abusers. GASB has been the source of some nosocomial infections, i.e. those acquired during hospitalization. The incidence of GASB blood infections in drug addicts recently admitted to a community hospital in Philadelphia was unusually high. The incidence increased from 2.5 per 10,0000 patients to 17.9. within 18 months. These results were compared with the incidence of infections in the four-year period before the outbreak. Although the number of admitted addicts remained unchanged, the number of addicts with soft tissue infections increased. Practitioners should be watchful for GASB infections in intravenous drug users. (Consumer Summary produced by Reliance Medical Information, Inc.)

Streptococcal infections, Causes of, Skin, Drug abuse, Blood

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