alexa Nocardiosis in a Patient with Acute Necrotizing Pancrea
ISSN: 2165-7920

Journal of Clinical Case Reports
Open Access

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Case Report

Nocardiosis in a Patient with Acute Necrotizing Pancreatitis. aCn A Simple Microscope Specimen Save a Patients Life? A Case Report

Krzysztof Madej1*, Hanna Tomczak2 and Marek Karczewski1
1Department of Transplantology, General and Vascular Surgery, Clinical Hospital of Poznan University of Medical Sciences, Poland
2Central Laboratory of Microbiology, Clinical Hospital of Poznan University of Medical Sciences, Poland
Corresponding Author : Krzysztof Madej
Department of Transplantology
General and Vascular Surgery
Clinical Hospital of Poznan University of Medical Sciences, Poland
Tel: +48618547900
Fax: +48618547901
E-mail: [email protected]
Received November 02, 2015; Accepted December 04, 2015; Published December 11, 2015
Citation: Madej K, Tomczak H, Karczewski M (2015) Nocardiosis in a Patient with Acute Necrotizing Pancreatitis. Can A Simple Microscope Specimen Save a Patient’s Life? A Case Report. J Clin Case Rep 5:662. doi:10.4172/2165-7920.1000662
Copyright: © 2015 Madej K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Objective: A 50-year-old immunocompetent patient was hospitalized following an episode of acute necrotizing pancreatitis. Piperacillin/tazobactam was administered empirically. Despite continuous IV , on the 20th day of treatment the patient required urgent laparotomy. A swab sample was collected and subsequent Vancomycin with Amikacin administered empirically. Design: Despite administration of intensive treatment, general clinical condition of the patient deteriorated. The question was, why we experienced ineffectiveness of conservative treatment, as well as of subsequent surgical procedures? Was the microbiological specimen taken incorrectly? Why was it difficult to identify bacteria constituting the etiological infection source? Results: What is emphasized in our article is the significance of proper collection of a specimen and gathering an appropriate clinical history. What also needs to be taken into account in severe acute pancreatitis is perhaps allowing for longer bacterial culture growth. Conclusion: In this case, the infection was caused by a past injury with the previously undiagnosed etiological factor, i.e. Nocardia spp., challenging both current diagnosis and treatment, which ultimately resulted in severe necrotizing pancreatitis. This indicates the importance of a microbiologist for diagnosis and treatment.

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