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JYMS : Journal of Yeungnam Medical Science

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Original article
Diagnostic value of serum procalcitonin and C-reactive protein in discriminating between bacterial and nonbacterial colitis: a retrospective study
Jae Yong Lee, So Yeon Lee, Yoo Jin Lee, Jin Wook Lee, Jeong Seok Kim, Ju Yup Lee, Byoung Kuk Jang, Woo Jin Chung, Kwang Bum Cho, Jae Seok Hwang
J Yeungnam Med Sci. 2023;40(4):388-393.   Published online April 3, 2023
DOI: https://doi.org/10.12701/jyms.2023.00059
  • 1,138 View
  • 52 Download
AbstractAbstract PDF
Background
Differentiating between bacterial and nonbacterial colitis remains a challenge. We aimed to evaluate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in differentiating between bacterial and nonbacterial colitis.
Methods
Adult patients with three or more episodes of watery diarrhea and colitis symptoms within 14 days of a hospital visit were eligible for this study. The patients’ stool pathogen polymerase chain reaction (PCR) testing results, serum PCT levels, and serum CRP levels were analyzed retrospectively. Patients were divided into bacterial and nonbacterial colitis groups according to their PCR. The laboratory data were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy.
Results
In total, 636 patients were included; 186 in the bacterial colitis group and 450 in the nonbacterial colitis group. In the bacterial colitis group, Clostridium perfringens was the commonest pathogen (n=70), followed by Clostridium difficile toxin B (n=60). The AUC for PCT and CRP was 0.557 and 0.567, respectively, indicating poor discrimination. The sensitivity and specificity for diagnosing bacterial colitis were 54.8% and 52.6% for PCT, and 52.2% and 54.2% for CRP, respectively. Combining PCT and CRP measurements did not increase the discrimination performance (AUC, 0.522; 95% confidence interval, 0.474–0.571).
Conclusion
Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.
Case report
Septic arthritis of the hip joint caused by Klebsiella pneumoniae: a case report
Jeong-Bo Moon, Jun-Hwan Lee, Byung-Ju Ryu
J Yeungnam Med Sci. 2023;40(2):193-197.   Published online January 13, 2022
DOI: https://doi.org/10.12701/yujm.2021.01613
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  • 128 Download
AbstractAbstract PDF
Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient’s pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.
Case Reports
A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy
Moni Ra, Myungkyu Kim, Mincheol Kim, Sangwoo Shim, Seong Yeon Hong
Yeungnam Univ J Med. 2018;35(1):84-88.   Published online June 30, 2018
DOI: https://doi.org/10.12701/yujm.2018.35.1.84
  • 5,460 View
  • 45 Download
AbstractAbstract PDF
A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature 38.7℃, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.
C-ANCA-positive glomerulonephritis associated with subacute infective endocarditis caused by Bartonella infection
Min Jeong Kim, Ha Nee Jang, Tae Won Lee, Hyun Seop Cho, Se Ho Chang, Hyun Jung Kim
Yeungnam Univ J Med. 2017;34(1):140-145.   Published online June 30, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.1.140
  • 1,724 View
  • 9 Download
  • 1 Crossref
AbstractAbstract PDF
Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.

Citations

Citations to this article as recorded by  
  • Clinicopathological differences between Bartonella and other bacterial endocarditis-related glomerulonephritis – our experience and a pooled analysis
    Mineaki Kitamura, Alana Dasgupta, Jonathan Henricks, Samir V. Parikh, Tibor Nadasdy, Edward Clark, Jose A. Bazan, Anjali A. Satoskar
    Frontiers in Nephrology.2024;[Epub]     CrossRef

JYMS : Journal of Yeungnam Medical Science