Other Infections Caused by the Enteric Bacteria
Gastroenteritis. A significant proportion of cases of gastroenteritis occurring in the neonatal period of life appear to be caused by enteric bacteria. About ten serologic strains of E. Certain strains of Proteus and Pseudomonas have at times also been held responsible for the similar illness. Meningitis and Brain Abscess. During the first four weeks of life, purulent meningitis is frequently caused by members of the enteric group of bacteria. Such cases are sporadically in nurseries and may be associated with infection of any other tissue of the body.
(see Meningitis Caused by Bacteria Other Than Meningococci.). Nontraumatic brain abscess is frequently due to infection by multiple species of anaerobic organisms similar to those found in the gastrointestinal tract. The sites of origin include chronically infected ears, sinuses, lungs, abdomen, and pelvis. Bacteremia in Hepatic Cirrhosis. Occasionally persons with cirrhosis of the liver develop an acute febrile illness and are found to lame ber-viremia caused by one of the enteric organisms. usually E. coli. Occasionally these patients signs of peritonitis, but in most of them, the event comes “out of the blue” without evidence of localized sepsis anywhere.
The illness is short and self-limited or responds to appropriate chemotherapy. Speculation as to its pathogenesis has included the possibility of shunting bacteria away from-the filtering action of the liver, impairment of humoral or cellular defense mechanisms, or complement inactivation owing to high blood ammonia. Surface Infection. Enteric bacteria, particularly Proteus and Pseudomonas, are commonly recovered from the surfaces of burns, varicose. The exudate from the sinus of chronic osteomyelitis or chronic otitis media often contains Proteus as the dominant ‘ organism: Otitis of the external auditory canal owing to Pseudomonas may give troublesome local symptoms, especially in swimmers. Perirectal Abscess.
This is an important complication in patients with marked granulocytopenia. Rectal examination should be carefully performed in such patients, particularly when they develop a fever and perianal pain. Abscesses at Sites of Subcutaneous Injections. Metastatic Infections. Despite the frequency with which enteric bacteria succeed in invading the blood, metastatic localization of infection is rare.
This is usually seen in men with the prostatic disease, chronic cystitis, and posterior urethritis. Enteric bacteria frequently predominate in the bronchial secretions of patients under treatment with large doses of penicillin or broad-spectrum antimicrobial agents. Primary gram-negative bacterial pneumonia often superimposed on viral influenza, however, does occur and may be exceedingly difficult to manage.