11/25. The expression of surface tissue factor apoprotein by blood monocytes in the course of infections in early infancy.The expression of surface tissue factor procoagulant activity and its shedding by blood monocytes can be induced by several stimuli. Few of these defined situations, other than the presence of bacteria and their toxins, are commonly present in the young human infant. In this study, measurements were made of the percentage of monocytes expressing surface tissue factor apoprotein (TFA) in blood taken from babies in the early weeks of life. Mononuclear cells were separated from blood in an environment free of detectable endotoxin. After exposure to a polyclonal rabbit antibody raised to purified brain TFA and subsequent exposure to a fluorescin-labeled murine anti-rabbit IgG, the cell fluorescent activity was analyzed by flow cytometry. The percentage of monocytes showing strong fluorescence was determined. In every instance when systemic bacterial infection was present, more than 60% of the monocytes examined showed fluorescence indicative of the presence of surface TFA. In a single case of fungal candida septicemia, none of the monocytes was positive. More than 60% of cells were found to be positive in certain instances where infection was highly probable but not proven. Positive cells were found in three cases of isoimmune hemolytic disease of the newborn, as had been anticipated from previous studies, whereas less than 25% of monocytes derived from babies in the absence of discernible infection or isoimmune hemolytic disease expressed surface TFA (p less than 0.001). These findings provide insight into a possible mechanism of coagulation activation in sepsis and may prove to be a useful predictor of the presence of infection or endotoxemia in young infants.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
12/25. Group A beta-hemolytic streptococcal bacteremia in a patient with sickle cell anemia on penicillin prophylaxis.Serious invasive bacterial infections, particularly those due to streptococcus pneumoniae and Hemophilus influenzae, are a well-known complication in patients with sickle cell disease. Early penicillin prophylaxis has been shown to prevent these infections and also to improve survival. This article describes a child with sickle cell anemia who, while on penicillin prophylaxis, developed a group A streptococcal bacteremia, a pathogen not commonly associated with bacteremia in sickle cell disease.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
13/25. Treatment of refractory disseminated nontuberculous mycobacterial infection with interferon gamma. A preliminary report.BACKGROUND. Studies conducted in vitro and in animals suggest that cytokine signals to monocytes or macrophages by interferon gamma are important in the containment and clearance of disseminated nontuberculous mycobacterial infections. methods. We studied seven patients with refractory, disseminated nontuberculous mycobacterial infections who were not infected with the human immunodeficiency virus. Three patients were from a family predisposed to the development of mycobacterium avium complex infections; four patients had idiopathic CD4 T-lymphocytopenia. Their infections were culture- or biopsy-proved, involved at least two organ systems, and had been treated with the maximal tolerated medical therapy. Cellular proliferation, cytokine production, and phagocyte function were assessed in peripheral-blood cells. Interferon gamma was administered subcutaneously two or three times weekly in a dose of 25 to 50 micrograms per square meter of body-surface area in addition to antimycobacterial medications. Clinical effects were monitored by cultures, biopsies, radiographs, and in one patient a change in the need for paracentesis. RESULTS. In response to phytohemagglutinin, the production of interferon gamma by mononuclear cells from the patients was lower than in normal subjects (P < 0.001), whereas stimulation with ionomycin and phorbol myristate acetate led to normal production of interferon gamma in the patients. Within eight weeks of the start of interferon gamma therapy, all seven patients had marked clinical improvement, with abatement of fever, clearing of many lesions and quiescence of others, radiographic improvement, and a reduction in the need for paracentesis. CONCLUSIONS. Interferon gamma in combination with conventional therapy may be effective for some cases of refractory disseminated nontuberculous mycobacterial infection.- - - - - - - - - - ranking = 7keywords = bacterial infection (Clic here for more details about this article) |
14/25. rhabdomyolysis associated with bacteremic pneumonia due to staphylococcus aureus.A case of rhabdomyolysis associated with bacteremic pneumonia due to staphylococcus aureus is reported. A 58-year-old man was admitted because of severe left lobar pneumonia, and presented myoglobinuria on admission. The serum creatine phosphokinase level was transiently elevated and myoglobinuria were disclosed. sputum and venous blood cultures grew staphylococcus aureus. rhabdomyolysis has rarely been reported in cases of bacterial infection, especially those due to staphylococcus aureus. This case might be an extremely rare case of rhabdomyolysis complicating staphylococcus aureus bacteremia following severe left upper lobar pneumonia.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
15/25. The limitations and usefulness of c-reactive protein and elastase-alpha 1-proteinase inhibitor complexes as analytes in the diagnosis and follow-up of sepsis in newborns and adults.c-reactive protein and elastase-alpha 1-proteinase inhibitor complexes were compared in the diagnosis of neonatal sepsis and bacterial infections in adults on the intensive care unit. Both analytes were measured in the same sample immediately after receipt. EDTA-plasma samples (n = 115) from 28 neonates (gestational age 29-42 weeks) within the first 72 hours of life with suspected neonatal sepsis, 2 babies between 14 and 28 days old with B-streptococcus infections and 28 adults on the intensive care unit with positive bacterial cultures were analysed for both analytes. Two adults with long-term infections were followed up over a period of 28 and 65 days respectively. The results showed that in 17 cases of confirmed neonatal sepsis within the first 24 hours of life, c-reactive protein levels were undetectable in 16 cases, one level of 13 mg/l being recorded. All had elevated elastase-alpha 1-proteinase inhibitor concentrations. Of the remaining 15 samples, 13 were normal and 2 were borderline for this analyte. c-reactive protein levels were between 5 and 10 mg/l in 5 cases and undetectable in the remaining 10 samples. Those neonates with detectable c-reactive protein levels were between 20 and 72 hours old with a gestational age greater than 31 weeks. c-reactive protein was undetectable in samples taken at the same time interval after birth from full-terms babies with a gestational age of 41-42 weeks, even in confirmed cases of neonatal sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
16/25. Myeloperoxidase deficiency and severe sepsis.We have described a 45-year-old obese white man found to have myeloperoxidase (MPO) deficiency of the granulocytic and monocytic series. Pancreatic necrosis due to bacterial infection developed as a complication of acute pancreatitis. Subsequently, he died of sepsis. MPO staining of terminal antemortem blood smears and postmortem bone marrow aspirates showed absence of MPO in cells of the myelocytic and monocytic series. family members' neutrophils and monocytes stained positive for MPO. MPO deficiency associated with severe sepsis is rarely reported. This case serves as a review of the association between hereditary and acquired MPO deficiency and severe infection.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
17/25. A virulent nonencapsulated haemophilus influenzae.Nontypeable haemophilus influenzae strain INT1 was isolated from the blood of a young child with clinical signs of meningitis following acute otitis media. No immunologic or anatomic predisposition of this child for invasive bacterial infection with an unusual organism was documented. Sensitive ELISA proved the absence of intra- or extracellular capsular polysaccharide production by INT1 and Southern blot analysis confirmed the lack of an intact capsulation (cap) gene locus within the chromosome. Nevertheless, INT1 established bacteremia and meningitis in infant and weanling rat models of invasive H. influenzae infection. High-molecular-weight dna isolated from INT1 was shown to confer an invasive phenotype on transformation of a nonencapsulated, avirulent laboratory strain of H. influenzae. Together these findings imply the presence of one or more as-yet-undiscovered, noncapsular virulence factors of H. influenzae that are capable of mediating invasive disease and resistance to immunologic clearance.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
18/25. rhabdomyolysis associated with bacteremia due to Streptococcus viridans.A 25-year-old man was admitted with complaints of fever and macrohematuria. Laboratory tests showed a substantial increase in serum creatine phosphokinase and creatinine in association with myoglobinuria and proteinuria. Blood culture grew Streptococcus salivarius and streptococcus oralis. Findings of renal biopsy were compatible with IgA nephropathy. The glomeruli had a mild mesangial proliferation without crescentic lesions. Changes of the interstitium and tubules were not evident. The clinical course and laboratory results strongly suggested a possible link between Streptococcus salivarius/oralis infection, and rhabdomyolysis. rhabdomyolysis is rarely seen as a complication of bacterial infection, and the present case emphasizes the importance of suspecting bacteremia due to Streptococcus salivarius/oralis in the presence of rhabdomyolysis.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
19/25. Fatal aeromonas hydrophila bacteremia in a hemodialysis patient treated with deferoxamine.A 49-year-old woman undergoing long-term hemodialysis and treated with deferoxamine (DFO) 1.5 g twice weekly for aluminum bone disease developed fever and bilateral calf pain caused by myonecrosis with gas gangrene. She had a rapidly fatal outcome. The cultures of blood and aspirates from both calf muscles demonstrated aeromonas hydrophila. No obvious entry point could be traced. The in vitro growth of the patient's strain was found to be stimulated by the deferoxamine-iron complex in an iron-deprived medium. It is suggested that high-dose DFO therapy in this patient was responsible for promoting a bacterial infection by this microorganism.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
20/25. Septicemia in a child undergoing callotasis limb lengthening.We report a patient undergoing femoral callotasis lengthening using the dynamic axial fixator to correct a post-infective leg length discrepancy of 7.8 cm. Seventeen days after the operation, the patient developed a pin site infection, which was successfully treated by oral antibiotics. On the 34th post-operative day, the infection reoccurred, and was accompanied by generalized malaise, vomiting and pyrexia. serology identified staphylococcus aureus enterotoxin. Following removal of the fixator, the child recovered, but only four cm of lengthening was achieved. The pins probably acted as a persistent foreign body, with local inflammation creating favorable ground for bacterial infection. The role of the previous multifocal osteomyelitis unclear, but it could have acted as a continuous source of pathogens. The resulting toxemia was not immediately suspected, and could have resulted in the loss of the patient had the fixator not been removed promptly.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
| <- Previous || Next -> |