1/79. stenotrophomonas (xanthomonas) maltophilia infection in necrotizing pancreatitis.CONCLUSION: Although the therapy of infected pancreatic collections or organized pancreatic necrosis remains surgical, we have demonstrated that infected organized pancreatic necrosis can be treated endoscopically. BACKGROUND: stenotrophomonas (xanthomonas) maltophilia has been increasingly recognized as a nosocomial pathogen associated with meningitis, pneumonia, conjunctivitis, soft tissue infections, endocarditis, and urinary tract infections. This organism is consistently resistant to imipenem, a drug commonly employed in patients with necrotizing pancreatitis to prevent local and systemic infections. methods AND RESULTS: We report the first case of infected pancreatic necrosis by S. (X.) maltophilia. Our patient was treated successfully with endoscopic drainage of the pancreatic fluid collection and appropriate antibiogram-based antibiotic therapy. Endoscopic drainage has emerged as one of the treatment modalities for pancreatic fluid collections.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/79. The treatment of meningitis in infants with co-trimoxazole administered parenterally.We found that co-trimoxazole had a good clinical and antibacterial effect when given parenterally to infants with infections of the central nervous system. We showed good concentrations in the serum and satisfactory penetrations into the cerebrospinal fluid. In one case, there was a side effect which may have been due to the sulpha or to the solvent. We think that at present the preparation should not be given to very premature babies or to babies with icterus, for the same reasons that we avoid using sulpha preparations in these conditions, but otherwise it may be of great use in difficult cases of meningitis caused by gram-negative bacteria in infancy.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
3/79. Developing or normocellular bacterial meningitis.Occult, normocellular bacterial meningitis is described in two cases, and additional records of similar cases reviewed. It is considered necessary to perform bacteriological cultures of all cerebrospinal fluids investigated for possible infective conditions even if of normal cell count, biochemistry, and naked eye appearance.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
4/79. Bacterial meningitis: a review of 53 patients.The mortality figures and incidence of bacterial meningitis in children from Tauranga are reviewed. The high rate of meningitis in relationship to overseas countries is discussed.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
5/79. Refractory bacillus cereus infection in a neonate.bacillus cereus is a Gram-positive aerobic or facultatively anaerobic spore-forming rod, which usually causes food poisoning. Its recognition as a pathogen in neonates has increased over the past two decades. The clinical course of a neonate (gestation 24 weeks) with B. cereus infection refractory to therapy is described. death occurred after withdrawal of support following persistently positive blood and bone marrow cultures despite therapy with vancomycin, gentamicin, imipenum, clindamycin, ciprofloxacillin, immunoglobulin and granulocyte colony stimulating factor over a period of 49 days. No obvious focus of sepsis was identified. Contamination from the environment into the hospital and clinics occurs because of the ubiquitous presence of B. cereus. Combination therapy with vancomycin and gentamycin is appropriate for meningitis/severe systemic infections related to most bacillus species. The significance of repeated isolation of B. cereus in neonates with compromised host defences is emphasised.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
6/79. A successful caesarean section after death from acute bacterial meningitis.A case of post mortem Caesarean Section is presented with a successful outcome. The urgency of the operation to achieve the delivery of a live and healthy baby is stressed. The mother died of Acute bacterial meningitis.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
7/79. Spontaneous cerebrospinal fluid otorrhea.A case of spontaneous cerebrospinal fluid otorrhea with recurrent meningitis is reported. The route of cerebrospinal fluid leak was through the internal auditory meatus. The cerebrospinal fluid otorrhea was stopped by packing the meatus with muscle and Gelfoam.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
8/79. Early manifestation and recognition of C2 complement deficiency in the form of pyogenic infection in infancy.OBJECTIVE: Although frequently asymptomatic, C2 complement component deficiency may lead to severe pyogenic infections or lupus-like illness. In the present report, we describe infectious manifestations in infancy and childhood in our C2-deficient patients. METHOD: A retrospective study of clinical manifestation in three patients was carried out. C2 deficiency was proved both by undetectable serum C2 level and typical homozygous 28 bp deletion of the C2 gene. RESULTS: All patients were hospitalized at least once by the age of 12 months, each had one episode of meningitis in infancy, one also had arthritis with septicaemia. Infections of the respiratory tract were the causes of other hospitalizations. Two patients also suffered from frequent mild respiratory tract infections; in both patients, decreased immunoglobulin IgA and immunoglobulin IgG2 or immunoglobulin IgG3 levels were recorded. CONCLUSION: Our observations point to an early manifestation of C2 deficiency within the first year of life, with meningitis as the most severe complication. The severity of immunodeficiency may be influenced by concomitant deficiencies of immunoglobulin isotypes.- - - - - - - - - - ranking = 2keywords = meningitis (Clic here for more details about this article) |
9/79. Immunodeficiency secondary to juvenile paracoccidioidomycosis: associated infections.Four patients with acute paracoccidioidomycosis, hypoalbuminemia, ascites and associated infections are reported. They have been admitted to hospital 35 times, 4 of them due to active paracoccidioidomycosis, 14 to associated infections, 14 to ascites, edema and diarrhoea and 3 to herniorrhaphy. Two of them recovered after sepsis and central nervous system, muscular and subcutaneous cryptococcosis. The remaining two died. One had infectious diarrhoea (S. flexneri), peritoneal tuberculosis and sepsis (S. epidermidis); the other had bacterial meningitis, erysipelas, beta-hemolytic streptococcus sepsis and miliary tuberculosis. Their immunodeficiency was attributed to enteric protein loss and/or malabsorption and malnutrition and was recognized by reduced response to delayed hypersensitivity skin tests in four patients and hypogammaglobulinemia in three of them. The authors discuss the need for prospective studies to be carried out, aiming at the mechanisms involved in secondary infections. Alternatives for maintaining the patients' adequate nutritional state should be investigated, to guarantee proper immune response and thus the ability to control intervening infections in patients with juvenile paracoccidioidomycosis.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
10/79. Populations at risk for penicillin-induced seizures.OBJECTIVE: This article reviews principles associated with penicillin's epileptogenic activity in an effort to alert clinicians of patients at high risk for penicillin-induced seizures. The case presentation exemplifies the most prevalent factor predisposing patients to penicillin-induced seizures--renal impairment. DATA SOURCES: References are identified from pertinent articles and books. DATA SYNTHESIS: The epileptogenic properties of penicillin are explained on the basis of the beta-lactam ring's binding to gamma aminobutyric acid receptors. Several patient populations are at risk for potentially fatal neurotoxic symptoms. Most of these patients demonstrate impaired renal function, either as the primary condition or secondary to an infectious process. The other at-risk populations include infants and the elderly, patients with meningitis, patients undergoing intraventricular antibiotic therapy, and patients with a history of seizures. Treatment remains controversial; however, benzodiazepines theoretically produce a favorable response. CONCLUSIONS: Pharmacokinetic parameters explain patient populations most at risk; a guideline equation has been recommended to allow clinicians to make appropriate dose adjustments based on creatinine clearance. physicians and pharmacists must recognize the populations most at risk for high-dose, penicillin-induced neurotoxicities; monitor these patients at least during the first 72 hours, and reduce or discontinue therapy when appropriate.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
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