1/17. epinephrine renal venography in acute bacterial infection of the kidney.epinephrine renal venography was performed in four cases of acute bacterial infection of the kidney. Selective renal arteriography was relatively nonspecific, while venography proved to be more helpful in excluding a malignancy. In cases of renal infection where the venous system of the kidney has not been occluded, epinephrine renal venography delineates the extent and nature of the process better than arteriography. Diffuse attenuation or smooth segmental narrowing of intrarenal veins, absence of irregularly encased veins, and veins draped around, as well as perforating, the abnormal region differentiated tumor from infection. An accurate diagnosis is important in view of the different therapeutic approach to these two entities.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/17. Interpretation of granulomatous lesions in malignancy.In patients with malignancy the most frequent granuloma-associated conditions are tumor-related sarcoid reactions, sarcoidosis, tuberculosis and other infections. Quite often, the finding of granulomatous lesions in patients with cancer may lead to difficulties of interpretation resulting in inappropriate treatment of both granulomatous disease and malignancy. This problem is reviewed and exemplified by a number of typical case histories. A systematic diagnostic approach must integrate anamnestic, clinical, histomorphological, immunohistological and laboratory information. In addition, prolonged follow-up may be necessary in order to establish the true nature of a granuloma-associated condition.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/17. Infected neonatal cephalohematomas caused by anaerobic bacteria.OBJECTIVE: To present the microbiological and clinical features of six children with infected cephalohematomas (IC) caused by anaerobic bacteria. DESIGN: Presentation of a case series. RESULTS: Polymicrobial infection was present in all instances, where the number of isolates varied from two to four. Two patients had anaerobes only and the other four had mixed flora of strict anaerobes and facultatives. There were 16 bacterial isolates (12 anaerobic, 4 aerobic). The anaerobic isolates were peptostreptococcus spp. (5 isolates), prevotella spp. (4), bacteroides fragilis group (2), and propionibacterium acnes (1). The aerobic isolates were E. coli (2), staphylococcus aureus (1) and group B streptococci (1). blood cultures were positive for three patients. The most common predisposing conditions were vacuum extraction and amnionitis (4 instances of each), instrumental delivery (3), electronic fetal monitoring (2), prolonged delivery (1), and premature rupture of membranes (1). All patients underwent drainage, and four also had surgical incision and drainage of the IC. osteomyelitis developed in one instance and scalp abscess developed in two patients, both of whom had electronic fetal monitoring. All patients eventually recovered from infection after receiving parenteral and subsequent oral antibiotic therapy for a total of 14-38 days. CONCLUSION: This study highlights the polymicrobial nature and potential importance of anaerobic bacteria in IC in newborns.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/17. infection and disease activity in systemic lupus erythematosus: a review of hospitalized patients.infection is a major cause of morbidity and mortality in systemic lupus erythematosus (SLE). A review of all SLE admissions to our hospital during a 5-year period was conducted to determine the rate and nature of infection, and its association with overall disease activity, measured by the SLE disease Activity Index (SLEDAI). Eighty-one patients (79 women, 2 men) were admitted for a total of 2,738 days (176 admissions). There were 53 proven infections, giving an infection rate of 1.94/100 hospital days. Twenty-three (43.4%) of these were major infections (requiring IV antibiotics). Two of 3 deaths were due to septicemia. By logistic regression analysis, infection was significantly associated with disease activity (p = 0.005), but not with disease duration or prednisone dosage. Our data confirm that infection is common in hospitalized patients with SLE, is associated with overall disease activity independent of prednisone dose, and causes significant mortality. These facts should be borne in mind when hospitalization is considered for patients with SLE.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/17. Nonclostridial gas gangrene.Although nonclostridial gas gangrene is not an unusual occurrence, relatively few cases including the distal lower extremity have been reported. Due to the serious nature of some of these infections, it is important for physicians to familiarize themselves with these nonclostridial crepitant infections, which are often confused with clostridial myonecrosis. Etiology, evaluation, and treatment is described by the authors. Also, a case study is presented.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/17. Puncture wound osteochondritis of the foot caused by CDC group Vd.A case of puncture wound osteochondritis of the foot caused by CDC group Vd is presented because of the unusual nature of the infecting organism. This organism may be confused with pseudomonas aeruginosa, the usual pathogen responsible for this type of infection, but does not have a similar antimicrobial susceptibility profile. For this reason, it is important to obtain appropriate culture specimens and to identify and test the susceptibility of bacterial isolates from cases of puncture wound-associated osteochondritis so that optimal therapeutic regimens can be determined.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/17. Unusual case of central vein thrombosis and sepsis.A patient with Crohn's disease who required placement of a right external jugular vein central catheter for total hyperalimentation is presented. Catheter-induced thrombosis and catheter-associated bacteremia and sepsis subsequently developed. Following the description of the case is a brief discussion of the complications inherent in central line placement, the mechanisms by which thrombosis and sepsis occur, and the measures that can be taken to decrease the incidence of thrombosis and sepsis in central line placement. The management of central venous thrombosis and sepsis is medical and not surgical in nature, and consists of catheter removal, antibiotics, and anticoagulation.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/17. osteomyelitis due to kingella kingae infection.A case of osteomyelitis due to kingella kingae is presented to illustrate the insidious onset and indolent course typical of bone infections caused by this organism. The frequently negative result obtained with Gram's stain and the fastidious nature of the organism makes diagnosis difficult. Initial therapy with an aminopenicillin such as ampicillin in addition to antimicrobial drugs for staphylococcus aureus should be effective in resolving bone and joint infections in children.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/17. Differential diagnosis of low-attenuation splenic lesions on computed tomography.A retrospective computed tomography evaluation of proved low-attenuation splenic lesions in nontraumatic cases was done. Computed tomography was able to distinguish cystic from solid lesions. Although computed tomography examination is sensitive in the detection of low-attenuation lesions, the computed tomography findings alone are not helpful in differentiation of different low-attenuation lesions. Associated computed tomography findings in other organs and clinical findings are more helpful than the size, shape, and computed tomography attenuation of the lesions. Splenic lesions may be the only metastatic manifestation in some cancer patients. A thin needle aspiration may be done to document the nature of the pathologic lesion in problematic cases.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/17. Infections in hairy-cell leukemia.In order to determine the nature of infectious complications in hairy-cell leukemia we studied 20 consecutive patients seen at UCLA and analyzed the available literature. The incidence of serious infection in our series was 40%, and pneumonia and septicemia due to Pseudomonas and E. coli organisms were the leading types of infections. Fungal infections with Cryptococci and histoplasma organisms were documented, and a single case of pneumocystis carinii pneumonia was observed. Noninfectious fever occurred in 30% of our patients. There was a clear relationship between fungal disease and corticosteroid therapy, and the overall incidence of infection was correlated with the degree of neutropenia and corticosteroid treatment. No relationship was found between age, duration of disease, or the use of cytotoxic chemotherapy and infectious complications. Of the 13 infectious episodes, 11 occurred in patients prior to splenectomy. Only two episodes were seen in splenectomized patients, both occurring in the immediate postoperative period. We conclude that splenectomy has a beneficial effect in reducing the incidence of infections in hairy-cell leukemia and that corticosteroids should be used cautiously, since they predispose to opportunistic infection in this disease.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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