1/73. Characteristics of a strain of clostridium carnis causing septicaemia in a young infant.clostridium carnis is a species which is only rarely isolated from man or animals and is occasionally found in the soil. This paper is an account of a single isolate found in blood cultures obtained from an 8-week-old boy who was suffering from gastroenteritis.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
2/73. Trauma, sepsis, and disseminated intravascular coagulation.disseminated intravascular coagulation (DIC) was first observed clinically in a case of sepsis following severe trauma. It was postulated that the observed clotting defect and bleeding were due to the using up of clotting factors in an episode of intravascular clotting. It was also postulated that the multiple organ failure observed was due to obstruction of the microcirculation of the organs by microclots. Evidence for this process was worked out in many animal studies. It was then postulated that if these microclots could be lysed before organ necrosis was produced, organ failure could be prevented. This prevention was shown to be possible in animals. It was then tried in humans using plasminogen activators, and the approach was found to be effective. Using a low dose of plasminogen activator over a 24-hour period caused no changes in the coagulation profile or bleeding.- - - - - - - - - - ranking = 2keywords = animal (Clic here for more details about this article) |
3/73. Ischaemic hepatitis in an elderly woman.An elderly woman presented with very high levels of transaminases and lactic dehydrogenase in her liver function tests. Viral and drug-induced hepatitis were considered unlikely because of the absence of risk factors. sepsis was suspected and antibiotic treatment was started with clinical improvement. A retrospective diagnosis of ischaemic hepatitis due to septicaemia was made. Markedly raised liver transaminases need not always be drug-induced or viral-related, especially in the elderly. It could be ischaemic in origin and the serious underlying condition needs to be sought and treated urgently.- - - - - - - - - - ranking = 3.998640440453keywords = hepatitis (Clic here for more details about this article) |
4/73. Successful treatment of late-onset infection due to resistant klebsiella pneumoniae in an extremely low birth weight infant using ciprofloxacin.OBJECTIVE: This paper presents a case in which an extremely low birth weight infant with multidrug-resistant klebsiella pneumoniae infection was successfully treated with ciprofloxacin and gentamicin. STUDY DESIGN: A clinical case report of a neonate who received broad spectrum antibiotics for possible infection despite negative cultures. The infant developed sepsis and meningitis resulting from multidrug-resistant K. pneumoniae, which was treated with ciprofloxacin and gentamicin. The literature for the use of ciprofloxacin in pediatric patients was reviewed. RESULTS: The infant responded to the antibiotic regimen with sterilization of blood and cerebrospinal fluid; no adverse effects were attributable to the ciprofloxacin. Although ciprofloxacin has been found to cause irreversible injury to cartilage in juvenile laboratory animals, a review of the literature found that this complication occurs rarely if at all in pediatric patients. ciprofloxacin has been found to be effective in the treatment of multidrug-resistant Gram-negative infections in pediatric patients, including premature infants. CONCLUSION: ciprofloxacin should be considered in the treatment of neonatal infection caused by multidrug-resistant Gram-negative organisms. Although the published experience with this drug suggests that it is effective and that significant toxicity is not common, its use should be restricted to the treatment of serious infections for which an alternative antibiotics is not available.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
5/73. streptococcus mitis septicaemia and hepatitis.The case of an otherwise well 9-y-old boy with fever, papular rash, jaundice and impaired liver function is presented. streptococcus mitis sensitive to penicillin grew in blood culture. The boy had an excellent outcome. The clinical spectrum of viridans streptococci may be wider than currently anticipated, and Streptococcus mitis may cause septicaemia and hepatitis in immunocompetent individuals.- - - - - - - - - - ranking = 3.3322003670442keywords = hepatitis (Clic here for more details about this article) |
6/73. mycobacterium tuberculosis infection in pediatric liver transplant recipients.OBJECTIVES: To study the incidence, clinical presentation, management, complications and outcome of tuberculosis in pediatric liver transplant recipients. methods: A retrospective review of the medical records of children who underwent liver transplantation between 1991 and 1998. RESULTS: mycobacterium tuberculosis infection occurred in 6 of 254 (2.4%) children undergoing liver transplantation between 1991 and 1998. cough, pyrexia and poor appetite were common presentations; one-half had normal chest radiographs. The median time to confirmation of diagnosis was 8 months (range, 1 to 17 months). Tests contributing to diagnosis included: Ziehl-Neelsen (ZN) stain (2 patients), M. tuberculosis polymerase chain reaction (1 patient), Mantoux test (1 patient) and histopathology (4 patients). family health screening was productive for 4 patients. Duration of treatment varied from 9 to 18 months. isoniazid-induced hepatitis was observed in 2 patients but resolved with dose reduction. Two patients died while receiving treatment, one of Klebsiella spp. septicemia and the other of pulmonary hemorrhage. CONCLUSIONS: Tuberculosis after liver transplantation has a significant morbidity and mortality. Pretransplantation a personal and family history of tuberculosis must be sought, and screening of patients and their families should be considered. Standard regimens incorporating isoniazid and rifampin are effective, but regular monitoring of liver function is essential to detect drug-induced hepatotoxicity.- - - - - - - - - - ranking = 0.66644007340884keywords = hepatitis (Clic here for more details about this article) |
7/73. Cholestatic syndromes in renal transplant recipients with HCV infection.We present two distinct types of cholestatic syndrome identified in eight renal transplant (RTx) patients with HCV infection. Four patients developed fibrosing cholestatic hepatitis (FCH) and four, vanishing bile duct syndrome (VBDS). All patients with FCH were anti-HCV (-) at the time of Tx and developed a cholestatic profile 1-4 months post-Tx, with high HCV-rna levels. Immunosuppressive therapy was drastically reduced. Two patients died of sepsis and liver failure 16 and 18 months post-Tx, and the other two showed marked improvement and seroconverted to anti-HCV. Regarding the patients with VBDS, three were anti-HCV (-) and one was anti-HCV ( )/HBsAg ( ) at the time of RTx. Two patients became anti-HCV ( ) 1 year, and one patient, 3 years post-Tx. Two patients developed progressive VBDS and died of liver failure 2 and 3 years after onset, and two showed marked improvement after withdrawal of immunosuppression. In two of the patients, the progression of the disease coincided with elevation in serum HCV rna levels. We concluded that a progressive cholestatic syndrome acquiring features of FCH or VBDS may develop in HCV-infected RTx patients. The association with high viral load implicated the virus in the pathogenesis. Drastic reduction of immunosuppression may favourably affect the outcome.- - - - - - - - - - ranking = 0.66644007340884keywords = hepatitis (Clic here for more details about this article) |
8/73. Human infection from an unidentified erythrocyte-associated bacterium.A 49-year-old splenectomized man had an infection from an unidentified, gram-positive, rod-shaped bacterium that adhered to the majority of his peripheral-blood erythrocytes. On transmission electron microscopy, the bacterium was seen to be extra-erythrocytic and was 0.2 micrometer wide by 1.0 to 1.7 micrometer long. It possessed a thick, granular cell wall, a trilamellar membrane external to the cell wall and prominent mesosomes. Attempts to cultivate the organism in vitro or to duplicate the patient's disease in splenectomized animals were unsuccessful. The patient's response suggested that the bacterium was susceptible to cell-wall-active antibiotics and to chloramphenicol but not to tetracycline. This bacterium may be the cause of other chronic, fever-producing, multisystem diseases of unknown origin.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
9/73. listeria monocytogenes tricuspid valve endocarditis with septic pulmonary emboli in a liver transplant recipient.listeria monocytogenes has long been known as a pathogen of immunocompromised hosts, including solid organ and bone marrow transplant recipients. Its principal manifestations include bacteremia and meningitis. endocarditis due to Listeria is far less common and in general affects the left side of the heart. We here report an unusual case of Listeria tricuspid valve endocarditis and septic pulmonary emboli in a sulfa-intolerant liver transplant recipient with a history of relapsing cytomegalovirus (CMV) hepatitis and an indwelling Hickman catheter. The literature on Listeria endocarditis and infections in transplant recipients is reviewed. The possible relationship between susceptibility to Listeria infection and the discontinuation of trimethoprim-sulfamethoxazole prophylaxis is of interest.- - - - - - - - - - ranking = 0.66644007340884keywords = hepatitis (Clic here for more details about this article) |
10/73. Pneumococcal vaccine failure in an hiv-infected patient with fatal pneumococcal sepsis and HCV-related cirrhosis.Pneumoccocal vaccination of hiv-positive individuals is recommended to prevent pneumococcal infection. We present a case of a 44-year-old hiv-infected male who came to the emergency room with bacterial pneumonia and sepsis. The patient also had a history of HBV and HCV infection. He expired in the emergency room and blood cultures were positive for streptococcus pneumoniae. The autopsy confirmed the clinical diagnosis and, in addition, hepatitis c-related cirrhosis and splenic abnormalities. The patient had no history of opportunistic infections. His CD4 count 3 months prior to coming to the emergency room was 216 cells/microL with a viral load of 1,270 copies/mL. The patient had received Pneumovax two years before his death. The organism isolated from blood cultures was streptococcus pneumoniae isotype 3, a strain included in Pneumovax. This is a case of pneumococcal vaccine failure with a fatal outcome in a person with an hiv infection and hepatitis c-related liver cirrhosis.- - - - - - - - - - ranking = 1.3328801468177keywords = hepatitis (Clic here for more details about this article) |
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