1/13. Long-term undiagnosed syphilis with clinical presentation of meningitis.A 43-year-old woman, with an 11-year history of progressive cutaneous lesions, was considered to have granuloma annulare and was treated as such for 4 years. She then developed chronic meningitis. Serological investigation revealed active syphilis. Appropriate antibiotic treatment led to a rapid resolution of the clinical symptoms. The recent reports of similar cases indicate the importance of an adequate knowledge of clinical manifestations and pathological patterns of syphilis.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/13. Disseminated gonococcal infection.The most frequent systemic complication of acute, untreated gonorrhea is disseminated infection, which develops in 0.5 to 3 percent of the more than 700,000 Americans infected with neisseria gonorrhoeae each year. The classic triad of features consists of dermatitis, tenosynovitis and migratory polyarthritis. Disseminated gonococcal infection is most common in young women but may develop in sexually active persons of any age. The diagnosis often is not suspected because the initial mucosal infection is frequently asymptomatic, providing no clue to an infectious etiology. Prompt identification and treatment are essential to prevent complications such as endocarditis, meningitis, perihepatitis and permanent joint damage.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
3/13. Group C streptococcal bacteremia: analysis of 88 cases.Eighty-eight cases of group C streptococcal bacteremia were reviewed retrospectively. Most patients had underlying diseases (72.7%), predominantly cardiovascular disease (20.5%) or malignancy (20.5%). The infection originated most often from the upper respiratory tract (20.5%), the gastrointestinal tract (18.2%), or the skin (17.1%). Prior exposure to animals or animal products was reported in 23.9% of cases. The most common clinical manifestations of group C streptococcal bacteremia were endocarditis (27.3%), primary bacteremia (22.7%), and meningitis (10.2%). Of streptococcal isolates, 61.4% were not speciated, 19.3% were Streptococcus equisimilis, 17.1% were Streptococcus zooepidemicus, and two (2.3%) were streptococcus equi. The isolates were sensitive to most antibiotics, and most patients were treated with beta-lactam agents. mortality was high (25.0%), especially among older patients and patients with endocarditis, meningitis, and disseminated infection. Group C streptococcal bacteremia does not differ from bloodstream infection caused by other beta-hemolytic streptococci with regard to clinical presentation, treatment, or outcome.- - - - - - - - - - ranking = 0.4keywords = meningitis (Clic here for more details about this article) |
4/13. Acute psoriasis associated with Lancefield Group C and Group G cutaneous streptococcal infections.Involvement of streptococcus pyogenes (beta haemolytic streptococcus, Lancefield Group A) infection, usually of the throat, in acute exacerbations of psoriasis is well known. We report here two cases of an acute psoriatic eruption associated in one patient with Group C streptococcal cellulitis and in another with Group G streptococcal intertrigo.- - - - - - - - - - ranking = 0.39167747567812keywords = streptococcus (Clic here for more details about this article) |
5/13. Unusual case of haemophilus influenzae type b: haemophilus influenzae type b meningitis cellulitis and subcutaneous abscess.An unusual case of beta-lactamase positive haemophilus influenzae type b infection is reported. Clinical manifestations included meningitis, a left ankle subcutaneous abscess, and bilateral hand cellulitis. Discussion and review of literature are presented for the previously unreported association of this common childhood pathogen.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
6/13. Infections due to Lancefield group G streptococci.The group G streptococcus has surfaced in the past 10 to 15 years as an important opportunistic and nosocomial pathogen. Although more precise organism recognition accounts for a portion of these cases, there can be little doubt that the group G streptococcus has become a more prevalent pathogen. Commercial kits, utilizing staphylococcal coagglutination or latex agglutination, are now available, affording all clinical laboratories the opportunity to identify this organism easily. Published reviews encompassing the experiences of a single institution or even several institutions affiliated with a single medical center, particularly as they were influenced by referral patterns, did not reflect the broad scope of infections that we discovered by extending our survey into the community, beyond the medical center complex and its immediate affiliated hospitals. Although malignancy is the single most obvious background factor, alcoholism and diabetes are also important host determinants of infection. skin and soft-tissue infections (and surface sources of infection) are equally important among patients with or without the element of malignancy. Polymicrobial infection, including polymicrobial bacteremia, is an important feature, with S. aureus infections accounting for most of these cases, relating to the skin and soft tissue sources of infections so commonly seen. We saw a panorama of problems including endocarditis, septic arthritis, pleuropulmonary infections, bone and joint infections, puerperal sepsis and neonatal infection, peritonitis and ophthalmitis; we also saw a significant number of patients with bacteremia and no apparent primary source of infection. Response to antibiotic therapy was dictated by the nature of the underlying diseases, and individuals without a background of malignant disease did well, particularly those with skin and soft-tissue infections. While the literature suggests that patients with endocarditis and septic arthritis due to this organism respond poorly to antibiotic therapy, implying that such failures relate to in vitro antibiotic phenomena, we preferred to examine the problem from the viewpoint of the host(s) involved. Subacute endocarditis and acute endocarditis due to the group G streptococcus may be clinically separable, and thus require separate therapeutic approaches. In patients with septic arthritis, prosthetic devices, prior joint disease and immunosuppressive diseases and therapy often adversely influence the response to antibiotic therapy.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 1.1750324270344keywords = streptococcus (Clic here for more details about this article) |
7/13. anthrax in children: a long forgotten, potentially fatal infection.After a brief account of anthrax morbidity in northern greece in recent years, 4 cases in 1977 of cutaneous anthrax in 10 to 13-year-old children are presented. Two had an atypical cutaneous lesion. In 1 of these, a 13-year-old girl, the disease was complicated by severe, eventually fatal meningitis. death ensued despite intensive treatment with high doses of penicillin and hydrocortisone. This case is the first report of anthrax meningitis in a child in greece and the third reported in the last 15 years. We stress the diagnostic difficulties in atypical cases of cutaneous anthrax and the need for early diagnosis and treatment to avoid spread of infection and appearance of complications such as the usually fatal meningitis.- - - - - - - - - - ranking = 0.6keywords = meningitis (Clic here for more details about this article) |
8/13. Cutaneous group B streptococcal infection.A 20-year-old man had a penile ulceration from which a pure, heavy growth of group B streptococcus was cultured. Cutaneous infection with this organism is unusual, and it is most often reported in postpartum women, diabetic patients, and immunocompromised individuals. Vaginal colonization with group B streptococcus is common. Since traumatic erosions or ulcerations of the penis are not uncommon, it is likely that a certain number of unrecognized infections of this type occur.- - - - - - - - - - ranking = 0.78335495135624keywords = streptococcus (Clic here for more details about this article) |
9/13. Rifampicin-containing antibiotic combinations in the treatment of difficult infections.Combination of rifampicin with trimethoprim, erythromycin, tetracycline or fusidic acid have some desirable features in the treatment of difficult infections. They are active against a very wide range of possible pathogens. Resistance to rifampicin is rare. Such combinations may be bactericidal and may be usefully synergistic. They may prevent or delay the emergence of bacterial resistant seen when some single agents are used. They can be used in patients with penicillin hypersensitivity. A series of life-threatening infections has been treated with rifampicin-containing combinations. The infections included endocarditis, meningitis, pneumonia, Legionnaire's disease, and head and neck sepsis. A major reason for the choice of drug was often penicillin hypersensitivity. A second reason was the presumption (mostly subsequently confirmed) that streptococci and/or staphylococci were implicated. The clinical outcome of these infections was generally satisfactory, with few side effects and little evidence of the emergence of antibiotic resistance.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
10/13. A clinical study of moxalactam in the treatment of infections due to gram-negative bacilli.47 episodes of infection due to gram-negative bacilli in 44 patients were treated with moxalactam in an open clinical trial of efficacy and safety. These included 25 urinary tract infections, 8 cases of pneumonia, 2 cases of meningitis, 3 wound and skin infections and 1 case each of peritonitis and osteomyelitis. 17 episodes of gram-negative bacteremia, either associated with local infection or primary septicemia, were treated. Cure, as defined as satisfactory clinical response with eradication of the infecting organism and absence of relapse, occurred in 34/47 episodes (72%). Fatality was associated with 5/17 episodes of bacteremia, but rapid clearance of bacteremia occurred in all but one of the 12 survivors. The most significant complication of therapy was colonization and superinfection with moxalactam-resistant organisms. Fatal infection with moxalactam-resistant serratia marcescens and pseudomonas aeruginosa occurred in one case of pneumonia caused by S. marcescens initially sensitive to moxalactam. Significant adverse effects were primarily hematologic with prolongation of clotting times in 4 patients (associated with bleeding in 2), eosinophilia in 6 patients, and thrombocytosis in 4.- - - - - - - - - - ranking = 0.2keywords = meningitis (Clic here for more details about this article) |
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