Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Due to mass tourism and the exodus of refugees from Africa and Asia, typhoid fever, common in the tropics, has reappeared in the more temperate climates. The clinical signs of prolonged fever, headache, general malaise, anorexia and abdominal pain are not specific enough to allow diagnosis and only a blood culture will prove the presence of the disease. Unless there is resistance, which is in fact rare in Southeast Asia, chloramphenicol, an effective, well tolerated and cheap antibiotic, remains the treatment of choice for typhoid. In the search for an alternative treatment a cephalosporin, ceftriaxone (Rocephin) seems promising. It has a low MIC of 0.05 micrograms/ml for S. typhi and a high level of biliary excretion which destroys S. typhi in the bile and thus prevents relapse. In Southeast Asia three consecutive studies, of which two were randomised and comparative with chloramphenicol given for 14 days, showed that treatment for two or three days, 3 or 4 g per day of ceftriaxone was as effective as chloramphenicol and was not followed by relapse. In 46 adults there was one failure with ceftriaxone (in an immunocompromised patient) and none in the 30 patients treated with chloramphenicol, three of which, however, relapsed in the 15 days after completion of treatment. Defervescence was a little more rapid with chloramphenicol (six to seven days) than with ceftriaxone (seven to ten days) even though blood, urine and stool cultures were all negative from the third or fourth day of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of typhoid fever for three days with ceftriaxone]. 228

From January 1984 to October 1991, 11 consecutive patients with complication of Salmonella infection received surgical intervention at our hospital. The age at operation ranged from 4 days to 8 years old, with a mean of 1 year and 8 months. Most of them (64%) were under the age of one year. Eight cases were male, 3 cases were female. The most common pathogen was Salmonella paratyphi Gr. B (73%); the most common presenting symptoms and signs were abdominal pain (82%), pyrexia (82%) and muscle guarding (82%). The indications for surgery included pneumoperitoneum (55%), peritonitis (36%) and intestinal obstruction (9%); 6 cases received one stage operation, 5 cases received staged operations (enterostomy). The most commonly involved organ was ileum (54%). Ceftriazone (rocephin) was the drug of choice for the first 2 weeks postoperatively. Total parenteral nutrition (TPN) was used for at least 2 weeks. The postoperative complications included adhesion ileus (9%), high output enterostomy (9%), reperforation (9%), and wound infection (18%); there was no surgical mortality. Prompt diagnosis, early resuscitation and operative management are mandatory to avoid mortality.
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PMID:Surgical management of complicated gastrointestinal salmonellosis in children. 837 76

Neisseria meningitidis infection (meningococcemia) is very common throughout the world. It usually presents as meningitis or sometimes pharyngitis. A gastroenteritis-like syndrome, with diarrhea, vomiting and abdominal pain, may occur in children but is very rare in adults. Search of the medical literature revealed only 3 such cases, all in young adults. We report an 80-year-old woman who presented with fever, diarrhea and abdominal pain. Meningococcus infection was later suspected, and proved by culture. Although treatment was intensive and included ceftriaxone (Rocephin) and garamycin, she did not respond and died 40 hours after admission. We draw attention to the possibility that what is usually a common symptom can be the first presentation of a serious, often fatal condition.
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PMID:[Fulminant meningococcemia presenting as a gastroenteritis-like syndrome]. 1141 36