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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of pseudomembranous colitis, one associated with administration of ampicillin and the other associated with administration of ampicillin and trimethoprim-sulfamethoxazole, are reported. Both patients presented with diarrhea, abdominal pain, fever and an elevated leukocyte count. Pseudomembranous colitis was diagnosed by sigmoidoscopy and biopsy. Both patients recovered with conservative management.
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PMID:Antibiotic-associated pseudomembranous colitis. 60 48

Listeria monocytogenes is a Gram-positive bacillus that is pathogenic in both the normal and compromised host. We describe Listeria peritonitis and cerebritis in a patient with cirrhosis due to non-A, non-B hepatitis, and review the 11 other cases of Listeria peritonitis reported in the English-language literature. Listeria is a rare cause of peritonitis in debilitated, older patients, with two-thirds of the cases occurring in patients with chronic liver disease. Listeria peritonitis may also occur in patients undergoing peritoneal dialysis, or in those with malignancy. Peritonitis due to Listeria is clinically similar to spontaneous bacterial peritonitis, and is associated with fever, variable abdominal pain, and neutrocytic ascites; bacteremia commonly accompanies Listeria peritonitis. This syndrome can be successfully treated with antimicrobial drugs, although the third-generation cephalosporins commonly used in the therapy of spontaneous bacterial peritonitis are not recommended. Ampicillin may be the drug of choice, with combination therapy with an aminoglycoside reserved for cases that do not respond to ampicillin alone.
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PMID:Listeria monocytogenes peritonitis: case report and literature review. 144 54

Gastritis associated with Helicobacter pylori was present in gastric biopsies from 24/95 (25%) children and adolescents undergoing endoscopy for recurrent abdominal pain and upper gastrointestinal symptoms. H pylori associated gastritis occurred mainly in older children (8-16 years) and was significantly associated with low socioeconomic class and a family history of peptic ulcer disease. Antral nodularity was a common endoscopic finding in H pylori positive children. Eighteen children, all over 5 years of age, were treated with tripotassium dicitratobismuthate (De-Nol) for two months and ampicillin for two weeks. In 12 children follow up gastric biopsies were obtained six weeks after completion of treatment. In 9/12 (75%) children H pylori was eradicated, and gastritis improved.
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PMID:Management and response to treatment of Helicobacter pylori gastritis. 151 61

Upon admission to Box Hill Hospital in Victoria, Australia, a 38-year old woman was pale and febrile (328.6 degrees Celsius) and had a pulse of 88 beats/minute. She had had midabdominal pain for 1 week and severe lower abdominal pain for 2 days. Her menses were heavy. Other than pain during examination, rectal and vaginal examinations were normal. She had considerable neutrophilia (leukocyte count = 21.2 x 1 billion). The X-ray revealed free fluid. Ultrasonography indicated an IUD which she had had for 10 years, a mass with small cystic areas near the right ovary, and fluid in the rectouterine pouch. The physicians suspected peritonitis and administered iv broad spectrum antibiotics (1 mg ampicillin, 80 mg gentamicin, and 500 mg metronidazole) every 8 hours. They did a laparotomy. An abscess containing much green pus, the necrotic right ovary, and the appendix, which appeared normal and later shown not to be infected, occupied the right iliac fossa. The tubes were fine. The surgeons removed the appendix and right ovary. They washed out the abdomen with saline and inserted a drain to the right iliac fossa. The woman improved immediately so the physicians stopped antibiotics 3 days after surgery. Histological tests revealed actinomycosis caused by fast-growing aerobic bacteria which is known to cause necrosis, fibrosis, and suppuration. During recovery, the physicians removed the IUD and performed dilation and curettage. Actinomyces normally just dwell in the mouth and intestines, but, in this case, probably migrated up the IUD tail after spreading from the bowel to the perineum to the vagina. The physicians suspected that the presence of Mycoplasma hominis provided the mucosal breach needed to permit actinomyces' invasion. Physicians should consider actinomycosis in acute abdominal sepsis cases with a longterm use of an IUD. They can treat it with antibiotics since Actinomyces tend to be sensitive to broad spectrum antibiotics.
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PMID:Ovarian actinomycosis presenting as acute peritonitis. 158 8

Physicians at Christian Albrecht University Hospital in Keil, West Germany treated 66 women with pelvic abscesses between 1983-1986. Pelviscopically treated patients were younger than laparotomy treated patients and IUD usage occurred 17% vs. 20% respectively. They 1st treated many patients with ampicillin and metronidazole or ampicillin and clavulanic acid. They were able to perform pelviscopy on 25 of the 33 patients with inflamed Fallopian tubes. 9 of these women experienced either a uni- or bilateral salpingectomy or salpingo-oophorectomy. They were able to do an organ preserving procedure designed to preserve fertility in 80% of the women, especially pelviscopically treated patients (81% vs. 16% laparotomy patients). They performed a laparotomy on the 6 patients with bilateral total abdominal tuboovarian abscesses. Of the 25 women who underwent a laparotomy, 20 required only a uni- or bilateral salpingectomy or salpingo-oophorectomy and 5 required a total hysterectomy and bilateral salpingectomy. No differences existed between pelviscopically and laparotomy patients in number of days in the hospital and duration of inpatient antibiotic therapy. Even though more laparotomy treated patients (37%) experienced chronic abdominal pain following treatment than pelviscopically treated patients (27%), the laparotomy patients initially experienced more severe and extensive infections than did pelviscopically treated patients. Of the 45 patients who were able to be examined 1-2 years after surgery, only 3 experienced recurrent pelvic inflammatory disease (8% of pelviscopically treated patients and 5% of laparotomy patients) which the physicians found encouraging since pregnancies may occur. In conclusion, to preserve fertility, they advocated pelviscopy along with organ preservation for patients in their reproductive years.
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PMID:Pelvic abscesses: pelviscopy or laparotomy. 183 33

3 cases of IUD-related abdominopelvic actinomycosis diagnosed after surgery are described. A 44-year old woman was admitted with high fever and diffused, strong abdominal pain. She had had an IUD for 4 years. Hypersensitivity all over the pelvis, an enlarged uterus, and peritoneal irritation were found upon vaginal examination. Opening the peritoneum yielded 1 liter of pus, a 6 cm diameter abscess of the right adnexa, and a myomatous uterus in 12 weeks of gestation. The uterus and the right adnexa were removed. Histology confirmed actinomycosis. Penicillin was given iv for 6 weeks, and after release she took oral penicillin for 4 more months. A 33-year old woman was admitted with high fever and excruciating pain in the lower right abdomen that had lasted on and off for months. She had had an IUD for 3 years. Vaginal examination revealed a hypersensitive uterus. enlarged right adnexa, and a firm mass between the vagina and the rectal shelf. Surgery showed the omentum attached to the sigmoid colon and the right fallopian tube with an abscess of 5 cm with cysts. The growth was resected, and the cysts were opened. She received iv erythromycin for 3 weeks and then orally for 2 months leading to full recovery. A 52-year old woman was hospitalized for hysterectomy. She had had abdominal pain radiating to the back for 1 year. She had had an IUD for 15 years. A myomatous uterus in 15 weeks of gestation was detected. Surgery revealed a 15 cm size myomatous uterus with an abscess of 6 cm around it. The uterus, the left adnexa, and the abscess were resected. Histology indicated actinomycosis. She received iv ampicillin for 1 month, and scar tissue from the abscess was treated with oral penicillin for 1 month. Cervical actinomycosis was found in 1-30% of women wearing IUDs. Diagnosis requires histopathological examination. The symptomless presence of cervical actinomycosis may require the temporary removal of the IUD and antibiotic treatment.
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PMID:[IUD-associated abdominopelvic actinomycosis]. 193 47

The effect of antibiotic therapy on intake of food and absorption of nutrients for 19 male children aged 1-5 years with suspected shigella infection was studied. The children were admitted to the hospital with acute diarrhea, high fever, abdominal pain, and greater than or equal to 25 red blood cells and white blood cells per high-power field in the stool. Microbiologic diagnosis was made within 48 hours of admission. On the basis of clinical and microbiologic criteria, children were classified as having mild or severe infection. Ten children with mild infection did not receive antibiotics, whereas nine children with severe infection were treated with ampicillin. After the children were rehydrated, a 72-hour balance study was carried out during the acute stage of infection with Shigella and was repeated 2 weeks after recovery. The levels of consumption of food and absorption of nutrients were estimated. During the acute stage of infection, such levels were higher for the children treated with antibiotics than for the untreated group. During the recovery phase, the levels of intake of food and absorption of nutrients were equal for both groups. Thus, children who are treated with appropriate antibiotics not only may recover from infection with Shigella more rapidly, but they also may be able to absorb nutrients more efficiently.
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PMID:Effect of antibiotics on food intake and absorption of nutrients for children with diarrhea due to Shigella. 204 61

A patient with multiple, pyogenic hepatic abscesses is described, and the pathophysiology, etiologies, clinical and laboratory manifestations, and management of the disease are reviewed. A 55-year-old man with a history of ethanol abuse and pancreatitis developed fever, chills, general malaise, and right upper quadrant abdominal pain two weeks before hospitalization. Baseline laboratory and hematology results included serum albumin concentration, 3.2 g/dL; serum alkaline phosphatase concentration, 239 mIU/mL; total serum bilirubin concentration, 1.3 mg/dL; white blood cell count, 18,400/cu mm; red blood cell count, 4.7 million/cu mm; hemoglobin, 12.5 g/dL; and hematocrit, 38.8%. Abdominal ultrasound showed echo-free cavities throughout the hepatic parenchyma; abdominal computed-tomography (CT) scan showed hepatomegaly and multiple radiolucent spaces. CT-guided needle aspiration of a hepatic mass yielded purulent material that grew Fusobacterium necrophorum under anaerobic conditions. On day 7, the patient was started on i.v. ampicillin sodium-sulbactam sodium. A CT scan two weeks later showed a reduction in the number and sizes of abscesses. The patient continued i.v. therapy for one month, then was discharged on a regimen of p.o. amoxicillin trihydrate-clavulanate potassium. Hepatic abscesses are either amebic or pyogenic; the latter usually has a higher mortality. The etiologies of pyogenic hepatic abscesses include ascending cholangitis, portal vein bacteremia, systemic bacteremia, extension from a contiguous focus of infection, and trauma. Diagnosis is difficult and relies highly on clinical suspicion. Clinical symptoms include hepatomegaly, fever, chills, and malaise. Abnormal laboratory values include leukocytosis, anemia, and hypoalbuminemia. The abscesses are frequently polymicrobial; Escherichia coli is the most commonly isolated species. CT is the best radiological technique for diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ampicillin-sulbactam therapy for multiple pyogenic hepatic abscesses. 229 77

Twenty-two patients with Whipple's disease are reviewed (21 male, 1 female; mean age 49.3 years). All but one were diagnosed by small intestinal biopsy. The most frequent clinical symptoms at diagnosis were weight loss (14/21 patients), diarrhea (13/21), arthralgias (13/21), cramping abdominal pain (11/21), and skin pigmentation (8/21), which anteceded the diagnosis by from 6 months to 10 years (median 3.5 years). All but three patients were treated successfully with tetracycline given for at least 2 years. Follow-up was done for a median of 7.7 years (range 1-15 years). Two of 17 patients who were followed for 2 years relapsed, as did 2/11 followed for at least 5 years. One patient relapsed twice. Each relapse could be treated with success. In no case did relapse occur in the central nervous system. Thus, tetracycline appears to be effective in the treatment of Whipple's disease if given for at least 2 years. In two further patients with confirmed central nervous system involvement at diagnosis, who were treated with ampicillin plus chloramphenicol, characteristic SPC cells disappeared from the cerebrospinal fluid. In addition, the recently recognized problems in the differential diagnosis of Whipple's disease and atypical mycobacterial infection in AIDS patients are discussed.
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PMID:Whipple's disease: a report of 22 patients. 245 1

We have retrospectively studied 89 episodes of spontaneous bacterial peritonitis (SBP) attended at our service with the purpose of analyzing clinical features, microbiologic data and possible etiopathogenic factors, treatment and course. The most frequent symptoms were ascites, abdominal pain and fever. Only 3.3% of episodes were asymptomatic. Twenty-four episodes (26.96%) resulted in death of the patient and only the presence of septic shock and prothrombin time lower than 35% statistically correlated with a higher mortality (100% and 53.8%, respectively, p less than 0.01) of the possible factors analyzed. The culture of ascitic fluid (AF) was positive in 52.8% of the episodes and there were no clinical or time course differences between these cases and those who presented negative culture. The isolated microorganisms were the usual ones in this condition, outstanding 37.5% of gram-positive cocci in monomicrobial SBP. Treatment was initiated within the first 12 hours from admittance in 76.4% of cases, between 12 and 72 hours in 12.3% and after 72 hours in 11.2%. Cefotaxime was given to 47.1% of episodes and 52.9% of patients received ampicillin or cefoxitin plus aminoglycoside; the mortality was lower with the first schedule (11.9% versus 40.4%, p less than 0.01).
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PMID:[Spontaneous bacterial peritonitis: clinical, microbiological and clinical course study of 89 episodes]. 249 Apr 77


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