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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 19-year-old young man was admitted to our hospital complaining of fever and general fatigue. There were infiltrative shadows and pleural effusions in the both lung fields. Mycoplasma pneumoniae infection was diagnosed because of the elevation of mycoplasma antibody titers in the serum and pleural fluid. There was no recovery in clinical symptoms in spite of the administration of the EM (1200 mg) and CLDM (1200 mg) combination chemotherapy. Three week after admission, a cavity-like shadow appeared in the lt. middle lung field on the chest X-ray film, suprative arthritis and penicillin resistant S. aureus by blood culture test were found. Mycoplasma pneumoniae infection followed by S. aureus bacteremia was diagnosed. After the administration of antibiotics (CTT, FMOX) the clinical symptoms and laboratory findings improved 2 month after admission. Clinical and basic studies about the dual infection between M. pneumoniae and several bacteria were discussed.
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PMID:[A case of Mycoplasma pneumoniae infection followed by Staphylococcus aureus bacteremia]. 233 8

Based on the findings of 50 patients with infective endocarditis, 37 affecting the aortic, six the mitral and seven both the aortic and mitral valves, in addition to analysis of predisposing factors, prominent signs and symptoms distinctive for the clinical entity were assessed (Tables 1 to 3). Preexistent conditions such as aortic valve lesions including bicuspid aortic valve as well as mitral valve lesions including mitral valve prolapse were proven in 66%. Factors which may have compromised host defense mechanisms such as cachexia and chronic alcohol or intravenous drug abuse were present in isolated cases. In 38% of the patients, a diagnostic or therapeutic manipulation, suspected to have given rise to the bacteremia, antedated the onset of endocarditis. Malaise, fatigue and chills were the most frequent symptoms (Table 4). Fever and cardiac murmurs were observed in all patients, anemia and bacteremia in 74% of the patients, respectively (Tables 4 to 6). In blood cultures, the most common microorganisms were found to be hemolytic and nonhemolytic streptococci accounting for 65% of positive findings, followed by enterococci and gram-negative bacteria each with 14% respectively (Table 6). Congestive heart failure predominated among cardiac complications with its occurrence in 84% of the patients. Valvular ring or myocardial abscess, aortic or sinus of Valsalva aneurysm, occasionally with perforation, were found in 24% of our patients. Coronary embolism was documented in 6%; infection-associated pericarditis was observed only rarely (Table 7). Extracardiac complications involved the skin, central nervous system, spleen and kidneys, respectively, in 20 to 30% of the patients. Complications afflicting the eyes, lungs, gastrointestinal tract and the musculo-skeletal system were seen with a lesser frequency of 0 to 12% (Table 8). The diagnosis of infective endocarditis, rendered highly-probable by the constellation of fever, cardiac murmur, bacteremia and anemia, necessitates, however, confirmation through cardiac examinations. In this respect, electrocardiographic and radiologic findings are of limited value, although they may be useful in the detection of cardiac complications. In 6% of the patients, positive criteria for myocardial infarction were indicative of coronary embolism and, i 30%, atrioventricular or fascicular block suggested the presence of abscess formation (Table 9). As radiologic evidence of heart failure, 74% of the patients were found to have pulmonary vascular congestion (Table 10).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Detection and evaluation of infectious endocarditis]. 664 98

The antipyretic action of naproxen has been reported as sufficiently selective for neoplasm-related fever such that the use of this agent has been recommended to distinguish neoplastic from infectious fever. The antipyretic effect of naproxen was evaluated in gynecologic oncology patients with advanced pelvic malignancies and fever without obvious source of infection (suspected neoplastic fever). Naproxen (250 mg orally every 8 hr) was given to 12 patients with (i) a daily temperature greater than 38.3 degrees C, (ii) fever for at least 3 days, (iii) no evidence of infection on physical exam, (iv) negative results of blood and urine cultures, and (v) a chest roentgenogram negative for pneumonia. Ten of the 12 patients initially received a minimum of 3 days of empiric antibiotic therapy without resolution of fever. Within 24 hr of starting naproxen therapy, 10 patients' (83%) fever responded: Eight patients (80%) had a complete lysis of fever and two had partial lysis (20%). Temperature response was accompanied by subjective improvement in patient malaise and fatigue. Naproxen therapy was continued for 5-7 days in these patients, and chemotherapy was administered to those patients scheduled to receive it. Two patients did not respond to naproxen therapy in 24 hr; thus, it was stopped and the fever workup was continued. Of these two patients, one was eventually diagnosed with bacteremia after multiple negative blood cultures and initially no response to antibiotics. Naproxen is clinically useful in the palliation of fever-related symptoms in gynecologic oncology patients with suspected neoplastic fever. Naproxen may also allow the limitation of extensive fever workups and prolonged empiric antibiotic therapy in these patients, and prevent delays in systemic therapy or supportive care.
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PMID:The effect of naproxen on fever in patients with advanced gynecologic malignancies. 753 41

A cross-sectional study of a cohort of 49 male human immunodeficiency virus (HIV)-infected intravenous drug users attending the Infectious Diseases Unit of the National University of Malaysia during 1991-94 yielded a clinical profile of these patients. The mean age of respondents was 33.2 years and the mean duration of intravenous drug use was 12.7 years. On average, these men had known of their HIV-positivity for 53.2 weeks. Intravenous drug use was the only reported HIV risk factor in 34 men (69%). Clinical symptoms at intake included fatigue (49%), weight loss (47%), night sweats (31%), fever (14%), and diarrhea (6%), while clinical findings included hepatomegaly (57%), lymphadenopathy (35%), and oral thrush (29%). Anemia (82%), leucocytosis (53%), hypoalbuminemia (43%), hyperglobulinemia (88%), elevated liver enzymes and hyponatremia (57%) were frequent laboratory findings. The prevalences of hepatitis B virus, cytomegalovirus, and toxoplasma infection were 12.1%, 72.7%, and 59%, respectively. A total of 91 diagnoses were made in these 49 patients: most common were pneumonia, tuberculosis, bacteremia, infective endocardiditis, mycotic aneurysm, and psychiatric disorders. The mean duration of known progression to acquired immunodeficiency syndrome (AIDS) in the 7 patients at this stage was 391 days. Pneumocystis carinii pneumonia was the most common AIDS-defining illness. Three months into the study, 19 men (57%) had defaulted, reflecting the difficulties of involving drug addicts in research and intervention projects. Moreover, 16 patients (33%) were first confirmed HIV-positive at presentation to the hospital, suggesting that many drug users' HIV status remains unknown until they develop symptoms requiring hospital care.
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PMID:A study of Malaysian drug addicts with human immunodeficiency virus infection. 906 11

A great deal of controversy and speculation surrounds the etiology of Chronic Fatigue Syndrome (CFS) in human patients and the existence of a similar illness in animals. To evaluate the association with a presumptive staphylococcal infection and bacteremia, seven dogs and eight cats diagnosed with CFS (two meeting the CDC working case definition) were submitted to rapid blood cultures and fresh blood smears investigations. Nine out of 15 blood cultures proved Staph-positive and four isolates were specified as S. xilosus (3) and S. intermedius (1). The presence of micrococci-like organisms in the blood was of common observation among these subjects, in association with fatigue/pain-related symptoms and biochemical abnormalities suggestive of a myopathy. Following treatment with a low dosage arsenical drug (thiacetarsamide sodium, Caparsolate, i.v., 0.1 ml/kg/day) all patients experienced complete remission. Micrococci disappeared from the blood at post-treatment controls made 10-30 days later. The outcomes were compared with those of five healthy controls and five 'sick with other illness' patients showing significant difference.
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PMID:Chronic Fatigue Syndrome (CFS) in 15 dogs and cats with specific biochemical and microbiological anomalies. 1144 Jan 90

Organisms of the genus Gemella can, on occasion, cause serious systemic illness. The present paper reports a successfully treated case of endocarditis in a 12-year-old girl with congenital heart disease caused by species of Gemella. The child presented with cough, fatigue and decreased appetite without fever. Echocardiogram demonstrated marked mitral insufficiency with flail posterior mitral valve leaflet, mitral valve vegetations, and an enlarged left atrium and ventricle. While being treated with vancomycin, the child initially had persistent bacteremia, which resolved after the addition of gentamycin; the course of therapy was completed with penicillin G and gentamycin once antimicrobial susceptibilities were available. Attempts to identify the species of Gemella were unsuccessful in the local laboratory, and at reference laboratories in Canada and the United States. The isolate is undergoing further evaluation to determine its taxonomic status.
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PMID:Gemella species endocarditis in a child. 1815 56

Bacteremia and/or toxic shock syndrome is a rare complication of streptococcal pharyngitis in adults. We describe a case of streptococcal toxic shock syndrome in a previously healthy young man who presented with fatigue, high fever, and suspected extensive streptococcal tonsillo-pharyngitis. Therapy consisted of high doses of antibiotics followed by treatment of consumptive coagulopathy, acute renal failure, and toxic shock syndrome. An attempt at hemodialysis and hemodiafiltration was ineffective, and the patient died 24 h after admission. The autopsy findings were compatible with the clinical diagnosis. The invasive group A streptococci isolated from the pharyngeal swab and blood cultures were identified as M1 and T1 type with pyrogenic exotoxin genes A and B. This was thus a definite case of streptococcal toxic shock syndrome complicated with multiorgan failure and lethal outcome. The benefit of intravenous immunoglobulins, surgical intervention, or clindamycin in survival improvement remains to be evaluated.
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PMID:Toxic shock syndrome due to group A streptococcal pharyngitis and bacteremia in an adult. 1878 44

Bacteremia and/or toxic shock syndrome are rare complications of streptococcal pharyngitis in adults. This report describes a previously healthy young man with streptococcal toxic shock syndrome who presented with fatigue, high fever, and suspected extensive streptococcal tonsillopharyngitis. Treatment consisted of high-dose antibiotics followed by therapy for consumptive coagulopathy, acute renal failure, and toxic shock syndrome. An attempt at hemodialysis and hemodiafiltration was ineffective, and the patient died within 24 h of admission. The autopsy findings were compatible with the clinical diagnosis. The invasive group A streptococci isolated from the pharyngeal swab and blood cultures were identified as M1 and T1 types with pyrogenic exotoxin genes A and B. This was a definitive case of streptococcal toxic shock syndrome complicated with multiorgan failure and fatal outcome. The benefits of intravenous immunoglobulins, surgical intervention, or clindamycin for improving survival remain to be evaluated.
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PMID:Toxic shock syndrome due to group A streptococcal pharyngitis and bacteremia in adults. 1981 63

Serum and blood samples from 192 patients, who reported animal exposure (100.0%) and recent animal bites or scratches (88.0%), were screened for antibodies by indirect immunofluorescence assays and for bacteremia using the BAPGM (Bartonella alpha Proteobacteria growth medium) platform. Predominant symptoms included fatigue (79.2%), sleeplessness (64.1%), joint pain (64.1%), and muscle pain (63.0%). Bartonella spp. seroreactivity or bacteremia was documented in 49.5% (n = 95) and 23.9% (n = 46) of the patients, respectively; however, indirect immunofluorescence antibodies were not detected in 30.4% (n = 14) of bacteremic patients. Regarding components of the BAPGM platform, Bartonella DNA was amplified from 7.5% of blood (n = 21), 8.7% of serum (n = 25), and 10.3% of enrichment culture samples (n = 29). Polymerase chain reaction (PCR) on only extracted blood would not have detected Bartonella infection in 34.7% (16/46) of bacteremic patients. Serology, in conjunction with blood, serum, and BAPGM enrichment culture PCR, facilitates the diagnosis of Bartonella spp. bacteremia in immunocompetent patients.
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PMID:Bartonella spp. bacteremia in high-risk immunocompetent patients. 2199 96

Bartonella spp. infection has been reported in association with an expanding spectrum of symptoms and lesions. Among 296 patients examined by a rheumatologist, prevalence of antibodies against Bartonella henselae, B. koehlerae, or B. vinsonii subsp. berkhoffii (185 [62%]) and Bartonella spp. bacteremia (122 [41.1%]) was high. Conditions diagnosed before referral included Lyme disease (46.6%), arthralgia/arthritis (20.6%), chronic fatigue (19.6%), and fibromyalgia (6.1%). B. henselae bacteremia was significantly associated with prior referral to a neurologist, most often for blurred vision, subcortical neurologic deficits, or numbness in the extremities, whereas B. koehlerae bacteremia was associated with examination by an infectious disease physician. This cross-sectional study cannot establish a causal link between Bartonella spp. infection and the high frequency of neurologic symptoms, myalgia, joint pain, or progressive arthropathy in this population; however, the contribution of Bartonella spp. infection, if any, to these symptoms should be systematically investigated.
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PMID:Bartonella spp. bacteremia and rheumatic symptoms in patients from Lyme disease-endemic region. 2325 52


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