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Target Concepts:
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Query: UMLS:C0017160 (
gastroenteritis
)
11,398
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The Authors describe a rare case of Yersinia Enterocolitica (Y.E.) infection in a child affected by
thalassemia
. The onset of the disease was that of an acute enteritis with diarrhea, fever, vomiting and abdominal pain which subsequently evolved in a picture consistent with an acute appendicitis. Laparotomy was then performed and showed a marked suppurative mesenterial lymphadenitis with mild appendicular inflammation and Y.E. infection was suspected. Culture from lymphonodes confirmed the presence of Y.E. sensitive to tobramicin and CTM. The use of these chemiotherapic agents has been followed by a rapid clinical improvement. Our recent experience could suggest some practical considerations: 1) Culture of Y.E. should be routinely performed in all children affected by acute
gastroenteritis
and particularly in those, above 5 years of age, in which the infection can simulate acute appendicitis. 2) Special attention should be carried out in children affected by
thalassemia
who can easily present more serious disease often complicated by septicemia. 3) Therapy depends on the form and severity of the disease and should be always guided by in vitro sensitivity test because of the possibility of resistence of Y.E. against the most frequently used antibiotics in septicemia.
...
PMID:[Yersinia enterocolitica infection in thalassemia. Report of one case (author's transl)]. 697 42
A prospective case-control study conducted on the north coast of Papua New Guinea in 1993-96 investigated the hypothesis that alpha(+)-
thalassemia
provides a selective advantage against endemic Plasmodium falciparum. In this geographic area, alpha(+)-
thalassemia
affects more than 90% of the population. 249 children admitted to Madang Hospital with one or more symptoms of severe malaria (severe anemia, coma, hypoglycemia, acidosis, and hyperlactatemia) were paired with 249 randomly selected healthy age- and sex-matched controls. Also enrolled were 233 children with infections other than malaria, primarily respiratory infections,
gastroenteritis
, and meningitis. Compared with healthy community controls, the risk of severe malaria was 0.40 (95% confidence interval (CI), 0.22-0.74) in alpha(+)-
thalassemia
homozygotes and 0.66 (95% CI, 0.37-1.20) in heterozygotes. The lowest odds ratios for alpha(+)-
thalassemia
homozygotes were recorded in the acidosis and hyperlactatemia subgroups--the two complications most predictive of malaria mortality. Unexpectedly, the risk of hospital admission with infections other than malaria was reduced to a similar degree in homozygous (0.36; 95% CI, 0.22-0.60) and heterozygous (0.63; 95% CI, 0.38-1.07) children. Although the relevant mechanism is unknown, these findings confirm a clear interaction between
thalassemia
hemoglobinopathy and both malarial and other infections. Given its high frequency and protective effect against malaria and some other infections, alpha(+)-
thalassemia
is likely to have a major impact on child survival in coastal Papua New Guinea.
...
PMID:alpha+-Thalassemia protects children against disease caused by other infections as well as malaria. 940 82
Infection is a major complication and the leading cause of death in
thalassemia
, especially E-beta thalassemia. The spectrum of infections in E-beta thalassemia include mild and severe infections, therapy-related infections such as Yersinia enterocolitica infection associated with desferrioxamine (DFO) therapy, and transfusion-transmitted disease, as well as unique infections such as with pythiosis. Prospective studies in Thailand indicate that patients with E-beta thalassemia had more frequent episodes of both mild and severe infections. The former included upper respiratory tract infection, acute
gastroenteritis
, cutaneous abscess, and gingivitis. Severe infections occurred more commonly in patients with splenectomy and included septicemia, pneumonia, biliary tract infection, salmonellosis, and urinary tract infection. Responsible organisms were Escherichia coli (26%), Klebsiella pneumoniae (23%), Salmonella (15%), and Streptococcus pneumoniae (13%). Other organisms included Pseudomonas, Staphylococci, Burkholderia pseudomallei (melioidosis), and Aeromonas. Patients undergoing DFO therapy are at risk for Y. enterocolitica infection which may be localized to mesenteric nodes and tonsils or occur as a generalized form such as septicemia. Recently, we have seen a unique infection so-called vascular pythiosis. Patients usually presented with clinical features of vascular occlusion of lower limbs from ascending arteritis and thrombosis. The causative organism, Pythium insidiosum, is fungus-like, in the kingdom Stramenopila, and in the class Oomycetes. The mortality rate is high and the only effective treatment has been early amputation or possibly immunotherapy. The predisposing factors of infections in
thalassemia
include splenectomy, iron overload, anemia, and granulocyte dysfunctions. General management of infections in
thalassemia
consist of prevention, i.e., immunization with pneumococcal and hepatitis vaccines, oral penicillins especially in patients with splenectomy, removal of predisposing factors such as gallstones, iron overload, and appropriate antibiotics.
...
PMID:Infections in E-beta thalassemia. 1113 34
Invasive, extra-intestinal infection with Vibrio cholerae non-O1, non-O139 is rare especially among children. Herein the authors report a 12-year-old girl with underlying beta-
thalassemia
status post-splenectomy presenting with V. cholerae non-O1, non-O139
gastroenteritis
with concomitant septicemia. The pathogen was identified from stool and blood culture and the patient recovered uneventfully after antimicrobial and supportive therapy. A review and comparison of clinical manifestations and outcomes with the previous four cases of invasive V. cholerae non-O1, non-O139 in postsplenectomy thalassemic pediatric patients is reported.
...
PMID:Invasive Vibrio cholerae non-O1 non-0139 infection in a thalassemic child. 2204 81
Salmonella infection can cause four predominant clinical syndromes: enteric fever, acute
gastroenteritis
, bacteraemia with or without metastatic infection, and the asymptomatic carrier state. Salmonella as an aetiological agent in osteomyelitis is essentially rare and salmonella osteomyelitis in itself is predominantly seen in patients with haemoglobinopathies such as sickle cell disease or
thalassemia
. There are very few cases reported in the literature in which salmonella osteomyelitis is seen in otherwise healthy individuals. We describe here a case of salmonella osteomyelitis in a young gentleman with no significant comorbidities who presented with fever and severe back pain, having returned from recent foreign travel. It is therefore important to consider uncommon pathogens in the differential diagnosis of travellers with prolonged fever and insidious symptoms.
...
PMID:Salmonella Osteomyelitis. 2666 20