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Query: UMLS:C0018681 (
headache
)
56,091
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Patients usually provisionally diagnosed as having typhoid fever or pneumonia are regularly admitted to the Rietfontein Fever Hospital suffering from psittacosis. The main symptoms are intense
headache
, chills and fever and an irritating non-productive cough. Later most patients develop signs of pneumonitis most clearly seen on radiographic examination. An important clue to the diagnosis is a history of contact with birds, most often budgerigars and more recently cockatiels. The diagnosis may be confirmed by the isolation of
Chlamydia
psittaci, the causative organism, but more usually reliance is placed on the results of serological tests revealing the development of chlamydial antibodies. None of the patients in this series developed serious complications, but if not treated psittacosis sufferers may develop severe pneumonitis, hepatitis and gastro-enteritis; the mortality rate is up to 20%. A rare but fatal complication is chlamydial endocarditis, presenting with the signs and symptoms of subacute bacterial endocarditis, but giving repeated negative blood cultures. The illness responds specifically to treatment with tetracycline antibiotics within 48 hours.
Chlamydial infections
are widespread among avian species. In the RSA most cases of psittacosis have resulted from contact with budgerigars and cockatiels, but outbreaks have been associated with imported batches of birds including South American parrots and Australian finches, emphasizing the need for vigilance at seaports.
...
PMID:Psittacosis in the RSA. 370 61
Three members of a family acquired psittacosis after exposure to a wild pigeon. Each of the patients had pulmonary infiltrates, prominent
headache
, abdominal complaints, and serologic evidence for infection with
Chlamydia
psittaci. Of 759 cases of psittacosis reported to the Centers for Disease Control for the period of 1974 to 1981, some 75 (10 percent) were associated with pigeons. Fifty-two of the cases were associated with domestic pigeons and 23 with wild pigeons. Pigeons represent a largely unrecognized reservoir of psittacosis in the United States.
...
PMID:Wild-pigeon-related psittacosis in a family. 376 73
One-hundred and fifty-two male patients suffering from non-gonococcal urethritis were treated with an oral dosage of 300 mg roxithromycin daily for seven days.
Chlamydia
trachomatis was isolated from the urethra in 53 patients (35%), and Ureaplasma urealyticum in 42 patients (28%). After treatment, 49 (92%) of the 53 patients with positive
Chlamydia
trachomatis cultures and 34 (81%) of the 42 patients with positive Ureaplasma urealyticum cultures had negative cultures at follow-up. A clinical cure was observed in 137 patients (90%). Ten patients (7%) showed side effects consisting of nausea, sensation of distended abdomen,
headache
and fatigue. Seventy-eight male patients suffering from nongonococcal urethritis were treated with an oral dosage of 2 X 150mg roxithromycin daily for seven days.
Chlamydia
trachomatis was isolated from the urethra in 22 patients (28%), and Ureaplasma urealyticum in 30 patients (38%). After treatment, all of the 22 patients with formerly positive
Chlamydia
trachomatis cultures and 23 (77%) of the 30 patients with formerly positive Ureaplasma urealyticum cultures were negative at follow-up. A clinical cure was observed in 70 patients (90%). Three patients (4%) showed side-effects consisting of nausea and
headache
. It is concluded that roxithromycin is a good alternative to tetracycline and erythromycin in the treatment of non-gonococcal urethritis in males.
...
PMID:Evaluation of roxithromycin in the treatment of non-gonococcal urethritis in males. 380 73
A 37-year-old man was admitted to hospital with fever, muscle tenderness,
headache
and mild exanthema on the right thigh. During his hospital stay, the
headache
worsened and aseptic meningitis was diagnosed. A bilateral iritis developed, and the exanthema developed into an atypical erythema nodosum. In liver function tests, pathological results were recorded. Vasculitis was suspected but could not be confirmed. All serological tests proved negative except for a fourfold titre rise to
Chlamydia
pneumoniae. We concluded that the meningitis, hepatitis, iritis and atypical erythema nodosum were most probably due to a C. pneumoniae infection.
...
PMID:An unusual manifestation of Chlamydia pneumoniae infection: meningitis, hepatitis, iritis and atypical erythema nodosum. 851 21
In Europe,
Chlamydia
psittaci is a relatively common cause of abortion in sheep and other mammals. Psittacosis in humans is typically described as a mild-to-moderate flu-like illness. If psittacosis is acquired during pregnancy, it can present as a severe, progressive, febrile illness, with
headache
, disseminated intravascular coagulation, abnormal liver enzyme studies, and impaired renal function. Only cases with significant fetomaternal morbidity and mortality have been reported. Recovery from this disease follows termination of pregnancy and appropriate antibiotic therapy. Direct exposure of gravid humans to infected products of conception is the most commonly reported mode of transmission. Diagnosis is suggested by the placental histopathologic findings, which consist of an intense, acute intervillositis, perivillous fibrin deposition with villous necrosis, and large irregular basophilic intracytoplasmic inclusions within the syncytiotrophoblast. Commercially available genus-specific monoclonal antichlamydial antibody is available for the rapid confirmation of the diagnosis. In the United States, only two cases of gestational psittacosis have been previously reported. In contrast to the experience in Europe, both cases were associated with psittacine birds. This is the first reported instance of ovine-related gestational psittacosis documented in the United States. Gravid patients should be warned to avoid contact with sheep and their products, particularly during the spring lambing period.
...
PMID:Gestational psittacosis: case report and literature review. 919 79
The objective of this investigation was to determine whether
Chlamydia
pneumoniae was involved in an outbreak of respiratory disease among military recruits, 92 patients (average age 20.1 years) were included in the study if they had a sore throat or cough for more than 1 week. In addition to sore throat and cough, fatigue,
headache
, dyspnoea and vertigo were the most frequent symptoms. The patients received standard treatment with 100 mg of doxycycline b.i.d. for 14 days. In 38.8% of cases symptoms were alleviated after 1-2 weeks of treatment, and in 22.4% of cases after 2-3 weeks of treatment. Pretreatment throat washings and sera were sampled for
Chlamydia
. Sera were drawn for
Chlamydia
, Mycoplasma and adenovirus serology. Cell culture (Hep-2) and 3 different serological methods-microimmunofluorescence (MIF), enzyme immunoassay with a recombinant glycoconjugate antigen (r-EIA) and immunoperoxidase assay (IPA)-were used. Cell culture was found to have too low a sensitivity to be of diagnostic value. Acute infection was demonstrated in 13% by MIF IgM and in an additional 21% by MIF IgG (titre rises). Enzyme immunoassay IgM was found in 17% and IPA IgM in 19% of individuals without MIF IgM antibodies. Microimmunofluorescence was found to be the most useful test for serodiagnosis. The combination of serological methods showed that 40 out of 52 (76.9%) had an acute infection with possible chlamydial aetiology. In conclusion, methodological improvements are necessary for the aetiological diagnosis of chlamydial respiratory infections.
...
PMID:Respiratory tract infection due to Chlamydia pneumoniae in military personnel. 925 77
Trovafloxacin is a fluoroquinolone antibacterial agent with a broad spectrum of activity. Trovafloxacin has similar or 2-fold lower activity than ciprofloxacin against Enterobacteriaceae and Pseudomonas aeruginosa. Against Haemophilus influenzae and Moraxella catarrhalis, trovafloxacin has similar activity to ciprofloxacin. Other susceptible Gram-negative pathogens include Neisseria gonorrhoeae,
Chlamydia
trachomatis and mycoplasmas. The drug is active against Gram-positive bacteria and consistently displayed greater activity (2- to 8-fold) than ciprofloxacin against all staphylococci and streptococci tested; activity included methicillin-resistant staphylococci and penicillin-resistant Streptococcus pneumoniae. Trovafloxacin has some activity against vancomycin-resistant enterococci. Anaerobes such as Bacteroides and Clostridium spp. are also susceptible to trovafloxacin. Preliminary clinical data suggest that trovafloxacin is effective in the treatment of patients with upper and lower respiratory tract and uncomplicated urinary tract infections and infections caused by C. trachomatis or N. gonorrhoeae. The most frequently noted adverse event with trovafloxacin is dizziness which is reported in 11% of patients versus 3% of those receiving comparator agents. Other commonly reported events (> 1% of patients) are nausea,
headache
, vomiting, vaginitis and diarrhoea.
...
PMID:Trovafloxacin. 927 5
The aim of this study was to compare the clinical, biological, and radiologic features of presentation in the emergency ward of community-acquired pneumonia (CAP) by Legionella pneumophila (LP) and other community-acquired bacterial pneumonias to help in early diagnosis of CAP by LP. Three hundred ninety-two patients with CAP were studied prospectively in the emergency department of a 600-bed university hospital. Univariate and multivariate analyses were performed to compare epidemiologic and demographic data and clinical, analytical, and radiologic features of presentation in 48 patients with CAP by LP and 125 patients with CAP by other bacterial etiology (68 by Streptococcus pneumoniae, 41 by
Chlamydia
pneumoniae, 5 by Mycoplasma pneumoniae, 4 by Coxiella burnetii, 3 by Pseudomonas aeruginosa, 2 by Haemophilus influenzae, and 2 by Nocardia species. Univariate analysis showed that CAP by LP was more frequent in middle-aged, male healthy (but alcohol drinking) patients than CAP by other etiology. Moreover, the lack of response to previous beta-lactamic drugs,
headache
, diarrhea, severe hyponatremia, and elevation in serum creatine kinase (CK) levels on presentation were more frequent in CAP by LP, while cough, expectoration, and thoracic pain were more frequent in CAP by other bacterial etiology. However, multivariate analysis only confirmed these differences with respect to lack of underlying disease, diarrhea, and elevation in the CK level. We conclude that detailed analysis of features of presentation of CAP allows suspicion of Legionnaire's disease in the emergency department. The initiation of antibiotic treatment, including a macrolide, and the performance of rapid diagnostic techniques are mandatory in these cases.
...
PMID:Comparative study of the clinical presentation of Legionella pneumonia and other community-acquired pneumonias. 959 85
GABHS is the most common bacterial cause of tonsillopharyngitis, but this organism also produces acute otitis media; pneumonia; skin and soft-tissue infections; cardiovascular, musculoskeletal, and lymphatic infections; bacteremia; and meningitis. Most children and adolescents who develop a sore throat do not have GABHS as the cause; their infection is viral in etiology. Other bacterial pathogens produce sore throat infrequently (e.g.,
Chlamydia
pneumoniae and Mycoplasma pneumoniae), and when they do, other concomitant clinical illness is present. Classic streptococcal tonsillopharyngitis has an acute onset; produces concurrent
headache
, stomach ache, and dysphagia; and upon examination is characterized by intense tonsillopharyngeal erythema, yellow exudate, and tender/enlarged anterior cervical glands. Unfortunately only about 20% to 30% of patients present with classic disease. Physicians overdiagnose streptococcal tonsillopharyngitis by a wide margin, which almost always leads to unnecessary treatment with antibiotics. Accordingly, use of throat cultures and/or rapid GABHS detection tests in the office is strongly advocated. Their use has been shown to be cost-effective and to reduce antibiotic overprescribing substantially. Penicillin currently is recommended by the American Academy of Pediatrics and American Heart Association as first-line therapy for GABHS infections; erythromycin is recommended for those allergic to penicillin. Virtually all patients improve clinically with penicillin and other antibiotics. However, penicillin treatment failures do occur, especially in tonsillopharyngitis in which 5% to 35% of patients do not experience bacteriologic eradication. Penicillin treatment failures are more common among patients who have been treated recently with the drug. Cephalosporins or azithromycin are preferred following penicillin treatment failures in selected patients as first-line therapy, based on a history of penicillin failures or lack of compliance and for impetigo. GABHS remain exquisitely sensitive to penicillin in vitro. There are several explanations for penicillin treatment failures, but the possibility of copathogen co-colonization in vivo has received the most attention. Treatment duration with penicillin should be 10 days to optimize cure in GABHS infections. A 5-day regimen is possible and approved by the United States Food and Drug Administration for cefpodoxime (a cephalosporin) and azithromycin (a macrolide). Prevention of rheumatic fever is the primary objective for antibiotic therapy of GABHS infections, but a reduction in contagion and faster clinical improvement also can be achieved. Development of streptococcal toxic shock syndrome and necrotizing fasciitis ("flesh-eating bacteria") are rising concerns. The portal of entry for these invasive GABHS strains is far more often skin and soft tissue than the tonsillopharynx.
...
PMID:Group A beta-hemolytic streptococcal infections. 974 11
Chlamydia
trachomatis is the most frequent sexually transmitted bacterial pathogen in developed countries [3, 12, 13]. The position is similar in the Czech Republic. Depending on the group of examined women active
Chlamydia
infection varies between 10 and 23%. The increasing incidence of urogenital
Chlamydia infections
and improving diagnostic possibilities call for adequate treatment. Correct treatment of urogenital infections caused by
Chlamydia
trachomatis is very important for the prevention of undesirable sequelae of inflammations of the lesser pelvis, subsequent risk of GEU, sterility, prevention of premature delivery and possible infection of the neonate. When starting treatment, selecting a suitable antibiotic and deciding on the therapeutic strategy it is important to select an antibiotic with regard to its efficacy, the epidemiological situation, regional sensitivity of the infectious agent, toxicity and tolerance of the antibiotic, to its bacteriostatic or bactericide action, and last not least, also its price. Despite selection of a suitable antibiotic sometimes treatment fails. For treatment of urogenital chlamydial infections tetracyclin and macrolid antibiotics are recommended or quinolone chemotherapeutic agents of the third generation. Tetracyclines are broad spectrum antibiotics with bacteriostatic action. As to oral forms doxycycline, tetracycline and oxytetracycline are used. The most frequent undesirable effects during treatment are nausea, vomiting, diarrhoea and abdominal pain. Tetracycline antibiotics are contraindicated in children under 8 years, during pregnancy and lactation and in case of sensitivity to this group of drugs. Macrolids are antibiotics with a medium broad antibacterial spectrum with bacteriostatic action. Macrolids of the first generation have a low antibacterial activity. They have a short biological half-life, not always a good tolerance, and serious clinically important drug interactions may develop. The most frequently used preparations of the first generation include erythromycin, josamycina and spiramycin. Macrolids of the second generation, azitromycin, roxitromycin and claritromycin lack the above negative properties. The most frequent undesirable effects after administration of macrolids include nausea and vomiting. Considerable differences were found in particular between different preparations containing erythromycin. Macrolids of the second generation have only slight undesirable gastrointestinal effects. Macrolid antibiotics are contraindicated in case of sensitization to this group, in severe hepatic disorders and great care must be taken in the treatment of pregnant women. Quinolone chemotherapeutic agents of the third generation, ciprofloxacine, enoxacine, ofloxacine and pefloxacine are synthetic drugs with a broad antibacterial spectrum which act on systemic infections. On oral administration they are rapidly absorbed and the blood and tissue concentrations are sufficiently effective. In the treatment of urogenital
Chlamydia infections
they are useful in the treatment of chronic infections after failure of previous macrolid and tetracycline therapy. The most frequent undesirable side-effects include nausea, vomiting, meteorism, diarrhoea, tinnitus,
headache
, changes of mood, allergic skin reaction. They are contraindicated in hypersensitivity to quinolone chemotherapeutic preparations, in children and adolescents under 18 years, during pregnancy and lactation. The objective of the present study was to evaluate different therapeutic patterns, their efficacy and tolerance.
...
PMID:[Treatment of chlamydial urogenital infections]. 975 Apr 1
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