Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021311 (Infection)
 38,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Granulocyte-macrophage colony-stimulating factor (GM-CSF), a pleiotropic molecule which displays a broad range of haematopoietic activities, has become available for clinical evaluation in various patient groups. It has been shown to be effective in preventing or reversing neutropenia. Adverse effects of GM-CSF, however, are dose related. Appropriate dose, route and schedules for GM-CSF in various clinical settings have recently been defined, the usual range being 5-10 micrograms/kg/day either by 4-6 h intravenous infusion or by subcutaneous injection. At such doses, adverse effects are predominantly mild-to-moderate in nature, occur in 20-30% of patients and usually comprise fever, myalgia, malaise, rash and injection site reaction. Early trials using very high doses of GM-CSF were often associated with marked adverse effects, which in rare cases proved severe (pericarditis and thrombosis). Similarly, a so-called "first-dose reaction", defined as a syndrome of hypoxia and hypotension after the initial but not subsequent doses of GM-CSF, was observed in certain predisposed patients following doses above 10 micrograms/kg/day. Subsequent trials have established that intravenous bolus or short infusions of GM-CSF are more likely to promote adverse effects. Certain patient groups, for example those with myelodysplastic syndrome, acute myeloid leukaemia, inflammatory disease, autoimmune thrombocytopenia or malfunctional immunological responsiveness, require careful clinical monitoring in order to avoid potential complications following the administration of GM-CSF. With the current appropriate administration and doses of GM-CSF, the benefit:risk ratio has been greatly improved.
Infection 1992
PMID:The side-effect profile of GM-CSF. 149 36

Cat-scratch disease is usually a benign, self-limited disease. Infection may be asymptomatic but is commonly associated with painful regional lymphadenitis. Occasionally, disease may result in systemic symptoms and dissemination. Five adult patients, aged 24 to 57 years, were diagnosed as having cat-scratch disease, based on a positive history of cat scratches followed by typical symptoms including painful regional lymphadenitis, malaise, and positive cat-scratch skin tests. Diagnostic evaluations revealed no other cause for the lymphadenitis. Three patients had not received prior treatment with antibiotics, and two patients had failed to improve on other antibiotics. All five were treated with oral ciprofloxacin, 500 mg by mouth, twice daily. All patients had dramatic improvement in symptoms within a few days and none has relapsed during follow-up. This is the first report of successful treatment of cat-scratch disease with ciprofloxacin, which appears to be an effective therapy for cat-scratch disease in adults.
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PMID:Successful treatment of cat-scratch disease with ciprofloxacin. 189 69

Two strains of Campylobacter jejuni ingested by 111 adult volunteers, in doses ranging from 8 x 10(2) to 2 x 10(9) organisms, caused diarrheal illnesses. Rates of infection increased with dose, but development of illness did not show a clear dose relation. Resulting illnesses with strain A3249 ranged from a few loose stools to dysentery, with an average of five diarrheal stools and a volume of 509 mL. Infection with strain 81-176 was more likely to cause illness, and these illnesses were more severe, with an average of 15 stools and 1484 mL of total stool volume. All patients had fecal leukocytes. The dysenteric nature of the illness indicates that the pathogenesis of C. jejuni infection includes tissue inflammation. Ill volunteers developed a serum antibody response to the C. jejuni group antigen and were protected from subsequent illness but not infection with the same strain.
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PMID:Experimental Campylobacter jejuni infection in humans. 334 22

Infection with Ehrlichia canis should be suspected in patients with fever, headache, malaise, leukopenia, thrombocytopenia, and a history of recent exposure to ticks. The cytopenia is caused by bone marrow hypoplasia which may be severe. The disease may be confused with spotless Rocky Mountain spotted fever but can be differentiated from this infection serologically with acute and convalescent sea. In humans, recovery has occurred with and without antibiotic therapy. However, prompt antibiotic therapy is advised prior to serologic studies, especially in immunocompromised individuals, splenectomized persons, and patients with AIDS-who may develop a more overwhelming rickettsial infection.
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PMID:Ehrlichiosis: a cause of bone marrow hypoplasia in humans. 336 36

A study in 50 children suffering from acute brucellosis demonstrated that acute arthritis is a common and often predominant manifestation of the disease. The patients lived in an area where brucellosis is endemic: their ages ranged from six months to 12 years. All patients had a brucella agglutination titer of greater than or equal to 1:320 on admission. The knee and hip joints were most commonly affected with symptoms and findings from only one joint predominating. Associated findings of only moderately elevated ESR and normal leucocyte counts with relative lymphocytosis in the vast majority of the cases made it fairly easy to distinguish acute brucella arthritis from septic arthritis of other origin. A positive blood culture for Brucella melitensis was obtained in 35 of the patients. Treatment with tetracyclines, trimethoprim-sulphamethoxazole, with or without combination with streptomycin, resulted in a prompt recovery in all patients. No mortality was seen. Seven patients were readmitted with reinfections during a mean follow-up period of 13 months. Two patients with a history of prolonged fever, malaise and arthralgia were found to have osteomyelitis of the adjacent bone tissue. They also recovered without sequelae.
Infection
PMID:Brucella arthritis in children. 379 38

Persistent unexplained lymphadenopathy (LAS) with intermittent fever, weight loss, night sweats and malaise was observed from March to October 1983 in 16 of 133 intravenous drug addicts who had been followed for at least two years in a Center for Drug Addicts Assistance in Milan, Italy. All the subjects lived in a restricted suburban area and indulged in frequent toxicomanic practices and mutual sexual intercourse. The subjects showed immunological alterations such as lymphopenia (50%), decreased T helper/T suppressor ratio (93%), both these abnormalities (43%), decreased T helper cells (75%), increased T suppressor cytotoxic cells (81%), decreased natural killer (NK) activity (77%), anergy (50%) or hypoergy (43%) to recall skin testing and elevated levels of IgG (87%). Anti-HTLV III antibodies were found in 14 of 16 (87%) patients with LAS and in 3 of 11 (27%) symptom-free drug addicts belonging to the same group. It will be important to assess in the future whether this clinical and immunological picture results in acquired immunodeficiency syndrome in an area so far untouched by this disease.
Infection
PMID:Outbreak of persistent, unexplained, generalized lymphadenopathy with immunological abnormalities in drug addicts in Milan. 609 48

Fourteen previously healthy young patients with unusual community-acquired opportunistic infections were seen over a period of three years. They differ from patients previously described in that 11 were heterosexual drug abusers (including two women) and only three were homosexual men. There were eight Puerto Ricans, five blacks, and one white. Infections included Pneumocystis carinii pneumonia (seven), disseminated Mycobacterium intracellulare infection, histoplasmosis, cryptococcosis, and cytomegalovirus infection (one each), oral thrush (13), and Candida esophagitis (two). All patients had impaired cellular immunity manifested by cutaneous anergy and lymphopenia, and all 11 tested had a markedly decreased ratio of T helper/inducer cells to T suppressor/cytotoxic cells. Twelve had evidence of associated viral infection (Epstein-Barr virus in nine, cytomegalovirus in five, Herpes simplex type 2 in two). Clinical presentation was with a severe opportunistic infection or with a prodrome consisting of oral thrush and nonspecific findings including malaise, fever, lymphadenopathy, or cough. The syndrome of immunodeficiency and opportunistic infection occurs in nonwhite heterosexual drug abusers, not exclusively in white homosexual men, and patients may present for medical care before the onset of a severe opportunistic infection.
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PMID:Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men. 621 79

Within a three-year period 712 patients with Campylobacter jejuni infection were diagnosed at our laboratory in Helsinki and 524 (72%) were treated as outpatients. More than half (57%) of the patients became infected when abroad, chiefly during holiday trips in the Mediterranean and in East European countries. The risk of acquiring infection was about 250 times greater abroad than in Finland, and it differed considerably from country to country, being highest in Morocco and Tunisia. Among domestic cases the incidence of infection was significantly higher (p less than 0.001) during the summer and autumn months than during winter or spring. Animal contact prior to infection was reported in 59% of domestic and 31% of imported cases, and previous consumption of poultry in 28% and 42% of those from whom information was obtained. Besides diarrhoea (98%), the main symptoms included abdominal pain (87%), fatigue (81%), fever (78%), malaise (70%) and headache (51%). Arthralgia was observed in 19% and arthritis in 2% of patients. The mean duration of diarrhoea was 10.8 days, of fever 2.8 days.
Infection
PMID:Infection due to Campylobacter jejuni: a report of 524 outpatients. 646 63

Infection with brucella microorganisms is considered uncommon in the paediatric age group. We report nine paediatric patients between the ages of 8 to 17 years with acute Brucella melitensis infection, who presented with spiking fever, night sweats, anorexia and malaise for 5 to 60 days prior to diagnosis. Four patients developed various osteoarticular complications: migratory arthralgia, hydroarthrosis of the knees, arthritis and osteomyelitis. Therapy with tetracyclines alone or in combination with streptomycin resulted in complete recovery in eight children. This combination failed in one patient who developed severe osteoarticular disease successfully responding to rifampicin. Since infection of bone and joints leads to irreversible damage, early recognition and immediate management are crucial for recovery. Rifampicin might be of benefit in children with severe osteoarticular complications when the traditional anti-brucella regimen fails.
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PMID:Elevated risk of osteoarticular complications in children with acute Brucella melitensis infection. 667 Oct 69

Infection-induced malnutrition, the most common form of cytokine-induced malnutrition, results from the actions of proinflammatory cytokines, ie, tumor necrosis factor (TNF) and interleukins 1,6, and 8 (IL-1, IL-6, and IL-8). During acute generalized infections, these cytokines initiate the acute-phase reaction. This reaction is quite stereotyped, and includes fever, malaise, myalgia, headaches, cellular hypermetabolism, and multiple endocrine and enzyme responses. In addition, there is heightened catabolism of muscle proteins and many amino acids; flux of free amino acids into the liver; hepatic synthesis of acute-phase plasma proteins; sequestration of iron and zinc; gluconeo-genesis; insulin resistance; impaired cellular uptake of fatty acids from plasma triglycerides; sizable losses of body nitrogen, potassium, magnesium, phosphate, and zinc; retention of body salt and water; heightened metabolic degradation and/or loss of vitamins; and an activation of the immune system. The pathogenesis of cytokine-induced malnutrition is thus vastly different from the malnutrition caused by uncomplicated starvation. Cytokine-induced malnutrition can have a devastating effect on the immune system and its functions. Although proinflammatory cytokines are found in mucosal fluids, where they contribute to the pathogenesis of inflammatory bowel diseases, it is not known whether cytokines play a role in toxigenic, secretory diarrheas such as cholera, which cause huge losses of body water, electrolytes, and bicarbonate while exhibiting no systemic manifestations of an acute-phase reaction.
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PMID:Herman Award Lecture, 1995: infection-induced malnutrition--from cholera to cytokines. 757 15


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