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Query: UMLS:C0021311 (Infection)
 38,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lumbar epidural abscess and vertebral osteomyelitis were diagnosed in a 3-month-old infant, born prematurely, who had had repeated lumbar punctures for the treatment of posthemorrhagic hydrocephalus. Staphylococcus aureus was the causative organism. Successful treatment was achieved with 6 weeks of intravenous antibiotics without surgical drainage. Infectious complications of lumbar punctures are rare, but may occur when multiple punctures are attempted in small premature infants whose subarachnoid space contains large amounts of blood. Infection can be introduced directly by a contaminated spinal needle, or trauma to the tissues with bleeding can create a favorable site for bacterial adherence and multiplication. Posthemorrhagic ventricular dilation often resolves spontaneously and serial lumbar punctures should be used to treat this condition only when CSF flow is easy to establish and maintain.
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PMID:Epidural abscess and vertebral osteomyelitis following serial lumbar punctures. 688 61

Determinations of gentamicin levels in serum and cerebrospinal fluid were performed in 11 tests of eight patients suffering from memingitis and in 18 tests of eight patients after neurosurgical operations. Neurosurgical operations had been performed in this group at least four days prior to testing. Only in four tests in neurosurgical patients were the gentamicin levels in CSF higher than the lowest measurable concentration of 0.4 mcg/ml, serum levels in this group ranged from below 0.4 mcg/ml up to 5.0 mcg/ml. No gentamicin level in CSF exceeded 1.5 mcg/ml. Gentamicin levels in CSF of patients with meningitis ranged from below 0.4 mcg/ml to 5.66 mcg/ml. This equals a CSF/serum ratio of 7.4-57.6%, mean 25.8%.
Infection 1980
PMID:[Gentamicin concentrations in cerebrospinal fluid of patients with inflamed and uninflamed meninges (author's transl)]. 739 Jun 24

Seven patients with Bacteroides fragilis infections were treated with intravenous and/or oral metronidazole. Infections treated included endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia, and pelvic infection. Some patients had failed to respond to therapy with chloramphenicol or clindamycin or both. Metronidazole was used alone or in combination with aminoglycosides. Serum levels of metronidazole several times in excess of the minimal inhibitory concentrations for the organisms were easily achieved and in one patient the CSF metronidazole level was equal to that of the serum. Response to therapy with metronidazole was considered to be excellent. The only serious side effect noted was hypotension, which occurred in the last patient. Therapy was discontinued, and therefore therapeutic results could not be evaluated. Metronidazole appears to be a safe and effective agent in the treatment of B fragilis infections.
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PMID:Metronidazole treatment of Bacteroides fragilis infections. 745 95

The microbiological, clinical and radiological findings of cerebral tuberculomas in four patients with and in five patients without HIV infection were compared. The study was carried out during the last 14 years. The CT scans were analyzed in a blinded fashion. Cerebral tuberculoma in HIV-negative patients was clinically characterized by seizures, while in HIV-positive patients this finding was absent. All four HIV-infected patients had headache and fever and their CSF showed lymphocytic meningitis. Two HIV-negative and three HIV-positive patients had concurrent extracerebral tuberculosis. In HIV-infected patients, the cerebral tuberculoma was a secondary finding of disseminated tuberculosis. In our small patient samples, the cerebral tuberculoma presented as spontaneous hypodense cerebral lesions in all the HIV-positive patients but as a hyperdense cerebral lesion in the HIV-negative patients. Two patients of each group had ring enhancement lesions. Cerebral tuberculoma was diagnosed in about 4 weeks for HIV-positive patients, but took some 16 weeks for HIV-negative patients, the latter being first suspected of having a cerebral tumor or bacterial abscess. Diagnostic craniotomy was thus necessary for the HIV-negative patients. One patient of each group died as a consequence of cerebral tuberculoma, all the remaining patients improved with treatment.
Infection
PMID:Cerebral tuberculoma--a comparative study in patients with and without HIV infection. 749 3

Infection of human umbilical vein endothelial cells with the clinical isolate of human cytomegalovirus (HCMV; at a multiplicity of infection of 2) severely suppresses the production of granulocyte-CSF and granulocyte-macrophage-CSF at late stages of infection (6 days post infection onwards). The effect was produced by actively multiplying virus which indicates that HCMV antigen expression is important for this suppression. The suppression in the production of these two cytokines was not due to their accumulation inside the cell nor to cell damage or lysis after infection.
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PMID:Cytomegalovirus infection of vascular endothelial cells alters production of GM-CSF and G-CSF. 751 78

Infection with human immunodeficiency virus type 1 (HIV-1) induces vigorous and persistent cytotoxic CD8+ T cell responses. CTL clones were derived from peripheral blood or cerebrospinal fluid of three HIV-1 patients, with depressed CD4+ T cell counts. When stimulated with HLA-compatible target cells (B-LCL) presensitized with cognate HIV-1 peptides, all clones produced GM-CSF, TNF-alpha, and IFN-gamma and most produced low amounts of IL2, IL3, and IL4. After nonspecific stimulation with a phorbol ester and calcium ionophore, the clones secreted cytokines at levels similar to those from CD4+ lines from an HIV-1 infected donor. The ability of supernatants from the stimulated CTL clones to support the formation of granulocyte-macrophage colonies in normal bone marrow suggests that the GM-CSF was biologically active. Release of cytokines by activated CTL may influence the immunopathogenesis of HIV disease.
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PMID:Cytotoxic CD8+ T lymphocytes reactive with human immunodeficiency virus-1 produce granulocyte/macrophage colony-stimulating factor and variable amounts of interleukins 2, 3, and 4 following stimulation with the cognate epitope. 752 47

Recombinant granulocyte colony-stimulating factor (rHuG-CSF) is a hematopoietic growth factor that acts selectively on the neutrophil lineage, and has had a major impact on clinical practice. Two forms are in clinical use: filgrastim has been approved for use in more than 45 countries for the amelioration of chemotherapy-induced neutropenia and restoration of granulopoiesis following bone-marrow transplantation and lenograstim has been approved in Europe and Japan. In some countries, rHuG-CSF is also approved for various other indications, such as severe chronic neutropenia. Infection and neutropenia are a major cause of morbidity and mortality following cytotoxic chemotherapy, and there is a known correlation between neutropenia and the risk of infection. Hematopoietic growth factors have been used successfully in the prevention and treatment of neutropenia. There is evidence to suggest that use of rHuG-CSF before the onset of neutropenia allows patients to receive the maximum benefit; however, patients who do not receive rHuG-CSF prophylactically still benefit from the use of rHuG-CSF for the treatment of febrile neutropenia. These patients have an accelerated neutrophil recovery and a shorter duration of febrile neutropenia. These effects seem to translate into a significant reduction in the number of patients requiring prolonged hospitalization. This paper reviews the use of rHuG-CSF in the treatment of febrile neutropenia and describes how it is routinely used by hematologists and oncologists in non-clinical trial settings.
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PMID:The clinical utility of granulocyte colony-stimulating factor: early achievements and future promise. 753 47

This prospective multicenter study examined whether simultaneous administration of granulocyte colony-stimulating factor (G-CSF; Filgrastim) and induction chemotherapy for adult acute lymphoblastic leukemia (ALL) could prevent treatment-related neutropenia, infections, and resulting treatment delays. Seventy-six patients were randomly assigned to receive either G-CSF (n = 37) or no growth factor (n = 39) in conjunction with a uniform chemotherapy consisting of cyclophosphamide, cytarabine, mercaptopurine, intrathecal methotrexate, and cranial irradiation. The median duration of neutropenia (absolute neutrophil count < 1 x 10(9)/L) during chemotherapy was 8 days in patients receiving C-CSF, compared with 12.5 days in the control group (P < .002). A similar reduction from 11.5 to 7 days was observed in patients with T-ALL receiving additional mediastinal irradiation (P = .13). Infections occurred in 43% and 56% of patients in the G-CSF and control arm, respectively (P = .25); the incidence of nonviral infections was reduced by 50%, from 32 episodes in the control arm to 16 episodes in the G-CSF arm. Prolonged interruptions of chemotherapy administration were less frequent, with delays of 2 weeks or more occurring in only 24% of patients receiving G-CSF as opposed to 46% in the control arm (P = .01). Accordingly, chemotherapy was completed significantly earlier with the use of G-CSF (39 v 44 days, P = .008). With a median follow-up of 20 months, the probability of disease-free survival was 0.45 in the G-CSF group and 0.43 in the control group (P = .34). In conclusion, adult ALL patients appear to benefit by the simultaneous administration of G-CSF with induction chemotherapy because of a significant reduction in the duration of neutropenia, a trend to fewer infections, and a more rapid completion of chemotherapy.
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PMID:Concomitant granulocyte colony-stimulating factor and induction chemoradiotherapy in adult acute lymphoblastic leukemia: a randomized phase III trial. 754 60

Rhinovirus infections cause over one third of all colds and are a contributing factor to exacerbations of asthma. To gain insights into the early biochemical events that occur in infected epithelial cells, we develop, for the first time, a model in which a pure respiratory epithelial cell population can be routinely infected by rhinovirus. Viral infection was confirmed by demonstrating that viral titers of supernatants and lysates from infected cell increased with time and by PCR. Infection by rhinovirus 14 was inhibited by homotypic antiserum and by antibodies to intercellular adhesion molecule-1 (ICAM-1), the receptor for this virus. Susceptibility of epithelial cells to infection by rhinovirus 14 (but not rhinovirus 2, an ICAM-1 independent strain) can be increased by preexposure of cells to TNF alpha, whereas IFN gamma reduces susceptibility to infection by both rhinovirus strains. Rhinovirus infection per se does not markedly alter ICAM-1 expression on epithelial cells. Finally, we demonstrate that rhinovirus infection induced increased production of IL-8, IL-6, and GM-CSF from epithelial cells. Production of IL-8 correlated with viral replication during the first 24 h after infection. This model should provide useful insights into the pathogenesis of rhinovirus infections.
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PMID:Infection of a human respiratory epithelial cell line with rhinovirus. Induction of cytokine release and modulation of susceptibility to infection by cytokine exposure. 761 27

We evaluated the effectiveness of 5-day antibacterial therapy for bacterial meningitis in children. The study group included 26 children from 2 months to 15 years of age, admitted with microbiologically confirmed bacterial meningitis in 1990-1993 and treated for 5 days. A historical comparison group of 49 patients treated for 8 to 15 days was used. Penicillin monotherapy (300 mg/kg body weight) was used for meningococcal and pneumococcal meningitis and ampicillin (300 mg/kg body weight) for Haemophilus influenzae b meningitis. On day 5 of therapy the activity of aspartate aminotransferase (AST), lactic dehydrogenase (LDH), creatine phosphokinase (CPK) and gamma-glutamyl-transpeptidase (gamma GT) in the CSF was determined by photocolorimetric assay and the concentration of creatine kinase BB (CK-BB) by ELISA. IL-6 was analysed using EIA technique and a cerebral ultrasound was performed at the time of the termination of the antibacterial therapy. The mean follow-up time was 1.3 years for children in the study group and 3.2 in the control group. The time of hospitalisation was shorter in children treated for 5 days (p < 0.005). Complete clinical recovery was 81% in the study group and 66% in the comparison group at the time of the termination of antibacterial therapy. No relapses occurred. The activity of AST, CPK, LDH, and gamma GT in the CSF had returned to normal by the 5th day of therapy, but almost a 7-fold higher concentration of CK-BB was registered. The concentration of IL-6 in the CSF decreased with the therapy from 1,800 pg/ml to 685 pg/ml but still remained high.(ABSTRACT TRUNCATED AT 250 WORDS)
Infection
PMID:Five days of antibacterial therapy for bacterial meningitis in children? 762 59


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