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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical features and haematologic indices of 100 young infants aged 3 months and below, admitted with suspected bacterial infections, were analysed. Fever, lethargy, hepatomegaly, poor feeding and irritability were the commonest features for suspecting a bacterial infection in these infants. However, the features significantly associated with bacterial infections were respiratory distress and cyanosis. Of the haematologic indices commonly associated with bacterial infections, only C-reactive protein and erythrocyte sedimentation rate were significantly predictive compared to leukocyte counts, absolute neutrophil counts and nitro-blue tetrazolium tests. When used in combination, a raised C-reactive protein with erythrocyte sedimentation rate, a raised erythrocyte sedimentation rate with abnormal leukocyte counts and a raised C-reactive protein with abnormal leukocyte counts were significantly associated with bacterial infections.
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PMID:Clinical features and haematological indices of bacterial infections in young infants. 162 Nov 14

The clinical manifestations of acute otitis media and otitis media with effusion are the result of abnormal eustachian tube function most often caused by inflammation from infection or allergy. The majority of cases involve bacterial infection of the middle ear caused by Streptococcus pneumoniae, Haemophilus influenzae, or Branhamella catarrhalis. Nearly half of all children will have had at least one episode of acute otitis media by 1 year of age, and over 70% by 3 years of age. The signs and symptoms include pain with rubbing or tugging at the ear, fever, irritability, lethargy, and hearing loss. The primary therapy for acute otitis media and otitis media with effusion is antibiotics with the goal of preventing possible complications and providing symptomatic relief. Amoxicillin remains the initial drug of choice in communities where beta-lactamase-producing strains of the common middle ear pathogens are infrequently isolated. If resistant organisms are prevalent, cefaclor, amoxicillin-clavulanate, or cotrimoxazole should be selected. Adjuvant agents such as decongestants have not been shown to provide additional therapeutic benefit. Children who develop chronic otitis media may require prophylactic antibiotic therapy and insertion of typanostomy tubes.
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PMID:Pharmacotherapy of otitis media. 186 12

Four hundred thirty-four febrile infants two months of age or younger were evaluated in the emergency departments of five major teaching hospitals over a one-year period. A culture-proven bacterial infection was present in 3.5% of the infants; bacteremia was detected in 3.3%. Bacterial meningitis was present in 2.4%, and aseptic meningitis was noted in 13.4%. Twenty-one percent had clinically apparent serious disease including pneumonia, otitis media, and gastroenteritis with dehydration. Six variables (age less than 1 month, lethargy, no contact with an ill individual, breast-feeding, total polymorphonuclear greater than or equal to 10,000/mm3 and band count greater than or equal to 500/mm3) were correlated with bacterial infection by step-wise discriminant analysis. However, these findings were neither sensitive nor specific enough to be clinically useful. Management varied, and 62% of the infants were hospitalized. Fifty-four percent, some of whom were managed as outpatients, received antibiotics. Febrile infants two months of age or younger require a comprehensive emergency department assessment, including appropriate laboratory studies (CBC, differential, urinalysis and culture, lumbar puncture, and blood culture), since 3.5% have bacterial infection that may be life-threatening. Hospitalization is warranted if the infant appears ill, laboratory studies indicate serious infection, or follow-up care is uncertain.
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PMID:Fever in infants less than two months of age: spectrum of disease and predictors of outcome. 384 82

Proventricular dilatation was diagnosed in 16 psittacine birds. Signs included anorexia, lethargy, weight loss, and intermittent vomiting. The proventriculus in all birds was thin-walled and impacted with ingesta and occupied most of the body cavity. Microscopic changes in the proventriculus varied from none to an infiltration of lymphocytes, macrophages, and heterophils. There was no evidence of viral or bacterial infection or lead toxicity.
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PMID:Proventricular dilatation syndrome in large psittacine birds. 638 50

A 2-phase study was conducted to evaluate the ability of the NEB-1 strain of porcine reproductive and respiratory syndrome virus (PRRSV) to potentiate common bacterial pathogens of swine. In phase I, 25 of 50 4-5-week-old specific-pathogen-free (SPF) pigs were exposed to NEB-1 PRRSV (day 0). Seven days after virus inoculation, 8 groups received 1 of 4 bacterial pathogens: Haemophilus parasuis, Streptococcus suis, Salmonella cholerasuis, and Pasteurella multocida. The ability of NEB-1 PRRSV to produce clinical disease, viremia, neutralizing antibody, gross and microscopic lesions and to potentiate bacterial pathogens was assessed. Response to NEB-1 PRRSV was similar among inoculated pigs; prolonged hyperthermia, lethargy, mild to moderate dyspnea, and cutaneous erythema were consistent clinical signs. No clinical differences were observed in groups after bacterial challenge. Virus was isolated from serum at weekly intervals through the end of the study, and all PRRSV-inoculated pigs had seroconverted by study termination. Two of 5 pigs died in non-PRRSV-inoculated groups challenged with H. parasuis and Streptococcus suis. Mortality in PRRSV-infected pigs was limited to 1 of 5 pigs from the Salmonella cholerasuis-challenged group. Gross lesions were seen in pigs dying after inoculation in H. parasuis- and Streptococcus suis-inoculated groups, in Salmonella cholerasuis- and P. multocida-challenged pigs, and in 1 non-PRRSV-inoculated control pig. Microscopic lesions consisted of mild to moderate proliferative interstitial pneumonia, nonsuppurative myocarditis, lymphoid hyperplasia, and nonsuppurative encephalitis in PRRSV-inoculated pigs. Findings in phase I indicated that NEB-1 PRRSV does not potentiate bacterial disease while inducing consistent clinical signs, viremia, seroconversion, and microscopic lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Porcine reproductive and respiratory syndrome: NEB-1 PRRSV infection did not potentiate bacterial pathogens. 757 44

Group B beta-hemolytic streptococci and Escherichia coli strains account for approximately two thirds of all cases of neonatal meningitis, while bacteria that typically account for meningitis in older age groups (Haemophilus influenzae type B, Neisseria meningitidis, and Streptococcus pneumoniae) are infrequent causes of meningitis in the neonatal population. As with other medical problems in neonates, signs and symptoms of bacterial infection of the central nervous system are generally few in number and nonspecific in nature. Manifestations that can suggest meningitis, as well as other serious illnesses, include temperature instability, lethargy, respiratory distress, poor feeding, vomiting, and diarrhea. Signs suggestive of meningeal irritation, including stiff neck, bulging fontanelle, convulsions, and opisthotonus, occur only in a minority of neonates with bacterial meningitis and cannot be relied on solely to identify such patients. Ampicillin and either gentamicin or cefotaxime are recommended for initial empiric therapy of neonatal meningitis. When the results of the cerebrospinal fluid (CSF) culture and susceptibilities are known, therapy can be narrowed to cover the specific pathogen identified. In general, penicillin G or ampicillin is preferred for group B streptococcal meningitis, ampicillin for Listeria monocytogenes meningitis, and ampicillin plus either an aminoglycoside or cefotaxime for gram-negative meningitis. For the very low birth weight neonate who has been in the nursery for a prolonged period of time, organisms such as enterococci and gentamicin-resistant gram-negative enteric bacilli must also be considered. In patients with long-term vascular catheters, Staphylococcus aureus or coagulase-negative staphylococci must also be considered. Empiric combinations of antibiotics for such patients would include ampicillin or vancomycin, plus amikacin or cefotaxime. All neonates should undergo repeat CSF examination and culture at 48 to 72 hours after initiation of therapy. If organisms are observed on gram stain, modification of the therapeutic regimen should be considered, and neuroimaging should be performed. In general, therapy should be continued for 14 to 21 days for neonatal meningitis caused by group B streptococci or L. monocytogenes, and for at least 21 days for disease caused by gram-negative enteric bacilli. All patients with neonatal meningitis should have hearing and development monitored serially. The first audiologic evaluation should occur 4 to 6 weeks after resolution of the meningitis.
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PMID:Meningitis in the Neonate. 1193 31

Hylesia metabus larvae are susceptible to several pathogens indigenous to the area in which they are found. Some larvae show symptoms characteristic of bacterial infection; they become flaccid and lethargic, and show a marked loss of appetite. We isolated and identified 29 bacterial strains from live, dead and experimentally infected H. metabus larvae, and evaluated their pathogenic activity. The bacteria which caused mortality in the larvae were: Pseudomonas aeruginosa (60-93.3%), Proteus vulgaris (20%), Alcaligenes faecalis, Planococcus sp. and Bacillus megaterium (10%), at doses of 3-4 x 10(7). Although P. aeruginosa is a well-known insect pathogen, this is the first report of its pathogenic activity on H. metabus. The potential risk to humans and low virulence make it unlikely that P. aeruginosa could be used in an augmentative biological control programme. However its natural incidence may be enhanced using parasites and predators of H. metabus as carriers.
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PMID:Pathogenic effects of bacteria isolated from larvae of Hylesia metabus Crammer (Lepidoptera: Saturniidae). 1223 36

Group A beta-hemolytic streptococcus and Staphylococcus aureus are the 2 most common pathogens implicated in secondary invasive bacterial disease after varicella. We describe a 3-month-old male infant from British Columbia, Canada, who presented on day 5 of varicella skin rash with fever, seizures, lethargy, and evidence of intracranial hypertension. A prominent subdural empyema was documented, and Streptococcus pyogenes was recovered from the subdural fluid. Central nervous system bacterial complications should be part of the differential diagnosis for infants and children with chickenpox who present with fever, lethargy, focal seizures, or similar neurologic findings. This case illustrates the importance of universal varicella vaccination to prevent associated bacterial complications of chickenpox.
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PMID:Group A streptococcal subdural empyema as a complication of varicella. 1562 62

In a population of spotted hyenas (Crocuta crocuta) monitored between 1996 and 2005 in the Ngorongoro Crater, Tanzania, 16 individuals from five of eight social groups displayed clinical signs of an infection, including severe unilateral swelling of the head followed by abscess formation at the mandibular angle, respiratory distress, mild ataxia, and lethargy. Two (12.5%) of these 16 individuals died within days of developing signs. Clinical signs in hyenas were first noted in 2001, and most cases occurred between September 2002 and February 2003, suggesting an outbreak of infection during this period. Histopathological examination of internal organs from one hyena that died with signs revealed morphological changes consistent with severe bacterial infection. Phenotypic examination and phylogenetic analysis of the 16S rRNA gene of the causative agent of infection revealed a Lancefield group C Streptococcus with a high level of homology to S. equi subsp. ruminatorum, a subspecies of S. equi recently described in domestic sheep (Ovis aries) and goats (Capra hircus) with mastitis in Spain. Strains similar to this bacterium were also isolated from two hyenas without obvious clinical signs, suggesting that hyenas may be 'carriers' of this bacterium, and from a sympatric Burchell's zebra (Equus burchelli), a herbivore species often consumed by hyenas. To our knowledge this is the first report of a Streptococcus infection in these two wildlife species. The high genetic similarity between the hyena and zebra isolates indicates that inter-specific transmission may occur, possibly when hyenas consume infected zebra carcasses.
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PMID:Severe Streptococcus infection in spotted hyenas in the Ngorongoro Crater, Tanzania. 1646 Aug 91

Bacterial infection shortly after mating interferes with establishment of pregnancy. Injection of peptidoglycan-polysaccharide (PG-PS), a component of gram-positive bacteria, into sheep on day 5 after mating reduces pregnancy rate. Experiments were designed to evaluate the acute-phase response (APR) in ewes to injection of PG-PS on day 5 after mating (day 0). Catheters were inserted into the jugular and posterior vena cava on day 4. On day 5, ewes were challenged with saline or 30 microg/kg body weight (BW) PG-PS (Exp 1) or 60 microg/kg BW PG-PS (Exp 2). Blood samples were collected every 15 min for 6 h (Exp 1) and every 15 min for 2 h, hourly for 12 h, and at 24, 36, and 48 h (Exp 2). Body temperature and clinical signs of infection were monitored in Exp 2. Plasma was assayed for concentrations of a pro-inflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha); 2 APR proteins, serum amyloid A (SAA) and haptoglobin (Hp); and progesterone (P(4)). Ewes injected with 60 microg/kg BW PG-PS exhibited fever, vaginal discharge, loss of appetite, and lethargy. After challenge with either 30 microg/kg or 60 microg/kg BW PG-PS, TNF-alpha increased in the posterior vena cava. Concentrations of SAA and Hp in the jugular increased after challenge with 60 microg/kg BW PG-PS. Only half (5/10) of the ewes treated with 60 microg/kg BW PG-PS had ultrasonically visible embryos, and none of them had functional corpora lutea (CL) (<1 ng/mL of P(4)) on day 21. On the other hand, 8/9 (88.9%) control ewes had visible embryos and all had functional CL on day 21. Using logistic regression, pregnancy on day 21 was predicted to depend on concentrations of TNF-alpha and Hp on day 5 and concentration of P(4) on day 14. In summary, injection of PG-PS on day 5 after mating resulted in fever; increased concentrations of TNF-alpha, Hp, and SAA on the day of and the day after the PG-PS challenge; and decreased concentrations of P(4) on days 14 and 21. These factors were related to failure to establish pregnancy.
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PMID:Tumor necrosis factor-alpha and acute-phase proteins in early pregnant ewes after challenge with peptidoglycan-polysaccharide. 2060 27


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