Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

A 7-year-old female buffalo (Bubalus bubalis) from a local herd in Serres, northern Greece, was presented to a private veterinary clinic with a chronic loss of appetite for 15 days. The clinical examination revealed high fever (41.5 degrees C), lethargy, yellow discoloration of skin and mucous membranes, an abdomen that appeared to be empty, hyperactive rumen motility, and tachypnea. A biochemical profile revealed an elevated total bilirubin concentration and hepatic enzyme activities, whereas globulin, creatinine, and glucose concentrations were within the reference intervals. The animal received a 12-day course of treatment with intramuscular administration of ampicillin and corticosteroids. However, no significant clinical improvement was achieved, and the buffalo was euthanized. Gross necropsy lesions included serous atrophy of adipose tissue and hepatomegaly. Microscopic lesions included necrotizing pyogranulomatous hepatitis with thrombosis, hemorrhages, edema, and fibrosis. Small, nonpigmented, bacterial colonies were harvested in pure culture from the liver and were confirmed as Stenotrophomonas maltophilia by polymerase chain reaction. The bacterium was sensitive to ciprofloxacin, enrofloxacin, colistin, polymyxin, trimethoprim/sulfamethaxazole, and chloramphenicol. In contrast, resistance to ticarcillin, piperacillin, imipenem, ceftazidime, amikacin, gentamicin, tobramycin, and tetracycline was displayed. The bacterial strain carried the L1 metallo-beta-lactamase (L1) and tet35 genes, which contribute to high-level resistance to beta-lactams and tetracycline, respectively. Although S. maltophilia is widely believed to be a contaminant, the present report suggests that the isolation, identification, and susceptibility testing of this multidrug-resistant bacterium may be of clinical importance in diagnostic samples.
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PMID:Stenotrophomonas maltophilia as a causal agent of pyogranulomatous hepatitis in a buffalo (Bubalus bubalis). 2080 41

We describe the successful medical management of an infected aorto-bi-Iliac endograft. In this case report, we provide an example of a patient with an infected aorto-bi-iliac endograft and how appropriate medical management may result in a positive outcome. We report a case of a 67-year-old man with several medical comorbidities who developed aorto-bi-iliac endograft infection one year after graft placement. The patient presented to our E.R. with fever, lethargy, tachycardia, tachypnea, and hypotension. The diagnosis of an infected endograft was established after excluding any other possible source of infection plus the strong radiological evidence by computed tomographic scan and WBCs labeled Indium-111 tropolone scan. Blood cultures revealed the development of Eggerthella lenta, Escherichia coli Extended-spectrum beta-lactamase (ESBL), and Enterococcus Faecalis. To our knowledge, this is a rare case of an infected endograft and bacteremia due to Eggerthella lenta. After the administration of vancomycin and Meropenem, no improvements were noted to the patient's clinical condition. However, upon the administration of Tigecycline, the patient's clinical condition improved. Two days later, repeat blood cultures were negative. After completion of the course of antibiotics and stabilization of other comorbidities, the patient was discharged home with long term antibiotic therapy under close control of inflammation markers.
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PMID:A rare case of an infected aortoiliac graft complicated with Eggerthella lenta bacteremia and septic shock. 3323 81