Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report on 17 Australian cases of human infection or colonization with Scedosporium inflatum. The spectrum of clinical manifestations was similar to that in infection caused by Scedosporium apiospermum. The patients were classified into three groups. Four immunocompetent patients who presented with localized infections of a joint, nail bed, eye, or sphenoidal sinus made up the first group. Our first case, in a boy with posttraumatic septic arthritis, responded to surgical drainage with amphotericin B followed by treatment with itraconazole. The other three cases were cured by surgery alone. The second group consisted of five immunocompromised patients who presented with disseminated infections in a variety of sites. Four of these patients did not respond to antifungal therapy and died. The fifth apparently responded to antifungal drugs after correction of his neutropenia. The third group included eight patients with asymptomatic colonization in the external ear (five cases) or respiratory secretions (three cases). The nine isolates of S. inflatum tested by both disk and agar dilution methods were resistant to antifungal drugs. In our first case, which responded clinically to itraconazole, the MIC of this drug for the fungal isolate was 25 micrograms/mL. Thus S. inflatum can cause a broad spectrum of human infections whose severity and prognosis depend largely on the host's immune status.
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PMID:Clinical features of human infection with Scedosporium inflatum. 153 93

We reviewed 75 outpatient cases of systemic infection due to group B beta-hemolytic streptococcus (GBS) evaluated during a 13-year period. Patient ages ranged from five days to eight months; 75% were younger than two months. Early-onset (less than or equal to seven days of age) GBS disease occurred in 10% of the patients, and late-onset GBS disease in 90%. The racial distribution was 60% black, 35% white, and 5% Hispanic. Symptoms included fever, irritability, lethargy, and altered-feeding pattern which lasted less than 24 hours in 88% of patients. On presentation, 33% were afebrile (eight had GBS meningitis); 32% did not appear ill (six had GBS meningitis). Of the total, 40% had GBS meningitis, of these, a greater proportion had either early-onset GBS disease or neutropenia. Infection other than meningitis was identified in 24% of all patients: pneumonia (six cases), cellulitis/adenitis (six cases), osteomyelitis/septic arthritis (five cases), and otitis media (one case). All patients survived. Systemic GBS infection in an outpatient population can involve infants up to eight months old, is more common in blacks than in whites, can be present without fever or compromised appearance, and usually has low mortality.
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PMID:Systemic infection due to group B beta-hemolytic streptococcus in children. A review of 75 outpatient-evaluated cases during 13 years. 156 97

Ceftriaxone has a very long serum half-life and enhanced in vitro activity against common pediatric pathogens. Therefore we evaluated the efficacy and safety of once daily ceftriaxone therapy in 57 children with serious infections including: meningitis (26 patients); ventriculitis (3); pyelonephritis (7); osteomyelitis (6); abscess (4); septic arthritis (3); sepsis (2); and miscellaneous infections (6). The most common isolates were Haemophilus influenzae (23), Escherichia coli (9) and Staphylococcus aureus (8). Ceftriaxone was given intravenously or intramuscularly in a dose of 50 mg/kg for non-central nervous system (CNS) infections. Patients with CNS infections received an initial dose of 100 mg/kg followed by 80 mg/kg 12 hours later and once daily thereafter. In a limited number of patients no major differences in serum ceftriaxone concentrations were found after intravenous or intramuscular injection. Of 57 patients with pathogens isolated 55 were completely cured; in one patient with Klebsiella pneumoniae ventriculitis, intraventricular gentamicin was briefly added to the regimen. Another patient with an anaerobic liver abscess recovered after metronidazole was administered. In three patients a delayed response to ceftriaxone was noted. One patient with previous recurrent infections had a second episode of H. influenzae meningitis 22 days after cessation of therapy. Clinical side effects were noted in 10 of 71 patients (including 14 treated patients who had negative cultures). Seven patients had diarrhea, one each had fever or rash and one had fever, rash and arthralgia. Laboratory side effects in 16 of 71 patients included eosinophilia (7), thrombocytosis (7), elevated liver enzymes (4) and leukopenia and neutropenia (2).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Once daily ceftriaxone for central nervous system infections and other serious pediatric infections. 372 39

The effectiveness of parenteral cefotaxime in the treatment of adults with acute septic arthritis or acute or chronic osteomyelitis was evaluated in a multicenter trial. The drug was given to 47 patients admitted to the University of Texas Medical Branch Hospitals or Hahnemann Medical College and Hospital (UT-H study) and to 40 patients in other medical centers using an identical protocol. In the UT-H study, cefotaxime was effective in 15 of 16 patients (94%) with acute osteomyelitis, in 24 of 27 patients (89%) with chronic osteomyelitis, and in four of four patients (100%) with acute septic arthritis. In the multicenter study, the success rates were as follows: acute osteomyelitis, six of six (100%); chronic osteomyelitis, 14 of 19 (74%); and septic arthritis, 12 of 15 (80%). The antibiotic was well tolerated in most patients. The most serious side effect was significant neutropenia, which occurred in three patients. Cefotaxime appears to be a clinically useful, broad-spectrum antibiotic for bone and joint infections.
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PMID:Cefotaxime treatment in patients with osteomyelitis and septic arthritis: a multicenter study. 629 13

Cefotaxime, a new cephalosporin, was evaluated for efficacy and safety in the treatment of 52 patients with serious bone and joint infections. For five of these patients therapy could not be evaluated. Diagnosis of osteomyelitis or septic arthritis was made on the basis of clinical and roentgenographic evidence of infection. The diagnosis of a bone infection was confirmed by either a positive culture of a bone biopsy or of blood in combination with a positive bone scan or roentgenogram. The diagnosis of a joint infection was confirmed by a positive culture of joint aspirate samples. Osteomyelitis was arrested in 93% (15 of 16 patients) of cases of acute osteomyelitis, 89% (24 of 27 patients) of cases of chronic osteomyelitis, and 100% (4 of 4 patients) of cases of septic arthritis. Follow-up ranged from 0-17 months after completion of cefotaxime therapy. Laboratory monitoring revealed positive direct Coombs' test (six patients), neutropenia less than 1,000 polymorphonuclear leukocytes (two patients), macular rash (two patients), phlebitis (two patients), and pseudomembranous colitis (one patient). It is concluded that cefotaxime is a useful and safe antibiotic for the treatment of osteomyelitis and septic arthritis.
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PMID:Cefotaxime therapy for patients with osteomyelitis and septic arthritis. 629 1

In disseminated candidiasis, various organs frequently become involved, usually as a consequence of hematogenous spread of the organism. However, involvement of the joints is rare even with dissemination. Nineteen cases of joint involvement have previously been reported in adults and 21 cases in children. The most commonly involved joint has been the knee; in such cases, amphotericin B has been effective in controlling the infection. Five patients with cancer developed septic arthritis due to Candida species at the M. C. Anderson Hospital and Tumor Institute in the past five years. Four of these patients were seen in 1980. Candida albicans was isolated from three patients and Candida tropicalis from two. All five patients had predisposing conditions - e.g., intravenous and/or urinary catheterization, neutropenia, and previous treatment with steroids and antibiotics. The knee was the affected joint in all five. Different modalities of treatment were used, including intravenous miconazole, oral ketoconazole, and systemic and local amphotericin B; adequate levels of these drugs were found in the joint fluid when measured. Infection was cured in two patients. The condition of the third patient improved. The fourth patient died of disseminated disease despite therapy, and the fifth died of malignancy without the benefit of antifungal therapy. For treatment of such infections, the use of an antifungal agent is recommended in addition to frequent evacuation of the joint fluid. Some new compounds may prove useful alternatives to amphotericin B. Arthritis can be resolved even in the presence of unresolved disseminated disease.
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PMID:Septic arthritis due to Candida species on patients with cancer: report of five cases and review of the literature. 695 Dec 37

Septic arthritis of the hip is uncommon in the school-age child. Presenting signs may be subtle and consequently may delay the diagnosis. This case report deals with a ten-year-old child who presented with an eight-day history of pain in the inner thigh associated with decreased range of motion of her hip, fever, and an inability to bear weight. Radiographic findings included demineralization of the femoral head. Initial laboratory findings showed leukocytosis and a sharply elevated Westergren sedimentation rate. Joint fluid Gram stain showed gram-positive cocci. Blood culture and joint culture grew Staphylococcus aureus. Therapy involved immediate operative drainage of purulent joint fluid, immobilization of the joint, and intravenous antibiotic therapy. Initial antibiotics were chosen based on synovial fluid Gram stain and the age of the patient. During therapy with antistaphylococcal penicillin, the patient developed a drug induced neutropenia.
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PMID:Septic hip in a child. 721 1

Thirty-two infants and children ranging in age from 3 to 151 months (mean, 26 months) were treated with parenteral cefoxitin (150 mg/kg per day). Ten patients with isolates of Haemophilus influenzae (six with cellulitis, two with arthritis, and two with mastoiditis), four with Staphylococcus aureus (one with lymphadenitis, one with septicemia, and two with abscess), and three patients with Streptococcus pneumoniae (one each with cellulitis, abscess, and arthritis), were clinically and bacteriologically cured by therapy. Two additional patients with septic arthritis and facial cellulitis developed meningitis with H. influenzae type b and S. pneumoniae, respectively. Minimal inhibitory and bactericidal concentrations were </=5 mug/ml for 15 isolates. Minimal bactericidal concentrations were >20 mug/ml for one strain of S. aureus and one of H. influenzae type b. The mean peak serum levels were 81.9 and 68.5 mug/ml 15 min after intravenous or intramuscular doses, respectively. The mean elimination half-lives were 42.4 and 40.1 min after intravenous or intramuscular doses, respectively. The mean volumes of distribution were 5,540 and 4,760 ml after intravenous and intramuscular doses, respectively. Mean plasma clearance was 242 and 257 ml/min per m(2) after intravenous and intramuscular doses, respectively. Therapy was discontinued in one patient because of neutropenia, which resolved after cefoxitin was stopped. Eosinophilia and transiently elevated liver function tests occurred in eight and six patients, respectively. These data indicate that cefoxitin may be an effective treatment for infections due to susceptible bacteria in the dosage tested, but its use may be limited because of the occurrence of meningitis during therapy in some patients.
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PMID:Clinical and pharmacokinetic evaluation of parental cefoxitin in infants and children. 739 56

Equine neonatal septicaemia was confirmed in 24 foals hospitalised at the Rural Veterinary Centre between 1989 and 1992 with suspected septicaemia. Septicaemia was confirmed by culture of bacteria from blood of live foals and tissues obtained at necropsy of foals that died or were euthanased. Pathogenic bacteria isolated were predominantly Enterobacteriaceae (including Escherichia coli and Salmonella serovars) and Actinobacillus equuli. Clinical manifestations of septicaemia included signs of depression, dehydration, abnormalities in body temperature and manifestations of localised infection including diarrhoea, pneumonia, and septic arthritis. Most common haematological abnormalities were neutropenia and increase of circulating band neutrophils. Survival rate of foals with confirmed septicaemia was 70.8%. Survival was found to be less likely in the presence of pneumonia, severe signs of depression, marked haematological changes or septic arthritis at the time of admission. Seven foals were confirmed to have septic arthritis without concurrent septicaemia. Of these, 4 had multiple joint involvement. Bacteria isolated from infected joints were predominantly Salmonella serovars. Four foals with septic arthritis failed to survive, due to multiple joint infection, which was unresponsive to treatment. The clinical and haematological abnormalities present in foals with confirmed septicaemia and septic arthritis were consistent with those observed in other studies. The bacterial isolates from foals with confirmed septicaemia were similar to those isolated in other studies. In contrast, the bacteria isolated from foals with septic arthritis without concurrent septicaemia were different from other studies.
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PMID:Equine neonatal septicaemia: 24 cases. 866 Feb 28

Within a 6-year period from January 1991 to December 1996, 19 patients with Salmonella choleraesuis bacteremia were enrolled for clinical and microbiological analysis. Young children, the elderly and patients with hematological malignancy (36.8%), liver cirrhosis (26.3%), systemic lupus erythematosus (10.5%), chronic renal impairment (10.5%), and peptic ulcer (10.5%) were at high risk of this infection. The ratio of male to female was 3:1. Three cases (15.8%) were nosocomially acquired. Fever (89.5%), chills (57.9%) and anorexia (52.6%) were the most common clinical manifestations. Seven patients (36.8%) presented no gastrointestinal manifestations. Normal white blood cell count was noted in seven patients (36.8%), and neutropenia caused by underlying diseases or severe infection was found in six cases (31.6%). Various types of metastatic focal infections were found, such as septic arthritis, cutaneous infection, spontaneous bacterial peritonitis, and pneumonia. The severe immunocompromised status of patients and the high virulence of this pathogen may contribute to the high case fatality rate (21%). Higher resistance rate to commonly used antimicrobial agents was noted in ampicillin (94.7%), chloramphenicol (89.5%), and TMP/SMZ (63.8%). All strains of S. choleraesuis were susceptible to third-generation cephalosporins and fluoroquinolones. Generally, S. choleraesuis bacteremia should be taken into account in the differential diagnosis of sepsis in immunocompromised patients, even without gastrointestinal manifestations. The third-generation cephalosporins and fluoroquinolones may be the first choice for treatment of this invasive infections.
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PMID:Salmonella choleraesuis bacteremia in southern Taiwan. 1033 Jul 99


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