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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective study of Streptococcus pneumoniae bacteraemia among adult patients in two large teaching hospitals in Spain identified 108 (10.6%) of 1,020 episodes as nosocomial pneumococcal bloodstream infections (NPBIs). Seventy-seven clinical records with sufficient data were available for analysis. The interval between admission and a positive blood culture was 3--135 days (median 17 days; interquartile range 8--27). The main underlying and predisposing conditions for NPBI were malignancy (31%), chronic obstructive pulmonary disease (28.6%), heart failure (16.9%), chronic renal failure (15.6%), liver cirrhosis (13%) and infection with human immunodeficiency virus (13%). Overall, 31.2% of patients developed severe sepsis, 11.7% septic shock, and 3.9% multi-organ failure. The main portals of entry were pneumonia (70.1%), meningitis (5.2%) and primary peritonitis (5.2%). Of the responsible serogroups, 78% were included in the 23-valent polysaccharide vaccine. Thirty-five (45.5%) patients died, with death considered to be related to the NPBI in 21 (27.3%) cases. Following multivariate analysis, factors that independently predicted death after adjusting for age were: ultimately fatal underlying disease (OR, 8.9; 95% CI, 0.8--94.3; p<0.001); rapidly fatal underlying disease (OR, 15.0; 95% CI, 2.8--81.3; p<0.001); heart failure (OR, 8.11; 95% CI, 1.1--60.8; p<0.03); inadequate empirical therapy (OR, 10.6; 95% CI, 1.2--97; p<0.003); a severe sepsis score (OR, 9.5; 95% CI, 1.9--47.0; p<0.001); and septic shock or multi-organ failure (OR, 63.7; 95% CI, 4.9--820.7; p<0.001). Adequate empirical therapy was an independent protective factor (OR, 0.05; 95% CI, 0.04--0.58; p<0.005), but the use of more than one antimicrobial agent was not.
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PMID:Nosocomial bloodstream infections caused by Streptococcus pneumoniae. 1621 9

Schimke immuno-osseous dysplasia is a rare autosomal recessive multi-system disorder, with clinical features of growth retardation, spondylo-epiphyseal dysplasia, nephrotic syndrome and immunodeficiency beginning in childhood. Here, we report a new case, in a 10-year-old boy with characteristic symptoms of Schimke immuno-osseous dysplasia. The patient presented with short stature and, later, developed nephrotic syndrome and peritonitis. In addition, he had perinuclear anti-neutrophilic cytoplasmic antibody (p-ANCA)-positive arthritis. Renal pathology of the patients with this disease usually show focal segmental glomerulonephritis, whereas our patient had membranous nephropathy, which has not previously been reported.
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PMID:Membranous nephropathy in Schimke immuno-osseous dysplasia. 1657 Feb 1

In cats, primary or secondary immune-mediated thrombocytopenia have rarely been described or characterised. The objective of this study was to determine platelet-bound antibodies (PBA) by a flow cytometric assay in both healthy and thrombocytopenic cats. Direct PBA testing was performed in 42 thrombocytopenic cats (platelet counts 6-179 x 10(9)/l, median 56 x 10(9)/l). Of these 42 cats, 19 had positive PBA test results, 17 of which were considered to have secondary immune-mediated thrombocytopenia (sITP). Underlying diseases included fat necroses (four cases), feline infectious peritonitis (three), feline leukaemia virus (two) or feline immunodeficiency virus (two) infections, lymphoma (two), leukaemia (one), hepatitis (one), pyelonephritis (one), or hyperthyroidism (one). In two cats, no underlying disease was found suggesting a primary immune-mediated thrombocytopenia (pITP). The PBA test was negative in 23 cats diagnosed with varying underlying diseases and in 47 healthy control cats with platelet values within the reference range. Only seven of the 42 cats with thrombocytopenia (platelet count 10-57 x 10(9)/l, median 34 x 10(9)/l) had spontaneous bleeding. This study suggests that immune-mediated destruction of platelets might be an important pathological mechanism for feline thrombocytopenia caused by various underlying diseases. In cats, pITP appears to be rarely diagnosed.
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PMID:Platelet-bound antibodies detected by a flow cytometric assay in cats with thrombocytopenia. 1661 69

Various semisynthetic derivatives of glycopeptide antibiotics including vancomycin, eremomycin, teicoplanin, ristocetin A and DA-40926 have been evaluated for their inhibitory activity against feline infectious peritonitis virus (FIPV) and human (SARS-CoV, Frankfurt-1 strain) coronavirus in cell culture in comparison with their activity against human immunodeficiency virus (HIV). Several glycopeptide derivatives modified with hydrophobic substituents showed selective antiviral activity. For the most active compounds, the 50% effective concentrations (EC(50)) were in the lower micromolar range. In general, removal of the carbohydrate parts of the molecules did not affect the antiviral activity of the compounds. Some compounds showed inhibitory activity against both, whereas other compounds proved inhibitory to either, FIPV or SARS-CoV. There was no close correlation between the EC(50) values of the glycopeptide derivatives for FIPV or SARS-CoV.
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PMID:Inhibition of feline (FIPV) and human (SARS) coronavirus by semisynthetic derivatives of glycopeptide antibiotics. 1667 38

Nocardiosis is an opportunistic infection especially in patients with underlying chronic debilitating disease or immunodeficiency. Nocardia peritonitis is an uncommon infection in peritoneal dialysis patients. Here, we report a case of peritonitis by Nocardia asteroides during automated peritoneal dialysis in a 35-year-old male patient who had prolonged immunosuppressive therapy to treat acute rejection of a nonfunctioning kidney allograft. The patient presented at our outpatient clinic with typical symptoms of acute peritonitis. The peritoneal fluid leukocyte count was 20,500 cells/microL, with 90% neutrophils. Gram staining showed gram-positive filamentous bacilli later identified as N. asteroides. After bacterial identification, the patient received trimethoprim 320 mg and sulfamethoxazole 3200 mg intravenously every 48 hours (TMP-SMX), plus amikacin 100 mg intraperitoneally daily. The immunosuppressive therapy was reduced. Peritoneal fluid cultures became negative after 1 week of treatment, concomitant with clinical improvement. Unfortunately, after 5 weeks of therapy, the patient developed hematologic side effects attributable to the TMP-SMX treatment. The TMP-SMX was suspended at that time, and the patient then received cefuroxime 500 mg by mouth and amikacin 100 mg intraperitoneally daily for a total of 12 weeks. The patient recovered completely and was discharged 3 months after onset of the peritonitis. Prolonged antibiotic therapy without catheter removal has not been previously described in immunosuppressed patients with APD peritonitis. The combination of amikacin and TMP-SMX may be safe and effective in APD patients who develop N. asteroides peritonitis.
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PMID:Successful treatment of Nocardia asteroides peritonitis in a patient undergoing automated peritoneal dialysis and receiving immunosuppressive therapy. 1668 87

Human immunodeficiency virus (HIV)-related renal disease is the third-leading cause of end-stage renal disease (ESRD) among African Americans aged 20-64 years. The number of HIV-infected (HIV+) patients reaching ESRD will increase exponentially over the next decade. Because of significant improvements in therapy and management during the last ten years, survival of HIV+ patients has improved. The survival experience of very long-term HIV+ peritoneal dialysis (PD) patients remains to be investigated. The objective of the present study was to examine the important differences in clinical and laboratory parameters between HIV+ and HIV-negative (HIV-) PD patients. To assess the factors associated with better survival in HIV+ PD patients, we retrospectively reviewed the charts of 488 PD patients, including 53 HIV+ patients, for the period 1987 to September 2004. We collected demographic, clinical, and laboratory data, including CD4 cell counts and history of hospitalizations and peritonitis. Maximum survival of HIV+ PD patients was 12.5 years as compared with 15.87 years in HIV-patients. Not surprisingly, HIV was a strong independent predictor of mortality in PD patients [relative risk (RR) = 3.09, p < 0.0001]. In HIV+ patients, higher CD4 counts at the initiation of dialysis were strongly associated with better survival (RR = 0.10 and p < 0.0001, > or =200 cells/mm3 vs. < or =50 cells/mm3). In univariate analysis, use of highly active antiretroviral therapy (HAART) was associated with significantly improved survival in HIV+ PD patients. Patients treated with I or 2 drugs had a 4.3-times higher mortality risk than those who received HAART therapy (p = 0.012). Independent associations were seen between HIV and younger age, African American race, male sex, and lower serum albumin. The rates of hospitalization (p < 0.0001) and peritonitis (p < 0.01) were significantly higher in HIV+ patients than in HIV-patients. Very long-term survival of HIV+ patients with chronic renal failure is possible on PD therapy. Morbidity and mortality of these patients may be improved with HAART therapy, better nutrition, and treatment of peritonitis.
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PMID:Survival experience of peritoneal dialysis patients with human immunodeficiency virus: a 17-year retrospective study. 1668 10

We report a case of primary pneumococcal peritonitis in a 28-year old previously healthy woman. There are no previously reported associations between this rare form of spontaneous peritonitis and HIV infection, and it is usually associated with underlying cirrhosis, ascites or other immune compromise. In this case this was the presenting illness of HIV infection. When atypical infections such as this arise in previously healthy adults the clinician must have a high index of suspicion of HIV or other underlying immunodeficiency.
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PMID:Primary pneumococcal peritonitis as a presenting feature of HIV infection. 1706 86

Serum samples from 14 lions (Panthera leo) from Queen Elizabeth National Park, Uganda, were collected during 1998 and 1999 to determine infectious disease exposure in this threatened population. Sera were analyzed for antibodies against feline immunodeficiency virus (FIV), feline calicivirus (FCV), feline herpesvirus 1 (feline rhinotracheitis: FHV1), feline/canine parvovirus (FPV/CPV), feline infectious peritonitis virus (feline coronavirus: FIPV), and canine distemper virus (CDV) or for the presence of feline leukemia virus (FeLV) antigens. Ten lions (71%) had antibodies against FIV, 11 (79%) had antibodies against CDV, 11 (79%) had antibodies against FCV, nine (64%) had antibodies against FHV1, and five (36%) had antibodies against FPV. Two of the 11 CDV-seropositive lions were subadults, indicating recent exposure of this population to CDV or a CDV-like virus. No lions had evidence of exposure to FeLV or FIPV. These results indicate that this endangered population has extensive exposure to common feline and canine viruses.
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PMID:A serosurvey of viral infections in lions (Panthera leo), from Queen Elizabeth National Park, Uganda. 1709

Immune reconstitution inflammatory syndrome (IRIS) is particularly observed after the start of therapy for pathogenic antigens in patients infected with human immunodeficiency virus (HIV) and receiving highly active antiretroviral therapy (HAART). Although tuberculosis (TB)-associated IRIS is the most common form, its presentation as a primary feature of acute peritonitis is extraordinarily rare. We report a 43-year-old man diagnosed with acquired immunodeficiency syndrome and pulmonary TB coinfection. His symptoms, sputum quantity, and chest radiologic appearance improved markedly after 3 weeks of antituberculous therapy, and HAART was initiated on the fourth week. However, acute abdomen with peritoneal signs resulting from the established tuberculous peritonitis developed on the seventh day of HAART. His clinical symptoms resolved after maintenance of HAART and antituberculous regimens. Tuberculous peritonitis must be considered in the differential diagnosis of acute abdomen in HIV-infected patients on antiviral therapy, especially in patients with known underlying TB. Early recognition of IRIS is important when managing HIV-infected patients with opportunistic infections.
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PMID:Acute peritonitis as presentations of tuberculosis-associated immune reconstitution inflammatory syndrome in an HIV-infected man. 1848 Jun 57

Since the outbreak of human immunodeficiency virus (HIV) infection, extrapulmonary tuberculosis has become increasingly frequent in developing countries. The purpose of this report is to describe a case of isolated tuberculosis of the appendix diagnosed following generalized peritonitis in a 53-year-old man. The appendix is the least frequent gastrointestinal location of isolated tuberculosis. Diagnosis was achieved by histopathological examination of the appendix immersed in formalin 10% after appendectomy. Paraffin-embedded histological sections stained with hematoxylin-eosin (HE) displayed caseofollicular lesions characteristic of infection by Koch bacillus. Outcome was favourable with a 9-month regimen of antituberculosis treatment according to the protocol of the World Health Organization (WHO).
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PMID:[A case of isolated tuberculosis of the appendix at the University Hospital Center in Brazzaville, Congo]. 1868 24


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