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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study describes the results of examination of blood cultures from infants born in a community with a high prevalence of fatal amniotic fluid infection. The incidence of first-week neonatal septicaemia was 5.5 per 1000 births. Septicaemia was detected in 38% within 12 hours and 75.6% within 72 hours of birth. The aetiological pattern of the septicaemia was similar to that of fatal amniotic fluid infections. The increase in mortality from septicaemia occurred in infants born after 34 weeks of gestation. Nearly 80% of the infections apparently occurred through intact membranes. Respiratory distress with or without radiological evidence of pneumonia was the only manifestation of septicaemia in most infants under four days of age. Low Apgar scores and multiple apnoeic episodes were more common in infants with septicaemia than in those without septicaemia. Neonatal jaundice with serum bilirubin in excess of 11 mg/dl was more common in septicaemic infants and indicated poor prognosis. Meningitis associated with septicaemia occurred in 3.8% and in all these infants the diagnosis of septicaemia was delayed beyond 72 hours. The results suggest that early recognition and treatment of antenatal bacterial infections may prevent mortality and morbidity from complications of septicaemia such as neonatal apnoea, meningitis and bilirubin encephalopathy.
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PMID:Consequences of amniotic fluid infections: early neonatal septicaemia. 26 66

Fifty-three infants and children, aged three months to 15 years, were treated with an average daily dose of 100 mg of cefamandole/kg intravenously. Of these patients, 47 had soft tissue cellulitis and six had pneumonia. Primary pathogens, including Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Haemophilus influenzae, were isolated from 43 of the 53 patients. Bacteremia was documented in six of the 53 patients. A satisfactory clinical and bacteriologic response to cefamandole was achieved in all cases except on (98%). The only treatment failure occurred in an infant with both periorbital cellulitis and bacteremia due to H. influenzae who developed meningitis while receiving cefamandole; no extravasation of the drug across the blood-brain barrier could be detected in spite of inflamed meninges. In general, the only aberrant effects of cefamandole were the appearance of eosinophilia in 28% of patients and a positive indirect Cooms' test without hemolysis in one patient. Cefamandole showed excellent in vitro activity against 87 ampicillin-resistant strains of H. influenzae. Because it has greater activity than any of the other cephalosporins against this important pediatric pathogen, cefamandole may have particular pertinence in the treatment of infections in infants and young children.
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PMID:Clinical and laboratory evaluation of cefamandole in infants and children. 30 2

During a 14-year period there were 65 cases of pneumonia caused by Haemophilus influenzae b; 83% were children less than 2 years of age and 80% of illness occurred in winter and spring. The roentgenographic picture was consolidative pneumonia in 75% and pleural effusions were present in 75% of all cases. Ten patients had associated meningitis and three had purulent pericarditis. Otitis media was diagnosed in 43% and H influenzae b was isolated from eight middle ear aspirates. Three patients (5%) died. Recommendations for diagnosis and treatment are made.
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PMID:Report of 65 cases of Haemophilus influenzae b pneumonia. 31 22

Children not initially admitted to the hospital accounted for 42 of 94 episodes of bacteremia due to Haemophilus influenzae. Antibiotics were prescribed for 22 of the 42 children who were initially sent home; at second visit, 17 were improved, including all 13 with pneumonia. No antibiotics were prescribed for 20 children; at second visit, 15 had persistent fever or new focal infection and five had resolution of symptoms. New diagnoses of focal infection were made at second visit in three of the 22 treated and in 11 of the 20 untreated children, including three who had a new diagnosis of meningitis (one treated with antibiotics initially; two not treated). Cultures of blood positive for H. influenzae were obtained at second visit in ten children who were not treated initially; no child who was treated initially had a second positive culture. These findings indicate that although young children with bacteremia due to H. influenzae may be mildly ill at first visit, many are at risk for development of serious focal infection, including meningitis.
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PMID:Unsuspected bacteremia due to Haemophilus influenzae: outcome in children not initially admitted to hospital. 31 72

Pneumonia is one of the most serious infections in the neonate and is responsible for a large percentage of neonatal mortality. Pneumonia in a premature or term infant who is debilitated by an underlying problem such as hyaline membrane disease carries an extremely high morbidity and mortality. Since most of the bacterial pneumonias are treatable, early recognition and diagnosis and vigorous treatment are essential. X-ray findings, though helpful, serve only as a guideline. Prognosis is adversely affected if pneumonia results in generalized sepsis, leading to meningitis, disseminated intravascular coagulation, and osteomyelitis. Prompt antibiotic treatment should be begun before the etiologic agent or drug susceptibility is known.
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PMID:Acute pneumonia in the newborn: changing picture. 32 96

Quantitative blood cultures were sought in 383 children, from whom routine blood cultures were obtained because of fever, by direct plating of 10 and 100 microliter blood onto solidified media. There were 14 positive cultures from 12 patients. These were 7 Hemophilus influenzae type b, 5 Streptococcus penumoniae, and 2 Staphylococcus aureus. The direct-plating technique permitted more rapid identification of positive cultures, and detected three episodes not identified by routine broth culture. Bacterial counts ranged from 20 to greater than 10(4) bacteria/ml blood. In the three cases of H. influenzae type b meningitis, bacteremia exceeded 10(3)/ml. Among nine patients in whom bacteremia was unassociated with meningitis, (bacteremia without evident localized disease 5, pneumonia 2, epiglottitis 1, peritonitis 1), bacteremia was less than 10(3)/ml. This technique may aid detection of bacteremia and help identify those children at highest risk for developing septic complications, such as meningitis.
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PMID:Detection and quantitation of bacteremia in childhood. 33 75

8 newborns with early onset group B streptococcal infection and two patients with late onset meningitis were observed during a period of three years. Respiratory distress, early onset of apnoic spells, and roentgenographic signs of hyaline membrane disease or perinatal pneumonia may lead to early diagnosis, especially if shock develops. The fatal course can only be prevented by prompt antibiotic treatment.
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PMID:Group B streptococci: a new threat to the newborn. 33 49

Cefamandole nafate was effective in the treatment of a variety of infections caused by Staphylococcus aureus, Streptococcus pyogenes group A, Streptococcus pneumoniae, and Haemophilus influenzae in infants and children. The infections included periorbital cellulitis and ethmoiditis, bacteremia, cellulitis, pneumonia, and lymphadenitis. In vitro, cefamandole was effective in inhibiting the growth of H. influenzae isolated from blood or cerebrospinal fluid of patients with meningitis or sepsis. In two patients rash developed and cefamandole was discontinued. Other significant adverse effects were not noted.
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PMID:Clinical and laboratory investigation of cefamandole therapy of infections in infants and children. 34 94

We conducted a prospective, randomized, double-blind comparison of intravenous penicillin and cefamandole in the therapy of pneumococcal pneumonia. Patients received either 1 g of cefamandole or 600,000 U of aqueous penicillin G every 6 h. Of the 100 patients entered into the study, 96 had clinical and radiographic evidence of pneumonia. Microbial etiology was determined from the results of sputum and blood cultures and/or sputum Gram stains. Streptococcus pneumoniae was pathogenic in 49 patients, of whom 24 received cefamandole and 25 received penicillin. There was no statistically significant difference in the response or cure rate. Of the 100 patients, 93 were treated for 3 days or more and were evaluated for adverse effects and toxicity. There was no significant difference between cefamandole-treated and pencillin-treated patients in the incidence of colonization, superinfection, phlebitis, thrombocytosis, decrease in hematocrit, or elevated liver function tests. Eosinophilia occurred more frequently in patients treated with penicillin (20 of 42) than in those treated with cefamandole (11 of 42 (chi square, P < 0.05). Only one patient receiving cefamandole developed a positive direct Coombs test. No patient in either group developed meningitis. We conclude that, with the doses and route of administration employed in this study, cefamandole is as effective as penicillin in the therapy of pneumococcal pneumonia without an increased incidence of colonization, superinfection, or adverse effects.
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PMID:Double-blind comparison of cefamandole and penicillin in pneumococcal pneumonia. 35 24

Sixteen cases of group B streptococcal (GBS) infections in neonates and infants aged up to 3 months were detected from November 1973 to January 1977. Three patients presented with pneumonia, 10 with meningitis and 3 with both pneumonia and meningitis. All diagnoses were confirmed by positive blood and/or cerebrospinal fluid cultures. The serotypes involved were type Ia (2 cases), type II (4 cases) and type III (10 cases). Ten patients died (62.5%). Early antibiotic treatment did not appear to affect the outcome, but low peripheral leucocyte count indicated a uniformly fatal outcome in 6 cases where leucopenia was documented, and this appeared to be associated with late-onset disease. The current status of GBS disease is presented, with particular reference to the control measures at present available and the possibility of immunotherapy and vaccination.
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PMID:Group B streptococcal infections in neonates and infants. Report of 16 cases, with referrence to the fatal outcome in late-onset leucopenic cases. 35 31


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