Gene/Protein Disease Symptom Drug Enzyme Compound
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 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight cases of invasive group A streptococcal disease in young children were reported over a three-month period, February to April 1990. The spectrum of clinical disease included: pneumonia with bacteremia (two patients), osteomyelitis/septic arthritis (three patients), epiglottitis/supraglottitis (two patients), and sepsis without a focus (one patient). Three cases followed chicken pox. Three children were in shock at the time of presentation, including one child who had a toxic shock-like appearance. Only four children had pharyngitis. Bacteremia was confirmed in three children and presumed in another three. All the subjects survived. Four isolates of group A streptococci were tested for exotoxin A, B, and C (A-0, B-4, C-1) production. These data confirm the reappearance of a highly invasive strain of group A streptococci capable of producing a variety of clinical diseases, including bacteremia and shock, in a significant proportion of victims.
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PMID:Emergence of invasive group A streptococcal disease among young children. 139 66

Haemophilus influenzae type b is responsible for an estimated 15,000 to 20,000 cases of meningitis per year in the United States, mainly in children 2 months to 5 years old. The mortality rate from meningitis due to H influenzae type b infections ranges from 5% to 10%. Despite antibiotic treatment, up to 35% of survivors have permanent neurologic sequelae. In addition to meningitis, H. influenzae type b is responsible for other invasive infections, including epiglottitis, septicemia, cellulitis, septic arthritis, osteomyelitis, pneumonia, pericarditis, and otitis media; approximately 30,000 cases H influenzae diseases occur annually in the United States. The diseases peak in incidence between 6 and 12 months of age, with almost one half of the cases occurring before 1 year of age. About 75% of disease caused by H influenzae type b occurs in children younger than 24 months old. The incidence of disease is higher in children of certain groups, including blacks, Hispanics, Eskimos and Native Americans, young children attending day-care facilities, patients with asplenia or antibody-deficiency syndromes, and children of lower socioeconomic status. There is considerable evidence that antibody to the capsular polysaccharide (polyribosylribitol-phosphate [PRP] of H influenzae type b is protective.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunogenicity of a new Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) (PedvaxHIB). 210 17

Haemophilus influenzae is a gram-negative rod, causing severe infections in childhood, including meningitis, sepsis, epiglottits, pneumonia and otitis. Most of the invasive infections are due to serotype b. Since ampicillin-resistance is increasing, modern cephalosporines like cefotaxime and ceftriaxone are the antibiotics of choice in severe disease. Bacterial meningitis due to Haemophilus influenzae and epiglottitis are both still life-threatening diseases with a lethality of 5% to 25%, and there are severe sequelae in 35% of meningitis cases. Efforts have been made to develop efficacious vaccines. While immunogenicity of type b polysaccharide was low in the high-risk age (below 18 months), conjugated vaccines with either diphtheria-toxoid or Neisseria meningitis outer membrane protein and the Hib polysaccharide were found to be strongly immunogenic even in the first months of life. These vaccines show every few side-effects and can easily be combined with other immunizations such as DPT and DT. Thus, the incidence of invasive infections due to Haemophilus influenzae type b might decline in future.
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PMID:[Haemophilus influenzae type B. Disease and prevention]. 219 58

Five cases of bacteremic infections due to Haemophilus influenzae type f in adults are described, and previous reports of type f disease in nonpediatric patients are reviewed. Respiratory tract infections were most common in our series (two cases of pneumonia, one of epiglottitis, and one of nosocomial septicemia probably resulting from aspiration pneumonitis). All of these patients had factors predisposing them to respiratory tract infections, e.g., neurologic disease, congestive heart failure, or cigarette smoking. A fifth patient, who was bacteremic without an apparent primary focus, had dysgammaglobulinemia. Six episodes of bacteremia occurred in five patients; 11 of 13 cultures of blood obtained before parenteral antibiotic therapy were positive. All isolates were biotype I and susceptible to ampicillin. Antibiotic therapy was curative in cases of proved respiratory tract infection but failed in the setting of nosocomial septicemia, perhaps because of delayed initiation. The brevity of antibiotic treatment of the cryptogenic bacteremia permitted infection of a prosthetic vascular graft and recurrent bacteremia. Graft removal and repeated antibiotic therapy were curative.
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PMID:Bacteremic disease due to Haemophilus influenzae capsular type f in adults: report of five cases and review. 220 Oct 66

A prospective nationwide surveillance of invasive Haemophilus influenzae type b disease among adults (greater than or equal to 16 years old) was conducted in Finland during 1985 through 1988. Thirty-one cases were identified (annual incidence, 0.22/100,000). Of these infections, 71% occurred in patients with severe underlying conditions. The overall case fatality rate was 26%. Septicemia (13 patients) and pneumonia (seven patients) were the most common clinical manifestations of H influenzae type b infection; the others were epiglottitis (six patients), meningitis (three patients), and arthritis (two patients). Epiglottitis occurred in significantly younger patients, all of whom were women and four of whom were previously healthy. Subtyping of the H influenzae type b isolates according to the major outer membrane protein subtype, biotype, and lipopolysaccharide serotype showed that patterns that were uncommon (14%) among children were more common (27%) in the adults.
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PMID:Spectrum of invasive Haemophilus influenzae type b disease in adults. 224 74

On the basis of intensified surveillance in Finland we report the epidemiology of invasive Haemophilus influenzae type b disease based on 333 consecutive culture-proved cases recorded during 1985 and 1986. The annual incidence rate among children younger than 5 years of age was 52/100,000; 46% of patients had meningitis, 29% had epiglottitis and 25% had other forms of invasive disease. The median age of patients was 27 months, with 45% younger than 2 years of age. Meningitis and epiglottitis were found more often among boys than among girls, whereas the opposite was found among patients with other types of invasive disease (P = 0.015). Among the latter 68% of children with pneumonia or septicemia were 2 years or older compared with 32% of patients with arthritis, cellulitis or pyelonephritis (P = 0.009). These background data are essential for correct interpretation and application of results from trials with H. influenzae type b conjugate vaccines that are currently ongoing in Finland.
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PMID:Epidemiology of invasive Haemophilus influenzae type b disease among children in Finland before vaccination with Haemophilus influenzae type b conjugate vaccine. 265 19

The spectrum of severe Haemophilus influenzae type b disease exclusive of meningitis includes: epiglottitis, pneumonia, arthritis, septicemia, cellulitis and pericarditis. The results of a 7 year-epidemiologic study (Jan 1980 to Dec 1986) performed in 2 French departments are reported. Sixty-nine cases were detected, representing a yearly rate of 9/100,000 children aged 0 to 4 years. The real incidence is probably higher and was estimated as 11/100,000. In all of France, it corresponds to 382 annual cases and, more specifically to 60 to 70 annual cases of epiglottitis. No deaths were recorded and only 2 cases with minor sequelae were documented in this series. These results, as compared with those of previous studies, show that the incidence is lower than that in other countries, especially with regard to epiglottitis which is more frequent in North America and in Scandinavian countries.
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PMID:[Epidemiology of Haemophilus influenzae type b infections (excluding meningitis) in 2 French departments]. 278 12

The case records of 258 children with adenovirus; influenza A or B virus; parainfluenza 1, 2, or 3 virus; or respiratory syncytial virus infections were studied retrospectively with special attention to the degree and duration of fever. A temperature of 39.0 degrees C or higher was most frequently recorded in adenovirus, influenza A, and influenza B virus infections (in 68%, 84%, and 65%, respectively). The mean highest degree of fever in respiratory virus infections (39.2 degrees C +/- 0.6 degrees C) during hospitalization did not differ from that in defined serious bacterial infections, ie, meningitis, epiglottitis, sepsis, and urinary tract infections (39.3 degrees C +/- 0.7 degrees C). The mean duration of fever varied from 2.5 days (parainfluenza 2) to 5.2 days (influenza B). Of all children with respiratory virus infections, 37% had fever lasting five days or longer. The data show that high and prolonged fever is frequently associated with respiratory virus infections in hospitalized children and that it does not differ significantly from fever in severe bacterial infections.
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PMID:Fever in respiratory virus infections. 302 Sep 65

The choice of treatment, the importance of chemoprophylaxis in household contacts and the potential impact of immunization with vaccines against Haemophilus influenzae type b (Hib) currently under investigation are discussed on the basis of the patients hospitalized for invasive Hib infections at the University Children's Hospital Geneva from 1976 to 1985. Among 122 culture-proven infections due to Hib, there were 41% of cases of meningitis, 37.7% of epiglottitis, 9.8% of pneumonia, 5.7% of septicemia, 3.3% of cellulitis and 2.4% of septic arthritis. From 1981 to 1983, one strain of Hib produced beta-lactamase, but between 1984 and 1985, 5 strains (19.2%) produced beta-lactamase. Only one case of possible horizontal transmission of the infection was found in this 10-year period. We conclude that 1. the appearance of beta-lactamase producing strains of Hib requires that treatment be initiated with an antimicrobial agent resistant to beta-lactamase when a Hib infection is suspected; 2. in our region, only one case of an invasive Hib infection could theoretically have been prevented by chemoprophylaxis; and 3. the calculated theoretical impact of vaccination with the new types of vaccines against Hib could have prevented 106 of 122 cases of invasive Hib infections.
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PMID:[Systemic infections due to type b Haemophilus influenzae. A retrospective study of 114 cases]. 326 4

The value of quantitatively determined C-reactive protein (CRP), measured from a finger prick sample for rapid detection of septicemia, was examined in 76 blood culture-positive infections in 54 immunocompetent and 18 compromised children; 73 patients with systemic viral infections served as controls. Development of a positive CRP reaction was also studied in 40 cases of acute epiglottitis. Beyond the neonatal age, an increased CRP value (greater than or equal to 20 mg/L) was found in 60 of 64 (94%) children with a positive blood culture for bacteria or fungus. By contrast, CRP remained below this value in 56 of 73 (77%) with viral infections. The immunologic status did not influence the CRP response. However, time had a highly significant (p less than 0.001) effect on CRP; a history of 6 to 12 hours of illness was required before CRP increased above normal. We conclude that CRP is a sensitive and rapidly reacting index in bacteremic infections. However, because other factors than septicemia also increase CRP, we deem a negative CRP value most informative; if two determinations taken several hours apart are less than 20 mg/L, the patient is very unlikely to have invasive bacterial infection.
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PMID:C-reactive protein in early detection of bacteremic versus viral infections in immunocompetent and compromised children. 326 35


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