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 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The now nine years old girl with growth retardation, started to be ill with otitis and then diabetes insipidus of central origin at 1974. A treatment with lysin-vasopressin is prescribed. The PNEG in May 1976 shows a little, pea like, suspicious, supra-sellar nodule who is not surgically explored since they was no ophtalmologic symptoms and because a normal CT scan. Corticoid and thyroid substitutive therapy is added until September 1977 when the general status becomes impaired and vomiting starts. Also because some visual loss, a new neuroradiological study is performed showing a supra-sellar tumour and a fourth ventricle mass. The CT scan asserts the double intracranial expansive process and a posterior fossa craniotomy is done with subtotal resection of a vermian tumour and Torkildsen drainage. The histology is : Immature Dysembryoma (seminoma type) or germinoma. The follow-up was good under hormonal care. X Rays Therapy over the posterior fossa, the suprasellar region, the brain and the spinal channel was instaured. Four months later, the CT scan shows normal sized ventricles and no tumour mass at all. This case gives the authors opportunity for comments and to study the concerned literature.
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PMID:[Germinoma (ectopic pinealoma) with double location : supra-sellar and the cerebellum without pineal tumour (author's transl)]. 49 37

The clinical characteristics of acute otitis media in relation to coexisting respiratory virus infection were studied in a 1-year prospective study of 363 children with acute otitis media. Respiratory viruses were detected using virus isolation and virus antigen detection in nasopharyngeal specimens of 42% of the patients at the time of diagnosis. Rhinovirus (24%) and respiratory syncytial virus (13%) were the two most common viruses detected. Adenovirus, parainfluenza viruses, and coronavirus OC43 were found less frequently. The mean duration of preceding symptoms was 5.9 days before the diagnosis of acute otitis media. Ninety-four percent of the children had symptoms of upper respiratory tract infection. Fever was reported in 55% and earache in 47% of cases. Patients with respiratory syncytial virus infection had fever, cough, and vomiting significantly more often than patients with rhinovirus infection or virus-negative patients. No significant differences were found in the appearance of the tympanic membrane and outcome of illness between virus-negative and virus-positive patients with acute otitis. Most patients respond well to antimicrobial therapy despite the coexisting viral infection. If the symptoms of infection persist, they can be due to the underlying viral infection, and viral diagnostics preferably with rapid methods may be clinically useful in these patients.
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PMID:Clinical role of respiratory virus infection in acute otitis media. 217 35

A retrospective review of charts for 650 children who had lumbar puncture for suspected meningitis was undertaken to determine the characteristics of patients with and without meningitis, identify other conditions suggesting meningitis, and evaluate the predictive value of signs and symptoms of meningitis. The incidence of positive lumbar punctures increased with patient age. Younger infants did not present with classical features of meningitis. Bulging fontanel, lethargy, and irritability were nonspecific symptoms. Vomiting and headache, although not specific, proved to be more sensitive indicators of meningeal infection. Most patients with meningitis (75%) had at least one sign of meningeal irritation, but so did 25% of patients without meningitis. Brudzinski's sign was not specific. In contrast, nuchal rigidity and Kernig's sign had high predictive value. Up to age five, the diseases most often suggesting meningitis were right-sided pneumonia, gastroenteritis, otitis, tonsillitis, exanthema subitum, and urinary tract infections. Of 171 patients with febrile convulsion, one (0.5%) had bacterial meningitis and four had aseptic meningitis.
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PMID:Diseases that mimic meningitis. Analysis of 650 lumbar punctures. 220 11

An outbreak of influenza virus type B infection occurred in Philadelphia from December, 1985, to April, 1986. During this epidemic 24 patients were admitted to Children's Hospital from whom influenza B was isolated from routine respiratory viral cultures. All were younger than 3 years of age. Clinical findings included fever (greater than or equal to 38 degrees C) (88%), rhinorrhea (62.6%), cough (50%), otitis (50%), rhonchi (42%), vomiting (38%), diarrhea (33%), rales (21%), pharyngitis (13%) and croup (4%). Remarkably 75% of the patients had underlying diseases which may have contributed to the severity of the infection. Nine (41%) patients had pneumonia. Two patients died of respiratory failure caused by overwhelming influenza B virus infection. Patients admitted to the hospital with respiratory and underlying diseases should have viral respiratory cultures which include influenza B.
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PMID:Children hospitalized with influenza B infection. 361 69

In the period 1970 through 1979, the Coxsackie B1, B2, B3, B4, and B5 viruses constituted 24 percent of more than 18,000 enteroviruses isolated and reported through national surveillance. Young children, especially males, were most frequently affected: 48 percent of the national surveillance population were less than 5 years of age, including 30 percent who were less than 1 year old. Among the most frequently reported clinical syndromes associated with B infection were meningitis (in 56 percent of patients with B1-B5 infections), encephalitis (in 15 percent), and respiratory tract disease (in 14 percent). Carditis, a well-known B syndrome, was reported with only 2 percent of B1-B5 infections. Like most enteroviral agents, Group B viruses were isolated primarily during the summer: 87 percent of all these isolations were made during the 5 months from June through October. Although B2, B3, and B4 viruses were isolated at relatively uniform levels each year, B1 and B5 viral illnesses occurred nationwide as explosive epidemics only in certain years. A separate population of B-infected patients, identified by the Nassau County Medical Center (NCMC) Virus Laboratory, East Meadow, N.Y., during the same 10-year period, was studied to compare epidemiologic characteristics and to evaluate in greater detail clinical and laboratory features of B infections. Because of more active solicitation of specimens for testing, ascertainment in the NCMC system was more complete. The most frequently reported clinical findings at NCMC included fever (97 percent of cases), which was biphasic in 27 percent; pharyngitis (85 percent); vomiting (56 percent); headache (49 percent); other respiratory signs and symptoms (44 percent); diarrhea (40 percent); abdominal pain (33 percent); rash (31 percent); and otitis (28 percent). Rash was more frequently associated with younger than with older age groups (P < .01) for all B agents. Overall, throat (T) and rectal (R) swabs had the highest B-positivity rates among known infected patients(83 percent for T and 78 percent for R). Only for T was the positivity rate correlated with the interval between onset of illness and obtaining the specimen (P < .05). B agents grew most quickly from T specimens, but most reliably from R specimens. On the basis of these data,the authors recommend that both T and R specimens be obtained from every patient for whom prompt and reliable laboratory diagnosis of B infection is sought.To the authors' knowledge, these results from 10 years of national surveillance represent the largest surveillance summary of Coxsackie B viruses to date in the literature. Comparison of these results with those reported over the same 10 years by NCMC reflects differences that arise mostly because of differences in ascertainment systems.
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PMID:Epidemiologic, clinical, and laboratory features of Coxsackie B1-B5 infections in the United States, 1970-79. 609 Nov 68

Clinical and epidemiologic characteristics of disease associated with a newly described nonhalophilic Vibrio species, Vibrio mimicus, were identified by studying isolates from 21 patients referred to the Centers for Disease Control between 1977 and 1981. Two isolates were from the ears of patients with otitis who had recently been exposed to seawater. Nineteen isolates were from stool samples; these patients generally had diarrhea, nausea, vomiting, and abdominal cramps, with fever, headache, and bloody diarrhea occurring in fewer than half. Persons with diarrhea were more likely than age- and sex-matched controls to have eaten raw oysters (p = 0.013). Although most cases were sporadic, three were associated with a single outbreak. Only two isolates produced toxin found by enzyme-linked immunosorbent assay or the Y-1 adrenal cell assay for heat-labile toxin, and none produced heat-stable toxin found by the infant mouse assay. Vibrio mimicus should be considered in the differential diagnosis of acute gastroenteritis occurring after recent ingestion of seafood (especially raw oysters) and in acute otitis after exposure to seawater.
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PMID:Disease from infection with Vibrio mimicus, a newly recognized Vibrio species. 688 69

Clinical and epidemiologic characteristics of disease associated with a newly described nonhalophilic Vibrio species, Vibrio mimicus, were identified by studying isolates from 21 patients referred to the Centers for Disease Control between 1977 and 1981. Two isolates were from the ears of patients with otitis who had recently been exposed to seawater. Nineteen isolates were from stool samples; these patients generally had diarrhea, nausea, vomiting, and abdominal cramps, with fever, headache, and bloody diarrhea occurring in fewer than half. Persons with diarrhea were more likely than age- and sex-matched controls to have eaten raw oysters (p = 0.013). Although most cases were sporadic, three were associated with a single outbreak. Only two isolates produced toxin found by enzyme-linked immunosorbent assay or the Y-1 adrenal cell assay for heat-labile toxin, and none produced heat-stable toxin found by the infant mouse assay. Vibrio mimicus should be considered in the differential diagnosis of acute gastroenteritis occurring after recent ingestion of seafood (especially raw oysters) and in acute otitis after exposure to seawater.
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PMID:Disease from infection with Vibrio mimicus, a newly recognized Vibrio species. Clinical characteristics and edipemiology. 688 70

The patient was a 26-year-old man who complained of headache and vomiting. On examination, there was nothing abnormal, but the edge of the right optic papilla was not clear. His temperature was 38.5 degrees C, pulse 96/min, blood pressure 120/80 mmHg. A space-occupying lesion in his fronto-dextra cupular part was found by CT scanning. He had a 12-year history of chronic purulent otitis. The diagnosis was a brain abscess in the fronto-dextra cupular part. The brain abscess was extracted and Pasteurella multocida was isolated from the dark brown pus draining from the abscess. The patient recovered through proper antibiotic therapy based on a sensitivity test. Reports of infections caused by this organism in foreign countries very widely from local infections due to bites and scratches by cats, dogs etc. to general infections such as infections of the respiratory tract, sepsis and meningitis. However, Pasteurella multocida brain abscesses are rare. Pasteurella multocida is a Gram-negative short rod which is best known as part of the mouth flora and as a pathogen causing septicemia in many domestic animals, such as cats, dogs etc.. Infection in man results mainly from animal bites or scratches. It has been reported that Pasteurella multodida can cause human septicemia, meningitis, respiratory tract infection, conjunctivitis and other infections. We isolated a strain of Pasteurella multocida from the pus of a brain abscess following chronic purulent otitis on August 6, 1990.
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PMID:Brain abscess due to Pasteurella multocida. 817 82

We present a study of acute otitis media among 20,532 Spanish children during a 6-month period from January through June 1991. The study was done by distributing a questionnaire to all Spanish pediatricians. Of the patients 51.7% were girls and 48.3% boys; 68.7% of all children were younger than 5 years. The most frequent symptoms were otalgia or irritability, 92.7%; fever, 63.5%; otorrhea, 24.9%; vomiting, 21.4%; and another concomitant upper respiratory tract infection, 65.5%. Otitis was bilateral in 45.6% of the cases. The most frequently used antibiotic was cefixime (38%), followed by amoxicillin-clavulanate (22.2%), amoxicillin (15.3%), 2nd-generation cephalosporins (13.5%) and macrolides (8.8%). In 11.8% of the patients, a change in the initial antibiotic therapy was required due to adverse effects. Resolution of symptoms occurred in 77.8% of the patients.
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PMID:Acute otitis media in childhood: a study of 20,532 cases. 853 35

Reovirus Type 2 was isolated from three patients aged 5, 9 and 10 years. The etiological role of Reovirus in one case was confirmed by demonstration of antibodies in convalescent serum and none in acute serum. Symptoms in this case were suggestive of infectious mononucleosis. In the second case, rhinitis and non-purulent otitis were preceded by two waves of fever, abdominal pain and emesis. Acute serum was not available but convalescent serum had a high titre to a Reovirus, thus supporting a Reovirus etiology. Symptoms in the third case were fever, intermittent headache, neck stiffness, abdominal cramps and weakness of a leg. Because of the unavailability of convalescent serum, evidence of a Reovirus etiology was incomplete. No attempt is made to associate Reovirus with a particular clinical picture. Rather, attention is simply drawn to the existence of Reovirus infections in Ontario.
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PMID:Occurrence of reovirus infection in Ontario. 1400 9


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