Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Biogenesis of tetrahydrofolate cofactors essential for bacterial growth and survival is blocked by sulfamethoxazole-trimethoprim. An intravenous form of the antimicrobial combination has recently been approved for the treatment of acute, symptomatic, bacterial pyelonephritis, recurrent urinary tract infections, shigellosis, and Pneumocystis carinii pneumonia. Intravenous sulfamethoxazole-trimethoprim has emerged as an invaluable agent for the management of selected infections, including bacterial meningitis and Salmonella bacteremia, where limited therapeutic alternatives exist. In addition, co-administration of intravenous sulfamethoxazole-trimethoprim with a carboxypenicillin provides an empiric treatment for the infected granulocytopenic patient that compares favorably with standard combinations. Adverse events unique to the intravenous form of the drug consist of phlebitis and fluid imbalances. Fluid overload results from the relatively large volumes of 5% dextrose solution required as diluent.
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PMID:Intravenous sulfamethoxazole-trimethoprim: pharmacokinetics, therapeutic indications, and adverse reactions. 698 49

Previously we reported that the rate of mild to moderate infections and upper respiratory infections in infants who undergo transplantation under 1 year of age was the same as that of the general population. Despite this, serious infections continue to be one of the major complications in the first 3 to 4 months after heart transplantation. Among newborns and infants at Loma Linda University Medical Center, there have been 35 deaths from various causes: six (17%) were the result of infectious causes, three were in the early perioperative period, and three were late complications. There were no deaths caused directly by cytomegalovirus. From 1989 to 1992, 128 under 1 year of age underwent transplantation. Of these, 65 had at least one episode of serious infection ranging from bacterial meningitis to viral pneumonia. Of these infants, 19 had cytomegalovirus infections, with the vast majority having symptoms in the first 2 to 3 months after transplantation. Eight infants had Pneumocystis pneumonia and were treated successfully. The risk of cytomegalovirus is highest in the first 4 to 8 weeks after transplantation and in a seronegative recipient who has received an organ from a seropositive donor. Currently, our protocol to reduce the likelihood of active disease includes the use of intravenous immunoglobulin immediately after transplantation and during rejection episodes that are treated with aggressive immunosuppression and the use of oral acyclovir for the first 3 months after transplantation. If active disease develops, ganciclovir is initiated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Infectious complications in infant heart transplantation. 831 37

A retrospective review of autopsy findings and medical records in 33 HIV-infected children living in a Kenyan orphanage is described. Their ages ranged from 1 month to 18 years and median age at death was 71 months (range 7-156). Respiratory disorders were probably the primary cause of death in 21 (64%), in 19 (90%) of whom pyogenic parenchymal lung disease was detected. A presumptive clinical diagnosis of pulmonary tuberculosis had been made in 14 (67%); these children also had a history of recurrent acute lower respiratory tract infections (more than four infections/year). At autopsy, however, only one case of tuberculosis was identified (disseminated disease). Pneumocystis carinii pneumonia was not identified. Primary bacterial meningitis was detected in 33%. The associated findings included disseminated Kaposi sarcoma in two children and cryptococcal meningitis in one child. It is concluded that pyogenic infections are common causes of morbidity and mortality in HIV-1-infected African children. Management should include prompt treatment and, if indicated, prophylaxis for recurrent bacterial infections, and early evaluation and treatment of pulmonary tuberculosis.
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PMID:The post-mortem pathology of HIV-1-infected African children. 1207 Sep 47

Clinicians have generally avoided prescribing corticosteroids for active infection because of their known immunosuppressive effects and concern about long-term complications. We conducted a review of the published randomized, double-blind trials comparing corticosteroids and placebo in infections. Except in some trials of viral infections, sore throat, and cerebral cysticercosis, all patients also received active antimicrobial agents in addition to placebo or corticosteroids. For patients with bacterial meningitis, tuberculous meningitis, tuberculous pericarditis, severe typhoid fever, tetanus, or pneumocystis pneumonia with moderate to severe hypoxemia, treatment with corticosteroids improved patient survival (group 1 infections). For patients with bacterial arthritis, corticosteroids were also beneficial and reduced long-term disability (group 2 infections). For about a dozen other infections, corticosteroids significantly relieved symptoms (group 3 infections), and clinicians should consider using them if symptoms are substantial. Corticosteroids were harmful in 2 infections, viral hepatitis and cerebral malaria (group 5 infections). We conclude that corticosteroids are beneficial and safe for a wide variety of infections, although courses longer than 3 weeks should be withheld from patients with concomitant human immunodeficiency virus infection and low CD4 counts.
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PMID:Use of corticosteroids in treating infectious diseases. 1850 31