Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085593 (chills)
 4,268 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection due to Staphylococcus aureus continues to be a source of significant morbidity and mortality. However, its treatment is increasingly complicated by the rising prevalence of resistance to antibiotics. Apart from the two recognized modes of staphylococcal resistance, namely, penicillinase production and intrinsic resistance, Sabath and associates have described a third type in which resistance is manifested by susceptibility to growth inhibition but tolerance to the lethal action of bactericidal agents. The mechanism of tolerance is attributed to a deficiency of autolytic enzyme activity in the part of bacteria, possibly secondary to an inhibition of autolysins in the tolerant staphylococcal strains. These strains are found in patients with infections responding poorly to treatment with cell-wall active antibiotics including vancomycin. Because of its unique mechanism of action and pharmacokinetic properties, rifampin has been reported to be the most active among 65 antistaphylococcal agents tested and have the capacity to kill intraleukocytic staphylococci. We present 2 cases who were cured following the addition of rifampin to previously established regimens. Case 1 was a 40-year-old male who had fever, cough, dyspnea, a right elbow abscess and left leg swelling for 2 weeks prior to admission. Culture of purulent material from the elbow abscess grew staphylococcus aureus. Chest X-ray showed bilateral septic embolism and phleborheography showed partial deep vein occlusion of the left ileofemoral vein. Case 2 was 22-year-old female with fever, chills and cough for 3 weeks. Blood culture grew staphylococcus aureus, and Chest X-ray revealed bilateral septic embolism with pneumonia. Neither of them responded to standard antibiotics which were judged adequate by in vitro sensitivity tests. Clinical cure was later obtained after rifampin was added to the regimens. These results suggest that rifampin may be a useful adjunct in the therapy of staphylococcal infections.
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PMID:[The use of rifampin in the treatment of infection due to Staphylococcus aureus]. 164 82

A retrospective study of 101 patients with cellulitis of the head and neck and extremities showed that cellulitis, predominantly a disease of males, occurred at all ages; the lower extremities were affected more frequently in the elderly, whereas upper extremity involvement prevailed in young adults. A clinical prodrome, most often including chills, was less common than is widely believed. Redness, heat, swelling, and tenderness were consistently present, and lymphangitis and lymphadenitis were less frequent. Fever was generally mild, and WBC counts were modestly elevated, if at all. Because needle aspirates and blood cultures were rarely helpful, delineation of specific cause was difficult. Therapy included rest, elevation, moist heat, analgesia, antibiotics (usually penicillinase-resistant penicillin or penicillin itself), and incision and drainage when indicated. Most patients improved rapidly. Prolonged course and complications were unusual and there were no deaths.
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PMID:Cellulitis: analysis of 101 cases and review of the literature. 697 17

The emergence of meningococcal strains with reduced susceptibility to penicillin has been reported in several countries during the past two decades, but not in Taiwan. We report a case of meningococcal meningitis with intermediate resistance to penicillin. A 20-year-old male soldier complained of chills, fever, and headache for 2 days, followed by drowsiness. Physical examination revealed erythema of the pharynx, stiff neck, erythematous maculopapules, and petechiae over the trunk and four limbs including palms and soles. Analysis of the cerebrospinal fluid (CSF) showed a white blood cell count of 9.06 x 10(6)/L, a glucose concentration of 0.165 mmol/L, and a protein concentration of 7.85 g/L. CSF culture yielded Neisseria meningitidis, serogroup B. The minimum inhibitory concentration of penicillin was determined using an E-test (0.125 microgram/mL); there was no beta-lactamase production. He recovered after high-dose penicillin G treatment with six doses of 24 million units per day for 11 days. The emergence of penicillin resistance in N. meningitidis in Taiwan requires surveillance. High-dose penicillin may be successful in treating penicillin-insensitive meningococcal meningitis. Alternative treatment with third-generation cephalosporins should be considered if poor response to penicillin is encountered.
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PMID:Meningitis due to penicillin-resistant Neisseria meningitidis in a 20-year-old man. 1176 Mar 76

Atopobium rimae, previously Lactobacillus rimae, is a strictly anaerobic, non-spore forming grampositive rod which was frequently isolated from odontogenic infection. We report a case of A. rimae bacteremia. A 47-yr-old man with liver cirrhosis was admitted to the hospital via emergency room due to fever and chill. His abdominal and pelvic computed tomography revealed a small abscess near the left adrenal gland. Three sets of blood cultures were taken and non-spore forming, grampositive rods were detected in all anaerobic vials. This isolate grew small nonhemolytic, gray-white translucent colonies on Brucella blood agar and was obligatory anaerobic on air-tolerance test. This organism was negative for catalase, indole, nitrate-reduction and beta-lactamase and failed to identify by Vitek ANI card (bioMerieux, France). 16S rRNA sequences of this showed 99.8% homology of the published sequence of A. rimae (GenBank accession number AF292371). Aspirates of periadrenal abscess grew Escherichia coli and Peptostreptococcus micros. He was treated with metronidazole and imipenem and follow-up cultures of blood were negative at days 4 and 10. To our knowledge, this is the first report of bacteremia of A. rimae.
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PMID:[A case of bacteremia by Atopobium rimae in a patient with liver cirrhosis]. 1809