Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0348321 (Haemophilus)
15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumatic otoscopy increases the physician's diagnostic acumen. Movement of the tympanic membrane is observed and measured more precisely by tympanometry and acoustic impedance. Ampicillin-resistant strains of Hemophilus influenzae are appearing. It is possible to detect these with deep nasopharyngeal cultures. New reports show the value of antimicrobial prophylaxis in recurrent otitis media. High-risk populations that deserve special attention are children with cleft palate and Down's syndrome.
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PMID:New concepts in otitis media. 31 93

The spectrum of otitis media includes acute and chronic forms, each of which can be either suppurative of nonsuppurative. In the usual clinical setting distinctions between these several forms can be difficult. Determination of accurate incidence figures is impeded by the unavailability of universally accepted diagnostic criteria. Risk factors include season of the year, genetic factors, race, preceding respiratory tract infections, cleft palate, and others. The effect of household size and allergy are uncertain. The most common infecting organisms are Streptococcus pneumoniae and Hemophilus influenzae, although in a significant number of cases either the fluid is nonpathogenic or no organisms can be isolated. The effects of several therapies are reviewed, including antibiotics, myringotomy, steroids, and middle-ear ventilating tubes.
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PMID:Otitis media. 675 27

Chronic otitis media with effusion (OME) has been assumed to be sterile, since several reports in the literature have described unsuccessful attempts to culture bacteria from it. However, several recent studies have confirmed an earlier report that there is a significant frequency of bacteria in the middle ears of children with chronic and/or recurrent OME. Similar studies in young infants with chronic and/or recurrent OME have not been previously reported. In this study, cultures were obtained at the time of myringotomy and tympanostomy tube insertion from 50 infants aged 1-12 months who had chronic and/or recurrent OME. From the 80 ears of 40 infants without cleft palate, 32% had bacteria isolated from their middle ears; 22% had Streptococcus pneumoniae or Haemophilus influenzae. In 21 of these ears, no effusion was apparent at myringotomy, but in 28% bacteria were isolated from middle ear washings. From the 20 ears of 10 infants with an unrepaired cleft palate, 55% had bacteria present in their middle ear aspirates; 50% had S. pneumoniae or H. influenzae. Even though the significance of bacteria in chronic OME in children, and now in young infants, is unclear at present, a therapeutic trial with an antimicrobial agent prior to surgical intervention would appear to be reasonable until such therapy is tested in a randomized, clinical trial.
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PMID:Microbiology of chronic and recurrent otitis media with effusion in young infants. 728 16

Many hyperplasias and lymphomas of marginal zone B-cells are associated with infection. We identified six children and one adolescent with cervical lymphadenopathy showing prominent polyclonal nodal marginal zone hyperplasia (pNMZH) and four adolescents with monoclonal paediatric nodal marginal zone lymphoma (pNMZL). The clonality status was assessed using BIOMED-2-IG PCR analysis. Haemophilus influenzae was identified in all six cases of pNMZH that could be tested by direct culture (N = 3) or a very sensitive PCR for the H. influenzae gyrase gene in frozen materials (N = 5). H. influenzae was not detected in three pNMZLs and 28 non-specific reactive cervical lymph nodes of age-matched controls, except for a single control node that was obtained during oropharyngeal surgery for a cleft palate showing very low copy numbers of H. influenzae. pNMZH patients were younger than pNMZL patients (median age 12 versus 21 years). pNMZH showed a prominent nodular appearance with variable fibrosis without acute inflammation. Within the nodules, the expanded germinal centres and variably sized marginal zones were colonized by activated B-cells with weak expression of IgD and lack of CD10 and/or BCL6 expression. Some areas showed skewed light chain expression in plasma cells (4/5 cases lambda). In four cases tested, this was confirmed by flow cytometry for surface Ig (3/4 cases lambda). In contrast, pNMZL showed more extensive expansion of marginal zones by centrocytoid cells and often expression of BCL2 protein. Several H. influenzae strains are known to interact with the constant part of IgD on human B-cells, leading to their polyclonal proliferation and activation. We speculate that in vivo stimulation of IgD+ marginal zone B-cells by this bacterium may be implicated in this particular lymphadenopathy that should be distinguished from monoclonal pNMZL.
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PMID:Paediatric nodal marginal zone B-cell lymphadenopathy of the neck: a Haemophilus influenzae-driven immune disorder? 2572 8