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

The increasing number of ampicillin-resistant Haemophilus influenzae recoveries have required a change in the treatment of meningitis due to this organism. Chloramphenicol has been recommended and is an effective though toxic substitute. Streptomycin combined with sulfisoxazole has been as effective as ampicillin in treating H influenzae meningitis. The results of treating 61 children with ampicillin were compared with results of those given streptomycin intramuscularly, in three intrathecal doses with sulfisoxazole intravenously, and by mouth to 50 children. Permanent neurological sequelae, including deafness, mental retardation, and persisting seizures, developed in the six given ampicillin; communic-ting hydrocephalus occurred in one who had been treated with streptomycin and sulfisoxazole. There was no phlebitis, buttocks abscess, or drug eruptions, and treatment was better tolerated in the streptomycin and sulfisoxazole group. This combination is suggested as an effective alternative to ampicillin.
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PMID:Streptomycin and sulfisoxazole for treatment of Haemophilus influenzae meningitis. 24 31

A retrospective evaluation of Haemophilus influenzae type b meningitis observed over a 2-year period documented 86 cases. Eight of these patients demonstrated an unusual clinical course characterized by persistent fever (duration: greater than 10 days), cerebrospinal fluid pleocytosis, profound meningeal enhancement on computed tomography, significant morbidity, and a prolonged hospital course. The mean age of these 8 patients was 6 months, in contrast to a mean age of 14 months for the entire group. Two patients had clinical evidence of relapse. Four of the 8 patients tested for latex particle agglutination in the cerebrospinal fluid remained positive after 10 days. All patients received antimicrobial therapy until they were afebrile for a minimum of 5 days. Subsequent neurologic examination revealed a persistent seizure disorder in 5 patients (62.5%), moderate-to-profound hearing loss in 2 (25%), mild ataxia in 1 (12.5%), and developmental delay with hydrocephalus which required shunting in 1 (12.5%). One patient had no sequelae.
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PMID:Haemophilus influenzae meningitis with prolonged hospital course. 220 58

The sequelae of acute bacterial meningitis in children who were treated with ampicillin or chloramphenicol for seven days during the period January 1979 to June 1983 were assessed prospectively. The 235 patients (117 boys and 118 girls) ranged in age from four days to 18 years (mean 26.4 months). Haemophilus influenzae type b was isolated in 70% of patients, Streptococcus pneumoniae in 20%, and Neisseria meningitidis in 10%. The mortality rate was 6.4%. No relapses occurred. Of the 220 survivors, 171 had neurologic psychometric, audiologic, and ophthalmologic assessments performed for a minimum of 1 year following their illness. One hundred thirty-six (80%) children had no detectable sequelae; 20% had mild to severe handicaps. The frequency of sequelae was greatest among children with S pneumoniae meningitis (57%) and least among children with N meningitidis (0%). The sequelae observed included: sensorineural hearing loss (12.9%), developmental delay (5.3%), speech defect (4.7%), motor defect (3.0%), hydrocephalus (1.7%), and seizure disorder (1%). The frequency of observed sequelae among these patients is similar to that previously reported in children treated for ten to 14 days. Our findings indicate that seven days of intravenous antibiotic therapy is adequate for the treatment of bacterial meningitis in children.
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PMID:Sequelae of acute bacterial meningitis in children treated for seven days. 242 33

The monobactam aztreonam was used to treat 22 young patients with meningitis caused by gram-negative bacilli. Haemophilus influenzae was isolated from the CSF of 21 patients and Salmonella heidelberg from the CSF of 1. Dosages ranged from 100 to 200 mg/kg/day in 4 doses at 6-hour intervals. Minimal inhibitory concentrations were determined by the broth dilution method for all isolated strains, and values ranged from 0.05 to 2.0 micrograms/ml. Blood and CSF drug levels were determined by a microbiologic plate diffusion method, and mean values for CSF and blood were 1.4 and 14.9 micrograms/ml, respectively. The outcome was good in 21 patients; 1 patient died. Complications were mild; subdural effusion occurred in 6 cases and was managed clinically; asymptomatic hydrocephalus was seen in 4; seizure during the acute phase occurred in 6 cases; hypoacusis was noted in 2, and motor impairment was detected at the follow-up in 1 case. Aztreonam achieved good blood and CSF penetration and performed well in the treatment of 20 cases of H. influenzae meningitis and in the one case of S. heidelberg meningitis.
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PMID:Aztreonam in the treatment of bacterial meningitis. 273 49

A 2 year-old child admitted for Haemophilus meningitis was immediately treated by adequate antibiotic treatment. Three days later multiple hypertonic strokes and periodic respiration occurred; a resuscitation was necessary. CAT scan showed an acute hydrocephalus with non visible 4th ventricle and low-density areas in both cerebellar hemispheres allowing the diagnosis of cerebellar infarction. External drainage of CSF was rapidly performed and maintained for 11 days with success. The child was secondarily discharged with temporary cortical blindness and persistent moderate static cerebellar signs. The etiology of the cerebellar infarction was likely to be an arterial thrombosis in the vertebro-basilar area, probably secondary to cerebral arteritis related to Haemophilus.
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PMID:[Acute hydrocephalus drained in emergency. Consequence of cerebellar infarction in Haemophilus meningitis]. 350 37

Cefotaxime has a good meningeal diffusion and is effective at low concentrations on many bacteria, especially ampicillin resistant Enterobacteriaceae and Hemophilus influenzae. We have therefore used cefotaxime (150 mg/kg/24 h, continuous infusions lasting 30 minutes q. 6 h.) in meningitis due to gram negative bacilli. Twenty eight infants and children have been treated within 4 years. The 13 Hemophilus influenzae meningitis (including 2 beta-lactamase producers) have been cured without immediate sequelae. The duration of treatment could be reduced from 3 weeks to 2 weeks. The 7 infants with Enterobacteria meningitis (6 E. coli and 1 Serratia) have been cured of their infection with a 21 to 28 days treatment. The C.S.F. was sterile 2-3 days after treatment except a case of E. coli persisting during 7 days in C.S.F. contrasting with a normal ventricular fluid. A case of relapse with E. coli remaining sensitive was cured with a new course of the same treatment. Five meningitis complicated with hydrocephalus needed external drainage: the fluid was sterile 1 day after treatment in 4 of them. Two superinfections of ventriculo-peritoneal shunt due to Enterobacteriaceae have been cured. To obtain a good result, the need for a careful drug monitoring must be emphasized.
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PMID:[Treatment of purulent meningitis in the child using Cefotaxime]. 390 93

Primary meningitis in children is caused by two gram-negative bacterial species, Neisseria meningitidis and Haemophilus influenzae, and one gram-positive bacterial species Streptococcus pneumoniae. Despite optimal penicillin susceptibility, with few exceptions, therapeutic results in pneumococcal meningitis are by far worse than with the other two pathogens. Therefore, and because of the detection of penicillin-resistant rods, the study of alternatives in therapy is justified and was started with cefotaxime. Including six of our own patients, there are reports on 87 patients in the literature suffering from S. pneumoniae meningitis who were treated with cefotaxime monotherapy. Results of these studies will be analyzed. As none of these patients belonged to a prospective controlled study group, final evaluation in comparison with penicillin therapy remains open. There are also several reports on successful treatment of group B streptococcus meningitis with cefotaxime, although there is no need to abandon penicillin therapy. Staphylococcus aureus and Staphylococcus epidermidis meningitis, usually secondary in shunted hydrocephalus, brain tumors, brain injury or other causes, should not be treated with cefotaxime because of its limited activity on these bacteria. Listeria monocytogenes and Streptococcus faecalis are primarily cefotaxime-resistant, and neonatal meningitis of unknown origin, therefore, should not be treated with cefotaxime alone as long as these pathogens cannot be excluded.
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PMID:Cefotaxime monotherapy of bacterial meningitis caused by gram-positive pathogens. 405 57

Thirteen children with meningitis due to Haemophilus influenzae, beta-haemolytic streptococcus group B, Streptococcus pneumoniae, Staphylococcus epidermidis, Neisseria meningitidis, Escherichia coli, or Pseudomonas aeruginosa and who had been unsuccessfully treated with other antibiotics or had causative organisms which were resistant to available antibiotics were treated with intravenous cefotaxime. Nine children were cured; in one case infection (with a different organism) recurred but a further course of cefotaxime was successful; one child died, with sterile CSF; one child died from his underlying disease (astrocytoma); and one child was cured with sequelae (hydrocephalus). A further child with meningitis caused by E. coli had been treated unsuccessfully by intravenous and intraventricular chloramphenicol and gentamicin; intravenous and intraventricular cefotaxime was successful. The agent was well tolerated. CSF levels were measured in seven children and ranged from 300 to 27 200 microgram/l; published and unpublished in-vitro studies suggest that minimum inhibitory concentrations for cefotaxime against the organisms commonly causing bacterial meningitis are usually well below 250 microgram/l.
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PMID:Intravenous cefotaxime in children with bacterial meningitis. 610 14

During a five-year period, 24 patients' conditions (age range, 2 to 6 weeks) were diagnosed, and they were treated for bacterial meningitis. Organisms recovered from the CSF included group B Streptococcus (n = 6), Escherichia coli (n = 5), Listeria monocytogenes (n = 5), Hemophilus influenzae (n = 4), Streptococcus pneumoniae (n = 2), and group D and group A Streptococcus (one each). Initial antimicrobial therapy must include antibiotics that are effective across this spectrum of potential pathogens. Symptoms and signs were often subtle. Six children (25%) experienced major neurologic residua, including five patients (21%) in whom hydrocephalus developed. Ultrasound examination of the head at the end of therapy was an effective technique for early assessment of neurologic sequelae.
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PMID:Bacterial meningitis in older neonates. 635 81

This study analysed the bacterial aetiology and outcome of childhood meningitis observed over an 11-year period. Charts of 70 children with this diagnosis were reviewed. Three children were under 1 month of age, five were between 1 and 3 months and 60 were between 3 months and 5 years. The remaining two were over 5 years. There were 36 females and 34 males. The presenting symptoms in decreasing order of frequency were fever 86%, vomiting 29%, poor feeding 19%, seizure 14% and lethargy 14%. Aetiological organisms were as follows: Haemophilus influenzae 66%, Streptococcus pneumoniae 24%, Neisseria meningitidis 4%, Group B Streptococci 4%, and Staphylococcus aureus 2%. All H. influenzae isolates except one were sensitive to ampicillin. None of the S. pneumoniae isolates were resistant to penicillin. Complications occurred in 26% of the patients and included subdural effusion 23%, hearing loss 14%, seizure disorder 10%, developmental delay 9%, hydrocephalus 6% and motor deficit 30%. One patient died. Among H. influenzae cases, one of the 15 patients treated with steroids developed hearing loss. In contrast, four out of 31 who did not receive steroid therapy suffered from hearing loss. Haemophilus influenzae type b is the predominant cause of childhood bacterial meningitis in Saudi Arabia. Universal H. influenzae type b vaccination for children is highly recommended.
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PMID:Childhood bacterial meningitis in Saudi Arabia. 957 Jun 46


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