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)

We have reviewed the clinical presentation of pneumonia to the Goroka paediatric ward. In comparison to survivors, children dying from pneumonia more often (p less than 0.05) had malnutrition (weight-for-age under 80%), anaemia (haemoglobin under 9g%), and a marked leucocytosis (total white cell count over 30,000 cells per c.m.m.). Children dying from pneumonia had been ill for longer and had been given more antibiotics prior to admission. There was no significant difference between children dying from pneumonia and survivors in age distribution, pulse rate, incidence of cardiac failure or duration of stay in hospital. 70% of the children dying from pneumonia at Goroka Hospital are infants under 12 months of age. Pneumococcal vaccine gives a poor antibody response in infants, and overseas studies using lung aspiration suggest that Haemophilus influenzae and Staphylococcus aureus might be causative organisms as well as Streptococcus pneumoniae. A study to determine the aetiology of pneumonia in Highlands children is required to enable a rational choice of routine antibiotic therapy and to plan further research on vaccination against pneumonia.
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PMID:Childhood pneumonia at Goroka Hospital. 29 32

The clinical pattern of acute lower respiratory tract infection (ALRTI) in children admitted to Port Moresby General Hospital (PMGH) was studied. Most patients (60%) were less than twelve months of age. Common symptoms were cough, fever and shortness of breath. Common signs were crepitations, chest recession, elevated temperature and tachypnoea. Concurrent illness was common, with evidence of malnutrition in 62% patients. Most patients were anaemic (haemoglobin less than 10g per dl). Blood cultures isolated pathogens in 13% of patients in which it was done, the most common isolate being Haemophilus influenzae. Chest radiograph showed most patients had multisegmental changes, with the lower lobes commonly involved. Of the 129 patients, discharges accounted for 106 (82%), while 15 (12%) absconded and eight (6%) died. Of those 121 discharged or absconding, 15 (12%) were readmitted within three months of departure. Sixty-six (51%) patients stayed in hospital for four days or less. Of the eight patients who died, six (75%) were malnourished, six (75%) were less than eighteen months of age, seven (87.5%) were sick for one week or less before admission, five (62.5%) had received antibiotics before admission and chest radiograph showed more lung zones affected than in those not dying. Of the eight patients who died, six had white cell counts (WCC) performed and none of these was more than 30,000.
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PMID:Acute lower respiratory tract infections in children admitted to Port Moresby General Hospital. 633 17

The middle ear effusion (MEE) total white cell count (TWCC) was correlated with clinical and bacteriologic data in 184 MEEs from 125 patients diagnosed as having acute primary and recurrent otitis media and chronic otitis media with effusion. The MEE total white cell count was classified as high, low, or acellular. Polymorphonuclear leukocytes predominate in the MEE having a high TWCC. The overall incidence of culture-positive MEE was 62.5 percent. A cellular component was found in 81 percent of the MEEs, 63 percent having a neutrophilic-predominant high TWCC. In very young children (up to 2 years old) a neutrophilic-predominant high TWCC was found in 80 percent of MEEs as compared with 28 percent in patients over 5 years old. According to the MEE type, neutrophilic-predominant high TWCCs were found in 89 percent of the purulent effusions, 46 percent of the mucoid, and 35 percent of the serous effusions. The incidence of neutrophilic-predominant high TWCC was 78 percent in acute primary 76 percent in recurrent otitis media and 18 percent in chronic otitis media with effusion. The impact of age on the MEE cellularity was shown to be independent of the chronicity of the disease. The incidence of neutrophilic-predominant high TWCC in MEE in which Streptococcus Pneumoniae or Hemophilus influenzae was identified was 85 percent and 92 percent respectively. The diagnostic value of a high TWCC in predicting a culture-positive MEE was shown by a sensitivity of 83 percent, false positivity of 25 percent, and false negativity of 27.5 percent.
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PMID:Otitis media: the middle ear effusion total white cell count. 654 Sep 96

Fever is one of the most frequent signs seen in children at consultation. In infants under the age of 3 months, fever is nonspecific and is often the only sign of a potentially severe infection. It has been estimated that two-thirds of the children hospitalized have a viral infection and 10% a bacterial infection with risks of complications including meningitis. It must be recalled that 5% of the infants with septicaemia due to Haemophilus influenzae b who does not receive an appropriate treatment will develop meningitis or another focal infection. There is agreement on the definition of potentially severe infections: meningitis, osteoarthritis, cellulitis or cellulodermitis, urinary infection, lung infection and gastroenteritis. Certain authors also include inner ear infections. In suspected cases, the need for hospitalization can be based on signs of impaired consciousness and/or muscle tone, abnormal heart rate, blood pressure or recoloration time, paleness, cyanosis, respiratory distress, signs of dehydration, or abnormal behaviour. In order to identify infants at low risk, in addition to the physical examination, the clinician can rely on essential laboratory tests: white cell count with differential count, blood culture, C-reactive protein and/or sedimentation rate with fibrinogen and an urinanalysis. A chest X-ray is required in case of respiratory signs and a culture of the fecal matter is needed in case of diarrhoea. On the basis of these findings and the clinical picture, if the criteria of low risk of bacterial infection are fulfilled in an infant under 3 months of age with fever, most authors agree that a spinal tap must nevertheless be performed. When these tests lead to the conclusion of low risk, close surveillance at home is appropriate. If the clinical picture worsens within 24h hospitalization is required.
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PMID:[Fever in infants under the age of three months without sign of focal infection. Criteria of therapeutic decision]. 807 34

A protocol for management of young febrile children at risk for bacteraemia has been used at Westmead Hospital, a university based hospital in the western Sydney region, since early 1994. Implementation of the protocol was retrospectively evaluated for the 12 month period 1 June 1994 to 31 May 1995, using the emergency department log book as the primary data source. Altogether 498 children, aged from 3 months to 3 years, with a fever > or = 39.5 degrees C were identified over this period, of whom 291 were admitted to hospital because of evidence of sepsis or identified focal infection and 207 children without focal infection were observed in the short stay annexe of the emergency department. Fifty children, considered at high risk of bacteraemia because of a total white cell count > or = 20 x 10(9)/1 received empiric antibiotic treatment with ceftriaxone, of whom 19 subsequently had proved bacteraemia and another 10 had focal infection identified during observation in the short stay annexe. Bacteraemia was due to Streptococcus pneumoniae in 16 cases and Haemophilus influenzae type b in three. No adverse events occurred at follow up. Use of a management protocol and selection on higher white cell count criterion than previously recommended by US centres resulted in restriction of empiric antibiotic treatment to a small proportion of young febrile children presenting to a busy emergency department of whom 38% were bacteraemic.
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PMID:Evaluation of a protocol for selective empiric treatment of fever without localising signs. 906 2