Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between July 1981 and June 1984 1223 cases of meningitis were seen in the Department of Paediatrics, Tygerberg Hospital. The commonest form in each population group was aseptic meningitis. Positive viral cultures were obtained from the CSF in 108 cases. The median age of white children with aseptic meningitis, 64 months, was significantly greater than that of coloured children, 45 months (P greater than 0.0001), and black children, 26 months (P greater than 0.014). The commonest cause of confirmed bacterial meningitis was Neisseria meningitidis (140 cases; 11.5%), which continues to affect mainly young coloured children (median age 16.9 months). Resistance to sulphonamides was found among 21% of 114 N. meningitidis isolates. Among white children Haemophilus influenzae was responsible for 9 of the 18 cases of confirmed bacterial meningitis. Tuberculosis was responsible for 62 cases of meningitis (5%) and was a commoner cause of meningitis than either H. influenzae (47 cases) or Streptococcus pneumoniae (34 cases). Thirty-four confirmed cases of bacterial meningitis were seen in children less than 1 month old. Klebsiella species were responsible for 8 cases (24%), Escherichia coli for 6 cases (12%), group B beta-haemolytic Streptococcus for 5 cases (15%) while 4 cases each were due to N. meningitidis and Strept. pneumoniae.
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PMID:Paediatric meningitis in the western Cape. A 3-year hospital-based prospective survey. 302 Jul 18

As a result of conducting experimental and clinical tests with the newly developed cephalosporin, cefoperazone (CPZ), the following conclusions were obtained: (1) When tested against 10 strains of Staphylococcus aureus and 16 strains of Staphylococcus epidermidis, the antibacterial activity of CPZ was found to be weaker than that of CEZ. Against 5 strains of A-beta-Streptococcus and 4 strains of Streptococcus pneumoniae, both CPZ and CEZ exhibited similar excellent antibacterial activity. CPZ was effective against 18 strains of Escherichia coli though its activity was influenced by the amount of inoculated bacteria present. Against 15 strains of Haemophilus influenzae and 10 strains of Haemophilus parahaemolyticus, CPZ was found to be more effective than CEZ though several high-resistant strains were noted. CPZ also showed more excellent antibacterial activity than CEZ against 4 strains of Haemophilus parainfluenzae, 5 strains of Klebsiella pneumoniae, 8 strains of Salmonella sp., 4 strains of Pseudomonas aeruginosa and 4 strains of Proteus sp. (2) The mean half-life in the blood following intravenous injections of 25 mg/kg and 10 mg/kg of CPZ to three children was 70 minutes. (3) One hour after intravenous injection of 25 mg/kg of CPZ to 3 cases of aseptic meningitis, drug concentration in the cerebrospinal fluid (CSF) was 1.20 mcg/ml, less than 0.39 mcg/ml and 1.55 mcg/ml. In one case, the CSF/serum ratio was 2.7%. (4) The average recovery rate in the urine of children who had received intravenous administrations of 25 mg/kg (3 children) and 10 mg/kg (1 child) was 17.8% between 0 and 6 hours. (5) Eighteen pediatric patients received CPZ in doses ranging from 48 to 170 mg/kg divided three-four times a day. They were RTI in 7, URI in 5, UTI in 5, SSSS in 1 and enteritis in 1 children. The clinical effectiveness of CPZ was judged to be remarkedly effective in 11 children, effective in 5 children and ineffective in 3 children, with an overall effective rate of 84.2%. One patient of tonsillitis combined sinusitis was considered 2 cases. The three cases in which the drug was found to e ineffective were 2 cases of pyothorax and 1 case of sinusitis. (6) Side effects were 1 case of eosinophilia, 2 cases of elevation of GOT and GPT, and 1 case of mild elevation of GOT. All were considered to be minor.
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PMID:[Fundamental and clinical studies of cefoperazone in children (author's transl)]. 645 30

The clinical and laboratory findings in seven children with Kawasaki disease are reviewed. Four of the patients had the more complicated course that has characterized the cases diagnosed in North America. This suggests that the benign forms are often mistaken for other febrile illnesses. The patients were two girls and five boys ranging in age from 4 months to 7 years; six were Caucasian and one was a North American Indian. Fever, redness of the oral mucosa, an erythematous or scarlatiniform rash and cervical adenopathy were seen in all; six patients had the characteristic fingertip desquamation and nonexudative conjunctivitis. Cardiac involvement occurred in four patients, two of whom had coronary artery aneurysm or thrombosis. Arthritis or arthralgia was seen in six patients, and aseptic meningitis occurred in four. Of the three patients with jaundice two underwent laparotomy and excision of a hydropic gallbladder; one of them died from Klebsiella pneumoniae sepsis and disseminated intravascular coagulopathy.
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PMID:Kawasaki disease, or mucocutaneous lymph node syndrome: report of seven cases in North America. 737 Aug 80

Meningeal defects and primitive ENT infections are known to promote pneumococcal meningitis. Other risk factors can be identified in the occurrence of community acquired bacterial meningitis (CABM) and play a key role either in the frequency of this kind of infection, the type of bacteria concerned, the prognosis or the risk of recurrence. Thus, epidural infiltrations are rarely responsible for staphylococcal or streptococcal meningitis. Cochlear implants are also known to increase the risk of pneumococcal meningitis. The occurrence in children of aseptic meningitis or meningitis due to Staphylococcus aureus or Enterobacteriaceae is strongly suggestive of congenital spinal or cerebral anomalies (dermal sinus or spina bifida). MRI must be rapidly performed. In cases of splenectomy or asplenism, pneumococcal meningitis is common and must be prevented. According to the larger series available on this topic, age over 60, diabetes mellitus, alcoholism and immune deficiency are found to promote CABM in about 25% of cases. Streptococcus pneumoniae is the most frequent causative bacteria in elderly patients, in case of alcoholism, as well as Listeria monocytogenes and some Enterobacteriaceae (Escherichia coli, Klebsiella pneumoniae). L. monocytogenes is frequently isolated in immunodepressed patients and patients treated by anti-TNF molecules (infliximab notably). Finally, some genetic polyphormisms promote CABM: complement and properdin deficiencies (meningococcal meningitis), mannose-binding lectin deficiency, Fcgamma receptors alteration or interleukin-1 and IL-1R polymorphisms. Screening for such genetic disorders may be discussed in case of CABM but is mandatory in case of recurrent meningococcal infections.
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PMID:[Predisposing factors of community acquired bacterial meningitis (excluding neonates)]. 1941 29

Hyperinfection syndrome with Strongyloides stercoralis is not uncommon in immunocompromised patients. We present 2 fatal cases of Strongyloides hyperinfection with initial presentation mimicking acute exacerbation of chronic obstructive pulmonary disease (COPD). Both cases had a history of COPD and had received systemic steroid treatment before or during admission. The initial chest radiograph in both of these cases showed diffuse axial interstitial pattern. The sputum examinations of Gram stain both yielded larvae of Strongyloides stercoralis precipitously. Case 1 developed acute respiratory distress syndrome and bacteremia of Escherichia coli and Klebsiella pneumoniae soon after admission, and died even after receiving albendazole and antibiotic treatment. Case 2 received albendazole and antibiotic treatment for over 2 weeks, but developed refractory aseptic meningitis and died of septic shock. Neither case had high eosinophil count in peripheral blood during admission. Clinical manifestations of unexplained wheezing and respiratory failure, increased infiltration on chest radiograph, Gram-negative bacteremia, and aseptic meningitis may all be clues of Strongyloides hyperinfection. Due to the high mortality rate and severe complications in these patients, clinicians should always keep this diagnosis in mind, especially when dealing with immunocompromised patients. We suggest that a screening test be done for patients who live in endemic areas and those who are going to receive steroids for chronic disease.
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PMID:Strongyloides stercoralis hyperinfection presenting with symptoms mimicking acute exacerbation of chronic obstructive pulmonary disease. 1968 2

To date, ceftazidime-avibactam (CAZ-AVI) neurotoxicity in patients with normal renal function has not been reported in the literature, and no data about its penetration into the CNS through the blood-brain barrier are available. We report the occurrence of severe encephalopathy in a patient with normal renal function, after the infusion of CAZ-AVI to treat a Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) sepsis. The radiological and clinical pictures of our patient, and particularly the encephalopathy resolution after drug discontinuation, support the hypothesis of a drug-induced aseptic meningitis (DIAM). The brain MRI-supported meningeal inflammation, along with the increase in blood-CSF-barrier permeability detected on the CSF analysis, could have paved the way for the drug's neurotoxicity by increasing its CNS entering (the CSF CAZ-AVI level in our patient was higher than the highest value reported in a study on children with meningitis). Neurotoxicity of CAZ-AVI and, by analogy, of other cephalosporins should be recognized as a potential adverse effect even in patients with normal renal function, with an increased risk of severe encephalopathy.
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PMID:Ceftazidime/avibactam neurotoxicity in an adult patient with normal renal function. 3328 78