A case of Henoch-Schönlein purpura syndrome following oral ampicillin.
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Biomedical subjects
Publications and source records attributed to A M Geddes.
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The results of previous studies of gentamicin auditory toxicity have depended largely on the criteria set for a significant change in hearing threshold. This paper proposes a design for future studies of aminoglycoside toxicity based on an investigation of factors other than aminoglycoside therapy which may influence the measurement of hearing threshold. Audiometry can be performed reliably in a ward but a patient's condition has both temporary and permanent effects on hearing threshold. Ototoxicity cannot be detected by assessing hearing after aminoglycoside therapy. However, an audiogram taken at the start of treatment may be misleading if the patient is seriously ill. Permanent hearing loss may be due to factors other than aminoglycoside therapy so that future studies must be controlled.
Campylobacter jejuni is now recognised as a common cause of acute enteritis in Britain. A prospective study of 16 patients with campylobacter infection has been performed. Characteristic clinical features include an abrupt onset of symptoms and severe abdominal pain and blood with the diarrhoea. The rectal mucosa was abnormal in all 15 patients examined during acute illness but had returned to normal at follow up.
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Septicaemia is a serious manifestation of an infection localized outside the vascular system and/or of an immune defect resulting in reduced capacity of the patient to eliminate invading bacteria by phagocytosis or antibody response. Identification of processes leading to septicaemia thus becomes important both for predicting the infecting organism and for determining the therapeutic measures which must be taken. In the septicaemic patient, therapy must be directed against the effects of the bacterial toxins, such as endotoxin shock and disseminated intravascular coagulation. It must also include the use of antibiotics to eliminate the causative agent from the blood as well as from the primary infectious focus. In the present review the above factors are discussed.
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Amoebiasis is usually acquired in countries where the disease is endemic. A case is presented of hepatic infection probably acquired indigenously with identification of the source of infection. The place of dual therapy for treatment is considered and the value of ultrasound scanning in management illustrated.
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Pseudomonas aeruginosa is an opportunist pathogen of low invasiveness which can cause serious disease in patients with abnormal defence mechanisms against infection. Advances in medicine and surgery have resulted in an increase in such patients and Ps. aeruginosa has therefore assumed greater importance in hospital practice. During the years 1974-1980 Pseudomonas organisms were cultured from the blood of 69 patients at East Birmingham Hospital. The records of these patients have been reviewed with the intention of identifying those at risk and suggesting a rational approach to the management and prevention of pseudomonas infections. The importance of differentiating pseudomonas septicaemia from transient bacteraemia or contaminated blood cultures is stressed.
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