Fatal pneumococcal bacteremia in a vaccinated, splenectomized child.
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Biomedical subjects
Publications and source records attributed to B S Shaikh.
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A 4-year-old boy with acute lymphoblastic leukemia in relapse with documented septicemia due to group C Streptococci (Streptococcus equisimilis) is described. The patient responded well to therapy with appropriate cytotoxic and antimicrobial agents. There is a general lack of recognition of the pathogenicity of group C Streptococci in man. The potential opportunistic nature of these organisms in immunocompromised hosts and the need for early recognition and appropriate treatment of such infection is emphasized.
Significant and sustained thrombocytopenia in mice maintained in a polycythemic state with weekly injections of washed packed RBCs prompted the examination of the relationship between the observed thrombocytopenia and the polycythemic state. Platelet production was determined by measurement of 75SeM incorporation into platelets. Platelet survival was studied with 51Cr-labeled platelets. Platelet sequestration was assessed by measuring the trapped platelet 51Cr-bound radioactivity in the spleens of these animals. Blood volume was calculated by measuring the dilution of injected 59Fe-tagged RBCs. These studies failed to reveal decreased platelet production, a shortening of the platelet survival, or significant splenic pooling as factors contributing to the observed thrombocytopenia. The blood volumes in the polycythemic group of animals were 8.9% +/- 0.15 (1 S.D.) body weight vs. 6.4% +/- 0.69 in the normals (p less than 0.001). Contrary to what has been reported for hypoxia-induced polycythemia, our results indicate that transfusion-induced polycythemia does not cause thrombocytopenia by decreasing platelet production. We suggest instead that the observed thrombocytopenia is mainly due to dilution of the circulating platelet mass by the expanded blood volume.
1. Normal data for routine hematologic studies including fibrinogen, VIIIAHF, AT III, and circulating platelet aggregates are reported for Holstein calves. 2. Therapy with warfarin, ASA, and dipyridamole does not alter these parameters such as VIIIAHF, AT III, or circulating platelet aggregates. 3. 75SeM can be used as an in vivo label to study the fibrinogen, platelet, and red cell kinetics simultaneously in calves. 4. Decreased VIIIAHF levels and decreased platelet survival are the most sensitive parameters to estimate the activation of coagulation in the animals with circulatory assist devices. 5. The total heart animals seem to have a significant decrease in fibrinogen and VIIIAHF levels as compared to normal and left ventricular assist animals. 6. Despite the use of warfarin and antiplatelet drugs, decreased platelet survival occurred in both the total heart and the left ventricular assist animals. Fibrinogen half life with 75SeM must be interpreted with caution until corrections for pool size, reutilization, and nonpeptide binding have been considered.
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