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Biomedical subjects

C S Block

Publications and source records attributed to C S Block.

14 recordsLinked to original sources
PubMed1979

Overwhelming pneumococcaemia 17 years after splenectomy. A case report.

We present a case of fulminant pneumococcaemia and disseminated intravascular coagulopathy in a young adult man 17 years after splenectomy. The clinical presentation, laboratory and postmortem findings are discussed. The diagnosis, management and prophylaxis of overwhelming infections in splenectomized patients are reviewed. The advent of pneumococcal and other vaccines could contribute significantly to the successful protection of asplenic patients against certain severe infections.

Adult↗
PubMed1978

Community versus hospital Staphylococcus aureus. Antimicrobial susceptibilities and some features of nasal carriage and acquisition.

Susceptibility of community and hospital isolates of Staphylococcus aureus to 15 drugs has been tested. The organisms were isolated from the noses of White adults admitted to two general surgical units. Approximately half of each group were resistant to beta-lactamase-labile penicillins. Hospital staphylococci displayed a greater degree of multiple drug resistance and resistance to methicillin and erythromycin than did community strains. A nasal carriage rate of 28.6% was found among White patients admitted. A comparative survey of 54 Black adults from a rural community revealed a significantly lower rate (14.8%). On non-carriers admitted to hospital, 21.9% acquired S. aureus nasally.

Anti-Bacterial Agents↗
PubMed1978

Bacillus cereus endocarditis. A case report.

Bacillus cereus may cause infective problems in compromised patients. No previous record of infective endocarditis due to this organism could be found. A 51-year-old White woman with B. cereus endocarditis after prosthetic mitral valve replacement is described. The problems of interpreting the significance of B. cereus bacteraemia, delayed diagnosis, and the inherent resistance of the organism are discussed.

Bacillus cereus↗
PubMed1978

Gentamicin-resistant gram-negative bacilli in hospital patients. Part II. In vitro aspects including susceptibility to tobramycin and amikacin.

A study of 259 clinical isolates of gentamicin-resistant Gram-negative bacili (GRNB) has revealed 99,2% crossresistance with tobramycin and 6,9% with amikacin. Resistance to all 3 drugs is transferable in vitro. Simultaneous transfer of resistance to ampicillin, carbenicillin, cephalothin, tetracycline, chloramphenicol, sulphonamides, co-trimoxazole, streptomycin and kanamycin was shown to occur, emphasizing the potential for the selection of aminoglycoside-resistant organisms by the use of many other drugs. All GRNB studied were multiresistant. While amikacin should prove useful for those infections caused by GRNB which require treatment, care should be exercised in its use, to minimize the emergence of large-scale amikacin resistance.

Amikacin↗
PubMed1978

Gentamicin-resistant gram-negative bacilli in hospital patients. Part I. Preliminary epidemiological assessment.

Gentamicin-resistant Gram-negative bacilli (GRNB) have been isolated from specimens received from 23 hospitals in and around Johannesburg. Most isolates are fermentative in nature. A pilot survey among inpatients at the Johannesburg Hospital revealed an intestinal carriage prevalence of 14,3%. A prospective study of intestinal acquisition showed that GRNB are acquired in hospital, and that colonization is associated with prior antibacterial therapy. Analysis of clinical specimens received from the Johannesburg Hospital from 1 July to 30 September 1976 has indicated that intensive care and urology units are worst affected. An assessment of the overall prevalence of GRNB in October 1976 revealed that 16,1% of all Gram-negative bacilli were resistant to gentamicin. Major contributing factors are the widespread use of systemic aminoglycoside antibiotics, and a high rate of cross-contamination. Measures aimed at minimizing these factors have been introduced by the Johannesburg Hospital administration.

Adolescent↗
PubMed1977

Early diagnosis of opportunistic systemic fungal and nocardial infections.

An approach to the expediting of the diagnosis of opportunistic systemic mycoses is presented. Communication between clinician and microbiologist is basic to this approach. The importance of the clinical assessment of the individual patient, coupled with a high index of suspicion, is stressed. Our experience with 11 of 42 cases of systemic mycosis over a 28-month period is analysed. For the diagnosis of fungaemia a method for the microscopical examination of peripheral blood is briefly evaluated, and a membrane filter blood culture technique is shown to be valuable, yielding results in 16-24 hours. In the absence of fungaemia the considered microscopical examination of suitable specimens, when feasible, is the most rapid method available. Serological methods may be helpful in early diagnosis, but this is often hampered by the absence of baseline sera and by the lengthy nature of some tests. Newer indirect methods such as gas chromatography are being developed but have not yet been used routinely.

Blood↗
PubMed1977

Aspergillus pneumonia--a cluster of four cases in an intensive care unit.

Four cases of Aspergillus pneumonia occurred in an intensive care unit within a short period. Clusters of cases of invasive aspergillosis are rare and have usually been attributed to excessive contamination of the environment. Extensive environmental studies were, however, negative. Three of the cases were diagnosed ante mortem. One patient survived after early initiation of treatment with amphotericin B.

Adult↗
PubMed1977

Torulopsis glabrata fungaemia. A report of two cases.

Two cases of Torulopsis glabrata fungaemia are presented. The literature on detection of micro-organisms in peripheral blood and on systemic T. glabrata infection is briefly reviewed. Microscopical examination of a buffy coat preparation, a simple and rapid procedure for diagnosing this condition, is described. A scheme of criteria which may be helpful in the diagnosis of clinically significant fungaemia is offered.

Adult↗
PubMedDate not supplied

Transfusion reactions due to bacterial contamination of blood and blood products.

Bacterial infections transmitted by blood or blood products, although rare, remain a serious threat to the recipient of a transfusion. We report on five cases of adverse reactions due to bacterial contamination of blood products, and we review 76 similar cases reported in the English-language literature. Most cases (70%) have been reported from the United States. Various sources of contamination have been suggested, including infection in the donor and invasion of the blood product during the process of collection, preparation, and storage. Frequent clinical manifestations are fever (80%), chills (53%), hypotension (37%), and nausea or vomiting (26%). The overall mortality is 35% (28 of 81 patients). In 38 patients (47%) the adverse reactions have appeared during transfusion; in the others the interval between completion of the transfusion and appearance of symptoms has ranged from 15 minutes to 17 days. A wide spectrum of bacteria have been implicated as causes of adverse reactions, with Pseudomonas species involved in 28% of episodes. Many such reactions are probably misdiagnosed or overlooked, the result being underestimation of the extent of the problem.

Adult↗
PubMedDate not supplied

A simple, disposable end-tidal carbon dioxide detector.

Detection of expired carbon dioxide is one of the most reliable methods of avoiding accidental esophageal intubation. Although capnography has become a standard monitoring technique in the hospital operating room, it is rarely available in the office setting or other arenas where emergency endotracheal intubation may be required. A new and inexpensive device, however, has been developed for assessing end-tidal carbon dioxide. This semi-quantitative detector fits between the endotracheal tube and the breathing circuit and uses a pH-sensitive indicator that changes color in response to different concentrations of carbon dioxide. Clinical studies indicate that this device provides similar results to standard capnography, and its inclusion in the emergency kit is strongly recommended.

Blood Gas Analysis↗