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Biomedical subjects

D S Davenport

Publications and source records attributed to D S Davenport.

7 recordsLinked to original sources

Successful treatment of Staphylococcus aureus bacterial endocarditis in a renal transplant recipient.

We report the successful treatment of Staphylococcus aureus endocarditis in a renal transplant recipient with preservation of his renal allograft. A 44-year-old man presented to the emergency room with sudden onset of fevers and rigors 7 weeks after renal transplantation. Infective endocarditis was diagnosed by Duke's Criteria (Durack et al. New criteria for the diagnosis of infective endocarditis. Am J Med 1994: 96: 200-209) with multiple positive blood cultures for S. aureus and a mitral valve vegetation on transesophageal echocardiogram. He was treated with intravenous antibiotics for 6 weeks with continuation of his immunosuppression. He has remained clinically stable for over 5 years. Although the treatment of S. aureus endocarditis in immunosuppressed transplant patients has traditionally resulted in loss of their allograft, prompt diagnosis and appropriate antibiotics with continued immunosuppressive therapy resulted in a successful outcome and allograft preservation in this case.

Adult↗

Guidelines for the prevention and treatment of B-virus infections in exposed persons. The B virus Working Group.

Cercopithecine herpesvirus 1 (B virus), enzootic among monkeys of the genus Macaca, causes minimal morbidity in its natural host. In contrast, human B-virus infection presents as rapidly ascending encephalomyelitis with a fatality rate of approximately 70%. This infection remains an uncommon result of macaque-related injuries, although the increase in the use of macaques for research on simian retrovirus infection and hepatitis has expanded the number of opportunities for human exposure. In response to this situation, Emory University and the Centers for Disease Control and Prevention jointly sponsored a B Virus Working Group to formulate a rational approach to the detection and management of human B-virus infection. The resulting guidelines are presented herein and are based upon information from published cases, unpublished cases managed by working-group members, knowledge of the behavior of herpes simplex virus, and--in the absence of hard data--the collective judgment of the group. Although consensus among the co-authors existed on the major points covered by these guidelines, opinions varied widely regarding specific recommendations.

Animals↗

Diagnosis and management of human B virus (Herpesvirus simiae) infections in Michigan.

Three men who had worked at the same animal research facility and had had contact with macaque monkeys were infected with B virus (Herpesvirus simiae). Their clinical presentations varied from self-limited aseptic meningitis syndrome to fulminant encephalomyelitis and death. Patient 1 was treated only after a respiratory arrest and other signs of advanced brain stem dysfunction had occurred. He died 8 days after hospital admission, despite treatment with acyclovir. Patient 2 presented with subtle signs and symptoms of brain stem encephalitis. He received antiviral therapy with intravenous ganciclovir. Patient 3 had a headache without meningismus and was also treated with acyclovir. Both patients 2 and 3 survived and did not have objective sequelae. Viral culturing, ELISA and western blot antibody testing, and magnetic resonance imaging all proved useful in the diagnosis of these patients' conditions.

Acyclovir↗

Usefulness of a test for slime production as a marker for clinically significant infections with coagulase-negative staphylococci.

The usefulness of a test for slime production as a marker for clinically significant infections with coagulase-negative staphylococci and its implications for therapy were examined. Hospital records were reviewed for 59 patients from each of whom more than one isolate of coagulase-negative staphylococci was obtained. In patients with a prosthetic device, 81% of 59 infectious episodes were due to a slime-positive coagulase-negative staphylococci. In contrast, 22 noninfectious episodes (in which the organisms were contaminants) were equally distributed between episodes due to slime-positive or slime-negative isolates (P = .005). Only 32% of infections caused by slime-positive organisms, in contrast to 100% of infections caused by slime-negative organisms, were improved by treatment with antibiotics alone (P = .02). Prosthetic device removal in addition to antibiotic treatment significantly improved the outcome in patients with infections due to slime-positive organisms when compared with treatment with antibiotics alone (93% vs. 32% improvement; P = .00025).

Anti-Bacterial Agents↗