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Biomedical subjects

E H Price

Publications and source records attributed to E H Price.

At least 19 recordsLinked to original sources
PubMed1997

Salmonella osteomyelitis in sickle cell disease children in the east end of London.

Five cases of Salmonella osteomyelitis are presented in children with sickle cell disease living in the East End of London. Four of these had involvement of the long bones and one (an infant) presented with hand-foot syndrome. Four required surgical drainage of pus and all required lengthy therapy with antibiotics. Factors contributing to the increased susceptibility of these patients to invasive disease with Salmonella sp. are discussed as are the clinical features, surgical and antibiotic management and possible preventative measures.

Anemia, Sickle Cell↗
PubMed1994

Rapid diagnosis of cutaneous herpes simplex infections using specific monoclonal antibodies.

One hundred children with suspected herpes simplex virus (HSV) infection and 20 controls were studied to compare a rapid immunofluorescence (RIF) test for detection and typing of HSV from smears of lesions with standard viral culture. The RIF test was evaluated for ease of use and speed of diagnosis. RIF and/or culture were positive in 64% of patients. All infections diagnosed by RIF and culture were HSV type 1. In 92% of patients RIF and culture results were in concordance. In 57 cases, RIF and cultures were positive for HSV infection and in 35 cases RIF and cultures were negative for HSV infection. Three patients had inadequate samples for RIF and five children had positive RIF but were culture negative. All controls had negative results both by RIF test and culture. The RIF test demonstrated 100% sensitivity and 95% specificity. The RIF test was type specific, easy to perform and gave diagnosis of HSV infections within an hour of taking the clinical specimen. This study suggests the RIF test is as good, if not more sensitive, in the diagnosis of HSV infections as standard viral culture and has the advantage of speed of diagnosis.

Adolescent↗
PubMed1993

Skin microflora of atopic eczema in first time hospital attenders.

The bacterial flora of the skin was assessed quantitatively in 50 children with eczema, aged 6 months to 14 years, referred to the hospital for the first time. Twenty nonatopic controls with an unrelated non-infective disorder were also studied. Cotton-tipped swabs and contact agar discs were taken from the worst affected area of eczema and from an uninvolved site in patients and from the forearm in controls. Swabs were also taken from the nose, axilla and groin in all children. Bacterial colonization of the skin was consistently more common and greater in amount from patients compared with controls. Staphylococcus aureus was the most common pathogen isolated from patients only; from the worst affected area of eczema in 74% of patients and from an uninvolved skin site in 30% of patients. Quantitative assessment showed that the density of colonization was proportional to the severity of eczema. The most common S. aureus phage group was group II accounting for 32% of strains. Resistance to penicillin was present in 88% of strains and to two or more antibiotics in 38% of strains. No relationship was noted between the pattern of resistance and phage group.

Adolescent↗
PubMed1993

Mycobacterial infection in an inner city children's hospital.

Childhood tuberculosis is perceived by many as a disease of the past. Experience in a children's hospital serving a deprived population suggested that tuberculosis and other mycobacterial infections were not declining in clinical practice. Fifty three tuberculous and 11 atypical mycobacterial infections were identified between 1978 and 1992. There was no decline in tuberculosis and nine of the 11 atypical infections occurred in the last five years. Altogether 40% of cases of tuberculosis were in non-Asian children; 32% had arrived in the UK or visited family overseas in the previous year; and 38% had a history of tuberculosis contact, usually a close adult relative. Nationally, the previous decline in tuberculosis in all ages has reversed. In the local health districts in London's east end, childhood tuberculosis has also stopped declining and seems to be increasing. It is regrettable that BCG vaccination has been abolished by some districts in the UK, against current recommendations. Childhood tuberculosis is still common in the practice described here, including among children who do not fall into conventionally recognised high risk groups. Inner city dwellers and junior doctors are both highly mobile populations, adding to the risk that paediatricians, particularly those in training, may encounter tuberculosis with little or no previous experience of the condition.

Adolescent↗
PubMed1991

Acute infectious erythemas in children: a clinico-microbiological study.

One-hundred children with an acute illness comprising fever and widespread erythematous rash were prospectively studied to determine whether clinical presentations are helpful in defining the causative agent and to identify the most appropriate microbiological specimens. An infectious agent was identified in 65 children; 72% were viruses, 20% were bacteria, 5% were Mycoplasma pneumoniae and in 3% both viruses and bacteria were detected. The most common infectious agents were picornaviruses, an atypical presentation of measles and Group A beta-haemolytic Streptococcus. Different patterns of rash occurred with each of these infections. The clinical presentation of a child with an acute febrile illness and rash was unhelpful in defining the causative agent. Routine management should include a throat swab for bacterial investigation and in selected cases a blood sample for IgM viral titres.

Acute Disease↗
PubMed1988

Clostridium difficile and acute enterocolitis.

Clostridium difficile belonging to groups not normally detected in infancy was the only potential pathogen detected in the stools of two infants with severe enterocolitis. Further information regarding the virulence of this organism was obtained by use of a recently introduced typing scheme.

Clostridium↗
PubMed1987

AIDS in an infant causing severe failure to thrive.

A nine-month-old female Jamaican infant presented with a history of severe failure to thrive, recurrent pneumonia and developmental delay. She was found to have hepatosplenomegaly, generalised lymphadenopathy and hypotonia. Investigations revealed polyclonal hypergammaglobulinaemia, cytomegalovirus in her urine, and patchy lung infiltrates on her chest radiographs. Three separate tests were positive for human immunodeficiency virus in both the infant and her mother, suggesting vertical transmission, and confirming AIDS as the cause of the severe failure to thrive.

Acquired Immunodeficiency Syndrome↗
PubMed1987

In-vitro antibiotic inactivation by mammalian cell and killed bacterial preparations.

Inactivation of a range of antibiotics acting at different points in the metabolism of the bacterial cell was detected by estimating the MIC and MBC in the presence of liver and other tissue preparations. High temperature treatment and sonication of liver cells increased their ability to inactivate antibiotic action. This treatment would have almost completely destroyed enzyme activity, which was, therefore, not thought likely to be the cause of the phenomenon. The loss of antibiotic activity may be related to "protein binding" and a dialysis experiment showed that penicillin binding with liver homogenate was very much greater than with human albumin. It may be that increased disruption of tissue cells by physical methods exposes more active binding sites which reduces the bioavailability of antibiotics. Some degree of binding specificity was indicated in experiments in which DNA was shown to block antibiotics acting primarily on DNA--related synthesis and RNA blocked antibiotics acting on RNA--related metabolism. Suggestions are made for the cause of failure of antibiotic treatment in certain clinical situations.

Animals↗
PubMed1986

Norwalk like viruses: study of an outbreak.

An outbreak of acute non-bacterial gastroenteritis is reported, during which a ward had to be closed, and stool samples from 15 patients showed a virus structurally similar to the Norwalk agent.

Child, Preschool↗
PubMed1986

Clinical associations of Aeromonas spp. in fecal specimens from children.

Human infections caused by Aeromonas spp. are being reported with increased frequency. We examined 1012 unselected stool specimens from 799 children for various pathogens, including Aeromonas spp., to evaluate the clinical associations of Aeromonas spp. in the stools of children in the East End of London. A total of 33 children had positive cultures for Aeromonas spp. These were identified as: Aeromonas hydrophila (16), A. sobria (9), A. caviae (8). Aeromonas spp. were identified by being oxidase positive in character, a property that distinguishes Aeromonas spp. from Enterobacteriaceae. Associated pathogens included Salmonella typhimurium (1), Campylobacter spp. (3), Enteropathogenic Escherichia coli (2), and Giardia lamblia (1). Electron microscopic examination of the stool of 13 children revealed viral particles in two, rotavirus (1), and coronavirus-like particles (1). The associated clinical features in the 25 children with only Aeromonas excretion were diarrhea (21), vomiting (10), abdominal pain (9), fever (4), and mild dehydration (2). Five patients had macroscopic blood loss in the stools. The illness was generally mild and lasted only a short time.

Aeromonas↗