Influenza immunization and lupus erythematosus.
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Humans↗
Biomedical subjects
F Tecson
Publications and source records attributed to F Tecson.
Infectious pneumonias: a review.
Diplococcus pneumoniae remains the most frequent cause of community-acquired bacterial pneumonia. Other frequently isolated bacterial pathogens are Hemophilus influenzae, Klebsiella organisms, and Staphylococcus aureus. The etiologic agents most commonly implicated in hopsital-acquired pneumonias are gram-negative bacilli including E. coli, proteus organisms, and species of Klebsiella-Enterobacter, pseudomonas, and Serratia. Among older children and young-adults, Myocoplasma pneumoniae is a common cause of penumonia. Influenza is the most important cause of viral pneumonia in adults, but there is increasing concern about pulmonary infection due to adenoviruses. In those with a history of travel to endemic areas, the diagnosis of fungal pneumonia due to Histoplasma capsulatrum, Blastomyces dermatitides, or Coccidioides immitis, should be considered. Penumonias due to opportunistic fungi (including species of Candida, Aspergillus, and Phycomycetes) and higher bacteria such as Nocardia asteroides are also on the increase, and these arise mostly in compromised hosts. Treatment of pneumonia almost always must be started before culture results are known and in the overwhelming majority of cases, appropriate regimens can be selected after taking an adquate history, doing a careful physical examination, evaluating expectorated sputum for cells and organisms, and examining the chest x-ray. Although anti-infective agents are the mainstay of treatment for most infectious pneumonias, supportive therapy, including adequate tracheobronchial toilet, drainage of abscesses, oxygen inhalation, maintenance of adequate nutrition, and monitoring for super-infection and anti-infective side effects may be life-saving in certain situations.
Anti-Bacterial Agents↗
Study on the usefulness of hypertonic culture media.
Specimens from 300 patients were studied using five to nine aerobic and anaerobic culture media, including five that were hypertonic, Groups studied included fever of unknown origin, suspected endocarditis, endocarditis during therapy, bacteremia during therapy, abscess and cellulitis, presumed infectious arthritis, renal transplantation during rejection, collagen disease, sarcoidosis, lymphoma, and colitis. Isolates in hypertonic media were reverted to parent form by agar passage. In only 5% of these selected cases were organisms found in hypertonic, but not conventional, media that appeared on the basis of repeated isolation and/or serological studies to come from the patient. Nine of the 16 appeared to be of major significance. The two groups in which use of highly enriched, hypertonic media seemed most helpful were suspected endocarditis and undefined meningitis with negative cultures using standard media. The most effective of the hypertonic media used was 0.3 M sucrose in brain heart infusion with 20% horse serum. In most instances, the organism grew only in the hypertonic sucrose, and in most cases it appeared in conventional rather than aberrant form. Hypertonic media, especially 0.3 M sucrose, are of substantial helpin a small number of carefully selected cases.
Adolescent↗
Candida endocarditis in two patients.
On the basis of the data currently available, no dogmatic statements can be made about optimal therapy for Candida endocarditis. In those with valve protheses, early surgery should be carefully assessed even though the differences in outcome (17% vs 53% survival) are not yet statistically significant.
Adolescent↗
Nosocomial Salmonella epidemic.
A patient admitted to the hospital with diarrhea due to Salmonella heidelberg subsequently developed fatal disseminated salmonellosis, despite vigorous antimicrobial treatment. Beginning five weeks after the initial patient's death, nine patients developed hospital-acquired S heidelberg infections characterized by diarrhea (in seven) and bacteremia (in two). A careful search for salmonellosis among patients and hospital staff revealed two asymptomatic excretors. Extensive culturing of samples from the environment did not show any contaminated objects or reservoirs. The epidemic ended after initiation of an energetic handwashing campaign and isolation procedures. The strain of S heidelberg isolated was resistant to chloramphenicol, ampicillin, and gentamicin. Especially interesting in the epidemic were the prolonged time between death of the index case and the appearance of nosocomial cases, the high fatality rate, and the marked antibiotic resistance.
Adolescent↗
Clindamycin in the oral treatment of putative anaerobic pneumonias.
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Administration, Oral↗
Aortotomy site infections: case presentation and review of the literature.
A patient with Aspergillus fumigatus infection involving an aortotomy site with multiple peripheral emboli following implantation of an aortic valve prosthesis for rheumatic heart disease is described. Eleven aortotomy site infections are reviewed from the literature. Eight cases were caused by fungi with Aspergillus sp accounting for four cases. Presenting symptoms were nondiagnostic and multiple. However, the diagnosis of aortotomy site infection should be entertained in patients who have had aortic valve surgery who develop fever and embolic phenomena with or without positive blood cultures coupled with no evidence of valve dysfunction, and who respond inappropriately to antibiotic therapy. Ten of the 11 patients reviewed from the literature died. Therapy should be directed at early recognition followed by prompt early surgery combined with the use of proper antimicrobial agents directed against the isolated microorganism.
Aorta↗