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Biomedical subjects

G O Westenfelder

Publications and source records attributed to G O Westenfelder.

11 recordsLinked to original sources
PubMed1994

Hospital carpeting and epidemiology of Clostridium difficile.

BACKGROUND: Clostridium difficile is the usual and most important cause of antibiotic-associated pseudomembranous enterocolitis. The source of nosocomial acquisition of the organism in nonepidemic settings has not been determined. METHODS: Epidemiologic and microbiologic studies were conducted in a community-teaching hospital complex to assess the impact of carpeting in patient rooms on environmental contamination with C. difficile, along with the prevalence of pseudomembranous enterocolitis. All C. difficile isolates were typed by means of a bacteriophage-bacteriocin typing scheme. RESULTS: No clear evidence of environmental acquisition of C. difficile in a nonepidemic setting of pseudomembranous enterocolitis was found. Carpeted floors were significantly more heavily contaminated for prolonged periods with clinical strains of C. difficile than were noncarpeted floors. CONCLUSION: There was no evidence that contamination of carpeting resulted in increased frequency of pseudomembranous enterocolitis in patients residing in carpeted rooms. Because there is strong evidence of exogenous acquisition of C. difficile during outbreaks, however, room carpeting should be considered a potential reservoir of this organism.

Clostridioides difficile↗
PubMed1986

Group G streptococcal endocarditis and bacteremia.

This report describes fifteen recent cases of group G streptococcal bacteremia in patients with acute illnesses. Seven patients had acute endocarditis (47 percent). Four deaths occurred, and four patients had significant clinical complications during prolonged stormy courses. This series indicates a relatively high incidence of infective endocarditis in patients with group G streptococcal bacteremia, which is at variance with recent reports. Group G streptococcal bacteremia (with or without endocarditis) is a serious infection that often follows a hectic course with significant morbidity and mortality. The need for prompt recognition and aggressive treatment of this infection is underscored.

Adult↗
PubMed1983

Omental anisakiasis: a rare mimic of acute appendicitis.

The authors recently encountered a patient with omental anisakiasis who presented with features of acute appendicitis and who made an uneventful recovery following resection of an inflammatory omental mass containing the larva(e). Anisakiasis refers to infestation of humans by species of marine nematode larvae belonging to the subfamily Anisakinae. Although this condition is rarely reported in the United States, it has been well described both in Holland and in the Orient. Several publications in the Japanese literature have detailed the morphology of the parasite and the clinical symptoms of infestation. The source of infestation is most often raw or uncooked fish, the latter widely enjoyed as a foodstuff in the Orient, but less popular in the United States. With the growing popularity of "sushi" bars and the increasing numbers of Americans developing a taste for raw fish, this condition may become more prevalent in the future.

Acute Disease↗
PubMed1982

The adherence of polymorphonuclear leukocytes in patients with sepsis.

Adherence of polymorphonuclear leukocytes (PMNLs) to nylon in patients with bacteremia was studied using a whole-blood assay. Adherence of PMNLs was studied in blood obtained from patients who were not in shock; the results did not differ from the control values (70.9% +/- 4.9% vs 72.1% +/- 2.8%, respectively; P greater than 0.3). Adherence of PMNLs in the whole blood of patients was studied 24-36 hr after antibiotic therapy was begun for documented bacteremia, and elevated values were demonstrated (79.2% +/- 8.6%; P less than 0.01). patients with bacteremic shock had a greatly augmented level of PMNL adherence (91.1% +/- 8.5%; P less than 0.001), and enhanced adherence was demonstrated when the normal PMNLs were suspended in plasma from hypotensive patients. The administration of methylprednisolone significantly reduced the adherence of PMNLs in the whole blood of four patients with bacteremia. Assay of PMNL adherence to nylon is a simple test with the potential of identifying bacteremic patients who are at risk of developing shock.

Adult↗
PubMed1982

Infective endocarditis in a community hospital.

Recent reviews from major university centers of infective endocarditis have stressed an increase in unusual infections owing to virulent pathogens. This article compares the 40 episodes of infective endocarditis at a community hospital complex with the recent literature. It was observed that the majority of infecting microorganisms were penicillin-susceptible streptococci similar to those seen in the early antibiotic era. An older patient population was encountered, but overall mortality was low. Streptococcus bovis was a frequent cause of both natural and prosthetic valve infections. Symptoms lasting longer than two months were associated with vegetations demonstrated by echocardiography and high morbidity. Clinical features in this series that significantly correlated with a poor prognosis were height of fever at admission, the failure of fever to resolve within one week of appropriate therapy, the degree of peripheral leukocytosis, gross hematuria, and CNS signs. Conservative parenteral treatment closely monitored by serum bactericidal levels was employed. No relapses occurred among patients surviving initial therapy.

Aged↗
PubMed1981

Acute transverse myelitis due to Mycoplasma pneumoniae infection.

We examined a woman who had acute transverse myelopathy (ATM) associated with respiratory illness due to Mycoplasma pneumoniae. To our knowledge, only one previously described case documented this relationship with serologic studies of spinal fluid. Since 16% to 35% of ATM patients experience antecedent respiratory illness, evidence of M pneumoniae infection should be sought in all cases.

Acute Disease↗