[Peritonitis due to a "minor" salmonella. Case presentation and review of the literature].
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Biomedical subjects
Publications and source records attributed to H Modde.
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A case is reported of Branhamella catarrhalis septicemia occurring during the aplastic phase of treatment for acute myeloblastic leukemia. Skin lesions were observed which are ordinarily seen in chronic gonococcal or meningococcal septicemia. The pathogenic role of this agent, which is normally considered nonaggressive, is discussed.
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A case of Group G streptococcal arthritis in a previously healthy man is reported. The 2nd and 3rd metatarso-phalangeal joints of the left foot were simultaneously affected. Unusual erosive joint destruction occurred in spite of early therapy and clinical improvement. Circulating immune complexes were raised and were not completely normal at 1 year.
Five cases of Campylobacter fetus bacteremia are reported. This germ, found in blood cultures, induces high fever and is accompanied by either gastroenteritis with colitis or thrombophlebitis. Other, but much rarer septic sites are the meninges and endocardium. Patients already debilitated by chronic disease are more susceptible to bacteremia with Campylobacter fetus, which worsens the prognosis of the infection. Although non-debilitated patients can contract this infection, the prognosis here is more favourable. Antibiotic treatment is indicated in all cases. Campylobacter fetus bacteremias are rare and their pathogenesis still little understood. This "microaerophil" germ does not survive in air which makes culturing difficult under ordinary conditions. On the other hand, Campylobacter jejuni induces gastrocolitis with spontaneous recovery. It is found in feces and thrives in contaminated water and milk.
431 recent clinical isolates from the families Enterobacteriaceae and Pseudomonadaceae drawn from the western part of Switzerland have been tested for Cefoperazone sensitivity. With 6 exceptions, all strains were susceptible or highly sensitive to the antibiotic. Striking was the excellent activity of cefoperazone against Pseudomonas aeruginosa, Serratia marcescens and indol-positive Proteus species, in contrast that of most of the already established cephalosporins.
After oral administration of 1 g 6-[D-2-amino-2-(cyclohexa 1,4-dien-1-yl)-acetamido]-penicillanic acid (epicillin Spectacillin capsules, 500 mg) in patients with renal impairment the elimination rate constant was calculated by means of the declining serum levels. There is good correlation (r = 0.83) between the elimination rate constant and the creatinine clearance. With this data it was possible to calculate the reduced loading and maintenance dose for a certain creatinine clearance and a certain dosage interval to avoid accumulation. The values could also be read from nomograms without calculation. For comparison the possibility to extend the dosage interval corresponding to the elimination rate constant in renal impairment is confronted.
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In the light of the author's diagnostic experience, attention is drawn to the fact that enteritis Salmonellae appear to be more frequently present in sputum than in generally supposed. The diagnostic and epidemiologic implications of this observation are discussed.
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