Primary Hemophilus influenzae pneumonitis in an adult.
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Biomedical subjects
Publications and source records attributed to I W Geere.
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During a 5-month period Enterobacter agglomerans, now described as a member of the phytopathogenic genus Erwinia, was isolated from 13 patients in a general hospital; in 1 patient it was isolated from two sites. In six instances the organism was the sole pathogen isolated, in two instances it may have contributed to infection and in the remaining instances it was probably a transient saprophyte. The strains showed some variation in biochemical reactions but were similar in colonial morphology and were consistently sensitive to several antibiotics. Although this organism is prevalent in the general environment and usually relatively benign, it does have a potential for nosocomial infection.
This report of a case of chronic subphrenic abscess, with a brief review and recommendations for diagnosis and prevention, draws attention to this clinical entity as a potential cause of chronic ill health. The clinical presentation and laboratory findings in this case were unremarkable. It is clear that the condition can be easily missed and the patient may be exposed unnecessarily to prolonged illness and to inappropriate investigation and therapy.
A study of 37,156 blood cultures over a 3-year period yielded 1,972 positive blood culture episodes, of which 63% were of clinical significance, 26% represented contamination, 7% represented transient bacteremia, and 3% were of indeterminate significance. Mortality curves were calculated for clinically significant bacteremia according to etiologic organism and source. Several curves with different shapes were demonstrated. Quantitative differences were noted between cases of bacteremia arising from different sources and caused by different organisms. No mortality was associated with bacteremia of bone and joint origin. Mortality from bacteremic pneumococcal pneumonia, bacteremia with Escherichia coli of urinary tract origin, endocarditis, and beta-hemolytic streptococcal bacteremia showed an early plateau effect, with a drop before day 20. Cases of bacteremia from intravascular sources other than endocarditis were associated with no initial mortality, but mortality rose progressively after day 5. Bacteremia related to most organisms and sources was associated with mortality that continued until at least day 20.