Adenosine deaminase (ADA) activity was studied in 221 patients with pleuroperitoneal effusions. Patients were subdivided into the following six groups: (1) 48 cases of tuberculosis; (2) 46 with malignancies; (3) 30 postpneumonic effusions; (4) 19 cases of several diseases; (5) 18 patients with pleural effusions of unknown origin; and (6) 60 with acellular transudates. Mean ADA activity was 92.43 +/- 29.43 U/L 37 degrees C in group 1; 13.43 +/- 10.69 in group 2; 19.91 +/- 19.64 in group 3; 14.27 +/- 17.47 in group 4; 14.48 +/- 13.92 in group 5; and 2.29 +/- 3.4 in group 6. Comparing the level achieved in group 1 with all others, the difference is significant at the p less than 0.001 level. Specificity (0.97) and sensitivity (1) of the test in tuberculosis is very high, when a value of more than 45 U/L is considered. In patients with pleural tuberculosis, T-lymphocytes predominate in the fluid but their number did not correlate with ADA-activity (p greater than 0.10). Assessment of ADA in pathologic fluids is of great value in the diagnosis of tuberculosis of the pleura.

Adenosine Deaminase↗

PubMedDate not supplied

Pseudomonas vesicularis bacteraemia.

A case of repeated episodes of Pseudomonas vesicularis bacteraemia, in a 54-year-old woman with a past history including systemic lupus erythematosus and chronic active autoimmune hepatitis is reported. She was treated with tobramycin and ceftazidime but bacteraemia persisted until surgical resection of the infected tissue was performed.

Female↗

PubMedDate not supplied

Catheter-related infection: an update on diagnosis, treatment, and prevention.

Catheter-related infection (CRI) accounts for a large percentage of nosocomial infections, and related bacteremia is a common complication. Bacteremia arises in approximately 1 of 15 episodes of CRI and causes considerable morbidity and occasional mortality, as well as increased medical costs. The diagnosis of CRI and catheter-related bacteremia (CRB) is still a challenge for practitioners treating catheterized patients. Semiquantitative tip culture by the roll-plate method is the cornerstone for diagnosis of CRI in routine practice. However, there is a great deal of interest in the alternative methods for diagnosing CRI without catheter withdrawal, since treatment of the patient can be successfully completed with the infected device maintained in place. The conservative management of CRI includes perfusion of antibiotics through the infected catheter and the antibiotic-lock technique (ALT). Catheter-related infection prevention is accomplished mainly by strict adherence to hygienic practices in insertion and manipulation of the catheter. However, knowledge of the pathophysiology of CRI has led to the development of new sophisticated catheters and hubs that incorporate mechanical and antibacterial barriers.

Catheterization↗

PubMedDate not supplied

[Listeriosis in the adult. Clinical, epidemiological, and therapeutic considerations based on a series of 26 cases].

The clinico-epidemiological characteristics and therapy in 26 patients with infection produced by Listeria monocytogenes were reported. In 14 cases there was a primary bacteremia and in 12 patients there was a meningeal involvement. In 22 patients a previous disease was detected. Chronic immunosuppressor therapy was present in 13 cases. The most common symptom was the fever associated with meningeal syndrome, decreased consciousness and or focal neurologic involvement in cases with meningitis. In 76.9% of the patients the form of presentation was acute. Cerebrospinal fluid examination revealed an increased number of cells with a predominance of polymorphonuclear elements. Ampicillin and penicillin either single or associated with aminoglycosides were the most used antibiotics. The overall mortality was 30.8%.

Adolescent↗

PubMedDate not supplied

[Digestive cytomegalovirus disease in AIDS patients].

BACKGROUND: In this paper we study the digestive manifestations of cytomegalovirus (CMV) in AIDS patients. Also, we evaluate the antiviral treatment and the necessity of maintenance therapy. METHODS: Retrospective review of medical charts of all patients with AIDS and digestive CMV disease diagnosed and followed-up since 1983 to december 1993. RESULTS: Of 720 AIDS patients, 96 presented a CMV disease. Among them, 30 patients (31%) complained digestive manifestations. These were 26 males and 4 females, mean age: 37.4 y-old. Risk factors for HIV were: 13 homosex and 12 intravenous drug abusers. Average of time between AIDS diagnosis and digestive CMV disease: 13.4 months. Fourteen patients had esophagitis, 9 proctocolitis, 3 hepatitis, 3 pancreatitis, 2 gastric ulcerations, one small bowel disease and other an oral ulceration. Two patients had a concomitant CMV chorioretinitis. CD4 lymphocytes were below 0.05 x 10(9)/l in 29 patients. Twenty-four patients received antiviral treatment during the acute disease period, with a clinical curation rate of 60%. Seven patients received maintenance therapy and remained free of CMV disease until death. Eleven patients didn't received maintenance treatment. Of them, one patient presented a digestive relapse and two developed a CMV chorioretinitis. Mortality in the first month from diagnosis was 23% and the median of survival time for patients who cured and initial episode of digestive CMV disease was 208 days, wether or not the patient received maintenance therapy or not. CONCLUSIONS: One third of ours patients with AIDS and CMV infection have a digestive disease. This CMV digestive disease appears in patients with a severe immunosuppression. Acute phase mortality was 23%. The median survival was 7 months, independently or receiving maintenance treatment or not.

AIDS-Related Opportunistic Infections↗