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J D Siegel

Publications and source records attributed to J D Siegel.

7 recordsLinked to original sources

Neonatal lung abscess. A report of six cases.

Six infants 8 weeks of age or younger had lung abscesses treated in our medical center during the 20-year period of from 1957 to 1977. The duration of symptoms prior to diagnosis, the etiologic organisms, and the therapeutic approach differ from those in older children and adults. The pathogenic organisms were Escherichia coli, group B streptococcus, and Klebsiella pneumoniae, initial therapy with a penicillin and an aminoglycoside are indicated until identification and susceptibility results are available on the organism isolated from the abscess cavity. Previously undiagnosed cystic malformations of the lung were seen in two of the six patients. Surgical intervention is usually required in this age group.

Escherichia coli Infections

Pharmacokinetic properties of netilmicin in newborn infants.

Netilmicin and gentamicin susceptibilities of 258 gram-negative organisms and 25 strains of Staphylococcus aureus were nearly identical. The pharmacokinetic properties of netilmicin were evaluated in 101 newborn infants and related to birth weight, gestational age, chronological age, and route of administration. Mean peak serum concentrations of 5.6 to 6.9 and 7.8 to 8.4 mug/ml were observed 30 min after 3- and 4-mg/kg doses, respectively, were given intramuscularly. The peak concentrations were directly related to gestational age. The average serum half-life values varied from 3.4 to 4.7 h and in general were inversely related to birth weight, gestational age, and postnatal age. The pharmacokinetics of netilmicin in 10 infants were similar after intramuscular and intravenous administration. A comparative study of netilmicin and gentamicin in seven neonates revealed greater variability in serum concentrations of gentamicin and a shorter half-life for netilmicin. There was evidence of accumulation of netilmicin in 12 low-birth weight, premature infants who received 4-mg/kg doses for an average of 6.4 days. Serum and urine levels of netilmicin were measured up to 11 days after discontinuation of the drug. These data are well characterized by a two-compartment model. Additional studies of efficacy and long-term toxicity of netilmicin in neonates are necessary.

Bacteria

Pneumococcal empyema in childhood.

Two serotypes, uncommon in pediatric infections, accounted for a disproportionately large number of cases of pneumococcal empyema at the Children's Hospital of Pittsburgh. Eight of ten empyemas were caused by types 1 or 3, and two additional cases of mixed infection involved the type 3 pneumococcus. The type 3 pneumococcal empyemas tended to be more severe than those due to other serotypes. Counterimmunoelectrophoresis (CIE) appeared to be more useful than culture in establishing the cause of this condition; in seven of ten cases, the pleural fluid was CIE positive while cultures of blood and pleural fluid were negative. In each of the seven culture-negative cases, antibiotics had been given prior to hospitalization. One case of type 7 pneumococcal empyema illustrated the potential value of the Ouchterlony test for the etiologic diagnosis of this condition.

Child