Misuse of hepatitis B vaccine for pre-exposure prophylaxis in health care workers.
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Drug Utilization↗
Biomedical subjects
J P Hutton
Publications and source records attributed to J P Hutton.
Office management of patients infected with the human immunodeficiency virus (HIV)--1990.
Human immunovirus (HIV) infections and related diseases continue to consume a major portion of health care resources nationwide and in the state of Oklahoma. There were 162 new cases of acquired immunodeficiency syndrome (AIDS) diagnosed in Oklahoma in 1989 and an additional 347 cases of other HIV infections were reported. It appears almost certain that few physicians in practice, if any, will escape seeing HIV-related illnesses. It is, therefore, important that all physicians have an adequate understanding of the basic management of these related illnesses. The reader is referred to our original article in the October 1988 issue of the Journal of the Oklahoma State Medical Association, which outlined the office management of HIV-positive patients. The current paper represents an update on this problem. Many of the original tenets and descriptions of management remain the same, and they will not be repeated.
Acquired Immunodeficiency Syndrome↗
Office management of the HIV-positive patient.
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Ambulatory Care↗
Staphylococcus epidermidis: a significant nosocomial pathogen.
Staphylococcus epidermidis is an organism formerly believed to be nonpathogenic. It is now recognized as a pathogen, causing infections on implanted devices and among immunosuppressed patients. Further, it has been involved in the development of resistance to a number of antibiotics. The epidemiology of this organism, its pathogenesis, and its treatment are important to infection control practitioners.
Anti-Bacterial Agents↗
Acute uvulitis associated with epiglottitis.
Acute infectious uvulitis is a rare condition. A case caused by Streptococcus pneumoniae occurred in a 56-year-old woman who also had coexisting epiglottitis. One other case of uvulitis reported in the literature has also been associated with acute epiglottitis. Because of potentially lethal complications, epiglottitis should be suspected in any patient who presents with acute painful swelling of the uvula.
Aged↗
Staphylococcus epidermidis arthritis following catheter-induced bacteremia in a neutropenic patient.
Sepsis due to methicillin-resistant Staphylococcus epidermidis occurred in a neutropenic man during management with a Hickman-Broviac catheter. Despite catheter removal and 10 days of i.v. cefazolin therapy, he developed septic arthritis 6 weeks later in a nonprosthetic hip joint. S. epidermidis was isolated from the joint and found to have plasmid and phage susceptibility patterns identical to the previous blood isolate. This case is the first to document a metastatic infection from catheter-associated S. epidermidis bacteremia. It suggests that cephalosporins may not be optimal in such infections despite in vitro sensitivity. Vancomycin appears to be the drug of choice for S. epidermidis bacteremia in the neutropenic population.
Adult↗
Response of tularemic meningitis to antimicrobial therapy.
A 60-year-old man had pyogenic meningitis due to Francisella tularensis acquired by tick bite. His disease initially improved but later relapsed after a standard course of streptomycin. Complete resolution resulted from prolonged combined therapy with streptomycin and tetracycline. Successful treatment of acute tularemic meningitis has not previously been reported. Our experience suggests that therapy should include agents that reliably penetrate the CSF, that is, tetracycline or chloramphenicol, for optimal treatment of this rare form of tularemia.
Acute Disease↗
Hyphal forms of Histoplasma capsulatum. A common manifestation of intravascular infections.
The usual tissue form of Histoplasma capsulatum is a small intracellular yeast, though extracellular organisms of unusually large size have also been described. The production of hyphae in tissue has been regarded as rare and we believe not generally appreciated. We report a case of probable Histoplasma endocarditis from which an embolus demonstrated abundant mycelial forms on histologic examination. Of previously reported cases of H capsulatum endocarditis with detailed pathologic description, nine of 27 cases are found to demonstrate hyphal forms. Hyphal structures should be considered a common morphologic variant of H capsulatum in intravascular lesions.
Embolism↗