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L H Hagelskjaer

Publications and source records attributed to L H Hagelskjaer.

14 recordsLinked to original sources
PubMed1998

Incidence and clinical epidemiology of necrobacillosis, including Lemierre's syndrome, in Denmark 1990-1995.

To establish the incidence and describe the clinical epidemiology of necrobacillosis and Lemierre's syndrome in Denmark, the clinical records of all laboratory-recorded cases of septicaemia due to Fusobacterium necrophorum biovar A, B, and C were reviewed retrospectively during a 6-year period. The incidence of necrobacillosis and Lemierre's syndrome was 1.5 and 0.8 per million persons per year, respectively, showing a tendency to increase during the period. Fusobacterium necrophorum was grown after three days' incubation, but the characteristic pleomorphic fusiform morphology was often disregarded as an important help in diagnosing necrobacillosis. The 24 patients with Lemierre's syndrome were all young and previously healthy, and none died, but pre-hospital delay was associated with a significantly higher morbidity and risk of metastatic infections. The remaining 25 patients with necrobacillosis had a high mortality, 24%, which was correlated with age and predisposing diseases, especially cancers. These findings stress the importance of a quicker clinical and microbiological diagnosis in cases of Lemierre's syndrome, and of screening for cancer in the remaining cases of necrobacillosis.

Adolescent↗
PubMed1997

Infective endocarditis, 1984 through 1993: a clinical and microbiological survey.

OBJECTIVES: To characterize the epidemiology and the clinical and microbiological spectrum of infective endocarditis in a Danish population. DESIGN: A retrospective review. SETTING: All episodes hospitalized of infective endocarditis from 1984 to 1993 in Viborg County were reviewed. The county is served by one general and four local hospitals. SUBJECTS: One hundred and nine episodes of suspected infective endocarditis with 62 episodes in 59 patients fulfilling the diagnostic criteria by von Reyn. RESULTS: An overall incidence of 27 episodes per million per year was found. The incidence was 17.4 episodes per million per year in the first part of the decade and 36.5 episodes per million per year in the second part (P < 0.001). Microscopic haematuria was found in 70.2% of the patients with infective endocarditis, compared to 16.7% of the patients in whom the diagnosis was rejected (P < 0.01). Staphylococcus aureus was found in 38.9%, non-beta-haemolytic streptococci in 24.1% and Enterococcus faecalis in 16.7%. The overall mortality was 35.5%. The mortality decreased significantly from 50.0% in the first part of the decade to 28.6% in the second part (P < 0.01). The mortality was 23.1% in patients in whom the diagnosis was established whilst they were alive. This finding was significantly lower than the overall mortality (P < 0.05). CONCLUSION: The incidence of infective endocarditis increased during the decade. The frequency of non-beta-haemolytic streptococci was lower than normally reported. Mortality is still high, with the main mortality within the first week in hospital, which stresses the importance of early case detection and treatment.

Causality↗
PubMed1996

[Peritonitis in continuous ambulatory peritoneal dialysis. An evaluation of the empiric initial antibiotic treatment].

Retrospectively, the clinical outcome and the initial empiric antibiotic treatment of peritonitis in 106 patients on continuous ambulatory peritoneal dialysis (CAPD) were evaluated during a two-year period. A mean frequency of 0.89 episodes of peritonitis per year of dialysis was found. There was a tendency towards an increased frequency of peritonitis in older patients. Diabetic patients constituted a younger age group and had a tendency towards having a lower risk of peritonitis. Patients with polycystic renal disease had a significantly increased risk. The risk of episodes with coagulase-negative staphylococci increased significantly with age. Repeated peritonitis episodes with coagulase-negative staphylococci was associated with a significant increase in the appearance of methicillin drug resistance. Carriers of Staphylococcus aureus had a significantly increased risk of Staphylococcus aureus peritonitis. Microorganisms were cultured in 94% of the episodes. The initial antibiotic therapy was only sufficient in 66% due to antimicrobial drug resistance. The initial antibiotic treatment was changed in 58% of the episodes. The treatment could have been changed to antibiotics with a narrower antimicrobial spectrum in 51% of the episodes. Relapse was seen in 11% of culture positive episodes. In 16% of the episodes (29% of patients with peritonitis) it was necessary to remove the dialysis catheter and transfer the patient to haemodialysis to clear the infection. Only 15% of these patients returned to CAPD again. We found that an initial empiric antibiotic regime of vancomycin combined with an aminoglycoside is to be recommended as achieving an antibiotic coverage of 88%, and this is now the standard regime in the department.

Adolescent↗
PubMed1996

[Peritonitis in continuous ambulatory peritoneal dialysis. Culture of peritoneal dialysate fluid].

Conventional aerobic and anaerobic culture of peritoneal dialysate effluent from patients in continuous peritoneal dialysis (CAPD) was compared to culture in a semiautomated blood culture system. During a two-year period 78 of 79 consecutive episodes of peritonitis among 45 Danish CAPD patients were cultured and the etiology of the infection found in 73 (94%). The sensitivity of the blood culture system was 88%, whereas the sensitivity of the conventional culture of the dialysate effluent was 81%. This difference is not significant (McNemar test; 0.5 > p > 0.3). The majority of isolates were Gram-positive bacteria dominated by coagulase-negative staphylococci (38%). In comparison, only 2% of the cultures of peritoneal dialysate effluent taken within the same period from patients without clinical signs of peritonitis were positive. All the Gram-positive aerobic bacteria were sensitive to vancomycin whereas 97% of the Gram-negative aerobic bacteria were sensitive to gentamicin. An initial empiric treatment of peritonitis with a combination of vancomycin and gentamicin is recommended.

Adolescent↗
PubMed1994

A fatal case of systemic strongyloidiasis and review of the literature.

Systemic strongyloidiasis is a rare but serious complication of intestinal strongyloidiasis. The condition occurs mainly in immunosuppressed patients and has a significant mortality rate. A case of systemic strongyloidiasis is described in a patient who received systemic steroid treatment, and a short review of the literature is given. The increased use of immunosuppressive and cytotoxic treatment necessitates increased awareness of this infection. HIV-infection, however, does not appear to increase the risk of developing systemic strongyloidiasis. Patients from endemic areas and travellers to such areas, even in the remote past, should be examined for strongyloidiasis before being given immunosuppressive treatment. Awareness of the possibility of systemic strongyloidiasis is essential if such a patient develops gastrointestinal or pulmonary symptoms or has repeated episodes of unexplained gram-negative infections while undergoing immunosuppressive treatment.

Adult↗
PubMed1993

[Systemic strongyloidiasis. Hyperinfection syndrome and disseminated strongyloidiasis].

Hyperinfection syndrome and disseminated strongyloidiasis are serious complications to the rather harmless upper bowel infection with Strongyloides stercoralis. The infection is endemic in tropical and subtropical climates as well as in many parts of Eastern Europe. Systemic strongyloidiasis occurs mainly in immunosuppressed patients, but apparently not in HIV-patients. The condition has a significant mortality. Early diagnosis and sufficient treatment is essential to reduce the mortality. The treatment is thiabendazole or albendazole. With increased travel and immigration the infection and its complications can also be seen in non-endemic areas. A case report is presented to heighten awareness of this serious condition, which is preventable.

Adult↗
PubMed1993

[Neurological complications of Mycoplasma pneumoniae infections].

Mycoplasma pneumoniae (Mp) infections are well known for the classical clinical picture of primary atypical pneumonia. The infection shows a predilection for young age groups. Every fourth-fifth year Mp epidemics are seen, lasting several months particularly in autumn/wintertime. The last Mp epidemic in Denmark was seen autumn/winter 1991-1992. The central nervous system (CNS) is involved in less than 0.1% of all Mp infections, but among patients treated in hospital, CNS involvement occurs in up to 7%. Among patients with acute, febrile, nonbacterial CNS affection the incidence of Mp infections is shown to be 5%, with a maximum of 10% during Mp epidemics. In up to 20% the CNS complications are seen without preceding pulmonary symptoms. The pathogenesis is unknown, but probably involves several mechanisms. The spectrum of clinical findings is wide, ranging from mild meningeal signs to severe neurological symptoms and a poor outcome. Mp encephalitis has a particularly high morbidity and mortality. The effect of antibiotic treatment is doubtful, but the treatment is often instituted late. It may be debated, whether early antibiotic treatment can reduce the frequency of the CNS complications and their sequelae. Mp infection should be remembered as a differential diagnosis in any patient with fever and neurological symptoms. It can be recommended to add Mp diagnostic measures to the screening investigations, especially in patients with recent respiratory symptoms and during Mp epidemics. It is important to attempt to detect Mp by culture or polymerase chain reaction (PCR) from throat, respiratory tract and cerebrospinal fluid (CSF). Mp serology from blood and CSF should be performed early in cases where Mp infection is suspected.

Central Nervous System Diseases↗
PubMed1992

[Necrobacillosis].

Necrobacillosis is an infection caused by the anaerobic Gram-negative rod Fusobacterium necrophorum. The infection is most common in previously healthy young adults and is characterised by sore throat followed by rigors, septicaemia and the formation of metastatic abscesses, often in the lungs. The infection has a certain mortality, which is reduced when early and sufficient treatment is administered. The treatment is a prolonged course of penicillin and/or metronidazole. Two case histories and a review of the literature are presented. The purpose of this article is to make the clinician aware of the syndrome, which is so characteristic that the diagnosis can be made from the clinical picture alone before bacteriological verification.

Adult↗
PubMed1992

Neurocysticercosis: a short review and presentation of a Scandinavian case.

Cysticercosis is a disease entity caused by the larval form (Cysticercus cellulosae) of the pork tapeworm (Taenia solium). When man becomes the intermediate host, cysticercal cysts can develop in various organs. Neurocysticercosis, i.e. cysticercosis of the central nervous system, can lead to a broad range of neurological disturbances. The disease is usually confined to geographical regions where sanitation is poor but can occur among immigrants or travellers from such regions. Due to increased travel and immigration the disease may appear in non-endemic areas. We describe a recent case of neurocysticercosis in a 28-year-old Danish woman, who had been travelling in the Far East. She was successfully treated with praziquantel. A short review of the literature is given as the knowledge of the diagnosis and treatment of the disease has increased greatly in the last decade.

Adult↗
PubMed1991

[Cerebral cysticercosis].

A Danish woman aged 28 years who had travelled in the Far East developed cerebral symptoms with headache and visual disturbances. Migraine was suspected. Subsequent CT scanning revealed multiple processes and metastases were suspected. As the patient had travelled in the Far East 1 1/2 years previously, she was examined for neurocysticercosis. This diagnosis was established and the patient was successfully treated with praziquantel. On account of increased travelling activity, the possibility of neurocysticercosis should be borne in mind when dealing with patients with cerebral symptoms and relevant travelling histories.

Adult↗