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Biomedical subjects

M D Hurwitz

Publications and source records attributed to M D Hurwitz.

8 recordsLinked to original sources
PubMed1991

Comparison of bacteraemic community-acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae in an intensive care unit.

In a study of 41 consecutive patients with bacteraemia-associated community-acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae an attempt was made to determine whether distinguishing criteria of disease due to these organisms could be identified according to demographic features and the results of initial clinical and laboratory investigations. Such information would aid in the early initiation of appropriate antimicrobial therapy. The most significant difference between the two groups of patients was the lower platelet count in the K. pneumoniae group (p less than 0.005). In addition leucopenia (p less than 0.05), higher serum albumin (p less than 0.05), and the male sex (p less than 0.05) featured with an increased frequency in patients with pulmonary infection due to K. pneumoniae. Initial antimicrobial therapy in critically ill patients with community-acquired lobar pneumonia and thrombocytopenia, particularly when associated with leucopenia and in male patients, should include agents effective against K. pneumoniae.

Adult↗
PubMed1989

Community-acquired pneumonia of diverse aetiology: prognostic features in patients admitted to an intensive care unit and a "severity of illness" core.

In a retrospective study of 73 patients with community-acquired lobar pneumonia of diverse aetiology admitted to an intensive care unit, an attempt was made to identify those factors among the demographic and clinical features and results of initial laboratory investigations that were predictive of the ultimate outcome. A lower mean white cell count (p = 0.03), platelet count (p = 0.02), total serum protein (p = 0.005) and albumin (p = 0.02) and a higher mean serum creatinine (p = 0.03) and phosphate level (p = 0.02) appeared to be predictive of a poor prognosis. The most significant variable predictive of mortality, was the presence of bacteraemia (p = 0.0005). Severity of illness scoring systems by omitting microbiological data appear to underestimate predicted patient mortality. The mortality rate of critically ill patients with community-acquired lobar pneumonia remains high, despite advances in antimicrobial chemotherapy and intensive care unit facilities, particularly in the presence of certain negative prognostic factors of which the presence of bacteraemia is the most important.

Adult↗
PubMed1988

Ankylosing spondylitis lung disease and Mycobacterium scrofulaceum.

The development of apical pulmonary fibrosis and bullous disease is a rare but well recognized extra-articular manifestation of ankylosing spondylitis (AS). The fibrobullous disease is usually asymptomatic and diagnosed at an incidental radiological examination. When symptoms do develop, they are usually due to superimposed colonization or infection by bacteria, fungi or mycobacteria. Only six cases of non-tuberculous mycobacterial superinfection in AS have been reported. We report a patient with AS and progressive apical fibrobullous disease in whom Mycobacterium scrofulaceum was repeatedly cultured over a 12-year period.

Adult↗
PubMed1987

Pneumocystis carinii pneumonia in Johannesburg.

Pneumocystis carinii pneumonia is today an opportunistic infection of major importance, occurring in immunosuppressed patients. Twelve cases of P. carinii pneumonia were seen by the Pulmonology Unit in Johannesburg between November 1984 and December 1985. The clinical presentation, laboratory and radiographic features, method of diagnosis, treatment, complications of therapy and outcome of these 12 cases are described.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Pneumocystis carinii pneumonia.

Pneumocystis carinii pneumonia (PCP) has become one of the most important of the opportunistic pulmonary infections of the 1980s. In view of the rapidly expanding population of immunosuppressed patients, many more cases of PCP may be expected in the future. The history, microbiology, pathogenesis, pathology, clinical and laboratory features, diagnosis, treatment, course and prognosis of this disease are reviewed.

Humans↗
PubMed1987

Transbronchial biopsy during mechanical ventilation.

The diagnostic yield and risks of transbronchial biopsy (TBB) during mechanical ventilation were assessed in 13 patients with progressive pulmonary infiltrates. TBB was of considerable diagnostic value in ten patients and useful in excluding potentially treatable infections in the remaining three patients. Complications included two pneumothoraces, pulmonary hemorrhage in one case, and supraventricular tachycardia in another. No fatalities were attributable to TBB. TBB proved to be a relatively safe procedure, with a high diagnostic yield in these critically ill patients.

Acute Disease↗
PubMed1986

Blastomycosis. A case report.

Blastomycosis was once thought to be restricted to North America; it has rarely been found in the RSA. The first case reported in the RSA was associated with a diffuse pulmonary infiltrate and cavitation; the patient responded to amphotericin B.

Amphotericin B↗