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Biomedical subjects

M S Drapkin

Publications and source records attributed to M S Drapkin.

16 recordsLinked to original sources
PubMed1993

Pylephlebitis associated with diverticulitis.

We have reported the cases of two patients who had acute pylephlebitis associated with portal vein thrombosis and septic hepatic emboli as a result of right colonic diverticulitis. Although rare, pylephlebitis is a treatable but often lethal complication of intra-abdominal sepsis. Several bacterial pathogens, especially Escherichia coli are associated with pylephlebitis. Early suspicion and prompt antibiotic therapy can lead to resolution of portal vein thrombosis and hepatic abscess formation, resulting in full recovery for the patient. Surgery may not be required. Our two patients received ampicillin--the best first-line drug--until specific antibiotic therapy could be given. Early administration of a broad spectrum antibiotic is essential.

Acute Disease↗
PubMed1987

Toxic shock syndrome after chemical face peel.

Two cases of toxic shock syndrome following chemical face peel are reported. Toxic shock syndrome is a severe toxin-mediated multisystem disease. The major signs are fever, rash, desquamation, and hypotension. It can occur in males as well as females and is not necessarily related to menstruation. The surgical wound does not usually appear infected. Early recognition is the hallmark of successful treatment. Therapy is symptomatic, with aggressive administration of fluids. Antistaphylococcal agents are used. Prophylactic antibiotics are not necessarily recommended.

Chemexfoliation↗
PubMed1985

Clostridium difficile colitis mimicking acute peritonitis.

Five patients receiving penicillin V potassium or a cephalosporin antibiotic for 18 hours to 22 days developed fever, marked leukocytosis, and signs and symptoms that suggested right-lower-quadrant peritoneal irritation. All underwent emergency laparotomy, at which dilatation and inflammation of the ascending colon were found. Only one of the patients had profuse diarrhea, and two patients had no diarrhea prior to laparotomy. Postoperatively, Clostridium difficile colitis was diagnosed by stool toxin assay and was confirmed in one case by proctosigmoidoscopic biopsy results. Antibiotic-associated colitis must be considered in any patient who develops peritoneal signs while or after receiving antibiotics. Over a two-year period, the "acute abdomen" presentation accounted for 5.2% of all patients with C difficile colitis at our institutions. Early proctosigmoidoscopy or stool examination for C difficile or its toxin may avoid unnecessary laparotomy in such patients.

Acute Disease↗
PubMed1980

Mitral valve prolapse: jet stream causing mural endocarditis.

A 53 year old man died of cerebral hemorrhage while being treated for Streptococcus mutans endocarditis. At autopsy the only endocarditic lesion was on the left atrial mural endocardium. The noninfected mitral valve demonstrated prolapse and mucinous degeneration. The latter had led to rupture of several chordae tendineae, with the resultant jet stream predisposing to endocarditis at its point of atrial impact. The case provides confirmation of current concepts of the pathogenesis of endocarditis and has important therapeutic implications.

Arteriosclerosis↗
PubMed1980

Community-acquired bacteremia in the elderly: analysis of one hundred consecutive episodes.

A retrospective analysis was made of the records of 100 consecutive geriatric patients with community-acquired bacteremia, admitted to a suburban hospital. The most frequently identified tissue sources for these bacteremias were the urinary tract (34 percent), biliary tract (20 percent), and lungs (13 percent). In 11 percent of the patients, the tissue focus was not established. E. coli, Klebsiella species and Streptococcus pneumoniae were the most common organisms isolated, and they contributed to 73 percent of the bacteremias. Of the 100 patients, 26 succumbed to the infection. Clinical manifestations unique to the geriatric patient are described.

Aged↗
PubMed1977

Bacteremic hemophilus influenzae type B cellulitis in the adult.

Described herein are three patients over the age of 50 years who had cellulitis of the neck and the upper portion of the chest, associated with Hemophilus influenzae type B bacteremia and respiratory tract infection--particularly that of the upper airway. Only one of the patients with cellulitis had the classic bluish-purple hue commonly seen in children affected with this syndrome. In the other two, the H. influenzae type B cellulitis could not be distinguished clinically from the more common group A streptococcal or staphylococcal cellulitis. Since the antibiotics employed in treating patients with infection due to the latter two organisms differ significantly from those used to treat patients with H. influenzae type B infection, the possibility of disease due to H. influenzae type B must be considered in any adult or child in whom cellulitis of the neck, chest and possibly face is associated with a respiratory tract infection, especially of the upper airway.

Aged↗
PubMed1976

Bacteremic infections due to clindamycin-resistant streptococci.

We have recently observed four patients with bacteremic infections due to group A streptococci that were highly resistant to clindamycin and only moderately susceptible to erythromycin. Two of the infections developed while the patients were receiving clindamycin. The organisms were not beta-hemolytic under standard conditions nor were they M or T typable. We urge that all streptococci isolated from patients with serious infections be grouped serologically and be tested for antibiotic susceptibilities, especially if therapy with antibiotics other than penicillin is to be considered.

Aged↗
PubMedDate not supplied

Pneumococcal aortitis in the antibiotic era.

The pneumococcus remains in the antibiotic era a formidable pathogen, capable of atypical, lethal clinical presentations. We report two fatal cases of thoracic aortitis caused by Streptococcus pneumoniae in the setting of bacteremic illness from this pathogen. One case occurred in an aortic graft and the other arose in a native aorta. We also discuss the indolent clinical presentation and the diagnostic failure of transesophageal echocardiography and leukocyte scintigraphy. Persistent pyrexia with atypical chest pain and unexplained blood loss should alert clinicians to the possibility of this uncommon, yet lethal complication of pneumococcal disease.

Aged↗