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Biomedical subjects

R H Bermúdez

Publications and source records attributed to R H Bermúdez.

At least 19 recordsLinked to original sources

Unusual presentation of Pseudomonas aeruginosa infections: a review.

Pseudomonas aeruginosa is an opportunistic, gram negative bacillus that causes serious hospital acquired infections. However, it also causes infections with unusual presentations which are acquired in a non-hospital environment. This report will discuss the pathogenesis, clinical manifestations, and therapy of this uncommon infection, such as: 1) Pseudomonas folliculitis: a superficial or deep bacterial infection associated with the use of public hot tubs, whirlpools and swimming pools. 2) Invasive external otitis: an infection that can progress to skull base mostly associated to elderly diabetic patients. It is usually secondary to aural irrigation with contaminated water. 3) Pseudomonas osteomyelitis: an infection usually associated with nail puncture wounds especially if wearing tennis shoes. 4) Toe with infection: mostly associated with individuals using topical antibacterial agents. 5) Green nail syndrome: a non tender paronychia lesion that appears most often in persons whose hands are constantly exposed to water, soaps and detergents or are subject to mechanical trauma. 6) Corneal ulcer keratitis: mostly associated with the use of soft lenses, eye drops, mascara or contaminated whirlpools. This condition may terminate in panophthalmitis. 7) Endocarditis: most commonly associated with intravenous drug addicts.

Corneal Ulcer↗

Radionuclide imaging of the liver in human fascioliasis.

The clinical, laboratory, and scintigraphic findings in four cases of human fascioliasis are described. Acute onset of fever, abdominal pain, and weight loss in a person who has ingested watercress constitutes the clinical syndrome often seen. Eosinophilia and alteration in liver function tests, particularly alkaline phosphatase are frequent. Tc-99m sulfur colloid images showed hepatomegaly in four patients, focal defects in two, splenomegaly in three, and increased splenic uptake in two. Gallium citrate (Ga 67) images show increased uptake in the focal lesions in two of two. Sonographic imaging showed focal lucent abnormality in one of three. Liver biopsy findings were nonspecific. The differential diagnosis from other invasive parasitic diseases is discussed. A possible role of hepatic imaging in the evaluation of fascioliasis is suggested.

Fascioliasis↗

Cefamandole in the treatment of soft tissue infections.

27 male adult patients with acute soft tissue infections including cellulitis, abscesses, ulcers and wound infections were treated with a dose of 2-4 g/day of cefamandole nafate by the intravenous route for a minimum of 10 days. Most patients were seriously ill with underlying conditions like diabetes mellitus, alcoholism and congestive heart failure and required hospitalization and parenteral antibiotics. Gram-positive cocci (predominantly Staphylococcus aureus) and gram-negative bacilli were recovered on pretreatment cultures from 81% of the patients. Clinical and bacteriologic response was excellent. Disappearance of the signs of infection occurred by the 7th day of treatment, by day 3 of treatment fever was down to normal, and by day 5 of treatment the WBC count was below 8,000. There were very few side effects noted, and there was excellent tolerance to the intravenous drug administration. Cefamandole nafate is a safe, effective and well-tolerated agent in the treatment of skin and soft tissue infections of adult patients caused by susceptible organisms.

Adult↗

Amikacin sulfate levels in human serum and bile.

Amikacin levels in blood and bile were measured in 10 patients who underwent cholecystectomy and T-tube drainage. Each patient received 500 mg of amikacin intravenously 12 h preoperatively, during surgery, and every 12 h thereafter for four more doses. Average levels of amikacin in bile were 8.3 micrograms/ml at 1 h after the intraoperative dose, with a bile/serum ratio of 0.44. Postoperative doses at 1 h produced levels in bile of 3.8 to 4.2 micrograms/ml, with a bile/serum ratio of 0.15 to 0.22. Levels in bile decreased at a rate lower than levels in blood, and bile/serum ratios increased from 0.54 at 2 h to 0.93 at 12 h. Amikacin accumulated in bile at 6 h after the intravenous dose.

Adult↗

Pulmonary infection with M. kansasii in a renal transplant patient.

A 24-year-old man developed a severe pleuropulmonary infection with Mycobacterium kansasii 18 months after receiving a kidney transplant from his mother. Intestinal malabsorption with severe diarrhea and a skin abscess disappeared and his pneumonia was cured when Rifampin was administered. This suggested that generalized dissemination with M. kansasii may have been present.

Adult↗