PubMed Health⌕ Search

Biomedical subjects

S D Pitlik

Publications and source records attributed to S D Pitlik.

At least 55 records · Page 3Linked to original sources
PubMed1988

Value of transrectal ultrasonography for diagnosis and treatment of prostatic abscess.

A new diagnostic and therapeutic application of transrectal ultrasonography (TR-US) is described. TR-US demonstrated one or more well-defined hypoechogenic areas in the prostate gland of 6 patients who presented with clinical signs of urinary tract infection and had only partial response to antibiotic therapy. The presence of a collection of pus in the prostate was confirmed in 4 of 6 patients by transperineal aspiration guided by TR-US, and by prostatic massage or transurethral prostatectomy in the other 2 patients. Ultrasonography also confirmed the resolution of abscesses in 5 patients.

Abscess↗
PubMed1988

AIDS in Israel, 1987.

Between mid-1982 and 1 January 1988, 35 cases of AIDS among permanent residents of Israel were reported to the Israel Ministry of Health. In contrast to the experience in the United States and Europe, the semiannual incidence rates of AIDS are low and have increased slowly over the past 6 years (0.6 to 1.1 cases/million). Risk factors for AIDS were identified in 34 patients: homosexuality in 18, hemophilia in 14 and blood transfusions in 2. Seventeen of the 18 homosexuals were most likely infected abroad, and all hemophilia patients had received imported commercial clotting factors. The two patients associated with blood transfusion received blood donated in Israel. The spectrum of clinical presentations and opportunistic pathogens is similar to that reported in the Western world, except for one case of disseminated Mycobacterium simiae infection. Sexual relations abroad of local homosexuals and receipt of imported clotting factors by Israeli hemophiliacs are currently the most important risk factors for AIDS in Israel. However, the prevalence of HIV infection among Israeli homosexuals is still low and is probably indicative of the more conservative life-style, the later introduction of the virus, and the earlier application of safe sex, in comparison with other Western countries. Furthermore, since spread of the virus seems to be increasing among Israeli i.v. drug abusers, attention should be focused on this group as well, so as to prevent a major outbreak of AIDS in Israel.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Shigella bacteremia in adults. A report of five cases and review of the literature.

Shigella bacteremia is rare, occurring mainly in children. We describe five adult patients with Shigella bacteremia and review data on 22 cases reported in the English-language medical literature. Eighteen (67%) of 27 patients had either an underlying condition or were aged older than 65 years. Most patients had clinical signs of acute febrile gastroenteritis. However, in six patients, the organism was not isolated from stool. Species isolated from blood included Shigella flexneri in 11 patients, Shigella sonnei in eight, and Shigella boydii and Shigella dysenteriae in one patient each. Isolation of the bacterium from blood only was associated with a high mortality rate, in contrast to its isolation both from blood and stool. It is suggested that blood cultures should be obtained from elderly or immunocompromised patients with acute febrile gastroenteritis to detect shigellemia as well as bacteremia caused by other enteric pathogens, such as Salmonella or Campylobacter.

Adult↗
PubMed1987

Ecthyma gangrenosum without bacteremia. Report of six cases and review of the literature.

We encountered six patients with ecthyma gangrenosum due to Pseudomonas aeruginosa who, uncharacteristically, had no evidence of bacteremia prior to the institution of antibiotic therapy. Seven similar cases have previously been reported in the English-language medical literature. These 13 patients resembled those with classic ecthyma gangrenosum accompanied by Pseudomonas septicemia in being immunocompromised and neutropenic and having skin lesions at similar sites. The most striking difference between these two groups of patients was a significantly lower mortality rate for the nonbacteremic patients. These findings suggest that ecthyma gangrenosum can occur as a primary skin lesion in the absence of bacteremia. Patients with this particular subtype of infection appear to have a better prognosis than those having a preceding bacteremia.

Aged↗
PubMed1986

Unintentional weight loss. A retrospective analysis of 154 cases.

Unintentional weight loss (UWL) was documented in 154 patients (2.8%) admitted to an internal medicine department during a two-year period. A retrospective analysis of the clinical charts showed that more than one third (36.3%) were found to have a neoplasm, involving preponderantly the gastrointestinal tract. Patients with neoplasia were older and more frequently had abnormal physical findings and significantly lower values of serum albumin as well as higher values of alkaline phosphatase than other patients. Despite extensive investigations, in 36 patients (23.3%) UWL remained unexplained even after prolonged follow-up periods. The remaining 62 patients had a variety of disorders, preponderantly gastrointestinal tract (26 patients) and psychiatric (16 patients) diseases. Endocrinologic disorders such as diabetes mellitus and hyperthyroidism were relatively uncommon (3.8%). Unintentional weight loss is a relatively common problem in clinical practice. Familiarity with the spectrum of disorders associated with UWL as well as selected clinical and laboratory values may help in the initial examination of these patients.

Adult↗
PubMed1986

Aquarium-borne Mycobacterium marinum skin infection. Report of a case and review of the literature.

A 33-year-old fish fancier developed a protracted skin infection that ultimately was found to be caused by Mycobacterium marinum. The organism was isolated from the lesion as well as from infected fish taken from his home aquarium. The lesion resolved after a six-week course of oral sulfamethoxazole and trimethoprim. Forty-four additional cases of culture-proved M marinum skin infections acquired from aquariums and reported in the English-language literature are reviewed. Almost universally, the lesions remained circumscribed and were either single nodular (14 patients) or multiple sporotrichoid (31 patients). Diagnosis was supported by acid-fast smears (15 patients) and isolation of the organism from skin lesions (43 patients) or from fish (two cases). In vitro studies, as well as clinical outcomes, suggest sulfamethoxazole-trimethoprim or ethambutol hydrochloride plus rifampin to be the drugs of choice.

Adult↗
PubMed1986

Overestimation of blood pressure in the elderly.

The blood pressure (BP) of 24 elderly (mean age +/- SD 73 +/- 5 years) and 10 young (35 +/- 11 years) hypertensive patients was measured indirectly by the cuff-mercury sphygmomanometer and directly by intra-arterial recording. The differences between indirect and direct BP (delta BP) recordings were significant (P less than 0.05) for both systolic BP (delta SBP +/- SD 16.55 +/- 15.91 mm Hg) and diastolic BP (delta DBP, 6.97 +/- 9.38 mm Hg) in the elderly group but not in the young group (delta SBP, +/- 2.50 +/- 9.70 mm Hg, delta DBP, +/- -0.03 +/- 6.55 mm Hg). The use of the cuff-mercury method may overestimate systolic and diastolic BP in elderly hypertensive patients.

Aged↗
PubMed1985

Infections in renal transplant recipients in Israel.

A 5-year retrospective survey of infections following 258 renal transplants in 233 patients is reported from a large medical center in Israel. The most common sites of infection were the urinary tract, the surgical incision, and the lung. We recorded 157 episodes of bacteriuria, 75% during the first month following transplantation. In 24 patients, 25 episodes of bacteremia were documented, with gram-negative bacteria being the most commonly involved organism. Pneumonia was diagnosed in 36 patients and was associated with relatively high mortality. Cytomegalovirus was the most common single organism responsible for infection. Fatal rhinocerebral mucormycosis was observed in three patients and was the most common invasive fungal infection. Other serious opportunistic infections were seen only rarely. Infectious diseases were the most frequent cause of death (51.1%) among these patients.

Adolescent↗
PubMed1984

Tuberculosis mimicking cancer--a reminder.

The charts of 26 patients who were referred with a presumptive diagnosis of neoplasms and who were ultimately found to have only tuberculosis were reviewed. Twenty-one patients (81 percent) were born in the United States, and only three patients had a history of exposure to tuberculosis. Most patients had few symptoms, and the average duration of symptoms was 2.8 +/- 1.5 months. Classic symptoms of tuberculosis, like fever, hemoptysis, and weight loss, were uncommon. Chest roentgenographic abnormalities were present in 62 percent of the patients. Although some of the patients had undergone nondiagnostic biopsy procedures before referral, none had had skin tests for tuberculosis. Underlying conditions were found in eight patients, and alcoholism was the most common. Laboratory abnormalities were rare with the exception of increased platelet counts, which were found in eight patients. The most common form of tuberculosis was pulmonary (14 patients) followed by lymphadenitis (nine patients). Tuberculosis remains an elusive disease even in countries with advanced medical technology. In some cases, its presentation may suggest the presence of malignancy.

Diagnosis, Differential↗
PubMed1984

Polymicrobial brain abscess in a homosexual man with Kaposi's sarcoma.

A progressive visual field defect and fever occurred in a 39-year-old homosexual man with acquired immunodeficiency syndrome and Kaposi's sarcoma. Computerized tomography of the brain documented a left parieto-occipital abscess. A specimen obtained at the time of surgical excision of the lesion revealed organisms with morphologic features of Toxoplasma gondii and Candida. Culture of this material grew Staphylococcus epidermidis. Appropriate therapy for this polymicrobial infection resulted in resolution of the fever and clinical improvement. The visual deficit remained unchanged despite antimicrobial therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Human cryptosporidiosis: spectrum of disease. Report of six cases and review of the literature.

Although once regarded exclusively as an animal parasite, Cryptosporidium has emerged during the last decade as a cause of diarrhea in humans. Of the 43 cases of human cryptosporidiosis reported, 27 patients in whom either humoral or cell-mediated immune defects were present had chronic protracted diarrhea that was almost invariably unresponsive to therapy and culminated in death. In contrast, 16 patients with intact immune systems had either self-limited disease or were asymptomatic. Animal exposure was almost exclusively recorded in the latter group. During the last six months at University of Texas M. D. Anderson Hospital and Tumor Institute, Houston, gastrointestinal (GI) tract cryptosporidiosis developed in six homosexual men with acquired immune deficiency syndrome (AIDS). The diagnosis of cryptosporidiosis was established histologically in five patients. In four, cryptosporidial oocysts were detected in the stool. In addition to extensive GI tract cryptosporidiosis, two patients had biliary tract involvement. Multiple chemotherapeutic agents failed to control the disease, and five patients eventually died. Cryptosporidiosis should be considered in the differential diagnosis of diarrhea, in animal handlers or in the severely compromised patient, especially one with AIDS, who has chronic protracted diarrhea.

Acquired Immunodeficiency Syndrome↗