Between 1989 and 1995 in the Hospital of Infectious Diseases from Iaşi have been diagnoses 4 cases of streptococcal/staphylococcal toxic syndrome. Three patients have been grown up and one child. Two of them were immunocompromised hosts (cirrhosis, lung tuberculosis, alcoholism). The gate of entry was cutaneous in 3 cases and probably mucous in the 4th case. The clinical symptoms were fever, generalized erythematous rush followed by desquamation, low arterial pressure with oliguria, tachycardia, jaundice moderate, elevated ALAT. The bacteriological diagnosis was confirmed by isolating the pathogen agent from the erysipelatous placard and from blood culture. The evolution of the illness was nefavourable in 2 cases. The cause of the death was the MSOF (multiple systemic organic failure).

Adolescent↗

PubMedDate not supplied

[Postoperative and posttraumatic meningitis. Comments on 87 cases].

Iatrogenic and traumatic cerebromeningitis infections are increasing in frequency in the last two decades. Retrospective analysis of 87 patients iatrogenic and traumatic bacterial meningitis were admitted in the Clinic of Infectious Diseases from Iaşi between 1, 01, 1990-31, 12, 1994. Head trauma, lumbar punctures and iatrogenic meningitis infections were the causes cerebromeningitis infections. The diagnosis is usually difficult because of the poor specificity of the clinical signs. Predominant pathogens were gram-negative bacteria and Staphylococcus in iatrogenic meningitis and gram-positive bacteria (S. pneumoniae) in traumatic meningitis. The treatment was based on the use penicillin G + chloramphenicol, 3rd generation cephalosporins and sometimes 2nd generation quinolones. Ten of the 87 patients with iatrogenic and traumatic cerebromeningitis infections died (10.3%).

Anti-Bacterial Agents↗

PubMedDate not supplied

[The value of C-reactive protein for the differentiation of bacterial meningitis from viral meningitis].

In order to differentiate bacterial meningitis versus viral meningitis, we have comparatively tested the efficacy of the following tests: C-reactive protein (CRP), erythrocytes sedimentation rate (ESR), fever, level of glucose in cerebro-spinal fluid (CSF), glucose in CSF/glycemia ratio, number of white blood cells in peripheric blood, percentage of neutrophils in peripheric blood, level of proteins in CSF and number of nucleated cells in CSF for a group of 49 patients, both children and adults with central nervous system infection (37 patients with bacterial meningitis and 12 with viral meningitis) hospitalised between May 1993 and July 1994 in Clinical Hospital for Infectious Diseases in Iaşi. The mean value of CRP in bacterial meningitis patients was 8.78 mg%, contrasting with the mean value of CRP = 1.92 mg% recorded in patients with viral meningitis. Ten out of 37 bacterial meningitis patients presented a CRP concentration < 1.85 mg%. All these 10 patients have already had an antibiotic treatment at the moment of the assay. One out of 12 cases of viral meningitis had a value of CRP = 3.3 mg%, all the remainder cases having values under 1.85 mg%. We recorded highly significant differences between the two patient groups for CRP (p < 0.001), ESR (p < 0.01), protein concentration in CSF (p < 0.001) and number of nucleated cells in CSF (p < 0.001). Differences recorded for fever, concentration of glucose in CSF, glucose in CSF/glycemia ratio, number of leucocytes in peripheric blood and percentage of neutrophils in peripheric blood, were not significant (p > 0.5). Data were analysed also by box-plot method which facilitates the visual appraisal of the differences recorded between the two aetiological groups. In conclusion, assays of CRP and ESR may be used as differentiation tests for bacterial meningitis versus viral meningitis, when assay is done before the antibiotic treatment, being sufficient sensitive, and easy to perform.

Adolescent↗

PubMedDate not supplied

[The usefulness of determining acute-phase reactants in establishing the bacterial etiology in lower respiratory tract infections].

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Acute-Phase Proteins↗