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W P Lewis

Publications and source records attributed to W P Lewis.

11 recordsLinked to original sources
PubMed1992

Yield of bronchoscopy for the diagnosis of tuberculosis in patients with human immunodeficiency virus infection.

The efficacy of bronchoscopy for the diagnosis of tuberculosis in patients infected with human immunodeficiency virus (HIV) has not been systematically evaluated. We therefore compared the diagnostic yield of bronchoscopy in 67 HIV-infected and 45 non-HIV-infected patients with culture-proven pulmonary tuberculosis. In all cases, acid-fast smears of sputum were negative or not obtained prior to bronchoscopy. Prebronchoscopic sputum culture yielded Mycobacterium tuberculosis in 34 (89 percent) of 38 HIV-infected patients and 26 (93 percent) of 28 non-HIV-infected patients from whom specimens were obtained. Bronchoscopy provided an early diagnosis of tuberculosis (positive acid-fast smear or granulomata on biopsy) in 23 (34 percent) of the HIV-infected patients and 20 (44 percent) of the patients without HIV infection. The sensitivities of the acid-fast smear and of mycobacterial culture of bronchoscopic specimens and postbronchoscopic sputum were similar in patients with or without HIV infection. In HIV-infected patients, granulomatous inflammation was noted on transbronchial biopsy in 11 (19 percent) of 59 patients with HIV infection, compared to 16 (43 percent) of 37 patients without HIV infection (p = 0.01). Nevertheless, transbronchial biopsy provided the exclusive means for an early diagnosis of tuberculosis in six (10 percent) of 59 HIV-infected patients. We conclude that the yield of bronchoscopy for the diagnosis of pulmonary tuberculosis in HIV-infected patients is similar to that in patients without HIV infection, and that transbronchial biopsy provides incremental diagnostic information not available from evaluation of sputum or bronchoalveolar lavage fluid.

AIDS-Related Opportunistic Infections↗
PubMed1977

Comparison of clindamycin and chloramphenicol in treatment of serious infections of the female genital tract.

A study was performed of 102 obstetric-gynecologic patients who were thought to have sepsis or a pelvic abscess. Fifty-three of these women received chloramphenicol and 49 received clindamycin. In addition, all patients received penicillin or a similar antibiotic and an aminoglycoside. Similar clinical results were observed with the two treatment regimens. In eight of the 49 patients who received clindamycin and in three of 52 patients who received chloramphenicol, use of the drug was discontinued because of side effects. These combinations of antibiotics did not eliminate the necessity for major operative drainage, which was required in 40 patients. Resistant organisms were recovered from only two patients. Although sepsis and shock were most frequently associated with gram-negative aerobic bacteremia, they occurred in two patients in whom only anaerobes were recovered from blood cultures. Because the clinical results with the two regimens were equivalent, a decision to use either clindamycin or chloramphenicol should be based on the individual physician's assessment of the toxicity of these agents.

Abscess↗
PubMed1976

A new approach to patients with suspected anaerobic postpartum pelvic infections. Transabdominal uterine aspiration for culture and metronidazole for treatment.

Oral metronidazole was given as therapy in 25 women with the clinical diagnosis of a postpartum anaerobic soft tissue pelvic infection following a vaginal delivery. There was a good clinical response in 80 per cent of these women. No anaerobic organisms resistant to metronidazole were recovered in the treatment failures. Different specimen collection techniques were evaluated, with anaerobes recovered in 4 per cent of the blood cultures, 26.3 per cent of the transabdominal endometrial aspirations, and 88 per cent of the transcervical endometrial samples. The aerobic recovery of organisms was 4 per cent from blood cultures, 15.8 per cent from transabdominal endometrial aspirations, and 96 per cent from the transcervical approach. The significance of these findings is discussed.

Abdomen↗
PubMed1976

The use of pr-reduced media and a portable jar for the collection of anaerobic organisms for clinical sites of infection.

A system for the isolation of anaerobic organisms from clinical specimens was evaluated at the LAC-USC Medical Center. Clinicians were provided with a Gas Pak with a broth tube and two prereduced blood plates for direct inoculation of specimens. In the first 50 patients evaluated, 74 separate anaerobic isolates were recovered in 36 patients, 72 per cent of the total. Bacteroides fragilis was the most common organism recovered. The impact of this system upon clinical management is discussed.

Anaerobiosis↗
PubMed1975

Guidelines for antibiotic prophylaxis in gynecology.

Using a random table of numbers, 100 premenopausal women undergoing vaginal hysterectomy were assigned to a short-term or long-term antibiotic prophylaxis regimen. The short-term regimen patients received a total of 3 Gm. of cephaloridine in divided doses on the day of operation, while the long-term regimen patients also received oral cephalexin postoperatively. The preoperative profiles of the two study groups were similar, and the postoperative results were not significantly different. A quantitative evaluation of aerobic and anaerobic bacteria recovered from the surface of the vagina was done, and cephaloridine content of vaginal washings, serum, and vaginal tissue was determined. This information was utilized to suggest guidelines for antibiotic prophylaxis in gynecology.

Adult↗
PubMed1971

Amebiasis--a symposium.

This is the transcription of the regular teaching conferences in infectious diseases held weekly at Harbor General Hospital, Torrance. These transcriptions are edited by Drs. J. A. Turner, I. Ziment and L. B. Guze.

Adult↗