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Biomedical subjects

Y Siegman-Igra

Publications and source records attributed to Y Siegman-Igra.

At least 73 records · Page 4Linked to original sources
PubMed1983

Late postoperative fever--viral infection following multiple blood transfusion.

The possibility of acquiring a viral infection by blood transfusion, although recognized for nearly 20 yr, is often ignored. Surgeons and internists submit patients to sophisticated, and sometimes invasive, diagnostic and therapeutic procedures without considering this possibility. We report here on two patients in whom febrile illness appeared about 5 wk after surgery. Both had received multiple blood transfusions in the perioperative period. Initial diagnoses indicated typhoid fever in one patient who received chloramphenicol therapy, and endocarditis in the other patient who was given massive combined antibiotic therapy. Both were later diagnosed by serologic methods as having cytomegalovirus and Epstein-Barr virus infection, respectively. Review of the literature reveals that this mechanism of acquiring these frequently asymptomatic viral infections is surprisingly common.

Adult↗
PubMed1983

A small outbreak of Serratia marcescens sepsis and meningitis.

Two fatal cases of Serratia marcescens sepsis and meningitis are reported here. The first case, a 1,420-g male infant born after 35 weeks of gestation, developed abdominal distension, hypotension and acidosis on the 3rd day after birth. Cerebrospinal fluid (CSF) was cloudy; blood and CSF cultures were positive for S. marcescens. He died within 24 hours after the appearance of symptoms, and purulent meningitis was found at autopsy. The second case, a 1,100-g boy born after 29 weeks of gestation, developed Escherichia coli sepsis at 14 days of age, from which he recovered. At 26 days of age he developed convulsions. Blood and CSF cultures grew S. marcescens. He was given gentamicin, chloramphenicol and supportive treatment, but expired 48 hours after the onset of symptoms. Both cases appeared within a 2-day period.

Bacterial Infections↗
PubMed1983

Meningitis and bacteremia due to Bacillus cereus. A case report and a review of Bacillus infections.

A patient with meningitis and bacteremia due to Bacillus cereus is described. The patient had transsphenoidal hypophysectomy for chromophobe adenoma, complicated by rhinorrhea, which was corrected by subarachnoid drainage. Three weeks after removal of the drain, the patient presented with meningitis and died the following day. The causative organism was identified as B. cereus. The literature on Bacillus infections is reviewed with special attention to severe infections. A modified classification is proposed, dividing infections into superficial, closed-space and systemic ones. Sixty-one previously reported cases of systemic Bacillus infections are reviewed according to type of infection (endocarditis, meningitis or pulmonary infection), and the underlying conditions, ways of acquiring the infection, clinical picture and mortality are discussed.

Aged↗
PubMed1983

Bacteremia in hospitalized children.

Among 7,205 children hospitalized in the Pediatric Service at the Rokach (Hadassah) Hospital during 1980 and 1981, 44 were found to be bacteremic. The most common pathogen was Streptococcus pneumoniae, followed by Salmonella, Staphylococcus, Klebsiella and others; 52% of the isolates were gram-negative. The most common focus of infection was the respiratory tract, followed by the gastrointestinal and urinary tracts. Almost half of the bacteremic children were under 2 years of age. Other data, such as predisposing conditions and mortality, and whether the bacteremias were hospital acquired, are also analyzed. All of the findings are discussed and compared to the findings from the few similar studies in the literature.

Adolescent↗
PubMedDate not supplied

Pseudomonas aeruginosa bacteremia: an analysis of 123 episodes, with particular emphasis on the effect of antibiotic therapy.

OBJECTIVES: To review current experience with Pseudomonas aeruginosa bacteremia and compare outcome of patients treated with single-drug, versus combination therapy. METHODS: The charts of all patients with P. aeruginosa bacteremia between 1990 and 1992 were reviewed, and pertinent demographic, clinical, and bacteriologic data were retrieved. In addition, similar data were collected from a series of patients with P. aeruginosa bacteremia from the literature of the past 20 years. RESULTS: One hundred and twenty-three episodes of P. aeruginosa bacteremia in 121 patients were identified. Most patients were older than 70 years, had at least one underlying condition, and had acquired the infection in the hospital. Attributable mortality was 34%. After exclusion for early mortality and inappropriate therapy, 57 patients remained eligible for comparison of outcome according to therapy protocol. Mortality from infection was equal between the group of 42 patients who received monotherapy and the 15 patients who received combination therapy (14% and 13%, respectively). The literature review revealed eight articles describing 21 to 410 episodes of Pseudomonas bacteremia. The clinical characteristics of these series did not differ significantly from those of the present series. CONCLUSIONS: Incidence, epidemiology, clinical characteristics, and outcome of pseudomonas sepsis did not change significantly over the past 2 decades. Appropriate monotherapy was as effective as combination drug therapy for individuals with pseudomonas bacteremia surviving the first 2 days of infection.

Adolescent↗
PubMedDate not supplied

Varied presentations of sporadic group A streptococcal bacteremia: clinical experience and attempt at classification.

The epidemiologic, clinical, and laboratory aspects of group A streptococcal bacteremia were studied in 33 patients seen at two urban hospitals in the Tel Aviv (Israel) area, over an 8-year period. Most patients (two-thirds) were female. Clinically significant bacteremia was observed in 26 patients, two of whom acquired their infection (puerperal sepsis) during hospitalization. A portal of entry, mainly cutaneous, was recognized in 61% of the patients, and a chronic underlying condition was observed in 69%. The case-fatality rate was 27%, with death occurring predominantly in patients admitted with shock or cryptogenic bacteremia. Our clinical experience and literature review show that the presentation of group A streptococcal bacteremia is diverse, with transient bacteremia of uncertain clinical significance on one end of the spectrum and overwhelming sepsis on the other. A practical classification of the various clinical forms of group A streptococcal bacteremia is proposed.

Adult↗
PubMedDate not supplied

West Nile encephalitis in Israel, 1999: the New York connection.

We describe two cases of West Nile (WN) encephalitis in a married couple in Tel Aviv, Israel, in 1999. Reverse transcription-polymerase chain reaction performed on a brain specimen from the husband detected a WN viral strain nearly identical to avian strains recovered in Israel in 1998 (99.9% genomic sequence homology) and in New York in 1999 (99.8%). This result supports the hypothesis that the 1999 WN virus epidemic in the United States originated from the introduction of a strain that had been circulating in Israel.

Aged↗
PubMedDate not supplied

Clinical characteristics of the West Nile fever outbreak, Israel, 2000.

West Nile (WN) virus is endemic in Israel. The last reported outbreak had occurred in 1981. From August to October 2000, a large-scale epidemic of WN fever occurred in Israel; 417 cases were confirmed, with 326 hospitalizations. The main clinical presentations were encephalitis (57.9%), febrile disease (24.4%), and meningitis (15.9%). Within the study group, 33 (14.1%) hospitalized patients died. Mortality was higher among patients >70 years (29.3%). On multivariate regressional analysis, independent predictors of death were age >70 years (odds ratio [OR] 7.7), change in level of consciousness (OR 9.0), and anemia (OR 2.7). In contrast to prior reports, WN fever appears to be a severe illness with high rate of central nervous system involvement and a particularly grim outcome in the elderly.

Adolescent↗