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Biomedical subjects

Z C Kaminski

Publications and source records attributed to Z C Kaminski.

10 recordsLinked to original sources
PubMed1996

Treatment of vancomycin-resistant Enterococcus faecium infections with an investigational streptogramin antibiotic (quinupristin/dalfopristin): a report of fifteen cases.

New therapies for vancomycin-resistant Enterococcus faecium (VREF) infections are urgently needed. We describe the treatment of 15 patients with VREF infection with quinupristin/dalfopristin (RP 59500), a new injectable streptogramin antibiotic. Primary infections treated were bacteremia (4), urinary tract (4), intraabdominal (5), otitis externa (1), and meningitis (1). Minimum inhibitory concentrations for quinupristin/dalfopristin ranged from 0.5 microgram/ml or less to 2 micrograms/ml, and minimum bactericidal concentrations were greater than 64 micrograms/ml for all VREF isolates tested. Peak serum inhibitory titers following infusion of quinupristin/dalfopristin ranged from 1:8 to 1:64; all bactericidal titers were less than 1:2. Development of resistance to quinupristin/dalfopristin during therapy was not observed. The only drug-related adverse effect noted was phlebitis in 4 patients; all had received quinupristin/dalfopristin by peripheral venous infusion. Three patients had clinical and bacteriologic cures. Relapses occurred in 5 patients with recovery of VREF from infected sites in post-treatment cultures. Ten patients died of severe underlying disease; VREF was believed to contribute directly to the death of only 1 patient. While evaluation of clinical efficacy was complicated by the severity of underlying disease in patients with VREF infection, our experience suggests that quinupristin/dalfopristin is a safe and potentially useful agent for the treatment of VREF infections.

Adult↗
PubMed1992

Meningitis due to Prototheca wickerhamii in a patient with AIDS.

The first documented case of algal meningitis due to Prototheca wickerhamii is reported in a patient with AIDS. The initial CSF culture yielded only Cryptococcus neoformans. P. wickerhamii was isolated on four subsequent lumbar punctures. The patient died, and at autopsy the alga was isolated from leptomeninges over the brain and about the spinal cord. Histologic sections from numerous locations of the brain revealed masses of cryptococci and prototheca.

AIDS-Related Opportunistic Infections↗
PubMed1987

Cutaneous onchocerciasis.

Onchocerciasis was diagnosed when a skin biopsy specimen immersed in saline revealed microfiliariae. The patient was a 22-year-old student from Cameroon, West Africa, complaining of small, recurrent, pruritic papules on his thighs. Chemotherapy with ivermectin, an established antiparasitic agent with newly recognized anti-onchocercal potential, was well tolerated, and microfilariae were not detected in post-therapy skin biopsy specimens. The diagnosis of onchocerciasis should be entertained in individuals returning or emigrating from endemic areas.

Adult↗
PubMed1983

Culture of Vibrio extorquens from severe, chronic skin ulcers in a Puerto Rican woman.

A 48-year-old Puerto Rican woman developed extensive ulcers on her buttocks, right arm, and thighs over a 3 1/2-year period. The lesions began as small, subcutaneous nodules which subsequently ulcerated and expanded up to 19 cm in diameter. Biopsy of both ulcerated and nonulcerated lesions showed acid-fast bacilli. Culture of both types of lesions grew Vibrio extorquens, a partially acid-fast methanolophilic organism not previously associated with disease in humans. The patient developed agglutinating antibody, titer 1:80, to this organism. The disease responded to treatment with antibiotics to which the organism was sensitive in vitro.

Female↗
PubMed1983

Comparative study of parenteral piperacillin and cefoxitin in the treatment of surgical infections of the abdomen.

Patients who had contaminated traumatic perforations of the gastrointestinal tract and those with acute peritonitis resulting from acute surgical inflammatory conditions were treated with piperacillin or cefoxitin infused intravenously as single therapy for a minimum of five days. Thirty-four patients were given 4.5 grams of piperacillin every six hours and 26 patients, 2.0 grams of cefoxitin every six hours. In the piperacillin group, 63 organisms (34 aerobes and 29 anaerobes) were isolated from pretreatment cultures, while in the cefoxitin group, 73 organisms (35 aerobes and 38 anaerobes) were isolated. Clinical recovery was achieved in 31 of 34 patients receiving piperacillin therapy and in 24 of 26 patients receiving cefoxitin therapy. Organisms were found to be resistant to the respective drug in two piperacillin-treated patients and in one cefoxitin-treated patient, and the patients were given other antibacterial treatment. One patient from each treatment group died of causes unrelated to septic conditions. No serious adverse effects occurred from either antibiotic.

Abdomen↗
PubMedDate not supplied

Syndrome of hyperinfection with Strongyloides stercoralis.

Two patients hyperinfected with Strongyloides stercoralis (an intestinal nematode) are described. Both were both in Puerto Rico and had left the island six to 15 years previously; both were receiving adrenal steroids (one for Hodgkin's disease and the other for Goodpasture's syndrome). One died shortly after diagnosis, but the other survived the hyperinfection syndrome and complicating bacterial sepsis and meningitis. In addition to our case reports, 103 previously described cases of presumed strongyloides hyperinfection are reviewed. Among 89 patients immunocompromised by therapy or disease, the mortality rate was 86%; bacterial sepsis often contributed to the fatal outcome. In most cases, infection was acquired in an endemic area, sometimes long before the hyperinfection syndrome occurred. The few patients who had never been to an endemic area had a history of prolonged contact with highly soiled material, an observation suggesting cross infection from a contaminated person. When administered in time, thiabendazole, the drug of choice for strongyloidiasis, was effective in 70% of cases. If intestinal infection with S. stercoralis is detected and treated before immunosuppressive therapy is initiated and if a high index of suspicion for the hyperinfection syndrome is maintained while immunosuppressive therapy is given, the mortality from this disease should decrease.

Adult↗