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At least 757 records · Page 42Linked to original sources

PubMed1985

Clinical efficacy and safety of cefmenoxime in children.

Cefmenoxime, an investigational semisynthetic cephalosporin, was evaluated in 18 pediatric patients with a variety of infections. There were seven patients with urinary tract infections, two with wound infections, two with osteomyelitis, two with abscess infections, one with cervical adenitis, one with hidradenitis, one with pneumonia and sepsis, one with periorbital cellulitis, and one with ventriculitis. A total of 16 (88%) patients had a satisfactory clinical response demonstrated by improvement in clinical signs and symptoms. A total of 12 (67%) patients demonstrated eradication of their infecting organisms. Of the pathogens isolated in these patients, 16 isolates were susceptible to cefmenoxime. One patient developed a generalized urticarial rash that resolved within 24 h after cessation of cefmenoxime therapy. Mean peak level in serum after intravenous infusion was 55 micrograms/ml.

Bacterial Infections↗

PubMed2000

Mycobacterium bovis BCG induces similar immune responses and protection by rectal and parenteral immunization routes.

We compared cellular immune responses to rectal, subcutaneous, and intradermal administration of Mycobacterium bovis BCG for 5 to 20 weeks in mice, guinea pigs, and macaques. Strong lymphoproliferative responses were induced in spleen cells after in vitro stimulation with purified protein derivative in guinea pigs and macaques, whatever the route of immunization. Comparable high numbers of gamma interferon- and tumor necrosis factor alpha-producing cells were found in the spleen after rectal, subcutaneous, and intradermal immunization of mice and macaques. Similar levels of precursors of cytotoxic T lymphocytes specific for mycobacterial antigens were observed in mice for all immunization routes. In macaques, cytotoxic activity, determined only at the end of the experiment (20 weeks), was similar after rectal and intradermal immunization. Six months after immunization, rectal and subcutaneous routes induced in mice similar levels of protective immunity against challenge with a virulent Mycobacterium tuberculosis strain (H37Rv). Rectal immunization gave immune responses and protective capacity similar to those for parenteral immunization and seemed to be a promising new route of vaccination against tuberculosis; in our study, immunization via the rectal route never induced side effects associated with parenteral routes (axillary adenitis) and could also effectively reduce the risks of viral transmission associated with unsafe injections in the developing world.

Administration, Rectal↗

PubMed1991

Inguinal lymphadenitis associated with Capnocytophaga bacilli.

Capnocytophaga organisms are capnophilic, gram-negative bacilli that have been associated with infections deriving from the flora of the oropharynx. We report a case of inguinal adenitis caused by Capnocytophaga species that probably represents sexual transmission of the pathogen.

Adult↗

PubMed2002

PFAPA syndrome in children evaluated for tonsillectomy.

Among 40 children undergoing tonsillectomy for recurrent pharyngitis, 15 (37.5%) had presented preoperatively with complaints compatible with PFAPA syndrome. All 15 had had periodic fever every three to four weeks and pharyngitis; 12 (80%) had cervical adenitis and five (33%) aphthous stomatitis. All children had been well between episodes and showed a dramatic postoperative improvement. PFAPA syndrome is not uncommon among children having tonsillectomy. Tonsillectomy is curative in most of these patients.

Child↗

PubMed1969

Acute abdominal pain in childhood, with special reference to cases not due to acute appendicitis.

Appendicitis is not the only common cause of acute abdominal pain in childhood. Almost equally common is an acute episode which in its early stages resembles acute appendicitis but which subsides without treatment in 24 to 48 hours. The clinical features of this syndrome are contrasted with those of appendicitis. The two conditions cannot always be distinguished on clinical grounds, leading to admission to hospital for observation and the finding of a normal appendix in 14% of operations for suspected appendicitis. Reasons are given for abandoning attempts to diagnose acute mesenteric adenitis at the bedside.

Abdomen, Acute↗

PubMed1969

Infection with the avian-Battey group of mycobacteria in England and Wales.

Of 109 cases in England and Wales in which mycobacteria of the avian-Battey group were isolated from man 89 were considered genuine infections (including 32 with Mycobacterium avium) and six were doubtful. Almost half the significant cases were lung infections in men in dusty occupations, mostly coal miners with pneumoconiosis, and just over a quarter were non-pulmonary, mostly cervical adenitis in children. The prognosis in lung infections was serious, especially in the presence of pneumoconiosis.

Adult↗

PubMed1960

Three cases of acute mesenteric lymphadenitis due to Pasteurella pseudotuberculosis.

Seventeen cases of mesenteric adenitis were investigated between May and October, 1959, for the presence of virus as well as for evidence of Pasteurella pseudotuberculosis infection. Specimens examined included mesenteric glands, appendix, throat swab, faeces, and serum, although glands were received from only 12 patients. Virus was not isolated from any of the specimens, but evidence of infection with Pasteurella pseudotuberculosis was obtained in three patients. The three cases of acute mesenteric lymphadenitis due to Pasteurella pseudotuberculosis are reported. Pasteurella pseudotuberculosis Type IA was isolated from the mesenteric glands of two of the cases, and all three cases showed serological evidence of infection with the organism. The mesenteric glands of two of the cases showed histological changes characteristic of pseudotuberculosis.

Acute Disease↗

PubMed1986

Cervical Castleman disease: CT study with angiographic correlation.

The computed tomographic (CT) appearance, angiographic appearance, and clinical features of a patient with cervical Castleman disease, an uncommon disease of benign lymph node hyperplasia, are reported. CT scans showed a densely enhancing cervical mass. On external carotid angiography, the mass was seen as hypervascular with a capillary blush. Differential diagnosis included carotid body chemodectoma, vagal neuroma, tumor of the salivary gland, tuberculous adenitis and other granulomatous diseases, inflammatory lymph nodes, metastatic disease, and lymphoma.

Adolescent↗

PubMed1990

Acute appendicitis in children: evaluation with US.

During a 4-month period, high-resolution ultrasonography (US) was used to prospectively evaluate 70 children with clinically suspected acute appendicitis. Thirty-five US scans showed a noncompressible appendix with maximal outer diameters greater than 6 mm. This finding was considered positive for the diagnosis of acute appendicitis. Thirty-one of these 35 patients had acute appendicitis documented by surgical and pathologic findings. The remaining four patients were observed, and their symptoms resolved. Thirty-five patients had US scans considered negative for appendicitis. Seventeen of these patients had US findings positive for other conditions including mesenteric adenitis, ileitis, intussusception, Crohn disease, and Burkitt lymphoma. In this series US enabled diagnosis of acute appendicitis with a sensitivity of 94%, a specificity of 89%, and a predictive accuracy of 91%. Diagnosis of acute appendicitis can be made with US with the same accuracy in children as has been previously reported in series of adult patients. The use of US in clinically ambiguous cases may allow earlier diagnosis, prevention of perforation, and decreased complications in the pediatric patient with acute appendicitis.

Acute Disease↗

PubMed1992

Appendicitis in children: color Doppler sonography.

The authors used color Doppler ultrasonography (US) to evaluate 33 children with suspected appendicitis and found locally increased blood flow in all of 10 patients with appendicitis or periappendiceal abscess; the studies were normal in 16 patients without appendicitis. The gray-scale sonographic results were concordant in all 26 of these patients. In two other patients with presumptive mesenteric adenitis and in one patient with a hemorrhagic ovarian cyst at gray-scale US, color Doppler imaging showed no increased perfusion and aided in confirming the absence of a significant inflammatory process. In four other children, color Doppler US clarified gray-scale sonographic findings that might have been confused with complicated appendicitis and aided in the diagnosis of other causes of acute abdominal pain. These findings indicate that color Doppler US is a useful adjunct to gray-scale US in evaluating children with suspected acute appendicitis.

Adolescent↗

PubMedDate not supplied

Unusual nonneoplastic peritoneal and subperitoneal conditions: CT findings.

Peritoneal disease can manifest at computed tomography (CT) as fluid accumulation within the peritoneal cavity (ascites) or soft-tissue infiltration of the various peritoneal ligaments and mesenteries. Beyond the commonly encountered cases of typical ascites and peritonitis, there is a wide spectrum of uncommon nonneoplastic conditions that may involve the peritoneal and subperitoneal spaces. For example, systemic or organ-based diseases that occasionally involve the peritoneum include eosinophilic gastroenteritis, amyloidosis, extramedullary hematopoiesis, Erdheim-Chester disease, sarcoidosis, and mesenteric cavitary lymph node syndrome. Tumorlike conditions that may affect the peritoneum include aggressive fibromatosis (desmoid), inflammatory pseudotumor, retractile mesenteritis, and Castleman disease. Atypical peritoneal infections include tuberculosis, actinomycosis, echinococcosis, Whipple disease, and mesenteric adenitis. Conditions involving the subperitoneal fat include epiploic appendagitis, mesenteric panniculitis, and segmental omental infarction, all of which have characteristic CT findings. CT is an excellent imaging modality for detection and characterization of peritoneal involvement from these unusual diseases.

Adult↗

PubMedDate not supplied

Imaging of chronic granulomatous disease in children.

Chronic granulomatous disease (CGD) is a rare immunodeficiency disorder. The inability of phagocytic cells to kill catalase-positive organisms, such as Staphylococcus and Aspergillus species, causes recurrent infections, persistent inflammation, and granuloma formation. The imaging findings in nine cases of CGD were studied. Recurrent pulmonary infection was the most common abnormality (seven cases). Its complications included pulmonary abscesses, bronchiectasis, mediastinal abscesses, osteomyelitis, sepsis, and brain abscesses. Suppurative cervical adenitis was the second most common abnormality (four cases) and was also the presenting abnormality in the youngest patient (aged 31 days). Abdominal manifestations included hepatosplenomegaly, recurrent hepatic and splenic abscesses, necrotic mesenteric adenopathy, and gastric outlet obstruction. Osteomyelitis occurred in two cases secondary to hematogenous spread or spread of contiguous infection from the lung. Persistent infections led to formation of chronic inflammatory masses and granulomas in five cases. With improvements in therapy, the prognosis of CGD patients has improved and the general consensus is that most patients will survive into adulthood. Hence, radiologists are more likely to encounter the complications of CGD and should familiarize themselves with the spectrum of imaging findings.

Child↗

PubMed1999

Species-dependent hemodynamic effects of adenosine A3-receptor agonists IB-MECA and Cl-IB-MECA.

The purpose of this study was to compare the hemodynamic effects of the adenosine A3-receptor agonists N6-(3-iodobenzyl)-9-[5-(methylcarbamoyl)-beta-D-ribofuranosyl]aden ine (IB-MECA) and 2-chloro-N6-(3-iodobenzyl)-9-[5-(methylcarbamoyl)-beta-D-ribofu ranosy l]adenine (Cl-IB-MECA) in isolated rat and rabbit hearts and in the intact, open-chest pig. Isolated hearts perfused with Krebs-Henseleit buffer at a constant pressure (70 mmHg) were treated with 50 nM of either IB-MECA or Cl-IB-MECA. Neither IB-MECA nor Cl-IB-MECA altered ventricular function or heart rate in the isolated rat and rabbit hearts, and neither agent altered coronary flow in the rabbit. However, 2 min of IB-MECA treatment in the isolated rat heart increased coronary flow by 25%, an effect that did not exhibit tachyphylaxis. The IB-MECA-induced coronary dilation was only partially attenuated by the adenosine A3-receptor antagonist MRS-1191 (50 nM). IB-MECA-induced coronary dilation was completely blocked by the adenosine A2a-receptor antagonist 7-(2-phenylethyl)-5-amino-2-(2-furyl)-pyrazolo-[4,3-e]-1,2, 4-triazolo[1,5-c]pyrimidine (Sch-58261, 50 nM). Cl-IB-MECA (50 nM) did not increase coronary flow in the rat, but 100 nM did increase flow by 18%. In pentobarbital sodium-anesthetized pigs IB-MECA (5 micrograms/kg iv) decreased systemic blood pressure and increased pulmonary artery pressure, effects that did exhibit tachyphylaxis. These results illustrate that adenosine A3-receptor agonists produce species-dependent effects, which in the rat heart appear to be caused by adenosine A2a-receptor activation.

Adenosine↗

PubMed1994

Adenosine receptor-mediated bronchoconstriction and bronchial hyperresponsiveness in allergic rabbit model.

Recently, there has been an increasing interest in adenosine as a potential mediator of allergic asthma. In the present study, we have employed an allergic rabbit model of late-phase asthma to characterize the adenosine receptor subtype in the asthmatic airways. The allergic rabbit model has physiological characteristics and pharmacological sensitivity comparable to human asthma. Adenosine causes a dose-dependent bronchoconstriction in allergic, but not in normal, rabbits. This adenosine-induced bronchoconstriction is significantly inhibited by theophylline, an adenosine receptor antagonist, thus suggesting the involvement of adenosine receptor(s). 5'-(N-ethylcarboxyamido) adenosine (NECA), a nonselective agonist, 2-[p-(2-carboxyethyl)-phenethylamino]-5'-(N-ethylcarboxamido)-aden osine (CGS-21680), an A2-selective receptor agonist, and cyclopentyl adenosine (CPA), an A1-selective agonist, were used to characterize the adenosine receptor subtype in the airways of allergic rabbits, respectively. The PC50 (concentration of agonist in mg/ml required to reduce the dynamic compliance 50% from the baseline) values for adenosine, CGS-21680, NECA, and CPA were 9.25 +/- 0.86, 6.8 +/- 0.69, 3.90 +/- 0.27, and 1.45 +/- 0.26 mg/ml, respectively. Thus the potency profile for the bronchoconstrictor of adenosine in this model is a typical A1-receptor subtype (CPA > NECA > CGS-21680 > adenosine). Adenosine also induced further bronchial hyperresponsiveness (BHR) at 1 but not at 24 h following aerosol challenge.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗

PubMed2005

[Pediatric infections caused by nontuberculous mycobacteria].

During the last few years, nontuberculous mycobacteria (NTM) have been isolated with increasing frequency in our environment. However, there are only a few reports of pediatric NTM infections in Spain (13 articles since 1990). This article presents an update of the epidemiology, diagnostic methods, and treatment of these infections in children. The most frequent clinical syndromes caused by NTM include lymphadenitis, pulmonary and disseminated infections in immunocompromised children. NTM cervical adenitis usually causes chronic infection associated with sinus tract formation and scarring. The treatment of choice is surgical excision of the involved node. Incision and drainage of the enlarged node should be avoided because it can lead to chronic drainage or sinus tract formation. Medical treatment with azithromycin or clarithromycin associated with rifabutin, ethambutol or ciprofloxacin should be reserved for cases in which the family refuses surgery, a recurrence occurs or complete excision is impossible. Pulmonary disease caused by NTM is relatively rare in immunocompetent children, but is increasingly reported in children with cystic fibrosis. In these patients, the clinical significance of the presence of NTM in the sputum is unclear. The persistence of positive cultures, especially if bacilloscopy is positive and the patient shows clinical evidence of pulmonary disease exacerbation, is an indication to start treatment. Disseminated infection caused by NTM can appear in patients with severe immunodepression, especially in HIV-infected children with CD4 cell counts of less than 100 cells/mm3. Early antibiotic therapy with at least three drugs including a macrolide, and immune recovery with aggressive antiretroviral therapy are the keys to improving quality of life and survival in these patients.

CD4 Antigens↗

PubMed2000

Lichen scrofulosorum - a series of eight cases.

Lichen scrofulosorum is a rare entity of children and young adults. The cutaneous lesions are typically symptomless papular eruptions, associated with a strong Mantoux reaction, tuberculosis of lymph nodes and/or other organs. Eight patients between the ages of 5 and 36 years were included in this series. Lesions were commonly seen on the trunk, though a case of involvement of the palms and soles was also observed. Pulmonary tuberculosis was seen in 5 adults; 1 patient each had pleural effusion, tuberculous adenitis and tuberculoma, respectively. Histopathological examination typically showed epithelioid cell granulomas around hair follicles. The histogenesis is unclear, a type IV hypersensitivity reaction provoked by chronic tubercular infection is probable. The patients responded well to antituberculous therapy.

Adolescent↗

PubMedDate not supplied

Microbiology and management of deep facial infections and Lemierre syndrome.

This review describes the microbiology, diagnosis and management of deep facial infections and Lemierre syndrome. The origins of most of these infections are odontogenic infections that spread to fascial spaces of the lower head and upper neck. Other sources include pharyngotonsillar, nasal, otologic, salivary gland and dermatologic infections, hematogenic spread, cervical adenitis and trauma. These space infections can be divided into those around the face (masticatory, buccal, canine and parotid), the suprahyoid area (submandibular, sublingual and lateral pharyngeal) and the infrahyoid region or lateral neck (retropharyngeal and pretracheal spaces). The organisms accounting for these infections are aerobic and anaerobic that arise from the oropharyngeal flora. Complications of these infections can be life threatening and can result from hematogenic or direct spread. Complications that arise following local extension include suppurative jugular thrombophlebitis, cavernous sinus thrombosis, carotid erosion, maxillary sinusitis and osteomyelitis of the jaws. Management includes surgical drainage and antimicrobial therapy.

Face↗

PubMed2004

Mycobacterial cervical lymphadenitis.

Cervical lymphadenitis is the most common head and neck manifestation of mycobacterial infections. The incidence of mycobacterial cervical lymphadenitis has increased. It may be the manifestation of a systemic tuberculous disease or a unique clinical entity localized to neck. It remains a diagnostic and therapeutic challenge because it mimics other pathologic processes and yields inconsistent physical and laboratory findings. A high index of suspicion is needed for the diagnosis of mycobacterial cervical lymphadenitis. A unilateral single or multiple painless lump, mostly located in posterior cervical or supraclavicular region can occur. A thorough history and physical examination, tuberculin test, staining for acid-fast bacilli, radiologic examination, fine-needle aspiration and PCR will be instrumental in arriving at an early diagnosis early institution of treatment before a final diagnosis can be made by biopsy and culture. It is important to differentiate tuberculous from nontuberculous mycobacterial cervical lymphadenitis because their treatment protocols are different. Tuberculous adenitis is best treated as a systemic disease with antituberculosis medication. Atypical infections can be addressed as local infections and are amenable to surgical therapy.

Biopsy, Fine-Needle↗