摘要:

Twenty-two infants with exanthema subitum and their mothers were studied for human herpesvirus 6 (HHV-6) infection. HHV-6 was isolated from 13 of the 22 infants, in 5 infants by cultivation of their peripheral blood mononuclear cells and in the other 8 infants by cocultivation of their mononuclear cells with those from newborn cord blood. Of the 22 infants 19 showed a 4-fold or greater rise in HHV-6 anti-body titers between the acute and convalescent stages of the disease. These findings support the contention that HHV-6 causes exanthema subitum. Attempts at isolation of HHV-6 from the saliva and peripheral blood mononuclear cells of the mothers of 14 of the 22 infants were unsuccessful. Serum samples from 22 mothers were all reactive to HHV-6 antigens, as evidenced by immunofluorescence and radioimmunoprecipitation analyses.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

One hundred two children, 45 days to 14 years of age, with proven brucellosis were studied to illustrate the epidemiologic, clinical and laboratory findings and to assess the outcome of antimicrobial therapy. The main source of infection was the consumption of raw milk in 80% of the patients. The predominant presenting symptoms and signs were fever, arthralgia, malaise, weight loss, arthritis, hepatosplenomegaly and lymphadenopathy.Brucella melitensiswas isolated from 75% of 87 patients. Diverse hematologic and biochemical abnormalities were found. Different durations and combinations of trimethoprim-sulfamethoxazole or tetracycline plus streptomycin or rifampin were used for therapy. Eight-five patients were followed for an average of 14 months. Twelve (85.7%) of 14 patients treated with two-antibiotic combinations for 3 weeks relapsed, as did 5 (8%) of 62 patients treated for at least 6 weeks (P< 0.001). No relapses occurred in 9 patients treated with trimethoprim-sulfamethoxazole and rifampin for 8 to 12 weeks plus streptomycin for the first 3 weeks. Longer duration and combination of antibiotic therapy seem warranted to improve outcome and to prevent relapses.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Existing data on tularemia infections in children caused by the biovarFrancisella tularensis palaearctica(type B) are limited. The case histories of all patients younger than the age of 16 years in northern Finland who had tularemia, based on the antibody response, during the years 1967 to 1986 are reviewed. A total of 67 children, 28 girls and 39 boys, were identified as having had tularemia. The occurrence of the disease varied greatly among years. Most of the cases occurred in July, August and September. The epidemiology differed significantly from that reported forF. tularensisbiovartularensis(type A). This is most probably attributable to the different vector, which was the mosquito in our series, but the tick in areas where type A is common. There were also clear differences in the clinical picture. The ulceroglandular clinical type was the most common. The clinical symptoms and signs were usually quite benign, but the symptoms lasted for a median duration of 26 days. The patients were treated with different antibiotics and there were no differences in the outcome related to the treatment given. Prospective comparative investigations of antibiotic therapy given for tularemia are needed. It is also important to try to identify which strain is causing the disease in each case.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In ongoing studies in Europe and the United States, 10 pediatric patients with bacterial meningitis caused byPseudomonasspecies were treated with ceftazidime.Pseudomonas aeruginosawas isolated from the CSF of 7 patients and otherPseudomonasspecies from the remaining 3. Eight of the 10 patients had received previous antimicrobial treatment which included aminoglycosides in 6, along with ticarcillin and ureidopenicillins in 3. Ceftazidime was administered 10 to 42 days in dosages ranging from 109 to 300 mg/kg/day. Seven of the 10 patients received ceftazidime only for 10 to 42 days. The other 3 patients received amikacin in 2 and gentamicin and tobramycin in the other.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Delta toxin-producing coagulase-negative staphylococci previously have been associated with necrotizing enterocolitis in neonates. We identified three preterm infants (body weight, 845 ± 59 g) infected with methicillin-resistantStaphylococcus aureus(MRSA) who had a similar clinical syndrome, characterized by pustular dermatitis, bacteremia and necrotizing enterocolitis accompanied by gastric residua, abdominal distention, hematochezia and pneumatosis intestinalis. MRSA was recovered from all three infants at infected skin sites, blood or venous catheters and from two of three infants in stool specimens. Two infants also hadStaphylococcus epidermidisisolated from stool. All MRSA isolates had identical microbiologic profiles: four plasmids with identical molecular weights; coproduction of enterotoxins A and B; and the same antibiotic susceptibilities.Of one skin isolate, two blood isolates and two stool isolates of MRSA that were tested, all had characteristic delta toxin hemolytic activity. All culture supernatants of these isolates evaluated for delta toxin were positive by Western blot analysis. The two strains ofS. epidermidisisolated from stool were negative for delta-like toxin by a standardized enzyme-linked immunoassay. The clustering of these cases, the similarity of the clinical syndrome, and the prior association of necrotizing enterocolitis with delta-like toxins produced byS. epidermidis, suggest that delta toxin-producing MRSA (or otherS. aureusisolates) also may be etiologic agent in some cases of necrotizing enterocolitis in newborns.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In 1983 our antibiotic regimen for suspected neonatal septicemia was changed from amoxicillin-gentamicin to cefotaxime-amoxicillin. During the subsequent 5-year period we studied the effect of this change in regimen on the bacterial flora of the infants in the unit and the occurrence of serious infections. This was done with bacteriologic surveillance and analysis of the positive blood cultures from 1978 through 1987.A change in the relative numbers of isolated pathogens was observed;Klebsiellasp. andEscherichia colidecreased whereasEnterobactersp. increased. The susceptibility of theEnterobacterisolates to cefamandole decreased from 85.3% in 1982 to 52.9% in 1983. The susceptibility of these bacteria to cefotaxime was 55.2% in 1983 and 55.0% in 1987. No change in susceptibilities to cefotaxime, amoxicillin or gentamicin was found in other pathogens.Although colonization withEnterobacterstrains has increased and the susceptibility of these bacteria to the cephalosporins has de-creased, the incidence of serious infections with Gram-negative bacteria decreased.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

From January, 1987, until July, 1988, a significant increase in newly diagnosed cases of acute rheumatic fever was noted at our hospital In sharp contrast to the 3 cases seen in 1986, 19 cases were diagnosed in 1987 (a significant increase from 1985 to 1986,P= 0.001). In the first 6 months of 1988 an additional 12 new cases were diagnosed (a further significant in. crease from 1987,P= 0.02). No further case: were diagnosed between July, 1988, and September, 1989. The major clinical manifestations were carditis in 73%, polyarthritis in 58% and chorea in 31%. In 15 of 26 patients an antecedent illness which included pharyngitis was noted; the remainder of patients were asymptomatic. Group A beta-hemolytic streptococci were isolated from 13 of 19 children cultured, Isolates from two patients with acute rheumatic fever were submitted for M typing: one isolate was mucoid M18/T18; the other isolate was a mucoid nontypable strain. The demographic characteristics of the 26 patients agree with classic descriptions in that patients were more likely to be urban, to come from large families and to have low incomes; racial breakdown of the group mirrored the Tennessee pediatric population. These characteristics stand in contrast to reports of recent outbreaks which describe suburban high income patients. These data suggest that practitioners should be again aware of acute rheumatic fever and that aggressive identification and treatment of streptococcal pharyngitis should continue to be a relevant public health concern.

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0891-3668    

出版商:OVID    

年代:1990

数据来源: OVID