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Dowzicky M, Talbot GH, Feger C, Prokocimer P, Etienne J, Leclercq R. Characterization of isolates associated with emerging resistance to quinupristin/dalfopristin (Synercid) during a worldwide clinical program. Diagn Microbiol Infect Dis 2000; 37:57-62. [PMID: 10794942 DOI: 10.1016/s0732-8893(99)00154-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Quinupristin/dalfopristin (Synercid) is an i.v. antibiotic active against serious Gram-positive infections. Its unique dual mode of action means that the potential for resistance development is expected to be low. To determine the incidence of in vitro emerging resistance in worldwide clinical studies, susceptibility to quinupristin/dalfopristin was measured for baseline pathogens and corresponding on- or post-study isolates from 880 evaluable patients. In comparative studies of community-acquired pneumonia, complicated skin and skin structure infections, and nosocomial pneumonia, the incidence of emerging resistance was low (1 of 453; 0.22%; 95% CI: 0. 01-1.4%). Resistance development occurred in only one pathogen (methicillin-resistant Staphylococcus aureus). In noncomparative studies, six instances (1.8% of 338 evaluable cases; 95% CI: 0.7 to 4.0%) of emerging resistance (all vancomycin-resistant Enterococcus faecium) were confirmed, accompanied by therapeutic failure in four cases. Molecular typing did not confirm the identity of one pair of strains. Overall, the incidence of emerging resistance to quinupristin/dalfopristin was low.
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MESH Headings
- Anti-Bacterial Agents/therapeutic use
- Community-Acquired Infections/complications
- Community-Acquired Infections/microbiology
- Drug Resistance, Microbial
- Drug Therapy, Combination/therapeutic use
- Enterococcus faecium/drug effects
- Global Health
- Humans
- International Cooperation
- Pneumonia, Bacterial/complications
- Pneumonia, Bacterial/drug therapy
- Pneumonia, Bacterial/microbiology
- Pneumonia, Staphylococcal/complications
- Pneumonia, Staphylococcal/drug therapy
- Pneumonia, Staphylococcal/microbiology
- Skin Diseases, Bacterial/complications
- Skin Diseases, Bacterial/drug therapy
- Skin Diseases, Bacterial/microbiology
- Staphylococcal Skin Infections/complications
- Staphylococcal Skin Infections/drug therapy
- Staphylococcal Skin Infections/microbiology
- Staphylococcus aureus/drug effects
- Virginiamycin/therapeutic use
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52
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Bitzan MM, Nagaraj SK, Georgitis JW, Givner LB, Lorentz WB, Iskandar SS. Staphylococcus aureus pneumonia, hyponatremia, hypertension, proteinuria, and hematuria in a 14-year-old boy. Am J Kidney Dis 2000; 35:354-9. [PMID: 10676740 DOI: 10.1016/s0272-6386(00)70351-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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53
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Stanić V, Stepić V, Sikimić S, Cvorović N, Cvijanović V. [Staphylococcal pneumonia associated with pneumatoceles, bilateral pyopneumothorax and sepsis]. VOJNOSANIT PREGL 1999; 56:541-5. [PMID: 10645160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
A case of soldier with community acquired staphylococcal pneumonia and multiple pneumatoceles as the rare complication in adults is presented. Their recognition provides appropriate treatment. In the patient were developed bilateral pneumothorax, pleural empyema and sepsis. Surgical treatment was performed by thoracic drainage. Recovery of pulmonary function was poor, as distinguished from children.
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54
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Maki DD, Sehgal M, Kricun ME, Gefter WB. Spontaneous tension pneumopericardium complicating staphylococcal pneumonia. J Thorac Imaging 1999; 14:215-7. [PMID: 10404509 DOI: 10.1097/00005382-199907000-00010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The authors describe a patient with spontaneous pneumopericardium complicating staphylococcal pneumonia and empyema that resulted in cardiac tamponade. Spontaneous pneumopericardium is an unusual disorder. The causes and clinical findings of pneumopericardium are reviewed, as are the radiographic features that differentiate this condition from pneumomediastinum. Early recognition of pneumopericardium is important, because emergent pericardiocentesis may be required if there is clinical evidence of tamponade.
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55
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Carrillo-Esper R, Ramírez-Hernández JM, Gargallo-Hernández JJ, Hernández-Vásquez R, Domínguez-Rodríguez MI, Alemán-Alarcón CE, Gallegos-Rodríguez G. [Inhaled nitric oxide: one modality in the treatment of ARDS]. GAC MED MEX 1999; 135:417-21. [PMID: 10491897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
We describe a patient with acute respiratory distress syndrome (ARDS), refractory to treatment with conventional mechanical ventilation. The hemodynamic parameters showed severe pulmonary hypertension with increased intrapulmonary shunt. Inhaled nitric oxide was administered and we observed a diminishing in pulmonary hypertension and intrapulmonary shunt with an important increase of oxygen exchange. We reviewed the literature and make a suggestion concerning use of inhaled nitric oxide in patients with ARDS.
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56
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Okimoto N, Fujita K, Karino T, Yano T, Kobashi Y, Nakamura J, Matsushima T, Soejima R. [Three cases of pneumonia due to mixed infection of bacteria and Mycoplasma pneumoniae]. KANSENSHOGAKU ZASSHI. THE JOURNAL OF THE JAPANESE ASSOCIATION FOR INFECTIOUS DISEASES 1999; 73:602-5. [PMID: 10423952 DOI: 10.11150/kansenshogakuzasshi1970.73.602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We reported three cases of pneumonia due to mixed infection of bacteria (2 cases: Streptococcus pneumoniae, 1 case: methicilline-sensitive Stapholococcus aureus) and Mycoplasma pneumoniae. Increased serum antibody titers of M. pneumoniae were noted in all cases. They were a 36-year-old-female with bronchial asthma, a 74-year-old-male with old pulmonary tuberculosis and a 82-year-old-male with chronic bronchitis. All cases had fever, productive cough with purulent sputum and coarse crackle by auscultation. Leukocytosis was noted in 2 cases. Chest X-ray films showed dense consolidation in all cases, 2 cases were cured by administration of cephems and 1 case was cured by administration of carbapenems and minocycline.
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57
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MRSA in cystic fibrosis. London, 16 June 1997. J Hosp Infect 1998; 40:179-91. [PMID: 9830589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This is a report of a consensus meeting held in London on 16 June 1997, where microbiologists and clinicians reviewed the implications of colonization/infection of patients with cystic fibrosis by methicillin-resistant Staphylococcus aureus (MRSA).
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58
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Kitazawa M, Tomosugi N, Ishii T, Hotta F, Nishizawa M, Itou T, Nakano S, Kigoshi T, Ishikawa I, Uchida K. Rapidly progressive glomerulonephritis concomitant with diabetic nephropathy. Intern Med 1997; 36:906-11. [PMID: 9475249 DOI: 10.2169/internalmedicine.36.906] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We describe a rare case of a rapidly progressive glomerulonephritis (RPGN) superimposed on diabetic nephropathy. A 68-year-old woman with non-insulin-dependent diabetes mellitus (NIDDM) complicated with diabetic triopathy demonstrated a rapid deterioration of renal function. Her urinary sediment contained many red blood cell (RBC) cells and casts, suggesting an additional renal disease accompanying diabetic nephropathy. Renal biopsy revealed crescent formation in many glomeruli characteristic of the pauci-immune type of RPGN. Steroid pulse therapy transiently halted the deterioration in renal function, but the patient died of pneumonia complicated with methicillin-resistant staphylococcus aureus (MRSA) infection. The unusual findings in diabetic nephropathy indicated the coexistence of primary glomerulonephritis and diabetic glomerulosclerosis in this case.
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59
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Tumbarello M, Tacconelli E, Lucia MB, Cauda R, Ortona L. Predictors of Staphylococcus aureus pneumonia associated with human immunodeficiency virus infection. Respir Med 1996; 90:531-7. [PMID: 8984527 DOI: 10.1016/s0954-6111(96)90145-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study is based on a retrospective logistic regression analysis of all human immunodeficiency virus (HIV)-infected patients with Staphylococcus aureus pneumonia (SAP) admitted to the Department of Infectious Diseases, Catholic University, Rome, Italy between January 1986 and December 1994. Nineteen patients with 24 episodes of SAP were enrolled in the study. A control group of 38 HIV-infected patients without pneumonia was included. The attack rate of SAP was 8.31/1000 HIV-related hospital admissions and the frequency, out of the total number of bacterial pneumonia observed in the study period, was 16% (24 of 154 patients). The large majority of SAP was community acquired. On the univariate analysis, intravenous drug abuse (IVDA) (P = 0.02), history of previous Pneumocystis carinii pneumonia (PCP) (P = 0.03) and cirrhosis (P = 0.03) were significant risk factors for SAP. In addition, IVDA and previous PCP were independent risk factors on multivariate analysis. All patients presented with fever associated with cough (74%), chest pain (26%) or shortness of breath (37%). Chest X-ray documented lobar pneumonia (78%), predominantly in the lower lobes, consolidation with cavitation (11%), and interstitial-nodular infiltrates (11%). Pleural effusion was present in 31% of patients. The response to therapy was favourable in 79% of patients. Recurrence occurred in 26% and death occurred in 21% of patients. Death was significantly associated with the low level (< 50 mm-3) of circulating T CD4+ cells (P = 0.03) and the recurrence of pneumonia (P = 0.03). In conclusion, the present study indicates that S. aureus is an important aetiologic agent of bacterial pneumonia in HIV-infected patients, especially if they are drug abusers with previous PCP.
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60
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Valenti S, Vignolo C, Benevolo E, Braido F. Mixed infection by Staphylococcus and Candida, and Wegener's granulomatosis. Monaldi Arch Chest Dis 1996; 51:387-90. [PMID: 9009626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We describe the case of a patient who initially presented with pneumonia from Staphylococcus aureus and Candida parapsilosis, which was resolved with antibiotic treatment, but reappeared 6 months later as full-blown Wegener's granulomatosis. The possible pathogenetic correlations between infective agents, in particular Staphylococcus aureus and Candida, and Wegener's granulomatosis are discussed.
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61
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Taylor IK, Coker RJ, Clarke J, Moss FM, Nieman R, Evans DJ, Veale D, Shaw RJ, Robinson DS, Mitchell DM. Pulmonary complications of HIV disease: 10 year retrospective evaluation of yields from bronchoalveolar lavage, 1983-93. Thorax 1995; 50:1240-5. [PMID: 8553294 PMCID: PMC1021344 DOI: 10.1136/thx.50.12.1240] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Pulmonary disease is a major contributor to morbidity and mortality in patients with HIV infection and AIDS. The aim of this study was to describe bronchoscopic findings and the spectrum of pulmonary pathogens in HIV seropositive patients undergoing investigation of respiratory disease over a 10 year period in a major UK referral centre. METHODS Recruitment was procedure based with data being captured when bronchoscopy was clinically indicated. Data were evaluated from 580 HIV seropositive patients (559 men, age 13-65 years) over a 10 year period from June 1983 to March 1993. RESULTS A total of 947 bronchoscopies was performed. The most frequent pulmonary pathogen isolated from bronchoalveolar lavage (BAL) fluid in 44% of all bronchoscopies was Pneumocystis carinii. Of all patients studied, 324 (55%) had at least one cytologically confirmed episode of P carinii pneumonia; this was AIDS defining in 219 (38%) of patients who underwent bronchoscopy. Between 1987 and 1993 the overall diagnostic yield from BAL fluid was 76%; 25% of all bronchoscopies yielded positive microbiological results, the most frequent isolates being Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas spp, and Haemophilus influenzae. Mycobacteria were identified in 8% of patients; M tuberculosis was the most common being identified in 3% of lavage samples and in 4% of patients. No drug-resistant M tuberculosis was found. Viral isolates (mainly cytomegalovirus) were identified in up to 31% of BAL fluid samples. Endobronchial Kaposi's sarcoma was seen in 15% of patients at bronchoscopy. CONCLUSIONS Of the 1956 newly diagnosed HIV seropositive patients receiving clinical care at St Mary's Hospital over this period, approximately 30% underwent bronchoscopy. Diagnostic rates for P carinii pneumonia, endobronchial Kaposi's sarcoma, and bacterial and mycobacterial infection have remained largely constant since 1989. Bronchoalveolar lavage produces high diagnostic yields generally, and P carinii pneumonia remains a common cause of pulmonary disease in these patients.
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62
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Morano LE, Guerra JL, Vázquez-Alvarez O, Rodríguez-Méndez MJ. [Community-acquired cavitating pneumonia in a HIV-infected patient]. Enferm Infecc Microbiol Clin 1995; 13:633-4. [PMID: 8808482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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63
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Gil Suay V, Cordero PJ, Martínez E, Soler JJ, Perpiñá M, Greses JV, Sanchis J. Parapneumonic effusions secondary to community-acquired bacterial pneumonia in human immunodeficiency virus-infected patients. Eur Respir J 1995; 8:1934-9. [PMID: 8620965 DOI: 10.1183/09031936.95.08111934] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of this study was to determine whether the clinical and microbiological characteristics of parapneumonic effusions in patients with community-acquired pneumonia (CAP) infected with the human immunodeficiency virus (HIV) were different from those observed in patients without HIV infection. One hundred and thirty seven patients with parapneumonic effusions were included and divided into two groups depending on whether they had HIV infection or not. The parapneumonic effusion rate was significantly higher in HIV-positive than in noninfected patients (21 vs 13%). Their clinical course was more severe, presenting a higher rate of bacteraemias (58 vs 18%). Pleural fluid in patients infected with HIV had significantly lower glucose levels than that of patients without HIV infection. Chest tube drainage was more frequent in parapneumonic effusions of patients infected with HIV than in those without HIV infection (71 vs 44%). Staphylococcus aureus was the most common microorganism found in the bacteriological samples of patients with CAP infected with HIV (53 vs 12%). We conclude that patients with community-acquired pneumonia and HIV infection have a higher rate of parapneumonic effusions and a more severe clinical course than non-HIV patients, and that Staphylococcus aureus predominates in their bacteriological samples.
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64
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Mark S. Hypercalcaemia in an immobilised patient with pneumonia. THE BRITISH JOURNAL OF CLINICAL PRACTICE 1995; 49:327-9. [PMID: 8554961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Hypercalcaemia is a serious complication of sepsis and prolonged immobility. Hormonal, humoral and mechanical factors play a complex role in its development. Because hypercalcaemia is associated with a significant increase in morbidity and mortality, early treatment is recommended. Pamidronate is an effective pharmacological agent and should be considered as primary therapy for this syndrome.
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65
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Zuhdi MK, Bradley JS, Spear RM, Peterson BM. Fatal air embolism as a complication of staphylococcal pneumonia with pneumatoceles. Pediatr Infect Dis J 1995; 14:811-2. [PMID: 8559636 DOI: 10.1097/00006454-199509000-00018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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66
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Joosten KF, Hazelzet JA, Tiddens HA, Hazebroek FW, Dzoljic-Danilovic G, Neijens HJ, de Groot R. Staphylococcal pneumonia in childhood: will early surgical intervention lower mortality? Pediatr Pulmonol 1995; 20:83-8. [PMID: 8570307 DOI: 10.1002/ppul.1950200206] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Staphylococcus aureus pneumonia (SAP) continues to be a serious bacterial infection which is associated with a high incidence of complications. We retrospectively reviewed the case records of 36 infants and children admitted with SAP to the Sophia Children's Hospital between 1970 and 1992 to analyse changes over time in the clinical presentation, diagnostic work-up, management and complications. Fifteen of these 36 children (42%) were less than 1 year old. Fever (97%) and respiratory distress (83%) were the most common symptoms at the initial presentation. Chest X-ray findings on admission or during hospitalisation included pleural effusion (75%), pneumothorax (47%), and abscess and/or pneumatocele (39%). Diagnostic and/or therapeutic thoracentesis of pleural fluid was performed in 17 of the 36 patients (47%). Twenty-one patients (58%) needed chest tube drainage. Twelve had a thoracotomy (33%). Artificial ventilation was needed in 13 of the patients (36%). Extrapulmonary complications included convulsions in 6 patients (17%) and osteomyelitis in 2 children (6%). The mean duration of hospitalization was 36 days. Two of the 36 children died (6%). The low mortality rate in this study may be the result of the relatively high rate of thoracotomy and of improvements in supportive treatment.
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67
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Saitoh Y, Nakamura H, Kagawa K, Umemoto M, Imamura H. [Pneumothorax with reduced pulmonary function complicated by MRSA pneumonia: a case report]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 1995; 48:418-21. [PMID: 7745871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The occurrence of pneumothorax in patients with compromised lung function or severe pulmonary disease may be fatal. We describe a 77-year-old patient with MRSA pneumonia complicated by pneumothorax and reduced pulmonary function. Although the patient was treated with drainage of the pleural cavity and nonsurgical pleurodesis, the pneumothorax could not be managed successfully. The patient underwent successful surgical treatment of the pneumothorax on 105 days after onset. The following factors must be considered in the surgical treatment of pneumothrax with reduced pulmonary function in patients with MRSA pneumonia: 1) When there is massive air leakage, adequate doses of VCM should be administered to prevent pyothorax, 2) when conservative treatment fails and surgical treatment becomes necessary, the operation should be instituted only when MRSA has been completely or almost completely eradicated so as to prevent the occurrence of postsurgical pyothorax, and 3) surgical intervention should be limited to what is necessary to repair the site of ruptured bulla; care should be exercised to preserve as much lung parenchyma as possible and to shorten the operation time.
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68
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Finnie IA, Jack CI, McKay JS. Pneumomediastinum and subcutaneous emphysema complicating staphylococcal pneumonia. THE ULSTER MEDICAL JOURNAL 1995; 64:105-7. [PMID: 7502393 PMCID: PMC2449077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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69
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Jain NK, Lie TH. Fever, multiple pulmonary nodules, and ulcerated skin lesions in a patient with AIDS. Chest 1995; 107:553-5. [PMID: 7842793 DOI: 10.1378/chest.107.2.553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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70
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Ogawa M, Ueda S, Anzai N, Ito K, Ohto M. Toxic shock syndrome after staphylococcal pneumonia treated with intravenous immunoglobulin. Vox Sang 1995; 68:59-60. [PMID: 7725673 DOI: 10.1111/j.1423-0410.1995.tb02548.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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71
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Rello J, Torres A, Ricart M, Valles J, Gonzalez J, Artigas A, Rodriguez-Roisin R. Ventilator-associated pneumonia by Staphylococcus aureus. Comparison of methicillin-resistant and methicillin-sensitive episodes. Am J Respir Crit Care Med 1994; 150:1545-9. [PMID: 7952612 DOI: 10.1164/ajrccm.150.6.7952612] [Citation(s) in RCA: 336] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
All episodes of ventilator-associated pneumonia (VAP) caused by Staphylococcus aureus were prospectively analyzed for a 30-mo period. Methicillin-sensitive S. aureus (MSSA) was isolated in 38 episodes and methicillin-resistant S. aureus (MRSA) in 11 others. The two groups were similar regarding sex, severity of underlying diseases, prior surgery, and presence of renal failure, diabetes, cardiopathy, and coma. MRSA-infected persons were more likely to have received steroids before developing infection (relative risk [RR] = 3.45, 95% confidence interval [CI] = 1.38-8.59), to have been ventilated > 6 d (RR = 2.03, 95% CI = 1.36-3.03), to have been older than 25 yr (RR = 1.50, 95% CI = 1.09-2.06), and to have had preceding chronic obstructive pulmonary disease (RR = 2.76, 95% CI = 0.89-8.56) than MSSA-infected patients. MSSA-infected persons were more likely than MRSA-infected patients to have cranioencephalic trauma (RR = 1.94, 95% CI = 1.22-3.09). All patients with MRSA VAP had previously received antibiotics, compared with only 21.1% of those with MSSA infection (p < 0.000001). The incidence of empyema was similar in both groups; nevertheless, the presence of bacteremia and septic shock was more frequent in the MRSA group. Finally, mortality directly related to pneumonia was significantly higher among patients with MRSA episodes (RR = 20.72, 95% CI = 2.78-154.35). This analysis was repeated for monomicrobial episodes, and the difference remained statistically significant. We conclude that MRSA and MSSA strains infect patients with different demographic profiles; previous antibiotic therapy is the most important risk factor for developing MRSA infection.(ABSTRACT TRUNCATED AT 250 WORDS)
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72
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Fagbule D, Parakoyi DB, Spiegel R. Acute respiratory infections in Nigerian children: prospective cohort study of incidence and case management. J Trop Pediatr 1994; 40:279-84. [PMID: 7807622 DOI: 10.1093/tropej/40.5.279] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A community-based prospective surveillance and case management study of acute respiratory infection (ARI) in children aged 2-60 months of age was carried out over a 12-month period in Pakata, a semi-urban community in Ilorin, Kwara State, Nigeria. A cohort of 481 children was followed by trained community health assistants with thrice weekly home visits to record all symptoms and signs of ARI, and institute treatment based on WHO recommendations. There were three episodes of mild, moderate, or severe ARI per child per year, including 1.3 pneumonia episodes per child per year. The peak of infection corresponded to the rainy season (July-November), and a smaller peak to the dry season (February-April). Most of the health worker decisions were considered appropriate, although there was a tendency toward over-treatment with antibiotic drugs. An effective referral system was established from the community to a tertiary centre. There were no ARI-related deaths during the study period. These data indicate that a system of case management using trained community health workers can improve case management of ARI and may prevent severe ARI-related disease and deaths.
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73
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Alba Losada J. [Infectious pathology and pulmonary hydatidosis]. CIRUGIA PEDIATRICA : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE CIRUGIA PEDIATRICA 1994; 7:69-72. [PMID: 8086293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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74
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Gupta S, Singh B, Minocha SK. Staphylococcal pneumonia associated with 'tropical pyomyositis'. Postgrad Med J 1994; 70:309-10. [PMID: 8183783 PMCID: PMC2397875 DOI: 10.1136/pgmj.70.822.309-a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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75
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Ivashkin VT, Iakovlev VN, Duganov VK, Shchegol'kov AM. [Current problems in the intensive therapy of patients with acute pneumonia]. VOENNO-MEDITSINSKII ZHURNAL 1993:16-20. [PMID: 8146960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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76
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Abstract
One hundred cases of pneumonia with chest indrawing were treated according to the treatment protocol of the ARI control programme. The majority of children were > 2 months old (85 per cent) with male predominance (61 per cent). All cases with severe pneumonia survived. A mortality rate of 7.7 per cent was seen in cases of very severe pneumonia. Three children in the severe pneumonia group deteriorated on benzyl penicillin to very severe pneumonia but subsequently improved on chloramphenicol. Six patients were treated as cases of Staphylococcal pneumonia and one of them died. Thirteen children (21.3 per cent) in the severe pneumonia group required oxygen for breathing rates > 70 per minute. Seventy-four per cent in the very severe pneumonia group required administration of IV fluids. Blood counts did not prove to be of help in differentiating the children at risk of dying. There was no significant difference in roentgenographic findings in the two groups. Congestive cardiac failure was the most common complication, seen in 33.3 per cent of cases of the very severe pneumonia group. The duration of stay was significantly less in cases of severe pneumonia (4.21 +/- 1.59 days) as compared to very severe pneumonia (9.35 +/- 2.39 days). The data from this study suggest that the treatment protocol for the ARI control programme for hospitalized children is reasonably effective and can be implemented in small hospitals.
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77
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Bouhaja B, Thabet H, Slim L, Aissa F, Amamou M, Yacoub M. [Mixte community-acquired Legionella pneumophila and Staphylococcus aureus pneumonia]. Presse Med 1993; 22:1280. [PMID: 8259357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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78
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Yoshida M, Yoshikawa K, Maezawa H, Shindou N, Sakamoto M, Nakazawa Y, Shiba K, Saito A, Sakai O. [Treatment of severe pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) and Candida krusei with granulocyte colony-stimulating factor (G-CSF): a case report]. KANSENSHOGAKU ZASSHI. THE JOURNAL OF THE JAPANESE ASSOCIATION FOR INFECTIOUS DISEASES 1993; 67:767-71. [PMID: 7691973 DOI: 10.11150/kansenshogakuzasshi1970.67.767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A 24-year-old male with chronic renal failure on Continuous Ambulatory Peritoneal Dialysis (CAPD) complained of cough and dyspnea. Chest X-ray film showed a pneumonia shadow and MRSA and Candida krusei were detected in the sputum. Pneumonia improved with vancomycin and fluconazole. Treatment with methylprednisolone was needed for retinodialysis. After this treatment, pneumonia deteriorated. Pneumonia did not improve with vancomycin and anti-fungal agents. This severe pneumonia was improved with a combination therapy of vancomycin, miconazole and G-CSF. A combination therapy of antibiotics and G-CSF is considered to be effective for severe pneumonia.
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79
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Lohse AW, Klein O, Hermann E, Löhr H, Kreitner KF, Steppling H, Meyer zum Büschenfelde KH, Staritz M. Pneumatoceles and pneumothoraces complicating staphylococcal pneumonia: treatment by synchronous independent lung ventilation. Thorax 1993; 48:578-80. [PMID: 8322253 PMCID: PMC464531 DOI: 10.1136/thx.48.5.578] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 54 year old man with a staphylococcal sepsis developed staphylococcal pneumonia complicated by multiple pneumatoceles and bilateral tension pneumothoraces caused by bronchopleural fistulae. Excessive enlargement of the right sided pneumatoceles and a tension pneumothorax not improved by drainage led to mediastinal shift and compression of the right lung. Reversal of the mediastinal shift and closure of the bronchopleural fistulae was achieved by assisted independent lung ventilation.
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80
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Abstract
OBJECTIVE To present a case of nafcillin-induced interstitial nephritis. METHODOLOGY Case report and literature review. SETTING Hospital. RESULTS Three days following initiation of nafcillin therapy for staphylococcal pneumonia, an 80-year-old woman developed allergic manifestations and progressive renal impairment suggestive of acute allergic interstitial nephritis. These manifestations were completely reversed within 96 hours of cessation of nafcillin therapy. CONCLUSIONS In the clinical setting of acute renal failure in a patient on nafcillin therapy, acute interstitial nephritis should be considered. Prompt cessation of nafcillin therapy has generally been associated with reversal of symptoms and an improvement in renal function.
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81
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Yoshitomi Y, Kohno S, Koga H, Maesaki S, Higashiyama Y, Matsuda H, Mitsutake K, Miyazaki Y, Yamada H, Hara K. Fatal pneumonia caused by Corynebacterium group JK after treatment of Staphylococcus aureus pneumonia. Intern Med 1992; 31:930-2. [PMID: 1450504 DOI: 10.2169/internalmedicine.31.930] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
A 76-year-old man who was admitted to the hospital because of chronic renal insufficiency and chronic hepatitis died of Corynebacterium group JK pneumonia, after showing a slight improvement by treatment of Staphylococcus aureus with sulbactam/cefoperazone and minocycline. Transtracheal aspiration (TTA) just before his death revealed numerous gram-positive bacilli phagocytized by many neutrophils and more than 10(8) colony forming units (CFU)/ml of Corynebacterium group JK. A drug susceptibility test showed Corynebacterium group JK was resistant to many antibiotics, with the exception of vancomycin and amikacin.
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82
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Gold W, Vellend H, Brunton J. The air crescent sign caused by Staphylococcus aureus lung infection in a neutropenic patient with leukemia. Ann Intern Med 1992; 116:910-1. [PMID: 1580448 DOI: 10.7326/0003-4819-116-11-910] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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83
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Martin WR, Siefkin AD, Allen R. Closure of a bronchopleural fistula with bronchoscopic instillation of tetracycline. Chest 1991; 99:1040-2. [PMID: 2009764 DOI: 10.1378/chest.99.4.1040] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Persistent bronchopleural fistulas (BPF) due to infection, trauma, or thoracic surgical procedures are often difficult to manage. We report a patient with fulminant Staphylococcus aureus pneumonia complicated by chronic BPF formation which prevented weaning from mechanical ventilation due to severe air leak. Fistula closure was obtained by instillation of tetracycline into the fistula via a fiberoptic bronchoscope using a balloon catheter and blood clot occlusion technique. This closed the BPF and allowed successful weaning from mechanical ventilation.
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84
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Gnarini R, Guerriero M, Postiglione A, Smeraglia R, Conte M, Galderisi P, Soscia M. [2 cases of spontaneous pneumothorax due to acute nosocomial bilateral staphylococcal bronchopneumonia]. GIORNALE ITALIANO DI CHEMIOTERAPIA 1991; 38:145-6. [PMID: 1365570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
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85
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Rivera CF, Rocha LA, Peñaranda JS, Marini M. [Massive hemoptysis secondary to an aortobronchial fistula: a rare complication of staphylococcal pneumonia]. Med Clin (Barc) 1990; 95:636. [PMID: 2097458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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86
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Davidson AC, Creach M, Cameron IR. Staphylococcal pneumonia, pneumatoceles, and the toxic shock syndrome. Thorax 1990; 45:639-40. [PMID: 2402731 PMCID: PMC462652 DOI: 10.1136/thx.45.8.639] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A case of community acquired staphylococcal pneumonia is reported with the unusual complication, in an adult, of multiple pneumatoceles. Recognition of this prevented inappropriate management. The patient also developed the toxic shock syndrome. In contrast to infants with pneumatoceles, recovery of lung function has been poor.
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87
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Jakab GJ. Sequential virus infections, bacterial superinfections, and fibrogenesis. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1990; 142:374-9. [PMID: 2166456 DOI: 10.1164/ajrccm/142.2.374] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Parainfluenza 1 (Sendai) and influenza A virus pneumonitis cause severe lung damage, which, upon resolution, is followed by persistent alveolitis and parenchymal changes characterized by patchy consolidation and collagen deposition in the affected areas. To determine whether these long-term sequelae of the virus pneumonias are cumulative, mice were infected by aerosol inhalation with Sendai virus, influenza A virus, or Sendai followed 30 days later by influenza virus infection. At 90 days after the initial infection, mice were killed for assay of long-term parenchymal changes as quantitated lung hydroxyproline (Hpr) content, morphometric analysis, and total and differential lavage cell counts. Sendai virus infection did not alter the proliferation of influenza virus in the lungs as quantitated by infectious virus titers on Day 1, 3, 5, 7, 9, and 11 of influenza infection. At Day 90, lung Hpr content was cumulative in dual-infected mice, with a concomitant increase in the persistent alveolitis. To determine whether bacterial infections played a similar role in these long-term pulmonary sequelae, mice were infected by aerosol inhalation with either Staphylococcus aureus or Klebsiella pneumoniae or, during the course of influenza virus infection, superinfected with each of the bacteria. Sixty days after infection with K. pneumoniae alone, lung Hpr levels were significantly increased over those in noninfected control mice. Infection with S. aureus had no effect on the quantitated parameters of long-term lung damage. In influenza-infected mice superinfected with K. pneumoniae, lung Hpr content was significantly increased over that of S. aureus did not elevate any quantitated parameter of lung damage when compared with the virus alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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88
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Kimura M, Udagawa S, Shoji A, Kume H, Iimori M, Satou T, Hashimoto S. Pulmonary aspergillosis due to Aspergillus terreus combined with staphylococcal pneumonia and hepatic candidiasis. Mycopathologia 1990; 111:47-53. [PMID: 2233979 DOI: 10.1007/bf02277302] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A female patient with systemic lupus erythematosus (SLE) developed pulmonary aspergillosis with staphylococcal pneumonia and hepatic candidiasis. Aspergillus terreus, which is a rare causative organism of pulmonary aspergillosis, was identified from a pulmonary lesion by culture. The aleurioconidium production, a characteristic of the genus Aspergillus sect. terrei, was demonstrated on short and irregular hyphal features in tissue sections. This report is the first of a combined case of pulmonary aspergillosis due to A. terreus with infections caused by other microorganisms.
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89
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Sánchez-Izquierdo Riera JA, Medina Asensio J, Moreno Sánchez D, Fernández Rodríguez R, Martínez Fernández R, Perpiñá C. [Cavitated pneumonia and toxic shock syndrome: presentation of a case]. Rev Clin Esp 1990; 186:444-6. [PMID: 2247680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Toxic shock syndrome (TSS) is a potentially fatal acute disease preferentially affecting menstruating women and is related to the use of vaginal tampons seems to be due to an specific exotoxin produced by some Staphylococcus aureus strains. We present here the case of a male patients suffering cavitated pneumonia who developed a systemic clinical picture comparable to TSS. This unusual form of presentation is discussed as well as the diagnostic criteria which define this entity.
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90
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Silverman MS, MacLeod JP. Pancoast's syndrome due to staphylococcal pneumonia. CMAJ 1990; 142:343-5. [PMID: 2302632 PMCID: PMC1451815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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91
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Levine SJ, White DA, Fels AO. The incidence and significance of Staphylococcus aureus in respiratory cultures from patients infected with the human immunodeficiency virus. THE AMERICAN REVIEW OF RESPIRATORY DISEASE 1990; 141:89-93. [PMID: 2297190 DOI: 10.1164/ajrccm/141.1.89] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study assessed the incidence and clinical significance of recovery of Staphylococcus aureus from the respiratory tract of patients infected with the human immunodeficiency virus (HIV). In a retrospective review of 129 consecutive episodes of respiratory disease in HIV-seropositive patients where respiratory tract cultures were obtained, S. aureus was recovered in 30 (23%) of the episodes. Twenty-nine of these were evaluated in this study, and the recovery of S. aureus was found to represent pneumonia in 8 cases (28%), to be of indeterminate significance in 18 cases (62%), and to represent colonization in 3 cases (10%). Episodes of S. aureus pneumonia were usually community-acquired (seven of eight episodes) and had an acute or subacute clinical presentation. Fever and physical signs of pneumonia were present in all patients. Chest radiographic presentations varied, but local infiltrates were seen in seven of eight episodes. Concomitant pulmonary disorders were common (seven of eight episodes). All patients were appropriately treated; five patients recovered and three died, giving a mortality rate of 38%. We conclude that S. aureus is a frequent isolate from respiratory tract cultures of HIV-seropositive patients referred for evaluation of pulmonary disease. It can cause a pneumonia with a high mortality rate, as it did in 6% of all episodes of pulmonary disease reviewed in this study. Clinicians should be aware that HIV-seropositive patients may develop respiratory disease secondary to S. aureus infection and that when this organism is suspected, appropriate antibiotic therapy should be instituted.
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92
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Shaw PJ, Eden OB. Pulmonary infection mimicking metastases in Ewing's sarcoma. Pediatr Hematol Oncol 1990; 7:213-5. [PMID: 2206863 DOI: 10.3109/08880019009033395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
MESH Headings
- Anti-Bacterial Agents
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Child
- Diagnosis, Differential
- Drug Therapy, Combination/therapeutic use
- Humans
- Lung Neoplasms/diagnosis
- Lung Neoplasms/secondary
- Male
- Pneumonia, Staphylococcal/complications
- Pneumonia, Staphylococcal/diagnosis
- Pneumonia, Staphylococcal/diagnostic imaging
- Pneumonia, Staphylococcal/drug therapy
- Radiography
- Sacrum
- Sarcoma, Ewing/complications
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/drug therapy
- Sarcoma, Ewing/radiotherapy
- Spinal Neoplasms/complications
- Spinal Neoplasms/drug therapy
- Spinal Neoplasms/radiotherapy
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93
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McManus AT, Mason AD, McManus WF, Pruitt BA. What's in a name? Is methicillin-resistant Staphylococcus aureus just another S aureus when treated with vancomycin? ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1989; 124:1456-9. [PMID: 2589968 DOI: 10.1001/archsurg.1989.01410120106020] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) strains, principally resistant to penicillinase-resistant penicillins and aminoglycosides, are increasingly common hospital isolates. We have examined the significance of MRSA colonization and infection in 1100 consecutively admitted, seriously burned patients in whom vancomycin was used to treat all staphylococcal infections. Colonization with S aureus (SA) was identified in 658 patients, in 319 of whom MRSA colonization was identified. Two hundred fifty-three SA infections occurred in 178 patients; of these infections, 58% were pulmonic and 38% were bacteremic. Methicillin-resistant SA infections occurred in 58 of the SA-infected patients. A severity index, based on multiple-regression analysis of mortality as a function of burn size and age in the study population, was used to estimate expected mortality. We demonstrated no measurable increase in mortality attributable to MRSA in this population of burned, SA-infected patients. The results question the clinical and economic value of added control practices, such as closing of units, refusal of transfer or admission, added isolation, treatment of carriers, furlough of colonized staff, and other expensive measures that are specifically directed at prevention of MRSA infections in critical care areas.
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94
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Singla R, Singh P, Bhagi RP, Singh PP. Pleuropulmonary complications of staphylococcal pulmonary infection in children. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 1989; 31:151-7. [PMID: 2638650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A series of 44 cases of staphylococcal pulmonary infection in children is reported. Their clinical features and characteristic roentgenological manifestations have been discussed.
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95
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Szlachetka R, Karski JB. [Pleural complications of pneumonia in children]. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 1989; 42:858-61. [PMID: 2634313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Four-year experiences are reported concerning the treatment in tropical climate of 37 children with pneumonia complicated with pleural empyema. Most children were aged below 3 years. Among clinical manifestations dysponoea, fever and toxaemia were in the foreground. The pathogen most frequently demonstrated in blood and pleural exudate was Staphylococcus aureus. In all cases antibiotics were given, hydration and diet with high protein content were given, pleurocentesis was done for decompression. Despite intensive hospital treatment every 7th child died.
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96
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Vengerov II, Kremenchugskaia IA, Kashin AI. [Infection with involvement of the central nervous system]. KLINICHESKAIA MEDITSINA 1989; 67:28-33. [PMID: 2724883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A detailed clinical characterization of 124 cases of sepsis with involvement of the central nervous system is presented and basic clinicopathogenic variants of its affection in sepsis, problems of diagnosis, etiotropic and pathogenic therapy are discussed.
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97
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Berkowitz FE, Cotton MF. Endotracheal aspiration for the bacteriological diagnosis of nosocomial- and measles-associated pneumonia. ANNALS OF TROPICAL PAEDIATRICS 1988; 8:217-21. [PMID: 2467606 DOI: 10.1080/02724936.1988.11748574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Endotracheal aspirates were obtained from 51 young children for the microbiological diagnosis of pneumonia acquired in hospital or associated with measles or severe protein-energy malnutrition. The procedure proved safe and the information obtained assisted in the management of most cases. There was a fairly good correlation between the findings of Gram stain and those of culture of the aspirates, which improved when only Gram stains showing many or moderate numbers of bacteria were used. The bacteria most frequently isolated were Gram-negative enteric bacilli, Staphylococcus aureus, Streptococcus viridans, Streptococcus pneumoniae and Haemophilus influenzae, many strains of which were resistant to conventional antibiotics. The role of endotracheal aspiration in the microbiological diagnosis of pneumonia in the above-mentioned types of patients is compared with that of percutaneous lung puncture, percutaneous transtracheal aspiration and expectorated sputum.
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98
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Kaszonyi M, Barcan F. [Circumscribed pulmonary hyperlucency with cystic and bullous aspects]. REVISTA DE IGIENA, BACTERIOLOGIE, VIRUSOLOGIE, PARAZITOLOGIE, EPIDEMIOLOGIE, PNEUMOFTIZIOLOGIE. PNEUMOFTIZIOLOGIA 1988; 37:351-70. [PMID: 2855763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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99
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Abstract
A case is described in which a tension pneumothorax complicated staphylococcal pneumonia 11 months after its onset. The delayed and subacute/chronic nature of the tension pneumothorax is unusual. The case also highlights the difficult differential diagnosis between subpleural lung cysts and encysted pneumothorax.
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100
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Verghese A, Catanese A, Arbeit RD. Staphylococcus aureus pneumonia in hamsters with elastase-induced emphysema--the virulence enhancing activity of mucin. PROCEEDINGS OF THE SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE. SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE (NEW YORK, N.Y.) 1988; 188:1-6. [PMID: 3368471 DOI: 10.3181/00379727-188-42698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Staphylococcus aureus pneumonia was studied in hamsters with elastase-induced emphysema and in saline-treated controls. Emphysematous animals cleared endotracheally administered inocula of S. aureus in saline as rapidly as controls. After infection with S. aureus in 1% mucin, emphysematous animals had impaired clearance compared with controls; after infection with S. aureus in 5% mucin, emphysematous animals had decreased survival at 96 hr compared to controls (6/24 vs 15/24, P less than 0.01 Fisher's exact test). Bronchoalveolar lavage of uninfected elastase-treated hamsters yielded twice as many cells per animal as uninfected controls (P less than 0.0001, paired t test), and the cells contained a higher percentage of polymorphonuclear leukocytes (37.8% vs 3.8%, P less than 0.0001). Lavage cells from both groups of animals were equally efficient per cell at killing opsonized S. aureus in an in vitro bactericidal assay. Hamsters with elastase-induced emphysema were resistant to infection with S. aureus alone despite marked structural abnormalities in the lung, possibly due in part to increased numbers of resident phagocytic cells. After infection with S. aureus in mucin as a virulence enhancing factor emphysematous animals had impaired clearance and decreased survival compared to controls.
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