Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 2000
Review Case ReportsIatrogenic meningitis: an increasing role for resistant viridans streptococci? Case report and review of the last 20 years.
Iatrogenic meningitis following lumbar puncture is a rare event. We present a 52-y-old man who developed symptoms of meningitis within 12 h after spinal anaesthesia. Cerebrospinal fluid cultures grew Streptococcus salivarius partially resistant to penicillin and ceftriaxone. ⋯ An upward trend in resistance of S. viridans isolates is cause for concern and may change empirical treatment strategies. Death was reported in 3 cases (5%) and was associated with Pseudomonas and staphylococcal isolates. The recognition of this entity and the importance of proper infection control measures are underlined.
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Plasmapheresis is one of the methods which has been tried in the effort to influence the course of severe sepsis with septic shock and to improve survival rates. This is a retrospective study of 17 consecutive patients with septic shock who were treated with acute plasmapheresis. Nine out of 16 patients with verified etiology suffered from infections with Gram-positive bacteria. ⋯ No serious side-effects of treatment were observed. This study indicates that plasmapheresis is a safe treatment for patients with septic shock and has a positive effect on survival. Prospective, randomized studies would be valuable to determine the role of plasmapheresis in the management of patients with septic shock.
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Scand. J. Infect. Dis. · Jan 2000
Case ReportsStreptococcus salivarius acute meningitis with latent petromastoiditis.
A 48-y-old woman, with a previous history of neurosurgical intervention for a trigeminal neurinoma, presented with acute meningitis due to Streptococcus salivarius. There were significant changes in the petrous region, as revealed by MRI, leading to the diagnosis of associated latent subacute mastoiditis.
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Scand. J. Infect. Dis. · Jan 1999
Impact and pattern of gram-negative bacteraemia during 6 y at a large university hospital.
In order to characterize the impact and pattern of Gram-negative bacteraemia (GNB) at a Swiss University hospital and to assess the effect of multi-resistance on mortality, we conducted a 6-y retrospective cohort study using linear regression and multivariate Cox-proportional hazard analysis. 1766 patients had 1835 episodes of GNB; 61% were community-acquired. The incidence of GNB increased linearly (r2 = 0.90, p = 0.014) from 7.07 episodes to 8.32 episodes per 1000 admissions, but this trend was no longer significant after adjustment for the number of blood cultures drawn/y. The in-hospital mortality for patients with GNB decreased from 20% in 1989 to 16% in 1994 (r2 = 0.94, p = 0.005). ⋯ Multi-resistance was not associated with an increased risk of death (HR 1.0). Although the crude mortality of GNB decreased, the population-attributable risk ratio for death remained significant. These data suggest the absence of a major impact of multi-resistant GNB on patient mortality.
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Scand. J. Infect. Dis. · Jan 1999
Case ReportsAfrican tick-bite fever imported into Norway: presentation of 8 cases.
We report on 8 Norwegian travellers to Southern Africa with African tick-bite fever (ATBF), a recently described spotted fever group rickettsiosis. All patients had acute flu-like symptoms and developed I or multiple inoculation eschars. The patients were treated with either doxycycline or ciprofloxacin, and all recovered. The diagnosis of ATBF was confirmed by the detection of specific IgM antibodies to Rickettsia africae by microimmunofluoroscence in convalescent-phase serum samples.