Treatment of Occult Bacteremia

PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1131-1132
Author(s):  
WILLIAM FELDMAN
Keyword(s):  
Antibiotic Therapy ◽  
Clinical Characteristics ◽  
Large Percentage ◽  
Source Of Infection ◽  
Occult Bacteremia ◽  
Obvious Source

To the Editor.— I am concerned about the conclusions in the paper on treatment of occult bacteremia.1 Carroll at al recommend "expectant antibiotic therapy for children who have no obvious source of infection and who have the clinical characteristics associated with occult bacteremia." As a relatively large percentage of infants aged 6 to 24 months have high fevers at one time or another, the implications of this approach were it to be widely implemented would be great.

Treatment of Occult Bacteremia: A Prospective Randomized Clinical Trial

PEDIATRICS ◽  
1983 ◽  
Vol 72 (5) ◽  
pp. 608-612 ◽  
Author(s):  
William L. Carroll ◽  
Michael K. Farrell ◽  
Jonathan I. Singer ◽  
Mary Anne Jackson ◽  
Jeffrey S. Lobel ◽  
...  
Keyword(s):  
Clinical Trial ◽  
At Risk ◽  
Antibiotic Therapy ◽  
Randomized Clinical Trial ◽  
Chest Roentgenogram ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Prospective Randomized Clinical Trial ◽  
Source Of Infection ◽  
Occult Bacteremia

Antibiotic therapy for children without foci of infection and at risk for bacteremia is controversial. A prospective randomized clinical trial was conducted using expectant antibiotic therapy in children at risk for bacteremia. A total of 96 children (aged 6 to 24 months) with temperature of more than 40°C, no identifiable source of infection, and a leukocyte count ≥15,000/µL and/or sedimentation rate ≥30 were enrolled. The following tests were performed on all children: blood culture, chest roentgenogram, urinalysis, and urine culture. A lumbar puncture was performed if a child was 12 months or less. Patients were randomized to receive either no antibiotic therapy or Bicillin C-R, 50,000 U/kg intramuscularly, followed by penicillin V, 100 mg/kg/d, orally four times a day for three days. Patients were examined at 24 and 72 hours. Fifty patients were treated expectantly and 46 received no antimicrobial therapy. Ten of the 96 patients were bacteremic (nine had Streptococcus pneumoniae, one had Haemophilus influenzae). Four of the five children treated for bacteremia showed improvement at the first follow-up visit (afebrile and no obvious focus of infection). The five untreated patients showed no improvement; four patients developed focal infections (two had meningitis, two had otitis media) (P ≤ .05, Fisher exact test). No complications of expectant therapy were detected. Thus, expectant antibiotic therapy for children who have no obvious source of infection and who meet these criteria associated with occult bacteremia is warranted.

“EPIDEMIOLOGICAL AND CLINICAL CHARACTERIZATION OF COVID19 PATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY OF 245 CASES IN A GOVERNMENT TEACHING INSTITUTE OF NORTH INDIA.”

2021 ◽  
pp. 50-53
Author(s):  
Divya Jain ◽  
Umesh Shukla ◽  
Jyotsna Madan ◽  
Bhanu K Bhakri ◽  
Devendra Kumar Gupta ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
North India ◽  
Contact Tracing ◽  
Mild Disease ◽  
Source Of Infection ◽  
Asymptomatic Patients ◽  
Care Workers ◽  
Study Population ◽  
The Mean ◽  
Novel Coronavirus

Background and objectives: Worldwide literature on presentation of patients infected with novel coronavirus shows huge variability in terms of severity and outcome depending on the demographic characteristics of the affected population. We aim to present epidemiological and clinical characteristics of COVID-19 patients admitted at our facility. Methods: Retrospective analysis of epidemiological, and clinical characteristics of patients admitted at a dedicated COVID hospital in North India. Results: Records of 245 patients were analyzed. The mean (SD) age was 32 (17.87) years ranging from 1 day to 81 years. Children <18 years of age constituted around 18% of the study population of which only about a fourth (23%) were symptomatic. About 52.4% of patients were males. Almost 40% cases were detected through contact tracing of known infected patients and in about 56% cases the source of infection was indeterminate. About 67% were asymptomatic and most of the symptomatic patients had mild disease. Among the symptomatic patients cough (19.9%) and fever (17.1%) were most common symptoms followed by throat irritation. Comorbidities were present in 32 (13.06%) patients, of which hypertension in 6.12% was the most common. There were 22 (8.97%) health care workers (HCW) among the patients. Majority of the affected HCW were working in areas with relatively low infection risk. Six (2.44%) patients required oxygen supplementation. The mean duration of stay in hospital was 9.6 ±.57 days. Interpretations & Conclusions: Our observations indicate a relatively younger age of affected population and high proportion of asymptomatic patients. Children are usually asymptomatic with relatively better prognosis.

Are Blacks at Higher Risk for Vancomycin-Related Acute Kidney Injury?

2019 ◽  
Vol 33 (5) ◽  
pp. 592-597 ◽  
Author(s):  
Mamta Sharma ◽  
Kaylin Braekevelt ◽  
Pramodini Kale-Pradhan ◽  
Susan Szpunar ◽  
Riad Khatib
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Characteristics ◽  
Trough Level ◽  
Kidney Injury ◽  
Comorbid Conditions ◽  
Black Race ◽  
Source Of Infection ◽  
Vancomycin Trough ◽  
Nephrotoxic Drugs ◽  
Trough Levels

Background: Black individuals have a higher lifetime risk of acute kidney injury (AKI) and chronic kidney disease than whites. Vancomycin has a potential for nephrotoxicity. The objective of this study was to determine whether the incidence of AKI among patients being treated with vancomycin differs by race. Methods: Retrospective study of adult (3 ≥18 years) inpatients who were on vancomycin for 348 hours between January 2012 and December 2014. Data on demographics, comorbid conditions, clinical characteristics, vancomycin dose, duration, and nephrotoxic drugs were collected. Patients with a creatinine clearance <30 mL/min or undergoing dialysis were excluded. Results: We identified 1130 patients during the study period; 48.1% (544) were black. The overall incidence of AKI was 8.2% (10.1% blacks, 6.5% whites; P = .03). Independent predictors of AKI included black race ( P = .011); higher Charlson score ( P = .006); higher body mass index (BMI; P = .002); higher vancomycin trough level ( P < .0001); and sepsis/systemic inflammatory response syndrome (<.0001), pneumonia ( P = .001) or gastrointestinal/genitourinary ( P = .025) as the source of infection. Conclusion: The incidence of vancomycin-related AKI was higher in blacks, independent of other risk factors. Based on our study, vancomycin trough levels and renal function need to be closely monitored in blacks.

scholarly journals Efficacy of stereotactic aspiration in deep-seated and eloquent-region intracranial pyogenic abscesses

2008 ◽  
Vol 24 (6) ◽  
pp. E13 ◽  
Author(s):  
Xavier G. Kocherry ◽  
Thimappa Hegde ◽  
Kolluri V. R. Sastry ◽  
Aaron Mohanty
Keyword(s):  
Antibiotic Therapy ◽  
Complete Resolution ◽  
Early Recurrence ◽  
Shunt Insertion ◽  
Stereotactic Aspiration ◽  
Source Of Infection ◽  
Cerebral Parenchyma ◽  
Eloquent Cortex ◽  
Repeated Aspiration

Object Intracranial abscesses located deep in the cerebral parenchyma and in eloquent regions are often difficult to manage surgically. The authors have attempted to analyze the efficacy of stereotactic aspiration in the management of these abscesses. Methods Cases involving 22 patients (including 9 children) with deep-seated and/or eloquent-region intracranial abscesses who underwent CT- or MR imaging–guided stereotactic aspiration between January 1995 and July 2001 were analyzed. Results A definite source of infection could be identified only in 9 of the cases. In 18 patients, the abscess was deep seated, whereas in the rest it was located in the eloquent cortex. Five patients had abscesses located in multiple sites. In 17 patients only 1 aspiration was required; in 5 others subsequent procedures were required. In the initial postaspiration CT, minor hemorrhage was noted in 3 patients not requiring further intervention. Antibiotics were administered for a period varying from 4 to 8 weeks following aspiration. An early recurrence (within 2 weeks of initial aspiration) was evident in 5 patients. All recurrent abscesses were reaspirated. In 2 patients new abscesses developed while the patients were still receiving antibiotic therapy. There were no late recurrences. In 1 patient ventriculitis developed, with subsequent hydrocephalus requiring a shunt insertion. Follow-up CT scans showed complete resolution of the abscess in all patients. There were no deaths. Conclusions Stereotactic aspiration is a useful management option for abscesses located in eloquent or inaccessible regions. Repeated aspiration should be considered in patients in whom the initial aspiration proves ineffective or partially effective. Complete resolution may require repeated stereotactic aspirations and continued antibiotic therapy.

scholarly journals Imported rocket salad partly responsible for increased incidence of hepatitis A cases in Sweden, 2000-2001

2001 ◽  
Vol 6 (10) ◽  
pp. 151-153 ◽  
Author(s):  
K Nygård ◽  
Y Andersson ◽  
P Lindkvist ◽  
C Ancker ◽  
I Asteberg ◽  
...  
Keyword(s):  
Public Health ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Hepatitis A ◽  
Case Control Study ◽  
Public Health Problem ◽  
Case Control ◽  
Source Of Infection ◽  
Obvious Source ◽  
Control Study

An increased incidence of domestic hepatitis A without any obvious source of infection in Sweden and a small outbreak in late spring 2001 led to the undertaking of a case-control study. Consumption of imported rocket salad was clearly associated with disease (odds ratio 9.1, 95% confidence interval 1.5 to 69). The importation of vegetables from countries where hepatitis A is endemic to countries where this disease is not endemic continues to be a public health problem.

scholarly journals Transmission and clinical characteristics of asymptomatic patients with SARS-CoV-2 infection

2020 ◽  
Vol 15 (6) ◽  
pp. 373-380 ◽  
Author(s):  
Jie Tan ◽  
Shousheng Liu ◽  
Likun Zhuang ◽  
Lizhen Chen ◽  
Mengzhen Dong ◽  
...  
Keyword(s):  
Viral Load ◽  
Clinical Features ◽  
Theoretical Basis ◽  
Clinical Characteristics ◽  
Transmission Characteristics ◽  
Asymptomatic Carriers ◽  
Source Of Infection ◽  
Asymptomatic Patients ◽  
Novel Coronavirus

The 2019 novel coronavirus disease, SARS-CoV-2, is now spreading globally and is characterized by person-to-person transmission. However, it has recently been found that individuals infected with SARS-CoV-2 can be asymptomatic, and simultaneously a source of infection in others. The viral load detected in nasopharyngeal swabs of asymptomatic carriers is relatively high, with a great potential for transmission. More attention should be paid to the insidious spread of disease and harm contributed by asymptomatic SARS-CoV-2 carriers. To provide a theoretical basis for the accurate and early clinical identification of asymptomatic patients, this review objectively summarizes the epidemic status, transmission characteristics and clinical features of asymptomatic patients with SARS-CoV-2 infection.

scholarly journals Adult Patients with Occult Bacteremia Discharged from the Emergency Department: Epidemiological and Clinical Characteristics

2001 ◽  
Vol 32 (4) ◽  
pp. 559-565 ◽  
Author(s):  
D. Epstein ◽  
D. Raveh ◽  
Y. Schlesinger ◽  
B. Rudensky ◽  
N. P. Gottehrer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Characteristics ◽  
Adult Patients ◽  
Occult Bacteremia
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