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  • 1
    Electronic Resource
    Electronic Resource
    Multiple organ dysfunction syndrome induced by whole body hyperthermia and polychemotherapy in a patient with disseminated leiomyosarcoma of the uterus (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1013-1016 
    Details
    ISSN: 1432-1238
    Keywords: Key words Systemic inflammatory response syndrome ; Multiple organ dysfunction syndrome ; Whole body hyperthermia ; Cytokines ; Polychemotherapy ; Leiomyosarcoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Whole body hyperthermia (WBH) in combination with chemotherapy is a relatively new promising treatment modality for patients with cancer. The objective of this report is to present the development of an acute systemic inflammatory response syndrome (SIRS) with multiple organ dysfunction syndrome (MODS) following WBH in combination with chemotherapy. Although WBH can also induce cytokine production, MODS has not been described before in association with WBH. Design: Case report. The patient was treated with WBH (core temperature 41.8 °C using a radiant heat device (Aquatherm) ) in combination with polychemotherapy (ifosfamide, carboplatin and etoposide (ICE) ) in the context of a clinical trial for metastatic sarcomas. Setting: Department of Medical Oncology and Intensive Care Unit of a university hospital. Patient: A 58-year-old Caucasian woman treated for disseminated leiomyosarcoma of the uterus, who developed SIRS with brain dysfunction, hypotension, respiratory failure and renal dysfunction following WBH/ICE. Interventions: She was successfully treated in the Intensive Care Unit by mechanical ventilation, inotropics and antibiotics. Measurements and results: There was a remarkable recovery within 2 days: she regained full conciousness, could be extubated, inotropic support was stopped and creatinine levels returned to pre-treatment levels. All cultures remained sterile. After almost complete recovery, 5 days later a second episode of fever during neutropenia occurred and, despite antibiotic treatment, she died of Bacteroides distasonis sepsis. Conclusion: WBH should be added as a new cause to the already known list of physical-chemical insults which can result in MODS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050999
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  • 2
    Electronic Resource
    Electronic Resource
    Inherited complement deficiency in children surviving fulminant meningococcal septic shock (1995)
    Springer
    European journal of pediatrics 154 (1995), S. 735-738 
    Details
    ISSN: 1432-1076
    Keywords: Neisseria meningitidis ; Complement system ; Properdin deficiency ; Protein C deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We evaluated the complement system in 29 children (mean age: 4.5 years) who survived fulminant meningococcal septic shock. No terminal complement deficiencies were found. One patient, who experienced the most dramatic disease course, had a decreased haemolytic activity in the haemolytis-in-gel test for the alternative pathway. The properdin concentration in serum of this patient was 〈 0.1 μg/ml (n = 17.1−27.7 μg/ml). Coagulation studies revealed a heterozygeous type I protein C deficiency as well. He was the only patient with aNeisseria meningitidis group Y infection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02276718
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  • 3
    Electronic Resource
    Electronic Resource
    Aspergillus fumigatus, a rare cause of fatal coronary artery occlusion (1992)
    Springer
    Infection 20 (1992), S. 45-47 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei abwehrgeschwächten Patienten kann eine Endokarditis durchAspergillus sp. auch ohne gefäßchirurgischen Eingriff auftreten, die allerdings extrem selten und schwer zu diagnostizieren ist. Wir berichten über einen 69 Jahre alten Patienten mit Haarzelleukämie, bei dem sich eine beidseitige Pneumonie entwickelte. Aus metastatischen subkutanen Knötchen wurdeA. fumigatus angezüchtet. Trotz Behandlung mit Amphotericin B in adäquater Dosierung (0,7 mg/kg/Tag i.v.) verstarb der Patient 18 Tage nach Therapiebeginn. Als Todesursache fanden sich eine Pilzendokarditis und ein Herzinfarkt infolge septisch- thrombotischen Verschlusses der linken Koronararterie, ausgelöst durchA. fumigatus. Trotz Behandlung mit Amphotericin B i.v. in einer Gesamtdosis von 756 mg konnteA. fumigatus noch aus autoptisch entnommenen Material aus der Aortenklappe kultiviert werden. Bei metastatischer Ausbreitung vonAspergillus spp. sollte eine Endokarditis vermutet werden.
    Notes: Summary Endocarditis byAspergillus species in patients without prior cardiovascular surgery is extremely rare and difficult to diagnose. We report and discuss a 69-year-old patient with hairy cell leukemia who developed severe bilateral pneumonia and metastatic subcutaneous nodules from whichA. fumigatus was cultured. He died after 18 days of treatment with an adequate dose (0.7 mg/kg/day) of amphotericin B intravenously. Fungal endocarditis and a myocardial infarction due to a septic thrombotic occlusion of the left coronary artery byA. fumigatus appeared to be the cause of death.A. fumigatus could still be cultured from the aortic valve postmortem despite a total dose of 756 mg amphotericin B. In case of metastatic spread ofAspergillus spp., endocarditis should be suspected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01704896
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  • 4
    Electronic Resource
    Electronic Resource
    Pneumocystis carinii Pneumonia in HIV-negative patients with haematologic disease (1997)
    Springer
    Infection 25 (1997), S. 78-81 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Since 1990,Pneumocystis carinii pneumonia (PCP) was diagnosed in 15 adult HIV-negative haematologic patients in our hospital. None of them had received PCP prophylaxis. All except one had been treated with prednisone. Symptoms usually started after stopping or tapering. In six patients the diagnosis of PCP was delayed because of confounding bacterial isolates from blood, sputum or urine leading to unsuccessful antibiotic treatment. PCP was diagnosed by demonstrating pneumocysts in bronchoalveolar lavage fluid. In four patients additional fungal or viral pathogens were identified. The infections were not clustered. The patients were treated with co-trimoxazole and, in case of a pO2〈60 mmHg, with prednisone. Three patients died (20%); they all had a coinfection with cytomegalovirus and/or aspergillus. The others recovered completely. There were no relapses. Primary PCP prophylaxis should be considered in patients with lympho-proliferative disease and exposure to prednisone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02113579
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  • 5
    Electronic Resource
    Electronic Resource
    FatalScedosporium prolificans infection in a leukemic patient (1997)
    Springer
    European journal of clinical microbiology & infectious diseases 16 (1997), S. 460-464 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case is described of a 42-year-old patient with acute myeloid leukemia who received two courses of chemotherapy complicated by prolonged bone marrow depression. He was admitted to hospital with fever, hepatosplenomegaly and bilateral nodular pulmonary infiltrates. After admission diffuse cutaneous skin nodules, and hypodense lesions in the hemispheres and cerebellum developed. Cultures of cerebrospinal fluid, bronchoalveolar lavage fluid, skin biopsy specimens and blood revealedScedosporium prolificans, indicative of disseminated mycosis. Treatment with amphotericin B and fluconazole was unsuccessful and the patient died within five days after admission. Features that may enhance early recognition ofScedosporium prolificans infection by both clinicians and microbiologists, as well as options in the treatment of infection with this fungal agent are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02471912
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  • 6
    Electronic Resource
    Electronic Resource
    Easier monitoring of aminoglycoside therapy with once-daily dosing schedules (1995)
    Springer
    European journal of clinical microbiology & infectious diseases 14 (1995), S. 531-535 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Little has been reported on serum levels attained using once-daily aminoglycoside regimens and their relation to dosage administered and renal function. Consecutive patients with serious infections were randomized to receive gentamicin 4 mg/kg q 24 h i.v. (n=69), gentamicin 1.33 mg/kg q 8 h i.v. (n=46) or netilmicin 5.5 mg/kg q 24 h i.v. (n=59) (with dose reduction in case of renal dysfunction). In the three groups, median first serum trough levels were 0.4, 1.0 and 0.4 mg/l, respectively, and median first serum peak levels were 9.5, 4.7 and 12.2 mg/l (p〈0.01 once-daily vs. thrice-daily regimens). Dose adjustment because of first trough concentrations of 〉 2 mg/l and/or peak concentrations of 〈 6 mg/l was required in 6 %, 78 % and 12 % of patients, respectively. Second trough and peak concentrations were significantly higher in the thrice-daily gentamicin group; serum levels remained constant in the other two groups. The six patients in the once-daily groups who developed elevated trough levels later in therapy were characterized in most cases by a decline in renal function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02113434
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  • 7
    Electronic Resource
    Electronic Resource
    NonserotypeableShigella dysenteriae isolated from a Dutch patient returning from India (1997)
    Springer
    European journal of clinical microbiology & infectious diseases 16 (1997), S. 553-554 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01708247
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  • 8
    Electronic Resource
    Electronic Resource
    Clinical Comparison of Two Commercial Blood Culture Systems (2000)
    Springer
    European journal of clinical microbiology & infectious diseases 19 (2000), S. 881-885 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A prospective, volume-controlled comparison of the BacT/Alert FAN (Organon Teknika, USA) and Vital (bioMérieux, France) blood culture systems was performed in a university hospital during a period of 11 months. Twenty to 40 ml of blood drawn from an adult patient was distributed equally between a BacT/Alert FAN and a Vital blood culture set, both consisting of an aerobic and an anaerobic bottle. Bottles were weighed prior to use and after incubation to calculate the blood volume. A compliant pair of aerobic, or anaerobic, bottles of a blood culture was defined as follows: blood volumes were 4–11 ml and the blood volumes in the two bottles differed by ≤20%. From 120 compliant pairs of aerobic bottles, 135 organisms were recovered, of which 78 were isolated in both bottles, 44 in the BacT/Alert FAN bottle only and 13 in the Vital bottle only (P〈0.0005). In particular, aerobic BacT/Alert FAN bottles yielded more members of the family Enterobacteriaceae (P〈0.01). The BacT/Alert FAN system also performed significantly better when comparing anaerobic bottles, and the yield was greater during septic episodes. Both culture systems were similar regarding detection time, recovery during antimicrobial therapy, and the occurrence of false-positive and false-negative bottles. The overall performance of the BacT/Alert FAN system was better than that of the Vital system.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100960000374
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  • 9
    Electronic Resource
    Electronic Resource
    Antimicrobial susceptibility of sixty human fecal isolates ofAeromonas species (1989)
    Springer
    European journal of clinical microbiology & infectious diseases 8 (1989), S. 248-250 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The MICs of 21 antimicrobial agents were determined for 60 strains ofAeromonas spp. isolated from human feces. All isolates tested were susceptible to aztreonam, tetracycline, imipenem, moxalactam, pipemidic acid, gentamicin, trimethoprim-sulfamethoxazole, pefloxacin and ciprofloxacin. Resistance to erythromycin and streptomycin was observed in all 60 strains.Aeromonas caviae was less susceptible to cefamandole, cefotaxime, norfloxacin, chloramphenicol, tetracycline, sulfamethoxazole and trimethoprim than was eitherAeromonas hydrophila orAeromonas sobria. It was concluded that cotrimoxazole or one of the newer quinolones can be considered for treatment of aeromonas-associated diarrhea.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01965270
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