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Biomedical subjects

D W Teele

Publications and source records attributed to D W Teele.

50 records · Page 3Linked to original sources
PubMed1980

Disparate cultures of middle ear fluids. Results from children with bilateral otitis media.

Cultures of middle ear fluids (MEFs) are needed to determine both efficacy of antibiotics and vaccines, and microbiologic outcome of otitis media (OM). We reviewed data on 221 children, aged 2 months to 12 years; 122 had acute otitis media (AOM), 99 had asymptomatic MEF. We included only Streptococcus pneumoniae, Haemophilus influenzae, Branhamella catarrhalis, and Staphylococcus aureus as pathogens. Of children with AOM, MEF was sterile or contained nonpathogens in both ears in 51, and one or more pathogens in 71. Of these 71, 40 had the same pathogen or pathogens in both ears; 25 patients had a pathogen in one ear and sterile fluid or only nonpathogens in the other; four patients had a different pathogen in each ear; and two patients had two pathogens in one ear and only one in the other. Of those with asymptomatic MEFs, in 80 the effusion was sterile or contained only nonpathogens in both ears, and in 19 contained one or more pathogens. Of these 19, ten had the same pathogen isolated from both ears; nine had a pathogen in one ear and sterile fluid or only nonpathogens in the other. Thus, in 31 children with AOM and nine with asymptomatic MEFs, results of cultures of MEF were different.

Bacteria↗
PubMed1979

Unsuspected bacteremia due to Haemophilus influenzae: outcome in children not initially admitted to hospital.

Children not initially admitted to the hospital accounted for 42 of 94 episodes of bacteremia due to Haemophilus influenzae. Antibiotics were prescribed for 22 of the 42 children who were initially sent home; at second visit, 17 were improved, including all 13 with pneumonia. No antibiotics were prescribed for 20 children; at second visit, 15 had persistent fever or new focal infection and five had resolution of symptoms. New diagnoses of focal infection were made at second visit in three of the 22 treated and in 11 of the 20 untreated children, including three who had a new diagnosis of meningitis (one treated with antibiotics initially; two not treated). Cultures of blood positive for H. influenzae were obtained at second visit in ten children who were not treated initially; no child who was treated initially had a second positive culture. These findings indicate that although young children with bacteremia due to H. influenzae may be mildly ill at first visit, many are at risk for development of serious focal infection, including meningitis.

Anti-Bacterial Agents↗
PubMed1977

Outcome of unsuspected pneumococcemia in children not initially admitted to the hospital.

The records were reviewed of 97 episodes of unsuspected pneumococcemia in children not initially admitted to the hospital. Antimicrobial agents were prescribed at the first visit for 46 children; at the second visit 37 of them were improved and nine were not. No antimicrobial agents were prescribed at the first visit for 51; at the second visit 16 of these patients were improved and 35 were not. Pneumococcemia persisted in two treated children and in 13 untreated children. Meningitis was identified later in four children (two treated and two untreated). Although pneumococcemia in children may be a transient event, it may also persist or result in meningitis or other localized infections.

Anti-Bacterial Agents↗
PubMed1977

The microbiology of chronic middle ear effusions in children.

Serous otitis media is the most common cause of hearing loss in childhood. Traditionally, this entity has been felt to be a sterile process. This study was undertaken to determine the incidence of infected middle ear fluid in patients with asymptomatic middle ear effusions. The external auditory canal, nasopharynx and middle ear fluids of 57 patients undergoing myringotomy were cultured. Of 57 patients, 26 had positive cultures; 67% of patients less than 36 months of age had positive culture, with a bacterial flora closely resembling that of acute otitis media. Further investigation is required to determine the significance of such infection together with the optimum therapy for chronic effusions of the middle ear in young children.

Bacteria↗
PubMedDate not supplied

Use of pneumococcal vaccine for prevention of recurrent acute otitis media in infants in Boston. The Greater Boston Collaborative Otitis Media Study Group.

The efficacy of pneumococcal polysaccharide vaccine for children suffering from recurrent acute otitis media (AOM) was determined by administration, in a randomized double-blind fashion, of one of two polyvalent vaccines to 124 children aged five to 21 months. The octavalent vaccine contained serotypes commonly associated with AOM: 1, 3, 6A, 7F, 14, 18C, 19F, and 23F. The heptavalent control contained serotypes not commonly associated with AOM: 2, 4, 5, 8, 9N, 12F, and 24F. Recipients of the octavalent vaccine experienced significantly (P less than 0.05) less AOM due to serotyes contained in the octavalent vaccine than did children who received the control vaccine. Although the recipients of octavalent vaccine suffered less from AOM due to types in that vaccine than did controls, their clinical experience with AOM was not different. Both groups of children were equally likely to experience at least one episode of AOM after vaccination (70% for octavalent vaccine and 78% for heptavalent vaccine). The mean numbers of episodes of AOM after vaccination also were similar (2.1 for octavalent vaccine and 2.3 for heptavalent vaccine). Similarly, the period of effusion in the middle ear after pneumococcal AOM was identical for both groups. Although immunization with pneumococcal vaccine appeared to reduce the number of episodes of AOM due to serotypes contained in octavalent vaccine, the clinical experience of the children was not favorably affected by this vaccine.

Acute Disease↗
PubMedDate not supplied

Ceftriaxone administered once or twice a day for treatment of bacterial infections of childhood.

Twenty-six children received a single daily intravenous dose of ceftriaxone, 50 mg/kg, for a variety of bacterial infections including abscess (5), cellulitis (5), periorbital cellulitis (5), bacteremia without focus (4), osteomyelitis (2), pneumonia (2), pyelonephritis (2) and otitis media (1). Organisms isolated from infectious foci were Staphylococcus aureus (9), Streptococcus pneumoniae (6), Streptococcus pyogenes (3), Escherichia coli (2); and Haemophilus influenzae type b, nontypable H. influenzae, Group B streptococcus, Pasteurella multocida, Haemophilus parainfluenzae and satelliting streptococcus (1 each). Microbiologic cure was achieved in 20 of 22 (91%) infections and clinical cure in 25 of 26 (96%). Fifteen possible adverse reactions occurred in 34 patients evaluable for drug safety; most were mild and self-limited. Neutropenia developed in two patients necessitating discontinuation of ceftriaxone in one, followed by prompt resolution. Seventeen children received ceftriaxone, 75 mg/kg/day, in two divided doses for a similar variety of infections. Bacteriologic and clinical cure rates of 100 and 94%, respectively, were demonstrated. Leukopenia developed in one patient and resolved when ceftriaxone was discontinued. Once a day dosing of ceftriaxone in pediatric patients provides greater ease of administration combined with efficacy equal to that achieved with a divided dosage schedule.

Adolescent↗
PubMedDate not supplied

Isolation of viruses and mycoplasmas from middle ear effusions: a review.

Reports of studies of middle ear effusions (MEE) obtained by needle aspiration are reviewed in this paper; viruses were isolated from 29 of 663 patients (4.4%) and respiratory syncytial virus was isolated most frequently (22 patients); only one mycoplasma, M. pneumoniae, was recovered from the MEE of 771 patients. Viruses were also sought from the throat or nasopharynx of 249 patients with MEE; 59 patients (23.7%) had a respiratory virus present. M. pneumoniae was isolated from the throat or nasopharynx in three of 116 patients. Although these results indicate that viruses and mycoplasmas are uncommonly found in effusions associated with acute or chronic otitis media, few studies have been attempted in recent years. The discovery of additional respiratory viruses and development of new techniques for isolation and identification of viruses indicate that the present results may be incomplete.

Adenoviridae↗
PubMedDate not supplied

Epidemiology of otitis media in children.

To determine the epidemiology of otitis media (OM) during the first three years of life, physicians participating in the Greater Boston Collaborative Otitis Media Program followed prospectively from birth 2,565 children. At every visit we recorded results of pneumatic otoscopy and epidemiology data. By three years of age 71% of the children had had one or more episodes of acute otitis media including 33% who had three or more episodes. Features associated significantly with first episode of OM were: sibling with recurrent OM, race (white > black), and sex (male > female). Having a sibling with allergy disposed propositi to first episode. Features associated significantly with recurrent OM (greater than or equal to three episodes) were those noted above. A parent with recurrent OM disposed propositi to recurrent OM. Middle ear effusion (MEE) persisted for prolonged periods after OM; after the first episode of OM, 70% of children still had MEE at two weeks, 40% had fluid at one month, 20% had fluid at two months, and 10% had fluid at three months. The sole feature associated significantly with persistent effusion in the middle ear after the first episode of OM was the practice of giving a child a bottle in bed.

Boston↗
PubMedDate not supplied

Persistent effusions of the middle ear. Cultures for anaerobic bacteria.

Recent reports of isolation of bacteria from effusions of the middle ear taken from asymptomatic children have suggested a possible role for persistent bacterial infection in the etiology of prolonged effusions. To investigate the significance of anaerobic bacteria in such effusions, we obtained 51 samples of middle ear effusion (MEE) from 30 children. After careful cleansing of the tympanic membrane with 70% alcohol, we performed tympanocentesis prior to performing a myringotomy. Fastidious bacteriologic methods failed to yield a single anaerobic isolate from any of these specimens. We conclude that anaerobic infection of MEE is exceedingly uncommon.

Bacterial Infections↗