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Biomedical subjects

H D Rose

Publications and source records attributed to H D Rose.

At least 37 records · Page 2Linked to original sources
PubMed1981

Empyema thoracis during a ten-year period. Analysis of 72 cases and comparison to a previous study (1952 to 1967).

In this series of 72 cases of empyema, 28 patients (38.8) had anaerobes isolated from their pleural fluid cultures. In 22 patients, anaerobes were the only isolates, and in six there were also aerobes. This observed frequency (38.8%) of anaerobic empyema is notably greater than the frequency noted in an earlier study (1952 to 1967) from the Veterans Administration Medical Center, Wood, Wis, while the contribution of various pathogenetic mechanisms was similar. Although closed chest tube drainage was instituted initially in 51 patients, 18 patients (35%) subsequently required additional procedures. The case-fatality ratio was 51.4% in this study compared with 46.6% in the earlier study. Twenty-two patients died during the same hospitalization period while the empyema was an active problem. Six (8.3%) of these empyema-related deaths occurred in patients without underlying disease, while 16 (22.2%) were in patients with underlying diseases.

Adult↗
PubMed1981

Meningococcal pneumonia. A source of nosocomial infection.

Pneumonia apparently resulting from aspiration became clinically apparent in an elderly man two days after admission to a private room on a general medical ward. Pneumonia developed in a patient in an adjacent room three days later. Both patients had group B Neisseria meningitidis isolated from a percutaneous transtracheal aspirate. A prevalence survey failed to identify meningococcal carriers among other ward patients. The index patient required frequent nasotracheal suctioning during the first two hospital days prior to penicillin G potassium therapy. The second patient was simultaneously receiving continuous oxygen therapy administered by nasal cannula. Events suggested that the organism may have been transmitted by direct contact, probably on the hands of hospital personnel.

Aged↗
PubMed1980

Fulminant gram-negative bacillemia (DF-2) following a dog bite in an asplenic woman.

In a 56 year old woman, shock, disseminated intravascular coagulation, symmetrical peripheral gangrene and the adult respiratory distress syndrome developed following a dog bite. She suffered from chronic alcoholism and was asplenic. The newly described gram-negative bacillus (DF-2) was isolated from the initial blood cultures on the eighth hospital day when she was recovering from the illness. Penicillin G, clindamycin, or both (administered intravenously in large doses), and therapy directed toward the severe complications appeared responsible for her successful outcome.

Alcoholism↗
PubMed1980

Lymphocyte function in relapsed pulmonary blastomycosis.

Lymphocyte function was studied in two patients with multiple relapses of pulmonary blastomycosis following antifungal therapy. Neither patient was anergic to routine delayed hypersensitivity skin testing with common antigens. Both had normal in vitro lymphocyte transformation responses to standard mitogens and common microbial antigens. The ability of lymphocytes from the two patients to respond to antigens of the infecting organism was evaluated using a yeast phase Blastomyces dermatitidis extract in tests of in vitro lymphocyte function. Both patients demonstrated positive responses to this extract in standard assays of two in vitro parameters of lymphocyte function, lymphocyte transformation, and lymphokine production. Therefore if an immunologic defect is responsible for the repeated relapses of treated pulmonary blastomycosis in these two patients, it apparently is not one of deficient lymphocyte responsiveness against the infecting organism, as has been found using similar techniques in patients with disseminated deep infections caused by other fungal organisms.

Antigens, Fungal↗
PubMed1980

Streptococcus zooepidemicus (group C) pneumonia in a human.

Lancefield group C streptococcal pneumonia appeared in a previously healthy young adult. The patient apparently acquired the infection while caring for her sick horse, and experienced a gradual onset of the illness. There was rapid accumulation of pleural fluid and empyema requiring open drainage. Group C pneumonia cannot be distinguished from classic group A pneumonia on clinical grounds. Beta-hemolytic streptococci isolated from sputum, transtracheal aspirates, pleural fluid, or blood of patients with pneumonia should be grouped by the precipitin method of Lancefield or one of its more rapid modifications.

Adult↗
PubMed1979

Haemophilus parainfluenzae mitral valve vegetation without hemodynamic abnormality. Demonstration by angiography and serial echocardiography.

The occurrence of Haemophilus parainfluenzae endocarditis on a previously normal mitral valve of a drug addict is described. A large mitral valve vegetation was demonstrated by serial echocardiography and cineangiography. The vegetation did not produce hemodynamic abnormalities preventing detection by physical examination. Multiple septic emboli to various organs, including brain, resulted in death. The role of serial echocardiography and the levophase of right heart cineangiography in detecting mitral valve vegetation in a patient suspected of having infective endocarditis is emphasized.

Cineangiography↗
PubMed1979

Filtering hospital air decreases Aspergillus spore counts.

We performed counts of airborne spores in a hospital with filtered air where a decrease in nosocomial infection with Aspergillus organisms had been documented. For comparison, similar studies were performed at a nearby general hospital in a ward with open windows. The total spore count inside the hospital with filtered air was significantly less than inside the ward with open windows. The total count of Aspergillus organisms in the filtered air was significantly less than that in the room with open windows. We conclude that the decrease in nosocomial infections with Aspergillus organisms in the hospital with filtered air is probably associated with fewer airborne spores.

Air Microbiology↗
PubMed1979

Infected left atrial myxoma with bacteremia simulating infective endocarditis.

A 58-year-old man had intermittent fever of eight months' duration following a dental extraction. There were no abnormal cardiac auscultatory findings. Multiple blood cultures yielded Streptococcus mutans. Treatment for infective endocarditis was initiated; however, an echocardiogram suggested the presence of a left atrial myxoma. The diagnosis was confirmed by angiography and the infected tumor was removed successfully. Differentiating features between left atrial myxoma and mitral valve endocarditis may not be obvious clinically, and bacteremia does not preclude atrial myxoma as a diagnostic possibility. We therefore suggest that all cases of infective endocarditis be evaluated by echocardiography to elucidate lesions such as large vegetations or left atrial myxoma, both of which may require urgent operative intervention.

Diagnosis, Differential↗
PubMed1978

Pulmonary candidiasis. A clinical and pathological correlation.

Thirty patients with systemic Candida infection underwent autopsy during a 13-year prospective study. Eleven patients had tissue-verified pulmonary candidiasis. Nine of these patients had hematogenous dissemination, as evidenced by multiple organ invasion; two had aspiration pneumonia with lung involvement only. Aspiration Candida pneumonia is rare. Pulmonary candidiasis usually arises from a focus of infection implanted during hematogenous dissemination. An infected indwelling venous catheter was the source of candidemia in six of these patients. Organisms in the lumen of pulmonary vessels caused a necrotizing vasculitis and appeared to invade the parenchyma from these areas.

Adult↗
PubMed1978

Miconazole treatment of relapsed pulmonary blastomycosis.

Two patients with second relapses of pulmonary blastomycosis after successful treatments with adequate doses of amphotericin B were retreated with miconazole. One patient had experienced an acute intrabronchial spread of disease to the contralateral lung before miconazole therapy. Marked clinical and roentgenographic improvement occurred with treatment, followed by mycologic relapse 1 month later. The other patient sustained a more indolent relapse of disease. A favorable response to treatment with miconazole was demonstrated by improvement in abnormalities noted on a chest roentgenogram and a [67]gallium-citrate scan.

Amphotericin B↗
PubMed1977

Acute Pasteurella multocida pneumonia.

Acute pneumonia caused by Pasteurella multocida appeared in two elderly patients. One patient had chronic obstructive lung disease and the other developed aspiration pneumonia after an episode of cardiac arrest. Pasteurella multocida was not isolated from the initial sputum cultures. The delay in recognizing the pathogen resulted in extension of the pneumonia and abscess formation in the patient with obstructive lung disease. Pasteurella multocida was isolated from a percutaneous transtracheal aspirate in both patients and from the blood of one. They recovered after treatment with a penicillin administered in higher than usual dosage over a period of several weeks.

Acute Disease↗
PubMed1977

Colonization of hospitalized patients with yeast-like organisms.

The pharyngeal, fecal and skin carrier rates of yeast-like organisms was determined in 126 patients on the day of admission to a larger Veterans Administration Hospital. None of these patients had been hospitalized or received anti-microbial agents during the previous year Candida and Torulopsis species were most common. A small percentage of patients were carriers of various species belonging to the genera Trichosporon, Rhodotorula, Saccharomyces, Leucosporidium and Endomycopsis. Fifty of the original 126 patients remained hospitalized for a sufficient duration to permit repeat cultures on days 7 and 14. Twenty-five of these patients served as controls and did not receive antibiotics; the other 25 received at least a 4-day course of antibiotic therapy for an underlying infection. Although there was no significant difference in the carrier rates in these 2 groups, organisms other than Candida continued to be isolated from the 50 patients who remained hospitalized for 2 weeks.

Adult↗
PubMed1977

Chronic rhinocerebral phycomycosis in association with diabetes.

Two patients with rhinocerebral phycomycosis associated with diabetes are presented. The chronic nature of the illness in these two cases in emphasized in contrast to the more fulminant course of most previously reported patients. A high index of suspicion is needed to establish the diagnosis as rapidly as possible. Treatment of the underlying disease combined with amphotericin B therapy and radical surgical excision of all infected tissue is important to establish cure of these patients.

Adult↗