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Biomedical subjects

H M Feder

Publications and source records attributed to H M Feder.

At least 91 records · Page 5Linked to original sources
PubMed1983

Herpetic whitlow. Epidemiology, clinical characteristics, diagnosis, and treatment.

Herpetic whitlow is a herpes simplex virus infection of a distal phalanx. It is characterized by pain, swelling, erythema, and nonpurulent vesicle formation. Herpetic whitlow follows direct inoculation (exogenous or autogenous) or reactivation of latent virus. In children, it most frequently occurs following a primary oral herpes infection. In adolescents, herpetic whitlow is commonly associated with genital herpes infections. In adults, it frequently occurs in medical personnel who have contact with patients' oral secretions or is associated with genital herpes infections. The diagnosis of herpetic whitlow is readily confirmed by Tzanck test and culture. It is important to distinguish herpetic whitlow from bacterial felon or paronychia, as herpetic whitlow is a self-limited infection for which surgical incision is not indicated. We described herpetic whitlow in five children, one adolescent, and two pediatric residents.

Adolescent↗
PubMed1983

Pseudomonas whirlpool dermatitis. Report of an outbreak in two families.

Pseudomonas aeruginosa skin infections developed in four children and their parents after use of a recreational whirlpool. These patients were carefully followed throughout the course of their illnesses. The incubation period was two to five days. The skin lesions included erythematous macules and papules, pustules, and nodules. The severity of the illness varied from a few scattered pustules in one patient to an extensive truncal rash, malaise, and fever in another patient. P. aeruginosa was recovered from skin lesions and the whirlpool water. Gram stains from two patients revealed polymorphonuclear leukocytes and gram-negative rods. In all patients, the rash improved within seven days and local application of povidone-iodine did not appear beneficial.

Adolescent↗
PubMed1983

Initial treatment of Hemophilus influenzae infections in children.

Life-threatening pediatric infections in which H. influenzae is the potential pathogen include meningitis, septic arthritis, cellulitis and epiglottis. Until the pathogen is identified, chloramphenicol should be part of the initial hospital therapy. This agent is effective against ampicillin-susceptible and ampicillin-resistant H. influenzae strains, and it reliably penetrates the central nervous system.

Anti-Bacterial Agents↗
PubMed1982

Comparative tolerability of ampicillin, amoxicillin, and trimethoprim-sulfamethoxazole suspensions in children with otitis media.

The tolerabilities of ampicillin, amoxicillin, and trimethoprim-sulfamethoxazole (TMP-SMX) suspensions were evaluated in 263 children with otitis media. Because of watery stools, therapy was discontinued in 6 of 83 patients treated with ampicillin, in none of 89 patients treated with amoxicillin (P less than 0.01), and in 1 of 91 patients treated with TMP-SMX (P less than 0.03). Of the patients who completed the treatment courses, 13 recipients of ampicillin suffered loose or watery stools for 4 or more days, compared with 6 of the amoxicillin recipients (P less than 0.04) and 5 of the TMP-SMX recipients (P less than 0.02). Thus, ampicillin was clearly less well tolerated than either amoxicillin or TMP-SMX.

Amoxicillin↗
PubMed1981

Severe meningoencephalitis: complicating Mycoplasma pneumoniae infection in a child.

Mycoplasma pneumoniae (MP) infections are infrequently associated with CNS disease. We studied one case of meningoencephalitis associated with serologic evidence of MP infection. The pathogen grew neither from culture of CSF nor from culture of brain tissue. Electron-microscopic examination of the brain biopsy specimen revealed no organisms. Except for a single case in the literature, MP has never been recovered from the CNS, suggesting that MP-associated CNS disease is not caused by direct invasion of the CNS by MP.

Acute Disease↗
PubMed1981

An audit of chloramphenicol use in a large community hospital.

In a large community hospital during a six-month period, 238 of 19,670 hospitalized patients (1.2%) received chloramphenicol. The drug was administered exclusively by the intravenous route in 98% of these patients. In 78% of the patients, chloramphenicol was used for an appropriate indication, whereas in 22%, its use was inappropriate. Serious toxic effects and unexpected clinical failures were not observed.

Bacterial Infections↗
PubMed1980

Occult pneumococcal bacteremia and the febrile infant and young child.

Occult pneumonoccemia (OP) is unsuspected Streptococcus pneumoniae bacteremia occurring in a previously well child who presents with fever associated with either no focus or an upper respiratory focus infection. In this report, four cases of OP are presented and the literature is reviewed. The risk of OP appears highest for children, seen in urban emergency rooms and clinics, who are 6 to 24 months of age with rectal temperatures greater than or equal to 38.9 C (102 F) and who have white blood cell counts greater than or equal to 15,000/mm3. Other symptoms associated with OP include irritability, rhinorrhea, and febrile seizures. When recalled because of positive blood cultures, 40 per cent of untreated patients with OP had had spontaneous resolution of their illness, 29 per cent had persistent fever or symptoms and sterile blood cultures, 22 per cent had persistent fever or symptoms and positive blood cultures, while 10 per cent had a febrile course complicated by pneumococcal meningitis.

Child, Preschool↗
PubMed1980

Bacterial endocarditis caused by vitamin B6-dependent viridans group Streptococcus.

Two cases of bacterial endocarditis in children, caused by viridans group Streptococcus which requires vitamin B6 or thiol compounds for growth are reported. It is important to recognize these organisms as a possible cause of endocarditis because supplemented media are needed for their isolation and sensitivity testing. These organisms may be penicillin-sensitive, -resistant, or -tolerant. An organism is considered tolerant to an antibiotic when the minimum bactericidal concentration of that antibiotic is greater than or equal to 32 times the minimum inhibitory concentration. One of our patients relapsed when treated with a single antibiotic to which the B6-dependent viridans group Streptococcus was tolerant. If a B6-dependent viridans group Streptococcus is isolated from a patient with endocarditis, therapy should be initiated with penicillin and an aminoglycoside until sensitivities are available. Sensitity testing should include both the MIC and MBC and adequate therapy can be confirmed by determing the serum bactericidal activity.

Adolescent↗
PubMed1977

Neonatal sepsis at The Johns Hopkins Hospital, 1969-1975: bacterial isolates and clinical correlates.

The experience with neonatal sepsis at The Johns Hopkins Hospital during 1969-1975 was reviewed. Major pathogens included Escherichia coli, group B streptococcus, other streptococci, and Klebsiella. Nineteen percent of coliform isolates were kanamycin-resistant. The frequency of recovery of E. coli was increased in early-onset sepsis, and the frequency of recovery of Klebsiella was increased in late-onset sepsis. The mortality rate was 23%. The frequency of recovery of E. coli was increased in fatal cases, and mortality was highly correlated with the presence of gastrointestinal catastrophe. Ampicillin and gentamicin are the initial antibiotics of choice for neonatal sepsis at this institution; a penicillinase-resistant penicillin should be added when Staphylococcus aureus involvement is likely, and addition of chloramphenicol or clindamycin should be considered for infants at increased risk for Bacteroides fragilis sepsis.

Escherichia coli Infections↗