Neurological complication of Mycoplasma pneumoniae infection.
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Adult↗
Biomedical subjects
M E Ellis
Publications and source records attributed to M E Ellis.
An open study of interferon in HIV-antibody-positive men.
Alpha-2a-recombinant interferon (Roferon A) was given subcutaneously in a dose of 3 mega units twice weekly for 15-18 months to 14 HIV-antibody-positive, p24-antigen-negative men with minimal HIV-related disease. Interferon was well-tolerated and safe. Although there was either improvement or lack of deterioration initially in 22 out of 26 HIV disease markers, including lymphadenopathy, thrombocytopenic purpura and nail fungal infection, there were 11 instances of HIV disease indicators appearing during the study. At 15 months, six patients were withdrawn from the study because of clinical and immunological deterioration.
Adult↗
Syphilitic retinitis in a homosexual man with concurrent HIV infection: case report.
A case is reported of secondary syphilis with ocular signs in a patient who had antibodies to human immunodeficiency virus (HIV) and hepatitis B infections and from whose urine cytomegalovirus was cultivated. Treatment with penicillin resulted in rapid recovery from his retinitis and uveitis. The case highlights the importance of testing for syphilis in all patients with HIV infection.
Acquired Immunodeficiency Syndrome↗
Infective respiratory exacerbations in young adults with cystic fibrosis: role of viruses and atypical microorganisms.
Thirty six adults with cystic fibrosis were studied over one year to determine the incidence of infection with respiratory viruses and atypical organisms. Nineteen patients entered the study during an acute exacerbation of respiratory symptoms with an increase in purulent sputum production, cough, or breathlessness accompanied by a fall in FEV1 (group 1); 17 patients entered when they were stable both clinically and in terms of lung function values (group 2). Group 1 patients had a mean of 2.6 (range 1-4) infective exacerbations during the year and group 2 patients a mean of 1.1 (0-2) exacerbations. Eleven patients developed serological evidence of viral (influenza virus A and B, cytomegalovirus, human rhinovirus 2, adenovirus) or Mycoplasma pneumoniae infection. There was no difference in seroconversion rates between group 1 (five patients) and group 2 (six patients). There was a weak association between viral seroconversion and the isolation of Pseudomonas aeruginosa from sputum, though this was not significant.
Adolescent↗
Acute schistosomiasis (Katayama fever): corticosteroid as adjunct therapy.
A 19-year-old male university student of West Indian origin presented with fever, rigor, watery diarrhoea and noted intermittent generalised giant urticarial wheals of 2 weeks' duration. He swam in Lake Victoria, Uganda, 6 weeks previously and developed a swimmers' itch. Ova of Schistosoma mansoni was demonstrated by the formol-ether concentration method of the faeces. An initial single dose (40 mg/kg) of praziquantel with prednisolone 40 mg once daily for 5 days was given with no clinical deterioration of his condition. It is therefore safe and beneficial to give corticosteroid with chemotherapy in acute schistosomiasis (Katayama fever).
Adjuvants, Pharmaceutic↗
Whither the specialist in infection?
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Infections↗
Does isolation of patients with infections induce mental illness?
Forty-one patients admitted into single-bedded isolation cubicles in an infectious diseases unit were assessed for evidence of mental disturbance. By use of the Crown-Crisp Experimental Index as a measure of mental state, the scores for somatic anxiety, free floating anxiety, and the total score were found to be significantly raised on admission, falling towards those found in a control general practice population by the time of discharge from hospital. Higher scores were associated with a past history of mental illness. There was, however, no statistical correlation between the psychological indices and consumption of alcohol, smoking, or patient's sex. Clinically apparent behavioural disturbance, mainly anxiety and agitation, was seen in 12 patients. Overall, patients expressed a preference for single rooms and did not find the isolation rituals disconcerting. The findings indicate that anxiety in patients with acute infections is more related to their illness and referral to hospital than to their imposed isolation. Only those patients with a past psychiatric history are likely to benefit from transfer to an open ward during convalescence.
Adaptation, Psychological↗
A double-masked, placebo-controlled trial of acyclovir cream in immunocompetent patients with herpes zoster.
Sixty-four patients with herpes zoster were entered into a randomised double-masked, placebo-controlled trial of 5% acyclovir cream applied five times daily for 5 days. Of these patients, 56 were included in the final analysis (26 acyclovir, 30 placebo). Significant and objective differences in either progression of the rash, severity of acute pain or incidence of post-herpetic neuralgia were not observed. Although significantly more rashes involuted in the acyclovir group, this isolated finding cannot be explained. Twenty-two patients (12 acyclovir, 10 placebo) experienced erythema or desquamation or both during treatment with the cream. The similar incidence of skin reactions in both groups suggests that they were related to the cream base rather than the acyclovir.
Acyclovir↗
Porphyria cutanea tarda in association with the human immunodeficiency virus infection.
A 42 year old heterosexual male with symptomatic human immunodeficiency virus infection presented with a 2-week history of tense blistering skin lesions following azidothymidine therapy. Urinary porphyrin excretion confirmed the diagnosis of porphyria cutanea tarda. The blisters resolved following the withdrawal of the drug but recurred when rechallenged. Three other cases of porphyria cutanea tarda, not associated with azidothymidine, who subsequently developed acquired immunodeficiency syndrome have recently been described. If azidothymidine is not the precipitating agent, it is possible that human immunodeficiency virus itself can impair porphyrin metabolism, leading to the clinical and biochemical features of porphyria cutanea tarda.
Acquired Immunodeficiency Syndrome↗
Alfa-2a recombinant interferon in HIV associated thrombocytopenia.
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Acquired Immunodeficiency Syndrome↗
Is smoking a risk factor for pneumonia in adults with chickenpox?
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Adult↗
Treatment of cytomegalovirus pneumonitis with foscarnet (trisodium phosphonoformate) in patients with AIDS.
Foscarnet was administered to eight AIDS patients for suspected cytomegalovirus (CMV) pneumonitis as a continuous intravenous infusion for a minimum of 8 days. All the patients improved, three showing complete resolution of symptoms. Evidence of CMV infection from bronchoalveolar lavage samples was lacking in two patients. Adverse drug experiences consisted of thrombophlebitis, transient decreases in haemoglobin concentration, and reversible rises in serum creatinine levels.
Acquired Immunodeficiency Syndrome↗
Neutropenia associated with dual antimalarial chemoprophylaxis--use of bone-marrow culture as an aid in further drug management.
Bone-marrow culture in soft agar was used to determine the cause of neutropenia in a visitor to Tanzania who had been taking both amodiaquine and proguanil for antimalarial prophylaxis. Desethyl-amodiaquine, a major metabolite of amodiaquine (but not amodiaquine itself, proguanil, cycloguanil or chloroquine) was implicated. Supplementary studies using amodiaquine binding techniques supported the notion that the parent compound, amodiaquine, was not the cause of the neutropenia. The bone-marrow culture technique proved useful in deciding further anti-malarial prophylaxis and in formulating the choice of curative antimalarial therapy, should this have proved necessary. The procedure may help in the managing other such patients with presumed drug-induced blood dyscrasias when the choice of appropriate and effective antimalarial drugs is limited.
Adult↗
Vivax malaria acquired in Trinidad, a malaria free area.
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Adult↗
Adrenal function in tuberculosis.
In a study of 41 African Zulus with acute pulmonary tuberculosis, 55% were found to have a suboptimal cortisol response to Synacthen and all had very low plasma dehydroepiandrosterone levels. Following a 2-week course of antituberculous chemotherapy there was an improvement in adrenal corticosteroid function with a reduction to 30% of those showing an impaired cortisol response to Synacthen, but adrenal androgen function did not improve in any. Patients who received rifampicin as part of their treatment appeared to show less improvement in adrenal corticosteroid function when compared to a group who received antituberculous treatment which did not include rifampicin.
Acute Disease↗
Infection of cardiac mural thrombus associated with left ventricular aneurysm.
Infection is a rare complication of cardiac mural thrombus and may prove difficult to diagnose and treat. We describe a patient with infected thrombus associated with a left ventricular aneurysm, involving Salmonella typhimurium. Cross-sectional echocardiography proved helpful in establishing the diagnosis.
Echocardiography↗