Staphylococcal infection in chick embryos: the effect of hydrocortisone on intra-allantoic infection.
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Abnormalities, Drug-Induced↗
Biomedical subjects
M J Raff
Publications and source records attributed to M J Raff.
Anaerobic osteomyelitis of long bones.
Nine cases of anaerobic osteomyelitis of long bones are reviewed, and data are tabulated for an additional 52 cases from the literature. Three major clinical presentations of this disease entity include an acute hematogenous form usually involving previously normal bones in younger patients; a chronic infection in which the anaerobic bacteria superinfect a fracture site already compromised by osteomyelitis due to aerobic organisms, usually Staphylococcus aureus; and an indolent infection at the site of indwelling prosthetic devices. This last form appears to be initiated at the time of surgery by the introduction of normal cutaneous anaerobic flora into the wound, but disease does not become apparent until months to years later. The responsible organisms, pathophysiology, and clinical presentations of these three forms are discussed; and the therapeutic necessity to remove all devitalized tissues, reestablish vascularity, graft bony defects, and combine this with long-term antibiotic therapy, preferably bactericidal against the causative organisms, is emphasized.
Adolescent↗
Spontaneous clostridial empyema and pyopneumothorax.
Five patients developed pleural empyema due to Clostridium perfringens in the absence of penetration of the thorax; two of the patients presented with pyopneumothorax. Thirteen additional cases from the literature are reviewed. Predisposing factors to the development of pleural empyema appear to include aspiration pneumonia, pulmonary embolization and infarction, and bacteremia from other foci. Pleural disease and pulmonary tuberculosis may also predispose patients to pleural empyema. Treatment consists of drainage and antimicrobial chemotherapy.
Adult↗
Radiology in the diagnosis of splenic abscess.
Radiologic findings in 20 patients with splenic abscesses were reviewed. Chest roentgenograms frequently showed abnormalities which were nonspecific and nondiagnostic. Results of barium sulfate studies were normal in 66.7% of patients tested. Gas beneath the left side of the diaphragm or within the splenic shadow was revealed by abdominal plain film or barium sulfate study in three patients. Focal splenic abnormalities were present in 50% of the patients who underwent 99mTc sulfur colloid scans; in 71.4% of patients who underwent 67Ga scans, increased uptake of isotope was seen in the left upper quadrant of the abdomen. In only one of six patients who underwent both 99mTc and 67Ga scans did results show corresponding abnormalities. Pathologic findings in the left upper quadrant of the abdomen were detected by ultrasonography in three of five patients. Angiography confirmed splenic abscess in one patient. Abnormal splenic lucencies were seen on computed tomography in four patients, although one repeat scan was interpreted as normal. Although no one technique consistently detected splenic abscesses and data from several studies are combined, computed tomography appears the best modality. The diagnosis of splenic abscess and the decision for surgical intervention should be based on clinical impressions, even in the absence of unequivocal radiologic findings.
Abscess↗
Endogenous aspergillus endophthalmitis.
A 27-year-old man with a history of intravenous-narcotic abuse presented with signs and symptoms suggesting fungal endophthalmitis. He underwent core vitrectomy with intravitreal injection of amphotericin B. Aspergillus flavus grew from cultures of the vitreous aspirate. There was no evidence of extraocular infection, and the patient was treated postoperatively with subconjunctival amphotericin B and oral flucytosine. Unlike previously reported cases of endogenous aspergillus endophthalmitis in drug abusers, the patient described here recovered normal visual acuity.
Adult↗
Metronidazole treatment of Bacteroides fragilis infections.
Seven patients with Bacteroides fragilis infections were treated with intravenous and/or oral metronidazole. Infections treated included endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia, and pelvic infection. Some patients had failed to respond to therapy with chloramphenicol or clindamycin or both. Metronidazole was used alone or in combination with aminoglycosides. Serum levels of metronidazole several times in excess of the minimal inhibitory concentrations for the organisms were easily achieved and in one patient the CSF metronidazole level was equal to that of the serum. Response to therapy with metronidazole was considered to be excellent. The only serious side effect noted was hypotension, which occurred in the last patient. Therapy was discontinued, and therefore therapeutic results could not be evaluated. Metronidazole appears to be a safe and effective agent in the treatment of B fragilis infections.
Adult↗
Clostridium perfringens septic arthritis. Report of a case and review of the literature.
This is a report of Clostridium perfringens septic arthritis in a 5-year-old boy and a review of the literature on 6 previously reported cases. The treatment is the same as for other organisms producing septic arthritis.
Anti-Bacterial Agents↗