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M R Hammerschlag

Publications and source records attributed to M R Hammerschlag.

138 records · Page 8Linked to original sources
PubMedDate not supplied

Epidemiology of sexually transmitted diseases in rape victims.

Rape is a violent crime that is increasing rapidly in incidence. Victims can include male and female adults and children. These victims may be at risk for the acquisition of many sexually transmitted conditions. The risk will vary with the sex and socioeconomic status of the assailant as well as with the nature of the sexual contact. Infections with Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus, human papillomavirus, and Treponema pallidum have all been found to occur following sexual assault of female adults or children. Although data are lacking, male victims of homosexual rape are presumably at risk for the acquisition of the above infections as well as hepatitis B, the acquired immunodeficiency syndrome, and other infections prevalent among homosexual men. All victims of sexual assault should undergo a comprehensive physical examination with a complete history. Baseline and follow-up laboratory tests should be performed. In some instances, prophylactic administration of antimicrobial agents may be warranted.

Female↗
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Activity of trimethoprim-sulfamethoxazole against Chlamydia trachomatis in vitro.

With use of a technique for cell culture, the minimal inhibitory concentration (MICs) of trimethoprim (TMP) and sulfamethoxazole (SMZ), alone and in combination at ratios of 1:1, 1:5, and 1:20, were determined against five strains of Chlamydia trachomatis. The drugs were added to idoxuridine-treated McCoy cells after inoculation of the cells with the pathogen. Cultures were examined after incubation for 48 hr; the MIC was defined as the highest concentration of drugs at which no inclusions were seen. Definite end points were observed only with inocula of less than or equal to 10(3) inclusion-forming units (IFU)/ml. With larger inocula, inclusions were present for all dilutions tested. The MICs for TMP alone were greater than or equal to 64 micrograms/ml for all strains. The MICs for SMZ alone ranged from 2 to 128 micrograms/ml. There appeared to be no better than an additive effect for all combinations of TMP and SMZ tested, although the effect of 1:20 was greater than that at 1:1 or 1:5. With increasing concentrations of both drugs, the inclusions became progressively fewer, smaller, and pyknotic. Even though definite end points could not be determined, there was a significant reduction in the number of IFU/ml at relatively low concentrations of both TMP and SMZ. The results of this study suggest that the activity of TMP-SMZ against C. trachomatis is primarily that of SMZ alone.

Chlamydia trachomatis↗
PubMedDate not supplied

Are rectogenital chlamydial infections a marker of sexual abuse in children?

In order to examine the occurrence of chlamydial infection in sexually abused children, we cultured 51 abused children and 43 controls, 2 to 14.5 years of age. Only seven of the children were male. Chlamydia trachomatis was isolated from the vagina or rectum of two abused girls, 10 and 12 years of age, at their follow-up examination several weeks after the suspected abuse. C. trachomatis was also isolated from the vaginal culture of two controls and from the throat and rectum of another girl enrolled as a control. The two control children with vaginal infection were sisters, 7 and 10 years of age, who had been abused by their step-father 3 years previously. An antichlamydial immunoglobulin greater than or equal to 1:32 or a fourfold rise in the titer of immunoglobulin G was found in 13 of 49 (27%) abused children and 2 of 40 (5%) controls. This difference was statistically significant. The isolation of C. trachomatis from a rectogenital site was not limited to children with recent sexual abuse in this population. Serology may also be of limited use since serologic evidence of recent chlamydial infection was present in 5% of controls.

Adolescent↗
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Safety and efficacy of once daily ceftriaxone for the treatment of bacterial meningitis.

Fifty-seven patients with bacterial meningitis were treated with once daily ceftriaxone. After an initial loading dose of 100 mg/kg, the patients received 80 mg/kg as a single daily dose. Etiologic agents included: Haemophilus influenzae type b, 37 (11 beta-lactamase-positive); Neisseria meningitidis, 11; Streptococcus pneumoniae, 6; Streptococcus pyogenes, 1; Haemophilus influenzae type f, 1; and Group B Streptococcus, 1. All patients showed clinical improvement and all were bacteriologically cured. Satisfactory cerebrospinal fluid bactericidal activity and drug concentrations were seen 24 hours after a dose even in those patients in whom repeat spinal taps were carried out following the last dose of therapy. The drug was well-tolerated and the major adverse effect seen was diarrhea in 20.4% of the patients. The diarrhea was mild and self-limited and did not necessitate discontinuation of the drug although it was frequently associated with alterations in the stool microbiologic flora. Based on this preliminary experience, ceftriaxone, when given in a single daily dose, appears safe and effective in the treatment of bacterial meningitis in nonneonatal infants and children.

Bacterial Infections↗
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Colonization of sexually abused children with genital mycoplasmas.

Although sexually abused children are usually evaluated only for the presence of infections with Neisseria gonorrhoeae and Treponema pallidum, they are also at risk for acquiring other sexually transmitted organisms prevalent in the adult population. Accordingly, we examined pharyngeal, anorectal and genital specimens from 50 children who had been sexually abused and from 40 healthy children who served as controls; these specimens were cultured for Mycoplasma hominis and Ureaplasma urealyticum. M. hominis was isolated from the anorectal and vaginal cultures of 11 (23%) and 16 (34%), respectively, of 47 abused girls as compared with three (8%) and six (17%), respectively, of 36 controls. U. urealyticum was isolated from the anorectal and vaginal cultures of nine (19%) and 14 (30%), respectively, of the abused girls as compared with one (3%) and three (8%), respectively, of 36 controls. Colonization with genital mycoplasmas was not associated with any symptoms.

Adolescent↗
PubMedDate not supplied

Lymphogranuloma venereum in a pregnant woman.

Lymphogranuloma venereum was diagnosed postpartum in a young black woman, who was a drug abuser. Chlamydia trachomatis was isolated from aspirate of a left inguinal mass, and the patient was also seropositive for human immunodeficiency virus. During hospitalization she was treated with ampicillin, gentamicin, and doxycycline. Her twin infant girls had no evidence of C. trachomatis infection. The mother was discharged from the hospital after partial resolution of the left inguinal mass and was lost to follow-up.

AIDS Serodiagnosis↗
PubMedDate not supplied

Diagnosis of chlamydial infection in the pediatric population.

The genus Chlamydia now contains 4 species, 2 of which, Chlamydia trachomatis and C. pneumoniae are important human pathogens. Both organisms cause infections in children and adults, but infection in children pose a unique set of problems. As C. trachomatis is primarily a sexually transmitted disease, the presence of rectal or genital infection in a prepubertal child has been used as evidence of sexual abuse. Although there are several categories of non-culture tests that have bear approved for genital sites in adults, these tests are not approved for these sites in children. Of these tests in rectal and vaginal specimens in children have been associated with a high rate of false positives. C. pneumoniae is emerging as a frequent cause of community acquired pneumonia in adults and children. Because culture is not generally available, serologic diagnosis is used more frequently. However, currently available serologic methods appear to be insensitive in children. The availability of a commercial PCR test will greatly facilitate the diagnosis of C. pneumoniae infections in children.

Bacterial Typing Techniques↗