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N J Raymond

Publications and source records attributed to N J Raymond.

7 recordsLinked to original sources
PubMed1998

Spinal epidural abscess.

AIMS: To review the clinical presentation and outcome of patients with spinal epidural abscess. METHODS: Following an index case, additional cases were identified during 1991-6. RESULTS: There were a total of seven patients with spinal epidural abscess and an average age of 52 years (range 24-75 years). The abscess locations were cervical (3), thoracic (3) or thoracolumbar (1), and extended on average 4.3 vertebral bodies (range 2-9). Staphylococcus aureus was the aetiologic agent in all of the six microbiologically confirmed cases. Three abscesses arose from adjacent vertebral osteomyelitis, one followed epidural anaesthesia and two arose by haematogenous spread. New spinal or radicular pain were the most frequent early symptoms, later, nerve root weakness or a sensory level. An ESR > 30 mm/hour was consistently present but fever and leukocytosis were absent in some patients. MRI (five cases) and myelography (one case) were diagnostic. Five patients underwent laminectomy and abscess drainage; in three, limb weakness improved markedly post operatively. Three of the four patients with paralysis died, two despite laminectomy. CONCLUSIONS: New spinal pain, radicular symptoms or signs, and a raised ESR were the most consistent early abnormalities in patients with a spinal epidural abscess. Diagnosis at an early clinical stage was associated with a better outcome.

Abscess↗
PubMed1997

Molecular epidemiology of sporadic (endemic) serogroup C meningococcal disease.

Understanding the basis of sporadic (endemic) meningococcal disease may be critical to prevention of meningococcal epidemic outbreaks and to understanding fluctuations in incidence. Active, prospective, population-based surveillance and molecular epidemiologic techniques were used to study sporadic serogroup C meningococcal disease in a population of 2.34 million persons (Atlanta area). During 1988-1994, in which no outbreaks or case clusters were reported, 71 patients developed sporadic serogroup C meningococcal disease (annual incidence, 0.51/100,000). Eighty-three percent of patients were >2 years old. By multilocus enzyme electrophoresis, pulsed-field gel electrophoresis, and serotyping, 84% (52/62) of the isolates available for study were identical or closely related members of the electrophoretic type 37 (ET 37) complex responsible for multiple serogroup C outbreaks in the United States in the 1990s. Sporadic disease caused by 9 clonal strains occurred over periods up to 4 years and accounted for 45% (28/62) of cases. Sporadic serogroup C meningococcal disease was most often due to a limited number of related strains that appear to slowly circulate in the population.

Adolescent↗
PubMed1995

Enterococcal arthritis: case report and review.

We report a case of septic arthritis due to Enterococcus species and review 18 additional cases reported in the literature from 1966 through 1993 for which clinical or treatment data were available. In 11 of the 19 cases, prosthetic joints were affected (9 knees, 2 hips) and in 8 cases, native joints were affected. Of those patients with prosthetic joint infections, 6 had preexisting osteoarthritis and 3 had rheumatoid arthritis; only one patient with native joint infection had a recognized (although unspecified), preexisting joint abnormality. Pain, fever (temperature, > 37 degrees C), and tenderness were the most common clinical findings in patients with native joint infections. The microbiological diagnosis was made by culture of synovial fluid or synovial tissue (16 of 19), blood (1 of 19), or an unstated specimen (2 of 19). Polymicrobial infection was present in 6 (32%) of 19 patients. Of fourteen patients treated with either a parenteral penicillin (11 of 19) or a glycopeptide (3 of 19), 11 made an uncomplicated recovery. An aminoglycoside was also used to treat 7 of these 14 patients (4 of these 7 had prosthetic joints). All 11 prosthetic joint infections were ultimately clinically cured; for most of these patients, the original prosthesis was removed. For two patients with native joint infections, amputation of the infected limb was necessary to cure the infection.

Adult↗
PubMed1995

The in-vitro activity of biapanem against 964 clinical isolates of aerobic bacteria.

The in-vitro susceptibilities of 964 clinical isolates of aerobic bacteria to biapenem (a novel carbapenem), imipenem, ceftazidime and ciprofloxacin were determined by an agar dilution method. Compared with imipenem, biapenem exhibited greater activity against aerobic Gram-negative bacilli, similar activity against Neisseria meningitidis, Neisseria gonorrhoeae and Haemophilus influenzae and less activity against Gram-positive cocci.

Bacteria, Aerobic↗