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Biomedical subjects

N M Gantz

Publications and source records attributed to N M Gantz.

47 records · Page 3Linked to original sources
PubMed1975

Fatal disseminated adenovirus infection in a renal transplant recipient.

A 61 year old woman died of diffuse interstitial adenovirus pneumonia 55 days after receiving a cadaveric renal allograft. The adenovirus was serologically distinct from the 33 known human adenovirus serotypes and appears to represent a new human adenovirus. Pathologic and virological findings indicate that the pneumonia was only one manifestation of a disseminated infection, the source of which may have been a latent adenovirus infection preexisting in the donor kidney. The establishment of the etiologic diagnosis in this case, which was complicated by the presence of oculocutaneous and esophageal herpes simplex virus infection as well as focal pulmonary aspergillosis, required coordinated histopathologic and virological investigation. Our findings demonstrate that severe viral infections in transplant recipients are not caused exclusively by members of the herpesvirus group.

Adenoviridae↗
PubMed1975

Listeroisis in immunosuppressed patients. A cluster of eight cases.

Bactermia due to listeria monocytogenes developed in eight patients who were receiving immunosuppresive medications during a 15 month period at one hospital. Seven survived. Meningitis was documented in only the four who received kidney transplants. Their neurologic signs were minimal, indicating a need to treat any immunosuppressed patient with Listeria bacteremia for meningitis. During this period the incidence of Listeria bactermia in immunosuppressed patients greatly exceeded that previously observed in this hospital or reported elsewhere, but the incidence of infection with other opportunistic agents was not increased. As with previously decreased listeria outbreaks in nonimmunosuppressed patients, no source or mechanism of spread could be identified. Thus, disease due to L. monocytogenes may occur focally among immunosuppressed populations, a pattern which also appears to be emerging for other opportunistic agents. A patient's exposure to different opportunistic agents may be as important as the kind of immunosuppressive therapy he recieves in determining which opportunistic infection he will acquire or even whether any infection will occur.

Adolescent↗
PubMedDate not supplied

Intravenous sulfamethoxazole-trimethoprim: pharmacokinetics, therapeutic indications, and adverse reactions.

Biogenesis of tetrahydrofolate cofactors essential for bacterial growth and survival is blocked by sulfamethoxazole-trimethoprim. An intravenous form of the antimicrobial combination has recently been approved for the treatment of acute, symptomatic, bacterial pyelonephritis, recurrent urinary tract infections, shigellosis, and Pneumocystis carinii pneumonia. Intravenous sulfamethoxazole-trimethoprim has emerged as an invaluable agent for the management of selected infections, including bacterial meningitis and Salmonella bacteremia, where limited therapeutic alternatives exist. In addition, co-administration of intravenous sulfamethoxazole-trimethoprim with a carboxypenicillin provides an empiric treatment for the infected granulocytopenic patient that compares favorably with standard combinations. Adverse events unique to the intravenous form of the drug consist of phlebitis and fluid imbalances. Fluid overload results from the relatively large volumes of 5% dextrose solution required as diluent.

Bacterial Infections↗
PubMedDate not supplied

Cost-effective antibiotic prescribing.

Antibiotics are often misused, resulting in a high frequency of adverse effects, emergence of drug-resistant organisms, and excessive costs. The high cost of antibiotics is currently receiving the greatest attention. Considerable cost savings can be achieved by appropriate prescribing of antibiotics for patients receiving these drugs prophylactically as well as for those with established infections. This article cites specific examples of how cost-effective antibiotic prescribing practices can realize substantial cost savings without any diminished quality in patient care.

Administration, Oral↗
PubMedDate not supplied

Antibiotic irrigations. A plea for controlled clinical trials.

Although the medical literature describes the perioperative use of antibiotic irrigations in abdominal, pelvic, orthopedic and vascular surgery, the lack of well-designed and executed, controlled clinical studies often precludes a definitive assessment of the value of this technique. Future randomized, double-blind, controlled clinical trials are required to establish its merit. In this age of cost consciousness, lavages with antibiotic solutions cannot at present be regarded as conventional medical therapy.

Anti-Bacterial Agents↗
PubMedDate not supplied

Salmonella prosthetic valve endocarditis.

Four cases of Salmonella prosthetic valve endocarditis have been reported previously in the English medical literature (Fraser et al. 1967; Yamamoto et al., 1974; Shanson et al., 1977; Bassa et al., 1989). This report describes a fifth case in a 62-year-old woman who developed tricuspid valve endocarditis after an episode of Salmonella gastroenteritis, and reviews prior cases of Salmonella prosthetic valve endocarditis.

Bioprosthesis↗
PubMedDate not supplied

Leishmanial infections: a consideration in travellers returning from abroad.

Seven cases of leishmaniasis, including a fatal case of visceral leishmaniasis and 6 cases of dermal leishmaniasis, were seen in Boston over a four-year period. Diagnosis was made by isolation of organisms in culture or by identification of organisms in stained preparations of tissue. Proper management of patients with leishmanial infections requires an appreciation of the geographical strain differences of each species.

Adult↗
PubMedDate not supplied

Isolation of Branhamella (Neisseria) catarrhalis from men with urethritis.

Branhamella (Neisseria) catarrhalis was recovered from urethral exudates of three men with acute urethritis. In all cases gram stain of the urethral exudates revealed intracellular gram-negative diplococci morphologically compatible with Neisseria gonorrhoeae. Branhamella (Neisseria) catarrhalis should be considered as a potential cause of acute urethritis in men with urethral discharge microscopically consistent with, but culture-negative for, N. gonorrhoeae.

Adult↗
PubMedDate not supplied

Maximizing the yield from blood cultures in suspected infective endocarditis.

The laboratory test of paramount importance in patients with suspected infective endocarditis is blood culture. This article considers the generations-old problem of the timing and frequency of these cultures, describes techniques to increase their yield, and outlines measures to take whenever special cultures fail to identify the etiologic agent.

Blood Specimen Collection↗