Fifty consecutive patients with meningococcal meningitis aged 7 to 75 years (mean, 29 years) were treated with intravenous penicillin G sodium (2 to 3 X 10(5) U/kg/d) for four days. Two of the patients (both teenagers) died of fulminant infection during the first 36 hours of therapy and one elderly woman developed aspiration pneumonia requiring penicillin therapy to be prolonged beyond four days. The remaining 47 patients recovered from the infection. On the fourth day, fever, mild meningeal signs, and moderate elevations of cerebrospinal fluid cell counts and protein contents persisted in some patients; nevertheless, all patients were cured without relapse. The results of our study suggest that meningococcal meningitis may be successfully treated with a four-day course of intravenous penicillin G.

Adolescent↗

PubMed1983

[Hypoaldosteronism].

Explore the source record for details and available documents.

Adrenocorticotropic Hormone↗

PubMed1983

Amyloidosis (AA type) associated with nodular nonsuppurative panniculitis.

A 42-year-old man had a 9-year history of idiopathic, nodular nonsuppurative panniculitis that was complicated by generalized AA-type amyloidosis. We believe that this is the first report of this association.

Adult↗

PubMedDate not supplied

Evaluation of aztreonam in the treatment of spontaneous bacterial peritonitis in patients with cirrhosis.

To determine the efficacy of aztreonam in the treatment of spontaneous bacterial peritonitis in patients with hepatic cirrhosis, 14 patients (7 males, 7 females) with 16 Gram-negative infective episodes (12 Escherichia coli and 4 Klebsiella pneumoniae) were treated with aztreonam infusions at doses of 1 gm per 8 hr for a planned 14-day period. Ages ranged from 40 to 75 years with a mean of 57 +/- 10 years. All organisms were highly susceptible to aztreonam (minimal inhibitory concentration less than or equal to 0.06 to 0.12 micrograms per ml). Serum antibiotic levels were 61.9 +/- 25.5 micrograms per ml (peak) and 27 +/- 18.5 micrograms per ml (trough). Ascitic fluid antibiotic levels were 33.6 +/- 22.5 micrograms per ml (peak) and 32.7 +/- 16.8 micrograms per ml (trough). Although the symptoms of infection were controlled within 3 days and ascitic fluid cultures became negative after 48 hr, 10 patients (62.5%) died, with hepatorenal syndrome and digestive tract hemorrhage as the principal causes of death. Three patients developed streptococcal superinfections during treatment; Streptococcus faecalis peritonitis in one case and spontaneous bacteremia due to Streptococcus equinus and Streptococcus mutans in the other two. Aztreonam was well tolerated and clinically and bacteriologically efficacious in controlling the infection. Serum and ascitic fluid levels were considerably higher than the minimal inhibitory concentration for the causative organisms, suggesting that lower doses may achieve suitable therapeutic levels. A negative aspect of the antibiotic therapy was the superinfections. The high mortality rate was attributable to the generally poor underlying condition of the patients.

Adult↗