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Biomedical subjects

S L Berk

Publications and source records attributed to S L Berk.

106 records · Page 6Linked to original sources
PubMed1981

Meningitis caused by Acinetobacter calcoaceticus var anitratus. A specific hazard in neurosurgical patients.

Acinetobacter calcoaceticus var anitratus caused meningitis in five patients between 1968 and 1978 at two hospitals affiliated with Boston University School of Medicine. All patients had had head trauma or neurosurgical procedures prior to the development of meningitis. The course of the disease was relatively indolent in that fulminant disease did not occur even when initial therapy was inappropriate and bacteria persisted in CSF. All five patients survived. On Gram's stain of CSF, A calcoaceticus may be confused with meningococci, pneumococci, or Haemophilus influenzae and thus cause delay in appropriate diagnosis and therapy.

Acinetobacter Infections↗
PubMed1981

Pneumococcal pericarditis: a persisting problem in contemporary diagnosis.

We reviewed the clinical and laboratory features of six patients with pericarditis caused by Streptococcus pneumoniae who were admitted to Boston City Hospital. The diagnosis of pneumococcal pericarditis was delayed or missed entirely during life in all patients. The frequent absence of pericardial friction rubs and cardimegaly on chest roentgenograms contributed to the difficulty in recognizing this illness. Electrocardiograms and physical examinations of the heart almost always disclosed abnormalities, but they were not sufficiently specific to suggest pericarditis, and patients were often thought to have had an acute complication of arteriosclerotic heart disease. Review of the English literature since 1945 supports the recent experience in our hospital that the diagnosis of pneumococcal pericarditis may be elusive.

Adult↗
PubMed1981

Mixed Streptococcus pneumoniae and gram-negative bacillary pneumonia in the elderly.

Of 24 elderly patients with Streptococcus pneumoniae pneumonia confirmed by transtracheal aspiration, six had concomitant infection with gram-negative aerobic bacilli. All six patients were elderly men with underlying cardiopulmonary disease. Three had had recent prior episodes of gram-negative pneumonia and four had previously received antibiotics. The clinical, laboratory, and epidemiologic characteristics of these six patients with mixed bacterial pneumonia are reported.

Aged↗
PubMed1981

Nosocomial pneumococcal pneumonia in the elderly.

Among 35 elderly patients with transtracheal aspirate (TTA)-documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic obstructive pulmonary disease were the most common predisposing illnesses. Four of the 9 patients had previously received antibiotic therapy. Gram-negative aerobic pneumonia was found before (2 cases), concomitant with (3 cases), and after (2 cases) the pneumococcal infection in these patients.

Aged↗
PubMed1981

Transtracheal aspiration in the severely ill elderly patient with bacterial pneumonia.

Transtracheal aspiration was performed in 32 elderly hypoxic patients with bacterial pneumonia. No morbidity or mortality was associated with the procedure. Gram stains of the transtracheal aspirate provided rapid, accurate delineation of the etiologic pneumonic agent, and were particularly valuable in indicating mixed bacterial infections. These included 5 cases of Streptococcus pneumoniae plus Gram-negative bacillary pneumonia. The safety and value of transtracheal aspiration in the severely ill elderly patient are discussed.

Humans↗
PubMed1980

An outbreak of type 1 pneumococcal pneumonia in a men's shelter.

A striking increase in blood culture isolates of Streptococcus pneumonia capsular type 1 was noted at Boston City Hospital in early 1978. The increased incidence of type 1 pneumococcal bacteremia was due, at least in part, to an outbreak of disease among alcoholic, male clients of Boston's largest shelter. Residents of the shelter also were found to have a high rate of nose and throat carriage of type 1 pneumococci. This outbreak of bacteremic pneumococcal pneumonia is compared with endemic disease caused by other serotypes observed at Boston City Hospital during the same period and with previous studies of epidemic pneumococcal disease. Routine serotyping of pneumococcal isolates is important, especially in light of the emergence of pneumococci resistant to multiple antibiotics and of the renewed use of polysaccharide vaccines.

Alcoholism↗
PubMed1980

Meningitis caused by gram-negative bacilli.

Thirty adults with meningitis caused by gram-negative bacilli were observed from 1968 to 1978 at four hospitals associated with Boston University School of Medicine. Equal numbers of two distinct types of gram-negative bacillary meningitis--spontaneously occurring meningitis and meningitis after neurosurgery--were found. Spontaneously occurring meningitis appeared to be caused most often by Escherichia coli and Haemophilus influenzae. Meningitis occurring after neurosurgical procedures was more insidious in onset, more protracted in course, and more often caused by organisms resistant to multilple antibiotics. Approaches to therapy are based on the differences in character of these two types of meningitis.

Adult↗
PubMed1978

Pneumococcal bacteremia diagnosed by peripheral blood smear in multiple myeloma.

A patient with multiple myeloma and a normal spleen died with high-grade pneumococcal bacteremia diagnosed by routine examination of a Wright-stained peripheral blood smear. In earlier reports, this finding has been described only in patients with abnormal or absent spleens. We review the proposed mechanisms of high-grade pneumococcal bacteremia in these patients and the immunologic abnormalities in patients with multiple myeloma that may result in increased susceptibility to this infection.

Female↗
PubMed1975

The effects of chronic alcohol ingestion in mice on contractile properties of cardiac and skeletal muscle: a comparison with normal and dehydrated-malnourished controls.

In vitro isometric contractile tension was measured in heart and skeletal muscle in 3 groups of mice: 1. a control group, 2. a group maintained for 27 weeks on 20% alcohol, and 3. a group whose fluid intake was restricted to the extent equaling that which occurred in the alcohol treated animals. Results showed a reduction in cardiac twitch tension in both the alcohol and fluid restricted group, as compared to normal controls. We therefore consider that dehydration per se may play an important role in the etiology of alcoholic cardiomyopathy.

Alcoholism↗
PubMedDate not supplied

Review of recent pneumococcal infections with attention to vaccine and nonvaccine serotypes.

Conflicting data on the efficacy of the pneumococcal vaccine have continued to evolve. One important aspect of vaccine efficacy is related to the percentage of disease-causing serotypes contained in the vaccines. If disease-causing serotypes were to vary from place to place and population to population, vaccine efficacy would be variable and difficult to assess. We reviewed the literature on serotypic distribution of pneumococcal infection. Percentage of disease-causing serotypes covered by the 14-valent vaccine varied significantly from one study to another. Differences in age, hospital type, and source of isolation showed statistically significant serotypic distribution.

Bacterial Vaccines↗
PubMedDate not supplied

Branhamella catarrhalis respiratory infections.

Branhamella catarrhalis, a normal commensal of the oropharynx, is increasingly recognized as an important cause of bronchitis and bacterial pneumonia. Six patients with B. catarrhalis pneumonia documented by transtracheal aspirate or blood culture were studied, and 429 previously reported cases of B. catarrhalis bronchitis and pneumonia were reviewed. The mean age of patients with B. catarrhalis infection was 64.8 years, and preexisting chronic obstructive pulmonary disease was common. The typical clinical picture was that of purulent tracheobronchitis; patients with pneumonia were not severely ill and differed from those with bronchitis mainly by the presence of patchy lower-lobe infiltrates on chest roentgenogram. Fifty-three percent of reported strains produced beta-lactamase. Thirty-nine percent of the cultures were mixed, predominantly with Haemophilus influenzae and Streptococcus pneumoniae. The microbiologic, immunologic, and clinical features of B. catarrhalis infection, as well as the antimicrobial susceptibilities of this organism, were reviewed. The reasons for the lack of recognition of this common pathogen and possible solutions were considered.

Antibodies, Bacterial↗
PubMedDate not supplied

Endocarditis caused by Streptococcus morbillorum.

Although patients with nutritionally variant streptococcal endocarditis have been reported in recent years, the specific clinical features of this disease have not been well characterized. We report here the clinical and laboratory features of a particularly unusual case of persistent bacteremia caused by Streptococcus morbillorum , one of the nutritionally variant streptococci. The patient was successfully treated with a combination of penicillin and rifampin after two treatment failures. We also review cases of nutritionally variant streptococcal endocarditis published in the English literature since 1971, in an attempt to understand some difficulties encountered in diagnosing and treating this type of endocarditis.

Drug Therapy, Combination↗
PubMedDate not supplied

Epiglottic abscess due to group B Streptococcus. Communication.

A group B Streptococcus caused epiglottitis with abscess formation in an adult with diabetes mellitus. Group B streptococci are being more commonly isolated from adults, and epiglottitis is another infection in which this organism has been implicated.

Abscess↗