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PubMedDate not supplied

[Secondary pericarditis after myocardial infarction (author's transl)].

Our study concerns 480 observations about myocardial infarctions. In 10% of the cases, we have found a premature pericarditis diagnosed on the pericardic friction, electric and biologic signes. Some complications such as rythmical troubles, left ventricular dificiency, parietal anevrism are more frequent and increase the prognosis. In 1,2% of the cases, we find a post-infarction syndrom of Dressler, the prognosis of which is mild. The diagnosis is founded on the revival of the thoracic pain, the fever, the pericarditis and an inflammatory syndrom. The corticothérapy is efficient but seems to favour relapses.

Adult↗
PubMed1986

An unusual central nervous system infection in a young immunocompromised host.

A 13-year-old girl with a ten-year history of lymphoblastic leukemia and several central nervous system (CNS) relapses developed a bone marrow relapse and accelerated CNS leukemia. Following treatment with CNS radiation and intravenous chemotherapy, she developed fever, pancytopenia, headache, and vomiting. Her neurological function deteriorated and she died on the 20th hospital day. Multiple CSF examinations failed to disclose either leukemic cells or organisms. Blood cultures obtained from a Broviac catheter yielded Micrococcus species. Postmortem examination showed meningoependymitis with intracellular coccal organisms. The pathology of this infection resembles intracranial Whipple's disease. Intracranial intracellular bacterial infection should be excluded in the infectious complications in the immunocompromised host.

Adolescent↗
PubMed1985

Acute febrile neutrophilic dermatosis (Sweet's syndrome). Successful treatment with short term corticosteroids.

Acute febrile neutrophilic dermatosis is a disease of unknown etiology characterized by fever, tender skin lesions, and arthritis. Histopathologic examination shows a perivasculitis of the skin with lack of inflammation of vessels. It occurs in a female: male ratio of 4:1 with middle age females affected most frequently. We report a 17-year-old male with acute febrile neutrophilic dermatosis in whom the relationship between the arthritis, skin eruptions, white blood cell count and erythrocyte sedimentation rate are presented. The young man was treated with prednisone for only 5 days with complete resolution of the signs and symptoms and without relapse for 11 months.

Acute Disease↗
PubMed1984

[Role of azlocillin in the treatment of Pseudomonas aeruginosa otitis in children].

From May, 1978 to October, 1983, 88 children with otitis due to Pseudomonas aeruginosa were seen at Paediatric Unit E.N.T. consultation of the University Hospital of Tours. Epidemiologically, it is worth mentioning that the majority of these infections was not of nosocomial origin: 56 children were infected outside the hospital and 26 during their stay in hospital; 3 neonates were referred directly from the Maternity Unit. Most strains of Ps. aeruginosa, with various serotypes, were sensitive to azlocillin. Twenty-four children received a systemic treatment required by their local or general condition. Azlocillin was used in 24 cases on the basis of positive sensitivity tests and was occasionally combined with topical treatment using antiseptics or the antibiotic itself. Or the 3 failures observed, 2 were due to acquired resistance to azlocillin and 1 to chronic otitis. An incomplete result was obtained in a case of otitis externa caused by a strain of intermediate sensitivity. The remaining 19 cases were cured, including 3 neonates with otitis externa or media, 1 child with otitis externa, 1 with combined otitis externa and media, 10 with otitis media, usually protracted, 2 with mastoiditis medically cured and 1 with superinfection following mastoidectomy for cholesteatoma. Secretions dried up within 3 to 4 days and treatment was discontinued after clinical cure was obtained in 9 to 19 days. Fever, which was present in 7 cases, abated within 2 to 8 days. The only relapse that occurred, one month after treatment of an otitis media, responded to a second course of azlocillin.

Adolescent↗
PubMed1993

[Halofantrine in the treatment of imported malaria in nonimmune travelers].

The efficacy (criteria: cure rate, time to resolution of fever or absence of parasites) and safety (criteria: clinical side effects, altered laboratory parameters) of halofantrin were investigated in a multi-centre study of 96 non-immune patients (71 men, 25 women, mean age 34.3 [21-62] years) with malaria imported from regions of high resistance into Germany or Switzerland. The initial 63 patients received one-day treatment (three doses of 500 mg halofantrin), while the last 33 patients received an additional course of treatment one week later. Treatment was curative in all patients in the second group, but relapses occurred in five of the 41 patients (12.2%) with falciparum malaria who received one-day therapy. Fever resolved after a mean of 45 hours and parasites were absent after a mean of 66 hours. There were small increases in transaminase values (most probably because of the infection) in five patients, but all became normal again within a few days. Halofantrin is a safe drug and is suitable for both therapy and stand-by therapy of resistant Plasmodium infections. Treatment should be repeated after 7 days.

Adolescent↗
PubMed1995

Mini-BEAM as salvage therapy for relapsed or refractory Hodgkin's disease before intensive therapy and autologous bone marrow transplantation.

PURPOSE: To evaluate the efficacy of carmustine (BCNU), etoposide, cytarabine (Ara-C), and melphalan (mini-BEAM) as salvage therapy in patients with relapsed or refractory Hodgkin's disease who were potentially eligible to undergo intensive therapy and autologous bone marrow transplantation (ABMT). PATIENTS AND METHODS: Forty-four patients with refractory or relapsed Hodgkin's disease after front-line combination chemotherapy referred for consideration of ABMT were treated with mini-BEAM (BCNU 60 mg/m2 on day 1, etoposide 75 mg/m2 on days 2 to 5, Ara-C 100 mg/m2 twice per day on days 2 to 5, and melphalan 30 mg/m2 on day 6) to maximum response. Eleven patients were refractory to primary chemotherapy. Twenty-three patients were treated in first relapse and 10 in second or subsequent relapse; 21 received mini-BEAM as their first salvage regimen. Patients were restaged to determine disease status immediately before intensive therapy and transplant. RESULTS: The overall response rate was 84% (exact 95% confidence interval [CI], 70% to 92%), with a complete response (CR) rate of 32% (95% CI, 20% to 47%) and a partial response (PR) rate of 52%. No treatment-related deaths were observed. Myelosuppression was the major toxicity. Almost all patients required platelet transfusions. Eighty-four percent were given RBC transfusions, and 54% required intravenous antibiotics for fever while neutropenic. CONCLUSION: Mini-BEAM is a safe and effective regimen for treatment of refractory or relapsed Hodgkin's disease. Further studies are required to determine if responding patients have improved disease-free survival (DFS) after intensive therapy and ABMT.

Adolescent↗
PubMed1995

Treatment of typhoid fever: randomized trial of a three-day course of ceftriaxone versus a fourteen-day course of chloramphenicol.

To compare the efficacy of a short course of ceftriaxone with a standard course of chloramphenicol for typhoid fever, a randomized trial was conducted in 46 patients (30 adults and 16 children) who were blood culture-positive for Salmonella typhi or S. paratyphi. Ceftriaxone was given intravenously once a day for three days to 15 adults at a dose of 2 g/day and to eight children at a dose of 50 mg/kg/day. Chloramphenicol was given orally four times a day to an equal number of patients at a dose of 60 mg/kg/day until defervescence, followed by 40 mg/kg/day for a total of 14 days. Clinical cure without complications or relapse occurred in 19 patients (83%) treated with ceftriaxone and in 20 patients (87%) treated with chloramphenicol (P > 0.05). Four patients with clinical failures in the ceftriaxone group included two with fever lasting six days or more, one with altered sensorium, and one with relapse; three patients treated with chloramphenicol developed leukopenia and thrombocytopenia and were switched to amoxicillin therapy. Bacteriologically, blood cultures of all 46 patients were sterile three days after the start of treatment, and remained so through day 15 of follow-up. These results extend previous observations on the efficacy of ceftriaxone in short courses for both adults and children with typhoid fever.

Administration, Oral↗
PubMed2002

A relapsed non-Hodgkin lymphoma presenting as panhypopituitarism successfully treated by chemotherapy.

We report a case of relapsed large B-cell non-Hodgkin lymphoma (NHL) affecting the anterior pituitary. The NHL relapsed after three years in complete remission. The patient was a 72-year-old woman who presented fever, weakness, hyponatremia, and hypotension. The levels of thyroid-stimulating hormone and gonadotropins were very low and magnetic resonance imaging showed infiltration of the pituitary gland and stalk. After controlling the hormonal deficiencies with substitution using hydroxycortisone and levothyroxin, the patient was treated with combination chemotherapy using cyclophosphamide, vincristine, mitoxantrone, etoposide, and bleomycin (VNCOP-B regimen), achieving a complete regression of the pituitary mass and partial recovery of the endocrine function. Lymphoproliferative disorders affecting the anterior pituitary are exceedingly rare, with only six cases in immunocompetent adults reported in the literature. To our knowledge this is the first report of a relapsed NHL presenting by hypopituitarism.

Aged↗
PubMed1998

[Cytarabine-induced pericarditis].

We report two cases of cytarabine (Ara-C) induced pericarditis. The first patient was a 61-year-old man with de novo acute myelogenous leukemia (AML) with trilineage myelodysplasia (M2). Fever and pericardial effusion developed after treatment with low-dose Ara-C and etoposide (VP16) during the patient's second leukemic relapse. The second patient was a 65-year-old man with myelodysplastic syndrome (MDS) transformed into AML (M2). He achieved a complete remission after treatment with low-dose Ara-C and VP16. However, during consolidation chemotherapy consisting of oral cytarabine ocfosfate and VP16, fever and pericardial effusion developed. In both cases, pericardiocentesis revealed exudative effusion with many neutrophils. Neither bacterial nor fungal infection was demonstrated. Chest symptoms and fever were resolved by methylprednisolone pulse therapy and pericardial drainage. Both patients were given a diagnosis of pericarditis caused by allergic reaction to Ara-C. We also report on 6 other patients with Ara-C syndrome who have been encountered by our hospital.

Aged↗
PubMed1989

[Relapse of Kawasaki disease: a case report].

Reports of the relapse in Kawasaki disease is rare in the literature. Prior to this study, it had never been reported in Taiwan. In November 1986, a 15-month-old boy developed a persistent high fever, dry red lips, conjunctivitis, neck lymph node swelling, erythema, indurated edema and desquamation of the perianal area and in areas of the palms and soles. A diagnosis of Kawasaki disease was made. Two dimensional echocardiography and cineangiography disclosed a fusiform aneurysmal dilatation of the right and left coronary arteries. He was treated with aspirin for 7 months. Nine months after the first attack of the illness, he again developed a persistent moderate rise of temperature, conjunctivitis, red lips, reddish swelling and desquamation of his palms. He was suffering from a second attack of Kawasaki disease. When comparing the clinical manifestations observed during the first attack and during the relapse of Kawasaki disease in this case, the duration of fever was found to be shorter and the severity of swelling and desquamation of palms milder.

Coronary Aneurysm↗
PubMedDate not supplied

The combination of pivmecillinam and pivampicillin in the treatment of enteric fever.

Thirty-nine patients with acute enteric fever received the fixed-dose oral combination of pivmecillinam/pivampicillin. Thirty-seven (95%) subjects responded satisfactorily. No relapses or persistent faecal excretion of salmonellae were seen in the 29 patients followed up for 2 to 19 weeks. The treatment was well tolerated, no side-effects being recorded. In vitro studies revealed a synergistic interaction between mecillinam and ampicillin against isolates of Salmonella paratyphi A.

Adolescent↗