Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Relapsing Fever”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,603 records · Page 89Linked to original sources
PubMed1986

Systemic high-dose ara-C for the treatment of meningeal leukemia in adult acute lymphoblastic leukemia and non-Hodgkin's lymphoma.

Considering the good penetration of systemic high-dose ara-C (HDara-C) into the CNS, we used this approach for treating overt meningeal leukemia, either isolated or with concurrent extraneurologic disease, in 15 adults with high-risk acute lymphoblastic leukemia (ALL), one adult with lymphoid blast crisis of chronic granulocytic leukemia (LBC-CGL), and four adults with poor-prognosis non-Hodgkin's lymphoma (NHL). Treatment consisted of ara-C, 3 g/m2 every 12 hours by three-hour infusion for eight doses followed by a second course of four doses on day 21. Remitters received consolidation with monthly courses of HDara-C for four doses. Additional systemic multi-drug reinduction therapy and direct CNS treatment with intrathecal methotrexate (IT MTX) and cranial irradiation (CRT) was administered to the three remitters last treated. Thirteen of 20 patients (65%) achieved complete remission (CR): seven of seven patients with isolated meningeal leukemia and six of 13 patients with concurrent CNS and bone marrow disease. Of the remaining seven patients, five had a complete CSF clearing with persistent marrow disease. In all cases there was prompt resolution of neurologic signs and symptoms. The median duration of CR was 5 months (range 2 to 8 months). The most significant toxicity seen was myelosuppression, which was predictable and manageable. Nonhematologic toxicity was generally acceptable and included moderate nausea and vomiting, diarrhea, drug fever, transient liver dysfunction, and dermatitis. No cases of CNS toxicity occurred. There were no treatment-related deaths. Disease-free survival was limited by marrow relapse, either isolated or with concurrent CNS disease. No instances of isolated meningeal relapse occurred. These results obtained in a poor-risk subset of patients indicate that HDara-C is an effective treatment for the induction of remission in ALL and NHL with meningeal leukemia. Therefore, HDara-C should be considered for inclusion in multiagent consolidation programs for patients at high risk for CNS disease.

Acute Disease↗
PubMed2004

Recurrence of acute disseminated encephalomyelitis after a 12-year symptom-free interval.

We report a patient with recurrent acute meningoencephalitis who had three episodes of headache, fever and unconsciousness; the first episode was at age 6 and the second, at age 7. After a 12-year symptom-free interval, she had a relapse, exhibiting the same symptoms as those in the previous two episodes. Head magnetic resonance imaging also revealed the recurrence of lesions in the basal ganglia and medial portion of the temporal lobe. The occurrences of stereotyped symptoms with meningoencephalitis and the same lesions in the basal ganglia observed in each episode favor the diagnosis of recurrent acute disseminated encephalomyelitis (ADEM) rather than multiple sclerosis or multiphasic disseminated encephalomyelitis. The occurrence of this rare case suggests that ADEM can relapse after a very long symptom-free interval.

Adult↗
PubMed1999

Antibody-targeted therapy for myeloid leukemia.

The availability of antibodies reactive with antigens expressed only by hematopoietic cells has provided clinical investigators with new tools for use in developing therapies for acute myeloid leukemia (AML). Studies performed to date have investigated the use of such antibodies in an unmodified state, combined with potent chemicals to form immunotoxins or combined with various radionuclides. Encouraging results have been obtained in all three settings. The CD33 antigen is expressed by most early myeloid cells and by more than 90% of cases of AML but is not present on the hematopoietic stem cell. Initial in vivo studies with an unmodified murine anti-CD33 antibody in patients with AML demonstrated that the antibody quickly bound to leukemia cells and that the antigen-antibody complex rapidly internalized following cell binding. However, when administered to patients with overt leukemia, unmodified antibody resulted in only brief decreases in peripheral blast counts, not in sustained response. A number of CD33-based immunotoxins have also been studied, including a calicheamicin conjugate, CMA-676. In a phase I dose-escalation study of patients with refractory AML, CMA-676 was well tolerated with the only consistent toxicities being the development of fevers and chills several hours after administration and the subsequent development of temporary pancytopenia. A phase III study has been performed involving patients with AML in first relapse. An interim analysis of the first 23 patients found that in 10, treatment with CMA-676 resulted in elimination of blasts from peripheral blood and marrow. This was achieved with far less toxicity than seen with standard chemotherapy. Radiolabeled antibodies have been explored as a stand-alone treatment or in the context of bone marrow transplantation. In an effort to avoid toxicities to normal stem cells residing alongside leukemic cells in the marrow, studies have been performed to explore the use of 231Bi conjugated to an anti-CD33 monoclonal antibody. The short path length of this alpha-emitter could theoretically allow killing of the targeted leukemic cell without damage to normal neighbors. Of 12 patients with recurrent AML who received this drug, eight had reductions in marrow and peripheral blast counts. Complete remissions (CRs) have not been observed to date. Another set of studies focused on the use of radiolabeled antibodies to deliver radiation specifically to sites of leukemia as part of a transplant preparative regimen. In a phase I clinical trial, 131I-labeled anti-CD45 antibody delivered at least threefold more radiotherapy to spleen and marrow than any other organ. In a phase II trial, among 25 AML patients in first remission, 22 are alive and in remission for periods up to 6 years.

Antibodies, Monoclonal↗
PubMed2005

The ten-year single-center experience with 6-mercaptopurine in the treatment of inflammatory bowel disease.

GOALS: To report the 10-year experience of a single center in treating patients with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6-mercaptopurine (6-MP). STUDY: The charts of 285 patients with IBD (Crohn's disease 160 and ulcerative colitis 125) receiving 6-MP were reviewed. Clinical response, subsequent breakthrough while taking 6-MP, and relapse rates when 6-MP was discontinued and side effects were assessed. RESULTS: Ninety-three percent of the patients were taking 50 to 75 mg/day of 6-MP. Complete remission was achieved in 62%, partial remission in 14.5%, and failure to achieve remission in 23.5% of the patients. Of complete responders, 27.5% had breakthrough while continuing 6-MP. Nine percent of those that achieved a complete remission experienced a relapse after 6-MP was discontinued. Side effects included leukopenia (11.2%), abnormal liver function tests (3.8%), various infections, including pneumonia (3.1%), pancreatitis (2.5%), nausea (2.1%), headache (2.8%), fever (1.4%), hair loss (1%), and rash (0.7%). Two cancers occurred while taking 6-MP: melanoma on the finger and a fatal colonic lymphoma. Four patients continued 6-MP throughout pregnancies and had normal outcomes. CONCLUSIONS: In our experience 6-MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommended higher dosage (1-1.5 mg/kg per day), when leukopenia was more frequent. Serious side effects, although rare, need to be monitored.

Female↗
PubMed1991

[Amebic abscess in the liver diagnosed initially as pneumonia].

Three cases of amoebic liver abscess were initially diagnosed as pneumonia. All three patients had fever, respiratory pain at the right costal margin, increased erythrocyte sedimentation rate and white blood cell count, pulmonary infiltrate and pleural exudate. The first case was a relapse of an infection acquired at a visit to the tropics sixteen years previously. The second patient had spent a short holiday in Morocco seven months before the illness and the third patient was probably infected in Greenland. The correct diagnosis was confirmed by demonstration of a cavity in the liver, amoebic antibodies in the blood and good response to amoebicidal treatment which was combined with closed drainage in two cases.

Adult↗
PubMed1987

Therapy of chronic myelogenous leukemia with recombinant interferon-gamma.

Recently, we reported that recombinant interferon-alpha (rIFN-alpha) can induce hematologic remissions and cytogenetic improvement in newly diagnosed Philadelphia (Ph)-positive chronic myelogenous leukemia (CML) patients. Although IFN-gamma is a structurally distinct molecule, this agent suppresses in vitro hematopoietic progenitor cells in a fashion similar to that of IFN-alpha. Therefore, we initiated a study of rIFN-gamma at doses of 0.25 to 0.5 mg/m2/d intramuscularly in patients with Ph-positive benign-phase CML. Twenty-six of 30 patients entered in the study were evaluable. Six patients have achieved a complete hematologic response; four, a partial hematologic response. The median follow-up period of patients who are in complete remission is 7.5 months (range, 5 to 12 months). No relapses have occurred among the complete responders. So far, five patients have had cytogenetic improvement with emergence of 5% to 45% diploid cells in the bone marrow. Fever and flulike symptoms were the most common side effects, with partial tolerance often developing after about 1 week. The majority of patients tolerated therapy with minimal change in performance status. In conclusion, rIFN-gamma has demonstrated clinical activity in CML. On the basis of these observations and the in vitro synergistic growth-inhibitory effects of IFN-alpha and IFN-gamma, we have started trials of combination IFN therapy in CML patients.

Adult↗
PubMed1994

[Campylobacter jejuni and HIV infection].

OBJECTIVE: To evaluate the characteristics of the Campylobacter jejuni infection in HIV positive patients. DESIGN: We report all cases appeared in our hospital between September 1991 and October 1992 with: HIV infection, chronic diarrhoea and C. jejuni in stool culture. Epidemiologic factors, other opportunist infections, immunologic situation, clinical symptomatology, antibiotic sensitivity and evolution are recorded. RESULTS: Six patients, 4 men and 2 women, with an average age of 38 years were recorded. They have different risk factors (drug abusers, sexual behaviour and haemophilia). Chronic liver disease and other opportunist infections of the gastrointestinal tract were the most important facts in past history. CD4 count were directly related with the severity of the illness. Quantitative or qualitative disorders of B lymphocytes or immunoglobulins were not found. All of term suffered from chronic diarrhoea with fever in four of them and bacteremia in 2 patients. First generation cephalosporins resistance in one occasion. A good evolution occurred in 3 patients, another had a relapse and bacteremia appeared in 2 patients whose CD4 count were lower of 100/mm3, have AST, ALT changes and other concomitant gastrointestinal infections. CONCLUSION: C. jejuni infection of the gastrointestinal tract results in chronic diarrhoea with a higher incidence than expected in HIV positive patients. The severity is directly related with CD4 count, and the existence of concomitants infections of the gastrointestinal tract or chronic liver disease. Antibiotic resistance to macrolide is possible, especially in chronic and severe forms.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Dissolution of gallstones with methyl-tert-butyl ether. An alternative to surgery in high risk patients].

We treated 27 symptomatic patients by dissolving cholesterol gallstones with methyl tert-butyl ether. Three patients were treated twice. Mean age was 70.2 years. Most patients had elevated risk for surgery. A 5 French polyethylene catheter was introduced percutaneously, transhepatic to the gallbladder. The placement of the catheter was successful in 26 of 30 procedures (87%). Cholecystography showed complete dissolution of stones in 22 of 26 patients treated (85%). Mean treatment time was 11.7 h. In four patients the treatment was stopped before dissolution was complete. Side effects were nausea, pain, fever and vasovagal reaction. 15 patients were followed up for a mean of 22.7 months after dissolution. Ten patients had no biliary symptoms, five patients suffered symptomatic relapse and three had asymptomatic recurrence of stones. We conclude that dissolution of gallstones by methyl tert-butyl ether is an adequate alternative to surgery in selected high risk patients.

Aged↗
PubMed1996

Hodgkin's disease presenting as a cholestatic febrile illness: incidence and main characteristics in a series of 421 patients.

In order to determine the frequency and characteristics of patients with liver abnormalities as the presenting manifestation of Hodgkin's disease (HD), 421 consecutive HD patients were studied. Six patients in the series (1.4%) presented with liver abnormalities that led to of a liver biopsy and the subsequent diagnosis of HD. All had fever prior to HD diagnosis, four frank jaundice, and one hepatic failure. No patient had pruritus. Moderate hepatomegaly was present in four patients. Cholestasis was observed in all cases; in most patients a moderate increase in the transaminase activity was also seen. Two patients had a mild rise in the serum LDH, four had leukopenia, and one eosinophilia. At liver histologic study, Reed-Sternberg cells were demonstrated in four patients; in the remaining two, the presence of atypical histiocytes, lymphocytes, and eosinophils was highly suggestive of HD, the latter diagnosis being confirmed by subsequent study of bone marrow and/or retroperitoneal lymphadenopathies. In three of the six patients, HD was not demonstrated in sites other than the liver. Three patients older than 60 years died shortly after HD diagnosis. By contrast, three patients younger than 40 years showed a dramatic response to chemotherapy: two of them had a further relapse, and one is considered cured after 14 years of continuous remission. Liver disease constitutes an infrequent form of HD presentation which must be included in the differential diagnosis of any patient with fever of unknown origin.

Adult↗
PubMed1998

Two imported cases of Penicillium marneffei infection in Belgium.

Two imported cases of Penicillium marneffei infection in Belgium are reported. Both patients are Thai women co-infected with HIV. P. marneffei infection should be suspected in immunocompromised patients originating or travelling from South-East Asia with unexplained fever (> 38 degrees C), weight loss, a generalised lymphadenopathy, hepatomegaly, splenomegaly, skin lesions, cough and anaemia. Diagnosis is made by culture and/or histopathological examination. Mild to moderate infections are treated with itraconazole 400 mg/day as first choice. Amphotericin B parenteral therapy may be required for seriously ill patients. Maintenance therapy with itraconazole 200 mg/day is necessary to prevent relapses.

AIDS-Related Opportunistic Infections↗
PubMed2003

[A case of childhood multiple sclerosis presented with meningitis and multiple silent plaques].

A 13-year-old girl presented herself with right optic neuritis and pleocytosis in the cerebrospinal fluid (CSF) in May 2000. Although her vision gradually improved after steroid therapy, the right optic neuritis relapsed a month later, and MRIs of the brain showed multiple high-signal intensity areas in the white matter of the right frontal and parietal lobes on T2-weighted and FLAIR images. She developed nuchal pain, low-grade fever, and general malaise in January 2002. Mononuclear pleocytosis and an elevation of myelin basic protein level were noted in CSF (33/microliter, 17.7 ng/ml, respectively). In addition to the plaque-like lesions seen in June 2000, MRI at this time showed an increase in the number of plaques in the medulla, pons, bilateral cerebellar peduncles and cerebellum. We thus considered this case as MS presenting with no focal neurological deficits but meningitis and asymptomatic MRI lesions. The past history of relapsed optic neuritis is supportive and compatible with that diagnosis. One might assume that the case belongs to that of relapsed type acute disseminated encephalomyelitis (ADEM). However, the cardinal pictures of the case are those of relapsing optic neuritis and multiple asymptomatic plaques despite clinical remission. Some atypical features like meningitis may predominate in clinical presentations of child MS, since immune response in child may differ from that of adult.

Adolescent↗
PubMed1999

Treatment with interleukin-2 (IL-2) and interferon (IFN(alpha 2b)) after autologous bone marrow or peripheral blood stem cell transplantation in onco-hematological malignancies with a high risk of relapse.

Nine patients with onco-hematological malignancies with a poor prognosis due to high risk of relapse received immunotherapy with interleukin-2 (IL-2) and interferon (IFN(alpha 2b)) s.c. as maintenance therapy after receiving autologous bone marrow or peripheral blood stem cell transplantation (ABMT/PBSCT). All the patients were considered at very high risk of relapse. We attempted to assess the efficiency, toxicity and clinical effects of these cytokines in these patients. Five patients were treated with high-dose of IL-2 and the other four patients with escalating doses every month. Side-effects in the first group of patients consisted of fever, chills, weakness, nausea, anorexia, loss of weight and local dermatitis in the injection site. Toxicity on the WHO scale was grade II in three patients and grade IV in the other two patients. In the second group of patients, the same clinical signs of toxicity appeared, but these were grade I on the WHO scale in all patients. None of the patients had infections or died in relation to administration of IL-2. Four patients died of relapse or progression of their hematological malignancies. The other five patients are alive, one in chronic phase of CML and the other four patients are in complete remission of their malignancies.

Adult↗
PubMed1984

Prevention of recurrent febrile convulsions--a randomized therapeutic assay: sodium valproate, phenobarbital and placebo.

The purpose of this study was to compare three different modes of treatment in the prevention of relapses of febrile convulsions (Phenobarbital = PH, Sodium Valproate = SV, Placebo = PO) in a randomized therapeutic trial. The patients included in the study had shown their first generalized convulsive seizure during a bout of fever (greater than or equal to 38.5 degrees C) and were aged between 6 months and 4 years. They were subsequently followed up as outpatients, and Phenobarbital and sodium valproate levels were measured regularly to ascertain compliance with the treatment and to adjust the dosage accordingly. The patients' families were questioned with respect to the occurrence of feverish bouts and convulsive seizures during the interval between visits, as well as possible adverse reactions. An EEG was carried out yearly. Results were as follows: - 69 patients - 35 boys and 34 girls - with an average age of 24 months were divided into 3 groups according to treatment: 21 cases on PH, 22 cases on SV, and 26 cases on PO. - they were followed up for an average duration of 21 months. - the average number of feverish bouts per child and per year was evaluated at 2.5, no statistically significant difference being noticeable between the various modes of prophylaxis. - 15 relapses of febrile seizures were noted in 14 children, over an average duration of 23 months; on average, relapses occurred after 9 months; among the 14 children who had relapsed, one had been treated with SV, 4 with PH and 9 with PO, leading to estimated relapse rates of 4%, 19%, and 35% respectively. There is a statistically significant difference in the relapse rates between the treated groups (SV and PH) and the Placebo group, and a particularly significant difference between Sodium Valproate and Placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1990

Septicaemia caused by an imported strain of multiply antibiotic resistant Salmonella typhi successfully treated with ciprofloxacin.

A case of typhoid fever caused by a multiply antibiotic resistant strain of Salmonella typhi is reported. The S. typhi strain was resistant to ampicillin, chloramphenicol and sulphamethoxazole-trimethoprim. Treatment with cefotaxime, resulted in a clinical and bacteriological cure, but the infection relapsed within a month after completion of therapy. It resolved completely with oral ciprofloxacin with no relapse after a follow up period of one year. To our knowledge this represents the first such reported case in South Africa. The role of ciprofloxacin in treating infections caused by multiantibiotic resistant S. typhi is also discussed.

Ciprofloxacin↗
PubMedDate not supplied

[Genetic factors in typhoid fever].

The study of genetic factors associated to infectious diseases is a promising research field for optimizing their management and control in the future. For typhoid fever, one of our major health problems, this approach has been sporadic an fruitless for having been addressed to disease's overall susceptibility. Moreover, difficulties on recognition of clinical sub-sets have prevented definition of unambiguous clinical phenotypes appropriate for this objective. With the aim of finding the basis for phenotypes identification, or definite disease expressions, a search including foreign and national literature was carried out for the 1960-88 period. From animal experimentation, human immunogenetics, epidemiology and clinical literature, data was obtained for proposing five phenotypes: the incubation period, typhoid relapse, agglutinins response (Widal's test), response to vaccination and metabolic behaviour of certain substances, including antibiotics. That one or more of these phenotypes and their possible association with polymorphic systems might lead to populational subsets recognition in typhoid fever is suggested.

Animals↗
PubMed1990

Remission induction of ANLL with low dose cytosine arabinoside combined with retinoic acid.

Fourteen cases of acute non-lymphocytic leukemia (ANLL) were treated with low doses of cytosine arabinoside (LDAra-C 20 mg/m/q12h) and etretinate (all-trans-9-3, 7-dimethyl-2, 4, 6, 8 non-atetraenoate, 75 mg/d). Of which 9 were untreated, 3 were in first relapse and 2 were refractory patients. Five of the 9 patients in the first group, and all 3 patients in the second group achieved complete remission (CR). The 2 cases with refractory ANLL showed no response. The CR rates in untreated, first relapse and refractory patients were 55.6%, 100%, and 0% respectively. In all, there was significant reduction of marrow cellularity in 13 patients, 5 of whom developed bone marrow aplasia with predominantly lymphocyte and plasma cells. Only 2 cases with M5 ANLL showed evidence of differentiating into monocytes and neutrophil in hypocellular marrow phase. The efficacy of this drug combination, however, appeared to be achieved through cytotoxicity rather than differentiation. The side effects in the treated cases included cheilitis, dermatitis, fever, petechiae, and impaired liver function, which soon improved upon discontinuation or reduction of dosage. This combination treatment might be most effective in achieving remission among elderly and severely infected patients with ANLL, and could be appropriate even for patients in first relapse.

Adolescent↗
PubMed1986

[Schizophrenia syndromes caused by infection].

Out of 908 patients with sepsis treated at the Republican Antisepsis Center, 19 presented with different schizophrenia syndromes (2 with acute delirium, 3 with encephalic manifestations, 3 with the amentive-catatonic form, the remainder with the amentive-depressive form). In 6 patients, psychic disorders preceded fever, in 3 patients, both conditions occurred simultaneously, and 9 developed psychosis in the presence of fever. In all the patients, with the exception of one, the diagnosis of sepsis was supported by repeated isolation of hecocultures of S. epidermidis (14 cases) and S. aureus (4 cases). The patients received antisepsis treatment. Two patients died and the rest 17 patients were cured of sepsis. The schizophrenic syndrome disappeared. No relapses were recorded with the exception of one female patient, in whom both sepsis and psychic disorders recurred. Later on, however, she also recovered.

Acute Disease↗
PubMed2005

Invasive fungal infection in children with persistent febrile neutropenia.

BACKGROUND AND PURPOSE: Children with persistent febrile neutropenia (fever > 96 hours) refractory to antibacterial therapy carry a high risk of invasive fungal infection (IFI). However, epidemiologic data in such patient populations is lacking in Taiwan. METHODS: A retrospective study was conducted to identify risk factors and outcome of IFI in children with persistent febrile neutropenia (> 96 hours) hospitalized at National Taiwan University Hospital from January 1, 1999 through December 31, 1999. They were categorized into proven, probable, possible, or no IFI according to host, microbiologic and clinical criteria. RESULTS: A total of 29 episodes (35.4%) of IFI occurred in 82 episodes of persistent febrile neutropenia and included 1 proven, 12 probable and 16 possible cases. Pneumonia was most common (69.0%), followed by disseminated infection (17.2%), paranasal sinusitis (6.9%), and hepatosplenic abscess (6.9%). Multivariate analysis revealed 4 risk factors independently associated with IFI: prolonged neutropenia (> 30 days; odds ratio [OR], 10.4; 95% confidence interval [CI], 1.8-60.5), prolonged steroid therapy (OR 2.0, 95% CI 1.0-10.8), allogeneic bone marrow transplantation (OR 5.3, 95% CI 1.0-28.0), and relapsed malignancy (OR 3.5, 95% CI 1.1-11.1). Patients with IFI carried higher in-hospital mortality than those without (51.7% vs 3.8%, p < 0.001). Among those with IFI, delayed antifungal therapy (persistent fever > 7 days) was associated with higher mortality rate than earlier treatment (73.3% vs 28.6%, p = 0.024) and was an independent adverse prognostic factor. CONCLUSION: IFI was common in patients with persistent febrile neutropenia and delayed antifungal therapy was an independent adverse prognostic factor.

Adolescent↗