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 1,639 records · Page 91Linked to original sources
PubMed1985

Ceftriaxone therapy in bacteremic typhoid fever.

The efficacy and safety of ceftriaxone in the treatment of bacteremic typhoid fever was studied in 14 patients. Ceftriaxone at a dosage of 50 to 60 mg/kg per day was administered intravenously in two divided doses in 13 patients and as a single dose in 1 patient. When the two patients with medical complications causing persistent fever and the patient who was febrile during therapy were excluded from the calculations, the mean period of defervescence was 4 days. Five to eight days of ceftriaxone therapy was adequate for the patients who were cured. The 14 patients treated with ceftriaxone included 13 patients who were considered cured, although 1 was a convalescent carrier, and one patient who was a treatment failure. There were no relapses in the 11 patients who were monitored for 1 to 8 months. Both peak and trough concentrations of ceftriaxone were well above the ceftriaxone MICs for the Salmonella typhi strains isolated from the patients. We have demonstrated that ceftriaxone can be used successfully in the treatment of typhoid fever in some patients. The advantages of its use include rapid clinical response, short course of treatment, and lack of serious adverse drug reactions.

Adolescent↗
PubMed1984

CSF shunt infections in pediatrics. A seven-year experience.

The medical records of children who had had CSF shunt procedures were reviewed for the seven-year period from 1975 through 1981. There were 516 procedures performed in 297 patients. Only three were ventriculoatrial shunts; the remainder were ventriculoperitoneal shunts. Fifty-nine infectious episodes (11%) occurred in 50 patients (17%); there were three relapses and six reinfections. The infecting pathogen was staphylococci in 75% of the infections and gram-negative bacilli in 19%, and there were two or more pathogens in 15% of the infections. The onset of the infection was within 15 days of surgery in 53% of the cases. The main symptoms were fever, irritability, and shunt malfunction. Gram's stain of the CSF was positive in 46% of the episodes and blood cultures were positive in 29%. Nineteen percent of patients had wound infection and 7% had peritonitis; in most of these cases there were no neurologic signs or symptoms. Thirteen episodes were managed with antibiotic therapy alone; among these, there were three relapses and two reinfections. Thirty-seven episodes were treated with antibiotics and immediate removal of the shunt; there were no relapses and three reinfections. Nine episodes were managed with antibiotics and delayed removal of the shunt; there was one reinfection. The median duration of antibiotic treatment was 15 days, and the time to defervescence was 24 hours in those with immediate removal of the shunt and six days in those in whom the shunt was not removed.

Anti-Bacterial Agents↗
PubMed1998

Typhoid fever in children--a retrospective study of 54 cases from Malaysia.

BACKGROUND/AIM OF STUDY: Typhoid fever, which is endemic in Malaysia, affects all age groups and it has been stated that classical features described in textbooks were absent in children. The aim of this study was to find out whether this was true in the local setting and hence a retrospective study was undertaken. METHODS: Fifty-four paediatric patients satisfied the inclusion criteria and all were seen consecutively during the study period of 10 years. Patients' records were reviewed for demographic data such as age, sex, ethnicity, clinical features, therapy and results of laboratory tests. RESULTS: Fever was the most common presenting symptom and diarrhoea was more common than constipation. Isolation of S typhi from blood and/or stools was the most important diagnostic tool *85.2%) and of these 99% had significant Widal titres. Clinical and bacteriological relapse occurred in 5 children (3%) who were successfully treated with ceftriaxone. The absence of mortality and low level of complications indicates either a mild nature of the disease or to early recognition or prompt and appropriate therapy.

Ceftriaxone↗
PubMedDate not supplied

Pefloxacin versus chloramphenicol in the therapy of typhoid fever.

An open, randomized clinical study was carried out to compare the clinical efficacy and safety of pefloxacin with that of chloramphenicol in the treatment of typhoid fever. Sixty hospitalized patients (40 men and 20 women, aged from 17 to 64 years), affected by severe proven typhoid sepsis, were randomly assigned to treatment with pefloxacin at a daily dose of 1,200 mg for 15 days (Group A) or with chloramphenicol at a daily dose of 2 g for 15 days (Group B). The two groups of patients were statistically homogeneous regarding both age and sex and all patients were followed for 30 days after the end of therapy. In Group A all the patients completely recovered from infection and all the isolated strains of Salmonella typhi were eradicated by pefloxacin treatment. In Group B two patients had a relapse, two patients became chronic enteric carriers of S. typhi and only 26 patients recovered from infection with complete eradication of the pathogen. The results indicate that pefloxacin is as active as chloramphenicol in the therapy of typhoid fever and that pefloxacin could be a valid antibacterial agent to be used together with appropriate hygienic measures for an eradication program of typhoid fever in the endemic countries.

Adolescent↗
PubMed1998

Bronchiolitis obliterans organizing pneumonia syndrome primed by radiation therapy to the breast. The Groupe d'Etudes et de Recherche sur les Maladies Orphelines Pulmonaires (GERM"O"P)

Reports of bronchiolitis obliterans organizing pneumonia (BOOP) occurring in women after radiation therapy for breast cancer have suggested that radiation to the lung could participate in the development of BOOP. We now describe the clinical, radiographic, functional, and bronchoalveolar lavage characteristics of this syndrome in a series of 15 patients reported to the Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P) in France. All 15 women (60 +/- 6 yr of age) fulfilled the following inclusion criteria: (1) radiation therapy to the breast within 12 mo, (2) general and/or respiratory symptoms lasting for at least 2 wk, (3) lung infiltrates outside the radiation port, and (4) no specific cause. The patients presented with fever, nonproductive cough, mild dyspnea, and peripheral alveolar opacities on chest radiograph with a characteristic migratory pattern. In five patients, BOOP was found at lung pathologic analysis. In all the patients dramatic improvement was obtained with corticosteroids, but relapses occurred in 12 patients while tapering or after stopping corticosteroids. This report demonstrates that a characteristic BOOP syndrome may occur after radiation therapy to the breast, including tangential radiation to the lung, thus suggesting that radiation therapy may prime the development of BOOP.

Aged↗
PubMed1994

Marrow transplantation for chronic myeloid leukemia: a randomized study comparing cyclophosphamide and total body irradiation with busulfan and cyclophosphamide.

A prospective randomized study was conducted comparing two conditioning regimens for the treatment of patients with chronic myeloid leukemia in chronic phase by marrow transplantation from HLA identical siblings. Sixty-nine patients received 60 mg/kg of cyclophosphamide on each of 2 successive days followed by 6 fractions of total body irradiation each of 2.0 Gy (CY-TBI), and 73 patients received 16 mg/kg of busulfan delivered over 4 days followed by 60 mg/kg CY on each of 2 successive days (BU-CY). There was no significant difference between the CY-TBI and the BU-CY groups in the 3-year probabilities of survival (0.80 for both), relapse (0.13 for both), or event-free survival (CY-TBI, 0.68; BU-CY, 0.71) or in speed of engraftment or incidence of venocclusive disease of the liver. The 4-year probabilities of survival and event-free survival for patients transplanted within 1 year of diagnosis were 0.86 and 0.72, respectively, for each group. Significantly more patients in the CY-TBI group experienced major creatinine elevations. There was significantly more acute graft-versus-host disease in the CY-TBI group. Fever days, positive blood cultures, hospitalizations, and inpatient hospital days were significantly more common in the CY-TBI group than in the BU-CY group. In conclusion, the BU-CY regimen was better tolerated than, and associated with survival and relapse probabilities that compare favorably with, the CY-TBI regimen.

Adolescent↗
PubMed2000

Failure of short-course ceftriaxone chemotherapy for multidrug-resistant typhoid fever in children: a randomized controlled trial in Pakistan.

The precise duration of therapy of multidrug-resistant (MDR) typhoid with broad-spectrum cephalosporins is uncertain. We prospectively randomized 57 children with culture-proven MDR typhoid to receive treatment with intravenous ceftriaxone (CRO) (65 mg/kg of body weight/day) for 7 days (short course; n = 29) or 14 days (conventional; n = 28). The response to therapy, as evaluated by the serial monitoring of the typhoid morbidity score and bacteriological clearance, was comparable between groups. In contrast to the conventional therapy, 14% of the children receiving CRO for 7 days had a confirmed bacteriological relapse within 4 weeks of stopping therapy.

Ceftriaxone↗
PubMed2006

Pyogenic liver abscess caused by Burkholderia pseudomallei in Taiwan.

Pyogenic liver abscess in Taiwan is a well-known disease entity, commonly associated with a single pathogen, Klebsiella pneumoniae. Melioidosis is an endemic disease in Taiwan that can manifest as multiple abscesses in sites including the liver. We report three cases of liver abscesses caused by Burkholderia pseudomallei. The first patient was a 54-year-old diabetic woman, who presented with liver abscess and a left subphrenic abscess resulting from a ruptured splenic abscess, co-infected with K. pneumoniae and B. pseudomallei. The second patient, a 58-year-old diabetic man, developed bacteremic pneumonia over the left lower lung due to B. pseudomallei with acute respiratory distress syndrome, and relapsed 5 months later with bacteremic abscesses of the liver, spleen, prostate and osteomyelitis, due to lack of compliance with prescribed antibiotic therapy. The third patient was a 61-year-old diabetic man with a history of travel to Thailand, who presented with jaundice and fever of unknown origin. Liver and splenic abscesses due to B. pseudomallei were diagnosed. A high clinical alertness to patients' travel history, underlying diseases, and the presence of concomitant splenic abscess is essential to early detection of the great mimicker, melioidosis. The treatment of choice is intravenous ceftazidime for at least 14 days or more. An adequate duration of maintenance oral therapy, with amoxicillin-clavulanate or trimethoprim-sulfamethoxazole for 12-20 weeks, is necessary to prevent relapse. Liver abscess in Taiwan is most commonly due to K. pneumoniae, but clinicians should keep in mind that this may be a presenting feature of melioidosis.

Anti-Bacterial Agents↗
PubMed1984

Can antibacterial therapy be discontinued in persistently febrile granulocytopenic cancer patients?

It has been suggested that empiric broad-spectrum antibiotics, instituted for fever in the presence of granulocytopenia, should continue to be administered, even when infection is not demonstrable, to those patients who remain persistently febrile and granulocytopenic. Therefore, the consequences of discontinuing antibiotics when the presence of infection is doubted in this setting were evaluated. In 16 (3.7 percent) of 429 episodes of fever and granulocytopenia for which empiric antibiotic therapy was instituted, after approximately four days, persistence of both fever and granulocytopenia was found, and yet infection was prospectively classified at that time as "doubtful." The initial empiric antibiotic regimen was therefore discontinued after a mean of 4.8 (median 5.0) days. Discontinuation of antibiotics proved appropriate for half of the patients; eight patients received no systemic therapeutic antibiotics with no evidence of infection during a period of at least two weeks. The other eight patients had antibacterial antibiotics reinstituted within a mean of 2.4 days; six infections were subsequently demonstrable. Six of these eight patients also required or were believed to require antifungal therapy with intravenous amphotericin B for presumed fungal infections. Patients with relapsed leukemia or lymphoma and those with a likelihood of continued profound granulocytopenia (counts below 100/microliters) or both were the ones who tended to require reinstitution of antibiotics. Discontinuation of antibiotics when infection was considered doubtful despite persistence of both fever and granulocytopenia was, therefore, successful in eight of 16 patients. Reinstitution of antibiotics was required in the eight remaining patients. No definite rule appears to be applicable to all patients.

Agranulocytosis↗
PubMed1988

Acute promyelocytic leukemia. Therapy results and prognostic factors.

From December 1976 to July 1986, 34 patients with acute promyelocytic leukemia (APL) were treated with daunorubicin (DNR) alone and simultaneous supportive therapy with low-dose heparin, platelet transfusions, and fresh frozen plasma. Two consecutive maintenance therapy regimens were employed in patients who achieved complete remission (CR): (1) a classical maintenance with methotrexate and 6-mercaptopurine, with DNR plus methyl-GAG re-inductions; (2) from 1982 an intensive sequential combination therapy regimen was administered. CR was achieved in 23 patients (68%). Only one patient had leukemic resistance. Other failures were a consequence of post-chemotherapy complications. A multivariate logistic regression analysis has been performed to evaluate the prognostic importance on response to remission induction of 25 patient and disease characteristics at diagnosis. The significant variables in decreasing order of significance were: serum albumin level, fever at diagnosis, serum creatinine level, and age. The median duration of remission and survival by Kaplan-Meier analysis were projected to be 24 and 25 months, respectively. Relapses occurred in 11 of 23 CR patients. Nine patients remained in the first remission from 5+ to 37+ months. Short-term (CR) and long-term results (duration of remission and survival) in APL treated for induction with DNR alone were similar to those obtained in other subtypes of acute myeloblastic leukemia by intensive combination chemotherapy.

Adolescent↗
PubMed1984

Relapsing acute febrile neutrophilic dermatosis and essential thrombocythemia.

Relapsing acute febrile neutrophilic dermatosis ( AFND ) is reported in a patient with essential thrombocythemia representing the first case of this kind described in the literature. The patient presented with fever, malaise, neutrophilic leukocytosis, dysproteinemia, and coalescing bluish-red painful plaques and papules at palms, forehead, lid, forearm, and thigh. There was a dramatic response to steroids, or indomethacin, with no scarring. AFND was preceded by sore throat and an upper respiratory infection and was accompanied by conjunctivitis and arthritis of knees and ankle-joint. The association of AFND with essential thrombocythemia and with other neoplastic disorders is discussed.

Dermatitis↗
PubMed1999

New strategies in diagnosis and treatment of thrombotic thrombocytopenic purpura: case report and review.

UNLABELLED: The pentad of thrombocytopenia, haemolytic anaemia, mild renal dysfunction, neurological signs and fever, classically characterizes the syndrome of thrombotic thrombocytopenic purpura (TTP). TTP usually occurs in adults but also children have been described with this condition. The disorder may take a relapsing course, termed chronic relapsing TTP (CRTTP), which although very rare, may also begin in childhood. Deficiency of a recently identified enzyme, the von Willebrand factor (vWF)-cleaving protease, seems to play a major role in the development of TTP. We report on a 3-year-old boy with a dramatic but typical clinical course of CRTTP. At the time of diagnosis, neurological deficits and multiple cerebral infarctions had already occurred. In plasma, vWF-cleaving protease was completely absent, both during acute TTP and in remission. There was no protease inhibitor detected. Regular infusions of fresh frozen plasma were successfully given for replacement on a prophylactic basis. CONCLUSION: Assay of von Willebrand factor-cleaving protease helps to diagnose a form of thrombotic thrombocytopenic purpura which may be managed by prophylactic treatment with fresh frozen plasma.

Blood Coagulation Tests↗
PubMed2002

High-dose cytarabine as consolidation treatment for patients with acute myeloid leukemia with t(8;21).

Seventeen patients affected by acute myeloid leukemia (AML) with t(8;21) were prospectively programmed to receive three courses of high-dose cytarabine (HDARA-C) as post-remission therapy. The median age was 39 years and in all cases t(8;21) was the only karyotypic abnormality. Complete remission (CR) was achieved in 14 out of 17 cases (82%) and, after first consolidation with NOVIA regimen (intermediate dose ARA-C plus mitoxantrone), all patients received the three planned courses of HDARA-C (3g/m(2) q12h on days 1, 3, 5). There were two documented infections, while all patients experienced fever of unknown origin (FUO). Nonhematological toxicity was mild. Thirteen out of 14 patients are in continuous CR after a median follow-up of 44 months. One patient relapsed at 16 months and, following CR2 achievement, underwent allogeneic transplantation; he died 3 months later while in CR from acute graft versus host disease (GVHD). Survival at 5 years is projected at 79%. Our data confirm the efficacy of repeated courses of HDARAC for patients with t(8;21) AML.

Acute Disease↗
PubMed2002

Successful treatment of post-transplant lymphoproliferative disorder in autologous blood stem cell transplant recipients.

We report three cases of post-transplant lymphoproliferative disorder (PTLD) in the context of autologous stem cell transplantation (ASCT) for multiple myeloma (MM) and non-Hodgkin's lymphoma. The first two cases received ASCT for MM, one with a CD34-selected autograft and the other with an unmanipulated autograft. Both these cases of PTLD achieved a complete response following treatment with IVIG, gancyclovir, solumedrol and interferon (IFN). The third case received ASCT with an unmanipulated autograft for relapsed angioimmunoblastic lymphoma. He also achieved a complete response but only after rituximab was added to IVIG, gancyclovir, solumedrol and IFN. None of these patients experienced a relapse of their PTLD with follow-up ranging from 1.5 to 5 years. These cases highlight the importance of considering PTLD in the differential diagnosis of lymphadenopathy and fever post ASCT. They also demonstrate the possibility of durable complete remission of post-ASCT PTLD following antiviral and immune modulating therapy.

Adult↗
PubMed1991

Testicular abscess caused by Salmonella typhi.

This case, which we believe is the first report of a bacteriologically proven infection of the testis by Salmonella typhi, illustrates the occurrence of this complication in the convalescent phase of typhoid fever and the absence of a clinically evident preceding bacteremic phase. The case also emphasizes the need for prolonged antibiotic therapy and the role of surgery in treatment of relapses.

Abscess↗
PubMed1995

Ifosfamide and etoposide in recurrent childhood acute lymphoblastic leukemia.

PURPOSE: The activity of the drug combination ifosfamide and etoposide (VP16) in refractory and relapsed childhood acute lymphoblastic leukemia (ALL) was assessed in a phase II study. PATIENTS AND METHODS: Twenty children with ALL, all heavily pretreated and in bone marrow relapse, were entered on the study. Drugs were given i.v. each day for 5 days at the following doses: ifosfamide 1.8 g/m2/day, VP16 100 mg/m2/day, and MESNA 2,880 mg/m2/day (as a uroprotectant); cycles were repeated every 28 days. At study entry, eight patients were in first relapse (five of whom had failed intensive reinduction regimens), seven were in second relapse, and five were in third relapse. All patients had received cyclophosphamide in regimens before relapse. RESULTS: Eight patients (40%; 95% confidence interval 19-64%) achieved complete bone marrow remission with ifosfamide/VP16. Three patients subsequently relapsed in the bone marrow while on ifosfamide/VP16 therapy. Duration of remission ranged from 21 to 247 days. Treatment was generally well tolerated, with myelosuppression the most common toxicity; fever and neutropenia occurred in 18 of 31 evaluable cycles. CONCLUSION: The combination of ifosfamide/VP16 has significant activity in recurrent and refractory childhood ALL with tolerable toxicity.

Adolescent↗