Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 1992
Complement activation and the production of inflammatory mediators during the treatment of severe sepsis in humans.
Sepsis or septic shock is frequently associated with activation of the complement system, coagulation and fibrinolytic changes and the release of several cytokines. In this study we analyzed the relation of complement activation to the inflammatory mediators, hemodynamic and biochemical parameters and severity of illness and outcome in 20 consecutive patients with clinically defined sepsis. Levels of C3a and C3d were elevated in 90% of the patients (median levels 0.19 mg/l and 8.6 mg/l respectively) in comparison to 14% and 42%, respectively of 7 patients with non-septic shock. ⋯ Levels of C3a and C3d did not decrease significantly during the first 24 h of treatment, in contrast to a clear decrease in IL-6 levels in all patients and a decrease in TNF in the surviving patients. TNF levels remained stable or increased in the non-survivors. We conclude that both the complement system and the cytokine system are involved in the pathogenesis of septic shock and may be involved in the development of some of the fatal complications like hypotension and disseminated intravascular coagulation.
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Scand. J. Infect. Dis. · Jan 1992
Review Case ReportsNail pigmentation associated with zidovudine: a review and report of a case.
Zidovudine has become the standard therapy for patients with AIDS and for asymptomatic HIV infected patients with low helper-T-cell levels. As experience with the drug has grown, knowledge of the range of side effects has increased. We describe progressive pigmentation of finger and toe nails in a white patient due to zidovudine therapy, a phenomenon not often described. ⋯ It appears to be reversible and relatively dose dependent. The mechanism responsible for the discoloration is unknown. It is important to alert patients to this side effect and to prevent unnecessary investigations and treatment for other diagnoses, such as cyanosis.
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Streptococcal myositis (SM), is a very serious condition with a high mortality rate. The port of entry of the infection is often unknown. ⋯ The patient survived after massive therapeutic interventions including intensive care with intravenous antibiotics, fasciotomy, plasma exchange, controlled respiratory ventilation and exarticulation through the shoulder. The patient's wife fell ill at the same time with a sore throat and the same type of streptococci (T-type 3) was found in both patients.
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Scand. J. Infect. Dis. · Jan 1992
Diagnosis of human parvovirus B19 infections by polymerase chain reaction.
The polymerase chain reaction (PCR) was used for detecting parvovirus B19 DNA in clinical specimens. A pair of oligonucleotide primers spanning the PstI-fragment of the B19 virus genome was used for PCR, and a PCR product of 727 bp was amplified. B19 virus DNA was detected in all sera (n = 26) of individuals in the incubation period and acute phase of infection. PCR was useful for detecting viral B19 DNA in amniotic fluid and fetal blood of hydropic fetuses, confirming fetal B19 virus infection.
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Scand. J. Infect. Dis. · Jan 1992
Case ReportsLong-term oral ciprofloxacin in the treatment of prosthetic valve endocarditis due to Pseudomonas aeruginosa.
Prosthetic valve endocarditis caused by Pseudomonas aeruginosa is refractory to medical treatment alone and early valve replacement is necessary. We describe a 40-year-old patient in whom endocarditis developed in the early postoperative period, and reoperation was not considered feasible. Ciprofloxacin was administered orally in order to suppress bacteremia for 36 months. Long-term oral ciprofloxacin may provide an opportunity in the treatment of prosthetic valve endocarditis caused by Ps. aeruginosa in patients who are unfavorable candidates for reoperation.