Scandinavian journal of infectious diseases
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Clarithromycin and rifabutin are among the most promising drugs for the therapy of infections caused by Mycobacterium avium or other atypical mycobacteria. Since synergism of combined drugs is important in order to achieve strong antimycobacterial activity, the combined inhibitory effects of antibacterial agents should also be investigated when agents are evaluated for possible use in antimycobacterial drug therapy. In the present study we examined the antimycobacterial activity of clarithromycin, rifabutin, and their combination against 51 clinical isolates of the M. avium complex from patients with acquired immune deficiency syndrome (AIDS) with disseminated mycobacteriosis. ⋯ The antibacterial effect was significantly more pronounced for the combined drugs than for the agents tested separately. Synergism, against up to 88% of the strains tested, was seen for the tested drugs combined at different concentrations. All 51 M. avium strains were susceptible to the combination of 4 mg/l clarithromycin and 2 mg/l rifabutin.
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Scand. J. Infect. Dis. · Jan 1996
Case ReportsRelapsing fever: a differential diagnosis to malaria.
A 20-year-old man who had spent several weeks in Asia suffered several attacks of fever, each lasting 1 day in a cyclic pattern. Initially he was suspected to have malaria, but no parasites were found in a blood smear. ⋯ Borrelia spirochaetes were detected in a blood smear, leading to a diagnosis of relapsing fever. He recovered immediately when treated with tetracyclin.
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Scand. J. Infect. Dis. · Jan 1996
Incidence and prognosis of meningitis due to Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis in Sweden.
The incidence, concomitant conditions and case fatality rate of Haemophilus influenzae (Hi) and pneumococcal meningitis and of invasive meningococcal infections were studied retrospectively in Sweden (population 8.4 million) for the years 1987-89, the period before vaccination against Hi type b started. A total of 1,019 cases with culture-verified infection were found. The incidence rates per 100,000 per year were 1.8 for Hi meningitis, 1.2 for pneumococcal meningitis and 1.0 for invasive meningococcal infections. ⋯ Development of a vaccine against N. meningitidis group B should have high priority. Furthermore, improved pneumococcal vaccines are needed for patients with predisposing conditions. The currently available pneumococcal polysaccharide vaccine seems to be underused.
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Scand. J. Infect. Dis. · Jan 1996
Classification of infective endocarditis by Duke's criteria and transesophageal echocardiography: a 1-year retrospective analysis.
A sensitive, specific, and rapid diagnosis of infective endocarditis (IE) is important for prognosis, and to exclude IE and thus avoid prolonged treatment with antibiotics. The diagnostic system for IE according to Duke's university includes echocardiographic results and classifies patients in 3 categories--'definite', 'possible', and 'rejected'--by combining pathologic, echocardiographic, clinical, and blood culture findings. Transesophageal echocardiography (TEE) has better diagnostic sensitivity compared to transthoracic echocardiography. ⋯ The remaining 37 patients (15 of whom were intravenous drug users) were treated and classified as follows: 'definite', 26 episodes in 24 patients, 'possible', 11 episodes in 11 patients; and 'rejected', 2 episodes in 2 patients. In this retrospective analysis Duke's criteria were easy to apply. A negative TEE made IE unlikely and a positive TEE made IE probable when other signs of infection were present.
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Scand. J. Infect. Dis. · Jan 1996
Case ReportsCerebrospinal fluid filtration in a case of severe pneumococcal meningitis.
Current therapy of bacterial meningitis includes high doses of antibiotics and, sometimes, addition of corticosteroids in order to reduce a harmful inflammatory response. The persisting high mortality and rate of sequelae, particularly regarding pneumococcal meningitis, calls for new therapeutic approaches. ⋯ The treatment was carried out without complications and the clinical outcome was favourable. We suggest that filtration of the CSF should be considered as a tool to eliminate noxious substances playing a harmful role in deteriorating course of bacterial meningitis.