Infectious disease clinics of North America
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Infect. Dis. Clin. North Am. · Sep 2007
ReviewThe prevention and management of infections in children with asplenia or hyposplenia.
Overwhelming sepsis remains a significant complication of asplenia and hyposplenia. The mainstays of prevention are education, immunization, and prophylactic antibiotics. ⋯ Such decisions as the specific immunizations required, the timing of immunizations, the duration of antibiotic prophylaxis, and the prevention of overwhelming postsplenectomy sepsis in children undergoing splenectomy are often empiric. This article reviews the current literature on the prevention and management of severe infections in children with underlying asplenia or hyposplenia.
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Infect. Dis. Clin. North Am. · Sep 2007
ReviewInfection in patients with severe burns: causes and prevention thereof.
The better understanding of burn pathophysiology has resulted in effective fluid resuscitation in the acute stage, but the morbidity and mortality of burn patients are mostly linked to the burn wound consequences. Once the initial acute phase is over, the burn wound becomes the source of virtually all ill effects, local and systemic. The dysfunction of the immune system, a large cutaneous bacterial load, the possibility of gastrointestinal bacterial translocation, prolonged hospitalization, and invasive diagnostic and therapeutic procedures all contribute to infectious complications. Wound infection may lead to septicemia that may not only consume additional resources but is associated with significant morbidity and mortality despite the advances in burn care.
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Osteomyelitis frequently requires more than one imaging technique for an accurate diagnosis. Conventional radiography still remains the first imaging modality. MRI and nuclear medicine are the most sensitive and specific methods for the detection of osteomyelitis. ⋯ Ultrasound represents a noninvasive method to evaluate the involved soft tissues and cortical bone and may provide guidance for diagnostic or therapeutic aspiration, drainage, or tissue biopsy. CT scan can be a useful method to detect early osseous erosion and to document the presence of sequestra. PET and SPECT are highly accurate techniques for the evaluation of chronic osteomyelitis, allowing differentiation from soft tissue infection.
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Infect. Dis. Clin. North Am. · Sep 2005
ReviewImplications of methicillin-resistant Staphylococcus aureus as a community-acquired pathogen in pediatric patients.
Methicillin-resistant Staphylococcus aureus is now an established community pathogen in many areas of the United States and the world. Community-acquired methicillin-resistant S aureus infections have changed several aspects of staphylococcal infections in children. This article discusses epidemiology, clinical manifestations, laboratory diagnosis, treatment, and prevention.
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Infection with protozoan parasites of the genus Leishmania leads to a wide variety of clinical disease syndromes called leishmaniasis, or more appropriately the leishmaniases. The three major clinical syndromes are cutaneous leishmaniasis, mucosal leishmaniasis, and visceral leishmaniasis. All three of these syndromes have been documented in returning travelers. This article focuses on cutaneous leishmaniasis with some comment on mucosal leishmaniasis.