Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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We prospectively determined the measles-mumps-rubella (MMR) antibody status of 39 previously vaccinated children before and after administering protocol-directed chemotherapy for acute leukemia. At diagnosis the seropositivity rates for measles and mumps-specific immunoglobulin G were > or = 90%, while the seropositivity rate for rubella was 85%. After treatment, rates of seropositivity for measles antibody declined by 13% (90% of patients to 77%; P = .13); for mumps antibody, by 18% (97%-79%; P = .02); and for rubella antibody, by 21% (85%-64%; P = .03). These findings suggest that some survivors of acute leukemia during childhood have an increased susceptibility to MMR viruses and would benefit from posttreatment evaluation of their immune statuses and from possible revaccination.
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Antibiotic prophylaxis after basilar skull fractures remains controversial. Previous studies have not clearly delineated the utility of prophylactic antibiotics in this setting. We undertook this study to determine if antibiotic prophylaxis after basilar skull fractures prevented meningitis. ⋯ Overall results suggest that antibiotic prophylaxis did not prevent meningitis among patients with basilar skull fractures (odds ratio [OR] = 1.15; 95% confidence interval [CI] = 0.68-1.94; P = .678). Patients with basilar skull fractures and cerebrospinal fluid leakage were analyzed separately (OR = 1.34; 95% CI = 0.75-2.41; P = .358), as were children (OR = 1.04; 95% CI = 0.07-14.90; P = 1.000). Antibiotic prophylaxis after basilar skull fractures does not appear to decrease the risk of meningitis.