Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
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Drowning and near-drowning can abruptly devastate the lives of both the affected victims and their families. In addition to the complications directly caused by the submersion, several indirect causes of morbidity exist. Infection is one of the complications associated with near-drowning, and pneumonia is the most severe of these infectious complications. ⋯ Herein, we review the epidemiology and pathophysiology associated with near-drowning, discuss the potential mechanisms of infection, and describe the likely risk factors for pneumonia related to near-drowning. We also detail the microbiological causes of this entity and provide important clinical and epidemiological information associated with specific pathogens. Finally, we summarize an appropriate diagnostic and therapeutic approach to pneumonia associated with near-drowning.
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Practice Guideline Guideline
Quality standards for immunization. Guidelines from the Infectious Diseases Society of America.
This is the third in a series of guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. It is presented as a standard of care rather than a practice guideline because the case for following these recommendations is very strong and it should be followed with rare exceptions. The purpose of this guideline is to provide assistance to clinicians when making decisions on providing immunizations to healthy infants, children, and adults. ⋯ The document has been subjected to external review by peer reviewers as well as by the Practice Guidelines Committee and was approved by the IDSA Council. An executive summary and tables highlight the major recommendations. Indicators for measuring compliance with the standards are included.
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Clinical Trial Controlled Clinical Trial
Role of benzathine penicillin G in prophylaxis for recurrent streptococcal cellulitis of the lower legs.
Cellulitis of the lower leg is an infection caused by streptococci or, less commonly, Staphylococcus aureus and other gram-negative rods. Recurrence of cellulitis is a common problem. In the present study, we evaluated the use of monthly intramuscular injections of benzathine penicillin G to prevent recurrences of cellulitis. ⋯ Predisposing factors for cellulitis were found in 57 (49.6%) of the 115 enrolled cases and were mostly related to the impairment of local circulation. Administration of prophylaxis successfully reduced the recurrence rate to zero among patients without predisposing factors but failed to prevent recurrence in those with predisposing factors (20%). We conclude that monthly benzathine penicillin G prophylaxis benefits only patients without predisposing factors for cellulitis.