Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Feb 2002
Procalcitonin, C-reactive protein and APACHE II score for risk evaluation in patients with severe pneumonia.
Procalcitonin (PCT) is a peptide that is found elevated in patients with sepsis and severe infections. In healthy persons PCT serum levels are below 0.1 ng/mL. The aim of this study was to investigate the value of serum PCT determination for risk evaluation in patients with pneumonia. ⋯ Change in PCT on admission and at the end of the observation period significantly indicated a clinical change.
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Clin. Microbiol. Infect. · Feb 2002
EditorialProcalcitonin and other markers of infection. What should be their role in clinical practice?
Clinicians are always faced with a decision when confronted with a febrile patient; they must decide between what is an infectious condition and what is not, and between what merits hospital observation, what requires empirical antibiotic treatment and what needs outpatient follow-up. In this respect, judgement based on medical history and physical examination outweigh the predictive value of various laboratory markers of infection, as the latter generally reflect a nonspecific reaction of the host to widely different infectious and inflammatory stimuli. In the evaluation of specific subgroups of patients, e.g. those in the intensive care unit, laboratory tests should also preferably form a continuum with medical history and physical examination, aimed at clarifying host condition, the setting and the source of a possible infection.
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Clin. Microbiol. Infect. · Dec 2001
Prevention and management of infections in patients without a spleen.
Patients who lack a functioning spleen become vulnerable to sepsis caused by bacteria and, occasionally, protozoa. The risk is higher in children and in those who have had immunosuppressive treatment, and the risk remains lifelong. Overwhelming post-splenectomy infection (OPSI) occurs at an estimated incidence of 0.23-0.42% per year, with a lifetime risk of 5%. ⋯ These are surgical conservation of the spleen; immunization against S. pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis; prophylactic antibiotics; stand-by antibiotics; patient information sheets; and a medical alert bracelet. Asplenic patients living in malaria-endemic areas require optimal prophylaxis. The initial step in prevention of OPSI is the creation of an asplenia register, as many patients are not covered by these simple measures.
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Clin. Microbiol. Infect. · Jan 2001
ReviewChanging spectrum of invasive candidiasis and its therapeutic implications.
Emerging trends in invasive candidiasis are notable for a dramatic increase in infections due to non-albicans Candida species. An increasing number of immunocompromised patients at risk from fungal infections, an overall greater acuity of illness in the hospitalized patients, particularly those in the critical care units, escalating rates of broad-spectrum antibiotic usage, and wide utilization of azoles as prophylaxis have probably contributed towards the changing epidemiology of invasive candidiasis. Given the inherent decreased susceptibility of many of the non-albicans Candida species to currently available antifungal agents, these evolving trends have far-reaching clinical relevance.