International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Int. J. Infect. Dis. · Jul 2012
Case ReportsRepeated dengue shock syndrome and 'dengue myocarditis' responding dramatically to a single dose of methyl prednisolone.
The place of steroids in the management of severe forms of dengue is unclear. A retrospective observational study showed the benefits of a single dose of intravenous methyl prednisolone in a highly selected group of patients who developed severe dengue during the febrile phase of infection. We report the case of a 14-year-old boy with dengue who developed three episodes of severe hemodynamic compromise while having high fever, 'myocarditis', third space fluid accumulation, progressive reduction in urine output, and altered mentation, who made a dramatic recovery following a single dose of intravenous methyl prednisolone. Results justify a well powered randomized controlled trial to evaluate the efficacy of this treatment in severe dengue.
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Int. J. Infect. Dis. · Jul 2012
Clinical characteristics of influenza A H1N1 versus other influenza-like illnesses amongst outpatients attending a university health center in Oman.
To identify the clinical characteristics of outpatients with flu-like illnesses stratified by influenza A H1N1 status. ⋯ This study provides useful data on the clinical characteristics of H1N1 influenza in a large outpatient population from the Middle East. Patients who tested positive for H1N1 were more likely to have fever, sore throat, diarrhea, and myalgia compared to those with other influenza-like illnesses.
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Int. J. Infect. Dis. · Jun 2012
Predictors of septic shock in patients with methicillin-resistant Staphylococcus aureus bacteremia.
Risk factors for septic shock associated with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia are not well described. We designed this study to assess the independent predictors of septic shock in patients with MRSA bacteremia. ⋯ The development of septic shock associated with MRSA bacteremia was independently correlated with baseline severity of illness, presence of acute renal failure, and an MRSA genotyping consistent with nosocomially acquired MRSA infection.
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Int. J. Infect. Dis. · May 2012
Bloodstream infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary care hospital in New Zealand: risk factors and outcomes.
To define local risk factors and outcomes for bacteremia with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) at a tertiary hospital in New Zealand. ⋯ The association with fluoroquinolone exposure suggests that measures to reduce unnecessary use may be an effective preventative strategy. Known colonization with ESBL-E is a strong risk factor for ESBL-E bacteremia, and colonization status should be taken into consideration when choosing empirical therapy.
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Int. J. Infect. Dis. · Apr 2012
Randomized Controlled Trial Comparative StudyComparison of doxycycline-streptomycin, doxycycline-rifampin, and ofloxacin-rifampin in the treatment of brucellosis: a randomized clinical trial.
Traditional regimens for the treatment of brucellosis are associated with significant relapse rates. The aim of this study was to compare the efficacy of ofloxacin plus rifampin (OFX-RIF) versus doxycycline plus streptomycin (DOX-STR) and doxycycline plus rifampin (DOX-RIF) regimens in the treatment of brucellosis. ⋯ We conclude that the DOX-STR combination should remain the first-line regimen for the treatment of brucellosis in our region; we recommend DOX-RIF and OFX-RIF combinations as the second-line regimens.