Arch Surg Chicago
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A retrospective review was conducted to determine the clinical reliability of computed tomography(ic) (CT) in the initial evaluation of pediatric blunt abdominal trauma. Sixty patients underwent CT with infusion over the two-year study period. Seventeen injuries were identified by CT scans in 12 patients. ⋯ Other diagnostic studies (nuclear imaging, ultrasonography, upper gastrointestinal tract studies) that were obtained in some patients also confirmed the CT findings. Patients who had normal CT scans had unremarkable hospital courses, and none required reevaluation for missed injury. Only two CT scans were inadequate due to motion artifact.
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A retrospective study was undertaken to examine the incidence and clinical significance of enterococcal bacteremia in burned patients with enterococcal burn-wound infections. During a 26-month period from 1983 to 1985, 38 patients were found to have enterococcal burn-wound infections. Twenty of these patients developed positive blood cultures for enterococcus with no other identifiable source for the bacteremia. ⋯ Prior antibiotic therapy did not appear to increase the risk for enterococcal infection, and specific therapy against the enterococcus after the bacteremia was identified appeared to have no effect on mortality. Mortality was significantly greater for bacteremic patients than for patients with enterococcal wound infection alone or for burned patients without enterococcal infections. Although previously not considered pathogenic, enterococcal burn-wound infections should prompt aggressive therapy to prevent the development of enterococcal sepsis with its associated high mortality.