Southern medical journal
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Southern medical journal · Apr 2001
Prevalence of penicillin-nonsusceptible Streptococcus pneumoniae in nasopharyngeal cultures from patients with sickle cell disease.
Prevention of pneumococcal sepsis in children with sickle cell disease (SCD) is threatened by the emergence of penicillin-nonsusceptible pneumococci. ⋯ Penicillin prophylaxis decreased the rate of S pneumoniae colonization in SCD patients; however, it also increased the risk of selective colonization with penicillin-nonsusceptible S pneumoniae.
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Scapulothoracic dissociation refers to the traumatic separation of the shoulder from the chest wall. This most commonly occurs as a closed injury. We present a case of open scapulothoracic dissociation and emphasize clinical features unique to this injury. ⋯ Patients with ischemia and an incomplete injury or unreliable neurologic examination need revascularization. Outcome is based on the extent of brachial plexus or cervical nerve root avulsion. Patients with loss of neurologic function ultimately benefit from amputation at the appropriate level.