Use of ceftriaxone in the treatment of bacterial infections in cirrhotic patients.

Sixty-two episodes of bacterial infection were studied in 51 cirrhotic patients. 2 g of ceftriaxone (active ingredient of Rocephin) were given intravenously once daily for 7-10 days. The infections were pneumonia, bacteremia, spontaneous bacterial peritonitis, urinary infection and others.

Congenital leukemia: persistent spontaneous regression in a patient with an acquired abnormal karyotype.

Congenital leukemia is a rare disease accounting for about 1% of all leukemias in childhood. While cases associated with Down's syndrome not infrequently show a spontaneous regression, such an event is very rare in non-Down cases and exceptional in those (among the latter) which present clonal cytogenetic alterations in the neoplastic cells. We present the case of a patient with congenital leukemia and an abnormal karyotype (limited to the neoplastic clone), in which an apparently spontaneous and prolonged remission occurred after a relapse.

[Mycoplasma pneumoniae infections. A multicenter retrospective study of 182 cases].

The spectrum of 182 hospital Mycoplasma pneumoniae infections, collected over a five-year period, is reviewed. The diagnosis was based on complement fixation test. Mycoplasma infection was encountered mainly in young people, mean age 29 years.

[Pharmacokinetics of ceftriaxone in intensive care].

Pharmacokinetic parameters of ceftriaxone were studied on day 1 and 5 in 21 patients admitted in an ICU for severe infections. All patients received a single daily infusion of 2 g of ceftriaxone during 15 minutes. We have determined the ratio to the daily dose of serum ceftriaxone concentrations (peak level and trough level) and of areas under the curve.

[Fatal acute pneumonopathies in disseminated lupus erythematosus].

Two cases of systemic lupus erythematosus (SLE) complicated by pneumonia which resulted in death are reported. The first patient, a 21-year old woman, died of acute diffuse lupus pneumonia; the initial and unusual radiological image of "multiple balloons" progressed within 2 months to terminal interstitial fibrosis. The second patient, a 60-year old woman, died of infection on an interstitial pneumonia which turned into severe fibrosis within 16 months.

[Ewing's sarcoma in preschool children. Description of 6 cases].

Ewing's sarcoma (ES) is rarely diagnosed in the pre-school age; these few cases however present a number of difficult diagnostic and therapeutic problems. The Authors describe a series of six such cases aged less than 4 years diagnosed in the period 1974-1987. Standard treatment was modified with the purpose to reduce acute toxicity and late sequelae.

Pharmacokinetics and toxicity of methotrexate in children with Down syndrome and acute lymphocytic leukemia.

Children with Down syndrome and acute lymphocytic leukemia (ALL) have poor tolerance to antineoplastic drugs, including methotrexate (MTX). We evaluated MTX pharmacokinetics and toxicity in five patients with Down syndrome and ALL who had received multiple high doses of MTX (1 g/m2). Three control patients without Down syndrome were matched to each case according to sex, race, age, and initial leukocyte count.

Ultrasensitive assay of thyroid stimulating hormone in patients with acute non-thyroidal illness.

Serum TSH in critically ill euthyroid patients is generally within the normal range when measured with conventional radioimmunoassays. Sensitive immunoradiometric assays allow detection of low levels of serum TSH. We assessed this method in a prospective study of 34 euthyroid patients admitted to our critical care unit.

[Antibioprophylaxis of Meningococcus group B meningitis. Must we implicate the use of the spiramycin].

A fatal meningitis due to a spiramycin-sensitive group B Neisseria meningitidis occurred 13 days after interruption of a prophylactic antimicrobial therapy with spiramycin. The efficacy of recommended antimicrobial preventive treatment is discussed with regard to this case, other published cases and to the known partial and short term eradication of the naso-pharyngeal carriage of Neisseria meningitidis.

Current concepts in immune derangement due to undernutrition.

Protein-calorie malnutrition (PCM) adversely affects more or less all immune competent cells. Nonspecific immunity is impaired, particularly adherence and chemotaxis of phagocytes, although the responsiveness of circulating cells may not be the same as that of noncirculating cells. PCM results in numerical and functional impairment in lymphocytes.

[Severe pneumopathy and acute renal insufficiency disclosing Chlamydia psittaci infection: resistance to the treatment with erythromycin].

The authors report one case of psittacosis with acute respiratory distress syndrome, acute tubulo-interstitial nephropathy and jaundice. Erythromycin therapy was uneffective but recovery was obtained with minocycline and rifampicin treatment. Early diagnosis of Chlamydia psittaci infection is mandatory in order to prevent severe complications and to institute appropriate antimicrobial therapy.

Measurement of irradiation doses secondary to bedside radiographs in a medical intensive care unit.

The authors prospectively studied the radiation doses to radio-sensitive organs secondary to bedside radiographs in intensive care patients and in a control phantom. Dosimeters were taped on different organs during each bedside X-ray. The mean radiation doses, expressed in 10(-5) Gy (m-rad), for an "average patient" who was hospitalized 9 days and had 6 chest X-rays were respectively: 292 to the sternal bone marrow; 239 to the thyroid gland; 3 to the testes; 1 to the ovaries; 605 to the eye for 2 maxillary sinus X-rays.

[2 unusual manifestations of LAV-HTLV virus infection: BCGitis and pulmonary chickenpox].

A patient with AIDS developed local complications of BCG vaccination and disseminated chickenpox with severe pneumonia. This cas suggests that AIDS patients should not receive BCG vaccination and that adults with severe chickenpox should be investigated for LAV/HTLV III virus carriage.

Neurologic complications in a group of 86 bacterial endocarditis.

Criteria defined by von Reyn were applied to 86 cases of bacterial endocarditis. Neurologic complications (NC) were categorized according to Pruitt definitions. Neurologic accidents were observed in 48 cases.

Acute renal failure caused by extreme hyperphosphatemia after chemotherapy of an acute lymphoblastic leukemia.

The authors report a documented case of hyperphosphatemia-induced nephrocalcinosis after chemotherapy of an acute lymphoblastic leukemia (ALL). Microscopic examination of the kidney showed numerous calcium deposits with concentric structure in the calyces and in the tubules. Electronic microsound analysis proved the deposits to be composed of calcium phosphate.