Publications by authors named "Martin Kleiman"

Piperacillin-tazobactam (PTZ) is known to cause false-positive results in the Platelia Aspergillus enzyme-linked immunoassay (EIA), due to contamination with galactomannan (GM). We tested 32 lots of PTZ and 27 serum specimens from patients receiving PTZ. GM was not detected in the lots of PTZ; one serum specimen (3.

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We report a case of mediastinal fibrosis secondary to histoplasmosis in a 9-year old male, who presented with superior vena cava syndrome. He was successfully treated by percutaneous superior vena cava stent placement in the outpatient cardiac catheterization laboratory.

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This report describes clinical manifestations of histoplasmosis in 6-month-old dizygotic twins, one of whom developed disseminated histoplasmosis of infancy while his sibling remained well, but developed serologic evidence of histoplasmosis. The report also documents histoplasma antigen concentrations in serum and urine before, during and after completing antifungal therapy.

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Study Objective: To determine whether a reported antibiotic allergy was likely to have been immunologically mediated.

Design: Questionnaire-based study.

Setting: Tertiary care, freestanding children's hospital.

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Life-threatening histoplasmosis is one of the most common opportunistic infections in patients receiving tumor necrosis factor (TNF) blockers. Delays in considering the diagnosis may lead to increased morbidity and mortality. Most affected patients present with pneumonitis, usually accompanied by additional signs of progressive dissemination, or with signs of progressive dissemination alone.

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Article Synopsis
  • A 14-year-old girl with hyperimmunoglobulin E syndrome experienced symptoms like fatigue, abdominal pain, fever, and weight loss.
  • Endoscopic tests showed her terminal ileum had ulceration and inflammation, and lab analysis revealed the presence of yeast linked to Histoplasma capsulatum.
  • She was treated with oral itraconazole, leading to a quick and full recovery.
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We report an infant with localized pulmonary histoplasmosis in whom Histoplasma antibody assays, quantitative Histoplasma urine and serum antigen concentrations, and histopathologic findings of a mediastinal mass were nondiagnostic. A provisional diagnosis of histoplasmosis was established by using laboratory methods that increase the sensitivity of the antigen assay using ultrafiltration of urine and ethylenediaminetetraacetic acid/heat denaturation of serum proteins.

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Hearing loss has long been documented to occur during the course of meningitis. We report a case of a child presenting with deafness as the principal complaint of bacterial meningitis.

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Evidence-based guidelines for the management of patients with histoplasmosis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 30:688-95). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them.

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We retrospectively identified all children with acute hip pain who underwent pelvic magnetic resonance (MR). Children with septic hip or history of trauma were excluded; the remaining children with signs of infection (fever, >38 degrees C; leukocytosis, >12 x 10(9)/L; or elevated erythrocyte sedimentation rate [ESR], >30 mm/h) comprised the study group. Thirty-three children (9 girls; age, 0.

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Article Synopsis
  • Acute pelvic pyomyositis is rare in non-tropical regions and primarily affects children, with a study analyzing 20 cases found between 2002 and 2005.
  • Most cases were secondary to other conditions like osteomyelitis or septic hip, with Staphylococcus aureus being the most commonly cultured bacteria.
  • The study highlights the importance of considering septic hip as a primary diagnosis in children with fever and hip pain, and suggests MRI as the best imaging method for detecting pyomyositis and related infections.
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  • - Three boys aged 8 to 14 faced dysphagia or chest pain during eating, leading to medical evaluations.
  • - Imaging studies revealed mid-esophageal traction diverticula, linked to inflammation from nearby infected lymph nodes due to histoplasmosis.
  • - Each boy received tailored antifungal and anti-inflammatory treatments, resulting in full recovery.
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  • Chlamydia trachomatis exposure at birth can lead to serious health issues such as conjunctivitis and pneumonia, prompting a shift in the recommended treatment from erythromycin prophylaxis to a watchful waiting approach.
  • A decision tree analysis was conducted to compare the costs of erythromycin prophylaxis against watchful waiting for 100,000 neonates, revealing that watchful waiting is significantly cheaper ($15.1 million vs $28.3 million).
  • The study concluded that while erythromycin can prevent some pneumonia cases, it also potentially causes pyloric stenosis, suggesting that the watchful waiting strategy is preferable for asymptomatic neonates, with certain conditions where prophylaxis might be reconsidered.
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Anti-tumor necrosis factor-alpha (TNF-alpha) antibodies are frequently used to treat inflammatory diseases. However, these drugs also have immunosuppressive effects. We report on three patients who developed disseminated histoplasmosis on therapy with TNF-alpha inhibitors.

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Capnocytophaga canimorsus causes dog-bite wound induced sepsis in adults, but infection may follow mucous membrane exposure. Systemic infection in children is extremely rare. A neonate with frequent exposure to a family dog and no cutaneous infection developed C.

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Histoplasmosis is the most common endemic respiratory mycosis in the United States. We report the clinical and imaging findings in a case of a child with the rare presentation of a neck abscess and mediastinal lymphadenopathy secondary to acute, non-disseminated histoplasmosis. Imaging findings often mimic other granulomatous infections such as tuberculosis or neoplastic processes such as lymphoma.

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