Publications by authors named "Sandra H Schwab"
We report a case of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) secondary to trimethoprim-sulfamethoxazole (TMP-Sx) therapy for presumed community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. Although the association between SJS/TEN and the sulfonamide class of antibiotics is well established, the increasing prevalence of CA-MRSA has left practitioners with limited regimens to effectively treat skin and soft tissue infections (SSTIs) in the outpatient setting. In the case of SSTIs, alternative treatment of these infections should be considered, especially when the bacterial pathogen is unknown.
View Article and Find Full Text PDFObjective: We evaluated the diagnostic utility of the presence and number of cerebrospinal fluid (CSF) bands in distinguishing bacterial from aseptic meningitis among children with CSF pleocytosis.
Methods: We identified retrospectively a cohort of children 29 days to 19 years of age with CSF pleocytosis (> or =10 x 10(6) leukocytes per L) who were treated in the emergency departments of 8 pediatric centers between January 2001 and June 2004 and whose CSF was evaluated for the presence of bands. We performed bivariate and multivariate analyses to determine the ability of CSF bands to distinguish bacterial from aseptic meningitis.
Article Synopsis
- The study aimed to assess how administering antibiotics before a lumbar puncture affects cerebrospinal fluid (CSF) profiles in children with bacterial meningitis.
- Researchers analyzed medical records from 245 children with confirmed or probable bacterial meningitis, particularly noting the impact of antibiotics given within 72 hours prior to the procedure.
- The results indicated that patients who received antibiotics had higher CSF glucose levels and lower protein levels, especially those with more than 12 hours of pretreatment, but the duration of antibiotic therapy did not relate significantly to white blood cell counts in the CSF.
Context: Children with cerebrospinal fluid (CSF) pleocytosis are routinely admitted to the hospital and treated with parenteral antibiotics, although few have bacterial meningitis. We previously developed a clinical prediction rule, the Bacterial Meningitis Score, that classifies patients at very low risk of bacterial meningitis if they lack all of the following criteria: positive CSF Gram stain, CSF absolute neutrophil count (ANC) of at least 1000 cells/microL, CSF protein of at least 80 mg/dL, peripheral blood ANC of at least 10,000 cells/microL, and a history of seizure before or at the time of presentation.
Objective: To validate the Bacterial Meningitis Score in the era of widespread pneumococcal conjugate vaccination.