马红球菌败血症一例

患者 ,女 ,5 5岁 ,农民。 2 0 0 1年 7月 2 8日就诊。因上腹部间断性疼痛 2年 ,持续性剧疼 7d ,并向左侧腰背部放射。伴高热、恶心、呕吐。查体 :皮肤干燥、精神萎靡、巩膜轻度黄染、上腹部有剧烈压疼。体温 39.2°C、脉搏 78次 /min、呼吸 2 0次 /min、血压 16 .6 / 10kPa(12 5 / 75mmHg)。B超检查 :胆总管扩张。X线检查 :十二指肠球部溃疡。实验室检查 :血白细胞 2 4 .0× 10 9/L、中性粒细胞 0 .88、淋巴细胞 0 .12。血淀粉酶 2 36U/L ,尿淀粉酶 5 12U/L。血培养两次均有细菌生长。临床诊断 :败血症、十二指肠溃疡。细菌鉴定 :无菌取…     

14例HIV并胸部马红球菌病的动态观察分析

目的探讨HIV并胸部马红球菌病影像动态变化特点。方法分析由细菌学或病理证实HIV并胸部马红球菌病14例,经2-4次X线摄影及2-3次计算机体层摄影影像图片进行动态观察。结果随访观察时间1~12个月,平均4.3个月。肺实变病灶12例,病灶范围消散50%以上6例,消散50%以下4例,无变化1例,肺实变范围增大1例。空洞12例,完全闭合1例,空洞缩小10例,空洞融合成大空洞1例。结节病灶14例,结节病灶数量消散50%以上5例,消散小于50%,大于1%7例,结节数量无变化1例,结节数量增多1例。结论 HIV并胸部马红球菌病影像表现多为实变、空洞、结节灶;结合临床病史、不同时期影像表现的特点,大部分HIV并胸部马红球菌病可以明确诊断。     

流感嗜血杆菌引起泪囊炎1例

患者女 ,33岁 ,因左眼流脓 ,以慢性泪囊炎 (左 ) ,于 2 0 0 1年 3月 15日收住院。入院时 T36 .2℃ ,P80次 /min,Bp10 0 /70 mm Hg(1m m Hg≈ 0 .133k Pa)。一般情况良好 ,神志清 ,心肺听诊无异常。眼科检查 :双睑无充血 ,角膜透明 ,对光反射存在 ,晶体透明 ,眼底正常 ,右侧泪道     

硫酸奈替米星治疗化脓性扁桃体炎28例疗效观察

2004年4月～2006年5月，我们应用硫酸奈替米星治疗化脓性扁桃体炎患者28例，效果较好。现报告如下。     

不同年龄小儿化脓性扁桃体炎与肺炎支原体感染的关系

目的探讨不同年龄小儿化脓性扁桃体炎与肺炎支原体（MP）感染的关系。方法将668例化脓性扁桃体炎（观察组）和2 286例呼吸道感染（对照组）患儿分别分为6个月~3岁、〉3~14岁两组,检测两组MP特异性抗体IgM（MP-IgM）,比较观察组不同年龄患儿的MP-IgM阳性率。结果观察组、对照组6个月~3岁患儿MP-IgM比较无统计学差异（P〉0.05）,〉3~14岁患儿MP-IgM有统计学差异（P〈0.01）;观察组6个月~3岁、〉3~14岁患儿的MP-IgM比较有统计学差异（P〈0.01）。结论 6个月~3岁患儿患化脓性扁桃体炎与MP感染无密切相关性,〉3~14岁患儿患化脓性扁桃体炎与MP感染有密切相关性;化脓性扁桃体炎与MP感染存在年龄差异。     

小脑扁桃体炎引起小脑扁桃体下疝1例报告

患者男,18岁,因进行性头、颈部疼痛伴走路不稳1个月于2005年5月4日入院。自1个月前起患者出现头颈部不适、咽痛、肌肉酸痛、走路不稳、眩晕、恶心呕吐,渐加重。入院查体:T 39.2℃,咽部充血。神经系统检查见眼球水平震颤,指鼻试验及跟膝胫试验阳性。实验室检查:白细胞9.8×109/L,淋巴细胞63%,中性粒细胞41%,谷草转胺酶46 U/L,谷丙转胺酶62 U/L,颅脑CT正常。腰穿见细胞数38/mm3,淋巴小脑扁桃体炎和颈脊髓炎。予内科保守治疗,3周后症状消失,神经系统检查无阳性体征。2个月后复查M R I发现小脑扁桃体大部分上升至正常位置。讨论:Ch iariⅠ…     

中西医结合治疗小儿化脓性扁桃体炎94例疗效观察

2006年1月～2007年1月,我们采用中西医结合的方法治疗小儿化脓性扁桃体炎94例.现报告如下. 临床资料:研究对象为162例急性化脓性扁桃体炎患儿,男90例,女72例;年龄1～15岁,平均9.3岁;均符合1991年全国中医耳鼻喉科学会杭州会议诊断标准:①自觉症状:起病急,咽干灼痛,吞咽痛增,恶寒发热,全身不适.②咽部检查:扁桃体充血肿大,重者隐窝口有黄白脓点,或成假膜,但不超出扁桃体本身,易拭去,不出血;咽部充血,颌下淋巴结肿大,有压痛.     

B群奈瑟脑膜炎球菌引起休克型流行性脑脊髓膜炎1例报道

1病例报告患者,女,16岁,学生,因发热、恶心、呕吐17h,手足发绀3h,于2006年12月9日10﹕30入院。患者开始发病时,感觉全身酸痛不适,发热,体温39.0℃左右,双眼眶胀痛,恶心、呕吐2次,偶有右下肢抽搐。在校医务室治疗,静脉滴注克林霉素,症状     

马棒状杆菌致肺部感染一例

机会感染是医院内感染的一种少见类型 ,随着抗生素、激素及免疫抑制剂的广泛应用 ,一些原发病导致免疫功能低下的患者发生机会感染的情况日渐增多。我们发现马棒状杆菌感染一例 ,现报道如下。患者 ,男性 ,5 3岁。因反复咳嗽、咳痰、喘 2 0余年 ,加重伴心悸、气短 10ｄ天入院。患者每年冬春季发病 ,天暖后缓解 ,常规抗菌药治疗可好转。近 10余年 ,患者出现气短 ,活动后加剧 ,间断双下肢浮肿。本病发作前 10天因受凉感冒后出现咳嗽、咳痰 ,痰为黄粘痰 ,不易咯出 ,伴有胸闷、气短、心悸。既往无家畜接触史。体格检查 :Ｔ 3 7℃ ,Ｐ 12 8次 /ｍ…     

Respiratory infections caused by non-typeable Haemophilus influenzae

PURPOSE OF REVIEW: This review will consider recent developments in the clinical aspects of infections due to non-typeable Haemophilus influenzae. In addition, newer developments in the areas of mechanisms of pathogenesis, host pathogen interaction, immune responses and efforts toward vaccine development will be reviewed briefly. RECENT FINDINGS: Non-typeable H. influenzae continues to be a common cause of otitis media in infants and children, sinusitis in children and adults, pneumonia in adults, and lower respiratory tract infection in adults with chronic obstructive pulmonary disease. While the rate of beta-lactamase production by isolates of H. influenzae varies geographically, most regions show a rate of 20-35% of isolates producing beta-lactamase. Recent studies have highlighted the possible role of bacterial biofilms formed by H. influenzae as a cause of otitis media. Several lines of evidence indicate that H. influenzae causes intracellular infection in the lower respiratory tract in chronic obstructive pulmonary disease and this observation has important implications in understanding the human immune response to the bacterium. Lipooligosaccharide is an important virulence factor for H. influenzae and research is generating new information on the complex role of this molecule in colonization and infection of the respiratory tract. Several surface molecules are under active evaluation as vaccine antigens. SUMMARY: Non-typeable H. influenzae is an important cause of respiratory tract infections in children and adults. Most strains are susceptible to amoxicillin/clavulanate, fluoroquinolones and the newer macrolides. Research in the next decade promises substantial progress in the challenge of developing vaccines for nontypeable H. influenzae.     

Lobar pneumonia caused by Haemophilus influenzae type B

Haemophilus influenzae type b is a rare cause of adult lobar pneumonia and we are unaware of any reported British cases. However in the United States this condition is well described and the incidence is increasing (Levin et al. 1977).     

Purulent pericarditis caused by Haemophilus influenzae type B

Purulent pericarditis, once a common entity associated with intrathoracic infections, such as pneumonia and empyema, has become an infrequent illness in the post-antibiotic era. Prompt recognition and therapy are vital in improving disease-related mortality. Herein, we describe a rare case of Haemophilus influenzae type B purulent pericarditis and associated cardiac tamponade. Antibiotic therapy, pericardial drainage, and subsequent pericardiectomy were performed with resolution of illness.     

Non-typable Haemophilus influenzae severe pneumonia in an infant: case report

Haemophilus influenzae b (Hib) disease used to be a frequent cause of pneumonia in children. After the widespread use of Hib conjugate vaccines, non-b H. influenzae have become an important cause of pneumonia. We present the case of an infant with severe pneumonia with empyema and bacteremia after he had completed the Hib vaccination schedule. Non typable H. influenzae was recovered from blood and pleural effusion cultures. We review the literature about this unusual clinical presentation in our community and alert about the possible emergence of non typable H. influenzae as a frequent cause of community-acquired pneumonia in children.     

Meningitis caused by Haemophilus influenzae in infant rats: protective immunity and antibody priming by gastrointestinal colonization with Escherichia coli.

Infant rats aged five to seven days were fed Escherichia coli O75:K100:H5, E. coli O13:K92:H4, or saline and five weeks later were inoculated with Haemophilus influenzae type b. The incidence of bacteremia and meningitis was significantly less (P less than 0.05) for rats fed E. coli that possessed K100 capsular antigen (cross-reactive with type b capsular antigen) than for rats fed E. coli K92 or saline. Antibody to capsular antigen was not detectable in sera obtained from rats prior to challenge with H. influenzae type b, but five days after challenge, antibody levels were significantly higher (P less than 0.001) in rats colonized with E. coli K100 than in controls. These results, together with data from passive-immunization studies, suggested that the protection against infection with H. influenzae type b was due to priming or serum anticapsular antibody, although a protective role for cell-mediated immunity and/or secretory antibody could not be ruled out. E. coli K100 primed rats vaccinated with purified H. influenzae type b antigen for a significantly increased, although transient, anticapsular antibody response.