Abstract:
:CSF evaluation is the single most important aspect of the laboratory diagnosis of meningitis. Analysis of the CSF abnormalities produced by bacterial, mycobacterial, and fungal infections may greatly facilitate diagnosis and direct initial therapy. Basic studies of CSF that should be performed in all patients with meningitis include measurement of pressure, cell count and white cell differential; determination of glucose and protein levels; Gram's stain; and culture. In bacterial meningitis, Limulus lysate assay and tests to identify bacterial antigens may allow rapid diagnosis. Where there is strong suspicion of tuberculous or fungal meningitis, CSF should also be submitted for acid-fast stain, India ink preparation, and cryptococcal antigen; unless contraindicated by increased intracranial pressure, large volumes (up to 40-50 mL) should be obtained for culture. If a history of residence in the Southwest is elicited, complement-fixing antibodies to Coccidioides immitis should also be ordered. Newer tests based on immunologic methods or gene amplification techniques hold great promise for diagnosis of infections caused by organisms that are difficult to culture or present in small numbers. Despite the great value of lumbar puncture in the diagnosis of meningitis, injudicious use of the procedure may result in death from brain herniation. Lumbar puncture should be avoided if focal neurologic findings suggest concomitant mass lesion, as in brain abscess, and lumbar puncture should be approached with great caution if meningitis is accompanied by evidence of significant intracranial hypertension. Institution of antibiotic therapy for suspected meningitis should not be delayed while neuroradiologic studies are obtained to exclude abscess or while measures are instituted to reduce intracranial pressure.
journal_name
Infect Dis Clin North Amjournal_title
Infectious disease clinics of North Americaauthors
Greenlee JEsubject
Has Abstractpub_date
1990-12-01 00:00:00pages
583-98issue
4eissn
0891-5520issn
1557-9824journal_volume
4pub_type
杂志文章,评审abstract::No practitioner can hide from HIV. Patients infected with HIV are treated in every type of practice setting as the number of cases increases at an alarming rate. This article provides 10 basic guidelines for the care of HIV-infected patients. ...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::Influenza is a zoonotic respiratory virus that affects birds, mammals, and humans. Influenza viruses are unique in their genetic instability, which frequently results in antigenic drift or shift. Antigenic shifts are responsible for influenza epidemics. Influenza A pandemics have been responsible for millions of death...
journal_title:Infectious disease clinics of North America
pub_type: 历史文章,杂志文章
doi:10.1016/S0891-5520(03)00095-3
更新日期:2004-03-01 00:00:00
abstract::The emergence of resistance to antimicrobial agents continues to be a major problem among both nosocomial and community-acquired pathogens. Bacteria employ a variety of strategies to avoid the inhibitory effects of antibiotic agents, and have evolved highly efficient means for the dissemination of resistance traits. T...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::Bronchiolitis is a lower respiratory tract illness caused by viral infection in children 2 years of age and younger, frequently associated with wheezing on physical examination. It is a common cause of hospitalization, particularly in patients with risk factors for more serious disease. The diagnosis can be made based...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2017.10.002
更新日期:2018-03-01 00:00:00
abstract::Staphylococcus aureus is an important pathogen in the hospital and in the community, and it is increasingly resistant to multiple antibiotics. A nonantimicrobial approach to controlling S aureus is needed. The most extensively tested vaccine against S aureus, which is a capsular polysaccharide-based vaccine known as S...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2008.10.005
更新日期:2009-03-01 00:00:00
abstract::The viral hemorrhagic fever (VHF) syndrome is a potentially life-threatening infection typified by a combination of a capillary leak syndrome and bleeding diathesis. Most but not all agents causing VHF are arboviruses, with transmission to humans resulting from an arthropod bite. Agents of VHF affect humans on all con...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2012.02.003
更新日期:2012-06-01 00:00:00
abstract::Antiretroviral management of treatment-naive patients begins with the decision of when to start treatment. Current treatment guidelines suggest starting therapy in anyone with AIDS, HIV-related symptoms, or a CD4 cell count less than 200/mm3 regardless of symptoms. Starting treatment in asymptomatic patients with CD4 ...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章
doi:10.1016/j.idc.2007.01.002
更新日期:2007-03-01 00:00:00
abstract::Prevention is the best method for avoiding potentially serious complications of Lyme and other tick-borne diseases. In this article, we discuss preventative measures that can be used by individuals or communities. Among the topics discussed are personal protective measures, tick reduction, reservoir reduction, and vac...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2008.03.007
更新日期:2008-09-01 00:00:00
abstract::Although antibiotic therapy is the mainstay of therapy for gram-negative bacillary bacteremia, the amelioration of the underlying conditions, the correction of predisposing factors, the drainage of abscesses, the removal of infected foreign bodies, and adequate supportive care are also of paramount importance for curi...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-12-01 00:00:00
abstract::Changes that occur in the pharmacology of drugs in the elderly must be considered in the use of antimicrobial agents. Although absorption of orally administered drugs is not affected in a significant way, renal function decreases, drug-drug interactions increase, compliance with regimens may be decreased, and drug tox...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(05)70252-x
更新日期:2000-06-01 00:00:00
abstract::Diarrhea is one of the most common causes of morbidity and mortality in children worldwide. The causes of acute diarrhea in children vary with the location, time of year, and population studied. There is increasing recognition of a widening array of enteric pathogens associated with diarrheal diseases. Adequate fluid ...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2005.05.003
更新日期:2005-09-01 00:00:00
abstract::Animal models have proven to be invaluable in bridging the gap between in vitro susceptibility testing of an antibiotic and anticipating results obtained in clinical studies. Variables such as antibiotic concentration, inoculum of organism, and pharmacokinetic parameters of the drug can be carefully controlled to prov...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::Traditionally, imaging of renal infections was largely through a multimodality approach. Excretory urography, ultrasonography, nuclear scintigraphy, and CT all played major roles; however, in recent years, CT has increased in prominence in the imaging and evaluation of renal infection. Part of the reason for this tren...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(05)70380-9
更新日期:1997-09-01 00:00:00
abstract::This article summarizes the epidemiologic evidence linking Mycoplasma genitalium to sexually transmitted disease syndromes, including male urethritis, and female cervicitis, pelvic inflammatory disease, infertility, and adverse birth outcomes. It discusses the relationship of this bacterium to human immunodeficiency v...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2013.08.003
更新日期:2013-12-01 00:00:00
abstract::The nature of infections after solid-organ transplantation has changed with increasingly potent immunosuppressive regimens, routine use of antimicrobial prophylaxis, and improved microbiologic diagnostic tools. New pathogens have been identified in this population including many with significant antimicrobial resistan...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2010.01.005
更新日期:2010-06-01 00:00:00
abstract::Bioterrorism preparedness is clearly a goal for the health care community, working in concert with city, county, state, and federal public health and emergency authorities and in collaboration with law enforcement at the local and federal levels. Opening the channels of communication between all groups involved, obtai...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(05)70189-6
更新日期:2001-12-01 00:00:00
abstract::Serum protein binding of antimicrobials can reduce antimicrobial activity, restrict tissue distribution, and delay drug elimination. Binding percentages of 80 per cent or more have the potential to significantly reduce free drug levels and affect therapeutic efficacy in patients. However, binding-induced alterations i...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-09-01 00:00:00
abstract::Cytomegaloviruses (CMVs) are DNA viruses and are members of the Herpesviridae family. Morphologically, CMV resembles other herpes viruses, particularly herpes simplex viruses, with important cytopathic differences. CMVs are recognized pathogens that cause community-acquired pneumonia (CAP) in compromised hosts, such a...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2009.10.008
更新日期:2010-03-01 00:00:00
abstract::Oral mucositis is a serious complication of cancer therapy and in severely immunosuppressed patients. In immunosuppressed patients, the signs and symptoms of infection often are muted because of limited host response, and accurate diagnosis and appropriate treatment may be difficult. Prevention of mucosal breakdown, s...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2007.03.003
更新日期:2007-06-01 00:00:00
abstract::Herpes zoster (HZ) is the result of reactivation of latent varicella zoster virus (VZV) and occurs most frequently in older adults. Classically, HZ presents as a unilateral, selflimited, dermatomal rash. Postherpetic neuralgia (PHN) is a common sequela, presenting as severe pain that persists after the rash has resolv...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2017.07.016
更新日期:2017-12-01 00:00:00
abstract::The most frequent and best-studied agent of urinary tract infection (UTI) is Escherichia coli, which serves as a useful model pathogen for understanding microbial virulence in relation to UTI pathogenesis. The E. coli strains that cause most UTIs and other extraintestinal E. coli infections represent a highly speciali...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(03)00027-8
更新日期:2003-06-01 00:00:00
abstract::The desideratum of "appropriate" antibiotic therapy include efficacy, safety, and low cost. Strategies for achieving these goals include education, control of the hospital formulary, written justification forms and automatic stop orders, ongoing utilization review, restriction, required consultation, control of labora...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1989-12-01 00:00:00
abstract::Infection with HIV is a problem of growing magnitude among women and children in the United States. During 1991, AIDS will be among the five leading causes of death for women of childbearing age. Over 80% of children with HIV have acquired the infection vertically, and AIDS is now a leading cause of death of children ...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::Viral hepatitis is a major global public health problem affecting hundreds of millions of people and is associated with significant morbidity and mortality. Five major biologically unrelated hepatotropic viruses cause most of the global burden of viral hepatitis. Hepatitis B and hepatitis C are associated with a signi...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2019.08.004
更新日期:2019-12-01 00:00:00
abstract::This article provides background information on the pharmacokinetics of antibacterial agents in patients who have normal and impaired renal function. Tables are provided to allow quick determination of appropriate dosages for varying degrees of renal failure. The use of serum levels; newer strategies for cefazolin, va...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.idc.2009.06.009
更新日期:2009-12-01 00:00:00
abstract::Pneumonia remains a major cause of morbidity and mortality in the immunocompromised host. The type and timing of immunosuppression will predispose the patient to infections with certain pathogens. This article discusses the types of immunosuppression and their infectious and noninfectious implications. Key points of t...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(05)70210-5
更新日期:1998-09-01 00:00:00
abstract::This article addresses current issues regarding serologic testing for selected STDs, particularly those for which serologic testing has been useful for diagnosis, monitoring therapy, or seroepidemiology. For each selected pathogen, the authors discuss the strengths and weaknesses of the serologic tests as diagnostic a...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
abstract::The rapid rate of increase in reported cases of Lyme disease exceeds that of any zoonotic disease, and the annual occurrence of cases is greater than the sum of all other tick-borne illnesses in the United States. This, in addition to the geographic spread of cases to most of the United States, has greatly heightened ...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1991-03-01 00:00:00
abstract::Antigens located in the midgut of the tick are hidden from the host's immune system. Egg production of ticks can be reduced when ticks are fed on animals vaccinated with midgut antigens of the tick, and a subunit vaccine formulated with the recombinant antigen Bm86 is now available that can reduce the number of ticks ...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(05)70051-9
更新日期:1999-03-01 00:00:00
abstract::Anti-varicella-zoster virus serum antibody assays and their use in vaccine development are described. Of particular interest are FAMA and neutralization assays and the gpELISA. These and other assays are compared and summarized in terms of characteristics including biologic relevance, sensitivity, specificity, and sui...
journal_title:Infectious disease clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0891-5520(05)70311-1
更新日期:1996-09-01 00:00:00