RESUMEN
Cancer of the colon is the second most common visceral cancer in the United States (lung cancer is the first). It is usually diagnosed in patients older than 40 years, with a peak incidence at 70 years of age. Rarely, are cases seen in the pediatric population. In this study, we report a case of a 13-year-old girl with an 11-month history of intermittent abdominal pain whose diagnosis was delayed due to vague symptoms and a low index of suspicion for this condition.
Asunto(s)
Dolor Abdominal/diagnóstico por imagen , Adenocarcinoma/diagnóstico por imagen , Carcinoma de Células en Anillo de Sello/diagnóstico por imagen , Neoplasias Retroperitoneales/diagnóstico por imagen , Dolor Abdominal/patología , Dolor Abdominal/cirugía , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adolescente , Carcinoma de Células en Anillo de Sello/patología , Carcinoma de Células en Anillo de Sello/cirugía , Resultado Fatal , Femenino , Humanos , Estadificación de Neoplasias , Neoplasias Retroperitoneales/patología , Neoplasias Retroperitoneales/cirugía , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a serious problem in the community setting, primarily as a cause of skin and soft tissue infections. METHODS: A retrospective study based on the review of pediatric inpatients admitted to Lincoln Medical and Mental Health Center from March 2006 to February 2007 was performed. RESULTS: Eighteen (55%) of the thirty-three patients identified were infected with community associated (CA) MRSA. All patients had skin and soft tissue infections. Seventeen (94%) of eighteen CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole and tetracycline, respectively, and eleven (61%) were susceptible to levofloxacin. CONCLUSIONS: Skin and soft tissue infections are the most common clinical manifestation of CA-MRSA in our population. The 55% prevalence of MRSA in our patients suggests reconsidering empirical antimicrobial choices. Surgical intervention is important in the management of these infections, and clindamycin resistance among CA-MRSA isolates should be monitored locally to determine if empiric therapy is appropriate.
Asunto(s)
Infecciones Comunitarias Adquiridas/microbiología , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Infecciones de los Tejidos Blandos/microbiología , Infecciones Estafilocócicas/microbiología , Infecciones Cutáneas Estafilocócicas/microbiología , Adolescente , Antibacterianos/uso terapéutico , Niño , Preescolar , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/terapia , Femenino , Hospitales Pediátricos , Hospitales Urbanos , Humanos , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Ciudad de Nueva York/epidemiología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Infecciones de los Tejidos Blandos/epidemiología , Infecciones de los Tejidos Blandos/terapia , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/terapia , Infecciones Cutáneas Estafilocócicas/epidemiología , Infecciones Cutáneas Estafilocócicas/terapiaRESUMEN
We identified main asthma risk factors for children living in the South Bronx, where asthma rates are eight times higher than the national average. This case-control study enrolled 261 children at Lincoln Medical and Mental Health Center from 2002 to 2003. We questioned the mothers on medical history and home environment. The most important risk factors for asthma in the South Bronx pediatric population are Hispanic ethnicity, family history of asthma, and exposure to tobacco smoke. South Bronx children limited to breast-feeding during the first 3 months of age are less likely to develop asthma.
Asunto(s)
Asma/epidemiología , Estudios de Casos y Controles , Preescolar , Humanos , Ciudad de Nueva York/epidemiología , Factores de RiesgoRESUMEN
OBJECTIVES: To characterize risk factors associated with pneumococcal disease and asymptomatic colonization during an outbreak of multidrug-resistant Streptococcus pneumoniae (MDRSP) among AIDS patients in a long-term-care facility (LTCF), evaluate the efficacy of antimicrobial prophylaxis in eliminating MDRSP colonization, and describe the emergence of fluoroquinolone resistance in the MDRSP outbreak strain. DESIGN: Epidemiologic investigation based on chart review and characterization of SP strains by antimicrobial susceptibility testing and PFGE and prospective MDRSP surveillance. SETTING: An 80-bed AIDS-care unit in an LTCF PARTICIPANTS: Staff and residents on the unit. RESULTS: From April 1995 through January 1996, 7 cases of MDRSP occurred. A nasopharyngeal (NP) swab survey of all residents (n=65) and staff (n=70) detected asymptomatic colonization among 6 residents (9%), but no staff. Isolates were sensitive only to rifampin, ofloxacin, and vancomycin. A 7-day course of rifampin and ofloxacin was given to eliminate colonization among residents: NP swab surveys at 1, 4, and 10 weeks after prophylaxis identified 1 or more colonized residents at each follow-up with isolates showing resistance to one or both treatment drugs. Between 1996 and 1999, an additional 6 patients were diagnosed with fluoroquinolone-resistant (FQ-R) MDRSP infection, with PFGE results demonstrating that the outbreak strain had persisted 3 years after the initial outbreak was recognized. CONCLUSIONS: Chemoprophylaxis likely contributed to the development of a FQ-R outbreak strain that continued to be transmitted in the facility through 1999. Long-term control of future MDRSP outbreaks should rely primarily on vaccination and strict infection control measures.
Asunto(s)
Infección Hospitalaria/microbiología , Brotes de Enfermedades/prevención & control , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/aislamiento & purificación , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/microbiología , Adulto , Profilaxis Antibiótica , Vacunas Bacterianas/inmunología , Infección Hospitalaria/prevención & control , Infección Hospitalaria/transmisión , ADN Bacteriano/análisis , ADN Bacteriano/genética , Farmacorresistencia Bacteriana/efectos de los fármacos , Farmacorresistencia Bacteriana/inmunología , Resistencia a Múltiples Medicamentos/efectos de los fármacos , Resistencia a Múltiples Medicamentos/inmunología , Electroforesis en Gel de Campo Pulsado , Femenino , Instituciones de Salud , Humanos , Tiempo de Internación , Cuidados a Largo Plazo , Masculino , Persona de Mediana Edad , Enfermedades Nasofaríngeas/epidemiología , Enfermedades Nasofaríngeas/microbiología , Enfermedades Nasofaríngeas/prevención & control , New York/epidemiología , Infecciones Neumocócicas/complicaciones , Infecciones Neumocócicas/epidemiología , Factores de Riesgo , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/inmunologíaAsunto(s)
Bronquiolitis/diagnóstico , Competencia Clínica , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Neuritis Óptica/diagnóstico , Neumonía Bacteriana/diagnóstico , Adolescente , Corticoesteroides/uso terapéutico , Antibacterianos/uso terapéutico , Bronquiolitis/tratamiento farmacológico , Niño , Trastornos de Alimentación y de la Ingestión de Alimentos/terapia , Femenino , Humanos , Lactante , Masculino , Moraxella catarrhalis/aislamiento & purificación , Infecciones por Moraxellaceae/diagnóstico , Infecciones por Moraxellaceae/tratamiento farmacológico , Neuritis Óptica/tratamiento farmacológico , Pediatría/normas , Pediatría/tendencias , Neumonía Bacteriana/tratamiento farmacológico , MuestreoAsunto(s)
Carbunco , Botulismo , Fiebres Hemorrágicas Virales , Viruela , Tularemia , Carbunco/epidemiología , Carbunco/etiología , Carbunco/fisiopatología , Bioterrorismo , Botulismo/epidemiología , Botulismo/etiología , Botulismo/fisiopatología , Fiebres Hemorrágicas Virales/epidemiología , Fiebres Hemorrágicas Virales/etiología , Fiebres Hemorrágicas Virales/fisiopatología , Humanos , Peste/epidemiología , Peste/etiología , Peste/fisiopatología , Viruela/epidemiología , Viruela/etiología , Viruela/fisiopatología , Tularemia/epidemiología , Tularemia/etiología , Tularemia/fisiopatología , Estados UnidosAsunto(s)
Bacteriemia/inmunología , Complemento C6/deficiencia , Huésped Inmunocomprometido , Infecciones Meningocócicas/inmunología , Adolescente , Bacteriemia/tratamiento farmacológico , Bacteriemia/genética , Ceftriaxona/administración & dosificación , Femenino , Asesoramiento Genético , Humanos , Infusiones Intravenosas , Masculino , Infecciones Meningocócicas/tratamiento farmacológico , Infecciones Meningocócicas/genética , Neisseria meningitidis/aislamiento & purificación , Linaje , PronósticoAsunto(s)
Microbiología de Alimentos , Leche Humana/microbiología , Sepsis/etiología , Antibacterianos/uso terapéutico , Enterobacter cloacae/aislamiento & purificación , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones por Enterobacteriaceae/etiología , Infecciones por Enterobacteriaceae/microbiología , Femenino , Humanos , Higiene , Recién Nacido , Enfermedades del Recién Nacido/tratamiento farmacológico , Enfermedades del Recién Nacido/etiología , Enfermedades del Recién Nacido/microbiología , Sepsis/tratamiento farmacológico , Sepsis/microbiología , Infecciones por Serratia/tratamiento farmacológico , Infecciones por Serratia/etiología , Infecciones por Serratia/microbiología , Serratia marcescens/aislamiento & purificaciónRESUMEN
A rapidly growing mycobacterium was isolated five times from blood cultures from a 6-year-old female patient with relapsed pre-B-cell acute lymphocytic leukemia. All five isolates had identical nucleotide sequences for the first 500 bp of the 16S rRNA gene, indicative of a single species. High-performance liquid chromatography analysis of mycolic acids indicated that the species was similar to Mycobacterium smegmatis. Sequence analysis of the 16S rRNA gene (1,455 bp) for one isolate demonstrated that the species was closely related to Mycobacterium diernhoferi. Based on the phenotypic features and phylogenetic analysis, it was concluded that the isolates represented a novel rapidly growing Mycobacterium species. The name "Mycobacterium hackensackense" is proposed for this unique strain, 147-0552(T), which was deposited in the American Type Culture Collection as ATCC BAA-823(T).