Assuntos
Surtos de Doenças , Meningite Meningocócica/epidemiologia , Antibacterianos/uso terapêutico , Antibióticos Antituberculose/uso terapêutico , Burundi/epidemiologia , Criança , Cloranfenicol/uso terapêutico , Surtos de Doenças/estatística & dados numéricos , Gentamicinas/uso terapêutico , Humanos , Lactamas , Meningite Meningocócica/tratamento farmacológico , Meningite Meningocócica/mortalidade , Neisseria meningitidis/classificação , Neisseria meningitidis/isolamento & purificação , Rifampina/uso terapêuticoRESUMO
The relation between the immune response and the clinical features of severe falciparum malaria was studied in Burundian adults with (n = 31) and without (n = 17) cerebral involvement. At the time of admission, mean values for age, temperature, and blood levels of hemoglobin, creatinine, bilirubin, and glucose were similar in the two groups. Plasma levels of tumor necrosis factor alpha, interferon gamma, interleukin 10 (IL-10), and soluble intercellular adhesion molecule 1 were similarly elevated in the two groups. Mean parasite counts and mean plasma levels of soluble E-selectin were higher in severe noncerebral malaria than in cerebral malaria and were correlated with each other. After adjustment for parasitemia, levels of soluble E-selectin remained higher in noncerebral malaria. All seven patients who died had cerebral disease. These patients had higher levels of creatinine, bilirubin, IL-10, and soluble E-selectin than did patients with nonfatal cerebral malaria. After adjustment for creatinine and bilirubin levels, IL-10 and soluble E-selectin concentrations were similar in fatal and nonfatal cases of cerebral infection. In these African adults, none of the immunologic variables investigated was specific to cerebral malaria or to a fatal outcome.
Assuntos
Moléculas de Adesão Celular/sangue , Citocinas/sangue , Malária Falciparum/sangue , Adolescente , Adulto , Criança , Humanos , Malária Cerebral/sangue , Malária Cerebral/etiologia , Malária Cerebral/imunologia , Malária Cerebral/mortalidade , Malária Falciparum/complicações , Malária Falciparum/imunologiaRESUMO
In this retrospective study, 100 cases of primary staphylococcal septicaemia collected in 5 hospitals over a 2-year period were reviewed. Out of 91 strains of Staphylococcus aureus isolated, 6 were methicillin-resistant, but all 6 came from the same hospital. The mortality rate was 36 per cent. The only prognostic factors elicited were chronic renal failure and septic shock. The 64 patients who survived stayed in hospital for a mean period of 42 days, and 42 recovered without sequelae. Staphylococcal infections remain serious and are not all hospital-acquired.