Archive for April 25, 2015

The diagnosis of urinary tract infection: a systematic review.

Dtsch Arztebl Int. 2010 May;107(21):361-7.

Schmiemann G1, Kniehl E, Gebhardt K, Matejczyk MM, Hummers-Pradier E.

1Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover, Germany. schmiemann.guido@mh-hannover.de

Abstract

BACKGROUND:

Urinary tract infections (UTI) are among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Because this problem is so common and so significant in routine clinical practice, a high level of diagnostic accuracy is essential. Antibiotics should not be prescribed excessively, particularly in view of the increasing prevalence of antibiotic resistance.

METHOD:

Systematic review of relevant articles that were retrieved by a search of the Medline, Embase, and Cochrane Library databases. The recommendations of selected international guidelines were also taken into account, as were the German national quality standards for microbiological diagnosis.

RESULTS:

The diagnosis of UTI by clinical criteria alone has an error rate of approximately 33%. The use of refined diagnostic algorithms does not completely eliminate uncertainty.

CONCLUSION:

With the aid of a small number of additional diagnostic criteria, antibiotic treatment for UTI can be provided more specifically and thus more effectively. Differentiating UTI from asymptomatic bacteriuria, which usually requires no treatment, can lower the frequency of unnecessary antibiotic prescriptions.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883276/pdf/Dtsch_Arztebl_Int-107-0361.pdf

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April 25, 2015 at 9:31 pm

Salmonella enteritidis bacteraemia as clinical onset of acquired immune deficiency syndrome.

Rev Esp Anestesiol Reanim. 2013 Feb;60(2):103-5.

Article in Spanish

Ayelo Navarro A1, Gerónimo Pardo M, Torres Lamberti V, Mateo Cerdán CM, Jiménez Vizuete JM, Peyro García R.

Author information

1Sección de Anestesia y Reanimación, Hospital General de Almansa, Almansa, Albacete, España. tayelo73@hotmail.com

Abstract

The case is presented of a 38 year-old patient who was admitted in the Emergency Department due to a severe acute respiratory failure and who was transferred to the Critical Care Unit with a suspected initial diagnosis of community acquired pneumonia caused by an atypical microorganism, which was complicated with an acute respiratory distress syndrome.

This was able to be treated with non-invasive mechanical ventilation. At 48 hours after admission, the growth of Gram negative bacilli in the blood culture was reported, which was subsequently identified as Salmonella enteritidis.

This information, along with the lymphopenia suffered by the patient, suggested an immunodepressed state, thus serological tests were performed which showed positive for HIV.

Antibiotic treatment was started based on the microbiological findings, with a favourable clinical outcome for the patient.

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90193169&pident_usuario=0&pcontactid=&pident_revista=344&ty=74&accion=L&origen=zonadelectura&web=www.elsevier.es&lan=es&fichero=344v60n02a90193169pdf001.pdf

 

http://www.elsevier.es/es-revista-revista-espanola-anestesiologia-reanimacion-344-linkresolver-bacteriemia-por-isalmonella-enteritidis-i-como-90193169

April 25, 2015 at 9:26 pm


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