Search

Your search keyword '"McCracken, George H."' showing total 1,228 results
Start Over Author "McCracken, George H."
1,228 results on '"McCracken, George H."'

3. Executive Summary: The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America

Author

Bradley, John S., Byington, Carrie L., Shah, Samir S., Alverson, Brian, Carter, Edward R., Harrison, Christopher, Kaplan, Sheldon L., Mace, Sharon E., McCracken, George H., Moore, Matthew R., Peter, Shawn D. St, Stockwell, Jana A., and Swanson, Jack T.

Published
2011
Full Text
View/download PDF

7. Mycoplasma pneumoniae Pneumonia in a Mouse Model

Author

Wubbel, Loretta, Jafri, Hasan S., Olsen, Kurt, Shelton, Sharon, Rogers, Beverly Barton, Gambill, Ginger, Patel, Padma, Keyser, Enid, Cassell, Gail, and McCracken, George H.

Published
1998

12. Contributors

Author

Adderson, Elisabeth E., primary, Agarwal, Aarti, additional, Aldrovandi, Grace M., additional, Allen, Upton D., additional, Amieva, Manuel R., additional, Ampofo, Krow, additional, Anderson, Alicia D., additional, Anderson, Margot, additional, Arguin, Paul M., additional, Arnold, John C., additional, Arvin, Ann M., additional, Ashkenazi, Shai, additional, Baker, Carol J., additional, Barson, William J., additional, Bausch, Daniel G., additional, Bechtel, Kirsten, additional, Benjamin, Daniel K., additional, Berkowitz, Frank E., additional, Blythe, Margaret J., additional, Bocchini, Joseph A., additional, Boeckh, Michael, additional, Bowen, Anna, additional, Bowie, William R., additional, Boyce, Thomas G., additional, Bradley, John S., additional, Brady, Michael T., additional, Bratcher, Denise F., additional, Braverman, Paula K., additional, Hall, Caroline Breese, additional, Bresee, Joseph S., additional, Brook, Itzhak, additional, Bryant, Kristina, additional, Buescher, E. Stephen, additional, Burns, Jane L., additional, Burstein, Gale R., additional, Byington, Carrie L., additional, Byrd, Kathy K., additional, Cappello, Michael, additional, Carter, Bryan D., additional, Cartwright, Emily J., additional, Caserta, Mary T., additional, Cerini, Chiara, additional, Chadwick, Ellen Gould, additional, Cheesebrough, Beth, additional, Chesney, P. Joan, additional, Christenson, John C., additional, Cleary, Thomas G., additional, Coffin, Susan E., additional, Conklin, Laura M., additional, Conklin, Laurie S., additional, Connelly, Beverly L., additional, Contopoulos-Ioannidis, Despina, additional, Conway, James H., additional, Cortese, Margaret M., additional, Cotten, C. Michael, additional, Cox, Elaine, additional, Crockett, Maryanne E., additional, Crowe, James E., additional, Curtis, Nigel, additional, Cunningham, Dennis J., additional, Shortliffe, Linda Marie Dairiki, additional, Darville, Toni, additional, Dasch, Gregory A., additional, Daskalaki, Irini, additional, Daum, Robert S., additional, Dawood, Fatimah S., additional, Demmler, Gail J., additional, Despommier, Dickson D., additional, Diefenbach, Karen A., additional, Dvorak, Christopher C., additional, Edwards, Kathryn M., additional, Edwards, Morven S., additional, Eichenfield, Lawrence F., additional, Elston, Dirk M., additional, Englund, Janet A., additional, Erard, Veronique, additional, Eremeeva, Marina E., additional, Feingold, Anat R., additional, Finn, Adam, additional, Fiore, Anthony E., additional, Fischer, Marc, additional, Fitch, Sarah J., additional, Flynn, Patricia M., additional, Fox, LeAnne M., additional, Frank, Michael M., additional, Fredrick, Douglas R., additional, Friedlander, Sheila Fallon, additional, Gans, Hayley A., additional, Garcia, Carla G., additional, Garzon, Maria C., additional, Gerber, Jeffrey S., additional, Geschwind, Michael D., additional, Gieraltowski, Laura B., additional, Gigliotti, Francis, additional, Gilligan, Peter H., additional, Glaser, Carol, additional, Gold, Benjamin D., additional, Goldstein, Brahm, additional, Gould, Jane M., additional, Green, Michael, additional, Greenberg, David, additional, Griffin, Patricia M., additional, Grom, Alexei A., additional, Gutierrez, Kathleen, additional, Guzman-Cottrill, Judith A., additional, Hall, Aron J., additional, Harper, Marvin B., additional, Harrison, Christopher J., additional, Haslam, David B., additional, Hawkes, Sarah J., additional, Hayes, Edward B., additional, Hazra, Rohan, additional, Heilig, Sara Jane, additional, Hendley, J. Owen, additional, Henry, Marion C.W., additional, Hilinski, Joseph A., additional, Holmberg, Scott D., additional, Holtzman, Deborah, additional, Hotez, Peter J., additional, Hsu, Katherine K., additional, Hu, Dale J., additional, Hwang, Loris Y., additional, Hyun, David Y., additional, Jackson, Mary Anne, additional, Jacobs, Richard F., additional, Jones, Jeffrey L., additional, Kamili, Saleem, additional, Karlowicz, M. Gary, additional, Katz, Ben Z., additional, Kersh, Gilbert J., additional, Kester, Laura M., additional, Keystone, Jay S., additional, Kimberlin, David W., additional, Kleiman, Martin B., additional, Kline, Mark W., additional, Koh, Andrew Y., additional, Konstantopoulos, Andreas, additional, Koranyi, Katalin I., additional, Korgenski, E. Kent, additional, Kroger, Andrew T., additional, Krogstad, Paul, additional, Lauren, Christine T., additional, Lawrence, Hillary S., additional, Leibovitz, Eugene, additional, Levasseur, Stéphanie, additional, Lewis, David B., additional, Lieberman, Jay M., additional, Liu, Jen-Jane, additional, Livingston, Robyn A., additional, Llata, Eloisa, additional, Loharikar, Anagha R., additional, Long, Sarah S., additional, Lopman, Ben A., additional, Lorber, Bennett, additional, Low, Donald E., additional, Lucero, Yalda C., additional, Luján-Zilbermann, Jorge, additional, Luzuriaga, Katherine, additional, MacDonald, Noni E., additional, MacNeil, Adam, additional, Maldonado, Yvonne A., additional, Mani, Chitra S., additional, Marcon, Mario J., additional, Marshall, Gary S., additional, Martin, Stacey W., additional, Matiz, Catalina, additional, Mawle, Alison C., additional, Mazzulli, Tony, additional, McCracken, George H., additional, McDonald, Matthew B., additional, McGregor, Robert S., additional, McIntosh, Kenneth, additional, McMorrow, Meredith, additional, McNeil, Candice, additional, McQuiston, Jennifer H., additional, Meislich, Debrah, additional, Meissner, H. Cody, additional, Mejías, Asunción, additional, Menon, Manoj P., additional, Mertsola, Jussi, additional, Michaels, Marian G., additional, Miller, Melissa B., additional, Mintz, Eric D., additional, Modlin, John F., additional, Mohan, Parvathi, additional, Montgomery, Susan P., additional, Montoya, Jose G., additional, Moore, Zack S., additional, de la Morena, Maite, additional, Moro, Pedro L., additional, Moscicki, Anna-Barbara, additional, Moss, R. Lawrence, additional, Murphy, Trudy V., additional, Murray, Dennis L., additional, Myers, Angela L., additional, Nadel, Simon, additional, Nataro, James P., additional, Neely, Michael N., additional, Nicholson, William L., additional, Nizet, Victor, additional, Nopper, Amy Jo, additional, Norrby-Teglund, Anna, additional, Ochoa, Theresa J., additional, O’Ryan, Miguel, additional, Orenstein, Walter A., additional, Paddock, Christopher D., additional, Pappas, Diane E., additional, Pass, Robert F., additional, Patterson, Thomas F., additional, Pelton, Stephen I., additional, Pickering, Larry K., additional, Piggott, Caroline Diane Sarah, additional, Pizzo, Philip A., additional, Pollard, Andrew J., additional, Posfay-Barbe, Klara M., additional, Poutanen, Susan M., additional, Powell, Dwight A., additional, Prince, Alice S., additional, Prober, Charles G., additional, Ramilo, Octavio, additional, Rangel, Shawn J., additional, Rawstron, Sarah A., additional, Read, Jennifer S., additional, Reed, Michael D., additional, Regan, Joanna J., additional, Reller, Megan E., additional, Reyes, Melissa A., additional, Rice, Peter A., additional, Rice-Townsend, Samuel E., additional, Richards, Frank O., additional, Rodgers, Gail L., additional, Rollin, Pierre E., additional, Romero, José R., additional, Rours, G. Ingrid J.G., additional, Rowley, Anne H., additional, Roy, Sharon L., additional, Rubin, Lorry G., additional, Ruiz-Palacios, Guillermo M., additional, Saiman, Lisa, additional, Sass, Laura, additional, Sauberan, Jason B., additional, Schantz, Peter M., additional, Schneider, Eileen, additional, Schutze, Gordon E., additional, Schwartz, Benjamin, additional, Schwarzwald, Heidi, additional, Shah, Kara N., additional, Shah, Samir S., additional, Shane, Andi L., additional, Shapiro, Craig A., additional, Shapiro, Eugene D., additional, Sharapov, Umid M., additional, Shaw, Jana, additional, Siberry, George Kelly, additional, Siegel, Jane D., additional, Siegel, Robert David, additional, Singh, Nalini, additional, Singh, Upinder, additional, Smith, P. Brian, additional, Snyder, John D., additional, Soper, David E., additional, Staat, Mary Allen, additional, Staples, J. Erin, additional, Starke, Jeffrey R., additional, Steinbach, William J., additional, Stephens, Ina, additional, St. Geme, Joseph W., additional, Stoner, Bradley P., additional, Strober, Jonathan B., additional, Subbarao, Kanta, additional, Sutton, Deanna A., additional, Swanson, Douglas, additional, Takada, Leonel T., additional, Tate, Jacqueline E., additional, Tauxe, Robert V., additional, Tebruegge, Marc, additional, Teshale, Eyasu H., additional, Thompson, George R., additional, Thompson, Herbert A., additional, Thomson, Richard B., additional, Thorell, Emily A., additional, Tohme, Rania A., additional, Tolan, Robert W., additional, Toltzis, Philip, additional, Treat, James, additional, Troy, Stephanie B., additional, Van Dyke, Russell B., additional, Velarde, Jorge J., additional, Vodzak, Jennifer, additional, Wald, Ellen R., additional, Weinberg, Geoffrey A., additional, White, A. Clinton, additional, Widdowson, Marc-Alain, additional, Wiesenfeld, Harold C., additional, Williams, John V., additional, Williams, Roxanne E., additional, Willoughby, Rodney E., additional, Wilson, Craig M., additional, Wingerter, Sarah L., additional, Winkelstein, Jerry A., additional, Workowski, Kimberly A., additional, Wright, Terry W., additional, Yagupsky, Pablo, additional, Yazigi, Nada, additional, Yen, Catherine, additional, Young, Edward J., additional, Zaenglein, Andrea L., additional, and Zaoutis, Theoklis E., additional

Published
2012
Full Text
View/download PDF

13. Effect of the 7-valent pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae in the first 2 years of life

Author

Ghaffar, Faryal, Barton, Theresa, Lozano, Juanita, Muniz, Luz Stella, Hicks, Patricia, Gan, Vanthaya, Ahmad, Naveed, and McCracken, George H., Jr.

Subjects
Pneumococcal vaccine -- Research, Pneumococcal vaccine -- Dosage and administration, Streptococcus pneumoniae -- Prevention, Streptococcus pneumoniae -- Research, Health, Health care industry
Published
2004

14. Epidemiology and clinical characteristics of community-acquired pneumonia in hospitalized children

Author

Michelow, Ian C., Olsen, Kurt, Lozano, Juanita, Rollins, Nancy K., Duffy, Lynn B., Ziegler, Thedi, Kauppila, Jaana, Leinonen, Maija, and McCracken, George H., Jr

Subjects
Pneumococcal vaccine -- Health aspects, Pneumococcal vaccine -- Research, Respiratory tract infections -- Research, Pneumonia -- Care and treatment, Pneumonia -- Research, Bacterial pneumonia -- Care and treatment, Bacterial pneumonia -- Research, Children -- Health aspects
Abstract

Objectives. The precise epidemiology of childhood pneumonia remains poorly defined. Accurate and prompt etiologic diagnosis is limited by inadequate clinical, radiologic, and laboratory diagnostic methods. The objective of this study was to determine as precisely as possible the epidemiology and morbidity of community-acquired pneumonia in hospitalized children. Methods. Consecutive immunocompetent children hospitalized with radiographically confirmed lower respiratory infections (LRIs) were evaluated prospectively from January 1999 through March 2000. Positive blood or pleural fluid cultures or pneumolysin-based polymerase chain reaction assays, viral direct fluorescent antibody tests, or viral, mycoplasmal, or chlamydial serologic tests were considered indicative of infection by those organisms. Methods for diagnosis of pneumococcal pneumonia among study subjects were published by us previously. Selected clinical characteristics, indices of inflammation (white blood cell and differential counts and procalcitonin values), and clinical outcome measures (time to defervescence and duration of oxygen supplementation and hospitalization) were compared among groups of children. Results. One hundred fifty-four hospitalized children with LRIs were enrolled. Median age was 33 months (range: 2 months to 17 years). A pathogen was identified in 79% of children. Typical respiratory bacteria were identified in 60% (of which 73% were Streptococcus pneumoniae) viruses in 45%, Mycoplasma pneumoniae in 14%, Chlamydia pneumoniae in 9%, and mixed bacterial/ viral infections in 23%. Preschool-aged children had as many episodes of atypical bacterial LRIs as older children. Children with typical bacterial or mixed bacterial/ viral infections had the greatest inflammation and disease severity. Multivariate logistic-regression analyses revealed that high temperature ([greater than or equal to] 38.4[degrees]C) within 72 hours after admission (odds ratio: 2.2; 95% confidence interval; 1.4-3.5) and the presence of pleural effusion (odds ratio: 6.6; 95% confidence interval: 2.1-21.2) were significantly associated with bacterial pneumonia. Conclusions. This study used an expanded diagnostic armamentarium to define the broad spectrum of pathogens that cause pneumonia in hospitalized children. The data confirm the importance of S pneumoniae and the frequent occurrence of bacterial and viral coinfections in children with pneumonia. These findings will facilitate age-appropriate antibiotic selection and future evaluation of the clinical effectiveness of the pneumococcal conjugate vaccine as well as other candidate vaccines. Pediatrics 2004;113:701-707; community-acquired pneumonia, child, epidemiology, diagnosis, etiology, hospitalized., The quest to define accurately and promptly the causative agents of lower respiratory infections (LRIs) in children has been impeded by inadequate clinical, radiologic, and laboratory diagnostic methods. A limited [...]

Published
2004

17. CONTRIBUTORS

Author

Aaskov, John G., primary, Abdel-Rahman, Susan M., additional, Aebi, Christoph, additional, Ament, Marvin E., additional, Anderson, Marsha S., additional, Arnon, Stephen S., additional, Arvin, Ann M., additional, Atkins, Jane T., additional, Atmar, Robert L., additional, Baker, Carol J., additional, Baltimore, Robert S., additional, Barenkamp, Stephen J., additional, Barnett, Elizabeth D., additional, Basow, Robert D., additional, Beisel, William R., additional, Bell, Beth P., additional, Benard, Gil, additional, Bernstein, David I., additional, Bernt, Kathrin M., additional, Berry, Andrea A., additional, Bluestone, Charles D., additional, Blumer, Jeffrey L., additional, Bortolussi, Robert, additional, Boyanton, Bobby L., additional, Boyer, Kenneth M., additional, Bradley, John S., additional, Brady, Michael T., additional, Britt, William J., additional, Broderick, Annemarie, additional, Bronstein, David E., additional, Bruckner, David A., additional, Buckingham, Steven C., additional, Burgos, Ana, additional, Byington, Carrie L., additional, Campbell, Judith R., additional, Cantu, Samson, additional, Chacko, Mariam R., additional, Chapman, Louisa E., additional, Charrel, Rémi N., additional, Chen, Tempe K., additional, Cherry, James D., additional, Chesney, P. Joan, additional, Chilakapati, Madhuri C., additional, Chinen, Javier, additional, Ching, Natascha, additional, Clark, H. Fred, additional, Cleary, Thomas G., additional, Coats, David K., additional, Correa, Armando G., additional, Cross, J. Thomas, additional, Cutrer, William B., additional, Dagan, Ronald, additional, Dassey, David E., additional, Davis, Jeffrey P., additional, Demmler-Harrison, Gail J., additional, Dennehy, Penelope H., additional, Doan, Minh L., additional, Dobson, Simon R., additional, Drutz, Jan E., additional, Edelstein, Paul H., additional, Edwards, Kathryn M., additional, Edwards, Morven S., additional, English, B. Keith, additional, Estripeaut, Dora, additional, Fan, Leland L., additional, Feigin, Ralph D., additional, Ferry, George D., additional, Fiore, Anthony E., additional, Fischer, Philip R., additional, Fisher, Randall G., additional, Flynn, Patricia M., additional, Flynn, Thomas R., additional, Frenkel, Lisa M., additional, Friedman, Ellen M., additional, Friedman, Richard A., additional, Garcia, Lynne S., additional, Gavin, Patrick J., additional, Gerber, Michael A., additional, Gershon, Anne A., additional, Gilger, Mark A., additional, Gillespie, Susan L., additional, Glaze, Daniel G., additional, Glezen, W. Paul, additional, Glodé, Mary P., additional, Goldmann, Donald A., additional, Goldstein, Ellie J.C., additional, Goldstein, Nira A., additional, Gonzales, Edmond T., additional, Gorman, Mark P., additional, Green, Michael D., additional, Greenberg, David, additional, Groll, Andreas H., additional, Grose, Charles, additional, Gubler, Duane J., additional, Guerrero, Roberto A., additional, Guevara, Javier Nieto, additional, Gutierrez, Kathleen M., additional, Hall, Caroline Breese, additional, Halstead, Scott B., additional, Hamano, Shinjiro, additional, Hamill, Richard J., additional, Hammerschlag, Margaret R., additional, Hanson, I. Celine, additional, Harik, Nada, additional, Harrison, Rick E., additional, Healy, C. Mary, additional, Heininger, Ulrich, additional, Heresi, Gloria P., additional, Hiatt, Peter W., additional, Hill, Harry R., additional, Hilmers, David C., additional, Hoffman, Jill A., additional, Hon, Ellis K.L., additional, Hostetter, Margaret K., additional, Hotez, Peter J., additional, Hughes, Walter T., additional, Hulten, Kristina G., additional, Hunstad, David A., additional, Hurwitz, Eugene S., additional, Huskins, W. Charles, additional, Hyun, David Y., additional, Jackson, Mary Anne, additional, Jacobs, Michael R., additional, Jacobs, Richard F., additional, Jaeger, Jenifer L., additional, Jhaveri, Ravi R., additional, Johnston, Samantha, additional, Jonas, Maureen M., additional, Julapalli, Meena R., additional, Kaplan, Edward L., additional, Kaplan, Sheldon L., additional, Karpen, Saul J., additional, Kearns, Gregory L., additional, Keller, Margaret A., additional, Khoury, Chaouki K., additional, Kleiman, Martin B., additional, Klein, Jerome O., additional, Kline, Mark W., additional, Knapp, Katherine M., additional, Kokkinos, Heidi M., additional, Krause, Peter J., additional, Krilov, Leonard R., additional, Krogstad, Paul, additional, Kuhls, Thomas L., additional, de Lamballerie, Xavier, additional, La Pine, Timothy R., additional, Laurens, Matthew B., additional, Leach, Charles T., additional, Leggiadro, Robert J., additional, Lennon, Diana R., additional, Lentzsch-Parcells, Carolyn, additional, Leroy, Eric, additional, Leung, Chi Wai, additional, Levy, Moise L., additional, Lewis, Karen, additional, Losikoff, Phyllis T., additional, Lotze, Timothy Edward, additional, Lowry, Adam W., additional, Mailman, Timothy, additional, Maloney, Susan A., additional, Mascola, Laurene, additional, Mason, Edward O., additional, Matson, David O., additional, Mayer, Alan N., additional, Mazade, Marc A., additional, McAuley, James B., additional, McCracken, George H., additional, McIntosh, Kenneth, additional, McJunkin, James E., additional, McKee, Kelly T., additional, McLeod, Rima L., additional, McLin, Valérie A., additional, Mendes-Giannini, Maria José Soares, additional, Meyers, Wayne M., additional, Michaels, Marian G., additional, Michelow, Ian C., additional, Milisavljevic, Vladana, additional, Miller, Aaron M., additional, Miller, James N., additional, Miller, Marjorie J., additional, Mills, James N., additional, Minnich, Linda L., additional, Moran, Ann, additional, Murphy, James R., additional, Nag, Pratip K., additional, Nania, Joseph J., additional, Nataro, James P., additional, Nicome, Roger K., additional, Nielsen-Saines, Karin, additional, Nieves, Delma J., additional, Oberhelman, Richard A., additional, Ochoa, Theresa J., additional, Oermann, Christopher M., additional, Olteanu, Alina, additional, Overturf, Gary D., additional, Palazzi, Debra L., additional, Pannaraj, Pia S., additional, Patel, Janak A., additional, Patrick, Christian C., additional, Paysse, Evelyn A., additional, Pérez, Norma, additional, Peters, C.J., additional, Petri, William A., additional, Phillips, Brandon Lane, additional, Pickering, Larry K., additional, Piecuch, Joseph F., additional, Pinheiro, Francisco P., additional, Plotkin, Stanley A., additional, Pomeroy, Scott L., additional, Pong, Alice, additional, Pugatch, David L., additional, Purcell, Joan S., additional, Ramraj, Ramya, additional, Remington, Jack S., additional, Rodriguez, Carina A., additional, Romero, José R., additional, Ross, Benjamin A., additional, Ross, Lawrence A., additional, Rowen, Judith L., additional, Rupprecht, Charles E., additional, Sáez-Llorens, Xavier, additional, Saiman, Lisa, additional, Geme, Joseph W. St., additional, Sánchez, Pablo J., additional, Sass, Laura A., additional, Sattler, Carlos A., additional, Schulte, Danica J., additional, Schutze, Gordon E., additional, Seeborg, Filiz O., additional, Shapiro, Eugene D., additional, Shapiro, Nina L., additional, Shearer, William T., additional, Shehab, Ziad M., additional, Shenep, Jerry L., additional, Shields, W. Donald, additional, Shimizu-Cohen, Robyn, additional, Shulman, Stanford T., additional, Simos, Constantine, additional, Smith, Arnold L., additional, Soden, Jason S., additional, Staat, Mary Allen, additional, Starke, Jeffrey R., additional, Stechenberg, Barbara W., additional, Steinbach, William J., additional, Steinkuller, Paul G., additional, Stiehm, E. Richard, additional, Stovall, Stephanie H., additional, Suen, Jeffrey, additional, Sumaya, Ciro V., additional, Summer, Andrea P., additional, Swanson, Douglas S., additional, Tan, Tina Q., additional, Tanowitz, Herbert B., additional, Tesh, Robert B., additional, Toltzis, Philip, additional, Topazian, Richard G., additional, Tosi, Michael F., additional, Travassos da Rosa, Amelia P.A., additional, Tsai, Theodore F., additional, Valdez, Tulio A., additional, Vallejo, Jesus G., additional, Vanchiere, John A., additional, Vasconcelos, Pedro Fernando da C., additional, Velarde, Jorge J., additional, Versalovic, James, additional, Wald, Ellen R., additional, Walsh, Douglas S., additional, Walsh, Edward E., additional, Walsh, Thomas J., additional, Ward, Mark A., additional, Ward, Richard L., additional, Weinberg, Michelle, additional, Welliver, Robert C., additional, Wheeler, J. Gary, additional, White, A. Clinton, additional, Whitworth, Suzanne, additional, Wiedermann, Bernhard L., additional, Williams-Bouyer, Natalie, additional, Wittner, Murray, additional, Woods, Charles R., additional, Yen, Kimberly G., additional, Yogev, Ram, additional, Young, Edward J., additional, and Zaoutis, Theoklis E., additional

Published
2009
Full Text
View/download PDF

22. Contributors

Author

Adderson, Elisabeth E., primary, Adler-Shohet, Felice C., additional, Amieva, Manuel R., additional, Armstrong, Gregory L., additional, Arvelo, Wences, additional, Arvin, Ann M., additional, Asher, David M., additional, Ashkenazi, Shai, additional, Ault, Kevin A., additional, Baker, Carol J., additional, Barson, William J., additional, Bell, Beth P., additional, Bell, Michael J., additional, Benjamin, Daniel K., additional, Bialek, Stephanie R., additional, Blythe, Margaret J., additional, Bocchini, Joseph A., additional, Boeckh, Michael, additional, Bower, William A., additional, Boyer, Kenneth M., additional, Braden, Christopher R., additional, Bradley, John S., additional, Brady, Michael T., additional, Bratcher, Denise, additional, Braverman, Paula K., additional, Bresee, Joseph S., additional, Brook, Itzhak, additional, Brown, Kevin E., additional, Browning, John C., additional, Buckingham, Steven C., additional, Buescher, E. Stephen, additional, Burns, Jane L., additional, Cappello, Michael, additional, Carter, Bryan D., additional, Chadwick, Ellen Gould, additional, Chesney, Patricia Joan, additional, Childs, James E., additional, Christenson, John C., additional, Cleary, Thomas G., additional, Coffin, Susan E., additional, Connelly, Beverly L., additional, Cotton, C. Michael, additional, Cox, Elaine, additional, Cramer, Robert Andrew, additional, Crockett, Maryanne E., additional, Crowe, James E., additional, Cunningham, Dennis J., additional, Darville, Toni, additional, Dasch, Gregory A., additional, Daum, Robert S., additional, de la Morena, Maite, additional, Demmler, Gail J., additional, Despommier, Dickson D., additional, Diefenbach, Karen A., additional, Dominguez, Elidia, additional, Downs, Stephen M., additional, Dvorak, Christopher C., additional, Edwards, Kathryn, additional, Edwards, Morven S., additional, Englund, Janet A., additional, Erard, Véronique, additional, Eremeeva, Marina E., additional, Finelli, Lyn, additional, Finn, Adam, additional, Fiore, Anthony E., additional, Fischer, Marc, additional, Fitch, Sarah J., additional, Flynn, Patricia M., additional, Fortenberry, J. Dennis, additional, Fox, LeAnne M., additional, Freedman, David O., additional, Gans, Hayley A., additional, Gerber, Michael A., additional, Gigliotti, Francis, additional, Gilligan, Peter, additional, Gold, Benjamin D., additional, Goldman, David L., additional, Goldstein, Brahm, additional, Goldstein, Susan T., additional, Gould, Jane M., additional, Green, Michael, additional, Greene, Sharon K., additional, Greenwald, Mark J., additional, Grom, Alexei A., additional, Grossman, Leigh B., additional, Guerra, Marta A., additional, Gutierrez, Kathleen, additional, Guzman-Cottrill, Judith A., additional, Hall, Caroline Breese, additional, Harper, Marvin B., additional, Haslam, David B., additional, Hayes, Edward B., additional, Hendley, J. Owen, additional, Henrickson, Kelly J., additional, Henry, Marion C.W., additional, Hilinski, Joseph A., additional, Hotez, Peter J., additional, Ingram, David L., additional, Jackson, Mary Anne, additional, Jacobs, Richard F., additional, Karlowicz, M. Gary, additional, Katz, Ben Z., additional, Keystone, Jay S., additional, Kimberlin, David W., additional, Kleiman, Martin B., additional, Klein, Jerome O., additional, Kline, Mark W., additional, Koh, Andrew Y., additional, Koranyi, Katalin I., additional, Korgenski, E. Kent, additional, Leggiadro, Robert J., additional, Levy, Moise L., additional, Lewis, David B., additional, Lieberman, Jay M., additional, Limaye, Abhijit, additional, Lohr, Jacob A., additional, Lorber, Bennett, additional, Long, Sarah S., additional, Low, Donald E., additional, Lowell, Gina, additional, Lowenthal, Elizabeth, additional, Lujan-Zilbermann, Jorge, additional, Luzuriaga, Katherine, additional, MacDonald, Noni E., additional, Maldonado, Yvonne A., additional, Mani, Chitra S., additional, Marcinak, John F., additional, Marcon, Mario J., additional, Marshall, Gary S., additional, Martin, Stacey W., additional, Massung, Robert F., additional, Mast, Eric E., additional, Mazzulli, Tony, additional, McCracken, George H., additional, McGregor, Robert S., additional, McIntosh, Kenneth, additional, McLean, Catherine A., additional, McLeod, Rima, additional, McMillan, Julia A., additional, McQuiston, Jennifer H., additional, Meissner, H. Cody, additional, Menon, Manoj P., additional, Michaels, Marian G., additional, Miller, Melissa B., additional, Millon, Juan Carlos, additional, Modlin, John F., additional, Moore, Matthew R., additional, Moore, Zack S., additional, Moran, Mary M., additional, Moro, Pedro L., additional, Moss, R. Lawrence, additional, Murray, Dennis L., additional, Nadel, Simon, additional, Nataro, James P., additional, Neely, Michael N., additional, Nizet, Victor, additional, Norrby-Teglund, Anna, additional, Nyquist, Ann-Christine, additional, Ochoa, Theresa J., additional, O'Hara, Sara M., additional, Orenstein, Walter A., additional, Ortega-Barria, Eduardo, additional, Overturf, Gary D., additional, Paddock, Christopher D., additional, Painter, John A., additional, Pappas, Diane E., additional, Parise, Monica E., additional, Pass, Robert F., additional, Patterson, Thomas F., additional, Pavia, Andrew T., additional, Pelton, Stephen I., additional, Peter, Georges, additional, Peters, Timothy R., additional, Petri, William A., additional, Pickering, Larry K., additional, Pizzo, Philip A., additional, Pollard, Andrew J., additional, Poutanen, Susan M., additional, Powell, Dwight A., additional, Prince, Alice S., additional, Prober, Charles G., additional, Rangel, Shawn J., additional, Rawstron, Sarah Anne, additional, Reed, Michael D., additional, Reller, Megan E., additional, Richards, Frank O., additional, Rodgers, Gail L., additional, Romero, Luz I., additional, Rotbart, Harley A., additional, Rowley, Anne H., additional, Rubin, Lorry G., additional, Ruiz-Palacios, Guillermo M., additional, Sáez-Llorens, Xavier, additional, Saiman, Lisa, additional, Sauberan, Jason B., additional, Sawyer, Mark H., additional, Schantz, Peter M., additional, Schlager, Theresa A., additional, Schutze, Gordon E., additional, Schwartz, Benjamin, additional, Schwartz, Richard H., additional, Schwarzwald, Heidi, additional, Shah, Samir S., additional, Shane, Andi L., additional, Shapiro, Eugene D., additional, Shetty, Avinash K., additional, Siegel, Jane D., additional, Siegel, Robert D., additional, Sipe, Walter E.B., additional, Skarbinski, Jacek, additional, Smith, P. Brian, additional, Snyder, John D., additional, Solaymani-Mohammadi, Shahram, additional, Staat, Mary Allen, additional, Starke, Jeffrey R., additional, Steinbach, William J., additional, Stephens, Ina, additional, St. Geme, Joseph W., additional, Subbarao, Kanta, additional, Sullivan, John L., additional, Sutton, Deanna A., additional, Sutton, Madeline Y., additional, Swerdlow, David L., additional, Tauxe, Robert V., additional, Thompson, Herbert A., additional, Thomson, Richard B., additional, Thorell, Emily A., additional, Todd, James K., additional, Toltzis, Philip, additional, Tsai, Theodore F., additional, Wald, Ellen R., additional, Wallace, Richard J., additional, Weinberg, Geoffrey A., additional, Weiss, Avery H., additional, White, A. Clinton, additional, Widdowson, Marc-Alain, additional, Williams, Ian T., additional, Williams, John V., additional, Willoughby, Rodney E., additional, Wilson, Craig M., additional, Winkelstein, Jerry A., additional, Workowski, Kimberly, additional, Wright, Terry W., additional, Yazigi, Nada, additional, Yogev, Ram, additional, Young, Edward J., additional, and Zaoutis, Theoklis E., additional

Published
2008
Full Text
View/download PDF

23. The UspA1 protein and a second type of UspA2 protein mediate adherence of Moraxella catarrhalis to human epithelial cells in vitro

Author

Lafontaine, Eric R., Cope, Leslie D., Aebi, Christoph, Latimer, Jo L., McCracken, George H. Jr., and Hansen, Eric J.

Subjects
Cell adhesion -- Molecular aspects, Respiratory organs, Lung diseases -- Physiological aspects, Bacteria, Pathogenic -- Physiological aspects, Biological sciences
Abstract

Results demonstrate construction of isogenic double mutants of Moraxella catarrhalis strains and their ability to adhere to human epithelial cells in vitro. Data reveal that besides UspA1 and 2 proteins, a second UspA2 protein is discovered which exhibit amino acid segments from UspA1 and 2 and also shows adhesin activity.

Published
2000

25. Contributors

Author

Adler, Stuart P., primary, Alford, Charles A., additional, Arvin, Ann M., additional, Baker, Carol J., additional, Barnett, Elizabeth D., additional, Bendel, Catherine M., additional, Bortolussi, Robert, additional, Bradley, John S., additional, Britt, William, additional, Cherry, James D., additional, Cleary, Thomas G., additional, Cooper, Louis Z., additional, D’Angio, Carl T., additional, Darville, Toni, additional, Davies, Jill K., additional, Desmonts, Georges, additional, Edwards, Morven S., additional, Embree, Joanne E., additional, Garofalo, Roberto P., additional, Gerber, Michael A., additional, Gershon, Anne A., additional, Gibbs, Ronald S., additional, Gutierrez, Kathleen M., additional, Hardy, R. Doug, additional, Heath, Joan A., additional, Ingall, David, additional, Klein, Jerome O., additional, Koch, William C., additional, Lewis, David B., additional, Long, Sarah S., additional, Mailman, Timothy L., additional, Maldonado, Yvonne A., additional, McCracken, George H., additional, McLeod, Rima, additional, McMillan, Julia A., additional, Miller, Michael J., additional, Nataro, James P., additional, Nizet, Victor, additional, Ogra, Pearay L., additional, Orscheln, Rachel C., additional, O’Ryan, Miguel L., additional, Overturf, Gary D., additional, Palazzi, Debra L., additional, Ramilo, Octavio, additional, Rassin, David K., additional, Remington, Jack S., additional, Sáez-Llorens, Xavier, additional, St. Geme, Joseph W., additional, Sanchez, Pablo J., additional, Shapiro, Eugene D., additional, Shinefield, Henry R., additional, Stagno, Sergio, additional, Starke, Jeffrey R., additional, Stoll, Barbara J., additional, Thulliez, Philippe, additional, Weinberg, Geoffrey A., additional, Whitley, Richard J., additional, Wilson, Christopher B., additional, and Zerr, Danielle M., additional

Published
2006
Full Text
View/download PDF

30. Management of infections caused by antibiotic-resistant Streptococcus pneumoniae

Author

Friedland, Ian R. and McCracken, George H., Jr.

Subjects
Drug resistance in microorganisms -- Care and treatment, Streptococcal infections -- Drug therapy, Streptococcus pneumoniae
Abstract

Newer drugs other than antibiotics must be used to treat antibiotic-resistant Streptococcus pneumoniae infections. Resistance patterns specific to a geographic area may need to be considered in addition to treatment agents. Determining the susceptibility of pneumococcal infections to penicillin and other antimicrobial agents is important. The clinician and laboratory should communicate with each other to provide the best treatment possible. Effects of penicillin resistance in Streptococcus pneumoniae and the organism's susceptibility to other antibiotics are discussed. Other streptococcal infections that may be penicillin-resistant are meningitis, sepsis, pneumonia and otitis media. Chloramphenicol, cephalosporin and other antimicrobials, beta-lactam antibiotics, and non-beta-lactam antibiotics are possible alternatives to penicillin.

Published
1994

32. Practice guideline for the management of infants and children 0 to 36 months of age with fever without source

Author

Baraff, Larry J., Bass, James W., Fleisher, Gary R., Klein, Jerome O., McCracken, George H., Jr., Powell, Keith R., and Schriger, David L.

Subjects
Fever in children -- Care and treatment, Pediatrics -- Practice, Medical protocols -- Methods
Abstract

Guidelines for the care of infants and children from birth to age 3 who have a fever of unknown origin were set forth. Such children constitute a significant proportion of ambulatory pediatric visits to physicians' offices and emergency departments. The guidelines developed by an expert panel called for hospitalization of infants and children and all febrile infants less than 28 days old for parenteral therapy, outpatient treatment and careful surveillance of low-risk febrile infants 28 to 90 days of age, and no laboratory tests or antibiotics for older children with a fever of less than 39 degrees C. The panel called for treatment of children 3 to 36 months with a fever of 39 degrees C or more and with a white blood bell count of 15,000/mm3 or more with antibiotics pending the outcome of a blood culture. It also stated that urine cultures be taken from all boys 6 months of age or less and from all girls 2 years of age or less who were being treated with antibiotics., Study objective. To develop guidelines for the care of infants and children from birth to 36 months of age with fever without source. Participants and setting. An expert panel of senior academic faculty with expertise in pediatrics and infectious diseases or emergency medicine. Design and intervention. A comprehensive literature search was used to identify all publications pertinent to the management of the febrile child. When appropriate, meta-analysis was used to combine the results of multiple studies. One or more specific management strategies was proposed for each of decision nodes in draft management algorithms. The draft algorithms, selected publications, and the meta-analyses were provided to the panel, which determined the final guidelines using the modified Delphi technique. Results. All toxic-appearing infants and children and all febrile infants less than 28 days of age should be hospitalized for parenteral antibiotic therapy. Febrile infants 28 to 90 days of age defined at low risk by specific clinical and laboratory criteria may be managed as outpatients if close follow-up is assured. Older children with fever less than 39.0 [degees] C without source need no laboratory tests or antibiotics. Children 3 to 36 months of age with fever of 39.0 [degrees] C or more and whose white blood cell count is 15 000/[MM.sup.3] or more should have a blood culture and be treated with antibiotics pending culture results. Urine cultures should be obtained from all boys 6 months of age or less and all girls 2 years of age or less who are treated with antibiotics. Conclusion. These guidelines do not eliminate all risk or strictly confine antibiotic treatment to children likely to have occult bacteremia. Physicians may individualize therapy based on clinical circumstances or adopt a variation of these guidelines based on a different interpretation of the evidence. Pediatrics 1993;92:1-12; practice guidelines, fever without source, bacteremia.

Published
1993

33. Cranial computed tomographic scans have little impact on management of bacterial meningitis

Author

Friedland, Ian R., Paris, Maria M., Rinderknecht, Stephen, and McCracken, George H., Jr.

Subjects
CT imaging, Meningitis, Family and marriage, Health
Abstract

* Objective.--To assess which clinical features predict an increased likelihood of an abnormal computed tomographic (CT) scan and how frequently CT influences management of bacterial meningitis. Design.--Retrospective patient series. Setting.--University-affiliated hospitals in Dallas, Tex. Patients.--Three hundred thirty-seven children with bacterial meningitis, of whom 107 (32%) had undergone CT scans. Results.--One or more abnormalities were found in 52% of the initial scans. The most frequent indication for CT at our institution was persistent or secondary fever, and in 56% of these children, subdural effusion or empyema was noted. However, findings on CT rarely predicted a need for intervention. In contrast, children with focal seizures or focal neurologic signs were more likely to have brain parenchymal changes. Scans in 19 patients (12%) prompted surgical intervention, most commonly drainage of a subdural collection. The conditions of only nine children (8.4% of those who had undergone CT scans) improved following intervention that was initiated because of findings on CT. Conclusions.--Although CT scans are frequently abnormal in children with meningitis, CT seldom reveals findings that require specific intervention. (AJDC. 1992;146:1484-1487)

Published
1992

34. The role of corticosteroid therapy in children with pneumococcal meningitis

Author

Kennedy, William A., Hoyt, Martha Jean, and McCracken, George H.

Subjects
Streptococcus pneumoniae, Corticosteroids -- Health aspects, Meningitis -- Causes of, Meningitis -- Drug therapy, Family and marriage, Health
Abstract

Pneumococci are a group of bacteria that are protected by an outer capsule. They can cause pneumonia and other serious infections. About 10 percent of cases of meningitis are caused by pneumococcal bacteria. About 10 percent of patients with pneumococcal meningitis die, while up to 30 percent are seriously affected. These rates have changed little, despite the availability of strong antibiotics that are active in infected meningeal tissues (membranes covering the brain and spinal cord). Experimental results suggest that a significant portion of pneumococcal meningitis symptoms are caused by the reactivity of immune cells to antibiotic-induced release of fragments from the bacterial capsule; this reactivity may result in inflammatory reactions involving human tissue. Steroids can suppress the activity of immune cells, and previous studies have suggested that steroid therapy may benefit children with pneumococcal meningitis. The current study reviewed the outcomes of 97 infants and children with the pneumococcal meningitis, 41 of whom were treated with steroids as well as antibiotics. The total duration of fever was significantly less in patients who were given steroids, and glucose levels in cerebrospinal fluid (CSF, the fluid that bathes the brain and spinal cord) were significantly higher in these children. Cerebrovascular instability, indicated by signs of sepsis (systemic infection), shock, or seizures, developed more often in children who received only antibiotics or were given steroids after antibiotic treatment. Likewise, cerebrovascular instability occurred less frequently in children who received steroids and antibiotics simultaneously and those who received steroids before antibiotic therapy. The death rates in the two groups were similar, but mortality was significantly higher in those who developed cerebrovascular instability. Steroid-treated patients less frequently developed overwhelming meningeal infection, which was associated with high mortality, seizures, and hearing loss. Subsequently, children who received steroids had a significantly lower rate of neurologic dysfunction and hearing loss. The report suggests that steroids, administered with antibiotics, improve the prognosis of children with pneumococcal meningitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

35. Endotoxin concentrations in cerebrospinal fluid correlate with clinical severity and neurologic outcome of Haemophilus influenzae type B meningitis

Author

Mertsola, Jussi, Kennedy, William A., Waagner, David, Saez-Llorens, Xavier, Olsen, Kurt, Hansen, Eric J., and McCracken, George H., Jr.

Subjects
Endotoxins -- Measurement, Hemophilus meningitis -- Complications, Hemophilus meningitis -- Diagnosis, Family and marriage, Health
Abstract

Meningitis (inflammation of the membranes that surround the brain) can be caused by several organisms, including Haemophilus influenzae type B. This bacterium, like all Gram-negative bacteria, is surrounded by an outer membrane containing lipopolysaccharides (LPS) or endotoxins: when these substances contact host tissue, they initiate a powerful inflammatory response that includes inflammation, brain swelling, increased pressure within the skull, and other changes. Haemophilus influenzae type B LPS have certain unique structural properties that may affect results when they are evaluated quantitatively using a standard assay (the Limulus amebocyte lysate assay). This study of endotoxin levels in patients with Haemophilus influenzae type B meningitis was carried out using lipo-oligosaccharide (LOS) instead of LPS as a standard. The patients were 38 children (aged between six weeks and 13 years) with Haemophilus influenzae type B bacteria in their cerebrospinal fluid. The children underwent treatment with cefotaxime sodium and dexamethasone sodium phosphate; the clinical severity of their conditions was monitored daily in the hospital. Results showed a steep drop in LOS levels between the time of admission to the hospital and 17 to 48 hours after therapy started. In general, the concentrations of Haemophilus influenzae type B in CSF predicted the likelihood of complications: patients who developed neurologic abnormalities had high LOS concentrations in the first CSF sample analyzed. LOS levels were also correlated with the levels of interleukin 1B (a factor released by cells of the immune system), protein, and glucose in CSF, as well as with the duration of secondary fever (a temperature of 38.0 degrees Centigrade or higher occurring after a fever-free period). The findings indicate that the level of endotoxin, as determined by the test described, in the CSF of patients with Haemophilus influenzae type B meningitis can be an important prognostic factor. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

36. The beneficial effects of early dexamethasone administration in infants and children with bacterial meningitis

Author

Odio, Carla M., Faingezicht, Idis, Paris, Maria, Nassar, Martin, Baltodano, Aristides, Rogers, Jodi, Saez-Llorens, Xavier, Olsen, Kurt D., and McCracken, George H., Jr.

Subjects
Neurologic manifestations of general diseases -- Prevention, Corticosteroids -- Health aspects, Dexamethasone -- Health aspects, Meningitis -- Drug therapy
Abstract

Children who recover from bacterial meningitis often suffer permanent brain damage, which can express itself as loss of hearing, or neurological symptoms including paralysis and hydrocephalus. Much of this damage seems to result not from the bacterial infection of the meninges that cover the brain, but from the inflammation of the meninges that occurs as a part of the body's response to the infection. There have been some experimental studies to suggest that the corticosteroid drug dexamethasone may reduce the likelihood of permanent damage by reducing the inflammatory response. This has now been confirmed in a study involving 101 infants and children with meningitis. All the children were treated with the antibiotic drug cefotaxime to destroy the bacteria causing the meningitis. Fifty-two children also received dexamethasone treatment, while 49 received only a placebo drug in addition to the cefotaxime. As soon as 12 hours after the initiation of treatment, differences could be seen between the two groups. The pressure of the cerebrospinal fluid had already begun to drop in the corticosteroid-treated patients, while the pressure increased in the patients who received only antibiotic and placebo. Likewise, tumor necrosis factor alpha and platelet-activating factor were both reduced in the cerebrospinal fluid of the patients receiving the dexamethasone; these two substances are considered to play important roles in the inflammatory process. After a follow-up period averaging 15 months, permanent brain damage was more common among the patients who did not receive the dexamethasone. Seven of the 51 surviving children treated with dexamethasone suffered at least one symptom of permanent damage. In contrast, neurologic symptoms or hearing loss persisted in 18 of the 48 patients who survived after treatment with antibiotics only. These results add to the mounting body of evidence indicating that the corticosteroid treatment of the inflammatory response is a very important aspect of the treatment of meningitis in children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

40. Cerebrospinal fluid prostaglandins, interleukin 1-beta, and tumor necrosis factor in bacterial meningitis: clinical and laboratory correlations in placebo-treated and dexamethasone-treated patients

Author

Mustafa, Mahmoud M., Ramilo, Octavio, Saez-Llorens, Xavier, Olsen, Kurt D., Magness, Ronald R., and McCracken, George H., Jr.

Subjects
Dexamethasone -- Health aspects, Cerebrospinal fluid -- Measurement, Tumor necrosis factor -- Physiological aspects, Prostaglandins -- Physiological aspects, Interleukin-1 -- Physiological aspects, Meningitis -- Drug therapy, Family and marriage, Health
Abstract

The death rate among children suffering from bacterial meningitis (infections of the membranes surrounding their brain and spinal cord) ranges from two to five percent. In approximately 20 percent of meningitis cases, the children are left with various neurologic problems. Recent advances in drug manufacture have provided newer and more powerful antimicrobial drugs for the treatment of meningitis, but the outcomes of treatment have not correspondingly improved. Some research has suggested that the endotoxins, or biologic poisons, produced by bacteria also induce the release of molecules by the body to mediate the inflammation of the meninges that characterizes the disease. These include prostaglandins, interleukins and tumor necrosis factor. Other animal experiments have shown that when some of these agents are injected into uninfected animals, injuries to the meninges and brain similar to those produced by bacterial meningitis occur. The levels of these chemical products were measured within the cerebrospinal fluid of patients with bacterial meningitis, before and after treatment with either dexamethasone (a synthetic glucocorticoid, used to control inflammation) or a placebo (an inactive control substance). In addition all patients also received various antibiotic treatments to sterilize their cerebrospinal fluid. Various prostaglandins, interleukins and tumor necrosis factor are found in the cerebrospinal fluid of most bacterial meningitis patients. Treatment for 18 to 30 hours with dexamethasone was found to lower prostaglandins and specific interleukins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

41. Glycerol and bacterial meningitis

Author

Saez-Llorens, Xavier and McCracken, George H. Jr.

Subjects
Hemophilus meningitis -- Causes of, Hemophilus meningitis -- Development and progression, Hemophilus meningitis -- Care and treatment, Glycerin -- Dosage and administration, Glycerin -- Physiological aspects, Glycerol -- Dosage and administration, Glycerol -- Physiological aspects, Hemophilus influenzae -- Health aspects, Health, Health care industry
Published
2007

44. Commentary on Practice Guidelines

Author

Baraff, Larry J., Schriger, David L., Bass, James W., Fleisher, Gary R., Klein, Jerome O., McCracken, George H. Jr, and Powell, Keith R.

Published
1997

50. Molecular pathophysiology of bacterial meningitis: current concepts and therapeutic implications

Author

Saez-Llorens, Xavier, Ramilo, Octavio, Mustafa, Mahmoud M., Mertsola, Jussi, and McCracken, George H. Jr.

Subjects
Dexamethasone -- Evaluation, Meningitis -- Care and treatment, Cytokines -- Physiological aspects, Pathology, Molecular -- Research, Health
Abstract

Bacterial meningitis, an infection of the membranes covering the brain and spinal cord, is a condition which in children is fatal in 3 to 7 percent of patients. This mortality rises to 30 percent among adults and newborns. One third of the patients surviving bacterial meningitis develop neurologic complications. These neurologic complications of meningitis may be caused by abnormal changes in molecular function. The currently identified elements of the meningeal inflammatory network, as well as experimental models and possible treatments are described. In addition, the results of clinical trials using dexamethasone to treat bacterial meningitis are reported. There are three components of bacteria which affect the strength of the organism: the capsule which surrounds the cell, the wall of the cell, and the lipopolysaccharide attached to the outer membrane of the cell. Recently, cytokines, chemicals secreted in response to the presence of bacteria, have been implicated as mediators in the inflammatory process. Interleukin-1, a cytokine, may be responsible for the body's response to bacterial infection, such as elevation of body temperature and white blood cell count. This new understanding of the role of mediators in infection may provide a new approach to treatment. Recent clinical trials of dexamethasone have shown that neurological complications occurred significantly less often in patients treated with dexamethasone than those receiving a placebo. Side effects of dexamethasone are infrequent. It is suggested that dexamethasone be considered to treat bacterial meningitis in children over the age of 2 months. Also, this treatment should be begun prior to or at the same time as the initial dose of intravenous antibiotic. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

Catalog

Books, media, physical & digital resources
See catalog results