PURPOSE: To determine whether parenteral or oral antibiotics given before admission to a regional hospital with a special intensive care unit (ICU) reduce the case fatality rate in patients with meningococcal disease. DESIGN: Prospective analysis of 164 consecutive patients with meningococcal disease admitted to 5 regional hospitals in the Czech Republic between August 1996 and October 2001. Main outcome measure was number of deaths from meningococcal disease. Fisher's exact test was used for statistical analysis. MAIN FINDINGS: Nine out of 116 patients (8%) given antibiotics before admission died, compared with five deaths in 48 patients (10%) admitted without such a treatment (p = 0.55). None of 19 patients given oral or combined oral and parenteral pre-admission antibiotics died. CONCLUSION: Parenteral and probably also oral antibiotics given before admission to a regional hospital and an adequate treatment of shock can reduce the case fatality rate from meningococcal disease.
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- antibiotická profylaxe * MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- meningokokové infekce farmakoterapie mortalita MeSH
- mladiství MeSH
- Neisseria meningitidis účinky léků MeSH
- předškolní dítě MeSH
- příjem pacientů * MeSH
- prospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- antibakteriální látky MeSH
BACKGROUND: From the late 1950s through 2000, a total of 8 cases of imported visceral leishmaniosis (VL) were registered in the Czech republic. OBJECTIVES: The authors were made to point to the issue of imported VL by the fact 3 cases of this disease (imported from East Africa, Croatia, and southern Italy) were reported in 1999, plus another one (again imported from Croatia) in 2000. METHODS: The case reports of 4 cases of imported VL are presented. They are cases 5-8 ever reported in the Czech Republic. RESULTS: The infection manifested itself by fever, marked splenomegaly, leukopenia, thrombocytopenia, and rapid weight loss. The diagnosis was confirmed by the microscopic finding of amastigotes in punctate obtained from bone marrow, liver, spleen and, also, by serology. All the patients were successfully treated with amphotericin B. CONCLUSION: Infection by VL should be considered when establishing the diagnosis not only in patient returning from endemic regions and show hepatosplenomegaly, fever, leukopenia, and thrombocytopenia. Given the long incubation time, VL may be encountered also in foreigners who had lived in the above regions. Besides, the diagnosis of VL should also be considered in immunocompromised individuals. (Ref. 27.).
- MeSH
- cestování MeSH
- dítě MeSH
- dospělí MeSH
- leishmanióza viscerální diagnóza epidemiologie MeSH
- lidé MeSH
- uprchlíci MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- MeSH
- hepatitida B komplikace patofyziologie MeSH
- hepatitida C komplikace patofyziologie MeSH
- hepatorenální syndrom diagnóza etiologie MeSH
- jaterní encefalopatie etiologie MeSH
- kreatinin moč MeSH
- ledviny patofyziologie MeSH
- lidé MeSH
- sodík moč MeSH
- virová hepatitida u lidí patofyziologie MeSH
- vyšetření funkce ledvin MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- kreatinin MeSH
- sodík MeSH
