cefotaxime and Jaundice

To investigate the prevalence of leptospirosis among patients from within and outside Kolkata, India, attending the Calcutta School of Tropical Medicine, for treatment during August 2002 to August 2008.. The leptospirosis cases were determined on the basis of clinical, epidemiological, and biochemical factors, and were tested for leptospiral antibodies using IgM ELISA. Serum samples with absorbance ratio ≥ 1.21 were interpreted as reactive.. The commonest presentation involved fever, headache and jaundice. The male-female ratio was 61:46. A total of 65(64.20%) cases had abnormal liver and renal functions respectively, and 57.1% had both the abnormalities. The highest incidence (75, 35.04%) was recorded in September-October followed by July-August (53, 24.77%). The reactive cases had absorbance ratios between 1.21 and 8.21, and 53 showed equivocal result, while IgM non reactivity were seen in 90 patients (absorbance ratios 0.10-0.90). The patients responded to treatment with parenteral antibiotics, penicillin, ceftriaxone and cefotaxime; follow up did not reveal case fatality.. The cardinal signs of leptospirosis help in making clinical diagnosis, but in any hyper-endemic situation any patient reporting with acute fever and signs of pulmonary, hepatic or renal involvement should be suspected to have leptospirosis and investigated accordingly. Increased awareness, and early diagnosis and treatment, can reduce mortality due to leptospirosis.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antibodies, Bacterial; Cefotaxime; Ceftriaxone; Child; Climate; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Female; Fever; Headache; Humans; Immunoglobulin M; Incidence; India; Infusions, Intravenous; Jaundice; Leptospira; Leptospirosis; Male; Middle Aged; Penicillins; Retrospective Studies; Risk Factors; Young Adult

To study the differences between the clinical presentation and complications of amoebic and pyogenic liver abscess. To correlate the diagnostic significance of Entamoeba Indirect Haemagglutination test (E.IHA) in establishing the diagnosis of amoebic liver abscess.. Open cohort observational study.. Department of Medicine (Medical Unit II) Jinnah Postgraduate Medical Centre, Karachi.. Fifty two patients aged 13-70 years admitted in Medical Unit II and diagnosed to have liver abscess.. Group A comprised of patients clinically diagnosed to have amoebic liver abscess and received Metronidazole 500mg iv x 8 hourly for atleast 10 days or more if patient developed complications. Group B comprised of patients diagnosed to have pyogenic abscess and received Cefotaxime 1g iv x 8 hourly for the same duration or more if complicated (antibiotic reviewed in accordance with culture and sensitivity report).. Differences in the clinical presentation, complications and diagnostic parameters between the two groups of patients.. It was not possible to differentiate between amoebic and pyogenic liver abscess on clinical grounds, routine investigations and imaging techniques. Aspiration of pus, especially if the abscess was multiple, was most helpful in differentiating the two types of abscesses. Serological test of E.IHA was highly specific and sensitive for amoebic liver abscess.. Majority of liver abscesses in Karachi are due to Entamoeba Histolytica. Pyogenic abscess though less frequent, must be excluded by pus aspiration and culture and sensitivity. E.IHA is a good rapid method of discriminating between the two types of abscesses.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antiprotozoal Agents; Cefotaxime; Cohort Studies; Diagnosis, Differential; Female; Humans; Jaundice; Liver Abscess; Liver Abscess, Amebic; Male; Metronidazole; Middle Aged; Treatment Outcome

Topics: Aged; Alcohol Drinking; Ascites; Cefotaxime; Cephalosporins; Citrobacter; Diagnosis, Differential; Diuretics; Enterobacteriaceae Infections; Fever; Humans; Jaundice; Male; Peritonitis; Spironolactone