exudates and Meningitis

To study the clinical features of non-typhoid Salmonella gastroenteritis and the incidence, risk factors and outcome of invasive complications in urban Malaysian children. To describe the serotypes of Salmonella species isolated and the pattern of antibiotic susceptibility.. Retrospective review of a group of 131 children with non-typhoid Salmonella gastroenteritis seen at the University Hospital, Kuala Lumpur, Malaysia from January 1994 to December 1996.. Sixty-seven percent were infants below one year of age. Fever and vomiting were seen in nearly half of children. Seven children (5.3%) had invasive complications: 5 bacteraemia and 2 meningitis. Age below 6 months, fever > 38.0 degrees C, and dehydration on admission were significantly associated with invasive complications. The commonest serotypes isolated were S. enteritidis, S. paratyphi B, and S. bovis-morbificans. A total of 94-100% of isolates were susceptible to commonly prescribed antibiotics.. Children with Salmonella gastroenteritis below 6 months of age who are febrile and dehydrated should be treated empirically with antibiotics until the result of blood culture is available.

Topics: Adolescent; Bacteremia; Child; Child, Preschool; Drug Resistance, Microbial; Female; Gastroenteritis; Humans; Incidence; Infant; Infant, Newborn; Malaysia; Male; Meningitis; Microbial Sensitivity Tests; Retrospective Studies; Risk Factors; Salmonella; Salmonella Infections; Treatment Outcome

The transseptal transsphenoidal hypophysectomy has become a relatively frequent procedure in recent years. We performed 20 such procedures between January 1984 and December 1987 for various pituitary disorders. Significant complications such as CSF rhinorrhea, meningitis, diabetes insipidus, haemorrhage and septal perforation are discussed. The mortality rate for the series was 5%. In analysing the data, we feel that this technique of hypophysectomy is a safe procedure.

Topics: Adolescent; Adult; Cerebrospinal Fluid Rhinorrhea; Diabetes Insipidus; Female; Hemorrhage; Hospitals, University; Humans; Hypophysectomy; Malaysia; Male; Meningitis; Middle Aged; Nasal Septum; Pituitary Neoplasms; Sphenoid Sinus

A prospective study was carried out to determine the aetiology of cerebral abscess in relation to the primary source of infections. Seventy-five patients with cerebral abscess were included in the study in the period January 1985 to December 1988. More than half of the patients studied had single lesions and the overall most common sites were in the frontal and parietal regions. Chronic suppurative otitis media, cyanotic congenital heart diseases and meningitis were among the important predisposing conditions in these patients. Approximately 25% of the patients with cerebral abscesses had no documented antecedent infections. Pure cultures were found to be predominant (66.7%) and sterile cultures were obtained from 10 (13.3%) patients. Streptococci were isolated from 23 (30.7%) patients, the commonest species being Streptococcus milleri. Proteus sp, Pseudomonas aeruginosa, Pseudomonas putrifaciens and Bacteroides sp were almost exclusively found in cerebral abscesses secondary to chronic suppurative otitis media; these organisms were found in mixed cultures. Streptococcus milleri, Bacteroides sp and Eikenella corrodens were found in pure cultures in patients with cyanotic congenital heart disease. In patients with ventriculoperitoneal shunts in-situ, Staphylococcus aureus, Staphylococcus epidermidis and diphtheroids were common. Anaerobes were found in 15 (20.0%) patients, the majority in mixed cultures. Culture, as well as gas-liquid chromatographic analysis of volatile fatty acids of cerebral pus, was carried out to enhance the detection of the anaerobes. Based on these findings, an antibiotic regimen consisting of penicillin, chloramphenicol and metronidazole is recommended as an initial therapy while awaiting culture and sensitivity results.

Topics: Adolescent; Adult; Age Factors; Bacteroides; Brain Abscess; Child; Child, Preschool; Chronic Disease; Eikenella corrodens; Heart Defects, Congenital; Humans; Infant; Malaysia; Meningitis; Middle Aged; Otitis Media, Suppurative; Prospective Studies; Proteus; Pseudomonas; Staphylococcus; Streptococcus; Ventriculoperitoneal Shunt

A 2.5-year retrospective study of pyogenic meningitis in hospitalized children in Kelantan was carried out with regard to aetiology, clinical features, investigation, treatment and outcome. There were 58 children with 43 cases (74.1%) occurring below the age of 1 year. Frequent presenting symptoms included fever (98.3%), fits (77.6%), anorexia (39.7%), vomiting (34.5%) and drowsiness (12.1%). On admission, 37 (63.7%) had neck stiffness, 10 (17.2%) had Kernig's sign and 32 (55.2%) had coma. CSF cultures were positive for Haemophilus influenzae in 29 (50%), Streptococcus pneumonia in 13 (22.4%) and Neisseria meningitidis in 3 (5.2%). The antibiotic sensitivity profiles showed that the three main organisms were 100% sensitive to Chloramphenicol, Streptococcus pneumoniae was 100% sensitive to penicillin, Neisseria meningitidis was 100% sensitive to penicillin and ampicillin, and Haemophilus influenzae was 90% sensitive to penicillin and ampicillin. The total hospital mortality was 18.9%. All but two of the eleven deaths occurred in children younger than 1 year. Nineteen of the 35 (54.3%) survivors attended for at least one follow-up after discharge from hospital. Of these 19 children, 47.4% had neurological sequelae.

Topics: Anti-Bacterial Agents; Bacterial Infections; Child; Child, Preschool; Drug Therapy, Combination; Female; Haemophilus influenzae; Humans; Infant; Malaysia; Male; Meningitis; Neisseria meningitidis; Streptococcus pneumoniae; Survival Rate

Topics: Adolescent; Adult; Cryptococcosis; Female; Humans; Lung Diseases, Fungal; Malaysia; Meningitis; Radiography

Topics: Age Factors; Female; Humans; Infant; Malaysia; Male; Meningitis; Sex Factors

Between January 1974 and June 1980, 85 cases of cryptococcosis were diagnosed in the University Hospital, Kuala Lumpur, Malaysia. The diagnosis was based on positive culture of the organism in 81 cases; the remaining four were diagnosed on histopathological findings. Cerebral cryptococcosis was the most common presentation and Chinese are particularly susceptible (72% of cases). The incidence of the disease is shown to be far greater than previously suspected. Association with compromised host status is uncommon (14%). The local literature is briefly reviewed and the findings discussed.

Topics: Adult; Child, Preschool; Cryptococcosis; Ethnicity; Female; Humans; Infant; Malaysia; Male; Meningitis

Topics: Hospitals; Length of Stay; Malaysia; Medical Audit; Meningitis; Organization and Administration; Radiology; Utilization Review; Workforce

Topics: Adolescent; Adult; Child; Diethylcarbamazine; Eosinophilia; Female; Humans; Malaysia; Male; Meningitis

Topics: Animals; Cryptococcosis; Cryptococcus; Culicidae; Humans; Malaysia; Meningitis; Meningitis, Cryptococcal