tetracycline and Fever

Although approximately 40 years have passed since Japanese spotted fever (JSF) was first reported in Japan, its treatment has not yet been standardised. As in other rickettsial infections, tetracycline (TC) is the first-line treatment, but successful instances of fluoroquinolone (FQ) combination therapy in severe cases have been reported. However, the effectiveness of TC plus FQ combined treatment (TC+FQ) remains controversial. Therefore, the antipyretic effect of TC+FQ was evaluated in this study.. A comprehensive search of published JSF case reports was conducted to extract individual patient data. In cases where it was possible to extract temperature data, after homogenising patient characteristics, time-dependent changes in fever type from the date of the first visit was evaluated for the TC and TC+FQ groups.. The primary search yielded 182 cases, with individual data evaluations resulting in a final analysis of 102 cases (84 in the TC group and 18 in the TC+FQ group) that included temperature data. The TC+FQ group had significantly lower body temperature compared with the TC group from Days 3 to 4.. Although TC monotherapy for JSF can eventually result in defervescence, the duration of fever is longer compared with other rickettsial infections such as scrub typhus. The results suggest that the antipyretic effect of TC+FQ was more effective, with a potential shortening of the duration that patients suffer from febrile symptoms.

Topics: Anti-Bacterial Agents; Antipyretics; East Asian People; Fever; Fluoroquinolones; Humans; Spotted Fever Group Rickettsiosis; Tetracycline

To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously.. In this retrospective study, records of all 26 adult patients with brucellosis, who presented with epididymitis or epididymo-orchitis at a tertiary hospital in Riyadh from 1983 to 2000, were reviewed. Positive blood culture or high agglutination titres of > or = 1 : 320 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Among these cases, epididymitis or epididymo-orchitis was diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis.. Epididymo-orchitis occurred in 1.6% of all patients with brucellosis. Most (58%) were 25--44 years old; approximately 77% of the patients presented with acute symptoms of < 2 weeks' duration. All patients complained of swollen painful testicles. Other presenting symptoms included undulant fever (96%), chills (54%) and arthralgia (23%). Four patients had dysuria and one haematuria. Ten patients gave a positive history of ingestion of raw milk and milk products; one patient had laboratory-acquired brucellosis. Six patients had unilateral epididymo-orchitis (two with features of florid presentation); the remaining 20 had only orchitis (bilateral in two, right in 10 and left in eight). Leucocytosis was present in six patients; 25 had initial agglutination titres of > 1 : 320 and the remaining patient had a positive blood culture. All patients received combined therapy with streptomycin for the first 2 weeks (or oral rifampicin for 6 weeks) with doxycycline or tetracycline for 6 weeks. All showed improvement, fever subsided in 2--5 days and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year.. In brucellosis-endemic areas, clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis. A careful history, a meticulous physical examination and a rapid laboratory evaluation help in diagnosis. Clinical and serological data are sufficient for diagnosis. Leucocytosis is not an atypical feature of brucellar epididymo-orchitis and so cannot be used for differentiating it from the nonspecific variety. Conservative management with combination antibiotic therapy is adequate for managing brucellar epididymo-orchitis.

Topics: Adolescent; Adult; Aged; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Fever; Humans; Length of Stay; Male; Middle Aged; Orchitis; Retrospective Studies; Rifampin; Saudi Arabia; Streptomycin; Tetracycline

The records of 20 children with imported malaria admitted to Kings County Hospital between October 1987 and May 1995 were reviewed. All had a history of recent travel or immigration from a malaria endemic area (West-Africa [16], Central-America [three], and the Caribbean [one]). None of the 10 children with a travel history received appropriate malaria chemoprophylaxis. The most common symptoms and signs were daily fever, chills, and hepatomegaly. Diagnosis was delayed in seven children who were initially felt to have pharyngitis or viral syndrome. Common laboratory findings were anemia and thrombocytopenia. P. falciparum was identified in 70% of the patients. Other species were P. malariae and P. vivax. Complications occurred in six children, hyponatremia in five, seizures in three, and cerebral malaria in one patient. The high incidence of chloroquine-resistant malaria makes chemoprophylaxis difficult in children. The clinical presentation of malaria is nonspecific, and diagnostic delays occur, so a high index of suspicion is needed in children with a travel history.

Topics: Animals; Antimalarials; Child; Child, Preschool; Drug Therapy, Combination; Female; Fever; Hepatomegaly; Humans; Malaria; Male; Plasmodium falciparum; Quinine; Splenomegaly; Tetracycline; Travel; Treatment Outcome; Tropical Climate

Because minocycline can cause serious adverse events including hypersensitivity syndrome reaction (HSR), serum sicknesslike reaction (SSLR), and drug-induced lupus, a follow-up study based on a retrospective review of our Drug Safety Clinic and the Health Protection Branch databases and a literature review was conducted to determine if similar rare events are associated with tetracycline and doxycycline. Cases of isolated single organ dysfunction (SOD) attributable to the use of these antibiotics also were identified.. Nineteen cases of HSR due to minocycline, 2 due to tetracycline, and 1 due to doxycycline were identified. Eleven cases of SSLR due to minocycline, 3 due to tetracycline, and 2 due to doxycycline were identified. All 33 cases of drug-induced lupus were attributable to minocycline. Forty cases of SOD from minocycline, 37 cases from tetracycline, and 6 from doxycycline were detected. Hypersensitivity syndrome reaction, SSLR, and SOD occur on average within 4 weeks of therapy, whereas minocycline-induced lupus occurs on average 2 years after the initiation of therapy.. Early serious events occurring during the course of tetracycline antibiotic treatment include HSR, SSLR, and SOD. Drug-induced lupus, which occurs late in the course of therapy, is reported only with minocycline. We theorize that minocycline metabolism may account for the increased frequency of serious adverse events with this drug.

Topics: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Anti-Bacterial Agents; Arthralgia; Canada; Databases as Topic; Doxycycline; Drug Eruptions; Drug Hypersensitivity; Drug Prescriptions; Female; Fever; Follow-Up Studies; Humans; Liver; Lupus Erythematosus, Systemic; Male; Middle Aged; Minocycline; Retrospective Studies; Safety; Serum Sickness; Syndrome; Tetracycline; Time Factors

Chlamydia pneumoniae is the third strain of Chlamydia and transmission is presumed to be by droplet spread from symptomatic patients. The authors show a literature scientific review on subject-matter emphasizing several sporadic and epidemic case of illness in every age, first months excepted. The described cases are few and therefore clinical characteristics are shadowy. Certain clinical features are suggesting of severe pneumonia with fever and pharyngitis without exudate. In the childhood and in the adolescence the clinical evolution is favourable. Tetracyclines or erythromycin is recommended for therapy.

Topics: Age Factors; Child; Child, Preschool; Chlamydophila pneumoniae; Erythromycin; Fever; Fluorescent Antibody Technique; Humans; Infant; Infant, Newborn; Lung; Pharyngitis; Pneumonia; Tetracycline

Penicillin remains the treatment of choice for syphilis, with sustained low blood levels curing virtually all patients having early syphilis and halting disease progression in most patients with symptomatic syphilis. Tetracycline, erythromycin or cephalothin yields similar cure rates for patients with early syphilis who are allergic to penicillin. The efficacy of non-penicillin regimens for the treatment of late syphilis is uncertain. Results of Venereal Disease Research Laboratory (VDRL) or other reagin tests should become negative or remain at very low titer following adequate therapy, although results of Treponema pallidum immobilization (TPI) and fluorescent treponemal antibody-absorbed (FTA-ABS) tests often remain positive.

Topics: Cephalexin; Cephaloridine; Cephalosporins; Chloramphenicol; Drug Hypersensitivity; Erythromycin; Female; Fever; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Neurosyphilis; Penicillin G Benzathine; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First; Syphilis; Syphilis Serodiagnosis; Syphilis, Cardiovascular; Syphilis, Congenital; Syphilis, Latent; Tetracycline; Treponema pallidum; United States

Topics: Abattoirs; Abscess; Agglutination Tests; Animals; Body Weight; Brucella; Brucella abortus; Brucellosis; Cattle; Chloramphenicol; Epididymitis; Fever; Humans; Illinois; Iowa; Lymphatic Diseases; Male; Occupational Diseases; Pyridazines; Splenomegaly; Streptomycin; Sulfanilamides; Tetracycline

Topics: Adolescent; Adult; Aged; Animals; Cat-Scratch Disease; Child; Child, Preschool; Disease Outbreaks; Female; Fever; Gastroenteritis; Humans; Indians, North American; Insect Vectors; Leukemia; Lymphogranuloma Venereum; Male; Middle Aged; New Mexico; Phagocytosis; Plague; Rodentia; Sciuridae; Siphonaptera; Streptomycin; Syphilis; Tetracycline; Tularemia; Yersinia pestis

Topics: Bacteriological Techniques; Diagnosis; Embolism; Endocarditis, Bacterial; Erythromycin; Fever; Heart Defects, Congenital; Heart Valves; Humans; Lung Diseases; Penicillin Resistance; Penicillins; Pneumococcal Infections; Postoperative Complications; Prognosis; Sepsis; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Autologous blood pleurodesis (ABP) is used for the treatment of pneumothorax with a good efficacy. The aim of this study is to determine the efficacy and safety of ABP in the treatment of malignant pleural effusion (MPE).. A prospective study was conducted at Songklanagarind Hospital, Thailand. Symptomatic MPE patients were randomized to receive pleurodesis with either autologous blood or tetracycline. In the ABP group, 100 ml of autologous venous blood was instilled via chest tube followed by 50 ml of sterile normal saline (NSS). In the tetracycline group, 20 ml of 1% lidocaine diluted in 30 ml NSS was instilled followed by 1 g of tetracycline diluted in 100 ml of NSS. The chest tube was clamped for 2 hours, then reconnected to suction and removed. Pleurodesis effectiveness was evaluated according to Paladine's criteria and adverse events were recorded.. A total of 48 symptomatic MPE patients were recruited. Of these, 24 cases were randomized to receive ABP and 24 cases received tetracycline. There was no difference between the two groups in baseline characteristics. The overall success rate of pleurodesis was the same in both the autologous blood group and the tetracycline group (83.4% versus 87.5%, p = 0.36). In the ABP group, the pain score and fever were significantly lower (8.3% versus 29.1%, p = 0.003) and there was a small percentage of cases that needed analgesia (4.2% versus 75%, p < 0.001); no serious events occurred.. ABP was as effective as tetracycline in the treatment of MPE. ABP produced less pain and fever, and could shorten the hospital stay.

Topics: Aged; Autografts; Blood; Female; Fever; Humans; Length of Stay; Male; Middle Aged; Pain; Pleural Effusion, Malignant; Pleurodesis; Prospective Studies; Sclerosing Solutions; Tetracycline; Thailand; Time Factors; Treatment Outcome

The efficacy and toxicity of oral quinine combined with oral chloroquine were studied in 50 Thai men with uncomplicated falciparum malaria. All were treated for 7 days with quinine sulphate (10 mg salt/kg every 8 h). Twenty-five of the patients, selected at random, were also given oral tetracycline (4 mg/kg four times daily) over the same period and the remainder were given chloroquine (25 mg base/kg over the first 3 days). There were no serious adverse effects. Overall fever-clearance times (FCT) and parasite-clearance times (PCT) in the chloroquine and tetracycline groups were not significantly different, with mean (S.D.) values of 51 (33) and 41 (27) h for FCT and 80 (25) and 83 (21) h for PCT, respectively. Most of the patients (18 in each group) were followed for > or = 2 months. Recrudescence rates (R1) were significantly higher in the chloroquine group than in the tetracycline group (39% v. 6%; P = 0.02), all recrudescences occurring within 4 weeks (18-25 days) of starting treatment. Subsequent parasitaemia with Plasmodium vivax, however, occurred less frequently in the chloroquine group (11%) than in the tetracycline group (33%) (P = 0.11) and took longer to develop in the chloroquine group [51 or 59 days compared with a mean (S.D.) value of 29 (10) days in the tetracycline group; P = 0.01]. Within the chloroquine group, FCT and PCT were both shorter in those with cure than in those with R1 resistance, with mean (S.D.) values of 41 (25) and 70 (33) h for FCT (P = 0.09) and 72 (20) and 100 (18) h for PCT (P = 0.01), respectively. Chloroquine does not potentiate the clinical response to quinine against resistant strains of uncomplicated falciparum malaria, nor does it convey any useful antipyretic effect.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antimalarials; Chloroquine; Drug Therapy, Combination; Fever; Humans; Malaria, Falciparum; Malaria, Vivax; Male; Middle Aged; Parasitemia; Quinine; Recurrence; Tetracycline; Thailand; Treatment Outcome

A clinical trial was conducted in order to evaluate the efficacy of procaine penicillin and tetracycline, respectively, in the treatment of louse-borne relapsing fever. 184 patients (160 men, 24 women) admitted to the Gondar hospital during the rainy season 1992 were assigned to 1 of 4 treatment groups: procaine penicillin 100,000 (PP100), 200,000 (PP200) or 400,000 (PP400) international units (IU) intramuscularly (i.m.), or tetracycline 250 mg per os (TTC, p.o.). All drugs were given as single doses. The overall case fatality rate was 3.3%. Frequency of relapses, Jarisch-Herxheimer-like reactions (JHR) and deaths were significantly different between patients treated with TTC and those treated with PP100. Relapses occurred most often in the group receiving the lowest dose of penicillin (46%), and decreased with increasing dosage of penicillin; none of the patients treated with TTC had a relapse. Occurrence of JHR showed the opposite pattern: whilst 2 (5%) patients treated with PP100 developed a JHR, 16 (29%) in the PP200 group, 10 (31%) in the PP400 group, and 27 (47%) in the TTC group developed a JHR. As mortality is linked to severe JHR, and most relapses are clinically mild and easily treated, these results speak in favour of using low-dose penicillin to initiate the treatment of relapsing fever.

Topics: Adolescent; Adult; Animals; Blood Pressure; Borrelia Infections; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Fever; Humans; Insect Vectors; Male; Middle Aged; Penicillin G Procaine; Phthiraptera; Recurrence; Relapsing Fever; Tachycardia; Tetracycline; Treatment Outcome

A randomized controlled clinical trial was undertaken in 542 consecutive emergency and elective abdominal operations, with one group of patients receiving tetracycline peritoneal and wound lavage and the other a single intravenous injection of 1 g latamoxef at induction of anaesthesia. Seventy-five patients were withdrawn because no potentially contaminated hollow viscus was opened, and a further 36 because they could not be assessed for wound infection. Of the remaining 431 patients, 212 received latamoxef resulting in 5 major and 8 minor wound infections in hospital; another 4 minor infections occurred at home (total incidence 8.0%). In the tetracycline group (n = 219) there were 7 major and 19 minor wound infections in hospital and 10 minor infections later (total incidence 16.4%). This is significantly higher than the rate with latamoxef (P = 0.012). Monitoring of operative and postoperative bleeding revealed no evidence (except in one doubtful case) of excessive bleeding associated with the use of a single dose of latamoxef. It is concluded that single-dose preoperative latamoxef is more effective than peroperative tetracycline lavage for the prevention of wound infections after potentially contaminated abdominal operations.

Topics: Abdominal Muscles; Adolescent; Adult; Aged; Clinical Trials as Topic; Enterobacteriaceae; Female; Fever; Humans; Intraoperative Care; Male; Middle Aged; Moxalactam; Premedication; Random Allocation; Staphylococcus; Streptococcus; Surgical Wound Infection; Tetracycline; Therapeutic Irrigation

Naloxone, an opioid antagonist, and meptazinol, an opioid antagonist with agonist properties, were tested in a double-blind placebo-controlled trial in 24 Ethiopian patients with louse-borne relapsing fever. The potentially fatal Jarisch-Herxheimer reaction (J-HR), which invariably follows tetracycline treatment of the disease, was unaffected by naloxone, 30-40 mg intravenously, but was diminished by meptazinol, 300-500 mg intravenously. Compared with naloxone and placebo, meptazinol reduced the clinical severity of the reaction, significantly delayed and shortened its chill phase, delayed the rise in temperature, and reduced peak temperature and changes in pulse and respiratory rates and leucocyte count. High-dose corticosteroids given before or at the time of tetracycline treatment failed to alter the reaction, which is thought to result from release of endotoxin-like substances. Meptazinol is the first effective treatment for the J-HR of louse-borne relapsing fever. This finding suggests a role for endogenous opioids in the pathogenesis of the J-HR.

Topics: Adolescent; Adult; Azepines; Clinical Trials as Topic; Double-Blind Method; Endotoxins; Fever; Humans; Infusions, Parenteral; Meptazinol; Naloxone; Prednisolone; Relapsing Fever; Spirochaeta; Tetracycline

Topics: Administration, Oral; Adolescent; Adult; Antigens, Bacterial; Clindamycin; Clinical Trials as Topic; Fever; Hospitalization; Humans; Length of Stay; Lung; Male; Mycoplasma Infections; Placebos; Pneumonia; Radiography; Tetracycline

Topics: Adolescent; Adult; Ampicillin; Chloramphenicol; Clinical Trials as Topic; Dehydration; Drug Combinations; Dysentery, Bacillary; Female; Fever; Humans; Male; Melena; Microbial Sensitivity Tests; Middle Aged; Pain; Shigella; Shigella boydii; Shigella dysenteriae; Shigella flexneri; Streptomycin; Sulfamethazine; Sulfamethoxazole; Tetracycline; Trimethoprim; Vomiting

Topics: Aged; Ampicillin; Anti-Bacterial Agents; Bacteriuria; Cephalosporins; Clinical Trials as Topic; Fever; Gentamicins; Humans; Kanamycin; Male; Middle Aged; Nitrofurantoin; Postoperative Complications; Prognosis; Prostatectomy; Sepsis; Sulfisoxazole; Tetracycline; Urinary Tract Infections

Topics: Albuminuria; Anemia; Arrhythmias, Cardiac; Aspartate Aminotransferases; Chloramphenicol; Conjunctivitis; Evaluation Studies as Topic; Fever; Hepatomegaly; Humans; Hypotension, Orthostatic; Leukopenia; Lymphatic Diseases; Male; Military Medicine; Recurrence; Scrub Typhus; Skin Ulcer; Splenomegaly; Tetracycline

Topics: Clinical Trials as Topic; Drug Hypersensitivity; Fever; Humans; Infant; Penicillin V; Respiratory Tract Infections; Tetracycline

Malaria is a parasitic infection characterized by anemia, splenomegaly and periodic fever. This infection has a tendency to cause serious complications. Falciparum malaria could occur in our country as an imported case due to increasing intercontinental travel opportunities. The World Health Organisation (WHO) recommends arthemether combination treatment as a first line choice. Here we report a Turkish case admitted to the hospital with high fever, sweating and fatigue. He had been in Uganda for 6 months without prophylaxis. Plasmodium falciparum with an intense parasitic load was diagnosed. We started arthemether-lumefantrine combination therapy immediately. 18 days after his discharge he was readmitted with the same complaints and parasitemia was detected once again. This time, we treated him with the quinine-tetracycline combination regime for 7 days. Within 48 hours the patient was afebrile and the blood smear was negative. Falciparum malaria must be considered in infection emergencies for febrile patients especially with any travel history. For an initial therapy, arthemetherlumefantrine combination is a successful choice of treatment. Even with adequate treatment of arthemether-lumefantrine combination, the problems of recurrence (recrudescence or reinfection) could occur due to treatment failure. For the possibility of recurrence, close monitoring of patients is very important in the critical course after adequate treatment.

Topics: Administration, Oral; Antimalarials; Artemether, Lumefantrine Drug Combination; Artemisinins; Drug Combinations; Ethanolamines; Fever; Fluorenes; Humans; Malaria, Falciparum; Male; Middle Aged; Plasmodium falciparum; Quinine; Recurrence; Tetracycline; Travel; Treatment Failure; Turkey; Uganda

Over six months, 129 consecutive brucellosis cases were diagnosed in females attending the outpatients' clinics the females in Al-Azhar and Ain Shams Universities Hospitals. Their ages ranged between 12-65 years old. 113 (87.6%) gave history of raw milk consumption, 13 (10%) gave history of home slaughtering of sheep, 2 (1.5%) gave history of animal contact, and one patient gave history of abortion, that partner had brucellosis. A total of 61.2% of patients gave serum agglutination test of 1: 640, who suffered acute or subacute infection. Titers of 1:320 (38.8%) were found in the majority of chronic cases. Causes of endemic parasitosis were excluded. Symptoms were fever (79.5%), headache (72.4%), generalized arthralgia (65.3%), sweating (65.3%), chills (63.8%), backache (34.6%), abdominal pain (27.5%), loss of appetite (25.5%), lassitude (17.2%), myalgia (14.2%), monoarthralgia (7.9%). Spinal involvement was in 15% patients, who had chronic brucellosis. 32/35 were successfully treated with a combination of streptomycin and tetracycline, 17/21 with streptomycin and septrin, 38/43 with tetracycline and septrin, and 26/26 (100%) with rifampicin and tetracycline or septrin, which treated all resistant patients.

Topics: Acute Disease; Adolescent; Adult; Age Factors; Aged; Anti-Bacterial Agents; Brucellosis; Child; Chronic Disease; Drug Therapy, Combination; Egypt; Female; Fever; Humans; Middle Aged; Rifampin; Risk Factors; Streptomycin; Tetracycline; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

We report a case of borreliosis mimicking uncomplicated malaria in a patient returning from Mali. Identification of spirochetes through examination of a thick blood smear completed by an acridine-orange quantitative buffy coat allowed the diagnosis of borreliosis. All symptoms rapidly resolved following tetracycline therapy. Epidemiological and clinical features of borreliosis, diagnostic tools and management are discussed.

Topics: Anti-Bacterial Agents; Borrelia Infections; Diagnosis, Differential; Fever; France; Humans; Malaria; Male; Mali; Middle Aged; Tetracycline; Travel

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Drug Hypersensitivity; Fever; Humans; Male; Tetracycline

We report 6 cases of marine typhus presented to us within a period of 3 months. The diagnoses were made based on the Weil-Felix reaction in the context of supportive clinical and epidemiological features, and response to appropriate antimicrobial therapy. This review serves to remind us that murine typhus is still an important cause of acute febrile illness in Singapore, especially among the migrant Indian workers.

Topics: Acute Disease; Administration, Oral; Adult; Agglutination Tests; Anti-Bacterial Agents; Doxycycline; Fever; Humans; Male; Middle Aged; Singapore; Tetracycline; Typhus, Endemic Flea-Borne

The management of malignant pericardial effusion remains controversial. We present our experience with 93 patients referred for drainage and sclerosing procedures between 1979 and 1994.. With continuous electrocardiographic monitoring, a Kifa catheter was inserted percutaneously into the pericardial sac and allowed to drain. A 100 mg dose of lidocaine hydrochloride was instilled intrapericardially, followed by 500 to 1000 mg tetracycline or doxycycline hydrochloride in 20 to 50 ml normal saline solution. The catheter was clamped for 1 to 2 hours and then reopened, and the procedure was repeated daily until the net drainage was less than 25 ml in 24 hours.. Subjects included 53 women and 40 men (median age 58 years). Eight patients could not undergo sclerosis because of technical failure. Eighty-five patients underwent sclerosis and required a median dose of 1500 mg of the sclerosing agent (range 500 to 700 mg), given in a median of three injections (range one to eight). Complications included pain (17 patients), atrial arrhythmias (eight patients), fever with temperature greater than 38.5 degrees C (seven patients), and infection (one patient). Two patients had cardiac arrest before sclerosis could be attempted. Sixty-eight patients (73%) had the effusion controlled for longer than 30 days, for an overall control rate of 81%. Seven other patients had control of the effusion but died of progressive malignant disease in less than 30 days. The overall median survival was 98 days (range 1 to 1724 days). Comparison of these results with outcomes reported for patients with malignant pericardial effusion who underwent surgical drainage indicates that drainage and sclerosis provide similar survivals but sclerosis carries lower morbidity, mortality, and recurrence rates.. Percutaneous drainage and sclerosis constitutes a safe and effective treatment for malignant pericardial effusion. Surgical management should be reserved for the small percentage of cases that cannot be controlled by this method.

Topics: Adult; Aged; Anesthetics, Local; Anti-Bacterial Agents; Arrhythmias, Cardiac; Bacterial Infections; Breast Neoplasms; Cardiac Tamponade; Catheterization; Doxycycline; Drainage; Electrocardiography, Ambulatory; Female; Fever; Follow-Up Studies; Heart Arrest; Humans; Lidocaine; Lung Neoplasms; Male; Middle Aged; Pain; Pericardial Effusion; Pericardium; Sclerosing Solutions; Survival Rate; Tetracycline; Treatment Outcome

Acne fulminans is an ulcerative form of acne with an acute onset and systemic symptoms. It most commonly affects adolescent boys.. Clinical and laboratory findings and treatment results of patients with acne fulminans were reviewed to obtain a better understanding of the clinical course and outcome of the disease.. Data of patients with severe acne were collected from the Dermatology Departments of Finnish hospitals during the years 1970 to 1991.. Twenty-four patients with acne fulminans are described. All patients had ulcerative acne with acute onset. In 22 patients acne was associated with high fever for at least 1 week. All patients had musculoskeletal pain. Increased uptake in bone scan or radiographic findings compatible with an infectious origin were detected in 17 patients. Eight patients were treated with antibiotics alone, but the response was poor; three patients had a relapse of musculoskeletal symptoms. Ten patients were given systemic steroids in addition to antibiotics. In this group the response was rapid, but acne and musculoskeletal symptoms tended to relapse when the steroid dosage was reduced. Four patients were treated with a combination of antibiotics, systemic steroids, and isotretinoin; all responded well, but one of these patients also had a relapse.. Musculoskeletal symptoms are common in patients with acne fulminans. Systemic steroid treatment rapidly controls the skin lesions and systemic symptoms. The duration of steroid treatment should be 2 to 4 months to avoid relapses. Therapy with isotretinoin, antibiotics, or both was often combined with steroids, but the role of these agents is still uncertain.

Topics: Acne Vulgaris; Adolescent; Adult; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Blood Sedimentation; Dermatitis, Atopic; Female; Fever; Glucocorticoids; Humans; Isotretinoin; Joints; Leukocytosis; Male; Muscles; Osteolysis; Pain; Retrospective Studies; Tetracycline; Ulcer

Clinical manifestations of louse-borne relapsing fever (LBRF) in children admitted to Jimma Teaching Hospital from March 1991 to September 1991 are described. The clinical manifestations were mild and the frequency of occurrence of each feature was lower than in adults. Jaundice and cardiac abnormality have not been found in children. The Jarisch-Herxheimer reaction was also mild and occurred in about 16% of the cases. The prognosis of LBRF was excellent. Initial treatment with penicillin and continued treatment with tetracycline for a couple of days was justifiable. Further detailed studies with a larger series is recommended.

Topics: Adolescent; Blood Pressure; Child; Child, Preschool; Electrocardiography; Ethiopia; Female; Fever; Heart Rate; Humans; Infant; Male; Penicillins; Relapsing Fever; Respiration; Tetracycline

Patients with pneumonia not responding to treatment with betalactam drugs and patients where an "atypical" etiology is suspected from the beginning, are often given erythromycin to cover mycoplasma and legionella. Erythromycin has also been effective for Chlamydia pneumoniae. If, however, ornithosis is suspected the recommended drug has been tetracycline. Since we noted that several patients had a favourable course on erythromycin despite a final serological diagnosis of ornithosis, we retrospectively studied patients admitted with acute lower respiratory tract infection and a 4-fold titer rise to C. psittaci. We found 35 patients treated with a betalactam drug (n = 12), tetracycline (n = 2), or erythromycin (n = 5) alone, or with a betalactam, which because of non-responsiveness was followed by either tetracycline (n = 4) or erythromycin (n = 12). The data were analysed with survival analysis by a Cox' regression model. There was a significant (p less than 0.001) effect of treatment on the time to defervescence, mainly due to a difference between the erythromycin treated group and the betalactam treated group. We found erythromycin to be at least as effective as tetracycline for treating C. psittaci pneumonia. Since erythromycin has to be used to cover legionella in patients with severe pneumonia when an atypical etiology cannot be excluded, it is an important conclusion that this drug seems to cover C. psittaci as well.

Topics: Anti-Bacterial Agents; Drug Therapy, Combination; Erythromycin; Fever; Humans; Lactams; Pneumonia; Psittacosis; Retrospective Studies; Tetracycline; Time Factors

Tick-borne rickettsiae of the genus Ehrlichia have recently been recognized as a cause of human illness in the United States. In the years 1986-1988, 10 cases of ehrlichiosis were diagnosed in children in Oklahoma. Fever and headache were universal: myalgias, nausea, vomiting, and anorexia were also common. Rash was observed in six patients but was a prominent finding in only one. Leukopenia, lymphopenia, and thrombocytopenia were common laboratory abnormalities. Six patients were treated with tetracycline, three with chloramphenicol, and one was not treated with antibiotics: all recovered. The onset of illness in spring and early summer for most cases paralleled the time when Amblyomma americanum and Dermacentor variabilis are most active, suggesting that one or both ticks may be vectors of human ehrlichiosis in Oklahoma.

Topics: Animals; Arachnid Vectors; Blood Cell Count; Child; Child, Preschool; Chloramphenicol; Ehrlichia; Female; Fever; Headache; Humans; Male; Rickettsiaceae Infections; Tetracycline; Ticks

Topics: Adolescent; Adult; Aminoglycosides; Anti-Bacterial Agents; Anti-Infective Agents; Cephalosporins; Child; Child, Preschool; Chloramphenicol; Drug Combinations; Fever; Humans; Infant; Infant, Newborn; Meningitis; Middle Aged; Penicillins; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

A full-term baby boy had respiratory distress, fever and pneumonia within 20 h of birth. Isolation of Mycoplasma hominis from blood taken after 20 h and 11 days was accompanied by an antibody response. Although chlamydial IgM antibody was detected, chlamydial infection probably did not cause the pneumonia. Penicillin was ineffective but treatment with gentamicin, and particularly tetracycline, was associated with slow improvement. Mycoplasma hominis should be considered as a cause of respiratory disease and fever in neonates.

Topics: Ampicillin; Erythromycin; Fever; Gentamicins; Humans; Infant, Newborn; Male; Mycoplasma; Mycoplasma Infections; Respiratory Tract Infections; Tetracycline

Topics: Adult; Fever; Humans; Listeriosis; Male; Tetracycline

Although previous large series have reported that from 0.3% to 1.3% of patients undergoing hysterosalpingography (HSG) develop infectious morbidity, our impression was that the incidence was higher among our patients. Therefore the records of 448 consecutive healthy women who underwent HSG were examined. Within 24 hours after the HSG, 14 of these 448 patients (3.1%) developed fever and pelvic peritonitis requiring hospitalization and treatment with parenteral antibiotics, a significantly greater frequency than reported elsewhere (P less than 0.01). Traditional laboratory tests failed to predict patients at risk, and prophylactic antibiotics effective against aerobic organisms could not protect against this complication. However, it was possible to design a scoring system based on specific findings in the history and previous physical examinations that was capable of identifying patients who would subsequently become infected. The clinical sensitivity of this scoring technique is 57%, clinical specificity 99%, and test efficiency 97%. It is suggested that in view of the major risk of post-HSG infection in certain identifiable women and because of the impact of this complication on their future fertility, hysterosalpingography should not be performed in those patients determined to be at high risk. In women at lowest risk, the procedure is safe. Finally, in patients assigned an intermediate risk-score, the risk-benefit ratio must be carefully weighed and discussed with the patient, and prophylactic antibiotics with anaerobic coverage should be considered.

Topics: Adolescent; Adult; Aminoglycosides; Ampicillin; Blood Sedimentation; Cephalosporins; Female; Fever; Humans; Hysterosalpingography; Leukocyte Count; Middle Aged; Pelvic Inflammatory Disease; Penicillins; Risk; Tetracycline

A previously healthy 14-year-old girl showed monosymptomatic hectic fever for over 3 weeks with negative clinical findings. Extensive laboratory investigation revealed only elevated ESR and a high titer of agglutinating antibodies against Yersinia enterocolitica, serotype 0-3. These abnormalities disappeared upon tetracycline therapy, after which she remained in excellent health. This unusual manifestation of yersiniosis, which was of unknown source, demonstrates that Yersinia infection should be considered in patients with prolonged febrile illnesses of obscure etiology.

Topics: Adolescent; Agglutination Tests; Antibodies, Bacterial; Female; Fever; Humans; Tetracycline; Yersinia Infections

Topics: Adult; Asthenia; Brucella abortus; Brucellosis; Depression; Fever; Humans; Male; Mental Disorders; Serologic Tests; Tetracycline

Out of 8 patients with Whipple's disease, 7 had roentgenographic findings consisting of slight dilatation of the small bowel, with thickening of the mucosal folds. The eighth patient had no abnormality on roentgenographic study. This series represents the first in which the roentgenographic changes have been quantitatively assessed. Confirmation of the diagnosis by biopsy is important because antibiotic treatment results in marked improvement both clinically and roentgenographically.

Topics: Adult; Aged; Amenorrhea; Biopsy; Body Weight; Diagnosis, Differential; Diarrhea; Duodenum; Edema; Female; Fever; Follow-Up Studies; Humans; Intestinal Mucosa; Intestine, Small; Jejunum; Joint Diseases; Lymphadenitis; Male; Middle Aged; Pain; Pigmentation Disorders; Purpura; Radiography; Tetracycline; Whipple Disease

Because the efficacy of prophylactic antibiotic therapy has yet to be established and because numerous variables often hamper studies of such therapy, the results of prophylactic antibiotic therapy were studied in a homogeneous gynecologic population. The patients were 4000 women undergoing first trimester abortions. The surgical procedure, the gynecologists' skill, and the hospital environment were relatively uniform, as was the patient age range. Two groups of 1000 patients each received tetracycline; the other 2000 patients served as controls. The complications associated with abortion were then analyzed in those receiving tetracycline and in the 2000 controls. Complications were less frequent among patients receiving tetracycline. This finding supports the argument of those who favor the prophylactic use of antibiotics in the management of various high-risk surgical problems.. An evaluative study of the prophylactic use of tetracycline in 1st-trimester abortions is presented. 2 groups of 1000 patients received 1.5 gm of tetracycline hydrochloride, orally, 2-3 hours before the abortion procedure, followed by 500 mg every 6 hours for 4 days. 2 groups of 1000 patients served as controls. The patient population and operative conditions were relatively uniform. The total complication rates for the antibiotic groups were 3.4% and 2.9%, and 9.1% and 8.8% for the controls. 118 of the control group patients experienced major complications compared with 45 patients in the antibiotic group. The results tend to support the arguments for the use of antibiotics in managing high-risk surgical procedures.

Topics: Abortion, Legal; Bacterial Infections; Female; Fever; Follow-Up Studies; Humans; Length of Stay; Patient Compliance; Postoperative Complications; Pregnancy; Pregnancy Trimester, First; Tetracycline; Vacuum Curettage

Report about cyclic agranulocytosis in a 10 1/2 years old girls, having stomatitis, sore throat and fever up to 39 degrees C in the interval of approximately 3 weeks since the age of 6 months. By the prophylactic treatment with pulverized tetracyclin, which is already given 2 days prior to the expected decrease of the neutrophils, the patient stays clinically asymptomatic since 7 months.

Topics: Agranulocytosis; Bone Marrow Cells; Child; Child, Preschool; Female; Fever; Humans; Infant; Leukocytes; Neutrophils; Periodicity; Pharyngitis; Powders; Punctures; Stomatitis; Tetracycline

Eight grivet monkeys infected with Borrelia recurrentis received tetracycline (12.5mg/kg body weight) on the 3rd or 4th day of spirochetemia. Leukopenia, fever, hyperpnea, and tachycardia developed within 2 hours as spirochete counts fell to undetectable levels. These events closely simulated the crisis in human louse-borne relapsing fever in both timing and extent.

Topics: Animals; Blood; Borrelia; Disease Models, Animal; Female; Fever; Haplorhini; Heart Rate; Insect Vectors; Leukocyte Count; Leukocytes; Leukopenia; Male; Phthiraptera; Relapsing Fever; Respiration; Tachycardia; Tetracycline

Topics: Agranulocytosis; Anemia, Aplastic; Anti-Bacterial Agents; Bronchial Spasm; Cephalosporins; Chloramphenicol; Drug Eruptions; Exanthema; Fatty Liver; Fever; Gentamicins; Hearing Disorders; Humans; Nalidixic Acid; Nitrofurantoin; Penicillins; Sulfanilamides; Tetracycline; Urticaria

Topics: Acute Disease; Administration, Oral; Adolescent; Adult; Alcoholism; Clindamycin; Fever; Hemoglobins; Heroin Dependence; Humans; Injections, Intramuscular; Injections, Intravenous; Length of Stay; Leukocyte Count; Lung Abscess; Male; Middle Aged; Penicillin G; Radiography; Seizures; Tetracycline; Time Factors

Topics: Africa; Asia; Brucellosis; Chloramphenicol; Chloroquine; Fever; Humans; Leishmaniasis, Visceral; Liver Abscess, Amebic; Malaria; Metronidazole; Plasmodium falciparum; Tetracycline; Travel; Trypanosomiasis, African; Tuberculosis; Typhoid Fever; United Kingdom

Topics: Adult; Amnion; Cervix Uteri; Female; Fever; Humans; Labor, Obstetric; Lincomycin; Mycoplasma; Mycoplasma Infections; Pregnancy; Pregnancy Complications, Infectious; Tetracycline; Vagina; Vaginal Smears

Topics: Acne Vulgaris; Acute Disease; Adolescent; Ampicillin; Anemia; Anti-Bacterial Agents; Cephalosporins; Erythromycin; Female; Fever; Follow-Up Studies; Humans; Joint Diseases; Leukemoid Reaction; Male; Nephritis; Prednisolone; Skin Diseases; Syndrome; Tetracycline; Triamcinolone

Topics: Adult; Child, Preschool; Darier Disease; Edema; Fever; gamma-Globulins; Hematocrit; Humans; Leukocyte Count; Middle Aged; Smallpox Vaccine; Staphylococcus; Tetracycline; Thiosemicarbazones; Vaccination; Vaccinia; Vaccinia virus

Topics: Ampicillin; Child, Preschool; Chloramphenicol; Colistin; Diagnosis, Differential; Drug Eruptions; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Electroencephalography; Erythromycin; Female; Fever; Humans; Hydrocortisone; Infections; Kanamycin; Kidney Diseases; Male; Middle Aged; Penicillins; Pericarditis; Pertussis Vaccine; Pleural Diseases; Recurrence; Salicylates; Tetracycline; Tonsillectomy

Topics: Acute Kidney Injury; Anti-Bacterial Agents; Cephalosporins; Chloramphenicol; Drug Hypersensitivity; Erythromycin; Female; Fever; Gentamicins; Humans; Hyperkalemia; Lincomycin; Methenamine; Nalidixic Acid; Nitrofurantoin; Penicillins; Photosensitivity Disorders; Polymyxins; Pregnancy; Seizures; Spectinomycin; Sulfonamides; Tetracycline

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Female; Fever; Humans; Hysterectomy; Infection Control; Middle Aged; Postoperative Complications; Preoperative Care; Tetracycline

Topics: Acute Disease; Adult; Fever; Humans; Lung; Male; Mycoplasma Infections; Pain; Penicillin G; Pleural Effusion; Pleuropneumonia; Radiography; Tetracycline; Transients and Migrants

Topics: Acute Kidney Injury; Antibodies; Blood Sedimentation; Cerebrospinal Fluid Proteins; Conjunctivitis; Erythrocytes; Fever; Gastroenteritis; Humans; Leptospira; Leptospira interrogans; Leptospirosis; Leukocyte Count; Male; Meningitis; Military Medicine; Muscular Diseases; Serotyping; Tetracycline; United States; Vietnam

Topics: Acetaminophen; Animals; Aspirin; Cattle; Coxiella; Disease Reservoirs; Feces; Fever; Headache; Humans; Milk; Occupational Diseases; Placenta; Q Fever; Radiography, Thoracic; Sheep; Tetracycline; Urine; Zoonoses

Topics: Adolescent; Adult; Bites and Stings; Blood Cell Count; Blood Coagulation Tests; Child; Child, Preschool; Chloramphenicol; Complement Fixation Tests; Female; Fever; Headache; Humans; Leukocytosis; Male; Mental Disorders; Rocky Mountain Spotted Fever; Seasons; Serologic Tests; Skin Diseases; South Carolina; Tetracycline; Ticks

Topics: Fever; Humans; Malaria; Tetracycline; Time Factors

Topics: Acute Disease; Acute Kidney Injury; Adult; Chronic Disease; Creatinine; Diet Therapy; Dietary Proteins; Female; Fever; Gastrointestinal Hemorrhage; Humans; Kidney Failure, Chronic; Lupus Erythematosus, Systemic; Male; Middle Aged; Peritoneal Dialysis; Pneumonia; Prednisone; Tetracycline; Urea; Uremia

Topics: Adult; Blood; Culture Media; Doxycycline; Female; Fever; Gonorrhea; Humans; Neisseria gonorrhoeae; Penicillins; Sepsis; Skin Manifestations; Tetracycline; Uterus

Topics: Animals; Blood Vessels; Borrelia; Constriction; Dilatation; Endotoxins; Fever; Humans; Hydrocortisone; Injections, Intravenous; Leukocytes; Male; Pyrogens; Rabbits; Relapsing Fever; Tetracycline

Topics: Adolescent; Blood Transfusion; Cephaloridine; Disseminated Intravascular Coagulation; Female; Fever; Fibrinogen; Heparin; Humans; Infectious Mononucleosis; Pharyngitis; Tetracycline; Trephining; Vomiting

Topics: Adolescent; Adult; Animals; Animals, Domestic; Child; Chloramphenicol; Disease Outbreaks; Disease Reservoirs; Female; Fever; Humans; Infant; Insect Vectors; Male; New Mexico; Plague; Rodentia; Siphonaptera; Streptomycin; Tetracycline

Topics: Abortion, Septic; Adult; Aged; Anti-Inflammatory Agents; Balsams; Chymotrypsin; Female; Fever; Genital Diseases, Female; Humans; Middle Aged; Pregnancy; Puerperal Infection; Tetracycline; Trypsin

Topics: Adult; Diagnosis, Differential; Fever; Humans; Male; Penicillin G Procaine; Q Fever; Tetracycline; Virginia

Topics: Ampicillin; Fever; Humans; Male; Middle Aged; Rosacea; Tetracycline

Topics: Adult; Animals; Biopsy; Blood Sedimentation; Diagnosis, Differential; Female; Fever; Granuloma; Guinea Pigs; Hodgkin Disease; Humans; Leukocytosis; Lymphadenitis; Mycobacterium tuberculosis; Pelvis; Sarcoidosis; Tetracycline; Tuberculin Test; Tuberculosis, Lymph Node

Topics: Adolescent; Adult; Cervix Uteri; Epithelium; Female; Fever; Gonorrhea; Humans; Neisseria gonorrhoeae; Penicillins; Salpingitis; Tetracycline

Topics: Adult; Alkaline Phosphatase; Antibodies; Aspartate Aminotransferases; Cephalothin; Diagnosis, Differential; Fever; Hepatic Encephalopathy; Hepatitis A; Humans; Infectious Mononucleosis; Jaundice; Leukocyte Count; Liver Function Tests; Male; Prednisolone; Tetracycline

Topics: Anti-Bacterial Agents; Cyanosis; Drug Eruptions; Drug Hypersensitivity; Edema; Episiotomy; Erythromycin Ethylsuccinate; Female; Fever; Hearing Disorders; Humans; Hysterectomy; Neomycin; Nystatin; Penicillins; Postoperative Care; Pregnancy; Pregnancy, Ectopic; Streptomycin; Tetracycline

Topics: Adult; Aged; Ampicillin; Anti-Bacterial Agents; Chloramphenicol; Colistin; Cystoscopy; Fever; Humans; Infection Control; Kanamycin; Male; Methods; Middle Aged; Nalidixic Acid; Nitrofurantoin; Penicillin G; Penicillin Resistance; Postoperative Complications; Preoperative Care; Prostatectomy; Streptomycin; Sulfonamides; Tetracycline; Urinary Tract Infections; Urine

Topics: Adult; Aged; Anti-Inflammatory Agents; Female; Fever; Humans; Infections; Inflammation; Male; Middle Aged; Suppuration; Tetracycline

Topics: Adult; Agglutination Tests; Amino Acids; Fever; Humans; Male; Respiratory Tract Infections; Tetracycline; Tularemia

Topics: Enterobacter; Epididymitis; Escherichia coli Infections; Fever; Humans; Male; Postoperative Care; Prostatectomy; Proteus Infections; Sulfisoxazole; Tetracycline; Vas Deferens

Topics: Adult; Anesthesia, General; Arrhythmias, Cardiac; Body Temperature Regulation; Cortisone; Fever; Humans; Male; Mannitol; Positive-Pressure Respiration; Spasm; Succinylcholine; Tetracycline

Topics: Abortion, Induced; Abortion, Septic; Abortion, Spontaneous; Female; Fever; Humans; Pregnancy; Tetracycline

Topics: Anti-Bacterial Agents; Bronchitis; Child; England; Erythromycin; Fever; General Practice; Headache; Hemoptysis; Humans; Staphylococcal Infections; Sulfonamides; Tetracycline; Vomiting

Topics: Adolescent; Anti-Bacterial Agents; Bacteriological Techniques; Child; Chloramphenicol; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Erythromycin; Fever; Infant; Infant, Newborn; Leukocyte Count; Meningitis; Methicillin; Middle Aged; Mortality; Osteomyelitis; Penicillins; Sepsis; Staphylococcal Infections; Streptomycin; Tetracycline

Topics: Birds; Child; Chlamydia; Chlamydophila psittaci; Complement Fixation Tests; Epidemiology; Fever; Humans; Influenza, Human; Lymphogranuloma Venereum; Penicillins; Pneumonia; Psittacosis; Scotland; Sulfonamides; Tetracycline

Topics: Drug Hypersensitivity; Dyspnea; Eosinophilia; Fever; Humans; Lung Diseases; Nitrofurantoin; Pleural Effusion; Radiography, Thoracic; Tetracycline; Toxicology; Urinary Tract Infections

Topics: Anti-Bacterial Agents; Chlortetracycline; Diagnosis; Fever; Humans; Recurrence; Tetracycline; Trench Fever

Topics: Abortion, Criminal; Abortion, Septic; Anti-Bacterial Agents; Anuria; Biopsy; Criminals; Curettage; Diuresis; Eclampsia; Female; Fever; Hemoglobinuria; Hemolysis; Humans; Jaundice; Kidney Cortex Necrosis; Kidney Diseases; Nephritis; Nephritis, Interstitial; Penicillins; Pregnancy; Sepsis; Tetracycline

Topics: Animals; Anti-Bacterial Agents; Arthropod Vectors; Chlortetracycline; Clinical Laboratory Techniques; Fever; Germany; Germany, West; Humans; Phthiraptera; Protein Synthesis Inhibitors; Recurrence; Tetracycline; Trench Fever

Topics: Anti-Bacterial Agents; Fever; Hospitalization; Humans; Pneumonia; Protein Synthesis Inhibitors; Tetracycline

Topics: Anti-Bacterial Agents; Brucellosis; Fever; Protein Synthesis Inhibitors; Tetracycline