RESUMO
PURPOSE: Ceftriaxone, a potent parenteral third-generation semisynthetic cephalosporin is widely used for the treatment of a variety of bacterial infections in both children and adult. Review of recent data indicates that ceftriaxone treatment has been associated with the development of reversible biliary pseudolithiasis and that is thought by many to be a benign process. Despite, several reports describe patients with ceftriaxone pseudolithiasis who required cholecystectomy for presumed acute cholecystitis. In this study we evaluated the incidence, risk factors, and prognosis of gallbladder pseudolithiasis after ceftriaxone treatment. METHODS: Between march, 1997 and January, 1998, any child admitted to the Children's hospital of National University of Seoul and prescribed ceftriaxone for probable or definite bacterial infection were eligible for the study. 21 of them had ultrasound examination on the 2~12 days later after the start of ceftriaxone treatment, 8 of whom documented gallbladder precipitates or pseudolithiasis during treatment by serial abdominal ultrasound. Repeat abdominal ultrasound was performed 10~80 days later after the end of ceftriaxone treatment. The children with underlying liver disease or decreased renal function were excluded in this study. RESULTS: 1) 21 children had ultrasound examinations of gallbladder during ceftriaxone treatment and 8 (38%) of them acquired pseudolithiasis. 2) The patients who developed gallbladder pseudolithiasis were significantly older (6.3+/-2.9 yr. vs 2.2+/-3.1 yr.)(p<0.05), and older than 24 months were probably the significant risk associated with this phenomenon (p<0.05). However, no significant differences in sex, type of infection, fasting, and ceftriaxone treatment regimen (dose, duration of therapy). 3) The abnormality found on gallbladder ultrasonography was a strikingly hyperechogenic material with post-acoustic shadowing in 5 patients without post-acoustic shadowing in 3 patients 4) Follow up of gallbladder ultrasound was performed in 6 patients after cessation of ceftriaxone treatment. Sonographic abnormalities completely resolved within 14 days post cessation of therapy in 2 patients; 30 days, 1 patient; 80 days, 3 patients. CONCLUSIONS: We suggest that routine abdominal ultrasound should be considered in all children who received high dose ceftriaxone in more than 24 months of age and developed hepatobiliary symptoms during or just after ceftriaxone treatment.
Assuntos
Adulto , Criança , Humanos , Infecções Bacterianas , Ceftriaxona , Colecistectomia , Colecistite Aguda , Jejum , Seguimentos , Vesícula Biliar , Incidência , Hepatopatias , Prognóstico , Fatores de Risco , Seul , Técnica Histológica de Sombreamento , UltrassonografiaRESUMO
BACKGROUND: To assess the risk of hospital outbreak and to guide immunization policy, seroprevalences of antibody to measles, rubella, and varicella-zoster were determined in hospital personnel. METHODS: A cross-sectional study of 290 workers in Seoul National University Hospital was conducted in June 1995. IgG antibody status was determined with commercially available enzyme linked immunosorbent assay (Behring Enzygnost; IgG kit). RESULTS: Seropositive rates of measles, rubella and varicella-zoster were 95.6%, 87.9% and 96.2%, respectively. There was no statistical difference in seropositive rate according to historical information. CONCLUSION: These results suggest potential for hospital outbreak of measles or varicella-zoster, especially of rubella. Immunization policy will be needed in hospital personnel.
Assuntos
Humanos , Anticorpos , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Imunização , Imunoglobulina G , Sarampo , Recursos Humanos em Hospital , Prevalência , Rubéola (Sarampo Alemão) , Seul , Estudos SoroepidemiológicosRESUMO
No abstract available.
Assuntos
Criança , Humanos , Citomegalovirus , Imunofluorescência , PrevalênciaRESUMO
No abstract available.