Bacteremia in an ambulatory setting. Improved outcome in children treated with antibiotics.
Am J Dis Child
; 144(11): 1195-9, 1990 Nov.
Article
em En
| MEDLINE
| ID: mdl-2239857
ABSTRACT
We undertook a study of 414 bacteremic patients (167 with Haemophilus influenzae and 247 with Streptococcus pneumoniae bacteremia) to evaluate their clinical presentation, laboratory and clinical results, and subsequent outcomes. Patients with H influenzae bacteremia were more likely to have soft-tissue foci, poorer clinical appearance at presentation, and be at higher risk for subsequent serious focal infections, persistent bacteremia, and subsequent hospital admissions than patients with S pneumoniae. Patients with H influenzae bacteremia had a 21.1-fold increase in risk of meningitis (95% confidence interval [CI] of 3.8 to 78.0) compared with those with S pneumoniae. The odds ratio for initial lumbar puncture was 5.25 (95% CI [1.1-23.6]). Ambulatory patients treated with antibiotics at presentation were less likely to develop new serious soft-tissue infections, persistent bacteremia, or to require subsequent hospital admissions than untreated patients. The effect of treatment was greater for patients with S pneumoniae than those with H influenzae. Careful follow-up and reevaluation of patients with presumptive bacteremia is essential because treated and untreated patients can still develop serious soft-tissue infections.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Pneumocócicas
/
Sepse
/
Serviço Hospitalar de Emergência
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Infecções por Haemophilus
/
Antibacterianos
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Adolescent
/
Child
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Child, preschool
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Female
/
Humans
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Infant
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Dis Child
Ano de publicação:
1990
Tipo de documento:
Article