6%) had been treated with antibiotics before tympanocentesis.
Eight patients (44.4%) had negative middle-ear fluid cultures.
Sixty
bacterial pathogens were isolated from the middle-ear fluid of 43 patients. Mixed infections were recorded in 14/52 patients (26.9%). Nine cultures were negative (17.3%), of which eight were from patients that had previously been treated with antibiotics. S. pneumoniae was isolated from middle-ear aspirates of 26/52 (50%) patients with acute suppurative otitis media. Twenty-two out of the 26 isolates were susceptible (84.7%) and four were intermediately susceptible to penicillin (15.3%). Streptococcus pyogenes was isolated in 3/52 (5.8%) and Haemophilus influenzae in 18/52 patients see more (34.6%). Five (27.8%) of these were beta-lactamase producers. Blood cultures, cerebrospinal fluid, and urine cultures were negative. Parenteral antimicrobial treatment was indicated in 29/52 (56%).
Conclusions: S. pneumoniae is the most frequent pathogen to cause AOM in this age group. Empirical treatment with amoxicillin or ceftriaxone should be considered depending on clinical suspicion of severe invasive infection. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“Background: The saline solution load test helps to determine if a wound extends into the knee joint. Little is known about the volume of injected intra-articular saline solution that is needed to effectively rule
in or rule out a traumatic arthrotomy of the knee. The Belnacasan mw purpose of the present study was to determine the appropriate volume and needle location for the diagnosis of a traumatic knee arthrotomy and to assess the effect of associated variables, including knee circumference, body mass index, and sex.
Methods: Fifty-six consecutive patients scheduled for knee arthroscopy were enrolled. A standard inferolateral arthroscopic portal was made with a single stab incision with use of a number-11 blade. Injection sites were randomized to either a superomedial or inferomedial location. Selleck GSK690693 The injection of normal saline solution at a rate of 5 mL/sec through an 18-gauge needle was continued while the knee was moved through a range of motion until fluid extravasated from the iatrogenic laceration. The volume
of injected fluid was recorded.
Results: The study group included thirty-one female patients and twenty-five male patients with a combined average age of fifty years and an average body mass index of 30.9. In order to effectively diagnose 50% of the arthrotomies, 75 mL of injected fluid was needed; the volumes that were needed in order to effectively diagnose 75%, 90%, 95%, and 99% of the arthrotomies were 110, 145, 155, and 175 mL, respectively. The mean volumes of injected fluid needed for a positive result at the inferomedial and superomedial needle locations were 64.0 and 95.2 mL, respectively; this difference was significant (p = 0.01). There was no correlation between necessary injection volume and sex, body mass index, or knee circumference.