Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Paratyphoid Fever ; complications ; diagnosis ; drug therapy

Antifungal Agents ; therapeutic use ; Fever ; Histiocytosis ; drug therapy ; etiology ; Humans ; Infant ; Lung Diseases, Fungal ; complications ; diagnosis ; drug therapy ; Male

Objective: To assess the efficacy and safety of polymyxin B in neutropenic patients with hematologic disorders who had refractory gram-negative bacterial bloodstream infection. Methods: From August 2021 to July 2022, we retrospectively analyzed neutropenic patients with refractory gram-negative bacterial bloodstream infection who were treated with polymyxin B in the Department of Hematology of the First Affiliated Hospital of the Soochow University between August 2021 to July 2022. The cumulative response rate was then computed. Results: The study included 27 neutropenic patients with refractory gram-negative bacterial bloodstream infections. Polymyxin B therapy was effective in 22 of 27 patients. The median time between the onset of fever and the delivery of polymyxin B was 3 days [interquartile range (IQR) : 2-5]. The median duration of polymyxin B treatment was 7 days (IQR: 5-11). Polymyxin B therapy had a median antipyretic time of 37 h (IQR: 32-70). The incidence of acute renal dysfunction was 14.8% (four out of 27 cases), all classified as "injury" according to RIFLE criteria. The incidence of hyperpigmentation was 59.3%. Conclusion: Polymyxin B is a viable treatment option for granulocytopenia patients with refractory gram-negative bacterial bloodstream infections.
Humans ; Polymyxin B/adverse effects* ; Retrospective Studies ; Gram-Negative Bacterial Infections/complications* ; Fever/drug therapy* ; Sepsis/drug therapy* ; Anti-Bacterial Agents/therapeutic use* ; Bacteremia/complications*

We describe a 51-yr-old man presenting with syncope due to torsade de pointes. The torsade de pointes was refractory to conventional medical therapy, including infusion of isoproterenol, MgSO4, potassium, lidocaine, and amiodarone. His past history, physical findings, and hormone study confirmed that QT prolongation was caused by anterior hypopituitarism that developed as a sequela of hemorrhagic fever with renal syndrome. The long QT interval with deep inverted T wave was completely normalized 4 weeks after starting steroid and thyroid hormone replacement. Hormonal disorders should be considered as a cause of torsade de pointes, because this life-threatening arrhythmia can be treated by replacing the missing hormone.
Hemorrhagic Fever with Renal Syndrome/*complications/physiopathology ; Hormone Replacement Therapy ; Human ; Hypopituitarism/drug therapy/*etiology/physiopathology ; Male ; Middle Age ; Tachycardia, Ventricular ; Torsades de Pointes/drug therapy/*etiology/physiopathology

The treatment of infectious complications in cancer patients has evolved as a consequence of the developments in the chemotherapy of cancer patients. In this prospective, randomized study, we compared imipenem-cilastatin and sulbactam-cefoperazone with amikacin in the empiric therapy of febrile neutropenic (< 1000/mm3) patients with liquids and solid tumours. Of 30 evaluable episodes, 15 were treated with imipenem-cilastatin and 15 were treated with sulbactam-cefoperazone plus amikacin. 73% of episodes were culture-positive: gram-positive pathogens accounted for 62% of the isolates. Bacteremia was the most frequent site of infection. The initial clinical response rate for both regimens was 60% (p > 0.05). No major adverse effects occurred. This study demonstrated that imipenem-cilastatin monotherapy and combination therapy of sulbactam-cefoperazone plus amikacin were equally effective empiric therapy for febrile granulocytopenic cancer patients.
Adolescence ; Adult ; Aged ; Aged, 80 and over ; Amikacin/therapeutic use ; Antibiotics, Combined/therapeutic use* ; Bacteremia/drug therapy ; Bacteremia/complications ; Cefoperazone/therapeutic use ; Cilastatin/therapeutic use ; Female ; Fever/drug therapy* ; Fever/complications ; Human ; Imipenem/therapeutic use ; Male ; Middle Age ; Neoplasms/drug therapy* ; Neoplasms/complications ; Neutropenia/drug therapy* ; Neutropenia/complications ; Prospective Studies ; Sulbactam/therapeutic use

OBJECTIVETo observe the therapeutic effect of rhubarb and Sanchi Powder (RSP) in treating patients with hemorrhagic fever in nephrotic syndrome (NS) complicated with digestive tract bleeding.

METHODSSixty patients clinically diagnosed as hemorrhagic fever in NS complicated with digestive tract bleeding were randomized into 2 groups. Fine ground rhubarb (3g) and SP (2g) were given orally to the patients in the treated group 3 - 4 times daily. Dicynonum (2g) was given by intravenously dripping to the patients in the control group.

RESULTSIn the treated group, 17 patients were cured, 5 markedly effective and 6 effective, with the markedly effective rate of 70.97% and the total effective rate of 90.32%. The corresponding number in the control group was 10, 3, 6, 44.83% and 65.52%, respectively, significant difference was shown in comparison between the two groups (P < 0.05 or P < 0.01). The average hemostatic time was (2.32 +/- 0.82) h, the platelet count was (8.84 +/- 1.13) x 10(9) /L, and the platelet aggregation rate was obviously improved in the treated group, which were significantly different to those in the control group [(4.15 +/- 0.69) h, (6.22 +/- 0.89) x 10(9)/L, respectively, P<0.01).

CONCLUSIONRSP has the action of promoting vasoconstriction, shortening the bleeding time and blood arresting, it can increase the platelet count and improve the platelet aggregation.

Adult ; Aged ; Araliaceae ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Hemorrhage ; drug therapy ; etiology ; Hemorrhagic Fever with Renal Syndrome ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Rheum

Cancerous fever is one of the common symptoms of advanced malignant tumors,which seriously affects the quality of life and survival of patients. At present,the clinical research on the treatment of cancerous fever by traditional Chinese medicine is limited,and there is a lack of research on the medication rules from multiple dimensions of disease-symptom-syndrome. The treatment of cancerous fever has not made substantial progress. In this study,we collected the literature on treatment of cancerous fever in Chinese medicine,and concluded that common syndrome types include Yin deficiency type,Qi deficiency type,Yang deficiency type,blood stasis type,damp-heat accumulation type,toxic heat flourishing type and liver meridian stagnated heat type. Two hundreds and fifty-seven prescriptions for Chinese medicine and 249 flavors for single medicine were extracted. The analysis of the drug composition of the drug found that the cancerous fever treatment was mainly based on heat-clearing drugs and deficiency-nourishing drugs. Apriori association analysis of the drug found that the second and third related drugs were mainly Rehmanniae Radix,Moutan Cortex,Artemisiae Annuae Herba,Trionycis Carapax and Anemarrhenae Rhizoma. The top five gray correlation degrees were Psoraleae Fructus,Bupleuri Radix,Hordei Fructus Germinatus,Scutellariae Radix and Massa Medicata Fermentata. And seven new prescriptions were evolved. The results showed that the treatment of cancerous fever can be started from the disease-symptom-syndrome,nourishing Yin and clearing heat is an important method for " disease differentiation and treatment". The combination of Bupleuri Radix and Scutellariae Radix is the embodiment of " symptom differentiation and treatment". The new prescriptions conform to the idea of " syndrome differentiation and treatment" of traditional Chinese medicine can provide reference for clinical medication. The grey screening method combined with multivariate analysis method was used to analyze the prescription rules of Chinese medicine in the treatment of cancer fever,which followed the black box structure of traditional Chinese medicine,made the potential rule of prescriptions explicit,broadened its thinking of Chinese medicine treatment,and made up for the deficiency of traditional analysis methods.
Drugs, Chinese Herbal ; therapeutic use ; Fever ; drug therapy ; etiology ; Humans ; Medicine, Chinese Traditional ; Meridians ; Multivariate Analysis ; Neoplasms ; complications ; drug therapy ; Quality of Life

Aspirin ; administration & dosage ; therapeutic use ; Female ; Fever ; drug therapy ; Humans ; Infant ; Mannitol ; administration & dosage ; therapeutic use ; Meningitis, Aseptic ; complications ; drug therapy ; pathology ; Mucocutaneous Lymph Node Syndrome ; complications ; drug therapy ; pathology

Mahuang Fuzi Xixin Decoction recorded in Treatise on Febrile Diseases by Zhang Zhongjing in the Han Dynasty have been widely used in treating Yang deficiency and exogenous wind-cold syndrome by traditional Chinese medicine physicians for thousands of years. The indications of Mahuang Fuzi Xixin Decoction include bradyarrhythmia,sinus bradycardia,sick sinus node syndrome,senile exogenous,asthmatic cold,rhinitis,bronchial asthma,optic neuritis,optic atrophy,sudden blindness,sudden onset of cough,laryngeal obstruction,migraine,joint pain,low back pain,insomnia,shock,heart failure,renal failure,accompanied by fever or nosocomial infection,and hyperpyrexia after tracheotomy; dark complexion,chills,cold limbs,listlessness,fatigue,insomnia,lack of thirst,liking hot drinks,slightly swollen limbs or whole body,pale fat tongue,greasy fur,and deep pulse. Mahuang Fuzi Xixin Decoction is a potential drug for Shaoyin disease complicated with fever and pain. Tracheal intubation is an artificial ephedrine syndrome. It is necessary to distinguish Yin and Yang syndrome in treating hyperpyrexia after tracheotomy. However,it belongs to Yin syndrome,which could be treated by Mahuang Fuzi Xixin Decoction. Mahuang Fuzi Xixin Decoction is effective in the treatment of sick sinus syndrome,second degree atrioventricular block and third degree atrioventricular block. It can significantly alleviate symptoms,improve heart rate,and heart rhythm in a short period of time. However,after one year of drug withdrawal,the diseases may recur,indicating that Mahuang Fuzi Xixin Decoction may not improve the long-term prognosis of slow arrhythmia. Mahuang Fuzi Xixin Decoction is often used for fever or nosocomial infection in critical care medicine. In the treatment of critical care medicine complicated with high fever,Mahuang Fuzi Xixin Decoction is often taken continuously by stomach tube.
Critical Care ; Cross Infection/drug therapy* ; Diabetes Mellitus ; Diabetic Neuropathies/complications* ; Drugs, Chinese Herbal/pharmacology* ; Fever/drug therapy* ; Humans ; Medicine, Chinese Traditional ; Myocardial Infarction/complications* ; Pain, Postoperative/drug therapy* ; Phytotherapy ; Syndrome ; Tracheotomy/adverse effects*

OBJECTIVE: To explore the feasibility of surgical treatment for cancer patients complicated with corona virus disease 2019 (COVID-19). METHODS: The management and clinical outcome of a sigmoid cancer patient with COVID-19 were analyzed. RESULTS: The inflammation indicators and fever of this patient were effectively controlled and the lung lesions remained stable after active anti-viral treatment, then the radical colorectomy was performed after the viral negative conversion for twice. CONCLUSIONS The case indicates that it may feasible to undergo radical tumor surgery for cancer patients with COVID-19 after the virus nucleic acid testing turns negative and more studies are needed to confirm this conclusion.
Antiviral Agents ; therapeutic use ; Betacoronavirus ; Clinical Laboratory Techniques ; Colonic Neoplasms ; complications ; surgery ; virology ; Coronavirus Infections ; complications ; diagnosis ; drug therapy ; Fever ; Humans ; Nucleic Acid Amplification Techniques ; Pandemics ; Pneumonia, Viral ; complications ; diagnosis ; drug therapy