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- Svanborg, Catharina, et al.
(author)
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Bacterial virulence in urinary tract infection
- 1997
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In: Infectious Disease Clinics of North America. - 0891-5520. ; 11:3, s. 513-529
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Journal article (peer-reviewed)abstract
- Bacteriuria is associated with acute disease conditions of varying severity.48 and 62 Consequently, the definition of bacterial virulence for the urinary tract depends on the end-point chosen. Acute pyelonephritis is characterized by fever, flank pain, and general malaise. Laboratory findings include pyuria (leukocytes in the urine), elevated acute phase reactants in serum (C reactive protein [CRP], erythrocyte sedimentation rate [ESR]), elevated levels of cytokines in serum and urine, and later increased levels of antibacterial IgA antibodies in urine and serum. Cystitis is characterized by dysuria, urgency, frequency of urination, and sometimes suprapubic pain. Acute cystitis should not be accompanied by acute phase reactants or cytokines in the serum, however, there is pyuria, and IL-6 and IL-8 levels in urine may be elevated. Asymptomatic bacteriuria (ABU) is commonly detected at screening because it is not accompanied by any of the symptoms seen for acute pyelonephritis and acute cystitis. The laboratory findings vary. The patients may have low level cytokine responses and leukocytes in urine, or they may have no host response to infection.
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| 6. |
- Olaison, Lars, 1949, et al.
(author)
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Current best practices and guidelines indications for surgical intervention in infective endocarditis.
- 2002
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In: Infectious disease clinics of North America. - 0891-5520. ; 16:2
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Journal article (peer-reviewed)abstract
- Optimal diagnosis and management of patients with infective endocarditis requires sound clinical judgment based on extensive experience. This is especially important in regard to the indications and timing for surgery. To achieve the best possible outcomes, surgical intervention during treatment is required in 25% to 30% of patients with infective endocarditis. Heart failure and progressive left-sided valvular dysfunction are the most common indications for operation. Valve repair should be considered as an alternative to valve replacement whenever feasible, especially in younger patients. Successful management of perivalvular abscesses and prosthetic valve infections requires radical removal of infected tissue followed by reconstructive procedures performed by experienced surgeons. Emergency or urgent surgery should seldom be delayed.
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