Showing papers by "Anne H. Rowley published in 1995"

Candidemia in a Pediatric Population

Abstract: Candidemia results in a mortality of > 50% among adults, but data on children with candidemia are limited. We reviewed 70 episodes of pediatric candidemia that occurred between January 1988 and October 1992. Of these episodes, 53% were caused by Candida albicans, 24% were caused by Candida parapsilosis, 16% were caused by Candida tropicalis, and 3% were caused by Candida krusei. Twenty-five percent of the patients were premature infants. Other underlying conditions included malignancy (15%); cardiac disease (14%); and short-gut syndrome (14%). A central venous catheter was in place during 61 (87%) of 70 episodes. Candiduria preceded candidemia in only 4 (8%) of 52 patients. The overall mortality rate was 19%; 36% of those with intravenous catheters that were not removed within 3 days died, whereas none of the patients from whom catheters were removed within 3 days died (P 2 months of age; 14 had candidemia for < or = 2 days; and 15 had an intravenous catheter removed within 2 days of the onset of candidemia. No patient stopped receiving amphotericin B because of side effects. The results of this study suggest the following: that mortality associated with candidemia is lower among children than among adults; that failure to remove the indwelling intravenous catheter usually results in a poor outcome; that candiduria rarely precedes candidemia in children; and that amphotericin B is well tolerated by children.

Lack of detection of enteroviral rna or bacterial dna in magnetic resonance imaging–directed muscle biopsies from twenty children with active untreated juvenile dermatomyositis

Abstract: Objective To investigate for the presence of increased titers of circulating antibody to putative infectious agents and for detectable viral RNA or bacterial DNA in children with active recent-onset juvenile der- matomyositis (DM) Methods Magnetic resonance imaging–directed muscle biopsies were performed in 20 children with active, untreated, recent-onset juvenile DM and in age-matched children with neurologic disease Sera were tested for complement-fixing antibody to Coxsack-ievirus B (CVB), influenza A and B, parainfluenza 1 and 3, Mycoplasma pneumoniae, mumps, respiratory syncytial virus, and Reovirus; and by immunofluorescence for IgG antibody to Toxoplasma gondii cytomegalovirus and IgM antibody to Epstein-Barr virus Muscle from juvenile DM patients and control children, CD-1 Swiss mice with and without CVB1 infection, and viral stock positive for CVB1–6 were tested using reverse-transcriptase polymerase chain reaction with 5 primer sets, 4 probes (1 Coxsackievirus, 3 Enterovirus), and universal primers for DNA Results No increased antibody, viral RNA, or bacterial DNA was present in the juvenile DM patients or the control children Conclusion Juvenile DM may be triggered by unidentified agent(s) in the genetically susceptible host