Browsing by Author "Burger, P. J."

Now showing 1 - 9 of 9
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    Bacteraemia in children in the south-western Cape. A hospital-based survey
    (Health & Medical Publishing Group, 1992-01) Cotton, M. F.; Burger, P. J.; Bodenstein, W. J. M.
    ENGLISH ABSTRACT: During 1989, of the 8524 children admitted to the paediatric wards of Tygerberg Hospital, 165 (1,96%) had bacteraemia. The incidence of community-acquired bacteraemias was 1,6% and that of nosocomial bacteraemias 0,5%. The most important community-acquired isolates were Streptococcus pneumoniae, Staphylococcus aureus and Neisseria meningitidis. The most important nosocomial isolates were Klebsiella and Salmonella spp. Both bacteraemia (relative risk (RR) = 2,08) and severe malnutrition (RR = 3,01) were more common in black patients. Overall, severe malnutrition was more common than mild malnutrition or a normal nutritional status in bacteraemic patients (odds radio (OR) = 3,17). Nineteen patients with bacteraemia died, there was a significantly higher case-fatality rate in patients with extreme malnutrition (P = 0,03; OR = 3,7). Gram-negative bacilli were found more commonly in patients with extreme malnutrition (OR = 5,4) and patients with nosocomial bacteraemia (OR = 4,6). Three of 39 patients (7,6%) with nosocomial bacteraemia had suppurative thrombophlebitis.
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    Bacteriologically confirmed pulmonary tuberculosis in childhood : clinical and radiological features
    (Health & Medical Publishing Group, 1985) Donald, P. R.; Ball, J. B.; Burger, P. J.
    Over a 4-year period 185 cases of pulmonary tuberculosis in children were confirmed by culture of Mycobacterium tuberculosis, usually from gastric aspirate. The majority of cases occurred in boys (62%) and the younger age groups were more commonly affected - 26% of patients were less than 1 year old and 65% less than 3 years of age. At the time of presentation 40% of the 151 children tested had a negative tuberculin test. A chest radiograph was available in 136 cases. The commonest changes seen were lymphadenopathy (63%) and segmental lesions (56%). The latter affected mainly the right lung and in particular the right middle lobe. Cavitating tuberculous disease was present in 19 children, including 5 aged less than 1 year.
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    Brucellosis in childhood in the Western Cape
    (Health & Medical Publishing Group, 1993) Hendricks, M. K.; Perez, E. M.; Burger, P. J.; Mouton, P. A.
    Human brucellosis, a multisystem disease which may mimic other conditions, has a low incidence in childhood and the diagnosis may easily be missed. Over a 7-month period 9 children with brucellosis presented to the Department of Paediatrics and Child Health, Tygerberg Hospital. Six of the children had consumed unpasteurised milk. The main presenting symptoms were fever, fatigue, headache, myalgia and haematuria. Clinical signs included lymphadenopathy (3), nasopharyngitis (2), features of lower respiratory tract infection (2), splenomegaly (2) and pyrexia (1). The diagnosis was made on the basis of a positive serological titre (> 1:160) for Brucella abortus. The prozone phenomenon was encountered in 6 cases; however, the Coombs test confirmed the diagnosis in these cases. Children under 7 years were treated with co-trimoxazole and rifampicin and those over 7 years with tetracycline and rifampicin, for at least 6 weeks. No relapses were detected on follow-up.
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    Detection of bacterial antigens in cerebrospinal fluid by a latex agglutination test in 'septic unknown' meningitis and serogroup B meningococcal meningitis
    (Health & Medical Publishing Group, 1989) Muller, P. D.; Donald, P. R.; Burger, P. J.; Van der Horst, W.
    The latex agglutination test (Wellcogen) was evaluated specifically in cases of 'septic unknown' meningitis, with CSF findings characteristic of bacterial meningitis but with no bacterial organisms grown on CSF culture or seen on microscopy after Gram staining. In only 4 (12%) of 33 cases of 'septic unknown' meningitis were antigens identified in the CSF. This kit contains for the first time reagents for the detection of serogroup B Neisseria meningitides antigens and was also evaluated for this bacteria. Only 6 (27%) of 22 serogroup B N. meningitides cases were identified.
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    Methicillin-resistant Staphylococcus aureus at Tygerberg Hospital
    (Health & Medical Publishing Group, 1988) Peddie, E. F.; Donald, P. R.; Burger, P. J.; Sadler, C. A.
    During 1985 Staphylococcus aureus was isolated from blood culture of 74 patients at Tygerberg Hospital who were suffering from serious illness compatible with systemic spread of the organism. Twenty-six isolates (35%) were community-acquired and none were methicillin-resistant, while 48 were hospital-acquired of which 23 (48%) were methicillin-resistant. Methicillin resistance appears to be a problem confined to hospital isolates of S. aureus.
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    Mumps meningo-encephalitis
    (Health & Medical Publishing Group, 1987-3) Donald, P. R.; Burger, P. J.; Becker, W. B.
    Between July 1981 and June 1985, 49 cases (36 boys (73%) and 13 girls (27%)) of mumps meningoencephalitis confirmed by culture of the virus from the cerebrospinal fluid (CSF) were seen. Patients presented particularly in the late spring and early summer. A CSF cell count > 500 x 106/l was obtained in 14 cases (28%), a total CSF protein > 0,8 g/l in 6 cases (12%) and a CSF glucose of < 2,2 mmol/l in 2 cases (4%). Two cases are reported to illustrate the diagnostic problems which the infection may cause, particularly when the CSF changes resemble those of tuberculous meningitis. In 1 case neurogenic pulmonary oedema developed after a convulsion; this caused further diagnostic uncertainty.
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    Paediatric meningitis in the western Cape : a 3-year hospital-based prospective survey
    (Health & Medical Publishing Group, 1986) Donald, P. R.; Burger, P. J.; Becker, W. B.
    Between July 1981 and June 1984 1223 cases of meningitis were seen in the Department of Paediatrics, Tygerberg Hospital. The commonest form in each population group was aseptic meningitis. Positive viral cultures were obtained from the CSF in 108 cases. The median age of white children with aseptic meningitis, 64 months, was significantly greater than that of coloured children, 45 months (P > 0,0001), and black children, 26 months (P > 0,014). The commonest cause of confirmed bacterial meningitis was Neisseria meningitidis (140 cases; 11,5%), which continues to affect mainly young coloured children (median age 16,9 months). Resistance to sulphonamides was found among 21% of 114 N. meningitidis isolates. Among white children Haemophilus influenzae was responsible for 9 of the 18 cases of confirmed bacterial meningitis. Tuberculosis was responsible for 62 cases of meningitis (5%) and was a commoner cause of meningitis than either H. influenzae (47 cases) or Streptococcus pneumoniae (34 cases). Thirty-four confirmed cases of bacterial meningitis were seen in children less than 1 month old. Klebsiella species were responsible for 8 cases (24%), Escherichia coli for 6 cases (12%), group B β-haemolytic Streptococcus for 5 cases (15%) while 4 cases each were due to N. meningitidis and S. pneumoniae.
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    Serogrouping and sulphonamide sensitivity of Neisseria meningitidis isolates from the south-western Cape
    (Health & Medical Publishing Group, 1989-10) Donald, P. R.; Quan, E.; Burger, P. J.; Coetzee, G. J.; Cameron, N.
    Neisseria meningitidis infections were first reported from the south-western Cape Province in 1883. Since then, against a backdrop of a relatively low incidence with winter exacerbation, epidemic periods have occurred at 10 - IS-year intervals. During the 1978 - 1979 epidemic more than 95% of isolates at Tygerberg Hospital were of serogroup B and only 5% were resistant to sulphonamides. Seventy-seven per cent of patients notified as suffering from meningococcal infections were under 4 years of age.3 In this report we briefly describe the pattern of serogrouping and sulphonamide resistance of N. meningitidis for the period 1980 - 1987.
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    Ventriculoperitoneal shunt infections in children : a 6-year study
    (Health & Medical Publishing Group, 1991) Cotton, M. F.; Hartzenberg, B.; Donald, P. R.; Burger, P. J.
    In a study of ventriculoperitoneal shunt infections conducted retrospectively between 1983 and 1987 and prospectively in 1988 39 infections from 372 shunt procedures (incidence 10,5%) were identified. The most common organism isolated was Staphylococcus aureus (18; 47%) followed by S. epidermidis (10; 26%). Forty-two per cent of staphylococci were methicillin-resistant. Gram-negative infections were associated with myelomeningoceles and Gram-positive infections with other forms of hydrocephalus (P = 0,048). Lymphocyte predominance was found more frequently than polymorphonuclear predominance in cerebrospinal fluid.