Tim Williams wrote:
> In article <338D2C54.64DF at CASRDH.HEALTH.nt.gov.au>, Gary Lum <Gary.Lum at C> ASRDH.HEALTH.nt.gov.au> writes
> >In Darwin we tend to treat alot of our _Shigella_ cases because many are
> >also malnourished at the same time.
> > I report ampicillin (remember amp is better than amox in
> >_Shigella_), co-trimoxazole and if systemic infection a third generation
> >cephalosporin.
> I have read a paper linking use of beta lactams in cases of _Shigella
> dysenteriae_ and EHEC to increased incidence of HUS (Mechanism appears
> to be increased inflammatory reaction following breakup of bacteria and
> exposure to more LPS. Increased cytokine then causes up regulation of
> receptors to shiga toxin). Anybody want to comment on this? - do the
> benefits of e.g amp outweigh possible risks of HUS ?
Yeah Tim, I've read that before and thought "Damned cytokines...their
everywhere". But seriously, we get a crook child, we prefer to treat
considering the other co-morbidities we see here.
Regards
Gary
--
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Dr Gary Lum
Director of Microbiology
Royal Darwin Hospital
Microbiologists do it with culture and sensitivity
Meet me at http://www.ozemail.com.au/~glum/index.html
E-mail me at mailto:glum at ozemail.com.au,gary.lum at nt.gov.au
