In article <33924C1A.23FA at CASRDH.HEALTH.nt.gov.au>, Gary Lum <Gary.Lum at CASRDH.HEALTH.nt.gov.au> says:
>>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
Interesting discussion--- I'd appreciate it if you defined HUS: I don't
recognize the term. It sounds like you are talking about the negative
effects of LPS mediated through cytokines when cells break up and release
endotoxin---but I need some help understanding exactly what HUS is.
Thanks.
>>--
>********************************************************
>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
