Group B Streptococcus Meningitis Following Elective Termination of Pregnancy: Two Case Reports

Background: Although maternal group B streptococcus (GBS) infections are common, serious infections are rare with prompt diagnosis and treatment. We present 2 cases of GBS meningitis occurring 3 and 10 days after elective abortion. In the first patient, GBS meningitis was definitely related to the elective termination. In the second patient, however, no evidence for a causal relationship could be established and can only be presumed

Infection on a gynecologic oncology service

Little information is available pertaining to infectious morbidity in women with genital malignancy. To define the magnitude of this problem, all patients admitted to the gynecologic oncology services at the University of Michigan Medical Center between January 1, 1986, and December 31, 1986, were followed prospectively for the development of infectious morbidity. One hundred nine bacteriologically confirmed infections occurred in 297 patients during 510 admissions. An additional 31 postoperative patients received empiric therapy for presumed infection. Urinary tract (54) and wound (22) infections were the most commonly confirmed infections. The pathogens isolated from oncology patients were significantly different in frequency of isolation and antibiotic sensitivity when compared with pathogens isolated from women developing infections on the benign gynecology service. Women with genital malignancies are at high risk for the development of a variety of infections by resistant pathogens, emphasizing the importance of obtaining cultures prior to initiation of therapy and carefully selecting the antibiotics to be prescribed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28592/1/0000400.pd

Postoperative Adverse Outcomes in Intellectually Disabled Surgical Patients: A Nationwide Population-Based Study

Intellectually disabled patients have various comorbidities, but their risks of adverse surgical outcomes have not been examined. This study assesses pre-existing comorbidities, adjusted risks of postoperative major morbidities and mortality in intellectually disabled surgical patients.A nationwide population-based study was conducted in patients who underwent inpatient major surgery in Taiwan between 2004 and 2007. Four controls for each patient were randomly selected from the National Health Insurance Research Database. Preoperative major comorbidities, postoperative major complications and 30-day in-hospital mortality were compared between patients with and without intellectual disability. Use of medical services also was analyzed. Adjusted odds ratios using multivariate logistic regression analyses with 95% confidence intervals were applied to verify intellectual disability's impact.Controls were compared with 3983 surgical patients with intellectual disability. Risks for postoperative major complications were increased in patients with intellectual disability, including acute renal failure (odds ratio 3.81, 95% confidence interval 2.28 to 6.37), pneumonia (odds ratio 2.01, 1.61 to 2.49), postoperative bleeding (odds ratio 1.35, 1.09 to 1.68) and septicemia (odds ratio 2.43, 1.85 to 3.21) without significant differences in overall mortality. Disability severity was positively correlated with postoperative septicemia risk. Medical service use was also significantly higher in surgical patients with intellectual disability.Intellectual disability significantly increases the risk of overall major complications after major surgery. Our findings show a need for integrated and revised protocols for postoperative management to improve care for intellectually disabled surgical patients