Diagnosis early-onset conditions

Fig. 19.2. Clinical approach to the diagnosis of oligosaccharidoses and related lysosomal disorders with early (infantile) onset. Associated with CNS involvement of various types. Facial dysmorphism and/or skeletal (vertebral) involvement suggestive of dysostosis multiplex. Bold conditions associated with abnormal oligosacchariduria italics conditions associated with abnormal mucopolysacchariduria. The percentage of patients showing macular cherry-red spot (when present) is indicated in parentheses. Absence of visceromegaly...

Once the diagnosis of nosocomial pneumonia has been established, several important factors must be considered before a rational empirical antimicrobial regimen can be chosen. These include severity of illness and comorbid conditions of the patient, prior antibiotic use, early versus late onset of infection, results of the sputum Gram s stain, and the resident flora profile of the institution, particularly in the intensive care unit (Table 1). Empirical antimicrobial therapy for nosocomial pneumonia in a ventilated patient with renal failure in whom multiple intra-abdominal abscesses develop following colon resection is very different from the patient who aspirates following an otherwise uncomplicated cholecystectomy. 

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