Brucellosis with spondylitis

We are reporting what we think is probably the first case of brucellosis in a Bahraini patient. Our patient was a 54 year old Bahraini who presented with a history of fever of three weeks and back pain. He has elevated liver enzymes, highly positive brucella serology and his spinal MRI revealed multilevel spondylitis. He was diagnosed as having Brucellar spondylitis and was treated with two courses of antibiotics over a period of 8 months. He improved dramatically and was discharged from the hospital in March 2007 and since then he had no recurrence

Microbiological infections in HIV positive Bahraini patients with low CD4+ T-lymphocyte count.

The correlation of CD4+ T-lymphocyte count and the distribution of pathogenic or opportunistic microbial infection most commonly found in HIV positive individuals differ from one area to the other. The present study reports such findings in 67 HIV positive Bahraini patients in the period May 1997 to Nov. 1998. CD4+ T-lymphocyte count was measured using flow cytometry. Bacterial and fungal cultures were performed. Serological diagnosis was performed when indicated. Viral study was done serologically. The distribution of CD4+ T-lymphocyte count in the studied group was: 21 patients (31.3%) less than 100 cells/microl, 5 patients (7.5%) 100-200 cells/microl, 25 patients (37.3%) 201-500 cells/microl and 16 patients (23.9%) with count more than 500 cells/microl. Among patients with low CD4 count (less than 100 cells/microl) (n=21), microbial infections varied from fungal infections 66%, bacterial infections 57% and viral infections 4.8%. Bacterial infections included Salmonellosis (14.3%), Staphylococcus epidermidis (14.3%), Pseudomonas aeruginosa (9.5%), H. influenzae (9.5%), Legionellosis (4.8%) and E. coli (4.8%). Fungal infection included Candida albicans (52.4%), Pneumocystis carinii (9.5%), Cryptococcus neoformans (4.8%). Viral infection included H. simplex to (4.8%). Fungal infections were the highest common infection in thus study. The most common microbial infection was Candida albicans. P. carinii and Cryptococcus neoformans were less common than found in other studies world wide.

Anatomy of the facial nerve [F N] within the parotid gland

Facial nerve [FN] paralysis is the most serious and frequently encountered complication of parotid surgery. Review of literature revealed that preoperative and intraoperative FN identification by radiological methods, FN monitoring and FN stimulating test failed in completely solving this problem. The present study aimed to detail the intraparotid anatomy of FN 25 cadaveric head sides with intact skin were dissected to identify the parotid gland and its surrounding structures. Then the parotid tissue superficial to FN and its branches was removed. The FN bifurcated 2.1-5 mm behind the retromandibular vein [RMV] into upper and lower divisions. Both divisions passed superficial to RMV in 22 cases, the upper division passed deep in 2 cases and the lower division passed deep in one case. The FN divisions or their branches were in close contact with RMV except in one case where the upper division was separated from the vein by a small amount of parotid tissue. The site of branching of the upper and lower divisions was variable and occurred either behind RMV, at the point of crossing of the vein or infront of it. The mean lengths of FN trunk, upper division and lower division were 17.6, 5.4 and 8.9 mm respectively. Communications between FN branches were observed both within and outside the gland. These results may be helpful for radiologists and surgeons dealing with the parotid region

Behcet's disease in Bahrain, clinical and HLA findings

To study the clinical features and the HLA findings of Behcet's disease in Bahrain. Method: A retrospective study of nine patients with Behcet's disease from the Salmaniya Medical Complex who were treated over a 15-year period are analysed. The male to female ratio was 3.5:1. Oral ulcers were present in all patients, genital ulcers in 88.9%, skin lesions in 66.7%, ocular involvement in 44.4%, arthritis in 44.4%, epididymitis in 57% of the males, and DVT in 22.2%. HLA B5 was positive in 66.7% of the patients. 66.7% of the cases had the HLA B5 allele. Their clinical manifestations are similar to those reported in the other Gulf countries

Pulmonary hypertension in SLE - a case report

Pulmonary Hypertension has been diagnosed in a young lady with Systemic Lupus Erythromatosus [SLE] using Doppler Echocardiography study. Despite the absence of active clinical and laboratory lupus signs, the course of her pulmonary Hypertension was rapidly fatal with no response to vasodilator therapy. This is the first reported case in Bahrain as shown by reviewing Salmaniya Medical Complex records of the all one hundred and ten SLE patients until the 31st of April 1998. The case history, the incidence, pathogenesis, treatment modalities and the prognosis of that SLE complication are discussed