ABSTRACT
Meningococcal disease is an illness caused by an organism called Neisseria meningitidis. The disease is highly contagious as it spreads through close contact. Immediate medical recognition of the disease is vital once it is suspected. Any person could be infected with meningococcal disease; however, certain groups are at practical risk. A healthy middle aged man presented with symptoms of fever, general fatigue, and widespread rash. The patient deteriorated rapidly and passed away. This case report is a typical presentation of meningococcal disease. The presentation could be vague and if not recognized early, might lead to rapid decline in health and eventual death
ABSTRACT
Background: Urinary tract infection [UTI] is one of the most frequent bacterial infections in the community; in the Kingdom of Bahrain, the currently recommended empirical antimicrobial regimen is based on international guidelines but not supported by local data
Objective: To evaluate the local antibiotics profile of most common urinary pathogens among patients visiting primary health centers
Design: A Retrospective Analytical Study
Setting: Primary Health Center, Salmaniya Medical Complex
Method: All outpatients seeking care in health centers for which the attending physician clinically suspected UTI and asked for the provision of urine culture from June 2016 to June 2017 were included. Mid-stream clean catch urine specimens were obtained from patients suspected clinically to be having UTI based on symptoms. Mid-stream urine specimens were plated on Cystine-Lactose-Electrolyte-Deficient [CLED] agar plate using calibrated loops for the quantitative method to provide isolated colonies for identification and susceptibility testing
Result: Total of 1,357 urine samples with significant bacterial growth were obtained; 1,230 [90.6%] were females and 943 [69.5%] were in the age group of 19-64 years. The four most common uropathogens that contributed to 90% of the cases were as follows: 829 [61.1%] Escherichia coli, 222 [16.4%] Klebsiella pneumonia, 123 [9.1%] Streptococcus agalactiae and 62 [4.6%] Enterococcus species. Eight hundred twenty-nine [61.1%] specimens were E. coli; 731 [53.9%] demonstrated low sensitivity levels to cephalothin, and 777 [57.3%] to cotrimoxazole, 887 [65.38%] moderate sensitivity to amoxicillin-clavulanate, and 1,035 [76.3%] to norfloxacin, but 1,284 [94.6%] retained very high sensitivity to nitrofurantoin
Conclusion: Based on this study, we recommend nitrofurantoin as the first choice of empiric antibiotics therapy for uncomplicated UTI in outpatient setting; despite the good sensitivity profile of fluoroquinolones, we recommend using it only as an alternative or second line. Other suggested therapy which might be proposed for use as possible alternative option is fosfomycin, but after confirming its local sensitivity profile
ABSTRACT
A case of severe thrombocytopenia with multiple bony lytic lesions is presented. Bone marrow examination revealed caseating granuloma suggestive of disseminated tuberculosis. There was no evidence of pulmonary involvement with tuberculosis and the patient didn 't have any other comorbid condition. The patient responded well to standard antituberculous treatment
ABSTRACT
Fifteen year old male presented with high grade intermittent fever and cervical lymphadenopathy. He had multiple enlarged bilateral cervical lymph nodes. The examination of other systems was normal. Work up for sepsis, malignancy and autoimmune disease were negative. Viral serology was negative. Histopathology of lymph node was consistent with kikuchi's disease