Epidemiological and clinical features of salmonella typhi infection among adult patients in qatar: a hospital-based study

Objectives: We sought to describe the epidemiological and clinical features of typhoid fever in Qatar

Methods: We conducted a retrospective study of adult patients treated for typhoid fever at Hamad General Hospital and Alkhor Hospital between 2005 and 2012

Results: The mean age of the 354 patients enrolled in the study was 28.4+/-9.3 years; 296 [83.6%] were males. There were 42, 48, 39, 44, 46, 47, 52, and 36 cases of adults with typhoid fever in 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012, respectively. Overall, 343 [96.9%] patients had a history of travel to endemic areas. Among them, 93.0% acquired typhoid fever in the Indian subcontinent. Fever was observed in all cases, and the other predominant symptoms were abdominal pain [38.1%], diarrhea [35.6%], and headache [33.1%]. Salmonella typhi, showed high resistance to ciprofloxacin [n = 163; 46.0%], and low resistance to ceftriaxone [n = 2; 0.6%]. Four patients developed intestinal perforation, which was surgically repaired in two cases. Two patients [0.6%] died

Conclusions: Typhoid fever was frequent among immigrants to endemic areas. Travelers returning from endemic areas with suspected typhoid fever should be treated empirically with third-generation cephalosporin after obtaining appropriate cultures. Moreover, preventive measurements such as education on food and water hygiene, and effective vaccination of travelers should be practiced widely among travelers to endemic areas to reduce morbidity and mortality

Improving influenza vaccination rates of healthcare workers: a multipronged approach in Qatar

We assessed whether an influenza vaccination [IV] campaign was effective at increasing vaccination rate in healthcare workers [HCWs] in 2 hospitals in Doha, Qatar that had no mandatory IV policy. The campaign comprised promotional, educational and vaccine delivery interventions; a dedicated IV team; telephone hotline; free IV with improved access, leadership involvement; incentives; group educational sessions; and reporting/tracking activities. During the 2014/15 influenza season, IV rates according to hospital and HCW category were calculated and compared with the 2 seasons before the intervention. The combined mean rate for IV for both hospitals increased for 2014/15 [64.3%] compared with 2013/14 [37.2%] and 2012/13 [28.4%]. There was increased IV uptake among doctors and nurses at each hospital, and the IV rate for the 2 hospitals [59.1 and 69.5%] were higher than in 2013/14 [21.1% and 53.2%] and 2012/13 [17.2% and 39.6%]. The findings highlight the importance of improving IV rates among HCWs in hospitals with no mandatory vaccination policies through multicomponent interventions

Gemella morbillorum endocarditis

A case of Gemella morbillorum [G.morbillorum] endocarditis of the mitral valve in a patient with previously normal heart valves is reported. The presentation was subacute, and the infection was complicated by perforation of the posterior mitral leaflet that necessitated valve repair. Gemella morbillorum infections are uncommon, and endocarditis is the most common presentation. G.morbillorum endocarditis is probably under recognized, and has not been reported from our region. The case is described, and problems in the identification of the organism are discussed

Miliary tuberculosis in Qatar: a review of 32 adult cases

This study was conducted to define the demographic, clinical and laboratory features, methods of diagnosis and outcome, in patients with miliary tuberculosis [TB] in Qatar, and compare the findings with other reported studies. Patients and A retrospective review of 32 cases of miliary TB treated at the Hamad Medical Corporation during a seven-year period [1992 to 1998] was undertaken. The 32 patients comprised 24 males and 8 females, and their mean age was 33.3 years. The majority [90%] were expatriates. The clinical features of the patients were similar to those of previously reported series. The most common presenting symptoms were fever, cough, night sweats, weight loss and sputum production. Fever, rales, lymphadenopathy, altered mental status and hepatomegaly were the most common signs. Chest radiograph was abnormal in 94% of patients, and showed a miliary pattern in 69%. Sputum, cerebrospinal fluid, bronchial washings, and urine smears for acidfast bacilli were rarely positive, however, cultures for Mycobacterium tuberculosis were positive in 54.8%, 37.5%, 33%, and 25%, respectively. The diagnoses in the majority of patients were made on the basis of the clinical presentation and supported by a miliary pattern on chest radiograph. In those whom chest radiograph did not show the classic miliary pattern, transbronchial biopsy was diagnostic in 1 of 2 patients [50%], bone marrow biopsy in 5 of 11 [45%], liver biopsy in 1 of 2 [50%], and lymph node biopsy in all 7 patients [100%]. Thirty patients were treated with a four-drug regimen consisting of isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol. Mortality due to miliary TB was 3%. Miliary TB is common in Qatar, especially among expatriates. Because the clinical features of the disease are nonspecific, a high index of suspicion is essential for early diagnosis in order avoid delays in therapy and poor outcome

cryptococcal meningitis: a report of three cases

Three cases of cryptococcal meningitis are described. Two patients were infected with the human immunodeficiency virus, whereas the other was immune competent. The disease was fatal in the first patient and complicated by severe visual loss in the third. Cryptococcal meningitis has been rarely reported from our region, but the incidence may be increasing