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Background: Catheter-related bloodstream infection (CRBSI) is frequent causes of mortality and morbidity in dialysis patients, and the sensitivity pattern of antimicrobials varies across different dialysis centers. Objectives: The present study aimed to investigate the pattern of microbes grown from catheter sites, blood and the sensitivity pattern. The data could help in initiating an empiric antimicrobial therapy. Materials and Methods: This was an observational retrospective study at Regional Kidney Center at King Abdul Aziz Specialist Hospital, Taif, in the western region of Saudi Arabia. The data collected were related to patients’ demographics, etiology of renal failure, presence of comorbidities, site of catheter insertion, and duration. Furthermore, microbiological data including cultures from catheter sites, blood, and catheters’ tips and antibiotic sensitivity. Results: Data on 130 patients (66 females, 50.8%) undergoing hemodialysis from June 2017 to March 2018 were analyzed. The infection rate was 23.6% in this study. In all patients with CRBSI, the catheters were removed, and antibiotics given. The highest infection rates (38.4%) were noted with femoral vein inserted catheters. However, the clinical sepsis was more with jugular catheters. Staphylococcus aureus was prevalent organism, and cephalosporins had the highest sensitivity. Ten catheters found to be mal functional were replaced. Conclusion: Chronic kidney disease patients with diabetes and ischemic heart disease were more prone to CRBSI. Femoral catheters had significantly higher infection rates. S. aureus was the most common type of isolated bacterial strain and cephalosporins showed the highest sensitivity for the isolated bacteria.
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The clinical scenario of a young male is presented in this report who presented with severe pain and swelling of both lower limbs of 3-day duration. On evaluation, he proved to have myositis and further evaluation unraveled Brucellosis. The index case improved with conventional Brucella melitensis treatment confirming the cause and effect relationship. The Brucella infection is a male predominant disease and frequently presents with typical symptoms of fever, fatigue, etc., and the diagnosis often is straightforward. Nevertheless, neurobrucellosis is uncommon, developing in <5% of patients with Brucella infection and producing diverse neurological syndrome. There are very few reports of Myositis caused by Brucella described in the literature. The heaviest disease burden of B. melitensis lies in countries of the Mediterranean basin and Arabian Peninsula. However, the disease is not uncommon in India, Mexico, and Central America. Hence, clinicians need to be aware of this clinical entity all over the globe. Myositis as the first presentation of acute brucellosis is presented in this report.
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In this paper we describe a clinical scenario of high grade fever, jaundice, hypotension and multi‑organ dysfunction syndrome in a 30‑year‑old homeless male without radiological biliary obstruction. He was brought to our hospital by the emergency medical service of Saudi Arabia (Red Crescent) from the street. After an initial resuscitation he proved to have Borrelia recurrentis. The clinical course during his hospital stay was not a smooth one, but the patient finally improved. After 20 days of hospitalisation, he was discharged in a stable condition. The present case underlines the need for high clinical vigilance, even in a non‑endemic area.
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We describe the clinical scenario in an 80 year old female who presented with history of epigastric discomfort and postprandial fullness of three weeks. duration without any alarming symptoms. On upper GI endoscopy she was found to have gastric polyp with a long stalk which was partially obstructing her pyloric ring giving rise to features of intermittent gastric outlet obstruction Polypectomy was done with complete relief of symptoms .She is following our clinic for last 6 months now. Although possibility of malignant etiology in gastric out let obstruction ranks high in the elderly some patients are lucky to have a benign cause as the index case. Report of the case and brief review is presented