Multiple myeloma of the central nervous system: a clinicopathological review

Multiple myeloma [MM] is a systemic malignancy of pathologic plasma cells that is treatable with chemotherapeutic agents and irradiation, but rarely curable. The spectrum of neurological complications of MM is diverse; however, involvement of MM in the cerebrospinal fluid and leptomeningeal infiltration is considered rare. There have been many reviews of central nervous system complications in MM but there are none on intracranial and leptomeningeal infiltration of MM. We review this here along with our clinicopathological experience and a summary of our present knowledge of this condition

Hepatitis C virus genotyping by polymerase chain reaction and DNA enzyme immunoassay among Saudi patients in the Western Province, Saudi Arabia

The distribution of hepatitis C virus [HCV] genotypes in the Western Province of Saudi Arabia is unknown. The purpose of our study was to determine the prevalent HCV genotypes among HCV seropositive Saudi patients in the Western Province, and to study the relationship between types/subtypes, clinical status and liver histology. Patients and Serum samples were collected from 140 consecutive patients attending the Hepatology Clinic with varying grades of liver diseases, high alanine transferase [ALT] for >6 months, positive HCV, qualitative PCR, and who had had liver biopsy. HCV genotyping was determined on patients who had tested positive by both HCV enzyme immunoassay [EIA] and recombinant immunoblot assay [RIBA]. Of the 140 patients, 97 [69.2%] had genotype 4, 18 [12.8%] had genotype 1a, and 16 [11.4%] had genotype 1b. Genotypes 2b and 5 were found in two patients [1.4%] each, while 5 patients [3.6%] had mixed infections with genotypes 4 and 5. Of the 97 patients infected with genotype 4, 84 [86.6%] had chronic active hepatitis [CAH], two [2.1%] had CAH with active cirrhosis, 9 [9.3%] had cirrhosis and two [2.1%] had normal liver histology [NLH]. The most prevalent HCV genotype in the Western Province of Saudi Arabia was genotype 4 [69.2%]. Genotype 1b was encountered in 16 [11.4%] patients. For the first time, genotype 5 was identified in the Western Province of Saudi Arabia. Genotypes 1b and 4 were associated with different histological grades of liver disease

Recurrent subcutaneous abscess due to salmonella group B

A case of recurrent subcutaneous abscess due to Salmonella Group B in a patient with uncontrolled diabetes is presented. Despite standard traditional therapy on four occasions, recurrence of the abscess at the same location occurred. The striking tendency of salmonella organisms to be localized at sites of preexisting disease is emphasized as well as their particularly difficult eradication

In vitro susceptibilities to ampicillin, co-trimoxazole, cephalexin and amoxicillin/clavulanate of infecting bacteria isolated at Riyadh armed forces hospital

Increasing resistance is being demonstrated by many microorganisms to the commonly used oral antibiotics for out-patient therapy of infections. This resistance is mostly due to production of Beta lactamases. The in vitro activity of amoxycillin / clavulanate against 1026 commonly isolated Gram- positive and Gram-negative organisms from patients attending our hospital was determined and compared independently with amplicillin, co-trimoxazole and cephalexin. Amoxycillin / clavulanate showed better antimicrobial activity than ampicillin, co-trimoxazole and cephalexin against many more of the common organisms such as staphylococci, Haemophilus spp., Escherichia coli and Klebsiella. For the initial therapy of infections due to these organisms, amoxycillin / clavulanate appears to be a more appropriate choice, prior to the availability of microbiological results. It is hoped that these data will offer some auidance to physicians in the community who frequently have to deal with infections