ABSTRACT
In South Australia in 1995, we treated 20 children with haemolytic-uraemic syndrome associated with Escherichia coli O111:H-. The source of the outbreak was contaminated locally produced semi-dry fermented sausage (mettwurst). One child died of multiple haemorrhagic cerebral infarcts. Eighteen children required renal dialysis (for a median of 14 days); 12 months after discharge five still had significant impairment of renal function. Other major complications included colonic necrosis (3), cerebral haemorrhage/infarction (3), convulsions (4), and glucose intolerance (2). Although E. coli O111:H- has been associated with sporadic cases of haemolytic-uraemic syndrome, this was the first large outbreak reported in Australia.
Subject(s)
Disease Outbreaks , Escherichia coli Infections/complications , Escherichia coli Infections/mortality , Escherichia coli/isolation & purification , Hemolytic-Uremic Syndrome/microbiology , Hemolytic-Uremic Syndrome/mortality , Meat Products/microbiology , Animals , Child , Child, Preschool , Escherichia coli Infections/therapy , Female , Hemolytic-Uremic Syndrome/therapy , Humans , Infant , Length of Stay , Male , South Australia/epidemiology , Swine , Treatment OutcomeABSTRACT
Pertussis is most severe in infants under one year of age in whom it can be a frightening disease. Early immunisation, supportive treatment, and prophylactic antibiotic therapy for susceptible contacts are dealt with by Dr Beare, who describes the condition from the specialist's viewpoint.
Subject(s)
Whooping Cough , Female , Humans , Immunization , Infant , Maternal-Fetal Exchange , Pregnancy , Respiratory Tract Diseases/etiology , Whooping Cough/complications , Whooping Cough/diagnosis , Whooping Cough/therapyABSTRACT
A case of concomitant cyclical neutropaenia and IgA nephropathy, a previously undescribed combination is reported. The patient has recurrent aphthous ulceration, and haematuria occurs with these episodes. The diagnosis of cyclical neutropaenia was based on the clinical features and serial peripheral blood studies, and a renal biopsy studied by light, electron and immunofluorescence microscopy in conjunction with the clinical features established the diagnosis of IgA nephropathy. Elevation of serum immunoglobulin, with a disproportionate elevation of IgA was found. The features of this case emphasise the importance of infection as an initiating event in the pathogenesis of IgA nephropathy, and they provide further evidence for the formation of poorly soluble immune complexes as a likely pathogenetic mechanism.
