ABSTRACT
Infectious mononucleosis was tentatively diagnosed in a patient who presented with a temperature of 39.5°C, red throat and enlarged nodes in the neck. He was given amoxycillin 250 mg tid and was admitted to hospital, where his clinical symptoms of diphtheria were investigated. Medication was switched to penicillin V 300 mg tid. On the fifth hospital day the laboratory reported a culture of a toxigenic strain of C. diphtheriae from an initial throat swab.On the same day, he developed an erythematous, highly pruritic maculopapular rash which was probably caused by the initial use of amoxycillin. The rash initially became generalized and slowly resolved in 7-9 days. He apparently had infectious mononucleosis and a coincidental pharyngeal infection with toxigenic C. diphtheriae.No indication exists for the use of antibiotics in infectious mononucleosis, unless throat cultures reveal bacterial pathogens. In that case, an appropriate antibiotic other than ampicillin-amoxycillin can be chosen.
ABSTRACT
Two cases of Listeria monocytogenes infection in patients receiving immunosuppressive treatment after kidney transplantation are described. In the first, the infection, which occurred soon after transplantation and was accompanied by signs of mild chronic rejection, was the immediate cause of death. The other case occurred in a patient whose transplanted kidney had been functioning well for more than four years; this patient recovered. These cases, plus a review of 40 similar cases in the literature, point out the importance of anticipating possible listerial infection when septic meningitis arises in a patient with a transplanted kidney.
Subject(s)
Immunosuppression Therapy , Kidney Transplantation , Meningitis, Listeria/etiology , Anti-Bacterial Agents/therapeutic use , Humans , Male , Meningitis, Listeria/drug therapy , Middle Aged , Prognosis , Transplantation, HomologousABSTRACT
A fatal case of generalized tetanus in a 67-year-old man is presented. The incubation period following finger damage was short, and the diagnosis was confirmed by the isolation of Clostridium tetani. Subsequently, a partial surgical amputation of the infected finger during the clinically active stage of the disease did not remove all the infecting organisms. Although convincing evidence of any previous active immunization was lacking, no form of tetanus antitoxin was given at the time of injury. This case illustrates the potential dangers of unfamiliarity with tetanus owing to its low incidence in developed countries.
Subject(s)
Tetanus , Aged , Humans , Male , Tetanus/diagnosis , Tetanus/prevention & control , Tetanus/therapy , Tetanus Toxoid/therapeutic useABSTRACT
A marked increase in the isolation of Group B streptococci from patients in the University Hospital, Saskatoon, has been noted over the past four years, and no change in technical methods has been found to explain this increase. Group B streptococci have been isolated from 242 patients, in 53 of whom the streptococcus was considered the cause of the infection. Infections occurred predominantly in the urinary tract, female genital tract and upper respiratory tract. There was a low incidence of infections in newborn infants, and only four infections were in patients under 1 year old. Infections were more frequent in women than men and in patients over 40 years of age. No particular affinity of Group B streptococci for diabetics was demonstrated.
