ABSTRACT
We describe a 40-yr-old woman who presented with abdominal pain and diarrhea, and who was found to have segmental colitis involving the cecum and ascending colon. Aeromonas hydrophila was isolated from the stool, and her symptoms responded to appropriate antibiotic therapy. Follow-up colonoscopy confirmed complete endoscopic and histologic resolution of her colitis. This report further supports the belief that Aeromonas species are pathogens in healthy humans. This organism needs to be considered in the differential diagnosis of diffuse and segmental colitis.
Subject(s)
Aeromonas/isolation & purification , Bacterial Infections/microbiology , Colitis/microbiology , Adult , Aeromonas/pathogenicity , Feces/microbiology , Female , HumansABSTRACT
We describe an approach to health care in the inner city: a multidisciplinary system of physicians and mid-level practitioners that provides individualized care to chronically ill, elderly, homebound, and nursing-home residents of urban Boston who would otherwise be forced into an inappropriate reliance on teaching hospitals. Linked to four neighborhood health centers, three home-care programs, and a teaching hospital, and financially self-supporting except for the home-care component, the system cared for 3000 ambulatory, 280 homebound, and 358 nursing-home patients in the representative year described. In-hospital use, particularly hospital days, was reduced when judged by existing data for comparable (though not identical) populations. Based on stable physician practices, the system offers a workable approach to the related problems of care, manpower, and cost in the urban core.
