ABSTRACT
OBJECTIVES: The diagnosis of tuberculous meningitis is easily missed because the variety of symptoms give rise to problems with the differential diagnosis. MATERIAL: Five cases of difficult to diagnose tuberculous meningitis are presented. RESULTS: Several reasons for the diagnostic delay are highlighted. The fact that tuberculous meningitis is rather rare in developed countries contributes to this problem. Recommendations for a quick diagnosis are given. CONCLUSION: The diagnosis of tuberculous meningitis in developed countries is often made after a substantial delay. In case of suspicion on the diagnosis additional examination should be performed and treatment should be started immediately.
Subject(s)
Tuberculosis, Meningeal/diagnosis , Adult , Aged , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Tuberculosis, Meningeal/pathologySubject(s)
Myocarditis/microbiology , Pericarditis/microbiology , Streptococcal Infections/diagnosis , Streptococcus pyogenes/isolation & purification , Tonsillitis/diagnosis , Acute Disease , Adult , C-Reactive Protein/analysis , Humans , Male , Myocarditis/drug therapy , Penicillins/therapeutic use , Pericarditis/drug therapyABSTRACT
We present the case of a 38-year-old man who developed acute myopericarditis, mimicking acute myocardial infarction, as manifested by electrocardiographic, echocardiographic alterations and elevated cardiac enzymes complicating Lancefield group A beta-hemolytic streptococcal tonsillitis. After receiving oral penicillin, the clinical recovery was complete. Fever, tachycardia and chest discomfort resolved within a few days. Furthermore, enzyme levels and C-reactive protein returned to normal within eight days.
Subject(s)
Myocarditis/microbiology , Penicillins , Pericarditis/microbiology , Streptococcal Infections/microbiology , Streptococcus pyogenes/isolation & purification , Tonsillitis/microbiology , Acute Disease , Adult , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Echocardiography , Electrocardiography , Follow-Up Studies , Humans , Intensive Care Units , Male , Myocardial Infarction/diagnosis , Myocarditis/diagnosis , Myocarditis/drug therapy , Nurses, Male , Pericarditis/diagnosis , Pericarditis/drug therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapy , Tonsillitis/diagnosis , Tonsillitis/drug therapyABSTRACT
From 1989 until 1992 an increase in the number of isolations of Acinetobacter was observed in a community hospital in The Netherlands. The organisms were spread throughout the hospital and a common source was suspected. Feather pillows were found to harbour high numbers of acinetobacters. Replacement with synthetic pillows and correction of the laundry procedure resulted in a significant reduction of Acinetobacter isolations. A number of isolates from patients and from pillows were indistinguishable using biotyping, antibiogram typing and cell envelope protein typing. By the use of DNA-DNA hybridization most isolates were identified to A. baumannii and the unnamed closely related genomic species 13. A number of isolates, mostly from pillows, were identified as A. radioresistens. The outcome of cultivation, intervention and typing suggests that the feather pillows played an important role in the outbreak.
Subject(s)
Acinetobacter Infections/transmission , Acinetobacter/isolation & purification , Bedding and Linens/standards , Cross Infection/transmission , Acinetobacter/classification , Acinetobacter Infections/epidemiology , Acinetobacter Infections/microbiology , Bacterial Typing Techniques , Cross Infection/epidemiology , Cross Infection/microbiology , Disease Outbreaks/statistics & numerical data , Environmental Microbiology , Hospitals, Community , Humans , Netherlands/epidemiologySubject(s)
Anti-Bacterial Agents/pharmacology , Bacteria, Anaerobic/drug effects , Drug Therapy, Combination/pharmacology , Humans , Microbial Sensitivity Tests , Penicillanic Acid/analogs & derivatives , Penicillanic Acid/pharmacology , Piperacillin/pharmacology , Tazobactam , beta-Lactamase InhibitorsSubject(s)
Drug Contamination , Mouthwashes/adverse effects , Pseudomonas Infections , Respiratory Tract Infections/transmission , Saliva, Artificial/adverse effects , Aged , Humans , Intensive Care Units , Male , Pseudomonas Infections/transmission , Pseudomonas aeruginosa , Respiratory Tract Infections/etiologyABSTRACT
A rapidly fatal case of enteritis necroticans in a 24 year old man with diabetes was caused by Clostridium perfringens type C. The role of beta toxin in the disease is discussed. This type has not been previously described as a causative agent in necrotising bowel disease of man outside endemic areas.
Subject(s)
Clostridium Infections/pathology , Enterocolitis, Pseudomembranous/etiology , Adult , Animals , Clostridium perfringens/classification , Enterocolitis, Pseudomembranous/pathology , Guinea Pigs , Humans , Male , Neutralization Tests , Skin TestsSubject(s)
Campylobacter Infections/microbiology , Campylobacter fetus/isolation & purification , Campylobacter/isolation & purification , Enteritis/microbiology , Animals , Bacteriological Techniques , Campylobacter Infections/transmission , Campylobacter fetus/growth & development , Feces/microbiology , Humans , ZoonosesABSTRACT
Group-specific polysaccharides of Neisseria meningitidis groups A and C have been demonstrated by means of a rapid, sensitive slide agglutination test with latex particles coated with antibodies. In this manner, the diagnosis can be made from the cerebrospinal fluid of patients with meningococcal meningitis caused by serogroups A or C even when the culture is negative. The method appears to be more sensitive than countercurrent immunoelectrophoresis and less elaborate.
