ABSTRACT
Infective endocarditis (IE) is a life-threatening condition caused by infection within the endocardium of the heart and commonly involves the valves. The subsequent cascading inflammation leads to the appearance of a highly friable thrombus that is large enough to become lodged within the heart chambers. As a result, fever, fatigue, heart murmurs, and embolization phenomena may be seen in patients with IE. Embolization results in the seeding of bacteria and obstruction of circulation, causing cell ischemia. Of concern, bacteria with the potential to gain pan-drug resistance, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being identified as the causative agent of IE in hospitals and among intravenous drug abusers. We retrospectively reviewed de-identified clinical data to summarize the clinical course of a patient with MRSA isolated using an automated blood culture system. At the time of presentation, the patient showed a poor consciousness level, and the calculated Glasgow scale was 10/15. A high-grade fever with circulatory shock indicated an occult infection, and a systolic murmur was observed with peripheral signs of embolization. This case demonstrated the emerging threat of antimicrobial resistance in the community and revealed clinical findings of IE that may be helpful to clinicians for the early recognition of the disease. The management of such cases requires a multi-specialty approach, which is not widely available in small-island developing states such as the Maldives.
ABSTRACT
Spontaneous bleeding from uterine leiomyoma is an unusual cause of hemoperitoneum. Fewer than 100 cases have been reported in the literature so far. We report a 30-year-old woman who needed surgical exploration for an acute abdomen. There was massive hemoperitoneum due to bleeding from a subserosal myoma. This case was important because physician should be aware of this rare complication in patient with uterine myoma to avoid any morbidity and mortality.
Subject(s)
Ovarian Diseases/diagnosis , Pregnancy, Ectopic/diagnosis , Adult , Female , Humans , Laparoscopy , PregnancyABSTRACT
To study the interference by mycotoxins in protein measurements, solutions of various concentrations of aflatoxin B1, citrinin, cytochalasin B, ochratoxin A, patulin, penicillic acid, rubratoxins A and B, T-2 toxin and zearalenone were tested for a positive copper-Folin reaction. Except for T-2 toxin, all mycotoxins tested developed a blue color, characteristic of proteins, in the copper-Folin solution. The Lowry reaction for the mycotoxins was linear over the concentration range of 20-100 µg/ml for most of these toxins. Aflatoxin B1 and citrinin at 2 µg/ml and zearalenone at 0.5 mg/ml developed a blue color in the copper-Folin solution. The linear relationship between color development and toxin concentration plus high sensitivity makes the copper-Folin reaction a potential analytical method for these toxins but only in the absence of protein or other copper-Folin positive materials.
