Enterobius vermicularis in the kidney: an unusual location.

A woman was admitted to hospital with abdominal pain. A large kidney stone was recovered and a nephrectomy was performed. Histology revealed the unusual presence of multiple Enterobius vermicularis ova. However, no other parasitic element was recovered on further investigations.

Cat-scratch disease presenting as a breast mass.

The case of a 14-y-old girl who presented with a mass in her left breast after having contact with a guinea pig is presented. The diagnosis of cat-scratch disease was made by detection of Bartonella henselae DNA by PCR analysis of abscess aspirate.

Risk factors analysis for Pneumocystis jiroveci pneumonia (PCP) in patients with haematological malignancies and pneumonia.

A retrospective matched case-control investigation was conducted to assess risk factors suggesting Pneumocystis jiroveci pneumonia (PCP) when pneumonia occurs in adult patients with haematological malignancies. Cases and controls included were HIV-negative, presented with pneumonia and had benefited from a bronchoalveolar lavage (BAL). The presence of Pneumocystis jiroveci cysts was systematically investigated by cytochemical staining and/or immunofluorescence. Cases were patients with Pneumocystis jiroveci cysts isolated on BAL fluid (n = 31, mean age 51+/-14 y; range 20-73 y). Controls were patients without Pneumocystis jiroveci cysts (n = 62, mean age 54+/-13 y; range 25-75 y) and were matched to case patients by age and y of pneumonia diagnosis. Statistical analysis indicated that the following factors were associated with PCP: vincristine (p = 0.009, odds ratio (OR) =2.11, 95% confidence interval (CI): 1.19-3.72), a daily corticosteroid therapy for more than 1 month (p = 0.05) during the past y, and a lymphocyte count less than 0.5 x 10(9)/l on the d of pneumonia diagnosis (p = 0.04). Clinicians should be aware, in order to evoke this diagnosis when pneumonia occurs in patients with these risk factors. The goal of this exploratory study was to identify risk factors that could eventually be further investigated by a larger prospective multicentre study.

Characteristics of brain abscess with isolation of anaerobic bacteria.

In view of its localization, brain abscess (BA) usually requires medical and surgical care. A broad spectrum of bacteria is involved. Recent reports stress the increasing frequency of anaerobes, but their impact has not been well evaluated. A retrospective review was conducted of all episodes of documented BA admitted in a tertiary-care hospital over a 10 y period. BA due to anaerobic bacteria (group A) were compared with other cases (group B) to determine the frequency and eventual characteristics of BA with isolated anaerobic bacteria. Between 1991 and 2000, BA were diagnosed in 42 patients (28M, 14F, mean age 54.6 y). No differences in clinical features and laboratory findings were found between patients with BA caused by anaerobic (n = 22) and only aerobic (n = 20) bacteria. Using appropriate microbiological techniques, 41 anaerobic bacteria strains were isolated in 22 of 42 patients (52.4%) with BA. Anaerobic bacteria were associated with aerobic strains in 5 patients (12%), whereas in 17 patients (40.5%) only anaerobic strains were isolated in cerebral puncture cultures. The most frequently isolated species were Fusobacterium nucleatum (n = 14), Prevotella sp. (n = 8), Actinomyces sp. (n = 6) and Bacteroides sp. (n = 4). Compared with group B, group A had more cases of a single abscess (p = 0.03) and ear, nose and throat (ENT) as a source of infection (p = 0.04), and seemed to have a better outcome (p = 0.07). These results emphasize the important role that anaerobic bacteria play in BA. The presence of such pathogens must be evoked when faced with a single abscess, an ENT infection, or both. Therapy should take into account this high frequency.

[Arizonae subspecies Salmonella enterica urinary infection with confusional syndrome]. / Infection urinaire à Salmonella enterica subspecies arizonae avec syndrome confusionnel.

INTRODUCTION: Infections due to subspecies arizonae Salmonella enterica are rare. These infections are transmitted by reptiles. We report the case of S. arizonae urinary tract infection that occurred in an immunocompetent woman. OBSERVATION: An 82 year-old woman was admitted for confusion. A urinary tract infection due to Salmonella arizonae was diagnosed. No neurological, iatrogenic or metabolic cause could explain the confusion. Treatment with ciprofloxacin was given. The confusion and the infectious syndrome disappeared. CONCLUSION: The prevalence of infections is probably underestimated because the digestive problems they generate are usually benign.

African trypanosomiasis acquired in an urban area.

A 28-year-old Zairian woman was presented with a diurnal somnolence, cervical polyadenopathy, splenomegaly, eosinophilia, and elevated IgM. A diagnosis of West African trypanosomiasis was confirmed and the patient improved after treatment with eflornithine.

Central venous catheter-related infection due to Agrobacterium radiobacter: a report of 2 cases.

We report 2 cases of Agrobacterium radiobacter bacteremia in immunocompromised patients. Removal of the central venous catheter and administration of antimicrobial therapy led to favorable outcomes in both patients. Infections due to A. radiobacter are rare and usually occur in patients with predisposing factors.

Infective endocarditis after transrectal prostatic biopsy.

We report the first case of infective endocarditis secondary to transrectal prostatic biopsy, occurring 2 weeks later in a patient with no obvious risk factors. Enterococcus faecalis was isolated in blood and urine cultures. This case suggests that infective endocarditis can be associated with transrectal procedures.