Purulent pericarditis with tamponade in a postpartum patient due to group F streptococcus.

Bacterial pericarditis with cardiac tamponade is a life-threatening disorder that has been associated with a variety of organisms. There is usually an associated underlying condition or a seeding of the pericardium from an infection elsewhere. We report the development of cardiac tamponade and a subsequent pericardial constriction due to group F streptococcus purulent pericarditis. We believe this to be the first report of a postpartum patient with purulent pericarditis.

Liver abscess due to Listeria monocytogenes: case report and review.

Involvement of the liver in cases of Listeria monocytogenes infection is uncommon but has been manifested as solitary liver abscess, multiple liver abscesses, and hepatitis. We describe a 73-year-old diabetic woman who presented with a solitary liver abscess and prolonged fever, and we review the world literature on hepatic manifestations of L. monocytogenes infection. Patients presenting with solitary liver abscesses uniformly recovered with antimicrobial therapy and abscess drainage, whereas almost all patients presenting with multiple liver abscesses died.

Nocardial brain abscesses in a pregnant woman.

We describe what we believe to be the second case in which a pregnancy was complicated by the formation of brain abscesses due to Nocardia asteroides; this case may be the first one in which no risk factor for the infection (other than the pregnancy itself) could be found. Craniotomy with surgical drainage of the abscesses, combined with prolonged antimicrobial therapy, led to clinical cure in the mother, and she gave birth to an unaffected infant. This case illustrates the difficulty in treating a nocardial infection of the brain during pregnancy as well as the importance of achieving adequate surgical drainage of the abscesses.

Strongyloidiasis in an institution for mentally retarded adults.

A serologic and epidemiologic survey was undertaken to explain the high incidence of eosinophilia (14.1%) in nine of 64 residents of a facility for mentally retarded adults in Pennsylvania. Seven residents had antibodies to Strongyloides stercoralis as determined by an IgG enzyme-linked immunosorbent assay system (10.9%) and five (71.4%) of this subset had persistent eosinophilia, suggesting a strong association. Sex, race, age, ward, degree of retardation, and medication were not associated with eosinophilia. Stool examination revealed S stercoralis larvae in two residents with S stercoralis antibodies and eosinophilia. Follow-up studies after thiabendazole treatment of the residents with S stercoralis antibodies showed resolution of eosinophilia and disappearance of S stercoralis antibodies in most. Eosinophilia in an adult institutional setting may be associated with strongyloidiasis, even in a nonendemic area. The enzyme-linked immunosorbent assay for antibody to S stercoralis may be useful in diagnosing or monitoring therapy of strongyloidiasis.

An unusual thromboembolic complication of a Greenfield vena caval filter.

The Greenfield inferior vena caval filter is highly effective in preventing recurrent pulmonary embolism and is associated with a low incidence of complications. We have recently seen a patient with the unusual finding of recurrent pulmonary embolism due to extension of thrombus from the surface of a Greenfield filter. The proximal extension of thrombus from a partially obstructed filter is documented by venacavogram. The proposed mechanism is discussed and principles of management are reviewed.