Infection control failures in a dental surgery--dilemmas in incident management.

Three separate incidents involving failure of decontamination of dental instruments were reported to our Unit in less than one year. We describe the risk assessment we undertook for the likelihood of detecting transmission of a blood borne virus infection. Even where 4000 patients attended the same dentist for seven years, there was no certainty of detecting even one person infected by the decontamination failure, while several people who had acquired infection by other routes would be identified. We conclude that these findings suggest that notifying patients is not usually justified.

Rapid latex agglutination test for extraluminal amoebiasis.

AIMS: To develop a rapid latex agglutination screening test for invasive amoebiasis. METHODS: The performance of an in-house latex agglutination test was compared with three standard serological techniques--the immunofluorescent antibody test (IFAT), the indirect haemagglutination test (IHA), and the cellulose acetate precipitin (CAP) test. Forty six sera were screened; 12 from negative controls; 10 sera from infections other than amoebiasis, and 24 sera from patients with luminal or extraluminal infection with Entamoeba histolytica. RESULTS: Strong positive latex agglutination reactions were observed, with 12 of 12 sera giving combined CAP positive, IFAT positive, and IHA positive results. These results are indicative of invasive amoebiasis. Twelve CAP negative, IFAT positive sera, and 10 of 12 IHA negative gave weak or negative agglutination reactions. One of 12 CAP negative, IFAT positive, and IHA positive sera gave a strong positive latex agglutination result; one with CAP negative, IFAT positive, and IHA positive sera gave a weak latex agglutination reaction. These results correlate with either treated amoebiasis or with the early stages of invasive amoebiasis for which the CAP test is known to have a lower sensitivity than the IFAT, but a higher specificity. No reactions were observed with 12 out of 12 CAP negative, IFAT negative, and IHA negative control sera and all 10 sera from other infections (two giardiasis, three schistosomiasis, three malaria, one filariasis). CONCLUSIONS: The latex agglutination test was a useful indicator test, paralleling the results obtained with standard serological techniques. It could also be a useful screening tool in the field.

Bartholin's abscess complicating food poisoning with Salmonella panama: a case report.

A patient is presented who developed an acute Bartholin's abscess four weeks after an attack of Salmonella panama enteritis. Aspirate from the abscess also grew Salmonella panama, indistinguishable from the gut isolate in serotype and antigenic structure (1 9, 12: 1, v: 1,5). Some aspects of the microbiology of Bartholin's abscess and its clinical management are discussed.

Listeria ivanovii infection in a patient with AIDS.

We describe a case of bacteraemia due to Listeria ivanovii in a patient with AIDS. This organism is a rare human pathogen.

Pancreatic function in amyotrophic lateral sclerosis.

No abnormality of exocrine function of the pancreas was found in 10 patients with amyotrophic lateral sclerosis. Eight patients showed abnormal glucose metabolism, attributed to the effects of age, malnutrition, diminished physical activity, and decreased muscle mass.