[Infectious endocarditis in a Norwegian hospital 1997-2006]. / Infeksiøs endokarditt ved Ålesund sjukehus 1997-2006.

BACKGROUND: Infective endocarditis is a serious disease with high morbidity and mortality. The causative microorganism and predisposing factors have changed over time. Four retrospective studies of this condition have been published in Norway; the most recent in 1998. Aetiology, treatment and mortality have been reviewed for such patients admitted to a Norwegian hospital in a 10-year period. MATERIAL AND METHODS: Medical records were reviewed for all patients ≥ 18 years admitted to Aalesund hospital, and diagnosed with infective endocarditis (as primary or secondary diagnosis) according to relevant ICD 9 and ICD 10 codes, in the period 01.01.1997-31.12.2006. Demographical, clinical, and laboratory data were recorded. RESULTS: 57 patients were diagnosed with infective endocarditis; the average age was 66 years and 37 were men. The average annual incidence was 6.3/100000 pr year. The average length of treatment was six weeks, and the first choice of antibiotics was usually a combination of penicillin and aminoglycosides (46%). The most common causative microorganism was S.aureus (21%). 42 (74%) patients had one or more complications. Nine (16%) patients died during their hospital stay. INTERPRETATION: The incidence of infective endocarditis in Aalesund hospital was in the upper range of previous reports. In accordance with previous studies, we found that staphylococcus is currently the most common causative micro-organism. The age of onset has increased compared to earlier Norwegian studies.

Chronic mucocutaneous candidiasis and primary hypothyroidism in two families.

UNLABELLED: We describe the clinical and immunological features of two families with chronic mucocutaneous candidiasis (CMC) and primary hypothyroidism. Family A includes three siblings with both candidiasis and hypothyroidism and four individuals with hypothyroidism only. Family B includes four members with candidiasis, of whom one (a male child) also had hypothyroidism. All individuals affected with CMC had suffered from oral candidiasis and onychomycosis since infancy. Facial seborrhoic dermatitis, general folliculitis and scaling blepharitis were main manifestations. Hypothyroidism became evident during childhood. No thyroid antibodies were present in the affected siblings in family A, while the male in family B with hypothyroidism had antibodies against thyroid peroxidase at diagnosis. Immunological evaluation revealed intra-individual variations in serum immunoglobulin levels, lymphocyte subsets and proliferative responses, but there were no consistent abnormalities. Vaccine responses were normal. AIRE gene region microsatellite markers did not segregate with disease nor were autoantibodies typical for autoimmune polyendocrine syndrome type 1 detected in the families. CONCLUSION: The link between hypothyroidism and chronic mucocutaneous candidiasis remains to be identified.