RESUMO
A 70-year-old Caucasian woman was treated for Capnocytophaga canimorsus septicaemia. The source of bacteraemia was very likely to be her household pet, an Italian greyhound. The patient presented with a presumed complex partial seizure but deteriorated rapidly with sepsis and multiorgan dysfunction. Neither scratch nor bite was established, although close petting including licks was reported. Blood cultures grew Gram-negative rods, identified by molecular techniques as C. canimorsus-a bacterium frequently isolated in the oral cavities of dogs and cats. A full recovery was made following 2â weeks of intensive care support and broad-spectrum antibiotics. No underlying immune dysfunction was found.
Assuntos
Capnocytophaga , Infecções por Bactérias Gram-Negativas/transmissão , Sepse/transmissão , Idoso , Animais , Cães , Feminino , Vínculo Humano-Animal , HumanosRESUMO
OBJECTIVE: To see whether elderly medical in-patients screening positive for depression on the Geriatric Depression Score show any change on discharge home and whether their scores predict this. DESIGN: A prospective study. SETTING: A large outer London district general hospital with acute wards for all medical admissions of people aged over 75 years. PARTICIPANTS: We studied 179 consecutive patients admitted to the acute wards with an abbreviated mental test score of > or = 7 who were resident within the London borough of Waltham Forest. MAIN OUTCOME MEASURE: Geriatric Depression Scores in hospital and at home after discharge. Account was taken of subsequent psychiatric treatment. RESULTS: 55 inpatients screened positive for depression (15x point Geriatric Depression Score of 5 or more). Repeat screening of these patients, after discharge, resulted in 24 scoring < 5 and only 19 scoring > or = 5. Three patients out of the 55 were admitted into psychiatric care with depression prior to follow-up screening. The 15 question Geriatric Depression Score was highly sensitive and the 4 question Geriatric Depression Score highly specific in predicting for depression after discharge. CONCLUSION: Many patients screen positive for depression on acute elderly medical admission wards and nearly half improve spontaneously upon returning home.
