Hyperbaric oxygen is effective in early stage of healing of experimental brain abscess in rats.

OBJECTIVES: Current therapy of brain abscess (BA) includes a combined approach that involves antibiotics and minimal invasive surgery, but also hyperbaric oxygen treatment (HBOT) as a supportive measure. Optimum treatment is still a matter of significant controversy. METHODS: The experiment, previously approved by a relevant ethical committee, involved 80 female Wistar rats. BA was experimentally induced by inoculation of Staphylococcus aureus. The animals were randomized into groups and treated either with antibiotics, HBOT, or with a combination of both. RESULTS: Beneficial effect of HBOT was evident in groups treated with HBOT or with a combination of antibiotic+HBOT. It was mainly manifested on days three and five of the experiment and was evident as statistically significant increase of a number of newly formed blood vessels, increase in mean vascular density, and smaller abscess necrotic core. DISCUSSION: Although the results of the present study should be interpreted cautiously, they suggest that HBOT has an important but limited role in the treatment of BA.

War-associated cases of typhoid fever imported to Split-Dalmatia County (Croatia).

OBJECTIVE: The goal was to investigate the number and origin of typhoid fever cases in Split-Dalmatia County, Croatia, during the period of 1970-2005. METHODS: Data from the medical records of typhoid fever cases treated at the University Hospital during the 35-year period were analyzed. Cases were defined as those in which Salmonella typhi was isolated from blood and/or stool. All isolates were tested for susceptibility to antimicrobial agents. RESULTS: A total of 45 cases were identified. Forty-four patients originated from Bosnia and Herzegovina, and all of their isolates were susceptible to all antimicrobial agents tested. One patient from Pakistan was infected with multidrug-resistant S. typhi. No autochthonous case of typhoid fever was identified. CONCLUSION: All cases of typhoid fever were acquired in countries where typhoid fever is endemic, and their importation to Croatia was the result of war-associated population movements. Increased awareness of health care workers regarding persons who originated from or have traveled to a typhoid-endemic area is needed. To avoid treatment failure, particular attention should be given to persons coming from regions with a known presence of multidrug-resistant S. typhi.