Pasteurella multocida: a case report of bacteremic pneumonia and 10-year laboratory review.

Pasteurella multocida is a normal oral commensal in animals. Animal bites are often complicated by severe wound infection due to P. multocida, but systemic infection is rare. We report a patient with bacteremic pneumonia successfully treated with ceftriaxone and ciprofloxacin. We also review the clinical isolates of P. multocida reported by a major teaching hospital laboratory over a 10-year period. There were 23 patients, comprising the present case, 17 patients with wound infections following animal bites, one case of neonatal meningitis and associated maternal vaginal carriage of P. multocida, and three sputum isolates of doubtful significance.

An unusual case of chylothorax complicating non-Hodgkin's lymphoma.

A 64 year old man with non-Hodgkin's lymphoma developed extremely troublesome chylous pleural effusions following effective chemotherapy. With the pre-operative use of olive oil, a diffuse leakage of lymph was seen at thoracotomy. Oversewing was performed eventually resulting in an excellent outcome.

A variant of pyothorax-associated lymphoma.

A case of pleural lymphoma that developed after an episode of empyema is described. This may be a variant presentation of the rare yet distinct condition termed pyothorax-associated lymphoma. This condition was first recognised in Japan; there have been only a few reports in Western countries to date. A feature of this case is the relatively short interval between diagnosis of empyema and subsequent development of lymphoma.

Relaxation therapy in asthma: a critical review.

This review discusses the relationship between the psychological and physiological factors responsible for airways in asthma and indicates the mechanisms by which psychological methods of treatment may influence airway caliber. The effects of mental and muscular relaxation therapy, systematic desensitization, and biofeedback-assisted relaxation are evaluated in children and adults with asthma. The methodology and results of studies are analyzed critically to present a balanced opinion of the subjective and objective effects of these methods of treatment. Muscular relaxation therapy alone appears to have no effect. Certain mental relaxation techniques, such as autogenic training and transcendental mediation, systematic desensitization, and biofeedback-assisted relaxation, can produce subjective improvement as well as clinically significant improvement in respiratory function and other objective parameters. As with any therapy the response is variable and is influenced by factors such as age and severity of asthma.

Pulmonary strongyloidiasis and lung abscess.

We report a case of lung abscess associated with pulmonary strongyloidiasis which occurred in an asthmatic patient three years after migrating to Australia from Burma where strongyloidiasis is endemic. Thiabendazole was effective in eradicating the Strongyloides infection.

Radiation pneumonia complicating adjuvant cytotoxic chemotherapy.

A patient with Hodgkin's disease developed acute radiation pneumonia four months after completion of mantle radiotherapy and during cyclical adjuvant chemotherapy. Respiratory function tests were useful in the diagnosis of the interstitial abnormality and in monitoring response to prednisone. Serial respiratory function tests in patients receiving bimodal therapy may facilitate early diagnosis of this potentially serious complication.

Atypical mast cell degranulation and focal hydropic degeneration of venular endothelium in diffuse fibrosing alveolitis.

Atypical scroll-like and tubular degranulation of mast cells closely associated with focal endothelial hydropic degeneration is reported in human lung from 4 patients with diffuse fibrosing alveolitis in which the predominant abnormality was hyperplasia and desquamation of type 2 pneumocytes.

Intrathoracic manifestations in non-Hodgkin's lymphoma.

A total of 16 of 86 patients (19%) with non-Hodgkin's lymphoma were found to have intrathoracic disease in this retrospective study. Paratracheal, mediastinal, and hilar lymphadenopathy was the commonest manifestation followed by pulmonary lesions and pleural effusion. The lymphoma was at an advanced clinical stage in all the patients with intrathoracic disease. About one-third of the intrathoracic lesions first developed at the time of relapse after successful initial therapy. There was a better response to therapy when intrathoracic disease was part of the initial presentation than when it was a manifestation of relapse. If it did not respond to therapy it was always indicative of a poor prognosis.

The relation of social factors to physical and psychiatric illness.

A study in social factors associated with illness status was conducted in an Australian suburban community. Forty six per cent of adults reported a chronic physical condition and twenty four per cent were psychiatrically impaired. Life event stress, adverse childhood experience and poor social support were related to both physical psychiatric illness. Low occupation status was associated with poor physical health and a poor coping style was associated with psychiatric illness. Twenty per cent of the physical illness and thirty seven per cent of the psychiatric impairment could be attributed to the presence of social factors.

Bronchodilator effect of hexoprenaline aerosol in bronchial asthma and chronic bronchitis.

The bronchodilator effects of aerosols of hexoprenaline (200 microgram and 400 microgram), and salbutamol (200 microgram) were compared in 15 patients with asthma, and nine patients with chronic bronchitis. In both groups of patients, hexoprenaline and salbutamol produced a similar increase in the forced expiratory volume in one second (FEV1), and mean percentage increase in FEV1. Neither drug caused tachycardia or arrhythmia. It was concluded that hexoprenaline aerosol was a safe and effective bronchodilator.

A bacteriology and treatment summary form for use in patients with tuberculosis.

A summary form for recording bacteriology results and treatment regimens is a concise method for recording essential information in patients with tuberculosis.

The relation between physical, psychological, and social morbidity in a suburban community.

Questionnaire scales of physical, psychological, and social morbidity were utilized to discover the relation between these indices in a representative Australian suburban sample of 863 adults aged 20-69 years. The physical and psychological morbidity of the sample was considerable and comparable to that revealed by other health surveys. There was a positive association between the occurrence of physical and psychological illness. The level of social isolation was low and in this residentially stable sample there was no association between social isolation and either physical or psychological morbidity.

Pseudomonas pneumonia with bacteraemia.

A previously healthy man developed fulminating pneumonia and bacteraemia due to Pseudomonas aeruginosa. This organism was isolated from sputum and blood before death, and from the lung, liver and spleen at autopsy. Bacteraemic psuedomonas pneumonia is rare, carries a high mortality, and is usually associated with serious underlying disease.

Ampicillin dosage and use of prednisolone in treatment of pneumonia: co-operative controlled trial.

A controlled trial was carried out to investigate whether the rate of recovery from pneumonia treated with ampicillin is dose related. Sixty-three patients received 1 g ampicillin daily and 63 received 2 g ampicillin daily for seven or 14 days depending on the rate of response. Twenty patients in each of these groups received, in addition, 20 mg prednisolone daily for seven days. The treatment groups were comparable and the results of treatment were similar in the four groups. The only difference which was of statistical significance was that a larger proportion of patients receiving 1 g ampicillin daily became afebrile within one week. All the ampicillin rashes occurred in the patients receiving 2 g ampicillin daily with and without prednisolone. Ampicillin 1 g daily appears to be adequate dosage in the treatment of pneumonia, and the rate of recovery has not been shown to be accelerated by using 2 g. No deleterious effects were noted with additional prednisolone therapy and this appeared to increase the rate at which the patients became afebrile, although the figures were not statistically significant.

Rifampin.

Rifampin is a potent antituberculous drug. In the treatment of drug-resistant tuberculosis it is highly effective provided it is given in combination with other drugs to which the patient's organisms are sensitive. Rifampin and ethambutol is a particularly powerful combination and will achieve almost 100% sputum conversion. It seems likely that rifampin will replace streptomycin, and ethambutol will replace PAS in first-treatment cases. Optimum first-line treatment will thus consist of rifampin, INH and ethambutol, with the probability of almost 100% success and the possibility also that the total duration of treatment may be considerably reduced. Rifampin is well tolerated but it may give rise to liver dysfunction and thrombocytopenia in a small proportion of patients. Patients treated with rifampin must be kept under close supervision because of the risk of side effects and, more important, because irregular treatment may lead to the development of rifampin-resistant organisms.