Molecular confirmation of transmission route of Staphylococcus intermedius in mastoid cavity infection from dog saliva.

We report a case of infection of a mastoid cavity after mastoidectomy had been performed for chronic otitis media with cholesteatoma. The infection was caused by Staphylococcus intermedius after a pet dog had licked the patient's ears. Bacterial strains from the dog's saliva and the otorrhea in the patient were confirmed to be identical by pulsed-field gel electrophoresis analysis. The possibility of an oral transmission route of S. intermedius from pets to humans should be noted.

Evaluation of dot-ELISA for serological diagnosis of amebiasis.

We improved the dot enzyme-linked immunosorbent assay (dot-ELISA) reported by Itoh and Sato, and assessed the usefulness of this test for the diagnosis of amebiasis. The sensitivity of dot-ELISA was compared with that of plate ELISA, the indirect hemagglutination test (IHA), and the indirect fluorescent antibody test (IFA) for the diagnosis of amebiasis. Of 37 serum samples from patients with documented amebiasis, 36 (97.3%) were positive by dot-ELISA. There was consistency among the results of dot-ELISA, plate ELISA, and IFA, although the positive rate of IHA was lower than that of the others (78.4%; 29 of 37 cases were positive). The specificities of dot-ELISA and plate ELISA were assessed using a total of 68 sera, collected from 38 patients infected with seven different parasites other than Entamoeba histolytica, 10 patients showing diarrhea or liver abscess without parasitic infection, and 20 healthy individuals. The two assays showed no false-positive results. There were no differences in sensitivity and specificity between dot-ELISA and plate ELISA. However, the dot-ELISA technique seems to be more feasible for clinical application than plate ELISA techniques, because the assay does not require any specific equipment.

[Severe falciparum malaria with prolonged hemolytic anemia after successful treatment with intravenous artesunate].

We report a 68-year-old woman with severe falciparum malaria contracted in Tanzania. She presented high parasitemia and was treated successfully with intravenous artesunate, a qinghaosu derivative, and aggressive supportive therapy. She developed hemolytic anemia and jaundice on day 11 and blood transfusion was required. This case illustrates that intravenous artesunate has excellent antimalarial activity with rapid efficacy and that no severe adverse effect but conventional aggressive supportive therapy is still important in the treatment of severe falciparum malaria.

[Hospital outbreak of viral gastroenteritis attributed to Norwalk-like viruses in Japan].

BACKGROUND: Norwalk-like viruses (NLVs), RNA viruses in the family of Caliciviridae, are known as a pathogen of nonbacterial food-borne gastroenteritis associated with eating raw oysters. NLV can spread from person to person with strong infectivity and can cause large epidemics in communities, schools, nursing homes, and hospitals. Here, we describe an outbreak of gastroenteritis associated with NLVs, possibly introduced from outside the hospital, in four different wards on four different occasions between November 1999 and April 2000, in a university affiliated hospital in Tokyo. METHOD: Total 61 specimens (stool or vomitus) from 46 patients and staffs were collected. Reverse transcription-polymerase chain reaction (RT-PCR) test was performed on each specimen. Standard precautions were applied strictly as control. RESULT: NLV was detected in 40 specimens from 28 patients and staff (20 patients, 8 nurses). Attack rate of the patients were 0.19, nurses were 0.15, and doctors were 0.07. CONCLUSION: The spread of NLV from person to person is considered to be a major infection pathway in each ward. A nurse is at a high risk of infection as a patient in some wards. A stringent policy of control must be applied.