Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 1998
Review Case ReportsMoraxella catarrhalis bacteraemia. A report on 3 cases and a review of the literature.
Over the last decade, an increase in invasive infections due to Moraxella catarrhalis has been reported. We have analysed 58 cases of bacteraemia due to M. catarrhalis reported in the literature and 3 cases found in Iceland, a total of 61 cases. Patients with bacteraemia could be divided into 3 groups on the basis of host factors. ⋯ The port of entry of the bacteraemia was frequently not elucidated in immunocompromised patients. Patients with a contributory respiratory tract disorder were more likely to develop bacteraemia as a result of a lower respiratory tract infection, whereas bacteraemia in a normal host was more frequently due to an upper respiratory tract infection. The overall prognosis of M. catarrhalis bacteraemia was good, the exception being when it caused endocarditis (5 cases), where mortality rates as high as 80% have been reported.
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Scand. J. Infect. Dis. · Jan 1998
Case ReportsIntramedullary spinal cord abscess associated with cervical spondylodiskitis and epidural abscess.
A 50-year-old man presented a cervical vertebral osteomyelitis and epidural abscess due to Staphylococcus aureus. There were significant changes in the cervical region, as revealed by CT scan and MRI, leading to the diagnosis of associated intramedullary abscess of the spinal cord, which was confirmed by anatomopathological study.
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Scand. J. Infect. Dis. · Jan 1998
Phlebotomus-transmitted toscana virus infections of the central nervous system: a seven-year experience in Tuscany.
Toscana virus (TOSv) is a recently discovered Phlebotomus-transmitted human pathogen involved in acute infections of the central nervous system (CNS) occurring during the summer in natural foci in Italy. The purpose of this prospective study was to investigate the role of this virus in 170 patients with meningitis-meningoencephalitis of suspected viral origin, admitted to the Departments of Infectious Diseases at the Siena Hospital from 1990 to 1996. Infections caused by tick-borne encephalitis virus (TBEv) and TOSv or other neurotropic viruses were routinely diagnosed by means of conventional virological methods. 89 cases were attributed to TOSv, about 10% of which were Europeans on vacation in Tuscany. ⋯ An increase in the number of cases was observed over the years, with a higher incidence among younger people. The clinical picture was similar to that observed in other viral infections of the CNS. Evolution was benign in all cases; in 2 subjects symptoms and signs of encephalitis were present.
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Scand. J. Infect. Dis. · Jan 1998
Case ReportsFatal necrotizing fasciitis caused by a toothpick injury.
Necrotizing fasciitis is a severe life-threatening infection. The portal of entry is usually a site of disruption of the skin barrier. We report a case of fatal necrotizing fasciitis caused by an accidental toothpick injury--a unique injury mechanism not reported this far to cause necrotizing fasciitis. Although toothpick injuries are usually regarded as trivial, it should be kept in mind that they have the potential to cause such a lethal infection.
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Scand. J. Infect. Dis. · Jan 1998
The diagnostic value of gram stain of bronchoalveolar lavage samples in patients with suspected ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is one of the most common causes of morbidity and mortality in intensive care unit patients. However, the diagnosis is quite difficult. Gram stain (GS) of bronchoalveolar lavage (BAL) sample is a time-saving diagnostic method for VAP. ⋯ Accordingly, the sensitivity of BAL-GS for VAP diagnosis was 77%, the specificity 87%, the positive predictive value 71% and the negative predictive value 90%. Our data suggest that BAL-GS has good sensitivity and high specificity for VAP diagnosis. It could therefore constitute a useful complementary tool in the task of early diagnosis and treatment of VAP.