Scandinavian journal of infectious diseases
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The clinical characteristics, outcome and treatment of non-tuberculous mycobacterial tenosynovitis are reviewed. From lesions localized in the hand, 10 different species of non-tuberculous mycobacteria have been reported. The most common are Mycobacterium marinum and Mycobacterium kansasii. ⋯ Surgical debridement and appropriate mycobacterial cultures are critical to enable diagnosis and appropriate management. Specimens should be inoculated on a range of media and incubated at a range of temperatures in order to isolate mycobacteria with different growth characteristics (with prolonged incubation). The optimal treatment of these infections is discussed.
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Scand. J. Infect. Dis. · Jan 1999
Impact and pattern of gram-negative bacteraemia during 6 y at a large university hospital.
In order to characterize the impact and pattern of Gram-negative bacteraemia (GNB) at a Swiss University hospital and to assess the effect of multi-resistance on mortality, we conducted a 6-y retrospective cohort study using linear regression and multivariate Cox-proportional hazard analysis. 1766 patients had 1835 episodes of GNB; 61% were community-acquired. The incidence of GNB increased linearly (r2 = 0.90, p = 0.014) from 7.07 episodes to 8.32 episodes per 1000 admissions, but this trend was no longer significant after adjustment for the number of blood cultures drawn/y. The in-hospital mortality for patients with GNB decreased from 20% in 1989 to 16% in 1994 (r2 = 0.94, p = 0.005). ⋯ Multi-resistance was not associated with an increased risk of death (HR 1.0). Although the crude mortality of GNB decreased, the population-attributable risk ratio for death remained significant. These data suggest the absence of a major impact of multi-resistant GNB on patient mortality.
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Scand. J. Infect. Dis. · Jan 1999
Case ReportsAfrican tick-bite fever imported into Norway: presentation of 8 cases.
We report on 8 Norwegian travellers to Southern Africa with African tick-bite fever (ATBF), a recently described spotted fever group rickettsiosis. All patients had acute flu-like symptoms and developed I or multiple inoculation eschars. The patients were treated with either doxycycline or ciprofloxacin, and all recovered. The diagnosis of ATBF was confirmed by the detection of specific IgM antibodies to Rickettsia africae by microimmunofluoroscence in convalescent-phase serum samples.
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Scand. J. Infect. Dis. · Jan 1999
Case ReportsPrimary sternal osteomyelitis and septicaemia due to Staphylococcus aureus.
Primary sternal osteomyelitis is rare in these recent decades. Only scattered cases have been reported, most of them in intravenous drug users. ⋯ The only predisposing factor was radiotherapy for a malignant tumour of the right mammary gland 20 y ago. Diagnostic evaluation and therapeutic management are briefly discussed.