The Journal of infection
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The Journal of infection · Nov 1993
Comment Letter Case ReportsAtypical presentation of a patient with meningococcaemia.
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The Journal of infection · Sep 1993
Case ReportsPhialophora richardsiae endocarditis of aortic and mitral valves in a diabetic man with a porcine mitral valve.
We report a case of Phialophora richardsiae endocarditis involving the aortic and a porcine mitral valve in a 52-year-old non-insulin dependent diabetic. Mitral valve replacement had been performed 4 years earlier. We believe this to be the first case of Phialophora richardsiae endocarditis to be reported.
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Cerebrospinal fluid (CSF) lactate values were measured in 26 children with meningitis (12 bacterial, 9 aseptic, 5 partially treated) and five children with meningococcaemia without meningitis. A reference range (0.5-3.2 mmol/l) was established from 100 control children. Amounts of lactate were significantly raised in bacterial meningitis (mean 6.5, range 4.5-10.2) compared with aseptic meningitis (mean 2.6, range 1.1-4.0) but this finding gave little practical help as the bacterial origin of the meningitis was clear from other CSF findings. ⋯ Unless the CSF lactate is raised, the test is of minimal value in partially treated meningitis (mean 3.4, range 1.4-6.2). The previously unobserved finding of increased CSF lactate in meningococcaemia without meningitis (mean 3.9, range 3.1-5.0) supports the view that raised CSF lactate values in bacterial meningitis are not solely due to the presence of neutrophils. Literature relating to CSF lactate is reviewed.
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Two cases of infection due to Corynebacterium minutissimum are described. On the basis of biochemical tests the organisms were thought at first to be Corynebacterium jeikeium. Methods of distinguishing between these species and the role of C. minutissimum in the pathogenesis of erythrasma and other skin infections are discussed.