Aust Fam Physician
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In the last decade, the microbiological cause of cat scratch disease (CSD) has been determined using a combination of traditional culture and modern molecular techniques. A bacterium known as Bartonelia henselae is responsible for the vast majority of cases. The natural history of the disease is being reinterpreted in the light of more sophisticated diagnostic tools. ⋯ Bartonelia henselae is ubiquitous in the domestic feline and causes zoonotic infection in humans. Although this infection is usually self limiting and benign, it may cause more extensive disease in the immunosuppressed. Antibiotic therapy may hasten recovery.
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This is the third in our series of regional nerve blocks. This month specific blocks of the hand are reviewed. The anatomy of the region is revised and the indications for using these blocks is discussed and some pitfalls to be aware of are highlighted. Some practical tips are also provided.
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Sustained nerve trauma is unlikely in a block. Local anaesthetics need time to work--the bigger the nerve the longer they need. ⋯ Very young children and the frail elderly are more susceptible to cardiac toxicity. When used appropriately adrenaline slows the uptake of local anaesthetic into plasma.