Harefuah
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The diagnostic approach to sore throat and its treatment by 7 doctors was studied in 692 community clinic patients. Redness of the throat, the commonest clinical feature in all age groups, was present in 88%. The prevalence of other clinical findings varied in the different age groups. 54% of the patients, most of whom were less than 13 years old, were treated initially with antibiotics. ⋯ From 11 (13%) of the throat cultures taken from children under the age of 4, beta hemolytic streptococci (BHS) were grown. Based on throat cultures, antibiotics had been given unnecessarily in 53% of those in whom it was initially prescribed, and wrongly withheld in 10% of those who initially did not receive them. This study reveals an urgent need for a rapid and accurate method of detecting BHS in patients with sore throat.
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Aortic dissecting aneurysm is a rare, serious complication of pregnancy. This condition was diagnosed in a 34-year-old woman in the 38th week of pregnancy. Cesarean section was immediately performed, and was followed by surgical repair of the dissection. A normal male infant was delivered.
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Patients with systemic lupus erythematosus (SLE) are prone to develop opportunistic infections. Nevertheless, arthritis due to Pseudomonas aeruginosa in SLE is very rare and seems to be related to corticosteroid therapy and previous penetrating injury. A 17-year-old girl with SLE and Pseudomonas arthritis and discitis which followed laparotomy is described. Arthritis is a common manifestation of SLE, but arthritis due to infection with Pseudomonas is very serious and the diagnosis should not be missed.