The West Virginia medical journal
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Case Reports
Steptococcus bovis meningitis and sepsis associated with Strongyloidiasis in an immunocompetent patient.
We report the case of a 69-year-old female who presented with headache, stiff neck, and decreased level of consciousness. Lumbar puncture results were typical of bacterial meningitis. ⋯ The patient responded to treatment of both infections. She refused to undergo colonoscopy despite a known association between Streptococcus bovis and colonic carcinoma.
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Report cards based on publicly disclosed data abound. Consumers can use the internet to review grades on physicians, hospitals, nursing homes, home health agencies, and insurance plans. The reports differ in their combinations of mortality data, process measures, access scores, and satisfaction surveys. ⋯ Public disclosure of quality data has had little impact on the behavior of consumers, larger purchasers of health care, and physicians. However, health care provider organizations have responded to the public reports of quality. Analysis of the impact of public report cards is lagging as web-available reports rapidly grow and pay for performance programs emerge.
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Twelve cases of pyomyositis treated at a rural tertiary care referral center are reported and compared to other published cases of this disorder in the United States. About 350 cases have been reported nationally and over a quarter of them are in patients infected with human immunodeficiency virus (HIV). ⋯ Imaging studies are conclusive in most cases by the time of presentation. Our series has a predominance of older females, no HIV positive patients and is unique in comparison to previously reported trends and cases.