1/37. Fatal encephalitis due to nipah virus among pig-farmers in malaysia.BACKGROUND: Between February and April, 1999, an outbreak of viral encephalitis occurred among pig-farmers in malaysia. We report findings for the first three patients who died. methods: Samples of tissue were taken at necropsy. Blood and cerebrospinal-fluid (CSF) samples taken before death were cultured for viruses, and tested for antibodies to viruses. FINDINGS: The three pig-farmers presented with fever, headache, and altered level of consciousness. myoclonus was present in two patients. There were signs of brainstem dysfunction with hypertension and tachycardia. Rapid deterioration led to irreversible hypotension and death. A virus causing syncytial formation of vero cells was cultured from the CSF of two patients after 5 days; the virus stained positively with antibodies against hendra virus by indirect immunofluorescence. IgM capture ELISA showed that all three patients had IgM antibodies in CSF against Hendra viral antigens. Necropsy showed widespread microinfarction in the central nervous system and other organs resulting from vasculitis-induced thrombosis. There was no clinical evidence of pulmonary involvement. inclusion bodies likely to be of viral origin were noted in neurons near vasculitic blood vessels. INTERPRETATION: The causative agent was a previously undescribed paramyxovirus related to the hendra virus. Close contact with infected pigs may be the source of the viral transmission. Clinically and epidemiologically the infection is distinct from infection by the hendra virus. We propose that this Hendra-like virus was the cause of the outbreak of encephalitis in malaysia.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/37. Potential errors in recognition of erysipelothrix rhusiopathiae.Here we describe four isolations of erysipelothrix rhusiopathiae associated with polyarthralgia and renal failure, septic arthritis, classic erysipeloid, and peritonitis. Although the biochemical identification was straightforward in each case, recognition presented a challenge to the clinical microbiologist, since in three cases E. rhusiopathiae was not initially considered due to unusual clinical presentations, in two cases the significance might not have been appreciated because growth was in broth only, and in one case the infection was thought to be polymicrobic. Because the Gram stain can be confusing, abbreviated identification schemes that do not include testing for H(2)S production could allow E. rhusiopathiae isolates to be misidentified as lactobacillus spp. or enterococcus spp. in atypical infections.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
3/37. Cutaneous manifestations in brucellosis: case report and review of the literature.brucellosis is a classical common zoonotic disease of worldwide distribution. skin complications are infrequent and affect less than 5% of patients with brucellosis, although they may occasionally occur during the clinical course of the disease. Here, we report a case of a shepherd presenting with fever and a diffuse maculopapular rash due to brucella melitensis infection, and we provide a review of the relevant literature.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
4/37. Primary cutaneous coccidioidomycosis in agricultural workers.Each of two Filipino agricultural workers experienced coccidioidal infection, characterized by a solitary skin lesion, by regional lymphadenopathy, and by a benign clinical course, without evidence of involvement of the lungs or other viscera. It is believed that these are cases of primary cutaneous coccidioidomycosis incurred under "natural" conditions. A similar interpretation seems acceptable for at least six other reported cases.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
5/37. Third report of ocular parastrongyliasis (angiostrongyliasis) from sri lanka.A further case of ocular parastrongyliasis has been seen in a patient from sri lanka. As it is a juvenile female worm it could not be identified to the species, but it is probably Parastrongylus (= angiostrongylus) cantonensis which is the commonly reported species in the country. This is the third authentic case of such an infection in sri lanka in recent years.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
6/37. Cutaneous protothecosis: report of five cases.prototheca, a genus of achlorophyllic algae, is a rare cause of opportunistic infection in humans. About 80 human cases, mostly cutaneous infection caused by P. wickerhamii, have been reported world-wide. We describe the clinicopathological findings and treatments of five cases diagnosed in our department during the period 1991-97. The patients, including four elderly farmers, presented with pyoderma-like lesions or infiltrating papules and plaques on the extensor side of the extremities or face. All patients were immunocompromised, mostly due to systemic or topical steroids. The diagnosis was made in each case by finding typical endospores with morula-like structures in skin biopsy specimens. P. wickerhamii was isolated in four cases in which pretreatment culture of skin tissue was done. Except for one patient who died of asthma, the infection was cured after 2-7 weeks of amphotericin b, ketoconazole, itraconazole or fluconazole. Our cases illustrate that cutaneous protothecosis commonly manifested non-tender, pyoderma-like or infiltrating lesions and should be considered in the differential diagnosis of deep fungal or mycobacterial infection. This rare infection seemed more frequent in our region, possibly due in part to common steroid abuse among old people in taiwan and there was a large population of elderly farmers in our area.- - - - - - - - - - ranking = 2.5keywords = infection (Clic here for more details about this article) |
7/37. Pseudo-outbreak of tuberculosis in poultry plant workers, Sussex County, delaware.delaware is a leading US poultry-producing state, and foreign-born workers make up a significant percentage of those employed by delaware's poultry plants. In Sussex County, delaware, a high percentage of the poultry workers are from two countries with a high incidence of tuberculosis (TB), mexico and guatemala, and thus are at risk for TB infection and disease. Furthermore, their risk of TB may be increased because many of these workers live in crowded conditions and lack access to medical care.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
8/37. Human infection by a swine influenza A (H1N1) virus in switzerland.The isolation of A/switzerland/8808/2002 provides further evidence of sporadic human infection by contemporary swine influenza A H1N1 viruses, antigenically and genetically distinct from H1N1 viruses circulating in the human population. Together with the recent emergence of human-swine-avian reassortant viruses in pig populations in europe and north america, frequent transmission between swine and human populations emphasises the potential for the emergence in pigs of novel subtypes with the capacity to cause major human epidemics.- - - - - - - - - - ranking = 2.5keywords = infection (Clic here for more details about this article) |
9/37. A case of primary tularemic pneumonia presenting with necrotizing mediastinal and hilar lymph nodes.tularemia is an unusual disease caused by the gram-negative coccobacillus francisella tularensis. The clinical features of the disease depend on the route of inoculation. Ulceroglandular and typhoidal forms have been recognized as occurring in tularemia, however primary or secondary pneumonic infections have also been reported. Symptoms, laboratory markers and radiological features are non-specific in tularemic pneumonia. diagnosis is made on clinical grounds and evidence of elevated agglutinating antibodies to F. tularensis (> 1:128). We report a case of primary tularemic pneumonia presenting with pulmonary infiltrates and necrotizing mediastinal and hilar lymph nodes in an otherwise healthy subject from a non-endemic area. diagnosis of tularemia was obtained serologically, and antibiotic therapy with doxycycline and streptomycin resolved symptoms and radiological abnormalities. We suggest that tularemia should be considered in the differential diagnosis of pneumonia with mediastinal and/or hilar lymphadenopathy.- - - - - - - - - - ranking = 0.5keywords = infection (Clic here for more details about this article) |
10/37. erysipelothrix rhusiopathiae endocarditis: a preventable zoonosis?BACKGROUND: erysipelothrix rhusiopathiae is a bacterium ubiquitous in the environment. It can cause a variety of diseases and the risk of infection is closely related to the level of occupational exposure to infected or colonised animals. AIMS: To discuss the clinical features and treatment of this zoonosis, to increase awareness of this pathogen and to emphasise the need for meticulous attention to hygienic work practices in reducing the risk of infection. METHOD: A case report of a farmer with E. rhusiopathiae endocarditis and the management of the infection. RESULTS: The patient was successfully treated with valve replacement surgery and antimicrobial therapy. CONCLUSIONS: Early identification of this microorganism is essential for appropriate treatment of endocarditis. Greater awareness and safe work practices can help reduce the risk of human infection by this microorganism.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
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