1/5. brucellosis in laboratory workers at a Saudi Arabian hospital.BACKGROUND: saudi arabia is hyperendemic for brucellosis, with more than 8000 cases reported each year to public health authorities. During 1998, brucellosis ranked as the No. 1 reportable communicable disease (22.5%) in Saudi Arabian National Guard communities. King Fahad Hospital is the major referral center for National Guard personnel in the nation's central region.methods And Results: From 1991 to 2000, brucellosis developed in 7 expatriate hospital employees. Six employees were bacteriology technologists, and one was a pathologist. Each had a clinical syndrome compatible with brucellosis (headache, fever, rigors, sweats, and myalgias) plus elevated brucella sp serum agglutinin titers > or = 1:1280; one patient also had positive blood cultures. All patients responded to anti-brucella therapy. Two patients had relapses, and complications occurred in four patients (septic endophlebitis of the leg, infected prosthesis, epididymoorchitis, and lumbar spondylitis). In all these employees except the pathologist, the infection was associated with processing brucella sp cultures. CONCLUSION: Despite the enforcement of stringent infection control measures including the use of a class II biosafety hood in the laboratory, the problem of nosocomial brucellosis persists because of the large number of infected specimens handled by the laboratory (17,500 specimens per year). Ultimately, risk reduction depends on efforts to reduce disease endemicity in the country. In the meantime, conversion of the laboratory to biosafety level 3 is under way.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
2/5. Percutaneous exposure resulting in laboratory-acquired leptospirosis -- a case report.A screw-capped glass tube containing a leptospira culture accidentally broke and the laboratory worker who was handling the tube sustained a cut on his hand. The wound was flooded with the culture. The culture was that of strain MG 347 belonging to serovar Australis recovered from a patient, and it had undergone 52 passages in Ellinghausen McCullough Johnson Harris medium. The laboratory worker developed a headache 21 days after the accident and became febrile the next day. He was hospitalized for 5 days and was treated initially with doxycycline and later with ciprofloxacin. A blood sample collected on the second day of illness, after starting doxycycline therapy, yielded leptospires and the isolate, HZ 651, was identified as serovar Australis. Monoclonal antibody patterns and randomly amplified polymorphic dna fingerprinting patterns of the isolate and strain MG 347 were identical, thus indicating that HZ 651 and MG 347 were clonal.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
3/5. epidemiology of boutonneuse fever in western sicily: accidental laboratory infection with a rickettsial agent isolated from a tick.A case is reported of an accidental laboratory infection with a strain of Spotted Fever-Group Rickettsiae freshly isolated from a tick collected in Western sicily. Inoculation into the left thumb of cell-cultured organisms (10(5)/ml) gave rise to clinical signs and symptoms of boutonneuse fever after six days, i.e., a lesion at the point of inoculation, fever, headache, conjunctivitis and myalgias. Rickettsiae were isolated from acute-phase blood samples collected from the infected individual and IgM and IgG response was detected in the patient's serum by indirect immunofluorescence. Complete recovery was obtained after antibiotic treatment. Serologic analysis of the strain, together with analyses of the proteins of the isolate, documented that the isolate was rickettsia conorii and was identical to prototype strain. The relationship of this infection to ongoing studies on the epidemiology of boutonneuse fever in Western sicily is discussed.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
4/5. Laboratory-acquired chagas disease.A laboratory technician developed fever, malaise, headache and non-tender erythematous swelling proximal to the site of accidental inoculation of his thumb, 24 days earlier, with a needle contaminated with trypanosoma cruzi. Findings included a characteristic rash, remarkable fever, relative bradycardia and leukopaenia--T lymphopaenia with maintenance of a normal helper/suppressor ratio. Trypanosomes were not detected in blood concentrates or in biopsies of an enlarged lymph node and a skin lesion. T. cruzi antibody was first detected 33 days after the laboratory accident, when parasites were first isolated. Therapy with nifurtimox was well tolerated and the patient's serology became negative 9 months after the accident.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
5/5. diagnosis and management of human B virus (Herpesvirus simiae) infections in michigan.Three men who had worked at the same animal research facility and had had contact with macaque monkeys were infected with B virus (Herpesvirus simiae). Their clinical presentations varied from self-limited aseptic meningitis syndrome to fulminant encephalomyelitis and death. Patient 1 was treated only after a respiratory arrest and other signs of advanced brain stem dysfunction had occurred. He died 8 days after hospital admission, despite treatment with acyclovir. Patient 2 presented with subtle signs and symptoms of brain stem encephalitis. He received antiviral therapy with intravenous ganciclovir. Patient 3 had a headache without meningismus and was also treated with acyclovir. Both patients 2 and 3 survived and did not have objective sequelae. Viral culturing, ELISA and western blot antibody testing, and magnetic resonance imaging all proved useful in the diagnosis of these patients' conditions.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |