Scandinavian journal of infectious diseases
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Scand. J. Infect. Dis. · Jan 2006
Review Case ReportsSpondylodiscitis due to Bacteroides fragilis: two cases and review.
Non-iatrogenic spondylodiscitis caused by anaerobic bacteria remains exceptional. We describe 2 cases of spondylodiscitis with epidural abscess due to Bacteroides fragilis, 1 after colonoscopy with biopsy and 1 in a cirrhotic patient. The clinical and imaging findings were not discriminant relative to other pyogenic spondylodiscitis. One should consider B. fragilis when treating a spondylodiscitis with epidural abscess, especially in patients with a possibly digestive portal of entry.
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Scand. J. Infect. Dis. · Jan 2006
Matrix-metalloproteinases and their inhibitors are elevated in severe sepsis: prognostic value of TIMP-1 in severe sepsis.
The enzyme group of matrix metalloproteinases (MMPs) and their inhibitors, so-called tissue inhibitors of matrix-metalloproteinases (TIMPs), are crucial mediators responsible for wound repair after parenchymal damage. Little is known about the role of MMPs and TIMPs in severe sepsis. The aim of the present study was therefore to investigate their levels in patients with severe sepsis and to examine their association with prognosis. ⋯ Septic patients with TIMP-1 values >3200 ng/ml were 4.5 times more likely to die than patients with lower values (RR = 4.5; 95% CI 1.14-17.6, p = 0.014). Our results indicate that MMP-9, TIMP-2 and TIMP-1 are elevated in severe sepsis. Furthermore, TIMP-1 may serve as a useful laboratory marker to predict the clinical outcome of patients presenting with severe sepsis.
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Various doses of the combined MMR vaccine containing the Rubini mumps strain were distributed in Catalonia in 1994 and 1995. We studied outbreaks of mumps reported from 1997 to 2002 to determine the possible involvement of this vaccine in the appearance of non-preventable mumps outbreaks. ⋯ Of these, 10 were non-preventable outbreaks. 66% of cases investigated had ages which coincided with vaccination in the period 1994-1996, during which the MMR vaccine containing the Rubini mumps strain was administered. In Catalonia, during the period 1997-2000, at least two-thirds of mumps cases in schoolchildren could be explained by vaccination with the combined MMR vaccine containing the Rubini strain, which has also been associated with mumps outbreaks amongst vaccinated people in other countries.
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Scand. J. Infect. Dis. · Jan 2006
Case ReportsSpondylodiscitis after facet joint steroid injection: a case report and review of the literature.
Spondylodiscitis is a rare complication after facet joint steroid injection. This article presents a 78-y-old male with chronic back pain and facet joint arthritis who developed Pseudomonas aeruginosa L2-L3 and L3-L4 spondylodiscitis after computed tomography-guided facet joint steroid injection. Magnetic resonance imaging, fine needle aspiration and cultures confirmed the diagnosis. ⋯ Sterile preparation prior to facet joint steroid injection should be stressed. To the best of our knowledge, this is the only reported case of iatrogenic spondylodiscitis after facet joint steroid injection. This iatrogenic complication should be considered in the risk-benefit analysis of facet joint diagnostic or therapeutic injections.
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Scand. J. Infect. Dis. · Jan 2006
Review Case ReportsFulminant varicella hepatitis in a human immunodeficiency virus infected patient: case report and review of the literature.
We report the case of a 35-y-old HIV-infected female, who presented fulminant varicella hepatitis and recovered under medical treatment. Varicella zoster virus is an uncommon cause of acute liver disease which occurs mainly in immunocompromised patients. Acyclovir is the cornerstone of the treatment.