Brit J Hosp Med
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There are many studies on central catheter related thrombosis (CCRT), however, there are significantly fewer studies focusing on the incidence and evolution of CCRT in the adult critical care population. This article reviews data collected from observational studies that have performed bedside duplex ultrasound for surveillance of CCRT and discuss if we should routinely screen for CCRT. ⋯ Nearly all CCRT are designated as asymptomatic (no associated pulmonary embolism (PE) or deep vein thrombosis (DVT)) and no significant changes in mortality rates amongst patients that develop CCRT were reported. Based on the evidence reviewed, we do not recommend screening routinely for CCRT in the adult critical care population.
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An elderly male with type 2 diabetes presented with a 2-month history of otalgia and severe headaches. He was diagnosed with malignant otitis externa (MOE) and was commenced on empirical treatment with oral ciprofloxacin. Pseudomonas is the most common cause of MOE. ⋯ Aspirations from accessible fluid collections, infratemporal fossa needle sample and bone biopsy can provide material for diagnosis. Scedosporium is a rare cause of disease in humans, however, fungal infections are increasing in humans, due to an increase in susceptible populations. Scedosporium apiospermum is a rare cause of SBO and should be considered in patients not responding to standard treatment.
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Case Reports
Listeria monocytogenes: a rare cause of rhomboencephalitis in an immunocompetent patient.
We present an unusual case of Listeria monocytogenes rhomboencephalitis in a young, healthy patient. Although L. monocytogenes meningitis is usually associated with immunodeficiency, rhomboencephalitis is more commonly seen in immunocompetent patients. ⋯ Without prompt pathogen identification and appropriate antibiotic regimen, L. monocytogenes central nervous system infections can be fatal. Cerebro-Spinal Fluid (CSF) Polymerase Chain Reaction (PCR) aided a prompt diagnosis and adjustment of therapy to achieve a good patient outcome.