[Non-tropical pyomyositis in Germany]. / Nichttropische Pyomyositis in Deutschland.

Haematogenous primary pyomyositis predominantly caused by staphylococcus aureus is a well-known entity in tropical regions. It is sporadicly observed in non-tropical areas. Lack of clinical familiarity not seldom contributes to delayed recognition of pyomyositis in the suppurative or complicated state. Initially, healing usually can be achieved by antibiotic treatment adjusted by antibiotic treatment adjusted to pyogenic staphylococci. Late stages require concomitant surgical or transcutaneous drainages of pus. In addition, treatment for osteomyelitis or bacterial carditis as typical complications may be necessary. The review of pyomyositis is illustrated by three case-reports from Germany.

[Acute interstitial nephritis following piperacillin]. / Akute interstitielle Nephritis nach Piperacillin.

A 75-year-old woman developed fever, exanthema and nonoliguric renal failure 16 days after the beginning of Piperacillin treatment. Renal biopsy revealed lympho-plasma-cellular acute interstitial nephritis (AIN). A lymphocyte-transformation-test showed significant stimulation of patient's lymphocytes by Piperacillin. Corticosteroid-therapy correlated to clinical and renal improvement. Nevertheless the patient died of foudroyant septicemia caused by E. coli. Our report describes the first immunologically documented case of AIN following Piperacillin treatment.

[A rare cause of infection in chronic dialysis patients: Malta fever (febris undulans melitensis)]. / Seltene Sepsisursache bei chronischem Dialysepatienten: Maltafieber (Febris undulans melitensis).

A 45-years-old Greek patient developed septicaemia in his 10th year of hemodialysis treatment. Clinical investigation was directed first on bacterial infection of the arteriovenous shunt, on urosepsis or bronchopulmonary infection. Then, serologically (Widal's reaction and ELISA-test) and in different blood-cultures Brucella melitensis was detected as causative agent for Malta fever (Febris undulans). The focus of infection is suspected in unpasteurized sheep-milk cheese of mediterranean origine, wherein Brucella species can survive for months. The patient was treated effectively by a combination of amoxycilline and clavulanic acid.

[Gallbladder tuberculosis. Review and case report of a patient with advanced renal failure]. / Gallenblasentuberkulose. Ubersicht und Kasuistik eines Patienten mit fortgeschrittener Niereninsuffizienz.

Tuberculosis of the gallbladder is a rare disease, which mostly is diagnosed by histological examination after cholecystectomy. Less than 60 cases are published. Four different manifestations are described by Weitz: The gallbladder infection by miliary tuberculosis in children or in adults, the disseminated abdominal tuberculosis including the biliary tract or the isolated infection of the gallbladder. Our case report outlines the progress of an isolated tuberculosis of the gallbladder wall in a patient with chronic renal failure. The uremic immunological anergy may have favoured the infection.

[Right bundle-branch block configuration in the pacemaker ECG--3 different observations]. / Rechtsschenkelblock-Konfiguration im Schrittmacher-EKG--3 unterschiedliche Beobachtungen.

We report on 3 cases of right bundle branch block configuration in the ECG after pacemaker implantation. In case 1 it was not noticed that the catheter had been directed through an unknown sinus venosus defect into the left atrium and the left ventricle. In case 2 the catheter reached the left ventricle via an iatrogenic perforation of the lower part of the atrial septum. In case 3 the catheter was situated correctly in the right ventricle, but the tip was penetrating the septum. Different possibilities of interpretation of this phenomenon are discussed, and a description of further pacemaker catheter misplacements which may be responsible for a right bundle branch block configuration is given. The authors take the view that a pacemaker catheter should not remain in the arterial area, in the pericardial space and in the coronary sinus. A lateral radiograph, a 12-lead ECG and an echocardiographic study are helpful for detecting and interpreting an unusual catheter position or a right bundle branch block configuration in the pacemaker ECG.

[Familial occurrence of cardiac myxomas]. / Familiäre Häufung von kardialen Myxomen.

A report is given on the occurrence of left atrial myxoma in both mother and daughter. A successful operation for a local recurrence was performed on the mother 4 years later. Sudden death of unknown cause occurred at young age in other siblings and was accompanied in one by arterial embolism, suggesting an even higher incidence. The potential accumulation of cardiac myxomas in a family was confirmed by a literature survey of 8 "myxoma families". Observation of these cases calls for the following Careful surgical excision because of the danger of a local recurrence. Echocardiographic follow-up for at least 5 years. Investigation of relatives.

[Relationship between frequency components of phonocardiography, vectorcardiography parameters and anatomic data]. / Untersuchung von Zusammenhängen zwischen Frequenz-komponenten des Phonokardiogramms, VKG-Parametern und anatomischen Daten

Regarding heart volume, fundamental frequency of the first and second part of first heart sound (SI), vectorcardiographic parameters and constitutional data, the formerly found strong correlation between fundamental frequency of the first part of SI and heart volume was re-established. Heart volume guess got even better utilizing certain VCG-parameters, whereas constitutional measurement data gave no further approach. Correlations between VCG-data and fundamental frequencies of both parts of SI are referred to.