[An unusual course of thoracic actinomycosis]. / Ungewöhnlicher Verlauf einer thorakalen Aktinomykose.

A 56-year-old farmer who had been suffering from exogenous allergic alveolitis developed, after a long prodromal period of illness, a granulocyte-rich pericardial effusion and bilateral pleural effusions in which Actinomyces aggregates were identified. Despite intensive treatment with clindamycin, erythromycin and tetracycline (he was allergic to penicillin) he died in septic shock.

Occupational asthma in a national disability survey.

The contribution of workplace exposures to the prevalence of asthma in adults has been minimized in the epidemiology of this illness. Analysis of the 1978 Social Security Disability Survey provides a population-based assessment as a novel approach utilizing self-attributed, occupationally related asthma as a measure of disease. Of 6,063 respondents, 468 (7.7 percent) identified asthma as a personal medical condition; 72 (1.2 percent [15.4 percent of all those with asthma]) attributed it to workplace exposures. These subjects were older and included more men and cigarette smokers than groups of both asthmatic and nonasthmatic subjects. The relative risk for occupationally attributed asthma was elevated among industrial and agricultural workers as compared with white collar and service occupations. Analysis of disability benefit status did not indicate that this introduced major reporting bias in this survey. This study suggests that occupational factors may have a greater role in adult asthma than previously thought.

Leptospira hebdomadis associated with an outbreak of illness in workers on a farm in North Yorkshire.

Four cases of illness attributed to Leptospira hebdomadis occurred on a cattle farm in North Yorkshire. The clinical features were a febrile illness that resembled influenza; in one case there was a lymphocytic meningitis. This infection is probably more common than is recognised at present, and prevention of further cases may be possible if diagnosed promptly.