Hematogenous osteomyelitis mimicking osteosarcoma due to Community Associated Methicillin-Resistant Staphylococcus aureus.

Community Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen with increasing clinical significance. Initially recognized as a cause of skin and soft tissue infections, it has soon been shown to cause life threatening illnesses. We describe two cases of osteomyelitis of the femur in young otherwise healthy adults. Initially a preliminary diagnosis of osteosarcoma was suggested by radiologic studies and both patients underwent an excisional biopsy. Following identification of the pathogen as CA-MRSA (Panton-Valentine leukocidin positive USA300 clone), both patients were successfully treated with prolonged courses of vancomycin.

Viral hemorrhagic fever in Pakistan: awareness among health care personnel.

OBJECTIVE: To assess the level of knowledge regarding viral hemorrhagic fever (VHF) among healthcare personnel at two largest tertiary care hospitals in Karachi, Pakistan. METHODS: A cross sectional convenience survey was conducted in February 2001 among doctors, nurses, laboratory technicians and janitors/orderlies of Jinnah Postgraduate Medical Centre and Civil Hospital, Karachi. The questionnaire included demographic information with their designation and knowledge level regarding VHF management, spread and prevention. Frequencies of the answers to each question were calculated for all questions and scores were assigned. The frequencies were also calculated on the basis of the designation of the respondent so that each group could be examined separately. RESULTS: A total of 187 healthcare personnel (121 doctors, 31 nurses, 19 laboratory technicians and 16 janitors/orderlies) were interviewed. Forty three percent (81) respondents were males and 57% (106) were females. By designation 90% doctors, 71% nurses, 32% laboratory technicians and 6% janitors knew about VHF. Only 57% doctors (69) knew the common signs and symptoms of VHF. Isolation for affected patients was suggested by 65% nurses and 6% janitors. Knowledge regarding burial procedure of dead patients was low in all groups. CONCLUSION: Differences in knowledge of different groups is obvious but it is essential to raise the knowledge regarding VHF at all levels including the housekeeping staff. There is also a need for continuing medical education (CME) for all health care personnel for the emerging health problems in Pakistan.