ABSTRACT
Osler advised physicians to "learn to see." Visual intelligence, an ability to look carefully, to be attentive to the visible information in one's environment, and to articulate that information to others, is a skill that can be learned. Being a skilled observer, seeing the world the way an artist might see it, can make one into a more skilled physician.
Subject(s)
Communication , Observation , Physicians/psychology , HumansABSTRACT
Cutaneous infections due to Listeria monocytogenes are rare. Typically, infections manifest as nonpainful, nonpruritic, self-limited, localized, papulopustular or vesiculopustular eruptions in healthy persons. Most cases follow direct inoculation of the skin in veterinarians or farmers who have exposure to animal products of conception. Less commonly, skin lesions may arise from hematogenous dissemination in compromised hosts with invasive disease. Here, we report the first case in a gardener that occurred following exposure to soil and vegetation.
Subject(s)
Listeria monocytogenes/isolation & purification , Listeriosis/diagnosis , Listeriosis/pathology , Skin Diseases, Bacterial/diagnosis , Skin Diseases, Bacterial/pathology , Adult , Aged , Female , Humans , Listeriosis/microbiology , Male , Middle Aged , Occupational Exposure , Skin Diseases, Bacterial/microbiologyABSTRACT
The vast microbiota in the human body is dominated by anaerobic gram-negative rods. The five recent publications reviewed here demonstrate important roles for Bacteroides species and other anaerobic bacteria both in the production of illness and the maintenance of health.
Subject(s)
Bacteria, Anaerobic/physiology , Bacteria, Anaerobic/pathogenicity , Bacterial Infections/microbiology , Bacterial Infections/pathology , Gastrointestinal Tract/microbiology , Gastrointestinal Tract/physiology , Bacteria, Anaerobic/classification , Bacteria, Anaerobic/isolation & purification , HumansABSTRACT
It has been known for a long time that many patients experience diarrhea antecedent to the development of bacteremia or meningoencephalitis due to Listeria monocytogenes, but it was only recently that convincing evidence was obtained that this organism can cause acute, self-limited, febrile gastroenteritis in healthy persons. At least 7 outbreaks of foodborne gastroenteritis due to L. monocytogenes have been reported. Illness typically occurs 24 h after ingestion of a large inoculum of bacteria and usually lasts 2 days. Common symptoms include fever, watery diarrhea, nausea, headache, and pains in joints and muscles. L. monocytogenes should be considered to be a possible etiology in outbreaks of febrile gastroenteritis when routine cultures fail to yield a pathogen.
Subject(s)
Gastroenteritis/complications , Gastroenteritis/microbiology , Listeria monocytogenes , Listeriosis/complications , Disease Outbreaks , Gastroenteritis/drug therapy , Gastroenteritis/epidemiology , Humans , Listeriosis/diagnosis , Listeriosis/epidemiologySubject(s)
Anti-Infective Agents/administration & dosage , Listeria monocytogenes/drug effects , Meningitis, Listeria/drug therapy , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosage , Administration, Oral , Female , Humans , Infusions, Intravenous , Middle Aged , Treatment OutcomeSubject(s)
Aminoglycosides/therapeutic use , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Endocarditis, Bacterial/drug therapy , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/drug therapy , Bacteremia/microbiology , Endocarditis, Bacterial/microbiology , Humans , Lipoglycopeptides , Staphylococcal Infections/microbiology , Treatment OutcomeABSTRACT
The relationship between dogs and humans is ancient and mutually beneficial. Dogs have served people well as companions, workmates, guides, and protectors. However, on occasion, dogs may injure humans through biting or may transmit pathogens resulting in a large number of problems ranging from a trivial rash to life-threatening bacteremia. Given that there are more than 80 million pet dogs in the United States, it is worth knowing the potential problems that can result from canine exposure. Annually, almost 5 million people in the United States suffer a dog bite. Dog bite wounds become infected up to 15% of the time. In those who have had a splenectomy, a dog bite may transmit the bacterium Capnocytophaga canimorsus, leading to life-threatening bacteremia. Other illnesses that humans can acquire from dog contact include ringworm, diarrheal disease (salmonellosis, campylobacteriosis, and intestinal parasites), leptospirosis, brucellosis, Q fever, visceral larva migrans, and echinococcosis. Evidence exists that the family dog may serve as a reservoir for uropathogenic Escherichia coli that can lead to urinary tract infections among human household contacts. In this article we discuss dog-related infectious diseases as well as measures to minimize dog-associated illness (e.g., do not disturb sleeping dogs; HIV-infected persons who wish to acquire a puppy should have the dog's stool checked for Cryptosporidium).
Subject(s)
Bacterial Infections/transmission , Parasitic Diseases/transmission , Zoonoses/transmission , Animals , Bacterial Infections/microbiology , Dog Diseases/microbiology , Dog Diseases/parasitology , Dogs , Humans , Parasitic Diseases/parasitology , PetsABSTRACT
The foodborne pathogen Listeria monocytogenes has a particular tropism for the central nervous system and can produce infection in the meninges and brain substance. Well-recognized clinical syndromes include meningitis, brain abscess, rhombencephalitis, and spinal cord abscess; simultaneous infection of the meninges and brain is common. Although it is an uncommon cause of infection in the population at large, L. monocytogenes is an important cause of central nervous system infection in those with impaired cell-mediated immunity, whether due to underlying disease or treatment with immunosuppressive therapeutic agents; it is the etiology in 20% of bacterial meningitis cases in neonates and in 20% of cases in those older than 50 years. Ampicillin is considered the treatment of choice, and trimethoprim-sulfamethoxazole is recommended for those allergic to penicillin. At-risk patients should be advised to avoid unpasteurized milk and soft cheeses along with deli-style, ready-to-eat prepared meats, particularly poultry products.
ABSTRACT
BACKGROUND: We describe a case and review ten other instances of group B streptococcal endocarditis in the setting of obstetric and gynecologic practice reported since the last review in 1985. CASE: Abortion remains a common antecedent event, but in contrast to earlier reports, most patients did not have underlying valvular disease, the tricuspid valve was most often involved, and mortality was low. Patients with tricuspid valve infection tended to have a subacute course, whereas those with aortic or mitral involvement typically had a more acute, fulminant course. CONCLUSION: Despite an improvement in mortality, morbidity remains high, with 8 of 11 patients having clinically significant emboli.