Mycobacterium Avium Arthritis with Extra-articular Abscess in a Patient with Mixed Connective Tissue Disease

A case of Mycobacterium avium arthritis in a 39-year-old female patient with mixed connective tissue disease (MCTD) was reported. An extra-articular abscess had formed outside the knee joint and extended down the calf. A culture was taken of the abscess and synovial fluid disclosed Mycobacteriun avium. This was resistant to most anti-tuberculosis agents. A combination of anti-tuberculosis drugs followed a total resection of the abscess. We concluded that M avium septic arthritis could insidiously develop into an extra-articular abscess. A combination of anti-tuberculosis drugs with a total resection of the abscess was an effective treatment.

Nutrition Care of Diet - refusal Patients having Difficulties in Adapting to Hospital Diet

The purpose of this study was to produce proper nutrition and foodservice through positive intervention for diet-refusal patients who has difficulties in adaptation to hospital diet, and to contribute to hospital management with the focus of fast recovery. The survey was conducted using questionnaires between July 18 and August 17, 2000. The subjects were consisted of 24 diet-refusal patients who were hospitalized in St. Mary's Hospital except the patients hospitalized for the purpose of operation or pre-therapy tests. Also chart reviews were conducted. The statistical analysis of data was done by SAS/win 6.11 package to determine descriptive analysis and paired t-test and Pearson's correlation. The summary of study results is as follows : 1. Most of the subjects was receiving chemotherapy. The leading place for offering private food was from patient's home. Subjects worried about delayed recovery from illness due to nutritional problems caused by extreme fasting. The problems were in order of anorexia, nausea and vomiting during therapy process. 52.4% of subjects ate hospital diet after positive intervention. 2. Major reasons of hospital diet-refusal patients' dissatisfation were in order of expeness, dissatisfation, serum total protein levels were significantly lower(p<.05). 3. Serum Alb(p<.05), Hb(p<.05), Hct(p<.05) and TLC(p<.001) levels showed significantly negative correlations with fasting duration. With these results, it is concluded that a major cause of malnutrition among patients is to last fasting.