Traumatic Pneumocephalus Without Skull Fracture From a High-Voltage Electrical Injury.

Pneumocephalus, the presence of intracranial air, most commonly occurs secondary to a traumatic injury. Patients with simple pneumocephalus often present with nonspecific symptoms or with headaches. These patients may have little to no clinically relevant physical examination findings and can be managed conservatively. Tension pneumocephalus can present more acutely as a neurosurgical emergency. On physical examination, patients can present with neurologic deficits or papilledema. Computed tomography is the imaging modality of choice to detect intracranial air. We present a novel case of a simple pneumocephalus in the setting of a high-voltage electrical injury without evidence of displaced skull fracture or dural violation. The identification of unanticipated air within the cranial vault should prompt emergency physicians to determine its etiology which can guide treatment and disposition.

Prevalence of Salmonella and Campylobacter in beef cattle from transport to slaughter.

The objective of this study was to evaluate the effect of typical production practices during the transport of cattle on the resulting incidence of Salmonella and Campylobacter in the feces, on the hides, and on the carcasses of these cattle and in the environment (trucks, holding pens, and knock boxes). Various factors were evaluated, including the type of animal (feedlot cattle vs. adult pasture cattle), the breed of cattle, the body condition of the animal, the age of the animal, the time of feed and water withdrawal, the contamination level of the transport vehicle at the feedlot or farm, the transport time, the time cattle were held in the holding pen at the plant, and the contamination level of the holding pen. Four groups of each type of animal were sampled on different days. Samples were collected from cattle prior to transport and after transport (rectal and hide swabs) as well as from the carcasses of these cattle. Pre- and posttransit samples were also taken from the transport vehicle and from the holding pen and knock box at the slaughter facility. For feedlot cattle, fecal shedding stayed fairly constant for both organisms before and after transport (3 to 5% for Salmonella and 64 to 68% for Campylobacter). However, the shedding rate for adult cattle increased from 1 to 21% for Salmonella but stayed constant for Campylobacter (6 to 7%). Contamination of hides with Salmonella increased for both animal types from a level of 18 to 20% to a level 50 to 56%. For Campylobacter, the contamination level decreased from 25 to 13% for feedlot cattle but remained unchanged for adult animals (1 to 2%). Nineteen percent of feedlot cattle carcasses and 54% of adult cattle carcasses tested positive for Salmonella, while only2% of feedlot cattle carcasses and none of the adult cattle carcasses tested positive for Campylobacter. Thus, for feedlot cattle, the factors considered in this study did not affect the shedding of either organism but did affect the contamination of hides with both. For adult animals, the factors increased both shedding of and hide contamination with Salmonella only, not Campylobacter.

Serotyping and antibiotic resistance profiling of Salmonella in feedlot and nonfeedlot beef cattle.

As part of a larger study to assess risk factors associated with hide and carcass contamination of beef cattle during transport to slaughter, a total of 281 salmonellae were isolated from 1,050 rectal, hide, carcass, and environmental samples. For feedlot cattle, salmonellae were recovered from 4.0% of rectal samples, 37.5% of hide samples, 19.0% of carcass samples, and 47.4% of environmental samples. For nonfeedlot cattle, salmonellae were recovered from 10.9% of rectal samples, 37.5% of hide samples, 54.2% of carcass samples, and 50.0% of environmental samples. Overall, the five serotypes most commonly associated with feedlot cattle and their environment were Salmonella Anatum (18.3% of the isolates), Salmonella Kentucky (17.5%), Salmonella Montevideo (9.2%), Salmonella Senftenberg (8.3%), and Salmonella Mbandaka (7.5%). The five serotypes most commonly associated with nonfeedlot cattle and their environment were Salmonella Kentucky (35.4%), Salmonella Montevideo (21.7%). Salmonella Cerro (7.5%), Salmonella Anatum (6.8%), and Salmonella Mbandaka (5.0%). Antimicrobial susceptibility testing of all of the isolates associated with feedlot cattle revealed that 21.7% were resistant to tetracycline, compared with 11.2% of the isolates associated with nonfeedlot cattle. None of the other isolates from feedlot cattle were resistant to any of other antimicrobial agents tested, whereas 6.2% of nonfeedlot cattle isolates were resistant to more than four of the antimicrobial agents tested.