RESUMEN
We describe a norovirus outbreak in an acute adult psychiatric area in a tertiary care hospital. Containment of the outbreak was challenging because of the patients' psychiatric conditions and the area's configuration. On the basis of this experience, recommendations were made to help prevent a similar scenario in the future.
Asunto(s)
Infecciones por Caliciviridae/prevención & control , Infección Hospitalaria/prevención & control , Brotes de Enfermedades , Gastroenteritis/epidemiología , Gastroenteritis/prevención & control , Control de Infecciones/métodos , Norovirus/aislamiento & purificación , Servicio de Psiquiatría en Hospital , Adulto , Infecciones por Caliciviridae/diagnóstico , Infecciones por Caliciviridae/epidemiología , Clostridioides difficile/aislamiento & purificación , Clostridioides difficile/fisiología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/transmisión , Heces/virología , Gastroenteritis/virología , HumanosRESUMEN
Histoplasma capsulatum is a dimorphic fungus endemic to North America. Histoplasmosis is primarily an inhalation-acquired mycosis that is encountered rarely outside of endemic regions. In nonendemic regions, histoplasmosis may present a diagnostic challenge and both clinical and laboratory vigilance are required to accurately identify infection. Unusual clinical presentations with limited physical findings may compound the difficulty in diagnosis. We describe a 78-year-old retired soil science professor who presented with an eroded epiglottic mass secondary to disseminated histoplasmosis in a nonendemic region (Alberta). Clinically, this mass was thought to represent a primary laryngeal carcinoma, as no other buccal or oropharyngeal ulcers were identified. Histoplasmosis was confirmed by tissue biopsy and a positive immunodiffusion test for immunoglobulin G. Disseminated histoplasmosis is often associated with laryngeal and oropharyngeal disease; however, isolated epiglottic histoplasmosis is rare. Histoplasmosis should be included in the differential diagnosis of neoplasms and chronic ulcers of the upper aerodigestive tract.
Asunto(s)
Epiglotis , Histoplasmosis/patología , Anciano , Alberta/epidemiología , Carcinoma/diagnóstico , Diagnóstico Diferencial , Enfermedades Endémicas , Epiglotis/patología , Histoplasmosis/diagnóstico , Histoplasmosis/epidemiología , Humanos , Neoplasias Laríngeas/diagnóstico , MasculinoRESUMEN
A 61-year-old previously healthy man developed chronic dermal granulomata in his right arm after receiving a coral injury in Thailand. After 7 biopsies, infection caused by Mycobacterium haemophilum was diagnosed. This case highlights the difficulty of isolating this fastidious organism in the laboratory and suggests that seawater or coral was the source of the infection.