[Rat bite fever in a three-year-old child].

Rat bite fever (RBF) is rare in Denmark. It can be very difficult to diagnose, as the causative agent is an extremely fastidious organism which needs microaerophilic conditions to grow. We report a case of arthritis in the right ankle due to Streptobacillus moniliformis in a three-year-old girl who fully recovered after 14-day treatment of intravenous administrated penicillin followed by four weeks of orally administrated amoxicillin. Social history revealed the presence of two domestic rats living in the child's home. As rodents are becoming more popular as pets, RBF must be considered in patients with a history of relevant exposure.

Changes in genetically drifted H3N2 influenza A viruses and vaccine effectiveness in adults 65 years and older during the 2016/17 season in Denmark.

BACKGROUND: In Denmark, influenza A virus of the subtype H3N2 has been dominating the 2016/17 season, as in most countries of the Northern Hemisphere. OBJECTIVES: This study was conducted as part of the Danish seasonal influenza surveillance programme to genetically characterize circulating H3N2 viruses and determine the seasonal vaccine effectiveness (VE) overall in the Danish population and further on the virus cluster level. STUDY DESIGN: Influenza virus positive samples submitted for the national surveillance programme were genetically characterized by sequencing. VE estimates against influenza A and the circulating virus clusters were determined in patients above 65 years using the test-negative case-control design. RESULTS: The genetic characterization revealed several genetically drifted viruses, which could be divided into four main clusters by the defining amino acid substitutions: 3C.2a/N121K/S144K, 3C.2a/T131K/R142K, 3C.2a1, and 3C.2a1/N121K. Some of the drifted viruses appeared to be more prominent in vaccinated or non-vaccinated individuals, respectively. Overall the adjusted VE was 7.4% (95% confidence interval (CI): -6.0-19.2) among inpatients and 19.3% (95% CI: -5.7-38.4) among outpatients, respectively. VE for the four main virus clusters was; cluster 3C.2a1: 38.8% (95% CI: -29.8-71.1), cluster 3C.2a/N121K/S144K: 9.2% (95% CI: -63.0-49.4), cluster 3C.2a/T131K/R142K: 19.0% (95% CI: -85.3-64.6), and cluster 3C.2a1/N121K: -12.2% (95%CI: -129.7-45.2). CONCLUSIONS: Several genetically drifted H3N2 viruses have been circulating in Denmark in the 2016-17 influenza season. An overall low VE was estimated and VE for the four main virus cluster indicate different VEs between the circulating drifted H3N2 viruses.

Concentration of prothrombin fragment 1 + 2 (f1 + 2) in patients with liver cirrhosis and chronic hepatitis C infection.

The aim of this study was to assess the serum concentration of F1 + 2 in patients with liver cirrhosis developed during HCV infection and in patients with chronic hepatitis C infection. The study group consisted of 52 patients hospitalised at the Department of Infectious Diseases of Medical University of Lublin, Poland. Among them, 18 patients (8 men and 10 women), aged 19-59 years, had a stable liver cirrhosis and 34 patients (21 men and 13 women), aged 20-41 years, were diagnosed with chronic hepatitis C infection. The control group consisted of 25 healthy individuals (13 men and 12 women), aged 19-60 years. The serum concentration of F1 + 2 was determined by the immunoenzymatic assay Enzygnost F1 + 2 micro. There were no statistically significant differences observed in serum concentration of F1 + 2, both in patients with stable cirrhosis and with CHC, compared to controls. However, in 16.7% of patients with cirrhosis and in 35.3% of patients with CHC elevated serum levels of F1 + 2 were observed.

Copper/zinc ratio in measles patients.

UNLABELLED: The aim of this study was to evaluate the serum copper (Cu), zinc (Zn) levels and Cu/Zn ratio in measles patients in comparison to the control group. The study was conducted on 26 patients. The serum Cu and Zn levels were determined three times using atomic absorbtion spectrometry. The control group included 24 healthy persons. The serum Cu and Zn levels in those persons were determined once. CONCLUSION: in the acute period of the disease, a significant and highly significant increase in Cu/Zn ratio takes place.