RESUMEN
During the summer of 2013, an increase of Salmonella enterica ssp. enterica serovar Szentes isolates from human clinical cases was registered by the Swiss National Centre for Enteropathogenic Bacteria and Listeria. In the course of the ensuing 9 months, 18 isolates originating from 13 patients and from one food sample were collected. Of the 13 human cases, 10 (77%) were female. The patients' ages ranged from 27 to 83 years (median age 49 years). Pulsed-field gel electrophoresis (PFGE) performed with XbaI, and multilocus sequence typing (MLST) were used to type the strains. PFGE as well as MLST showed the strains as indistinguishable. The PFGE pattern and MLST sequence type (ST427) were identical to those of Salmonella enterica serovar Szentes isolated in previous years (2002-2013) from sporadic cases in Switzerland and Germany. The increased isolation frequency continued for 6 months after the detection of Salmonella Szentes in sprouts. No common food exposure could be established. Due to lack of information on the potential food source, further investigations were not possible. The outbreak of this unusual serotype was detected because of its temporal clustering.
Asunto(s)
Brotes de Enfermedades/estadística & datos numéricos , Intoxicación Alimentaria por Salmonella/epidemiología , Intoxicación Alimentaria por Salmonella/microbiología , Salmonella enterica/genética , Serogrupo , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Plantas Comestibles/microbiología , Plantas Comestibles/envenenamiento , Salmonella enterica/aislamiento & purificación , Plantones/microbiología , Plantones/envenenamiento , Suiza/epidemiologíaRESUMEN
An altered mentality, or delirium, is a common medical condition of the elderly in emergency medicine or neurology clinics. Among causes of this, toxic etiology due to an anticholinergic agent is not rare. The authors present two elderly women who were brought to an emergency room because of anticholinergic syndrome. The patients displayed agitative behavior, confusion, urinary retention, dry mouth and dilated pupils within 3 h of ingesting the dried seeds of Datura stramonium which has been used as a herbal medicine or as a traditional folk remedy for relieving coughing and asthma in Korea. They were discharged with a complete recovery after receiving conservative therapy for 5 days. Physicians of emergency medicine should be mindful of anticholinergic syndrome due to herbal medicine when the elderly with a history of delirium come to a hospital.