RESUMO
An atypical case of Crimean-Congo haemorrhagic fever is presented. The diagnosis of the case in the presence of several comorbidities was complicated and illustrates the importance of maintaining a high index of suspicion for viral haemorrhagic fever in cases presenting with multisystem disease and an epidemiological history that could present opportunities for exposure to a haemorrhagic fever virus.
Assuntos
Febre Hemorrágica da Crimeia/diagnóstico , Acidose/diagnóstico , Comorbidade , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , Cetoacidose Diabética/diagnóstico , Diagnóstico Diferencial , Overdose de Drogas/diagnóstico , Cefaleia/etiologia , Febre Hemorrágica da Crimeia/complicações , Febre Hemorrágica da Crimeia/epidemiologia , Humanos , Hipertensão/epidemiologia , Hipoglicemiantes/intoxicação , Masculino , Metformina/intoxicação , Pessoa de Meia-Idade , Mialgia/etiologia , Obesidade/epidemiologia , Hiperplasia Prostática/epidemiologia , Trombocitopenia/etiologiaRESUMO
Notified malaria cases in South Africa (SA) decreased significantly over the past 14 years, from over 60 000 in the 1999/2000 malaria season to less than 13 000 in 2013/2014. However, the past two seasons have seen increases in both local and imported cases. Mozambique contributes the highest number of imported cases in SA. This update provides recommendations for malaria treatment and prevention (in travellers and residents) for 2015.
Assuntos
Antimaláricos/uso terapêutico , Malária/tratamento farmacológico , Humanos , Malária/epidemiologia , Malária/prevenção & controle , Moçambique/epidemiologia , Estações do Ano , África do Sul/epidemiologia , ViagemAssuntos
Blastomicose/diagnóstico por imagem , Tuberculose Osteoarticular/diagnóstico por imagem , Adulto , Vértebras Cervicais/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Artropatias/diagnóstico por imagem , Masculino , Radiografia , Doenças da Coluna Vertebral/diagnóstico por imagemRESUMO
In a 3,000-bed tertiary care hospital, 88 cases of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia were identified from 22,383 blood cultures (0.39%) submitted to the microbiology laboratory over a one-year period. Two high-risk areas were identified: the paediatric oncology unit, in which 12 cases of MRSA bacteraemia were identified from 924 blood cultures (1.3%), and the intensive care unit (ICU), in which 14 cases of MRSA bacteraemia were identified from 1,391 blood cultures (1.0%). In a one-year targeted intervention programme in which staff and patients were screened for MRSA carriage, patient carriers isolated, and mupirocin and chlorhexidine treatment administered, the number of MRSA bacteraemia cases decreased in these areas to 0 and 4, respectively (p = 0.000123 and 0.016), while the incidence of MRSA bacteraemia in non-targeted areas increased from 62 of 20,068 blood cultures (0.3%) to 82 of 18,784 blood cultures (0.44%) (p = 0.047). In the year post intervention the incidence of MRSA bacteraemia increased to 3 of 815 cultures (0.37%) in the paediatric oncology unit, 10 of 1,934 cultures (0.5%) in the ICU, and 112 of 18,977 cultures (0.59%) in the rest of the hospital (p = 0.00004 versus preintervention period). This study demonstrates the efficacy of targeted MRSA control measures in a hospital in which MRSA is endemic.
