Clinical microbiology Q & A

A 2-week-old boy is brought to the emergency department with fevers and fussiness. He appears very ill, so a lumbar puncture is performed. Blood cultures are also collected. The Gram stain of the cerebrospinal fluid (CSF) shows abundant polymorphonuclear cells and moderate Gram-negative rods. A photo of the CSF Gram stain is shown in Fig. 1.
Source: Clinical Microbiology Newsletter - Category: Microbiology Tags: Q & A Source Type: news

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ConclusionsCryptococcosis develops in various organs. Typical radiological manifestation accompanied with positive serum CrAg provides helpful clues for the diagnosis. Lumbar puncture is a critical diagnostic method to distinguish CM. The accumulated dose of GC is associated with cryptococcosis in patients with CTD.Key Points•Pulmonary cryptococcosis is suspected if pulmonary nodules adjacent to the pleura are present, with serum CrAg positive.•Cryptococcal meningitis has insidious onset and the diagnosis mainly depends on lumber puncture.•Cryptococcal sepsis is not rare and needs timely blood culture in suspected patients.
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
Authors: Headman ZC, Matson MC, Schneider RP, Potter JL, Loguda-Summers DL, Bhatia S, Kondrashova T Abstract Context: Various forms of simulation-based training, including training models, increase training opportunities and help assess performance of a task. However, commercial training models for lumbar puncture and epidural procedures are costly. Objective: To assess medical students' and residents' perception of 3-dimensional (3D)-printed lumbar, cervical, and pelvic models for mastering joint injection techniques and to determine the utility of ultrasonography-guided needle procedure training. Methods:...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Abstract BACKGROUND/AIMS: In the era of increasing incidence of syphilis globally, ocular syphilis is re-emerging as an important cause of uveitis. The aim of this study was to determine the clinical and laboratory characteristics of ocular- and neurosyphilis among individuals with and without HIV infection. METHODS: Retrospective analysis of patients diagnosed with ocular syphilis presenting to Tygerberg Hospital, South Africa, over a 5-year period ending December 2018. RESULTS: Two-hundred and fifteen eyes of 146 patients were included. HIV coinfection was present in 52.1% of the patients, with 23.7% o...
Source: The British Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Br J Ophthalmol Source Type: research
AbstractPurpose of ReviewThe goal of this review is to describe the presenting features of fulminant idiopathic intracranial hypertension (IIH) and outline the multimodal approach to its treatment.Recent FindingsVenous sinus stenting may be an appropriate alternative to optic nerve sheath fenestration or cerebrospinal fluid shunting in select patients with fulminant IIH. Prompt surgical intervention maximizes the chance of visual recovery in patients with fulminant IIH.Summary“Fulminant IIH” is defined as intracranial hypertension with no secondary cause, severe vision loss within 4 weeks of symptom onset,...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
Authors: Sun JM, Wang C, Jin DQ, Deng F Abstract Congenital tuberculosis (TB) is rare and the prognosis is poor if not detected early. The diagnosis is often delayed owing to non-specific clinical presentation, misdiagnosis and undiagnosed maternal TB during pregnancy. A 12-day-old girl presented with a 5-day history of fever, cough, poor feeding and respiratory distress. Her mother had a cough and fever at 30 weeks gestation which was managed empirically as community-acquired pneumonia without a TB workup. Immediately postpartum, her mother developed a high fever and shortness of breath and required admission...
Source: Paediatrics and international child health - Category: Pediatrics Tags: Paediatr Int Child Health Source Type: research
A 45-year old HIV patient presented to the hospital with a 1-week history of holocranial headache. He was in regular use of antiretroviral therapy with a CD4 count of 1,128 cells/mm3. The patient complained of soft tissue mass on his frontoparietal region, which was noticed 6 months ago. He denied fever. Radiological examination suggested an osteosarcoma (Fig. 1). Biopsy of the lesion showed chronic granulomatous inflammation with areas of necrosis and fibrosis. Lumbar puncture revealed 13 leucocytes/ µl (87% lymphocytes), protein 93 mg/dl, glucose 53 mg/dl (serum glucose was 139 mg/dl), and VRDL 1:1 (serum 1:128).
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Tags: Medical Imagery Source Type: research
Conclusion: Bariatric surgery appears to lead to considerable improvement in IIH. Idiopathic intracranial hypertension is not a well-publicized comorbidity of obesity, but its presence may be considered as an indication for bariatric surgery. PMID: 32195557 [PubMed - as supplied by publisher]
Source: Canadian Journal of Surgery - Category: Surgery Authors: Tags: Can J Surg Source Type: research
ConclusionsThe LP protocol described herein may reduce adverse event rates and improve patient comfort in future studies.
Source: Journal of Neurology - Category: Neurology Source Type: research
Ethos Medical, a startup founded by Georgia Tech alumni, has developed the Iris needle guidance system to assist clinicians in successfully performing lumbar punctures. The system allows a clinician to visualize the needle traveling through tissue in...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Exclusive Neurology Neurosurgery Radiology Source Type: blogs
We report the case of a 44-year-old woman who had undergone a clandestine abortion six weeks before admission. One week later, she had abnormal vaginal discharge. Three weeks prior to admission, headache, hyperpyrexia and mental alteration were added. At admission, a transvaginal ultrasound showed abnormalities of the uterine cavity. Sepsis and endometritis were diagnosed, and a hysterectomy was scheduled. During preoperative evaluation, meningeal signs were found. The first lumbar puncture (LP) showed a lymphomononuclear pleocytosis, hypoglycorrhachia and hyperproteinorrachia. After five days treatment with ceftriaxone, v...
Source: Infezioni in Medicina - Category: Infectious Diseases Tags: Infez Med Source Type: research
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