Perfusion Abnormalities are Frequently Detected by Early CT Perfusion and Predict Unfavourable Outcome Following Severe Traumatic Brain Injury.

Background: In patients with severe traumatic brain injury (TBI), early CT perfusion (CTP) provides additional information beyond the non-contrast CT (NCCT) and may alter clinical management. We hypothesized that this information may prognosticate functional outcome.

Methods: Five-year prospective observational study was performed in a level-1 trauma centre on consecutive severe TBI patients.

Experience with infection by Scedosporium prolificans including apparent cure with fluconazole therapy.

Five cases of human infection with Scedosporium prolificans are described. There were two groups of patients. In group one, two were immunocompetent males with localized bone and joint infections, a man with post-traumatic septic arthritis, responded to surgical treatment alone and a boy with post-traumatic septic arthritis, appeared to respond to treatment with oral fluconazole, without surgery.

Peritoneal eosinophilia associated with Paecilomyces variotii infection in continuous ambulatory peritoneal dialysis.

A 65-year-old woman maintained on continuous ambulatory peritoneal dialysis (CAPD) presented with a 5-month history of intermittent cloudy bags and sterile peritoneal and peripheral blood eosinophilia, which failed to clear despite conventional antibiotics. Impaired catheter inflow and delayed effluent drainage gradually occurred and intracatheter streptokinase, administered to rectify catheter dysfunction, dislodged a catheter cast composed of fungal hyphae of Paecilomyces variotii. Fungal peritonitis and Paecilomyces fungemia ensued, which were treated with amphotericin B and catheter removal.

Experience with a simplification of the petroff method for laboratory diagnosis of mycobacteria in sputum.

In the original Petroff procedure sputum is digested with NaOH and the centrifuged deposit neutralized with HCl before culturing. A modification in which digestion is arrested by dilution with water and the sediment is seeded on buffered media is simpler, quicker, safer and in our hands seems to give a greater number of positive smears and cultures for mycobacteria with less overgrowth by contaminants. The usefulness of regular smear examinations for excluding tuberculosis in nonspecific chest complaints is questioned.