Limitations of infrared ear temperature measurement in clinical practice.

Principles: Detection of elevated body temperature is critical in the early diagnosis of sepsis. Due to its convenience, infrared ear temperature measurement (IETM) has become the standard of care. Unfortunately, the limitations of this method are largely unexplored.

Patients presenting to the emergency department with non-specific complaints: the Basel Non-specific Complaints (BANC) study.

Objectives: Patient management in emergency departments (EDs) is often based on management protocols developed for specific complaints like dyspnea, chest pain, or syncope. To the best of our knowledge, to date no protocols exist for patients with nonspecific complaints (NSCs) such as "weakness,""dizziness," or "feeling unwell." The objectives of this study were to provide a framework for research and a description of patients with NSCs presenting to EDs.

Peripheral lymphadenopathy in immunocompetent adults.

Although unexplained lymphadenopathies are not particular prevalent in the general population (<1%), they represent a diagnostic dilemma. The differential diagnosis is broad, and although only few diseases will be either severe or treatable, patients as well as their doctors are in fear of missing a relevant diagnosis such as a malignancy. For the differential diagnosis it is prudent to distinguish between localised and generalised lymphadenopathy.

[Headaches and aphasia in an immunocompromised patient].

We report the case of a 81-year-old, immunocompromised Patient, admitted to our hospital with new-onset headaches and word-finding difficulties. The MRI of the brain revealed a temporal mass on the left with marginal contrast-enhancement. During the next days Listeria monocytogenes grew in the bloodcultures so that the diagnosis of a brain-abscess caused by Listeria was established.

Serum procalcitonin for discrimination between septic and non-septic arthritis.

Background: Early differentiation between septic and non-septic arthritis is difficult. A previous study showed promising diagnostic accuracy of serum Procalcitonin (PCT) in septic arthritis, limited by a low sensitive PCT test kit.

Objective: To investigate the diagnostic value of PCT in patients with septic and non-septic arthritis using a novel test with low detection limit.

Appropriateness of antibiotic treatment in intravenous drug users, a retrospective analysis.

Background: Infectious disease is often the reason for intravenous drug users being seen in a clinical setting. The objective of this study was to evaluate the appropriateness of treatment and outcomes for this patient population in a hospital setting.

Methods: Retrospective study of all intravenous drug users hospitalized for treatment of infectious diseases and seen by infectious diseases specialists 1/2001-12/2006 at a university hospital.

Vertebral osteomyelitis caused by Actinobaculum schaalii: a difficult-to-diagnose and potentially invasive uropathogen.

We report the first case of vertebral osteomyelitis caused by Actinobaculum schaalii and review all cases of A. schaalii identified at our institution between 2002 and 2005. A.

[Infection with Aeromonas hydrophila after use of leeches (Hirudo medicinalis) in a free microvascular osteo-(myo-)cutaneous flap--suggestions for successful management].

Medical leeches (Hirudo medicinalis) are an important therapeutic option in the treatment of venous congestion of flaps. In a case report an infection with Aeromonas hydrophila of a free microvascular osteo-(myo)-cutaneous flap after leech application for venous congestion is described and the current literature reviewed. Infection associated with leech therapy is a documented complication of leech application, with reported incidences ranging from 2.

TB in a low-incidence country: differences between new immigrants, foreign-born residents and native residents.

Background: New immigrants and foreign-born residents add to the burden of pulmonary tuberculosis (TB) in low-incidence countries. The highest TB rates have been found among recent immigrants. Active screening programs are likely to change the clinical presentation of TB, but the extent of the difference between immigrant and resident populations has not been studied prospectively.

[Diagnostic procedures for patients with community acquired pneumonia].

The diagnosis of community acquired pneumonia (CAP) is based on a patient history with respiratory symptoms and additional symptoms and signs such as fever over more than 4 days, dyspnea and tachypnea and/or a positive lung auscultation. Despite recently developed tests, radiology is a key diagnostic procedure for confirming CAP. Importantly, the first treating physician must judge whether to hospitalize a patient or not.

[Diagnostics for pulmonary tuberculosis in adults].

The incidence of pulmonary tuberculosis (TB) is decreasing in Western Europe. However, TB should not be considered to be a rare disease, particularly in immigrants and in immunocompromised persons (i.e.

Course and outcome of Staphylococcus aureus bacteraemia: a retrospective analysis of 308 episodes in a Swiss tertiary-care centre.

Staphylococcus aureus bacteraemia (SAB) is associated with substantial morbidity and mortality worldwide. The charts of adult patients with SAB who were hospitalised in a Swiss tertiary-care centre between 1998 and 2002 were studied retrospectively. In total, 308 episodes of SAB were included: 2% were caused by methicillin-resistant strains; 49% were community-acquired; and 51% were nosocomial.

Dynamics of serum procalcitonin in patients after major neurosurgery.

Classical markers of infection cannot differentiate reliably between inflammation and infection after neurosurgery. This study investigated the dynamics of serum procalcitonin (PCT) in patients following major neurosurgery. PCT concentrations remained < 0.

Vertebral osteomyelitis caused by non-tuberculous mycobacteria.

Vertebral osteomyelitis caused by non-tuberculous mycobacteria is a rare disease, with only 31 cases and one nosocomial outbreak reported in the literature (MedLine review between 1965 and December 2003). The clinical features are often indistinguishable from those of pyogenic osteomyelitis. Early diagnosis of such infections is a major challenge because of the slow growth of these microorganisms.

Procalcitonin and the early diagnosis of infective endocarditis.

Background: Variability in the clinical presentation of infective endocarditis (IE) makes the diagnosis a clinical challenge. We hypothesized that serum procalcitonin, a marker of systemic bacterial infection, might be helpful in its diagnosis.

Methods And Results: We conducted a prospective cohort study in 67 consecutive patients admitted to the hospital with the suspicion of IE or in whom the suspicion arose during the hospital course.

Polymerase chain reaction for Mycobacterium tuberculosis: impact on clinical management of refugees with pulmonary infiltrates.

Study Objectives: Screening for pulmonary tuberculosis (TB) in war refugees entering low-prevalence countries for TB is a common policy, but workup strategies are difficult and expensive.

Design: Prospective screening of war refugees for TB by chest radiograph and evaluation of the impact of additional polymerase chain reaction (PCR) testing for Mycobacterium tuberculosis complex (MTB) on clinical management in case of pulmonary infiltrates suspicious for TB.

Setting: Academic university medical center.

Endocarditis caused by Finegoldia magna (formerly Peptostreptococcus magnus): diagnosis depends on the blood culture system used.

We present a patient with prosthetic valve endocarditis caused by Finegoldia magna (formerly Peptostreptococcus magnus). Blood cultures in the BacT/ALERT and BACTEC 9240 system were negative. We therefore tested different blood culture systems: F.

Pharmacokinetics and pharmacodynamics of gatifloxacin against Streptococcus pneumoniae and Staphylococcus aureus in a granulocyte-rich exudate.

The pharmacokinetics of gatifloxacin were assessed in serum and in skin blister fluid (SBF), as was the pharmacodynamic activity in SBF. Five hours after a single dose of gatifloxacin, SBF killed 2.5 logs of Streptococcus pneumoniae and 1.