Outbreak of nosocomial Burkholderia cepacia infection and colonization associated with intrinsically contaminated mouthwash.

From August 1996 through June 1998, 69 ventilated, intensive care unit patients at two Arizona hospitals had nosocomial respiratory tract cultures positive for Burkholderia cepacia. Intrinsically contaminated alcohol-free mouthwash was identified by pulsed-field gel electrophoresis as the source of the outbreak.

Typhim Vitrade mark Vaccine.

Long before the term "Typhoid Mary" entered the vernacular in the early 1900s, investigators such as Huxham1 in 1782 and Schoenlein2 in 1839 had already differentiated typhoid fever-the typhus-like fever caused by Salmonella typhi-from other prolonged febrile syndromes such as rickettsial typhus fever.3 The notorious Mary Mallon had been identified as a carrier of the typhoid fever bacillus in 1907; by the time she was captured 8 years later, she had infected at least 50 people (causing the death of three) while working as a New York City cook under several assumed names.4 Even though the incidence of this serious infection has obviously decreased since 1900 in developed countries, it continues to be prevalent in developing countries.

Fatal massive hepatic necrosis from varicella-zoster hepatitis.

An unusual case of varicella-zoster hepatitis is reported which resulted in fatal massive hepatic necrosis in a 64-year old white female. The patient had had chickenpox 30 years prior to death but no cutaneous zoster at any time. The liver showed typical eosinophilic intranuclear inclusions and herpesvirus virions were demonstrated by electron microscopy.

Cytomegalovirus encephalitis in immunologically normal adults. Successful treatment with vidarabine.

Acute cytomegalovirus (CMV) encephalitis developed in two immunologically normal adults. The diagnosis was confirmed by isolation of CMV from the CSF and urine in one case and from temporal lobe biopsy tissue, CSF, and urine in the second case. Both patients were treated with vidarabine and showed dramatic clinical improvement.

Osler node, Janeway lesions, and splinter hemorrhages.

This report documents the occurrence of an Osler node, subungual hemorrhages, and Janeway lesions peripheral to an infected arterial catheter. A brief review of these dermatological manifestations of infection is given and the importance of surgical removal of the involved artery after poor response to medical therapy is stressed.

Side effects of minocycline: a double-blind study.

We studied the incidence and type of side effects of minocycline in a double-blind study. A total of 45 volunteers (18 men and 27 women) were given minocycline, and 44 volunteers (23 men and 21 women) were given placebo. The men in both the minocycline and placebo groups were significantly (P < 0.

Puncture wound of the eyelid causing brain abscess.

A case of brain abscess following an apparently trival puncture wound to the eyelid is presented to emphasize the importance of meticulous examination of eye wounds in children to look for penetration into the cranial vault. Any suggestion of such penetrating injury either by history, examination, or X-ray should dictate neurosurgical consultation, and immediate local culture and debridement of the wound. If nonoperative management is elected, a careful watch must be kept for signs of infection, which dictate early exploration, and broad-spectrum antibiotic coverage of Gram-positive and Gram-negative organisms common to penetrating skull trauma.

A case of bilateral Escherichia coli endogenous endophthalmitis.

The first reported case of bilateral endogenous endophthalmitis is presented and discussed with reference to pertinent literature. Diagnostic and therapeutic recommendations for suspected gram-negative endophthalmitis are presented and include: immediate paracentesis of the eye for gram stain and culture, systemic therapy with an antibiotic such as gentamicin and either subconjunctival, subtenon or intraocular injection of antibiotics. Despite these measures vision may be lost, and, as in this case, enucleation necessary.

Gentamicin- and cephalothin-associated rises in blood urea nitrogen.

Standardized rates of drug-attributed rises in blood urea nitrogen were 8.6%, 2.9%, and 9.

Distressing side-effects of minocycline hydrochloride.

Minocycline hydrochloride is a tetracycline derivative that has been advocated as the drug of choice in the treatment of meningococcal carriers. Recently, we studied a group of 30 patients who experienced a large number of side-effects after receiving minocycline for treatment of meningococcal meningitis. Twenty-seven of 30 (90%) suffered from dizziness, vertigo, ataxia, weakness, nausea, and vomiting.