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Biomedical subjects

B Castor

Publications and source records attributed to B Castor.

15 recordsLinked to original sources
PubMed1996

Bilateral isolated adrenal coccidioidomycosis.

A case of bilateral isolated adrenal coccidioidomycosis in a previously healthy and immunocompetent 43-year-old Caucasian male is presented. He had never travelled to a coccidioidomycosis endemic area. Subclinical adrenal dysfunction was found with elevated plasma ACTH and mineralocorticosteroid and androgen pathway abnormalities. The implement of the fungal infection on adrenal function, and the diagnosis and management of adrenal coccidioidomycosis are discussed.

Adrenal Gland Diseases↗
PubMed1994

Septic cutaneous lesions caused by Mycobacterium malmoense in a patient with hairy cell leukemia.

Patients with hairy cell leukemia seem to be prone to infections with mycobacteria. This report describes a patient with hairy cell leukemia and pulmonary infection as well as disseminated cutaneous infection caused by Mycobacterium malmoense cultured from sputum and skin scrapings on Loewenstein-Jensen medium in eight weeks. Despite multiresistance of the causative strain, the infection was successfully treated with ethambutol, cycloserine and isoniazid.

Humans↗
PubMed1992

Immune response to Giardia lamblia in a water-borne outbreak of giardiasis in Sweden.

In one of the largest outbreaks of waterborne giardiasis reported from Europe, more than 3000 persons were exposed to contaminated water and over 1400 cases of giardiasis were diagnosed by microscopy. The outbreak resulted from an overflow of sewage water into the drinking water system of a Swedish ski resort. The period of contamination was about 1 week. Sweden is a non-endemic area for Giardia lamblia infection and, for most individuals affected, this was their first contact with the parasite. Few other enteropathogens were isolated from the patients involved. Therefore, an immune response to Giardia was unlikely to be biased by other concomitant infections. Serum samples from 352 exposed persons were collected and analysed for specific IgG and IgA antibodies to G. lamblia by indirect immunofluorescence and the results were related to the microscopic examination of faeces and the occurrence of diarrhoea. As controls, sera from 428 healthy persons were analysed at the same time by identical methods. IgG or IgA antibodies, or both, were found in 68% of patients whose diagnosis was made by microscopy, and in 22% of exposed by microscopically Giardia-negative persons, but in only 10% of healthy controls. The findings show that patients reported as negative for parasites might be infected. The time between infection and blood sampling influenced the result of the antibody test. The results suggest that stool examination should be the primary means of diagnosis of G. lamblia infection and that serological analysis performed at least 3 weeks after infection could contribute to diagnosis in a non-endemic region, when giardiasis is suspected but the parasite has not been detected.

Adolescent↗
PubMed1992

Intestinal symptoms and serological response in patients with complicated and uncomplicated Yersinia enterocolitica infections.

Clinical course, serological response and effect of antibiotic treatment were evaluated in 34 patients with uncomplicated enterocolitis and in 27 patients with reactive arthritis (ReA) due to Yersinia enterocolitica. Patients participating in this prospective multicentre trial were randomised to treatment or no treatment with antibiotics. Only 3 (11%) of the patients who later developed ReA asked for medical care because of intestinal symptoms and fever and they all developed arthritis within 2 days after admission to hospital, i.e. before an etiological diagnosis was obtained. Patients with ReA had a history of milder intestinal symptoms than patients with uncomplicated enterocolitis. The peak IgA titer to Y. enterocolitica, as measured by enzyme linked immunosorbent assay, was higher in ReA patients and it was not affected by the presence of HLA-B27 antigen. On the other hand, untreated patients with uncomplicated enterocolitis had the longest duration of IgG antibodies. The duration of IgG antibody response was shortened in uncomplicated enterocolitis patients treated with antibiotics, but not in ReA patients. Treatment did not influence intestinal or ReA symptoms. It is concluded, that patients with uncomplicated enterocolitis due to Y. enterocolitica differ in intestinal symptoms and serological response, compared with patients who develop ReA. These parameters could however not be used to predict the development of arthritis in individual patients.

Abdominal Pain↗
PubMed1991

Failure of aspirin in symptomatic treatment of acute diarrhoea.

Aspirin-mediated prostaglandin inhibition has been suggested in symptomatic relief of diarrhoea. The aim of the study was to evaluate in a controlled double-blind trial if a short-term treatment with aspirin could limit the clinical course of acute diarrhoea in adults. Seventy patients attending the Department of Infectious Diseases, General Hospital of Malmö, Sweden, with acute diarrhoea due to different causal agents, received either 1500 mg aspirin per day (n = 33) or placebo (n = 37) for two days. No difference was observed in the duration of diarrhoea, frequency and consistency of stools during treatment or subjective general discomfort. The previously reported effect of aspirin on acute diarrhoea could not be confirmed in this clinical study.

Acute Disease↗
PubMed1990

Early antibiotic treatment of reactive arthritis associated with enteric infections: clinical and serological study.

OBJECTIVE: To find out whether a 10-14 days' course of antibiotics early in the course of reactive arthritis associated with enteric infections could reduce the severity and duration of the disease and whether the antibody response in patients with reactive arthritis associated with yersinia infection differed between those treated and those not treated with the antibiotics. DESIGN: Prospective multicentre trial in which patients were randomised to treatment or no treatment with antibiotics. Patients were seen at three and six weeks and three, six, nine, 12, and 18 months after their first visit. SETTING: Departments of infectious diseases in three hospitals in Linköping, Malmö, and Stockholm, Sweden. PATIENTS: 40 Consecutive patients who had had symptoms of reactive arthritis associated with enteric infection for less than four weeks. INTERVENTIONS: 20 Patients were allocated to treatment with antibiotics and 20 patients did not receive antibiotics. All patients received non-steroidal anti-inflammatory drugs, and four also received intra-articular steroid injections after at least six weeks' observation. MAIN OUTCOME MEASURES: Arthritic symptoms assessed clinically and by using Ritchies' index; blood measurements reflecting inflammatory activity; serum IgG, IgM, and IgA antibody titres; HLA tissue type. RESULTS: No difference was observed concerning duration of arthritis, grade of inflammation, and number of joints affected between patients treated and those not treated with antibiotics. Furthermore, there was no significant difference between the two groups in erythrocyte sedimentation rate and haptoglobin, IgG, and IgA concentrations. All values had returned to normal within three months. No patient developed chronic arthritis, but sustained slight arthralgia occurred in three patients. The HLA-B27 antigen was found in 23 (58%) of the patients, and its presence did not affect clinical outcome. The IgG, IgM, and IgA antibody responses were similar in patients treated with antibiotics and those not treated. CONCLUSION: Short term antibiotic treatment has no beneficial effect on the clinical outcome of reactive arthritis associated with enteric infection.

Adult↗
PubMed1990

Infected wounds and repeated septicemia in a case of factitious illness.

During 19 years an assistant nurse, now 35 years old, has been repeatedly treated for several malingered and self-induced disorders escalating to self-mutilation. An ulcer of her right leg never epithelialised in spite of various local treatments and surgical intervention. During repeated attacks of self-induced septicemia altogether 11 different bacterial species were isolated; on 8 occasions Rhodococcus equi. The septicemias were successfully treated with antibiotics. The underlying psychiatric problem, a borderline personality disorder, has not been possible to treat in a conventional manner. Probably due to collaboration between the plastic surgeon and the psychiatrist she has had fewer attendances and shorter hospital stays lately. Her prognosis is still dubious as regards further self-mutilation and other expressions of self-destructive behaviour.

Actinomycetales Infections↗
PubMed1988

Acute diarrhoea in adults: aetiology, clinical appearance and therapeutic aspects.

A prospective study of acute diarrhoea was performed during 15 months 1981/1982 and included 731 patients and 240 controls. 43% had been infected abroad. A cluster of travellers with bacterial pathogens was diagnosed in July-August. The following pathogens were found: Campylobacter (18%), enterotoxigenic E. coli (6%), Salmonella spp. (5%), rotavirus (4%), Yersinia enterocolitica (3%), Giardia lamblia (3%), Shigella spp. (2%), Clostridium difficile (2%), enteroviruses (2%) and Entamoeba histolytica (less than 1%). More than 90% of the bacterial or parasitic enteropathogens were detected in the first stool sample. Only 10% of the patients needed hospital treatment and for 97% oral fluids were sufficient. The median duration of diarrhoea was 9 days. No fatal cases occurred and only 2 cases of chronic bowel disease were detected.

Acute Disease↗
PubMed1987

Cryptosporidiosis in southern Sweden.

Two different groups of patients with diarrhoea, altogether 1,478 individuals, were examined for cryptosporidium oocysts. The technique used was feces concentration and staining according to a modified Ziehl-Neelsen method. 20 cases of cryptosporidiosis (3%) were found among 698 consecutive patients with acute gastroenteritis. In feces samples sent for parasitological examination from 780 patients, cryptosporidia were found on 9 occasions (1%). None of 519 healthy persons excreted cryptosporidia. 19/29 patients with cryptosporidiosis had recently been abroad and in 8 of these additional enteric pathogens were found. The median duration of diarrhoea was 14 days. All patients except 1 were cryptosporidia-negative in faeces within 2 months. An immunosuppressed patient excreted cryptosporidia for 14 months.

Age Factors↗
PubMedDate not supplied

Fusidic acid for the treatment of antibiotic-associated colitis induced by Clostridium difficile.

Twenty courses of fusidic acid were given to 16 patients with antibiotic-associated colitis caused by Clostridium difficile. Fusidic acid was given in a dose of 0.5-1.5 g daily for seven to 21 days. Diarrhoea disappeared rapidly. Clinical relapse occurred after five courses and once when the patient was still on treatment. Clinical cure with persistence or reappearance of toxin occurred in four further patients. Nineteen courses of metronidazole were given to 19 patients who experienced six failures or relapses. Seven courses of vancomycin were given to five patients, three of whom had had relapse. Five patients healed without treatment. The relapses occurred only in old and prostrated patients. They often recurred several times in the same patient. 0.5 g of fusidic acid daily appears to be as effective as vancomycin and metronidazole for the treatment of C. difficile-induced colitis.

Adult↗