PubMed Health⌕ Search

Biomedical subjects

J G Gubler

Publications and source records attributed to J G Gubler.

9 recordsLinked to original sources
PubMed2001

Recurrent soft tissue abscesses caused by Legionella cincinnatiensis.

Recurrent soft tissue abscesses of the jaw, wrist, and arm developed in a 73-year-old housewife with nephrotic syndrome and immunoglobulin A(kappa) gammopathy of unknown etiology. Conventional cultures remained negative, despite visible gram-negative rods on microscopy. Broad-spectrum PCR revealed Legionella cincinnatiensis, which was confirmed by isolation of the organism on special Legionella medium. Infections due to Legionella species outside the lungs are rare. L. cincinnatiensis has been implicated in only four cases of clinical infection; these involved the lungs in three patients and the central nervous system in one patient. We conclude that broad-spectrum PCR can be a valuable tool for the evaluation of culture-negative infections with a high probability of bacterial origin and that Legionella might be an underdiagnosed cause of pyogenic soft tissue infection.

Abscess↗
PubMed2000

Eosinophilic pneumonia and respiratory failure associated with venlafaxine treatment.

Drugs are well known causes of eosinophilic lung disease. In many patients, symptoms increase slowly, pulmonary infiltrates and eosinophilia progress over weeks, and resolve upon withdrawal of the offending agent. Rarely, the disease presents like acute eosinophilic pneumonia with acute onset of symptoms and rapidly progressing infiltrates which may be associated with respiratory failure. This report describe a case of venlafaxine-induced acute eosinophilic pneumonia causing respiratory insufficiency that rapidly resolved upon institution of corticosteroid treatment. This 5-hydroxytryptamine and noradrenaline reuptake inhibitor was previously not known to cause lung or peripheral blood eosinophilia. Considering the increasing use of this class of medication physicians have to be aware of this life-threatening and fully reversible complication.

Acute Disease↗
PubMed1999

Whipple endocarditis without overt gastrointestinal disease: report of four cases.

BACKGROUND: Cardiac manifestations of Whipple disease are rarely diagnosed before death. OBJECTIVE: To describe four patients with endocarditis caused by Tropheryma whippelii who did not have overt gastrointestinal disease. DESIGN: Case series. SETTING: Five hospitals in eastern Switzerland. PATIENTS: Three men and one woman undergoing replacement of insufficient heart valves. MEASUREMENTS: Histologic characteristics of heart valves and intestinal biopsy; broad-range and specific polymerase chain reaction for T. whippelii. RESULTS: Tropheryma whippelii was found in the heart valves (three aortic valves and one mitral valve) of four patients with culture-negative endocarditis necessitating valve replacement. All patients had arthralgia for different lengths of time. Only one patient had mild gastrointestinal symptoms. Histologic characteristics of intestinal mucosa were normal in all patients, and polymerase chain reaction on intestinal biopsy was positive for T. whippelii in only one patient, who did not have diarrhea. In all patients, arthralgia resolved promptly after institution of antibiotic therapy. Disease did not recur in any patient after prolonged antibiotic therapy with cotrimoxazole. CONCLUSION: In patients with culture-negative endocarditis, the absence of clinical, microscopic, or microbiological evidence of gastrointestinal disease did not rule out T. whippelii.

Actinobacteria↗
PubMed1992

Pseudoepidemic of nontuberculous mycobacteria due to a contaminated bronchoscope cleaning machine. Report of an outbreak and review of the literature.

We describe a pseudoepidemic due to nontuberculous mycobacteria contaminating the water tank of a machine used to clean and disinfect fiberoptic endoscopes. Forty-six bronchoscopies performed on 41 patients during a six-month period yielded 16 specimens positive for acid-fast bacilli (AFB). One specimen showed Mycobacterium avium complex from an AIDS patient and one, M tuberculosis from a patient with active cavitary tuberculosis. In four patients, only the smears showed AFB; subsequent cultures remained negative. Of the rest, seven contained M chelonae and three M gordonae, all in patients with no clinical signs of mycobacterial disease. Two of the three M gordonae isolates represented laboratory contamination from an antimicrobial solution in a culture medium. Four patients in the beginning of the pseudoepidemic were treated for presumed tuberculosis until negative culture results were available. Control of the "outbreak" was achieved by regular disinfection of the implicated water tank in the cleaning machine. Contamination of bronchoscopes with nontuberculous mycobacteria can lead to unnecessary diagnostic and therapeutic interventions.

Bronchoscopy↗
PubMed1992

[Fever without a recognizable cause in general practice: what should be done?].

Fever is one of the most common presenting symptoms for consultation in general practice. For the vast majority of cases, a specific cause is never found, and the fever disappears spontaneously. We present an algorithm for the management of a febrile adult patient with the aim to help recognize early a potentially dangerous infection and to avoid unjustified blind antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1990

[Classical pseudomembranous diphtheria caused by Corynebacterium ulcerans].

In a 63-year-old patient presenting with signs of classical diphtheria including membranous pharyngotracheobronchitis and myocarditis, Corynebacterium ulcerans was isolated in pure culture from the membranes. The strain produced a toxin specific for C. ulcerans but no diphtheria toxin. The patient was discharged after a complicated hospital course including respiratory and cardiac failure. Besides Corynebacterium diphtheriae, which has very rarely been isolated in Switzerland in recent years, Corynebacterium ulcerans should be considered as a cause of classical diphtheria.

Bacterial Toxins↗
PubMed1990

[Sepsis caused by Fusobacterium necrophorum: the re-discovered postangina sepsis Lemierre syndrome and other manifestations].

Among 5 patients with bacteremia due to Fusobacterium necrophorum, 3 young adults had post-anginal sepsis (Lemierre syndrome), including one with the classical secondary metastatic complications of pulmonary abscesses, pleural empyema, arthritis and hepatobiliary disturbances. The primary focus was a cholangiogenic abscess in an 81-year-old woman, and fetid otitis following a radical operation for cholesteomatous chronic otitis media in a 29-year-old male. Septicemia due to Fusobacterium necrophorum, and in particular Lemierre syndrome, are presented in the light of the literature.

Adult↗
PubMed1989

Pleuropulmonary infection due to Clostridium subterminale.

Clostridial pleuropulmonary infection in a patient with suspected pulmonary embolism is described. Clostridium subterminale was recovered as the sole pathogen on several occasions despite antibiotic therapy. The patient died of cardiac failure after a complicated course in hospital. Clostridium subterminale is a rare pathogen and has not so far been reported as the sole cause of pleuropulmonary infection.

Amoxicillin↗