Biomedical subjects
Publications and source records attributed to S J Durning.
Clostridium difficile infection is usually associated with antibiotic therapy and is almost always limited to the colonic mucosa. Small bowel enteritis is rare: only 9 cases have been previously cited in the literature. This report describes a case of C. difficile small bowel enteritis that occurred in a patient after total colectomy and reviews the 9 previously reported cases of C. difficile enteritis.
Ectopic thyroid tissue may reside anywhere along its embryologic path of descent. Most ectopias manifest as simple thyroglossal duct cysts in conjunction with a normally developed thyroid gland in its usual thyroid cervical bed. Lingual thyroid is a rare developmental abnormality characterized by the failure of the thyroid gland, or remnants, to descend from its embryologic site of origin at the foramen cecum to its usual pretracheal position. Carcinoma arising in a lingual thyroid is even more unusual with fewer than 30 cases reported in the literature. We report the second case of lingual papillary thyroid carcinoma and review the clinical features, natural history, diagnosis, and treatment of lingual thyroid carcinoma.
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OBJECTIVE: To determine whether a high rate of methicillin-resistant Staphylococcus aureus at our institution was due to laboratory misclassification and to evaluate the effect of this misclassification. MATERIAL AND METHODS: We evaluated all S. aureus isolates identified at our institution during a 60-day period in 1997. Automated susceptibility test results (using the Vitek system) from our clinical microbiology laboratory and an independent laboratory were compared with oxacillin agar screen plate results at both laboratories. Isolates with discordant results for susceptibility to oxacillin were tested by broth microdilution minimal inhibitory concentrations and for the presence of the mecA gene. RESULTS: Eighteen (72%) of the 25 organisms (obtained from 17 patients) found to be resistant to oxacillin by the Vitek system at our institution were susceptible by the oxacillin agar screen. Discordant isolates tested by broth microdilution minimal inhibitory concentrations and for the mecA gene were found to be oxacillin susceptible and mecA gene negative. Thus, at our hospital, almost three fourths of the organisms initially identified as methicillin-resistant S. aureus by the Vitek system were actually susceptible to oxacillin. This misclassification resulted in needless infection control measures and unnecessary vancomycin use. CONCLUSION: Hospitals that use only automated susceptibility testing for S. aureus should periodically validate their results with additional testing.
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