Pneumococcal soft-tissue infections: possible association with connective tissue diseases

Article Abstract:

Streptococcus pneumoniae, the cause of bacterial pneumonia, is also a common cause of meningitis, otitis media, sepsis and sinusitis. In addition, S. pneumoniae, or pneumococcus as it is also known, has been implicated in a variety of soft tissue infections. In less than 4 years, 12 cases of S. pneumoniae soft tissue infection occurred in the Philadelphia area. Case histories of all 12 patients are presented. Six patients were diagnosed with pneumococcal bacteremia (bacteria in the blood), and S. pneumoniae was found to be the origin of infection in 11 of the 12 patients. Sites of infection included fascia, tongue, epiglottis, brain, thyroid and breast tissue. Various underlying diseases, including AIDS, systemic lupus erythematosus, and diabetes mellitus, were identified in several patients. Four of six patients with connective tissue diseases, who were receiving corticosteroid treatment, developed pneumococcal soft tissue infection. (Three of the four patients had SLE.) Patients with SLE, and perhaps other connective tissue diseases, appear to be at greater risk of soft tissue infection due to S. pneumoniae. (Consumer Summary produced by Reliance Medical Information, Inc.)

Streptococcal infections, Complications and side effects, Risk factors, Systemic lupus erythematosus, Streptococcus pneumoniae

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The ciguatera poisoning syndrome from farm-raised salmon

Article Abstract:

A ciguatera poisoning syndrome may result from eating farm-raised fish. Ciguatera poisoning involves gastrointestinal and neurological disturbances, and is usually caused by eating warm-water fish containing ciguatoxins. A 30-year-old woman developed symptoms of ciguatera poisoning after eating farm-raised salmon. She experienced difficulty swallowing, nausea and diarrhea, as well as numbness in her hands and feet followed by shooting pains down her arms and legs. The patient also developed insensitivity to hot and cold and a sensation of loose teeth, two classic symptoms of ciguatera poisoning. Although her symptoms abated over time, the patient continued to have episodes of pain and tingling sensations for over two years. Analysis of an uncooked portion of the salmon revealed the presence of ciguatoxin. The salmon had probably been raised in Chile and acquired the ciguatoxin by eating contaminated food.

Case studies, Identification and classification, Seafood poisoning, Ciguatoxin

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Nodular lymphangitis: a distinctive but often unrecognized syndrome

Article Abstract:

Nodular lymphangitis is most commonly caused by a small number of organisms and identification of these organisms should make effective treatment easy to determine. Lymphangitis is an infection of lymph vessels. Symptoms can include swelling of the affected area, pain, inflamed lymph nodes and wounds that do not heal. A variety of bacterial infections are associated with lymphangitis. Consideration of the type of wound and the environment where it occurred can help the practitioner determine which bacterium might be present. Appropriate biopsies or cultures can then be ordered. Some of the bacteria most commonly associated with lymphangitis in the United States are Sporothrix schenckii, Francisella tularensis and Nocardia brasiliensis. Most infectious agents are confined to specific geographical and environmental regions.

Diagnosis, Lymphangitis

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