Acute Brucellosis Presenting as Gastroenteritis: Case Report

Brucellosis is a systemic infection with multiple presentations. In spite of its oral mode of transmission and gastrointestinal pathogenesis, systemic symptoms are usually more prominent than gastrointestinal ones. Acute brucellosis presenting as gastroenteritis is rare in adults and could be the only manifestation of the disease. We report a case of gastroenteritis caused by Brucella species

Management of Pleural Brucellosis: Case Report

Background Brucellosis is a zoonotic disease, with low incidence rate in developed countries, however the incidence rate in Middle Eastern countries remains high. Chest symptoms in brucellosis cases account for about 15% of the cases, but dealing with respiratory system involvement is rare particularly pleural involvement. Case Report We report a case of a 60-year-old Saudi woman who was admitted with two months history of fever, productive cough anorexia and weight loss, contact with sheep. She was ill looking, underweight and febrile while she was on treatment. Examination of the chest showed signs of pleural effusion on the right side with right infrascapular crepitations. Chest X-ray: showed pleural effusion and right LL infiltrates. CT chest: showed right loculated, pleural effusion. Pleural fluid examination showed exudative changes, on culture of pleural fluid, Brucella species grew. AFB in pleural fluid was negative. She was treated with Streptomycin, Doxycyclin and Ciprofloxacin. She improved within one week of treatment and was discharged, after 14 days on antibrucella therapy. Discussion Pulmonary brucellosis is reported in medical literature occasionally but only few reports are available about pleural brucellosis. The challenge with pleural brucellosis and the association of loculated abscesses lies in therapy. Due to lack of previous information with such cases, we suggest that a period of more than six weeks is needed to treat this condition. We recommend that pleural brucellosis needs to be treated with at least two therapeutic agents for nine weeks

<i>Brucella</i> Peritonitis in a Patient on Peritoneal Dialysis

Brucellosis is endemic in Saudi Arabia. Brucella peritonitis is an uncommon clinical condition. We herewith report a 67-year-old man with chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) for four months, who developed chronic brucella peritonitis. Peritoneal fluid grew brucella species with positive brucella serology

What is the Real Prevalence of HIV-Infection in Saudi Arabia?

Acquired immunodeficiency syndrome (AIDS) continues to be transmitted in the developing world. The World Health Organization (WHO) produces an annual report from the United Nations AIDS (UNAIDS) Epidemic Update declaring the new AIDS cases across the world. UNAIDS had to make an estimates from certain countries like Saudi Arabia (SA), due to the fact that there is no adequate reporting of AIDS cases to the WHO. In 2001, the Ministry of Health in SA had created the Saudi AIDS—National Program which became responsible for counting old and new HIV-infection in Saudis and non-Saudis cases and produce an annual report in SA. Data collection shows that obtaining number of AIDS from Saudi—National Program would be more accurate than UNAIDS estimate in SA

Knowledge and Attitude of Physicians toward Prescribing Antibiotics and the Risk of Resistance in Two Reference Hospitals

Introduction Antibiotics are essential and abundantly prescribed in hospitals because of their effectiveness and lifesaving benefits. However, the unnecessary use of antibiotics has been observed in earlier studies, and it has persisted through recent years as a major issue since it is one of the leading causes of antibiotic resistance. The increase in antibiotic resistance nowadays is one of the most critical concerns in global public health around the world. The objective of this study was to evaluate the knowledge and perceptions related to antibiotic prescription among physicians at our medical centers. Method A cross-sectional survey of non-infectious diseases specialized physicians. The study was conducted during 2015 at two tertiary care centers in Riyadh, Saudi Arabia. Result Of the 107 returned questionnaires, 93 were complete and valuable. Most respondents (82%) perceived antibiotic resistance to be a critical problem globally, and 78% also think that it is a very important national problem. These attitudes did not differ across specialty or level of training. Widespread antibiotic use and inappropriate empirical choices were believed by 81% of the participants to be important general causes of resistance. Only half of respondents thought that antibiotic restriction is a useful intervention to decrease the antibiotic resistance. The physicians believed educational interventions are the most useful and effective way to improve prescription patterns and decrease antibiotic resistance. Complications due to infection with resistant organisms were acknowledged by almost all of the participants, with some differences in their estimations of how often it will occur. Conclusion Antimicrobial resistance, globally and nationally, is considered as a serious threat, and physicians in this survey acknowledged that. Among the most significant factors is antimicrobial misuse, either by overprescribing or providing inappropriate drugs with some ambivalence, as well as the importance of hand hygiene and antibiotic restrictions. By adhering to local guidelines, continuous education, and other practical interventions, the burden of resistance can be alleviated, as highlighted in this survey

Successful treatment of multi-focal XDR tuberculous osteomyelitis

Summary: We herein describe the nosocomial transmission of a pre-XDR or MDR case of pulmonary tuberculosis in a HIV-negative health care worker in an area endemic for MDR and XDR tuberculosis. Following inadequate therapy and non-compliance, he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after two years of treatment with various anti-tuberculous drugs in addition to interferon gamma. Keywords: XDR tuberculosis, Osteomyelitis, Therap

Neurobrucellosis: Challenges for Therapy

Background Brucellosis is a common zoonotic infection throughout the world, and is endemic in Saudi Arabia. Neurobrucellosis is a rare, severe form of systemic brucella infection. Treatment of neurobrucellosis continues to be variable, depending on the location of diagnosis. Methods A retrospective patient chart review was undertaken from 1995 to 2010 at King Abdulaziz Medical City, Riyadh, to identify cases of neurobrucellosis following a proposed case definition. Follow-up visits were evaluated to determine response to treatment. Results A total of 22 cases of neurobrucellosis were identified from a total of 517 cases of brucellosis. The mean patient age was 42.5 years with a male to female ratio of 1:1. Most antibiotic combinations included doxycycline, rifampin, and cotrimoxazole (36%). Three patients received ciprofloxacin in combination with other antibiotics and showed a satisfactory response. Conclusion Combination of antibrucella antibiotics is recommended, but there are no clear guidelines regarding antibiotic selection and duration of therapy. The use of ciprofloxacin in cases of neurobrucellosis should be evaluated

Phosphonium-based Ionic Liquid Modified Activated Carbon from Mixed Recyclable Waste for Mercury(II) Uptake

The contamination of water surfaces by mercury is a dangerous environmental problem due to its toxicity, which leads kidney damage. Activated carbon from mixed recyclable waste modified by phosphonium-based ionic liquid (IL-ACMRW) was therefore prepared and evaluated for Hg(II) remediation. The activated carbon used in this study was prepared from mixed waste, including cardboard, papers and palm wastes as cheap raw materials. The mixed Recyclable Waste Activated Carbon was combined with trihexyl(tetradecyl)phosphonium Bis2,4,4-(trimethylpentyl)phosphinate (Cyphos&#174; IL 104) ionic liquid to form an adsorbent with organic-inorganic content, in order to improve the Hg(II) uptake from aqueous solutions. FTIR confirms the presence of P, C=O and OH after this modification. The adsorption process was investigated and the evaluated results showed that the capacity was 124 mg/g at pH 4, with a contact time of 90 min, an adsorbent dose of 0.4 g/L, and a Hg(II) concentration of 50 mg/L. This Hg(II) adsorption capacity is superior than that reported in the literature for modified multiwall carbon nanotubes. The adsorption of Hg(II) on the modified activated carbon from mixed recyclable waste was found to follow the pseudo second-order kinetics model. Isotherms of adsorption were analyzed via Freundlich and Langmuir models. The results indicated that Freundlich is the best model to describe the process, suggesting multilayer adsorption