Tuberculous Meningitis in Adults: A Review of 160 Cases

Objective. This study aimed to evaluate epidemiological, clinical, laboratory, and neuroimaging features of 160 adult patients with tuberculous meningitis (TBM) according to “Thwaites' diagnostic index.” Methods. The subjects of this retrospective study are the patients with TBM who were followed up between years 1998 and 2009 in a tertiary referral hospital. Diagnosis of TBM was based on clinical, laboratory, and neuroimaging signs and Thwaites' diagnostic index. Results. Mycobacterium tuberculosis was isolated from CSF in 59 of 148 patients. Seventeen percent of the patients died, 71% recovered completely, and 13% recovered with neurological sequel at the end of the sixth month. Conclusions. Despite new developments in laboratory or neuroimaging techniques, the diagnosis of TBM is still based on clinical features with the help of laboratory. Early diagnosis by suspecting TBM may prevent therapy delay and may result in decrease in the mortality and morbidity

Tricuspid Endocarditis and Septic Pulmonary Embolism in an Intravenous Drug User with advanced HIV Infection

Abstract Cardiac complications are becoming increasingly important in patients with HIV infection. Right-sided endocarditis are more common in intravenous drug users (IVDU) with HIV infection. Some studies have pointed out that the clinical outcome of such patients depends on the affected valve referred to the responsible agent rather than the HIV serostatus. However, severe immunosupression and low CD 4 count are associated with increased risk of death. This report presents a case of isolated tricuspid valve endocarditis with advanced HIV infection who was also an IVDU

Tricuspid Endocarditis and Septic Pulmonary Embolism in an Intravenous Drug User with advanced HIV Infection

Cardiac complications are becoming increasingly important in patients with HIV infection. Right-sided endocarditis are more common in intravenous drug users (IVDU) with HIV infection. Some studies have pointed out that the clinical outcome of such patients depends on the affected valve referred to the responsible agent rather than the HIV serostatus. However, severe immunosupression and low CD4 count are associated with increased risk of death. This report presents a case of isolated tricuspid valve endocarditis with advanced HIV infection who was also an IVDU

CITROBACTER PERITONITIS: TWO CASES AND REVIEW OF THE LITERATURE

One of the uncommon gram negative organisms causing peritonitis in peritoneal dialysis patients is Citrobacter. Because of this organism's resistant nature, treatment for Citrobacter peritonitis may be difficult, and removal of the catheter may be necessary in refractory cases. Here we present 2 cases of peritonitis caused by this organism and fully treated with antibiotics. The literature contains only a limited number of reports on Citrobacter peritonitis, mostly case reports or portions of general papers about the microbiological spectrum of peritonitis in the relevant units. Until enough data about this micro-organism have been accumulated to map out an approach, it is wise to individualize treatment by watching the response of the patient during the wait for the antibiogram result and not to hesitate to remove the catheter if the clinical situation deteriorates

A rare case of peritonitis: Streptococcus salivarius

Streptococcus salivarius is a Gram-positive bacteria that may cause infections like endocarditis and meningitis. However, it has not been reported as a causative agent of peritonitis in peritoneal dialysis patients. In this paper we present a rare case of peritonitis with Streptococcus salivarius admitted to our Clinic with abdominal pain, who had been on peritoneal dialysis treatment for 19 months. Streptococus salivarius was cultured from the effluent, sensitive to ampicillin and penicillin G. Patient was discharged completely cured. Peritonitis is the most important clinical issue that occurs in patients treated with peritoneal dialysis, and every effort should be invested to determine the causative agent while even rare bacteria as Streptococcus salivarius may be found