A case of septicaemic anthrax in an intravenous drug user

<p><b>Background:</b> In 2000, Ringertz et al described the first case of systemic anthrax caused by injecting heroin contaminated with anthrax. In 2008, there were 574 drug related deaths in Scotland, of which 336 were associated with heroin and or morphine. We report a rare case of septicaemic anthrax caused by injecting heroin contaminated with anthrax in Scotland.</p> <p><b>Case Presentation:</b> A 32 year old intravenous drug user (IVDU), presented with a 12 hour history of increasing purulent discharge from a chronic sinus in his left groin. He had a tachycardia, pyrexia, leukocytosis and an elevated C-reactive protein (CRP). He was treated with Vancomycin, Clindamycin, Ciprofloxacin, Gentamicin and Metronidazole. Blood cultures grew Bacillus anthracis within 24 hours of presentation. He had a computed tomography (CT) scan and magnetic resonance imagining (MRI) of his abdomen, pelvis and thighs performed. These showed inflammatory change relating to the iliopsoas and an area of necrosis in the adductor magnus.</p> <p>He underwent an exploration of his left thigh. This revealed chronically indurated subcutaneous tissues with no evidence of a collection or necrotic muscle. Treatment with Vancomycin, Ciprofloxacin and Clindamycin continued for 14 days. Negative Pressure Wound Therapy (NPWT) device was applied utilising the Venturi™ wound sealing kit. Following 4 weeks of treatment, the wound dimensions had reduced by 77%.</p> <p><b>Conclusions:</b> Although systemic anthrax infection is rare, it should be considered when faced with severe cutaneous infection in IVDU patients. This case shows that patients with significant bacteraemia may present with no signs of haemodynamic compromise. Prompt recognition and treatment with high dose IV antimicrobial therapy increases the likelihood of survival. The use of simple wound therapy adjuncts such as NPWT can give excellent wound healing results.</p&gt

When in doubt should we cut it out? The role of surgery in non‐small cell lung cancer

Will we ever really know whether surgery is effective in patients with resectable NSCLC

Lo que compra un dólar (What a Dollar Buys)

Students in USD’s SPAN 330: Reading and Writing for Communication course wrote a collection of stories for their mid semester creative writing project. For this project, students were challenged to write an original text in Spanish that included an object purchased at a dollar store. This project was inspired by the Dollar Storeys, a series of short audio stories produced by Chicago Public Radio and The Dollar Store Show. In Lo que compra un dólar, audience will learn about the story behind a sad elf boy, the reason for misshaped animal crackers, the enablement a scrunchy can give, the hidden powers of a garden gnome, the life of an energy drink container, the multidimensional experience that reading glasses can offer, the idyll benefits of a garden

Creativity and Life Cycles of Artists

Age curves, disegno and colore , Modes of artistic creation,