Cases reported "Laboratory Infection"

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1/5. Cryptogenic rabies, bats, and the question of aerosol transmission.

    Human rabies is rare in the united states; however, an estimated 40,000 patients receive rabies postexposure prophylaxis each year. Misconceptions about the transmission of rabies are plentiful, particularly regarding bats. Most cases of human rabies caused by bat variants have no definitive history of animal bite. Three hypotheses are proposed and reviewed for the transmission of rabies from bats to human beings. They include nonbite transmission (including aerosol transmission), the alternate host hypothesis (an intermediate animal host that acquires rabies from a bat and then transmits rabies to human beings), and minimized or unrecognized bat bites. Nonbite transmission of rabies is very rare, and aerosol transmission has never been well documented in the natural environment. The known pathogenesis of rabies and available data suggest that all or nearly all cases of human rabies attributable to bats were transmitted by bat bites that were minimized or unrecognized by the patients.
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2/5. A Japanese case of tinea corporis caused by Arthroderma benhamiae.

    We report a case of tinea corporis in japan caused by Arthroderma benhamiae. A 53-year-old female scientist, who had been working on dermatophytes in a laboratory, noticed pruritic erythema on the outer corner of her left lower eyelid. She used a steroid ointment for three days, but the lesion continued to expand. When she visited our clinic, the erythema was 15 mm in diameter and clearly demarcated with a slightly depressed center. A scale from the periphery of the erythema was positive with direct KOH examination, and T mentagrophytes was isolated from the lesion. The erythema was successfully treated with topical application of butenafine hydrochloride. The isolate was mated with a ( ) strain of the Americano-European race of A. benhamiae. Using the most sensitive molecular typing method, restriction exzyme analysis of the non-transcribed spacer region of the ribosomal dna, the restriction profile of the isolate was the same as that of strains used in her laboratory but different from those of any Japanese isolates associated with pet animals. The results suggest that the patient became infected during her experiment.
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3/5. Lymphocytic choriomeningitis outbreak associated with nude mice in a research institute.

    OBJECTIVE--After an employee at a cancer research institute was diagnosed with lymphocytic choriomeningitis, an investigation was performed to determine the extent of lymphocytic choriomeningitis virus (LCMV) infections among the institute's employees and to identify risk factors for infection. DESIGN--Retrospective cohort study. SETTING--A US cancer research institute. PARTICIPANTS--Eighty-two of 90 institute employees. MAIN OUTCOME MEASURES--serum LCMV antibodies. RESULTS--Seven workers (9%) with definite LCMV infection (LCMV IgG antibody titer greater than or equal to 16) and one worker (1%) with probable infection (IgG titer = 8) were identified (10% overall seroprevalence). All infected employees handled animals or animal tissues and were more likely than other animal handlers to have worked with nude mice (Mus musculus) (P less than .02). Among the 31 employees who worked with nude mice at the institute, infected workers were more likely to clean the cages of nude mice (P much less than .001), change their bedding (P less than .01), and change their water (P less than .001). The institute had been injecting nude mice with LCMV-infected tumor cell lines and had recently increased the nude mouse population and the duration of experiments. These changes would have increased the LCMV burden at the facility and were temporally associated with the cluster of LCMV infections in employees. CONCLUSIONS--This LCMV outbreak, the first reported since 1974, is the first associated with nude mice. It illustrates the ongoing hazard LCMV poses in research laboratories. Since the symptoms of LCMV infection can be nonspecific, clinicians should consider this diagnosis in ill patients who report laboratory rodent exposure.
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4/5. diagnosis and management of human B virus (Herpesvirus simiae) infections in michigan.

    Three men who had worked at the same animal research facility and had had contact with macaque monkeys were infected with B virus (Herpesvirus simiae). Their clinical presentations varied from self-limited aseptic meningitis syndrome to fulminant encephalomyelitis and death. Patient 1 was treated only after a respiratory arrest and other signs of advanced brain stem dysfunction had occurred. He died 8 days after hospital admission, despite treatment with acyclovir. Patient 2 presented with subtle signs and symptoms of brain stem encephalitis. He received antiviral therapy with intravenous ganciclovir. Patient 3 had a headache without meningismus and was also treated with acyclovir. Both patients 2 and 3 survived and did not have objective sequelae. Viral culturing, ELISA and western blot antibody testing, and magnetic resonance imaging all proved useful in the diagnosis of these patients' conditions.
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5/5. Acute gastritis associated with spiral organisms from cats.

    Numerous studies implicated helicobacter pylori as one causative agent producing gastritis and dyspepsia. Recent reports focus on another bacterium, Gastrospirillum hominis, as a possible pathogen producing gastritis. We report a 30-year-old researcher who became acutely ill with epigastric pain indicative of esophagitis or peptic ulcer disease. gastritis and a gastric ulcer were observed endoscopically. Histological examination of the gastric mucosa revealed an acute gastritis and large spiral-shaped organisms. The spiral forms were present in large quantities in the gastric mucosa of experimental animals (cats) handled by the patient in his research. Electron microscopy confirmed that the organisms from the cat and patient were morphologically identical. The patient was successfully treated with bismuth subsalicylate. His symptoms resolved and the organisms were cleared from his stomach. This study provides evidence that another bacterium, a Gastrospirillum, may cause gastritis in man and may be transmitted from animal to man.
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