1/40. Sewer workers: occupational risk for hepatitis c--report of two cases and review of literature.Two sewer workers contracted hepatitis c. The epidemiological literature in which sewer-contaminated water is described as a known vector for outbreaks of hepatitis c, as well as the specific occupational history of the two patients described here, suggest that sewer workers may be at increased risk of contracting hepatitis c.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/40. Molecular evolutionary analysis of the complete nucleotide sequence of hepatitis B virus (HBV) in a case of HBV infection acquired through a needlestick accident.To elucidate needlestick transmission of hepatitis b virus (HBV), strains isolated from 1 physician who acquired HBV infection through a needlestick accident and 3 patients with chronic hepatitis B (donor patients A, B, and C) were tested using molecular evolutionary analysis based on full-length HBV genomic sequences. Nucleotide sequences of these isolates were aligned with 55 previously reported full-length genomic sequences. Genetic distances were estimated using the 6-parameter method, and phylogenetic trees were constructed using the neighbor-joining method. Strains isolated from patient A and the recipient pair were clustered within a closer range of evolutionary distances than were strains recovered from the recipient pair and patients B and C. Furthermore, strains from patient A and the recipient were also clustered on the S gene sequences of HBV. These results demonstrated that patient A alone was the source of direct transmission to the recipient. This approach can be used to investigate the transmission route of HBV.- - - - - - - - - - ranking = 0.85714285714286keywords = hepatitis (Clic here for more details about this article) |
3/40. Successful treatment with adefovir dipivoxil in a patient with fibrosing cholestatic hepatitis and lamivudine resistant hepatitis b virus.Fibrosing cholestatic hepatitis (FCH) is a severe clinical and histological variant of hepatitis b virus (HBV) infection seen most commonly in the HBV infected allograft after liver transplantation. Without treatment, FCH is fatal, rapidly and universally. Remission has been reported with lamivudine but is associated with evolving resistance to lamivudine. Adefovir dipivoxil has recently been reported to be a potent and highly effective inhibitor of HBV replication in both wild-type and lamivudine resistant HBV infection. We report a case of FCH 15 months after liver transplantation for HBV related cirrhosis despite therapy with lamivudine and hepatitis B immunoglobulin (HBIg). Within two weeks of commencing treatment with adefovir dipivoxil 10 mg once daily, the patient had made a remarkable recovery with resolution of jaundice and normalisation of liver biochemistry. HBV dna and hepatitis B e antigen were lost from serum subsequently and liver histology had improved at four months. This case report suggests firstly, that advanced FCH can be reversed and secondly, that addition of adefovir dipivoxil to lamivudine and HBIg may be an effective antiviral strategy.- - - - - - - - - - ranking = 1.7142857142857keywords = hepatitis (Clic here for more details about this article) |
4/40. Occupational hepatitis due to chronic inhalation of propane and butane gases.Toxic hepatitis due to anaesthetic gas inhalation has been well documented, but hepatitis caused by inhalation of non-halogenated hydrocarbons has not been reported. We present an acute case of occupational hepatitis due to chronic inhalation of propane and butane gases.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
5/40. Transmission of hepatitis c by blood splash into conjunctiva in a nurse.The risk of transmission of hepatitis c virus (HCV) infection is an important problem for the health care worker. HCV transmission by blood splashing into eyes is very rare. In a hemodialyses department, a 23-year-old female nurse splashed blood from a patient who was anti-HCV positive into her eyes. She washed her eyes with water immediately and reported to the infection control department. She had never used intravenous drugs nor received transfusions. At the time of exposure, there was no abnormality in her laboratory tests. Her anti-HCV and HCV-rna tests produced negative results. She was followed up for anti-HCV and alanine aminotransferase activity. After 6 months, she presented with sore throat, nausea, vomiting, fatigue, and weight loss. She had icterus and hepatomegalia. In laboratory tests, alanine aminotransferase level was 504 U/L, aspartate aminotransferase level was 388 U/L, and anti-HCV and HCV-rna tests produced positive findings. She was treated with interferon alfa-2a for a 1-year period. After treatment, an HCV-rna test produced negative results and transaminase levels were normal. In conclusion, splashing blood from patients who are HCV positive into the face or eyes is a risk for health care workers. They should be educated to prevent a nosocomial acquisition of bloodborne infection and they should observe protective precautions.- - - - - - - - - - ranking = 0.71428571428571keywords = hepatitis (Clic here for more details about this article) |
6/40. Bilateral mycotic axillary artery false aneurysms in an intravenous drug user: unsuspected broken needle-tips pose a risk to the treating personnel.Mycotic false aneurysms due to local arterial injury from attempted intravenous injections in drug addicts are increasing in frequency. The high incidence of hiv and hepatitis b virus in parenteral drug users may present a considerable risk to the treating personnel. This paper reports the unsuspected presence of broken needle-tips in the subcutaneous tissues of an intravenous drug abuser, in association with bilateral mycotic aneurysms of the axillary arteries. Broken needle-tips have the potential to cause needlestick injury to the operating team and the nursing staff, with the associated risk of transmission of hiv and hepatitis b virus infection. The presence of broken needle-tips should be suspected in drug users presenting with false aneurysms associated with local arterial injection injury and a specific history of needle-breakage should be sought. Preoperative plain radiographs should be performed of the planned operative field to exclude the presence of such needle-tips. Any soft tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being a false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management.- - - - - - - - - - ranking = 0.28571428571429keywords = hepatitis (Clic here for more details about this article) |
7/40. Implications of postvaccination hepatitis B surface antigenemia in the management of exposures to body fluids.A neonate vaccinated against HBV was the source of an occupational exposure to blood. She was tested for hepatitis B surface antigen and found to be positive, leading to unnecessary treatment, retesting, and concern. Evaluation of the infectious status of HBV should rely on other means if vaccination has recently occurred.- - - - - - - - - - ranking = 0.71428571428571keywords = hepatitis (Clic here for more details about this article) |
8/40. Safe inoculation of blood and bone marrow for liquid culture detection of mycobacteria.BACKGROUND: needlestick injuries confer an unnecessary risk of occupational bloodborne infections such as human immunodeficiency virus (hiv), hepatitis b virus (HBV) and hepatitis c virus (HCV) infections. After an accidental needlestick injury, procedures for inoculation of liquid culture media for rapid detection of mycobacterium tuberculosis complex and other mycobacteria from blood and bone marrow specimens were reviewed. AIM: To identify a safer transfer device, which could replace the ordinary syringe in inoculation of liquid culture vials. methods: We identified a transfer device to transfer blood or bone marrow specimens from bedside tubes into liquid culture vials. CONCLUSION: The changed procedure will reduce the risk of needlestick accidents and be of benefit to other microbiological laboratories using the same or similar inoculation techniques.- - - - - - - - - - ranking = 0.28571428571429keywords = hepatitis (Clic here for more details about this article) |
9/40. Two cases of accidental transmission of hepatitis c to medical staff.Two medical doctors (a 38-year-old male and a 25-year-old female) were admitted to our department with jaundice. They had injured themselves with, respectively, a scalpel and a needle contaminated with anti-hepatitis c virus antibody-positive blood, at 2 and 1.5 months, respectively, prior to admission. They were both suffering from clinically typical acute hepatitis. The polymerase chain reaction showed that hepatitis c rna and anti-hepatitis c virus antibody were transiently positive in the male doctor, while serum transaminase levels were transiently abnormal. In the female doctor, hepatitis c rna was initially negative, but became strongly positive, and abnormal serum transaminase levels persisted. Interferon therapy resulted in the hepatitis c rna's becoming negative again, and the transaminase levels returned to normal. The clinical and other findings strongly suggested that in both patients hepatitis c developed as a result of the respective in-hospital accidents.- - - - - - - - - - ranking = 1.5714285714286keywords = hepatitis (Clic here for more details about this article) |
10/40. Occupational plasmodium falciparum malaria following accidental blood exposure: a case, published reports and considerations for post-exposure prophylaxis.A French nurse presented plasmodium falciparum malaria 10 d after a needlestick while sampling blood in a source patient with malaria. As did the source patient, the nurse recovered fully although diagnosis was delayed and her malaria severe. We proceeded to a thorough description of the transmission profile of P. falciparum following occupational needlestick. A review of the literature found 21 published reports of occupational malaria including our own, documenting 22 P. falciparum infections. One of these was lethal. The mean incubation time to fever onset was documented in 21 reports including our own and is 11.60 /- 3.38 d (median 12.0, range 4-17 d). The incubation period was compatible to that found in experimental anopheline bites or transfusion malaria. The transmission profile cites a pathogen which may be more easily transmissible by occupational exposure to blood than human immunodeficiency virus (hiv) or hepatitis c virus (HCV). Undiagnosed malaria in non-immune health care workers can be lethal. Presumptive treatment of malaria is widely available and well tolerated. Clinicians should consider P. falciparum malaria when faced with a febrile patient who has or may have been exposed to biological fluids. Further research is needed in the field of P. falciparum prophylaxis following accidental exposure to a malaria patient's blood.- - - - - - - - - - ranking = 0.14285714285714keywords = hepatitis (Clic here for more details about this article) |
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