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1/5. Fite stain positivity in rhodococcus equi: yet another acid-fast organism in respiratory cytology--a case report.

    rhodococcus equi is an aerobic Gram-positive and acid-fast coccobacillus that may cause cavitary pneumonia in immunocompromised hosts such as hiv-infected patients. Numerous Grocott's methenamine silver (GMS)-positive organisms were initially noted on the direct smear; a minor number of acid-fast organisms were seen in the Thin-Prep slide. Since the abundant mucous material with the attached organisms seen in conventional smears may be lost in liquid-based preparations, more sensitive stains such as Fite, as well as a more diligent search for organisms, is needed. This case illustrates the importance of careful selection and evaluation of special stains in sputum specimens.
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ranking = 1
keywords = bacillus
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2/5. orbital cellulitis caused by eikenella corrodens.

    eikenella corrodens is a gram-negative, facultative anaerobic bacillus with specific culture and growth requirements and unusual antibacterial susceptibilities. It has only recently been recognized as a human pathogen. Ocular and adnexal infections with this organism are rare especially in children. We treated two children with orbital cellulitis caused by E. corrodens. One was an 8-year-old boy; the other was an 11-year-old girl. orbital cellulitis in both patients occurred after an upper respiratory tract infection. sinusitis and a subperiosteal abscess were present in both patients. eikenella corrodens and streptococcus viridans were isolated from the boy; E. corrodens was the sole isolate in the girl. Intravenous ampicillin, prolonged hospitalization, and surgical drainage of the orbit were required to control the infection in both patients. eikenella corrodens must be considered in the differential diagnosis of orbital cellulitis in children, and ophthalmologists must become familiar with the characteristics of this peculiar organism.
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ranking = 1
keywords = bacillus
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3/5. mycobacterium heckeshornense infection in an immunocompetent patient and identification by 16S rRNA sequence analysis of culture material and a histopathology tissue specimen.

    mycobacterium heckeshornense is a rare isolate in clinical specimens. We performed simultaneous 16S rRNA sequence analysis of a mycobacterium culture and a histopathology specimen to determine the relevance of M. heckeshornense infection in an immunocompetent patient initially presenting with pneumothorax.
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ranking = 1.4220386467225
keywords = mycobacterium
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4/5. legionnaires' disease in non-Legionnaires. A report of five cases.

    Seventeen patients with illness resembling legionnaires' disease were evaluated for antibodies to the Legionnaires' bacillus. Three patients were Legionnaires who developed pneumonia after attending the July 1976 convention. All three were seropositive (titers greater than or equal to 1:128) to the Legionnaires' bacillus. None of the remaining 14 patients were Legionnaires. Five were seropositive and nine, seronegative (titers less than or equal to 1:32). The seropositive patients had illnesses best explained by legionnaires' disease, whereas the seronegative patients had illnesses better explained by other diagnoses. This correlation between serology and clinical findings supports the specificity of the antibody test for legionnaires' disease. Of the five non-Legionnaire seropositive cases, two occurred before, and one 3 months after, the convention. The case histories of these five patients are presented. Disease generally involved the lungs, kidneys, and the central nervous system. Although the pathogenesis of this multiple organ involvement is unclear, a possible explanation is the production of a toxin by the Legionnaires' bacillus.
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ranking = 3
keywords = bacillus
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5/5. legionnaires' disease--the Benidorm episode.

    The clinical pattern of illness in 2 fatal cases of legionnaires' disease is described. Common factors in the 2 patients were residence in a hotel in Benidorm, spain, a severe and progressive pneumonia unaffected by wide-spectrum antibiotics and failure to incriminate an infecting organism. The similarities with the philadelphia outbreak, in which a bacillus known as the Legionnaire agent was isolated, led to a retrospective diagnosis in the Benidorm episode. Subsequent serological surveys indicate that legionnaires' disease is widespread in nature; it is not a new disease.
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ranking = 1
keywords = bacillus
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