Cationic antimicrobial peptides are important components of the innate immune defences of all species of life. Variants of these natural molecules have a broad range of antibiotic, antifungal, antiviral and anti-endotoxic activity. Two of these cationic peptides have shown signs of efficacy in early clinical trials of oral mucositis and the sterilisation of central venous catheters, respectivel...

Extrameningeal complications of meningococcal septicaemia occur in about 11–19% of cases, and include myocarditis, acute renal failure, arthritis, pneumonia, skin gangrene, conjunctivitis, endocarditis, pericarditis, endophthalmitis, urethritis, WaterhouseFriderichsen syndrome, vasculitis, and digital ischaemia. We describe the use of a prostacyclin analogue in the treatment of cutaneous digita...

BACKGROUND Improving the recognition of transient ischaemic attack (TIA) at initial healthcare contact is essential as urgent specialist assessment and treatment reduces stroke risk. Accurate TIA detection could be achieved with clinical prediction rules but none have been validated in primary care. An alternative approach using qualitative analysis of patients' experiences of TIA may identify ...

Meningococcal septicaemia has high mortality, especially when the diagnosis is delayed or missed. Early recognition is not always straightforward, as classic clinical features may be absent or overlooked at initial presentation. Septicaemia without focal infection accounts for 15%-20% of cases of meningococcal disease and is the most worrisome manifestation in terms of diagnosis and outcome; in...

Correspondence The State of the World's Children Sir, We were interested to read in David Morley's recent annotation 'The State of the World's Children' that in the Gambia there is a 10% mortality in the subsequent nine months after infection with measles, and this compares with only 1% in controls.' Our own interest in the possible predisposition to subsequent death from measles infection was ...

RESULTS: The 8 patients ranged in age from 30 to 62 years old; seven males and one female with injuries at fingertip. Mean follow-up period was about 8 months. All the adipofascial island flaps survived completely and provided excellent soft tissue coverage, and all the skin grafts were taken well. There were no complications, such as infection or re-exposure of bone. And the donor site showed ...

A 17-year-old male presented to the emergency department with complaints of fever, rash that originated on the abdomen, malaise, and a cough for 10 days prior to evaluation. The patient reported an encounter with an opossum three days prior to the onset of symptoms. Vital signs were a temperature of 101.2°F, a heart rate of 129 beats per minute, 12 respirations per minute and a blood pressure o...

CONTEXT In 1993, Oregon's incidence of serogroup B meningococcal disease began to rise because of a highly clonal group of strains designated enzyme type 5 (ET-5), the first such increase observed in the United States. OBJECTIVE To evaluate the impact that the ET-5 strain has had on the epidemiology of meningococcal disease in Oregon. DESIGN AND SETTING Epidemiologic analysis of surveillanc...

Hyperacute infections, i.e., infections which are often fatal within 24 hours from the onset of symptoms, and resistant strains of organisms, account for the vast majority of failures in the use of antibiotics. A few cases cannot be classified into either category and remain as unexplained failures. The magnitude of the problem of hypenacute infections can be judged by the fact that in a contag...

BACKGROUND Genetic variation in immune response genes is associated with susceptibility and severity of infectious diseases. Toll-like receptor (TLR) 9 polymorphisms are associated with susceptibility to develop meningococcal meningitis (MM). The aim of this study is to compare genotype distributions of two TLR9 polymorphisms between clinical severity variables in MM survivors. METHODS We use...