We report a case of a 72-year-old male with a history of scleroderma who presented to the emergency room with an asymptomatic pneumoperitonum after undergoing a CT thorax for evaluation of intersitial lung disease. Abdominal imaging was performed with oral contrast and did not reveal extravasation of the contrast into the peritoneum suggesting there was no perforated viscus. The patient was man...

Dr Luis Ostrosky-Zeichner (Memorial Hermann Texas Medical Centre, Houston, USA) reported latest progress in developing predictive risk scores for invasive candidiasis (IC) in ICU patients – now responsible for 5-10% of ICU-acquired infections, with mortality comparable to that of severe sepsis/septic shock. A risk score based on ICU stay for at least 3 days, mechanical ventilation, broad-spectr...

Tigecycline, the first of a new class of broad-spectrum antibiotics (the glycylcyclines), has been licensed in South Africa for the parenteral treatment of adult patients with complicated intra-abdominal infections (cIAIs) and complicated skin and soft-tissue infections (cSSTIs). This article serves as a summary of the guideline on the appropriate use of tigecycline, published in mid-2010 as a...

Oesophagal perforation after foreign body ingestion may result in an arterio-oesophageal fistula. We present a case of a man who presented with haematemesis and hypovolemic shock after ingestion of a chicken bone. Imaging revealed an infected fistula between the oesophagus and the left subclavian artery. Haemorrhage stopped after endovascular deployment of a stent graft in the subclavian artery...

Neonatal necrotising enterocolitis (NEC) affects 1-2% of admissions to most neonatal units and is the commonest surgical emergency in the newborn. Premature infants with additional medical problems account for most cases but about 10% are term infants with a recognised risk factor such as congenital heart disease.' 2 NEC usually responds to intensive medical treatment, which includes cessation ...

One-day-old term male newborn admitted with features of birth asphyxia. An NG tube was passed and IV fluids with parenteral antibiotics were started. Next day, the patient developed a progressive abdominal distention and bilious vomiting. A plain abdominal X-ray showed evidence of massive pneumoperitoneum. Laboratory tests were within normal limits. At operation, there was an ovoid gastric perf...

The evolution of methicillin-resistant and vancomycin-resistant Staphylococcus aureus has demanded serious review of antimicrobial use and development of new agents and revised approaches to prevent and overcome drug resistance. Depending on local conditions and patient risk factors, empirical therapy of suspected S. aureus infection may require coverage of drug-resistant organisms with newer a...

Orbital penetrating injuries may cause significant harm to the optic nerves and eyeball as well as to the brain and cerebral vessels. Management of orbital foreign bodies should include prompt recognition of the extent of the injury, broad-spectrum parenteral antibiotics, tetanus prophylaxis, anticonvulsant medication and early surgical intervention under direct vision to remove the foreign bod...

Two-stage exchange remains the gold standard for treatment of peri-prosthetic joint infection after total hip replacement (THR). In the first stage, all components and associated cement if present are removed, an aggressive debridement is undertaken including a complete synovectomy, and an antibiotic-loaded cement spacer is put in place. Patients are then treated with six weeks of parenteral an...

Slow growth with respiratory and eye infections are the principal obstacles to rearing litters of kittens under laboratory conditions (Scott, 1952 b). Remarkable increases in growth have been produced by the addition of antibiotics to the diet of piglets and chicks (Stokstad & Jukes, 1950). An increase in the appetite of kittens was observed in this laboratory after parenteral injections of the...