Beware the steroid responsive nature of a pyrexial illness

Article Abstract:

The diagnosis of skeletal tuberculosis can be obscured by treatment with steroids. A 74-year-old woman who had worked in a tuberculosis sanitarium 40 years previously was admitted with a fever. Inflammation of the thyroid was diagnosed and steroids prescribed for fever. Over the next two years, she experienced recurrent episodes of fever, pain in her hip, and swelling of her thigh. Infected hematoma and muscle inflammation were diagnosed and treated at different times. A Staphylococcus aureus lung infection and a lung clot occurred. These responded to antibiotics and anticoagulants, respectively, but steroids were repeatedly necessary for fever. Two years after her initial admission, a magnetic resonance imaging scan was performed, and an abscess was found in her hip. The abscess was surgically drained, and the pus grew Mycobacterium tuberculosis. She was treated and cured. Skeletal tuberculosis is difficult to diagnose because symptoms spontaneously worsen and improve. In this case, steroids further confused the diagnosis by relieving her recurrent fever.

Health aspects, Care and treatment, Tuberculosis, Bacterial infections, Steroids (Drugs)

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Intensive care

Article Abstract:

Professor Christopher Wastell, who leads the surgery team at London's Westminster Hospital, recommended giving patients and staff better protection from HIV and hepatitis virus transmission during surgery at a meeting of the Royal Society of Medicine. Preventative measures including wearing two pairs of latex gloves and other protective clothing. Intensive training and prophylactic AZT after injury are also important. Similar advice for protecting against virus infection in dental surgeries was presented by David Croser of the Riverside Dental Clinic.

Safety and security measures, Prevention, Medical personnel, Protection and preservation, AIDS (Disease), Surgeons, Hepatitis, Dental personnel

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