A case of hypothyroidism that manifested as depression and deteriorating functional status and that ultimately resulted in the death of a 41-year-old patient with AIDS is described. Postmortem examination revealed destruction of the thyroid gland by Kaposi's sarcoma. Analysis of stored serum samples revealed that the patient had become profoundly hypothyroid during his terminal illness. Practitioners are reminded of the need to exclude metabolic causes when treating encephalopathy in patients infected with human immunodeficiency virus.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Spotted fever group rickettsial infections in Australia.

More than four decades ago, Rickettsia australis was discovered to be the etiologic agent of Queensland tick typhus (QTT), yet many unanswered questions persist about the ecology, epidemiology, and clinical features of this disease. We review 46 previously published cases of QTT along with 16 cases discovered by active surveillance. QTT is usually a mild disease. Patients often have regional lymphadenopathy and eschars. Some have vesicular rashes. Because clinical features overlap, serologic tests are necessary to distinguish QTT from other endemic Australian rickettsial diseases (scrub and murine typhus). Only two tick vectors of R. australis have been identified: Ixodes holocyclus and Ixodes tasmani. Until rickettsiae are isolated from patients in Victoria and Tasmania, it remains unproven that spotted fever group infections in these locations are due to R. australis. However, available serologic, epidemiologic, and clinical data suggest that QTT is not confined to the area in which R. australis was first isolated (Queensland); rather, it occurs along a 3,200-km span of eastern coastal Australia, from tropical to temperate climates.

Adolescent↗

PubMedDate not supplied

Immunoblot confirmation of immune response to Campylobacter pyloridis in patients with duodenal ulcers.

The specificity of serum immune responses to Campylobacter pyloridis that were found in the sera of patients with duodenal ulcers has been confirmed by means of the Western blot method. The presence of the same immune response to the organism in apparently healthy individuals, especially older people, suggests a repeated exposure throughout life to this organism, the source of which remains unknown.

Adult↗