Biomedical subjects

M Jensenius

Publications and source records attributed to M Jensenius.

33 records · Page 2Linked to original sources

PubMed1998

[Imported fever. A diagnostic challenge].

Fevers without distinguishing symptoms in persons who have visited tropical or subtropical areas is an increasing health problem in most western countries. The condition may be caused by several different microbes, but among cases diagnosed in Norway five infections dominate: falciparum malaria, vivax malaria, typhoid fever, paratyphoid fever and dengue fever. Primary measures should be taken against immediate life-threatening diseases e.g. typhoid fever and falciparum malaria.

Africa↗

PubMed1997

[Dengue fever. Another infectious disease out of control?].

In the 1950s dengue fever left its home in South-East Asia. The result, as we see it 40 years later, is terrifying. From being an almost unknown infection, dengue fever is today's most common arboviral disease with up to 100 million cases annually. In addition, the clinical picture has changed from a benign influenza-like disorder (classic dengue fever) to a serious disease with bleeding and hypovolemic shock (dengue hemorrhagic fever). In this article the authors give an overview of the present epidemiology, prognosis and possible preventive measures against dengue fever.

Dengue↗

PubMed1997

[Dengue fever imported to Norway. Serologically confirmed cases 1991-96].

With up to 100 million cases annually, dengue fever is today's most important arboviral disease. Dengue fever is endemic in many parts of South-East Asia, the Indian subcontinent, Oceania and the Americas. The disease mainly affects the local population, but occasionally also visitors from non-endemic areas. In this article we present epidemiological and clinical data on all 26 cases with serological confirmed dengue fever diagnosed in Norway in 1991-1996. 21 patients (81%) were infected in Asia. Typical exanthema, leucopenia, and thrombocytopenia were seen in 71%, 79% and 84% of the cases, respectively. A 37-year-old Indian-born woman developed dengue haemorrhagic fever grade 1 after a visit to New Delhi, while the remaining 25 patients had classical dengue fever. Postinfectious complications were common, and four weeks after the acute illness, hair loss, mental depression and asthenia were reported by 45%, 50% and 100% of the cases, respectively.

Adult↗

PubMed1997

[Q-fever imported into Norway].

Q fever is an important zoonosis that occurs throughout the world. In contrast to most other European countries, there has been no evidence of endemic Q fever in Norway up to now. The disease is caused by Coxiella burnetii, a rickettsia-like bacterium. Humans are infected mainly by inhalation of contaminated aerosols from cattle, sheep and goats. Clinical manifestations are protean, ranging from asymptomatic infection to life-threatening endocarditis. In this article we present the first four cases of serological proven acute Q fever imported into Norway. The patients were Norwegian tourists who had visited Bhutan, the Canary Islands, and Morocco. Two patients had fever with maculopapular exanthema, one had pneumonia, and one had biopsy-proven granulomatous hepatitis. Three were treated with tetracyclines. All four patients recovered well.

Aged↗

PubMed1997

[Endemic typhus imported to Norway].

Murine typhus, caused by Rickettsia typhi, is an important zoonosis in all parts of the world. The disease is transmitted from rodents to humans by fleas. In this article we describe the first three cases of serologically proven murine typhus imported into Norway during the 1990s. The patients were Norwegian tourists who had visited respectively Guinea-Bissau, Crete and Thailand. They all became acutely ill with fever, chills and severe headache 1-10 days after return to Norway. None of them had a rash. Two patients were admitted to hospital, and one was treated with ciprofloxacin for suspected typhoid fever. All the patients recovered without sequelae. The diagnosis of murine typhus was based on detection of IgM-anti-bodies against R typhi in serum samples during reconvalescence.

Adult↗

PubMed1997

[Serous meningitis associated with primary genital herpes infection].

Aseptic meningitis is not an uncommon complication to primary genital herpes infection caused by herpes simplex virus type 2 (HSV-2). Compared with other types of viral meningitis, HSV-2-meningitis is associated with a significant rate of neurological complications in the acute stage. In addition, some patients will suffer from recurrent aseptic meningitis (Mollaret's meningitis) later. We describe six patients, five women and one man, age 26-35 years, with aseptic meningitis caused by HSV-2. All the patients showed serological evidence of primary herpes infection (negative HSV-IgG and/or positive HSV-IgM in serum samples). Polymerase chain reaction detected HSV-2 in cerebrospinal fluid in all five of five cases, while virus cultures were positive in two of the six cases. Only three patients showed clinical signs of simultaneous genital herpes infection. One patient, a 28-year-old female, developed transient autonomic nervous system dysfunction with urinary retention, constipation, and neuralgic pain in the buttocks, perineum and lower limbs. 13 months later she was hospitalised for a genital herpes infection with headache, parestesia and fever, but spinal fluid examination showed no abnormality.

Adult↗

PubMed1997

[An outbreak of hepatitis A among intravenous drug addicts in Oslo 1995-96].

Intravenous drug abuse is a well-known risk factor for acquiring hepatitis A infection. Among drug abusers most cases are sporadic, but epidemic outbreaks may occur occasionally. In this article we describe an epidemic outbreak including 144 serologically proved cases of hepatitis A among intravenous heroin and amphetamine abusers in Oslo. The outbreak lasted for 11 months. 59 (41%) of the patients were admitted to hospital. One of them died and seven developed severe but reversible acute hepatitis. We also registered 26 cases of hepatitis A among close contacts, 14 of whom were associated with a nosocomial outbreak that affected nurses, fellow patients and relatives. We do not know how the hepatitis A virus was introduced into the abuser population, but the further spread was probably dominated by a combination of faecal-oral transmission and parenteral transmission secondary to sharing needles. Although we were unable to detect hepatitis A virus in confiscated drug samples by means of polymerase chain reaction we cannot exclude that some abusers were infected by injection of contaminated amphetamine.

Adult↗

PubMed1997

Characterisation of an epidemic of hepatitis A virus involving intravenous drug abusers--infection by needle sharing?

An epidemic of hepatitis A virus (HAV) among intravenous drug abusers in Oslo involved 144 serologically confirmed cases. Another 26 patients (non-drug abusers), of whom 14 were derived from a single nosocomial outbreak, were associated with the epidemic. Sequencing of the VP1/P2A junction revealed that viruses associated with the epidemic were completely identical, whereas other HAV samples collected during the same period differed by up to 10%. HAV was detected in the serum of 48 of 100 patients by a nested PCR. Viremia was observed as early as 25 days before the onset of clinical hepatitis, and up to 30 days after. The large number of patients within the drug abuser group, and the few secondary cases, raised the question of whether the virus could be transmitted by the use of needles. To establish whether viral contamination of drugs did contribute appreciably to maintaining the epidemic, we examined heroin and amphetamine confiscated during the period, using immunomagnetic separation coupled to nested PCR, but failed to detect any virus. Antibodies against hepatitis B virus and hepatitis C virus were common among the HAV infected drug abusers (43% and 81%, respectively), suggesting widespread sharing of needles. This observation and the large number of patients with a demonstrable viremia suggest that needle sharing may contribute to the dissemination of HAV.

Amphetamine↗

PubMed1996

[Deep venous thrombosis in intravenous drug addicts].

Long-lasting intravenous drug abuse causes sclerosis of the superficial venous system. Many drug abusers thus choose to inject into the major veins of the groin or neck. Such practice may, among various other complications, cause deep venous thrombosis. We describe four patients with venous thrombophlebitis localised at the ileo-femoral junction. All patients were intravenous drug abusers, who for many years had injected various drugs into the groin. Two patients suffered a relapse after the treatment was discontinued. One patient had nonfatal pulmonary embolism. All four patients were treated with low-molecular-weight heparin. Three patients were later treated with warfarin, but, owing to bad compliance, this treatment had to be discontinued quite soon in two cases. We conclude that the management of deep venous thrombosis can be difficult in intravenous drug abusers. This is due mainly to poor venous access, the risk of transmitting blood-borne viruses to health personnel, asocial behaviour, and poor compliance. For most patients, we advocate administration of low-molecular-weight heparin for at least three months. Supporting treatment with metadone should be considered in selected cases.

Adult↗

PubMed1995

[Proper use of antibiotics--what is that?].

Antibiotics are one of the cornerstones of modern medicine. During the last 20 years there has been an alarming world-wide spread of multiple-resistant bacteria. One of the main reasons is the overuse of all types of antibiotics, especially broad-spectrum drugs. This paper gives general advice on antibiotic therapy in Norway. We adovcate the use of drugs with little ecological impact, such as the penicillins. Whenever possible, empiric treatment with macrolides, tetracyclines cefalosporines, imipenem and fluoroquinolones should be avoided.

Anti-Bacterial Agents↗

PubMed1995

[Extrapulmonary tuberculosis. An important differential diagnosis in immigrants with suspected malignancy].

The incidence of tuberculous disease is increasing all over the world, mostly in the poor, developing countries, but also in some industrialized countries. In Norway, extrapulmonary tuberculosis is a rare phenomenon. It is found mostly among older Norwegians and in younger immigrants from the third world. Since the disease is rare, it may be overlooked or confused with malignant disease. We describe two patients with unusual forms of extrapulmonary tuberculosis, both mimicking neoplastic disease. The first patient was a 27-year-old woman from South-East Asia, who was operated on for suspected intraductal comedo-type carcinoma of the breast, but histological examination showed tuberculous mastitis. The second patient was a 26-year-old man from East Africa with a medical history indicating intra-abdominal lymphoma. The final diagnosis, however, was mesenteric tuberculous lymphadenitis. Both patients were treated successfully with isoniazid, rifampicin and pyrazinamide.

Abdomen↗

PubMed1995

[The end of antibiotics? Increasing bacterial resistance in global and Norwegian perspective].

During the last 20 years there has emerged a growing world-wide problem with regard to multidrug-resistant microbes. The most serious examples so far are vancomycin-resistant strains of Enterococcus faecium, totally resistant isolates of Mycobacterium tuberculosis and multiple-resistant Staphylococcus aureus and Streptococcus pneumoniae. With the exception of some few strains of methicillin-resistant S. aureus and vancomycin-resistant enterococci, such bacteria have not been found in Norway. In this article we discuss possible ways of preventing further selection and spread of multiple-resistant microbes. We stress the importance of infection control programmes and restrictive use of antibiotics.

Communicable Disease Control↗

PubMed1995

[Yersinia enterocolitica septicemia after blood transfusion].

Transfusion-associated transmission of Yersinia enterocolitica was first described in 1982. Since then more than 40 cases have been reported world-wide. The blood units are contaminated from apparently healthy donors who may, however, recently have had an episode of diarrhoea. Y enterocolitica is able to grow in packed red cells at refrigerator temperature. The mortality rate among recipients of contaminated blood is more than 50%. We describe a non-fatal case of a 80 year-old male who received one unit of packed red blood cells contaminated with Y enterocolitica (serogroup O:3, biotype 4). The blood had been collected 14 days before from a Norwegian donor with transient and slight abdominal discomfort. The microbe was isolated both from the patient's blood and from the donor blood bag. The patient was treated with ofloxacin and recovered without sequelae.

Aged↗

PubMed1995

[Hookworm disease. A differential diagnosis in iron deficiency anemia].

Hookworms are among the most widespread of human parasites and occur all over the tropics and subtropics. They are bloodsucking roundworms that inhabit the duodenum and jejunum. Usually the infection is mild (hookworm carrier state), but sometimes the infection is heavy and results in anaemia and/or hypoproteinemia (hookworm disease). Hookworms are occasionally imported to Norway by immigrants. This paper describes two cases of severe and life-threatening hookworm disease treated in our hospital. The first patient was a Pakistani woman born in 1929 who on admission was hypovolemic with severe hypochromic anaemia (haemoglobin 3.6 g/100 ml). The second patient was a Bolivian refugee born in 1946 with a similar clinical picture (haemoglobin 3.3 g/100 ml). Both patients were treated with blood transfusions followed by mebendazol and iron substitution. The article also reviews the current literature on the epidemiology, pathogenesis and therapy of hookworm infection.

Aged↗

PubMed1990

Detection of serum antibodies against Borrelia burgdorferi with some commercially available serological tests.

Sixty-three sera were analysed for antibodies against Borrelia burgdorferi with an in-house indirect immunofluorescence assay. Thirty-nine sera were positive (titer greater than or equal to 256), seven borderline (titer 128) and 17 negative (titer less than or equal to 64). These results were compared with results obtained with four different commercial assays for detection of such antibodies. Indirect immunofluorescence tests yielded most positive results. The flagellin ELISA test detected antibodies in patients with erythema chronicum migrans (ECM) more often than the other test systems. Sera from patients with acrodermatitis chronica atrophicans (ACA) were positive in all systems. The serological diagnosis of borreliosis is difficult and direct methods for detecting the presence of the microbe are highly needed.

Antibodies, Bacterial↗