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PubMedDate not supplied

Lasiodiplodia theobromae isolated from a subcutaneous abscess in a Cambodian immigrant to Australia.

A patient from Cambodia presented at a hospital in Melbourne with a persistent subcutaneous abscess of the right buttock. Septate fungal hyphae were seen in biopsy tissue. Lasiodiplodia theobromae was isolated and identified by the formation of pycnidia that produced typical conidia. The abscess was managed by drainage and debridement only. We briefly review the history and importance of the fungus as a wound parasite in tropical horticulture and its relatively rare occurrence in human infections. The significance of this fungus in Australian horticulture and its potential as an opportunistic human pathogen is noted. This paper records the first isolation of L. theobromae from a human lesion in Australia and the second isolation from a subcutaneous lesion worldwide.

Abscess↗

PubMedDate not supplied

The utilization of midazolam as a pharmacologic adjunct to endotracheal intubation by paramedics.

OBJECTIVE: Pharmacologic agents have been used in the prehospital setting for facilitating endotracheal intubation (ETI). The purpose of this study was to determine the utility of intravenous midazolam for prehospital patients who require pharmacologic relaxation to facilitate ETI. METHODS: Data were reviewed retrospectively using paramedic charts from an eight-month period for a three-county state EMS system. RESULTS: There were 26,133 paramedic dispatches during the study period. Six hundred eighty-three ETIs were attempted, including 72 midazolam-facilitated intubations (MFIs). The most common indications for MFI were "clenched teeth," "gag," and "combativeness." Successful MFI was achieved in 45 of 72 cases (62.5%). Midazolam-facilitated intubation was less successful for trauma patients (41.2%) than for medical patients (69.1 %) (p = 0.04). Of the 58 failed conventional ETIs that occurred during the study period, 25 (43.1%) were identified as having one or more indications for the use of MFI. Although the use of intravenous midazolam was effective in facilitating ETI, a high MFI failure rate (37.5%) was noted. CONCLUSION: Although it is of limited efficacy, MFI is underutilized and should be considered by medical direction as a pharmacologic adjunct to ETI in selected field patients.

Delaware↗