This review provides a practical and simple clinical approach to the diagnosis and management of foodborne infections. Most episodes of acute diarrhea are self-limited, and investigations should be performed only if the results will influence management and outcome. After history taking and physical examination, the clinical should be able to classify the acute diarrheal illness, assess the severity, and determine whether investigations are needed. Most patients do not require specific antimicrobial therapy. Therapy should be directed mainly at preventing dehydration. Oral rehydration solutions suffice in mild, self-limited diarrhea, as they are formulated to stimulate sodium and water absorption. However, intravenous hydration therapy is required in diarrheal patients with severe dehydration. Antibiotic therapy is required in dysentery.
Absorption ; Dehydration ; Diagnosis ; Diarrhea ; Dysentery ; Fluid Therapy ; Humans ; Physical Examination ; Sodium ; Water

No abstract available.
Dysentery, Bacillary*

No abstract available.
Dysentery, Bacillary*

No abstract available.
Fever*

No abstract available.
Enterohemorrhagic Escherichia coli*

Patients with human immunodeficiency virus (HIV) infection have a higher burden of seizures, but few studies have examined seizures in HIV-infected individuals in Korea. A retrospective study was conducted to determine the epidemiology and clinical characteristics of seizures in patients with HIV infection. Among a total of 1,141 patients, 34 (3%) had seizures or epilepsy; 4 of these individuals had epilepsy before HIV infection, and the others showed new-onset seizures. Most patients exhibited moderate (200 to 500, n = 13) or low (below 200, n = 16) CD4 counts. The most common seizure etiology was progressive multifocal leukoencephalopathy (n = 14), followed by other HIV-associated central nervous system (CNS) complications (n = 6). Imaging studies revealed brain lesions in 21 patients. A total of 9 patients experienced only one seizure during the follow-up period, and 25 patients experienced multiple seizures or status epilepticus (n = 2). Multiple seizures were more common in patients with brain etiologies (P = 0.019) or epileptiform discharges on EEG (P = 0.032). Most seizures were controlled without anticonvulsants (n = 12) or with a single anticonvulsant (n = 12). Among patients with HIV infection, seizures are significantly more prevalent than in the general population. Most seizures, with the exception of status epilepticus, have a benign clinical course and few complications.
Adult ; Aged ; Anticonvulsants/therapeutic use ; Causality ; Comorbidity ; Electroencephalography/*statistics & numerical data ; Female ; HIV Infections/diagnosis/*epidemiology ; Humans ; Incidence ; Longitudinal Studies ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Risk Factors ; Seizures/*diagnosis/*epidemiology/prevention & control ; Treatment Outcome

BACKGROUND: Shiga toxin (Stx)-producing Enterohemorrhagic Escherichia coli (EHEC) infections are increasing in incidence. Sorbitol fermenting E. coli O157 has been reported and many serotypes of E. coli produce various Stx such as Stx1, Stx2, or variants of Stx2. The aim of the present study is to examine the validity of colony hybridization using stx-specific oligonucleotide to identify EHEC. METHODS: Stx1-producing E. coli ATCC 43890, Stx2-producing E. coli ATCC 43889, and Stx2c- producing E. coli ATCC 51435 were used as reference strains. Multiplex PCR was conducted on diarrheal stools and colony hybridization with stx1- and stx2- specific oligonucleotide was tested on PCR positive and PCR negative diarrheal stools. Biochemical tests and O serotyping were performed for the colonies isolated by colony hybridization. Vero cell cytotoxicity was determined to confirm whether the isolated E. coli produced Stx. RESULTS: Colony hybridization of 3 reference strains could detect Stx-producing E. coli at 10(3) CFU per 0.1 g of stool. Among 131 stools, 2 stx1 gene positive stools and 5 stx2 gene positive stools were detected by PCR. 124 PCR negative stools were also negative in colony hybridization. Colony hybridization detected 1 stx1-positive E. coli and 4 stx2-positive E. coli of 7 PCR positive stools. The serotypes of positive E. coli were O146, O8, O153, O26, but 1 strain was non-typable. All of the isolated E. coli fermented sorbitol, and 3 strains had EHEC-hlyA. All of the isolated E. coli showed characteristic cytotoxicity in Vero cell monolayer culture. CONCLUSION: Colony hybridization with stx-specific oligonucleotide is a sensitive and highly specific diagnostic test to identify EHEC. However to improve the sensitivity, stool culture in a selective enrichment media before colony hybridization should be considered.
Diagnostic Tests, Routine ; Enterohemorrhagic Escherichia coli* ; Escherichia coli ; Incidence ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction ; Serotyping ; Shiga Toxin ; Sorbitol ; Vero Cells

The rapid spread of severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2) in the population and throughout the cells within our body has been developing. Another major cycle of coronavirus disease 2019 (COVID-19), which is expected in the coming fall, could be even more severe than the current one. Therefore, effective countermeasures should be developed based on the already obtained clinical and research information about SARSCoV- 2. The aim of this review was to summarize the data on the empirical treatment of COVID-19 acquired during this SARS-CoV-2 infection cycle; this would aid the establishment of an appropriate healthcare policy to meet the challenges in the future. The infectious disease caused by SARS-CoV-2 is characterized by common cold along with hypersensitivity reaction. Thus, in addition to treating common cold, it is essential to minimize the exposure of cells to the virus and to mitigate the uncontrolled immune response. A proper combination of antiviral agents, immune modulators such as prednisolone, and anticoagulants such as heparin and anti-C5a antagonists could be employed to minimize lung damage and prevent systemic involvements. Finally, strategies to achieve population immunity against SARS-CoV-2 should be developed through understanding of the interaction between the immune system and the virus.

OBJECTIVES: This study aimed to investigate the psychiatric status of HIV-infected/AIDS inpatients in a general hospital over the past 2.5 years. METHODS: A retrospective chart review was conducted of psychiatric consultations performed between January 1, 2011, and July 30, 2013. The records of 97 HIV-infected/AIDS patients were analyzed. These included a total of 282 psychiatric consultations. RESULTS: Of the 97 patients, 91(93.8%) were male, the mean age was 48 years, and mean number of consultations was 2.8. Depressed mood was reported in 102 consultations(23.8%), insomnia in 60(14.0%), and anxiety in 31(7.2%). Psychiatric disorders diagnosed on initial consultation included depressive disorder(37 patients ; 37.0%), cognitive disorder(11 ; 11.0%), and delirium(9 ; 9.0%). Recommended psychotropic medication included Lorazepam(99 ; 17.2%), Escitalopram(90 ; 15.7%), and Quetiapine(84 ; 14.6%). CONCLUSIONS: The main complaints of HIV-infected/AIDS patients were depressed mood, insomnia, and suicidal ideation(including suicide attempts). In total, 85(93.3%) patients of those consulted were diagnosed as meeting the criteria for a psychiatric condition. However, considering that only 16.9% of patients consulted received follow-up treatment, longitudinal research is needed to examine the influence of psychiatric disorders on the transmission of HIV-infection/AIDS, as well as on prognosis and treatment adherence.
Anxiety ; Follow-Up Studies ; HIV ; Hospitals, General ; Humans ; Inpatients ; Male ; Prognosis ; Referral and Consultation ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; Suicide