Henoch-Schönlein purpura complicating staphylococcal endocarditis in a heroin addict

A 21-year-old heroin addict with right-sided staphylococcal endocarditis developed skin purpura, abdominal pain, bloody diarrhea, proteinuria and microscopic hematuria. Skin biopsy showed leukocytoclastic vasculitis with IgA deposits in dermal vessels and renal biopsy disclosed proliferative glomerulonephritis with granular mesangial IgA and fibrinogen deposition. These features are typical of Henoch-Schönlein purpura. Symptoms abated spontaneously. Since the syndrome appeared during cloxacillin therapy, both this drug or the infectious disease itself could have triggered the immune response. Henoch-Schönlein purpura is a distinct clinical entity that can complicate the course of staphylococcal endocarditis.

Marrow aplasia during high dose mebendazole treatment

A patient with chronic liver disease was treated with large doses of mebendazole for a hepatic hydatid cyst. Eighteen days after beginning treatment he developed marrow aplasia which reverted to normal after the drug was stopped. This is the marrow aplasia which reverted to normal after the drug was stopped. This is the sixth patient described as developing marrow aplasia when treated with large doses of mebendazole. We suggest that the aplasia is related to the dose of the drug, and that the patient's chronic liver disease was an important factor in its genesis. Patients treated with large doses of mebendazole should have their blood counts monitored during treatment.

Disseminated visceral infection with Mycobacterium fortuitum in a hemodialysis patient

A 28-year-old patient with chronic renal failure on maintenance hemodialysis developed fever, granulomatous hepatitis, pulmonary infiltrates, sacroiliitis, and spondylitis which were unresponsive to conventional antituberculous treatment. Cultures of the sputum gave repeated growth of Mycobacterium fortuitum. This organism was resistant 'in vitro' to most antituberculous drugs and sensitive to some aminoglycosides and doxycycline. No mycobacteria were found in the water used for dialysis. The patient was successfully treated with amikacin and doxycycline. Nontuberculous mycobacterial infection should be considered in the differential diagnosis of febrile illnesses resembling tuberculosis in hemodialysis patients. Defective immune mechanisms could contribute to this complication. Since M. fortuitum is usually resistant to antituberculous drugs, precise identification and sensitivity testing are essential for optimal management.

Simple colorimetric method for seminal plasma zinc assay

Zinc concentration in seminal plasma is one of the best biochemical parameters with which to assess prostatic function in the study of male infertility. Nevertheless, this parameter is not determined in many laboratories because of technical difficulties. In this paper a simple colorimetric method for seminal plasma zinc assay is presented. This assay is performed with only one reagent solution making deproteinization and extraction with organic solvents unnecessary. The method is based on the reaction between 1-(2-pyridylazo)-2-naphthol and zinc which yields a coloured complex, that is soluble in the reagent solution when dodecyl hydrogen sulfate sodium salt is present. The solubilized complex has an absorbance peak at 560 nm. The accuracy of this method is proved by statistical comparison with atomic absorption spectrophotometry. Furthermore, the method has a good precision and is free of interference.