Lactococcus garvieae is a part of the genus Lactococcus which was previously a part of the genus Streptococcus. It has been associated with serious diseases in aquaculture. However, human infections are rare. The most common presentation in humans is infective endocarditis. Urinary tract infection (UTI) is a unique presentation of this pathogen. We report the case of a 70-year-old male with a past history of benign prostatic hyperplasia who presented with confusion. Urinalysis confirmed the growth of L. garvieae. A seven-day treatment course of amoxicillin-clavulanate successfully treated the patient. The risk factors for acquiring the L. garvieae infections include contact with seafood or aquaculture. Other risk factors include immunosuppression, gastric acid suppression, and anatomical or physiological defect in the gastrointestinal tract. Special tests, such as VITEK ® 2, API® 32 strep system, 16S rRNA, or polymerase chain reaction (PCR) testing, are needed for its diagnosis. Hence, we suggest underreporting of the infection may be possible. It is a novel cause of UTI, we suggest a high index of suspicion should be kept, especially in people with associated risk factors or exposure to seafood.

A number of orthopedic injuries can occur during epileptic seizures. Anterior shoulder dislocation is one such orthopedic injury that is quite rare. The shoulder dislocation may injure the brachial plexus. Besides seizures, the nerves can also be damaged by anticonvulsive therapy. Muscle wasting following a seizure can misguide a clinician to investigate only neural or muscular pathologies. We report here an individual with epilepsy who was referred to us for electrodiagnostic evaluation of proximal muscle wasting related to a suspected proximal neuropathy. He was found to have a normal electrodiagnostic evaluation and later on discovered to have had bilateral shoulder dislocation on X-rays. This report advocates a thorough clinical appraisal, radiographs, and electrodiagnostic evaluation in a case with muscle wasting following a seizure.

No abstract

Objective: To determine the spectrum of findings in patients presenting for upper gastrointestinal (UGI) endoscopy and investigate role of age and gender. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gastroenterology & Internal Medicine, Combined Military Hospital Kharian, from Jul 2017 to Mar 2019. Methodology: The data regarding 638 consecutive patients who underwent upper gastrointestinal endoscopy in the department were collected from the computer-based database and patients were stratified into two groups according to their age: ≤50 and >50 years. Results: The mean age was 50.2 ± 17.4 (range: 7-100) years. There were 431 males and 207 females. The commonest presenting complaint was decompensated chronic liver disease (CLD) 162 (25.4%). The upper gastrointestinal endoscopy was normal in 306 (48%) and abnormal in 332 (52%) patients. The commonest abnormality seen on upper gastrointestinal endoscopy was esophageal varices seen in 167 (26.2%) followed by non-specific gastropathy, and hiatal hernia seen in 28 (4.4%) and 21 (3.3%) patients respectively. No significant differences were observed among males and females for a positive upper gastrointestinal endoscopy. Significantly large number of patients of age >50 years had an abnormal upper gastrointestinal endoscopy (p<0.001). The commonest upper gastrointestinal endoscopic abnormalities were similar in both genders and age-groups. Conclusion: The commonest finding on upper gastrointestinal endoscopy were esophageal varices and non-specific gastropathies. Females and patients ≤50 years had a higher prevalence of a normal upper gastrointestinal endoscopy. The commonly observed upper gastrointestinal endoscopy findings were generally similar among the genders and the age-groups.

No abstract