Displaying publications 221 - 240 of 568 in total

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  1. Haemorrhagic fever with renal syndrome involving the liver
    Chan YC, Wong TW, Yap EH, Tan HC, Lee HW, Chu YK, et al.
    Med J Aust, 1987 Sep 07;147(5):248-9.
    PMID: 2890086
    A case of haemorrhagic fever with renal syndrome that originated in Malaysia is reported. The patient presented with clinical symptoms which were not typical of the disease as seen in endemic regions. Renal involvement, which is characteristic of haemorrhagic fever with renal syndrome, was mild, and the predominant symptom was a persistently marked elevation of serum transaminase levels that was suggestive of hepatitis. Liver involvement has not been described in the Asian form of haemorrhagic fever with renal syndrome. The patient developed a petechial skin rash and had severe thrombocytopenia. Serological confirmation of the diagnosis of haemorrhagic fever with renal syndrome was obtained by the demonstration of significant antibody rises to hantaviruses in the patient's acute- and convalescent-phase sera.
    Matched MeSH terms: Hemorrhagic Fever with Renal Syndrome/complications*; Hemorrhagic Fever with Renal Syndrome/diagnosis
  2. Increasing genetic diversity of Salmonella enterica serovar typhi isolates from papua new guinea over the period from 1992 to 1999
    Thong KL, Goh YL, Yasin RM, Lau MG, Passey M, Winston G, et al.
    J Clin Microbiol, 2002 Nov;40(11):4156-60.
    PMID: 12409390
    Pulsed-field gel electrophoresis (PFGE) of XbaI-digested chromosomal DNA was performed on 133 strains of Salmonella enterica serovar Typhi obtained from Papua New Guinea, with the objective of assessing the temporal variation of these strains. Fifty-two strains that were isolated in 1992 and 1994 were of one phage type, D2, and only two predominant PFGE profiles, X1 and X2, were present. Another 81 strains isolated between 1997 and 1999 have shown divergence, with four new phage types, UVS I (n = 63), UVS (n = 5), VNS (n = 4), and D1 (n = 9), and more genetic variability as evidenced by the multiple and new PFGE XbaI profiles (21 profiles; Dice coefficient, F = 0.71 to 0.97). The two profiles X1 and X2 have remained the stable, dominant subtypes since 1992. Cluster analysis based on the unweighted pair group method using arithmetic averages algorithm identifies two main clusters (at 87% similarity), indicating that the divergence of the PFGE subtypes was probably derived from some genomic mutations of the X1 and X2 subtypes. The majority of isolates were from patients with mild and moderate typhoid fever and had various XbaI profiles. A single isolate from a patient with fatal typhoid fever had a unique X11 profile, while four of six isolates from patients with severe typhoid fever had the X1 pattern. In addition, 12 paired serovar Typhi isolates recovered from the blood and fecal swabs of individual patients exhibited similar PFGE patterns, while in another 11 individuals paired isolates exhibited different PFGE patterns. Three pairs of isolates recovered from three individuals had different phage types and PFGE patterns, indicating infection with multiple strains. The study reiterates the usefulness of PFGE in assessing the genetic diversity of S. enterica serovar Typhi for both long-term epidemiology and in vivo stability and instability within an individual patient.
    Matched MeSH terms: Typhoid Fever/microbiology; Typhoid Fever/epidemiology*
  3. Analysis of Salmonella typhi isolates from Southeast Asia by pulsed-field gel electrophoresis
    Thong KL, Puthucheary S, Yassin RM, Sudarmono P, Padmidewi M, Soewandojo E, et al.
    J Clin Microbiol, 1995 Jul;33(7):1938-41.
    PMID: 7665677
    Pulsed-field gel electrophoresis (PFGE) revealed that multiple genetic variants of Salmonella typhi are simultaneously present in Southeast Asia and are associated with sporadic cases of typhoid fever and occasional outbreaks. Comparative analysis of PFGE patterns also suggested that considerable genetic diversity exists among S. typhi strains and that some PFGE patterns are shared between isolates obtained from Malaysia, Indonesia, and Thailand, implying movement of these strains within these regions of Southeast Asia, where they are endemic.
    Matched MeSH terms: Typhoid Fever/microbiology; Typhoid Fever/epidemiology
  4. Epidemiologic analysis of sporadic Salmonella typhi isolates and those from outbreaks by pulsed-field gel electrophoresis
    Thong KL, Cheong YM, Puthucheary S, Koh CL, Pang T
    J Clin Microbiol, 1994 May;32(5):1135-41.
    PMID: 7914202
    Pulsed-field gel electrophoresis (PFGE) was used to compare and analyze 158 isolates of Salmonella typhi from five well-defined outbreaks of typhoid fever in Malaysia and also isolates involved in sporadic cases of typhoid fever occurring during the same period. Digestion of chromosomal DNAs from these S. typhi isolates with the restriction endonucleases XbaI (5'-TCTAGA-3'), SpeI (5'-ACTAGT-3'), and AvrII (5'-CCTAGG-3') and then PFGE produced restriction endonuclease analysis (REA) patterns consisting of 11 to 24 DNA fragments ranging in size from 20 to 630 kbp. Analysis of the REA patterns generated by PFGE after digestion with XbaI and SpeI indicated that the S. typhi isolates obtained from sporadic cases of infection were much more heterogeneous (at least 13 different REA patterns were detected; Dice coefficient, between 0.73 and 1.0) than those obtained during outbreaks of typhoid fever. The clonal nature and the close genetic identities of isolates from outbreaks in Alor Setar, Penang, Kota Kinabalu, Johor Bahru, and Kota Bahru were suggested by the fact that only a limited number of REA patterns, which mostly differed by only a single band, were detected (one to four patterns; Dice coefficient, between 0.82 and 1.0), although a different pattern was associated with each of these outbreaks. Comparison of REA patterns with ribotyping for 18 S. typhi isolates involved in sporadic cases of infection showed a good correlation, in that 72% of the isolates were in the same group. There was no clear correlation of phage types with a specific REA pattern. We conclude that PFGE of s. typhi chromosomal DNA digested with infrequently cutting restriction endonucleases is a useful method for comparing and differentiating S. typhi isolates for epidemiological purposes.
    Matched MeSH terms: Typhoid Fever/microbiology*; Typhoid Fever/epidemiology*
  5. Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000
    Sejvar J, Bancroft E, Winthrop K, Bettinger J, Bajani M, Bragg S, et al.
    Emerg Infect Dis, 2003 Jun;9(6):702-7.
    PMID: 12781010
    Adventure travel is becoming more popular, increasing the likelihood of contact with unusual pathogens. We investigated an outbreak of leptospirosis in "Eco-Challenge" multisport race athletes to determine illness etiology and implement public health measures. Of 304 athletes, we contacted 189 (62%) from the United States and 26 other countries. Eighty (42%) athletes met our case definition. Twenty-nine (36%) case-patients were hospitalized; none died. Logistic regression showed swimming in the Segama River (relative risk [RR]=2.0; 95% confidence interval [CI]=1.3 to 3.1) to be an independent risk factor. Twenty-six (68%) of 38 case-patients tested positive for leptospiral antibodies. Taking doxycycline before or during the race was protective (RR=0.4, 95% CI=0.2 to 1.2) for the 20 athletes who reported using it. Increased adventure travel may lead to more frequent exposure to leptospires, and preexposure chemoprophylaxis for leptospirosis (200 mg oral doxycycline/week) may decrease illness risk. Efforts are needed to inform adventure travel participants of unique infections such as leptospirosis.
    Matched MeSH terms: Fever/microbiology; Fever/epidemiology
  6. Fulltext A case of prolonged fever and a diagnosis obscured by an opaque sinus
    Velayudhan M, Lee CW
    Med J Malaysia, 2014 Jun;69(3):140-1.
    PMID: 25326357 MyJurnal
    Prolonged fever in patients can be a diagnostic challenge. Clinicians generally consider infectious diseases, malignant diseases and collagen vascular diseases as possible causes of pyrexia of unknown origin (PUO). Even after extensive evaluation as many as 15 percent of patients with prolonged fever may remain undiagnosed. This case report describes subacute thyroiditis as a cause of prolonged fever and documents how that diagnosis was finally made after 40 days of fever.
    Matched MeSH terms: Fever of Unknown Origin
  7. Fulltext Multi-isotype antibody responses against the multimeric Salmonella Typhi recombinant hemolysin E antigen
    Ong EB, Ignatius J, Anthony AA, Aziah I, Ismail A, Lim TS
    Microbiol. Immunol., 2015 Jan;59(1):43-7.
    PMID: 25399538 DOI: 10.1111/1348-0421.12211
    The detection and measurement of different antibody isotypes in the serum provide valuable indicators of the different stages of typhoid infection. Here, the ability of S. Typhi recombinant hemolysin E (HlyE) to detect multi-isotype antibody responses in sera of patients with typhoid and paratyphoid A was investigated using an indirect antibody immunoassay. Nanogram amounts of HlyE were found to be sufficient for detection of IgG and IgA isotypes and, in a study of individuals' sera (n = 100), the immunoassay was able to distinguish between typhoid and non-typhoid sera. The overall sensitivity, specificity and efficiency of the ELISA were 70% (39/56), 100% (44/44) and 83% respectively.
    Matched MeSH terms: Paratyphoid Fever/diagnosis; Typhoid Fever/diagnosis*
  8. Fulltext An unusual presentation of adult onset Still's disease
    Ghosal A, Pal RB, Das SK, Das T
    Med J Malaysia, 2012 Oct;67(5):532-3.
    PMID: 23770876
    Adult onset still's disease usually presents with high grade intermittent fever, polyarthritis, salmon pink evanescent rash and hepatosplenomegaly. Pulmonary involvement in the form of pneumonitis, as a presenting feature is very rare. We report a case of a young lady who presented with fever, cough and respiratory distress. Chest X-ray revealed patchy infiltration in left upper lung zone. She was subsequently diagnosed as Adult onset Still's disease. There was no improvement in clinical condition despite five days of antibiotics. On trans-bronchial lung biopsy (TBLB) proved she had interstitial pneumonitis and responded dramatically to steroid treatment.
    Matched MeSH terms: Fever
  9. Genotypic and phenotypic differentiation of Salmonella enterica serovar Paratyphi B in Malaysia
    Thong KL, Ang CP
    Southeast Asian J. Trop. Med. Public Health, 2011 Sep;42(5):1178-89.
    PMID: 22299444
    Abstract. Salmonella enterica serovar Paratyphi B is known to cause either paratyphoid fever or gastroenteritis. Differentiation of Salmonella ser. Paratyphi B into biotype Java (d-tartrate fermenting, dT+) and biotype Paratyphi B (d-tartrate non-fermenting, dT) is important for Salmonella epidemiology. This study applied a PCR approach to differentiate the two biotypes to augment the conventional biochemical method and to determine the antibiograms and genomic diversity of Malaysian S. Paratyphi B. Among 100 strains tested (clinical, 86; non-humans, 14), only two clinical strains were confirmed as biotype Paratyphi B as indicated by both lead acetate test and PCR. Antibiotic resistance rates were as follows: streptomycin 18%, sulphonamides 13%, ampicillin 10%, chloramphenicol 4%, tetracycline 3%, cefotaxime 2%, cefpodoxime 2%, ceftazidime 2%, gentamicin 1% and trimethoprim 1%. None showed resistance towards amoxicillin-clavulanic acid, ceftiofur, ciprofloxacin, nalidixic acid and trimethoprim-sulphamethoxazole. Seven strains showed multidrug resistance towards 3 or more classes of antimicrobial agents. REP-PCR and PFGE generated 32 and 76 different profiles, respectively. PFGE (D = 0.99) was more discriminative than REP-PCR (D = 0.93) and antimicrobial susceptibility test (D = 0.48) in subtyping the strains. Strains isolated 18 years apart (1982 - 2008) from different localities in Malaysia were clonally related as demonstrated by REP-PCR and PFGE, indicating that these strains were stable and widely distributed. In some clusters, strains isolated from different sources (clinical, food and animal) were grouped together. Thus, biotype Java was the most common biotype of Salmonella ser. Paratyphi B in Malaysia. The PCR approach is highly recommended due to its simplicity, specificity and ease of operation. The level of antimicrobial resistance among Salmonella ser. Paratyphi B remained relatively low in Malaysia but the emergence of resistance to cephalosporins is a cause for concern.
    Matched MeSH terms: Paratyphoid Fever/drug therapy; Paratyphoid Fever/genetics; Paratyphoid Fever/microbiology*
  10. Fulltext A respite from chikungunya for now
    Lim KG
    Med J Malaysia, 2010 Dec;65(4):255.
    PMID: 21901939
    In the last four years, Malaysia has had three outbreaks of chikungunya virus infection. The first two occurred in Perak in 2006.The third began in Johor in early 2008. The genome of the viruses suggests that on each occasion a different virus was introduced into the population. The first outbreak in Bagan Panchor was due to an Asian genotype virus. The second in the Kinta district of Perak in late 2006 was due to a Central/East African genotype virus. Contact tracing was even able to discover the patient who was the source of the virus from the Indian subcontinent. The third outbreak in Johor was also of a Central/East African strain of virus, but introduced independently. The epidemiology of that outbreak is described in this issue of the MJM.
    Matched MeSH terms: Chikungunya Fever
  11. Fulltext A fatal case of chikungunya virus infection with liver involvement
    Chua HH, Abdul Rashid K, Law WC, Hamizah A, Chem YK, Khairul AH, et al.
    Med J Malaysia, 2010 Mar;65(1):83-4.
    PMID: 21265260 MyJurnal
    Recovery from chikungunya is previously considered universal and mortality due to the virus is rare and unusual. Findings from recent chikungunya outbreaks occurred in Reunion Island and India have since challenged the conventional view on the benign nature of the illness. Malaysia has experienced at least of 4 outbreaks of chikungunya since 1998. In the present on-going large outbreak due to chikungunya virus of Central/East African genotype, a previous healthy sixty six years gentleman without co-morbidity was noted to have severe systemic infection by the virus and involvement of his liver. He subsequently passed away due to cardiovascular collapse after 5 days of illness.
    Matched MeSH terms: Chikungunya Fever
  12. Fulltext Drug reaction with herbal supplement: a possible case of drug induced lupus erythematosus
    Muthupalaniappen L, Jamani N, Muhammad M, Adawiyah J, Aziz N
    Malays Fam Physician, 2010;5(2):99-100.
    PMID: 25606196 MyJurnal
    A 24-year-old lady presented with four days history of fever, non-pruritic rash, ankle pain and swelling. She had consumed herbal supplement five days before the onset of symptoms. Examinations revealed erythematous maculo-papular lesions of varying sizes on sun exposed areas. Patient was suspected to have Drug Induced Lupus Erythematosus (DILE) and subsequently symptoms subsided rapidly on withholding the herbal medication.
    Matched MeSH terms: Fever
  13. A comparison between infrared tympanic thermometry, oral and axilla with rectal thermometry in neutropenic adults
    Dzarr AA, Kamal M, Baba AA
    Eur J Oncol Nurs, 2009 Sep;13(4):250-4.
    PMID: 19386547 DOI: 10.1016/j.ejon.2009.03.006
    This study assessed the agreement between infrared tympanic membrane (TM), axillary, corrected axillary (+0.5 degrees C), oral, and corrected oral (+0.3 degrees C) to rectal thermometry as reference standard in neutropenic adults. The sensitivity and specificity of the mentioned thermometries in detecting rectal fever (> or =38 degrees C) were also analysed.
    Matched MeSH terms: Fever/chemically induced; Fever/diagnosis*; Fever/microbiology
  14. Fulltext Genome Sequence of Salmonella enterica subsp. enterica Serovar Typhi Isolate PM016/13 from Untreated Well Water Associated with a Typhoid Outbreak in Pasir Mas, Kelantan, Malaysia
    Muhamad Harish S, Sim KS, Najimudin N, Aziah I
    Genome Announc, 2015;3(6).
    PMID: 26564032 DOI: 10.1128/genomeA.01261-15
    Salmonella enterica subsp. enterica serovar Typhi is a human-restricted pathogen that causes typhoid fever. Even though it is a human-restricted pathogen, the bacterium is also isolated from environments such as groundwater and pond water. Here, we describe the genome sequence of the Salmonella enterica subsp. enterica serovar Typhi PM016/13 which was isolated from well water during a typhoid outbreak in Kelantan, Malaysia, in 2013.
    Matched MeSH terms: Typhoid Fever
  15. Exotic and emerging viral encephalitides
    Solomon T
    Curr. Opin. Neurol., 2003 Jun;16(3):411-8.
    PMID: 12858080
    The exotic and emerging viral encephalitides are caused by animal or human viruses and characterised by sudden unexpected outbreaks of neurological disease, usually in tropical and sub-tropical regions, but sometimes spreading to temperate areas. Although a wide range of viruses come within this label, as this review highlights, there are common research questions as to the origin and spread of the viruses, the contribution of viral and host factors to the clinical presentations and outcome, and the possibilities for treatment and vaccination.
    Matched MeSH terms: West Nile Fever/pathology; West Nile Fever/therapy; West Nile Fever/virology
  16. Surveillance study of bacteraemic episodes in febrile neutropenic children
    Ariffin H, Navaratnam P, Lin HP
    Int J Clin Pract, 2002 May;56(4):237-40.
    PMID: 12074201
    We prospectively studied the type, frequency and outcome of infections in 513 patients with 762 consecutive episodes of febrile neutropenia (FN) over a five-year period between 1995 and 1999 in a single paediatric oncology unit. The findings were then compared with a similar study carried out in our unit between 1990 and 1994. The types of bacterial isolates and sensitivity patterns were also studied to identify trends and to gauge the suitability of antibiotics chosen for empirical therapy. Bacteraemia was documented in 35.4% of FN episodes, although 70% of patients did not have an obvious site of sepsis. The majority of isolates (61.9%) were gram-negative bacteria, a consistent finding throughout the study period. Resistance to ceftazidime, amikacin and imipenem among gram-negative bacteria was 26.3%, 21.2% and 0.7%, respectively. Methicillin resistance among gram-positive bacteria was 26.3%, while no vancomycin-resistant bacteria were encountered. There were 36 sepsis-related deaths. Factors associated with a fatal outome were prolonged capillary refill time, hypotension, fever above 39 degrees C and pneumonia. Rapid neutrophil recovery was associated with a good prognosis. A change to our current choice of empirical antibiotics for FN, comprising ceftazidime/ceftriaxone and amikacin appears necessary because of the relatively high resistance rates found.
    Matched MeSH terms: Fever/drug therapy; Fever/microbiology*; Fever/epidemiology
  17. Complications of bacteriologically confirmed typhoid fever in children
    Malik AS
    J Trop Pediatr, 2002 Apr;48(2):102-8.
    PMID: 12022423
    To find the incidence, markers and nature of complications of typhoid fever, we studied 102 children with cultures positive for Salmonella typhi in a cross-sectional study, prospectively, over a period of almost 5 years. All isolates were sensitive to commonly used antibiotics. One third of these children developed complications which included: anicteric hepatitis, bone marrow suppression, paralytic ileus, myocarditis, psychosis, cholecystitis, osteomyelitis, peritonitis, pneumonia, haemolysis, and syndrome of inappropriate release of antidiuretic hormone (SIADH). Twelve children developed multiple complications. If hepatitis is excluded from the complications, the rate of complications in bacteriologically confirmed cases of typhoid fever drops to 11 per cent. These complications were not related to: the age or sex of patients, duration of illness before admission, use of antibiotics before admission, nutritional status, level of 'O' or 'H' titre, presence of IgM or IgG antibodies, or treatment with chloramphenicol or ampicillin. Children with splenomegaly, thrombocytopenia or leukopenia were more likely to develop complications.
    Matched MeSH terms: Typhoid Fever/complications*; Typhoid Fever/diagnosis; Typhoid Fever/drug therapy
  18. Fulltext Retrospective review of dot enzyme immunoassay test for typhoid fever in an endemic area
    Jackson AA, Ismail A, Ibrahim TA, Kader ZS, Nawi NM
    Southeast Asian J. Trop. Med. Public Health, 1995 Dec;26(4):625-30.
    PMID: 9139364
    Typhoid fever remains a common problem in Malaysia, but for its diagnosis both blood culture and the Widal test have drawbacks. A dot enzyme immunoassay (EIA) has been developed which detects IgM and IgG antibodies to a specific 50 kDa outer membrane protein on Salmonella typhi. This study was performed among outpatients attending the university hospital in Kelantan, a state on the east coast of Peninsular Malaysia where typhoid is endemic. The dot EIA was done on 149 outpatients of all ages in whom typhoid was suspected. Of these, 60 were not analysable due to insufficient data. The other 89 were retrospectively classed as typhoid (total = 21), or not typhoid (total = 68). The criteria for diagnosis of typhoid was either, blood culture was positive, or with blood culture negative, temperature was at least 38 degrees C and Widal O and/or H titer greater than or equal to 1/160. We then compared the diagnosis with the EIA result. For the result where either IgM or IgG was positive, sensitivity was 90%, specificity 91% and negative predictive value 97%. For IgM positive, specificity was 100%. But the specificity of IgG positive alone was reduced by six false positives, which were probably due to persistence of IgG after acute infection. Other cases were found where IgG positive alone appeared in the first week of typhoid fever, probably due to rapid response in a second or subsequent infection. We also found that IgM-producing patients were significantly younger than those showing IgG alone positive.
    Study site: Community Medicine clinic, Accident & emergency department, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Typhoid Fever/diagnosis*; Typhoid Fever/immunology; Typhoid Fever/epidemiology
  19. Fulltext Coxiella-like bacteria in fowl ticks from Thailand
    Trinachartvanit W, Maneewong S, Kaenkan W, Usananan P, Baimai V, Ahantarig A
    Parasit Vectors, 2018 Dec 27;11(1):670.
    PMID: 30587229 DOI: 10.1186/s13071-018-3259-9
    BACKGROUND: Coxiella bacteria were identified from various tick species across the world. Q fever is a zoonotic disease caused by the bacteria Coxiella burnetii that most commonly infects a variety of mammals. Non-mammalian hosts, such as birds, have also been reported to be infected with the pathogenic form of "Candidatus Coxiella avium". This research increases the list of tick species that have been found with Coxiella-like bacteria in Thailand.

    METHODS: A total of 69 ticks were collected from 27 domestic fowl (Gallus gallus domesticus), 2 jungle fowl (Gallus gallus) and 3 Siamese firebacks (Lophura diardi) at 10 locations (provinces) in Thailand. Ticks were identified and PCR was used to amplify Coxiella bacteria 16S rRNA, groEL and rpoB genes from the extracted tick DNA. MEGA6 was used to construct phylogenetic trees via a Maximum Likelihood method.

    RESULTS: The phylogenetic analysis based on the 16S rRNA gene showed that the Coxiella sequences detected in this study grouped in the same clade with Coxiella sequences from the same tick genus (or species) reported previously. In contrast, rpoB gene of the Coxiella bacteria detected in this study did not cluster together with the same tick genus reported previously. Instead, they clustered by geographical distribution (Thai cluster and Malaysian cluster). In addition, phylogenetic analysis of the groEL gene (the chaperonin family) showed that all Coxiella bacteria found in this study were grouped in the same clade (three sister groups).

    CONCLUSIONS: To our knowledge, we found for the first time rpoB genes of Coxiella-like bacteria in Haemaphysalis wellingtoni ticks forming two distinct clades by phylogenetic analysis. This may be indicative of a horizontal gene transfer event.

    Matched MeSH terms: Q Fever/microbiology; Q Fever/transmission; Q Fever/veterinary*
  20. Fulltext Genome sequencing and analysis of Salmonella enterica serovar Typhi strain CR0063 representing a carrier individual during an outbreak of typhoid fever in Kelantan, Malaysia
    Baddam R, Kumar N, Shaik S, Suma T, Ngoi ST, Thong KL, et al.
    Gut Pathog, 2012;4(1):20.
    PMID: 23234298 DOI: 10.1186/1757-4749-4-20
    Salmonella Typhi is a human restricted pathogen with a significant number of individuals as asymptomatic carriers of the bacterium. Salmonella infection can be effectively controlled if a reliable method for identification of these carriers is developed. In this context, the availability of whole genomes of carrier strains through high- throughput sequencing and further downstream analysis by comparative genomics approaches is very promising. Herein we describe the genome sequence of a Salmonella Typhi isolate representing an asymptomatic carrier individual during a prolonged outbreak of typhoid fever in Kelantan, Malaysia. Putative genomic coordinates relevant in pathogenesis and persistence of this carrier strain are identified and discussed.
    Matched MeSH terms: Typhoid Fever
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