Læknablaðið : fylgirit - 01.08.1978, Page 78

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greind(14). Þannig bíður greining ósjaldan
fistilmyndana eða haematogen meinvarpa
til húðar, sem liggja þá vel við höggi, með
tilliti til ræktana og vefjaskoðana.
Hér, sem oftar, er það meðvitundin um
sjúkdóminn og þar með hæfilega hár grun-
semdar-index, ásamt góðri samvinnu við
skurðlækna og sérfræðinga í sýkingarsjúk-
dómum og meinafræði, sem vænlegast er til
réttrar sjúkdómsgreiningar. Því eru þessi
tilfelli tínd til.
— O —
Höfundur þakkar Jónasi Hallgrímssyni,
dósent, myndir af vefjasýnum og aðstoð
við greiningu á fyrsta sjúklingnum, enn-
fremur Þorkeli Bjarnasyni lækni, fyrir ljós-
myndir af röntgenmyndum sama sjúklings.
SUMMARY.
Four cases of childhood actinomycosis in Ice-
land are reported. They were seen over a seven
year period in a pediatric unit with an annual
admission rate of 1000-1100 patients.
Three of the children had the commonest
cervicofacial form, whereas the fourth pre-
sented with the extremely rare form of primary
pericardial actinomycosis, with subsequent
metastases to skin and subcutaneous tissue
finally making a diagnosis possible 4 months
after admission.
The importance of diligent search for the
infective agent is emphasized, even continuing
special anaerobie cultures for days after the
institution of intensive antibiotic therapy in
expectance of a diagnostic success.
With appropriate anticipation and level of
suspicion, more cases of actinomycosis would
be expected to be identified.
HEIMILDIR:
1. ) Bartlett, J.G. et al.: Treatment Of Anaerobic
Infections With Lincomycin And Clindamycin.
N.E.J.M. 287: 1006, 1972.
2. ) British Medical Journal: Actinomycosis, I:
365, 1973.
3. ) Butas, C.A. et al.: Disseminated Actinomy.
cosis. C.M.A. Journal 103: 1063, 1970.
4. ) Datta, J.S., Raff, M.L.: Actinomycotic Pleuro-
pericarditis. Am. Rev. Resp. Dis. 110: 338,
1974.
5. ) Drake, D.P., Holt, R.J.: Childhood Actinomy-
cosis (Report of 3 recent eases).
Arch. Dis. Child. 51: 979, 1976.
6. ) Graybill, J.R., Silverman, B.D.: Sulfur Granu-
les. Arch. Int. Med. 123: 430, 1969.
7. ) Griiner, O.P.N.: Strálesoppsykdommen (Act-
tinomykose-nocardiose). T. norske Læge-
foren. 89: 1007, 1969.
8. ) Harvey, J.C. et al.: Aetinomycosis, Its Reco-
gnition And Treatment.
'Ajnn. Int. Med. 6: 868, 1957.
9. ) Heilbrigðisskýrslur (Public Health in Ice-
land), 1972.
10. ) Moses, J. et. al.: Actinomycosis In Childhood.
Clin. Ped. 6: 221, 1967.
11. ) Rippon, J.W.: Bacteria v5. Fungi N.E.J.M.:
Mar. 16, 606, 1972.
12. ) Rose, H.D., Rytel, M.W. Actinomycosis Trea-
ted With Clindamycin. JAMA 221: 1052. 1972.
13. ) Slade, P.R. et al.: Thoracic Actinomycosis.
Thorax 28: 73, 1973.
14. ) Varkey, B. et. al.: Thoracic Actinomycosis.
Arch. Int. Med. 134: 689, 1974.