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The purposes of this study were to investigate the epidemiologic, clinical, and microbiologic features of patients with nontyphoid salmonellosis and to elucidate the impact of resistance on the outcome of nontyphoid salmonellosis in Taiwan. The authors also sought to develop a severity score to derive an objective guideline for antibiotic use in nontyphoid salmonellosis in the era of increasing antibiotic resistance. The authors prospectively monitored 311 children with nontyphoid salmonellosis in Kaohsiung, Taiwan. The demographic, clinical, and microbiologic features, underlying diseases, treatment regimen, complications, and outcome were analyzed. In vitro susceptibility testing of the isolates was performed. The median age of affected patients was 15 months. Salmonella enteritidisB caused 68.5% of episodes, followed by S. enteritidisC1 (11.9%), D (7.7%), C2 (7.1%), E (2.6%), S. choleraesuis(1.6%), and S. paratyphi(0.6%). Sixty percent of isolates were resistant to ampicillin. Patients with bacteremia could not be differentiated from patients without bacteremia on clinical grounds. Patients receiving antibiotics that were inactive in vitro (discordant therapy) had more days of fever and longer hospital stay compared with patients receiving antibiotics that were active in vitro (concordant therapy). Patients receiving no antibiotic treatment had the fewest days of fever and shortest hospital stays, especially among patients with mild illness (severity score, 0–1). Blood culture should be obtained in patients with nontyphoid salmonellosis to detect bacteremia. In treating antibiotic-resistant nontyphoid salmonellosis, antibiotics are still not mandatory for patients who present with primarily gastrointestinal symptoms and limited signs of systemic inflammation reflected by a low severity score (low C-reactive protein, fewer band cells in peripheral blood, and fewer days of fever before admission). Susceptibility data should be promptly obtained because use of discordant antibiotics appears to prolong illness.

The purposes of this study were to investigate the epidemiologic, clinical, and microbiologic features of patients with nontyphoid salmonellosis and to elucidate the impact of resistance on the outcome of nontyphoid salmonellosis in Taiwan. The authors also sought to develop a severity score to derive an objective guideline for antibiotic use in nontyphoid salmonellosis in the era of increasing antibiotic resistance.

We report a rare respiratory complication after esophageal stenting for esophageal cancer. The patient, a 58‐year‐old male, presented with dysphagia and frequent choking of six months' duration. Malignant obstruction due to esophageal cancer complicated by a bronchoesophageal fistula was diagnosed. Total collapse of the left lung occurred on the second day after implantation of a rigid esophageal stent. The esophageal tumor was pushed into the left bronchial lumen resulting in complete obstruction. The left lung re‐expanded after removal of the stent. The bronchial tumor was reduced in size after radiotherapy and, subsequently, a mesh stent was successfully implanted into the obstructed bronchial segment. The original rigid esophageal stent was then re‐inserted and the left lung regained sufficient aeration after the double‐stenting therapy. (Dig Endosc 1996; 8: 216‐219)

Acute compartment syndrome of the upper limb due to dialysis access-related bleeding is a rare and severe complication of hemodialysis. In most reported cases, this complication is caused by an enlarging hematoma after puncture or perforation of a fistula in combination with the use of heparin. In this case report, we describe a 52-year-old woman presenting with venous hypertension and left-arm swelling that progressed suddenly on the fifth day of presentation to neurological deficits, cyanotic skin changes, and typical clinical symptoms of acute arm compartment syndrome. An angiographic scan confirmed a critical stenosis at the proximal cephalic–axillary venous junction, and balloon angioplasty successfully dilated the lesion. The arm swelling and other symptoms subsided dramatically within 3 days. This case represents a potentially different mechanism for the development of acute arm compartment syndrome in dialysis patients as well as a treatment strategy different from standard fasciotomy to reduce intracompartmental pressure.