cys-C levels increase and cys-GFR levels decrease with increasing severity of glucose intolerance and are highest and lowest, respectively, in type 2 diabetes mellitus (T2DM) subjects with microalbuminuria and retinopathy. In T2DM subjects, cys-C and cys-GFR appear to be useful markers of early renal damage.
Pasteurella species cause zoonotic infections in humans. Human pasteurella infections usually manifest as local skin or soft tissue infection following an animal bite or scratch. Systemic infections are less common and are limited to patients at the extremes of age or those who have serious underlying disorders, including cirrhosis. Most human pasteurella infections are caused by the multocida species. We report a case of Pasteurella dagmatis peritonitis and septicaemia in a patient with cirrhosis. The infection followed a scratch inflicted by a pet dog. Despite appropriate antibiotic treatment the infection proved fatal. Spontaneous bacterial peritonitis caused by P dagmatis has not been reported previously. Pasteurella dagmatis is a relatively recently described species, which is rarely reported as a human pathogen. This species may be misidentified unless commercial identification systems are supplemented by additional biochemical tests.A 56 year old woman with biopsy confirmed alcoholic cirrhosis and known portal hypertension with ascites was admitted to hospital complaining of worsening ankle swelling and abdominal distension, abdominal pain, and spontaneous bruising over the previous week. She was at that time drinking one third of a bottle of sherry (seven to eight units of alcohol) each day. She reported having been scratched on her left arm by her dog one week previously.She was found to be febrile (37˚C) and jaundiced with bilateral peripheral oedema to her mid thighs. Her pulse rate was 95 beats/minute, her blood pressure was 115/45 mm Hg, and she had a tender abdomen distended with ascites and covered in echymoses. Her left arm was erythematous and warm and the overlying skin was indurated.Laboratory tests showed a normal white blood cell count (8.2 6 10 9 /litre; normal range, 4?0-10?0), deranged liver function tests (bilirubin, 357 mmol/litre; normal range, 0-17; alkaline phosphatase, 153 U/litre; normal range, 40-130; aspartate aminotransferase, 48 U/litre; normal value, . 30), and abnormal synthetic liver function (albumin, 31 g/litre; normal range, 35-50 g/litre; prothrombin time, 32 seconds; normal range,
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