Dokara A, Mengshoel AT, von der Lippe H
… +2 more, Gerl JMA, Strand KB
Tidsskr Nor Laegeforen
· 2026 Mar · PMID 41778573
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BACKGROUND: Non-tuberculous mycobacterial (NTM) infections are an emerging complication of injection treatments and may lead to delayed diagnosis when routine cultures are insufficient. CASE PRESENTATION: We present a ca...BACKGROUND: Non-tuberculous mycobacterial (NTM) infections are an emerging complication of injection treatments and may lead to delayed diagnosis when routine cultures are insufficient. CASE PRESENTATION: We present a case of a woman in her 50s with a chronic ulcerative lesion following hyaluronic acid injections administered abroad. Her history included prior nasal trauma and a silicone implant. Initial empirical treatment and repeated routine cultures were unsuccessful. Only after extended aerobic and anaerobic incubation and referral for molecular analysis were Mycobacterium wolinskyi, a rare rapidly growing NTM, together with Cutibacterium acnes identified. The patient was successfully treated with a 14-week course of ciprofloxacin and doxycycline alongside implant removal. INTERPRETATION: This case underscores the importance of providing thorough clinical information on microbiology requisitions, especially in suspected foreign body infections or after injection treatments, and the need for heightened awareness of NTM infections.
Rahman M, Knudsen PK, Ramm-Pettersen A
… +2 more, Dudman SG, Landaas ET
Tidsskr Nor Laegeforen
· 2026 Mar · PMID 41778566
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BACKGROUND: Enteroviruses are common causes of infections in neonates. Enterovirus infections can present with mild and nonspecific symptoms but may also cause more severe disease, such as sepsis-like illness and meningi...BACKGROUND: Enteroviruses are common causes of infections in neonates. Enterovirus infections can present with mild and nonspecific symptoms but may also cause more severe disease, such as sepsis-like illness and meningitis. Distinguishing enterovirus infections from bacterial infections can be challenging. Consequently, patients may be given unnecessary broad-spectrum antibiotics, which is particularly undesirable in neonates. CASE PRESENTATION: A newborn boy, healthy at birth, developed fever in his first week of life. His clinical course fluctuated over several days, ultimately culminating in seizures. Blood cultures and cerebrospinal fluid analysis did not reveal a bacterial aetiology. However, enterovirus RNA was found in both serum and cerebrospinal fluid by polymerase chain reaction, confirming a diagnosis of enterovirus meningitis due to Coxsackievirus B5. Anticonvulsant therapy was initiated, antibiotics were discontinued, and the infant recovered without complications. INTERPRETATION: This case illustrates that the clinical presentation of enterovirus infections in neonates can be difficult to distinguish from other viral and bacterial infections. Greater awareness of enteroviruses as potential causes of severe neonatal infections, along with knowledge of appropriate testing, may facilitate accurate diagnosis and help avoid unnecessary antibacterial therapy.
Aaslestad P, Bakke MCA, Ringen PA
… +1 more, Hem E
Tidsskr Nor Laegeforen
· 2026 Mar · PMID 41778558
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BACKGROUND AND AIM: Over recent decades, formal requirements for medical records have been strengthened, for example through patients' rights of access. However, clinical documentation in mental health services has been...BACKGROUND AND AIM: Over recent decades, formal requirements for medical records have been strengthened, for example through patients' rights of access. However, clinical documentation in mental health services has been criticised for becoming increasingly juridified and for failing to recognise patients as whole persons. The aim of this study was to conduct an exploratory investigation of current record-writing practices in mental health care. MATERIAL AND METHOD: We reviewed ten medical records from patients discharged from the Adult Inpatient Mental Health Unit at the Clinic for Mental Health and Substance Use Disorder, Oslo, who had at least one previous inpatient admission. The material comprised more than 5500 pages in total. A multidisciplinary research group, consisting of a literary scholar and healthcare personnel, analysed clinicians' notes, observational notes from ward staff recorded during admission, and outpatient records. RESULTS: The records contained overwhelming volumes of text, with extensive verbatim repetition resulting from copy-and-paste practices, which at times obscured inconsistencies and contradictions. New information could appear suddenly and disappear again without reflection. The texts often displayed an inherent unreliability, with contradictory statements appearing side by side. Considerable emphasis was placed on diagnosis and discharge, while reflective discussion of clinical processes was often absent. INTERPRETATION: Authors of medical records must balance medical, legal and patient-centred requirements. Artificial intelligence is increasingly being introduced into clinical documentation, with the potential to fundamentally alter practice. However, there is also a need for authors to reclaim ownership of the medical record. In this study, the patient record emerges as a document that often exposes the author's sense of powerlessness.
Tidsskr Nor Laegeforen
· 2026 Feb · PMID 41670322
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BACKGROUND: Major causes of elevated liver enzymes are toxic, infectious, neoplastic and autoimmune disease. In immunocompromised patients, the spectrum of infectious pathogens causing hepatitis is broader and the immune...BACKGROUND: Major causes of elevated liver enzymes are toxic, infectious, neoplastic and autoimmune disease. In immunocompromised patients, the spectrum of infectious pathogens causing hepatitis is broader and the immune response is blunted, making diagnosis more challenging. CASE PRESENTATION: A man in his sixties had received CAR-T therapy for multiple myeloma. INTERPRETATION: The increasing number of immunocompromised patients means that more patients are at risk of developing chronic hepatitis E. Serologic tests may be unreliable for this patient population, and nucleic acid testing for HEV RNA should be the primary diagnostic approach. HEV can be contracted in Norway, and hepatitis E is an underdiagnosed infection.