Penicillium chrysogenum endophthalmitis.
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Adult↗
Biomedical subjects
B C West
Publications and source records attributed to B C West.
Vancomycin-induced neutropenia.
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Agranulocytosis↗
Subconjunctival corticosteroid therapy complicated by hyperinfective strongyloidiasis.
A 57-year-old man was treated for a corneal ulcer with a penetrating keratoplasty, followed by six weeks of a regimen of 4 to 8 mg of dexamethasone injected subconjunctivally daily. Before therapy, he was clinically well and 10% eosinophils were noted on his differential white blood cell count. He developed a gastric peptic ulcer with hemorrhage and severe strongyloidiasis of the stomach and duodenum that worsened as the ulcer responded to medical therapy. The strongyloidiasis resulted in physiologic gastric outlet obstruction by decreasing gastrointestinal motility. There was evidence of hyperinvasive and disseminated strongyloidiasis, complicated by meningitis and Serratia marcescens bacteremia. He survived and received thiabendazole treatment for strongyloidiasis, which was successful. Subconjunctival corticosteroids caused a systemic effect that changed asymptomatic Strongyloides infection into hyperinvasive strongyloidiasis.
Conjunctiva↗
Mycetoma caused by microsporum audouinii. First reported case.
A 25-year-old black man had generalized tinea corporis for 19 years and had associated subcutaneous mycotic granuloma of the scalp and nape of the neck for 17 years. The dermatophyte from the skin was identified as Microsporum audouinii and responded to oral griseofulvin treatment. Biopsy specimens of the subcutaneous nodules revealed yellowish granules containing masses of irregularly septated hyaline hyphae with frequent vesicles. This fungus differed only in gross colonial morphology from the M. audouinii isolated from the skin and has also been identified as M. audouinii. The subcutaneous nodules were treated and controlled by amphotericin B and are still under treatment.
Adult↗
Pseudomonas putrefaciens and group A beta-hemolytic streptococcus septicemia.
Pseudomonas putrefaciens was isolated twice in blood cultures from which group A beta-hemolytic streptococci were concurrently isolated from a moribund woman. Only once previously has P putrefaciens bacteremia been reported. To our knowledge, we are reporting the first blood isolate of P putrefaciens, albeit with group A beta-hemolytic streptococci, associated with fatal septicemia.
Aged↗
Saccharomyces cerevisiae septicemia.
We report the first known case of septicemia caused by Saccharomyces cerevisiae. It occurred nosocomially in a hyperalimented burned man. It is a rare example of disease caused by S cerevisiae, which, like many saprophytes, can become pathogenic in the debilitated. The case is remarkable for its apparent origin in a bleeding esophageal lesion, for its clinical characteristics, including profound neutropenia, thrombocytopenia, hypothermia, and monocytopenia, and for its cure by amphotericin B.
Burns↗
Gentamicin failure in staphylococcal bacteremia.
Gentamicin has been relied upon in some antibiotic combinations against Staphylococcus aureus, should it be present. Reported is a case of Staphylococcus aureus bacteremia treated inadvertently by gentamicin, and the gentamicin failed.
Drug Resistance, Microbial↗
Clostridium pseudotetanicum bacteremia in a patient with Pasteurella multocida conjunctivitis.
Clostridium pseudotetanicum only once previously has been identified as causing disease. Pasteurella multocida has been identified only three times as the cause of purulent conjunctivitis. A very debilitated patient had C. pseudotetanicum bacteremia and P. multocida conjunctivitis from which she recovered only to die of a nosocomial Staphylococcus epidermidis septicemia, originating in a site for the administration of intravenous fluids.
Blood↗
The hypereosinophilic syndrome: analysis of fourteen cases with review of the literature.
Several closely related disease entities make up the idiopathic hypereosinophilic syndrome (HES). The syndrome is manifest by persistent and prolonged eosinophilia with organ damage. A group of 14 patients had hematologic, cardiac, and neurologic abnormalities attributable to this disease. Patient survival and response to chemotherapy was significantly better in this group than in previously reported patients. The etiology of HES remains unknown, as does the mechanism of tissue damage.
Adolescent↗
Isolation and partial characterization of human eosinophil granules. Comparison to neutrophils.
Human blood eosinophils obtained from untreated patients with large numbers of circulating eosinophils were purified and lysed. An eosinophil contains 2.65 times as much peroxidase, 2.44 times as much beta-glucuronidase, approximately two times as much acid beta-glycerophosphatase, and 1.2 times as much protein as a neutrophil. Lysate filtration allowed isolation of eosinophil granules by isopycnic ultracentrifugation in sucrose. The granules had a mean density of rho 1.24 g/ml, and contained peroxidase, beta-glucuronidase, and acid beta-glycerophosphatase. They totally lacked muramidase and alkaline phosphatase. Electron micrography confirmed the isolation.
Acid Phosphatase↗
Separation and characterization of human neutrophil granules.
Human blood neutrophilic leukocytes were separated and purified by modifications of the Hypaque/Ficoll and dextran separation methods, resulting in a suspension which was greater than 96% neutrophils. Neutrophils were prepared in 0.34 M sucrose containing heparin and were clarified of nongranular debris by sequential passage through polycarbonate filters of pore size 5 mu and 2 mu. Isopycnic sucrose gradients of such filtrates revealed three major bands. The gradient separated fractions were studied by electron microscopy including peroxidase cytochemistry and by enzyme assay for myeloperoxidase (MPO), beta-glucuronidase, muramidase alkaline phosphatase and acid phosphatase utilizing both p-nitrophenylphosphate (pnp) and beta-glycerophosphate as substrates. Peroxidase-positive granules were observed at both density 1.22 (band A) and density 1.20 (band B). Three peroxidase-negative granules were identified: the round or oval peroxidase-negative granule of density 1.22 (band A) and two smaller granules, distinguishable by size and shape at density 1.18 (band C). Band C granules contain crystalloid inclusions. Peaks of muramidase activity coincided with bands A and C, suggesting the presence of muramidase in the peroxidase-negative granules of density 1.22 and in one or both of the peroxidase-negative granules at density 1.18. beta-Glucuronidase was distributed like MPO, with a major peak in band B and a minor peak in band A. Acid beta-glycerophosphatase was largely in band A. Acid pnp phosphatase was nonspecifically associated with soluble nongranular protein which always remained at the origin of sucrose gradients. Alkaline phosphatase was not granule associated and sedimented alone to density 1.145, which is highly suggestive of a cytoplasmic membrane localization for this enzyme.
Acid Phosphatase↗
Effects of certain contraceptive pills on uterine myomas.
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Contraceptives, Oral↗
Vibrio vulnificus: did Hippocrates describe a fatal case?
In the fifth century B.C., Hippocrates described a fatal illness in a man who lived on an island in the Aegean Sea. This acute infection was characterized by black bullous skin lesions, rapidly progressive septicemia, and death on the second day. It is hypothesized that this disease was caused by Vibrio vulnificus.
History, Ancient↗
Aplastic anemia associated with parenteral chloramphenicol: review of 10 cases, including the second case of possible increased risk with cimetidine.
A case of aplastic anemia quickly followed therapy with intravenous chloramphenicol and cimetidine and rapidly resulted in death. This is the second such case reported and the 10th case of fatal aplastic anemia complicating therapy with parenteral chloramphenicol. The patient died 19 days (and the previously reported patient 18 days) after the initiation of intravenous therapy with chloramphenicol and cimetidine; the interval from the start of treatment to death was 414 +/- 683 days (mean +/- SD) in the total of nine evaluatable cases of aplastic anemia following parenteral administration of chloramphenicol. Chloramphenicol and cimetidine, each a rare cause of aplastic anemia, should be used--separately or together--with caution. The case described herein is consistent with reports of liver disease, uremia, or bone marrow dysfunction influencing the toxicities of these drugs. The potential for aplastic anemia must be considered whenever chloramphenicol is used, regardless of the route of administration.
Anemia, Aplastic↗
Human leukocyte antigen and leprosy: study in northern Louisiana and review.
We examined the relationship of human leukocyte antigen (HLA) phenotype to leprosy in six sporadic cases in northern Louisiana and in the world literature through pooling of the results of several studies. We found that HLA antigens DR2 and DQwl were associated with leprosy in the six cases in northern Louisiana (relative risks, 4.57 for DR2 and 4.53 for DQwl), but the results are not statistically significant. We pooled the Louisiana study and other population studies of HLA and leprosy. The results of the pooling show DR2 and DQwl to be associated with leprosy (relative risks, 2.65 for DR2 and 2.73 for DQwl), and these associations are highly statistically significant (P less than 1 x 10(-8) for DR2 and P = 3.6 x 10(-8) for DQwl). Further, we pooled studies of lepromatous leprosy patients vs. controls and studies of tuberculoid leprosy patients vs. controls and found that DR2 and DQwl are associated with both the lepromatous and the tuberculoid forms of leprosy and that these associations are statistically significant. We consider the associations of DR2 and DQwl in these population studies to be evidence for an HLA-associated genetic influence on susceptibility to leprosy.
Adult↗
Environmental nonhuman sources of leprosy.
Leprosy has been considered to occur only after exposure to a human case. However, evidence has been accumulating that this conventional view is wrong and that an environmental nonhuman source is critical to some human infections with Mycobacterium leprae. Observations, some of which date back to the nineteenth century, support soil, vegetation, water, arthropods, and armadillos (Dasypus novemcinctus) as environmental sources of leprosy. Disparate clinical, epidemiologic, and microbiologic evidence has been critically reviewed in light of the fact that 50%-70% of sporadic cases of leprosy in well-studied populations occur in persons who have had no known contact with human leprosy. Historical data and current information alike substantiate the concept of nonhuman sources of the disease; recent observations with monoclonal antibody have shown that phenolic glycolipid-I antigen, which is unique to the M. leprae cell wall, is present in soil. In the absence of a technique for in vitro cultivation, indirect methods and the body of observations reviewed here persuasively favor but do not prove the existence of environmental nonhuman sources of M. leprae.
Animals↗
Survival from sino-orbital mucormycosis due to Rhizopus rhizopodiformis.
We report the first case of sino-orbital mucormycosis caused by Rhizopus rhizopodiformis. Therapy consisted of conservative surgical drainage and intravenous amphotericin B. The patient, an insulin-dependent diabetic, survived her infection with minimal residual deformity. This case and a literature review suggest that infection due to R. rhizopodiformis in diabetics might be more amenable to treatment than mucormycosis caused by other species of fungi. Speciation of such fungi would permit the determination of species specific mortality rates, and may be of therapeutic and prognostic value.
Adult↗