Biomedical subjects
Publications and source records attributed to D W Warnock.
A counter immunoelectrophoresis method was compared with a double diffusion test for detecting Aspergillus fumigatus antibodies. Of 70 patients, 23 gave positive results in both tests and the remainder gave negative results. Fifteen patients with proven aspergillosis gave positive results in both tests.
The incidence of IgA and IgG antibodies against Candida albicans was determined in cervicovaginal secretions from 95 non-pregnant women. IgG antibodies were detected in 21.2% of women with vaginal candidosis, in 23.5% of women harbouring yeasts in the vagina without clinical signs of infection, and in 26.6% of women not harbouring yeasts in the vagina. IgA antibodies were found in 6.1% of women with vaginal candidosis, in 5.9% of women harbouring yeasts in the vagina without clinical signs of infection, and in 8.9% of women not harbouring yeasts in the vagina. IgG antibodies against C. albicans were detected in the serum of all 95 women. It is suggested that a proportion of the antibodies found in the secretions was derived from the circulation.
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Precipitins to mannan and cytoplasmic antigens of Candida albicans and Torulopsis glabrata were determined in 25 patients with colonization of the bladder urine by yeasts and in 25 control patients with bacteriuria. Precipitins were present in 64% of the patients with funguria and in 56% of the patients with bacteriuria. There was no correlation between the reactions obtained and the clinical significance of the yeast colonization. It is suggested that a single precipitin test is unhelpful in the assessment of the significance of urinary colonization by yeasts in hospital patients.
An indirect immunofluorescence test was used to determine the titre of serum antibodies to Candida albicans in 300 female patients. Titres from 1:4 to 1:6 were detected in 85 uninfected subjects and nineteen subjects with gonococcal infection. Titres from 1:4 to 1:16 were also detected in 166 of 169 patients found to be harbouring C. albicans, C. parapsilosis, or C. tropicalis in the digestive tract, genital tract, or both, without overt clinical infection. Titres from 1:32 to 1:128 were detected in one of four patients with vaginal candidiasis as compared with eleven of 23 patients with vaginal candidiasis who were also harbouring C. albicans or C. parapsilosis in the digestive tract. It is emphasized that titres of less than 1:32 did not preclude vaginal candidiasis.
Of 300 female patients seen in a Venereal Diseases clinic, 84 (28-0 per cent) were found to be harbouring Candida albicans or C. parapsilosis in the genital tract and 33 per cent of these patients had clinical signs of vulvovaginitis. Of the 84 patients, 71-4 per cent harboured yeasts in the ano-rectal tract; of the remaining 216 patients, 25-9 per cent harboured yeasts in the ano-rectal tract. There was no evidence to suggest that the incidence of yeasts in the mouth, ano-rectal or genital tracts changed with age or use of oral contraception.
An indirect immunofluorescence test was used to determine the titre and immunoglobulin classes of antibodies to Aspergillus fumigatus in human serum. In 15 patients with aspergillosis, significant titres of IgG but not IgA or IgM antibodies were found. The IgG, IgA and IgM fractions of serum from 2 patients with aspergillosis were separated. This confirmed that antibodies to A. fumigatus reside in highest titre in the IgG fraction. Precipitating antibodies to A. fumigatus in these patients also belonged to the IgG class of immunoglobulin.
An indirect immunofluorescence test was both sensitive and specific in detecting IgG antibodies to Aspergillus fumigatus. The test revealed a significant increase in titre of antibodies in patients with the allergic or mycetomal forms of pulmonary aspergillosis.
Onychocola canadensis is a recently recognized cause of human nail infection. We present the first four cases of onychomycosis caused by this organism among patients resident in the UK.
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An open trial was carried out in 50 women with clinical signs and mycological evidence of vaginal candidiasis to compare the effectiveness of treatment with 2% miconazole cream with that of nystatin pessaries. Both groups were given intravaginal treatment for 14 days and were followed up at monthly intervals for 3 months. Relief of symptoms and clinical signs was comparable in the two groups but the mycological cure rate at 1 month was higher with miconazole. At 2 and 3 months, however, there was no significant difference between the cure rate obtained with the two treatments in the patients still included in the study.
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We report the first four North American cases of Candida dubliniensis fungemia, including the first isolation of this organism from the bloodstream of an HIV-infected person. All isolates were susceptible in vitro to commonly used antifungal drugs. This report demonstrates that C. dubliniensis can cause bloodstream infection; however, the incidence of disease is not known.