Biomedical subjects
Publications and source records attributed to E Stolz.
Antibodies against Chlamydia of lymphogranuloma-venereum type were detected by the micro-immunofluorescence technique in 38 (69%) of 55 patients with Crohn's disease. Weak positive reactions were seen in only 2 or 21 patients with other gastrointestinal disorders and 1 of 50 healthy blood-donors.
Results of the Veneral Disease Research Laboratory (VDRL), rapid plasma reagin (RPR), Treponema pallidum haemagglutination (TPHA), T. pallidum immobilisation (TPI), and fluorescent treponemal antibody absorption (FTA-ABS) tests on sera of 661 children from a region where yaws is hypoendemic are compared. For 107 (16.2%) out of 661 sera the FTA-ABS test was the only one showing reactivity; in these instances the test was weakly reactive (intensity of fluorescence scored as +) and the children had no history and no signs or symptoms of treponemal disease. A solitary, weakly reactive FTA-ABS test result seems to have no clinical significance in these cases. The FTA-ABS test can be used as a confirmatory test for yaws instead of the TPI test, if only the results of sera showing an intensity of fluorescence scored as ++ or more are considered to be positive. There appeared to be no significant differences in the results of the VDRL, RPR, and TPHA tests as screening tests for yaws when the TPI or FTA-ABS tests were used as reference tests.
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The incidence of chancroid in Rotterdam has increased by more than five-fold during 1977-78. In a retrospective study of 53 patients with chancroid seen at this clinic during this period, the results of smears were positive in 82% and of cultures in 84% (of those for whom cultures had been performed). Symptoms were generally mild. Treatment with co-trimoxazole was highly effective clinically, as confirmed by in-vitro sensitivity studies.
The case history of a 50-year-old assistant pharmacist, who had been working with 8-methoxypsoralene (8-MOP) without any protection, is discussed. Shortly after this work, he was exposed to sunlight. Within 72 h he developed a typical local reaction with painful erythema and vesiculation on the back of both hands, followed by hyperpigmentation a week later. Light testing on skin dusted with 8-MOP resulted in the same clinical picture. Histopathological examination of a lesion showed the characteristics of a phototoxic dermatitis. Guidelines for the prevention of complications in those who are professionally exposed to 8-MOP are emphasized.
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Quantitative determinations of the sensitivity to epicillin, ampicillin, penicillin and tetracycline were carried out for 67 gonococcus strains isolated from 67 males with urogenital gonorrhoea, and 38 strains isolated from 38 females with urogenital/rectal gonorrhoea. The results of the sensitivity determinations for ampicillin, penicillin and tetracycline were compared with the findings of a previous investigation. It was found that the gonococcus strains isolated from males had become slightly less sensitive to penicillin between 1971-1972 and 1976. The penicillin and tetracycline had not changed during this period. It was also striking that the in vitro activity of epicillin for strains isolated both from males and females was significantly greater than that of ampicillin.
This paper describes the results of treatment of 124 patients (78 male and 46 female) with urogenital/rectal gonorrhoea with epicillin (3.5 g orally) in combination with 1 g of probenecid (instant therapy). High cure rates were found for both the male (98.6%) and female patients (100%). Serious drawbacks of this treatment are a high frequency of postgonococcal urethritis (45.6%) and a short-lived increase in the frequency and looseness of faecal discharge in a considerable amount of patients (6.8% in the male and 22.7% in the female patients).
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This paper reports the results of treating 152 women with carnidazole, a new trichomonacidal drug. They were divided into two groups. The first comprised 91 patients who were treated with 2 g, while the second group comprised 61 patients who were treated with 1-5 g carnidazole in a single oral dose. Defaulter rates were 6-6% for the first group and 13-1% for the second. Of the remaining 85 patients in the first group, 76 (89-5%) were negative at the first follow-up one to three weeks after treatment, three (3-5%) were considered to be treatment failures, and six (7-0%) were considered to be reinfected. Of 53 women treated with 1-5 g, 39 (73-6%) were negative at first follow-up, eight (15-1%) were considered to be treatment failures, and six (11-3%) were considered to be reinfected. The difference between the number of patients cured in both groups is statistically significant. Fourteen patients experienced side-effects, but these were of little significance. Carnidazole given in a single oral dose of 2 g in 16 women did not cause consistent changes in any of the haematological and biochemical parameters studied.
The case history of a man with primary syphilis of the right hand is described. This type of luetic condition nowadays is rare. The incidence of genital, anorectal, and extragenital primary syphilis in both men and women and in sailors presenting at the Venereological Outpatient Clinic of the Department of Dermatology of the University Hospital Rotterdam-Dijkzigt during a period of seven years was studied. In sailors and women only genital primary lesions were found, whereas in male civilians 6.3% of cases of primary syphilis had anorectal lesions. The primary lesions in this study were different from those reported in earlier literature.
Quantiative determinations of the sensitivity of 322 Neisseria gonorrhoeae strains to sulphamethoxazole (Su), trimethoprim (Tr) and a combination of Su and Tr in a ratio of 5:1 are described. Data are also given on the potentiation of Su by tr. It was striking that the Su-sensitive N. gonorrheoeae strains showed no potentiation of Su by Tr when a Su/Tr ratio of 5:1 is used. The sensitivity to combinations of Su and Tr in various ratios was determined for seven N. gonorrhoeae strains with known senstivity to Su and Tr. On the basis of these data, the rules according to which Su is potentiated by Tr. could be formulated.
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The sensitivity of four groups of gonococcal strains to ampicillin (Am), penicillin (P), tetracycline (T), rifampicin (Ri), spectinomycin (Sp), sulphamethoxazole (Su), trimethoprim (Tr), and a combination of Su and Tr in the ratio 5:1 (Su/Tr 5:1) has been determined. The various groups of strains were isolated from male civilians (MC), female civilians (FC), and sailors (S) in Rotterdam (R) in 1972, and from FC in Amsterdam (A) in 1967. The S-R strains, which may be regarded as mainly imported, were compared with the MC-R and FC-R (which may be considered as mainly of Dutch origin). Also investigated was whether the incidence of relative resistance to the antibiotics investigated among Dutch strains has changed in the period from 1967 to 1972. For this purpose, the FC-A and FC-R strains were compared. The MC-R and FC-R strains were also compared with one another. Finally, Spearman's rank correlation coefficient r were calculated between the sensitivity distributions for each pair of antibiotics investigated, for all strains. The S-R strains were significantly less sensitive to Am, P, T, Ri, and Tr than the MC-R and FC-R strains. Comparison of the FC-A and FC-R strains revealed that the FC-R strains were significantly less sensitive only to Su/Tr 5:1. A possible explanation for this finding is given. With the exception of one FC-A strain, all gonococcal strains were sensitive to Sp. High values of r (larger than or equal to 0.50) were found between Am and P, Am and T, and P and T for all groups of strains. The values of r between any pair of the antibiotics Am, P, T, Ri, and Tr (with the exception of the pair Am-P) were always highest for the S-R strains. High values of r (larger than or equal to 0.50) were found between Su and Su/Tr 5:1 for all groups of strains. The FC-A strains, unlike the R strains, gave low values of r between Su and Tr and between Tr and Su/Tr 5:1. A possible explanation for this is given. Finally, a hypothesis is put forward to explain the fact that no significant changes were found in the sensitivity of Dutch gonococcal strains to Am, P, T, Ri, Sp, Su, and Tr in the period from 1967 to 1972, while the S strains (which may be regarded as imported) showed a significantly higher percentage of strains relatively resistant to Am, P, T, Ri, and Tr.
Two cases of insufficiently treated early syphilis with solitary papular lesions on the penis are described. There seems to be a close resemblance between these cases and descriptions from the Salvarsan era concerning the occurrence of solitary papules located on or near the place of the healed primary syphilitic lesion, after insufficient treatment with Salvarsan. Problems in diagnosing these cases are discussed.