Biomedical subjects
Publications and source records attributed to J M Boyce.
In June and July, 1974, an anthrax epizootic in Falls County, Texas, resulted in the death of 236 animals (228 cattle, 5 horses, 2 mules, and 1 pig) on 48 premises. Death rates were highest for horses (18.2%) and bulls (16.8%). The epizootic was apparently precipitated by drought, and infection appeared to be the result of ingesting intrinsically contaminated soil and grass. Human illness was not associated with the epizootic.
A 27-year-old farmer in the Oklahoma panhandle was pinned under his overturned tractor for 2 hr and received superficial and deep lacerations. He contracted an infection of a pelvic wound with an organism that had cultural and biochemical characteristics identical to those of Pseudomonas pseudomallei. Identical organisms were recovered from soil taken from the site of the accident. The organism isolated from the wound proved to be less virulent in guinea pigs than usual laboratory strains of P. pseudomallei; fatty acid analysis showed a distinctly different pattern from that of laboratory strains of P. pseudomallei. The infecting organism may be a variant of P. pseudomallei or a new species of Pseudomonas.
An outbreak of seven cases of bubonic plague in New Mexico was investigated. Clinical features were studied and correlated with field studies in an attmept to determine the source of infection in patients with indefinite histories of exposure. Most patients presented with fever, malaise, and an acute painful lymphadenitis (bubo). One death occurred in a patient with bubonic-septicemic plague complicated by meningitis due to Yersinia pestis. All patients lived in rural or semirural areas, and most had been in the general vicinity of their usual residence during the six days prior to onset of symptoms. The outbreak was associated with probable epizootics in rodents in two different areas of the state. One case was traced to direct hand contact with plague-infected rabbits. One patient developed insect bites after sleeping in the same bed with a flea-infested cat. Three of the other five patients had insect bites, presumably flea bites, but none of the five recalled contact with rodents or rabbits. Four of the five, however, had been in contact with dogs or cats that were later shown to have titers of antibody to Y. pestis. These findings provide further support for the hypothesis that contact with domestic dogs and cats may result in direct or indirect transmission of Y. pestis to humans.
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Staphylococcus aureus infections developed in 16 of 721 infants born at a general hospital during a six-month period (October 1972 to March 1973). Twelve of the 16 affected infants had cervical adenitis, which usually became manifest two to four months after they were discharged from the hospital. Although most infants with adenitis underwent incision and drainage procedures, physicians noted few constitutional symptoms. Staphylococcal phage types from infants with adenitis were identical to phage types commonly recovered from colonized newborns and nursery personnel at the hospital. Despite the long period between hospital discharge and onset of clinical symptoms, cases of cervical adenitis were probably nosocomial in origin.
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Agglutination tests were used to study the surface antigens of two recently described species of the genus Haemophilus, H. paraphrophilus and H. paraphrohaemolyticus, and their antigenic relationship to other members of the genus. The results obtained with a few strains of H. haemoglobinophilus and H. aphrophilus are also reported. The species H. paraphrophilus appears to be homogeneous; no major cross-reactions were observed. The species H. paraphrohaemolyticus contains at least three serotypes, of which two have been defined in terms of agglutination reactions. Cross-agglutinations occurred between one strain of H. paraphrohaemolyticus and strains of the other V-dependent species, H. parainfluenzae and H. parahaemolyticus. Of the X-dependent species, H. haemoglobinophilus seems to be homogeneous, and the species H. aphrophilus is not. A non-specific antibody against horse blood in the medium occurred erratically and was present in only two antisera, those raised to H. aphrophilus strain Khairat and H. haemoglobinophilus strain no. NCTC8540.
The case is described of a 49-year-old woman who developed endocarditis in relation to the prosthetic valve two months after insertion of a Starr-Edwards mitral valve prosthesis. Initially Corynebacterium hofmanni was isolated from blood culture. Later, while the patient was receiving antibacterial chemotherapy, Candida albicans was also isolated and she was treated with 5-fluorocytosine. A cure was effected without the need for further valve replacement.
Gonorrhoea was not found to be a problem in antenatal patients. It was found in only one out of 625 women, thus confirming other British surveys which do not agree with the North American figures. Candidiasis is commoner than trichomoniasis (27.4 and 4.7 per cent. prevalence respectively) and culture of a high vaginal swab is more effective as a means of diagnosis than a cervical cytology smear. The two conditions seldom occur together. The detection rate for Candida increases with gestation, but not with age, parity, or premarital and extramarital conception. The species isolated was predominantly Candida albicans. Trichomonads are detected in culture of a high vaginal swab more often than in a cervical cytology smear. Detection does not increase with age, parity, or gestation, but does increase with premarital and extramarital conception. It is difficult to diagnose clinically the cause of vaginal discharge in a pregnant woman.
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