[Mycoplasma pneumoniae infections. Clinical manifestations of the disease during an epidemic in Frederiksborg county].
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Biomedical subjects
Publications and source records attributed to K Lind.
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116 cystic fibrosis patients were observed, by monthly examinations over an eight-month period, to investigate the importance of non-bacterial respiratory infections (NBI) in exacerbations of the respiratory disease. Sputum was examined for bacteria, and serum investigated for antibody response against virus, mycoplasma and chlamydia and for antibodies against Pseudomonas aeruginosa. During this period each patient had, on an average, 2.9 exacerbations of which 76% were associated with bacteria, most frequently P. aeruginosa (51%), and 20% with NBI, although bacteria were also present in most of these cases. No etiology was established in 18% of the exacerbations. The NBI were caused by respiratory syncytial virus (RSV) (9%), parainfluenza virus (5%), influenza virus (3.6%), adenovirus (2.4%), mycoplasma (0.6%) and chlamydia (0.6%). The incidence of exacerbations was higher in patients with chronic P. aeruginosa infections. RSV infections were more common in patients who developed chronic P. aeruginosa infection during the study period, and RSV infections were frequently associated with a rise of P. aeruginosa antibodies in patients who harboured these bacteria. The important role of NBI as mediators of onset of chronic P. aeruginosa infections in cystic fibrosis patients is suggested.
In 23 patients with Mycoplasma pneumoniae (MP) infection (13 with pneumonia and 10 with an acute febrile, non-bacterial disorder of the central nervous system (CNS)) and in 26 healthy control persons, thymidine incorporation of blood lymphocytes stimulates stimulated in vitro by killed MP was studied. The lymphocyte response to MP was significantly higher in the pneumonia patients than in the controls. In the patients with an acute disorder of the CNS, lymphocyte responses to MP tended to be low or normal in lack of pleocytosis in the spinal fluid, but were predominantly high when either pleocytosis or a pulmonary infiltrate was present. Lymphocyte responses to the mitogens PHA, PWM and Con-A were normal in all groups. The lack of increased responses to MP antigen in some of the neurological patients, despite a current MP infection, may reflect an antigen-specific depression or a lack of specific sensitization of their lymphocytes.
Soluble Mycoplasma pneumoniae antigens were analysed by crossed immunoelectrophoresis. At least 15 precipitation arcs were developed between the soluble antigens and rabbit anti-Mycoplasma pneumoniae hyperimmune sera. Sera from Mycoplasma pneumoniae infected patients formed precipitation arcs which were identified with those formed by a chloroform-methanol extract of Mycoplasma pneumoniae. Low concentrations of human antibodies, not detectable in a complement fixation test, were found to react with these antigens. The antigens were shown to cross-react with antigens of Mycoplasma neurolyticum. Emphasis was placed on the technical development of the crossed immunoelectrophoresis for the analysis of immune-precipitable antigens of Mycoplasma pneumoniae.
A total of 371 patients with acute, febrile, non-bacterial affection of the CNS hospitalized between Nov. 1, 1971, and June 1, 1976, were examined for Mycoplasma (M.) pneumoniae infection. Nineteen of the patients showed evidence of a current M. pneumoniae infection, 32 of a previous infection, and 320 no evidence. In patients with a current infection due to M. pneumoniae, suggestive evidence is presented that this agent might be involved in the pathogenesis of the neurological syndromes. Compared to cases without the infection, these cases and, to a lesser degree, those with a previous M. pneumoniae infection showed an increased frequency of pathological values, found by various laboratory and instrumental parameters, and a slightly higher frequency of neurological sequelae. Respiratory illness was present in only 11 of the 19 patients infected with M. pneumoniae, a classical respiratory tract pathogen. The overall incidence of current M. pneumoniae infections among patients with neurological syndromes was 5%, with a maximum of 10% during the 1972 epidemic. This is a much higher figure than expected from a mere coincidence of the two conditions.
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Qualitative and quantitative examinations of the cultivable bacterial flora in biopsies from recurrent aphthous ulcerations (RAU), experimental oral ulcerations (EOU), and normal oral mucosa (NOM) were carried out under aerobic and continuous anaerobic conditions. An attempt was made to culture yeasts, mycoplasma, and virus from the biopsies of RAU, which were also tested for the presence of herpes virus antigen by the fluorescent antibody method. The predominant bacteria recovered in RAU were alpha-hemolytic streptococci, coagulase-negative staphylococci, and Neisseria. In EOU the main recoveries were alpha-hemolytic streptococci, Corynebacterium, Veillonella, Neisseria, and Haemophilus. In NOM alpha-hemolytic streptococci dominated the cultures. Yeasts were only cultured from one patient with RAU. No mycoplasmas or viruses were isolated, nor was herpes virus antigen demonstrated in any of the RAU specimens. The role of the microorganisms in the pathogenesis of RAU is discussed.
The in vitro transformation of lymphocytes stimulated by a Mycoplasma pneumoniae preparation was measured by the uptake of 14C-thymidine. The lymphocytes from five patients with M.pneumoniae pneumonia showed a high degree of responsiveness when they were compared to the lymphocytes taken from eleven healthy control subjects who lacked M.pneumoniae antibodies. Another four patients with an acute affection of the central nervous system and serological evidence of an actual or recent M.pneumoniae infection had a lymphocyte response within the same range as that of the controls. The transformation of lymphocytes was studied at intervals for seven months after the onset of the illness in one of the patients with pneumonia. These studies showed an increasing response to a small dose of mycoplasma antigen. Lymphocyte transformation induced by other microbial antigens was studied in three pneumonia patients during and after convalescence. The first responses were low and increased more steeply than the response to M.pneumoniae. The later responses to the mycoplasmal and to the other microbial antigens increased in parallel. The usefulness of incorporating other microbial antigens in the evaluation of the patient's immune response to a relevant antigen in this type of experiment is discussed.
The variations in the incidence of Mycoplasma pneumoniae infections in Denmark over a period of 17 years could be demonstrated in the central serological laboratory which serves the whole of the population. This observation was made possible for the first and major part of this study by testing cold agglutinin (CA) positive sera, which had been kept frozen sine 1958, for antibodies to M.pneumoniae. The second part of the study is based upon results from routine tests for CA and M.pneumoniae antibodies on all samples which we receive. A statistical analysis of the total material indicates that four epidemics of M.pneumoniae antibodies on all samples which we receive. A statistical analysis of the total material indicates that four epidemics of M.pneumoniae infection had taken place from January 1958 to December 1974 and that these epidemics occurred at regular four and a half year intervals. By a follow-up of the study a fifth epidemic was demonstrated during the first eight months of 1975 which broke the regular periodicity by appearing two years earlier than expected. The consequences of including only CA positive sera in this study was investigated. Antibodies to M.pneumoniae were measured by either an indirect immunofluorescence test, an indirect haemagglutination test or a complement fixation test. The observed difference in sensitivity of these tests is discussed in relationship to a possible influence on the overall incidence.
The study is a retrospective and prospective serological investigation of the incidence of Mycoplasma (M.) pneumoniae infection in Denmark during a 17-year period. By least square multiple regression analysis it was shown that four major outbreaks or epidemics had occurred which culminated at regular intervals of four and a half years. The study was based on cold agglutinin (CA) positive sera tested for antibodies to M. pneumoniae by an indirect immunofluorescence (IF) test, an indirect haemagglutination (IHA) test or a complement fixation (CF) test. By the criteria chosen for a positive test, the CF test was found to detect more cases than the IF or IHA tests. A shift during the study from the latter two tests to the CF test influenced the incidence, but not the periodicity of epidemics. The consequence of including only CA positive sera in the study was investigated.
Two fatal cases of meningoencephalitis with serological indication of Mycoplasma pneumoniae infection are reported. The patients were young boys, 13 and 17 years old. Attention is drawn to the risk of sequelae or of a fatal outcome in patients where this infection is associated with symptoms from the central nervous system.
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Mycoplasma pneumoniae infection in a 47-year-old man is reported. Symptoms of upper respiratory tract infection were followed by pneumonia and meningoencephalitis. In contrast to published cases with neurological manifestations of infection with M. pneumoniae, the patient was disabled by persistent cerebellar symptoms with generalized ataxia and atactic dysarthria. Some possible pathogenic mechanisms of the neurological manifestations of infection with M. pneumoniae are considered.
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