Jamshedpur fever and Reye's syndrome.
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Biomedical subjects
Publications and source records attributed to L C Olson.
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Three children had staphylococcal infections of the CNS. In two cases the organisms were resistant to methicillin sodium. Each case was treated with a combination of vancomycin hydrochloride and rifampin; in one instance vancomycin alone had been unsuccessful. The addition of rifampin resulted in prompt clinical and bacteriologic resolution. Satisfactory levels of rifampin were achieved by administering the drug either orally or intravenously, and in one patient oral administration of rifampin produced assayed levels in subdural pus many times that required for minimal bactericidal activity. Combination therapy with vancomycin and rifampin is recommended for staphylococcal infections of the CNS.
Acute suppurative thyroiditis in children is rarely reported. It is generally associated with upper respiratory tract infections and is manifest as an acute febrile illness with swelling of the thyroid gland. Diagnosis is established by aspiration of the affected area, and cultures for both aerobic and anaerobic bacteria should be carried out. Therapy is based on drainage of the abscess and treatment with specific antimicrobial drugs, as determined by culture results. We describe a 3 1/2-year-old girl with a thyroid abscess from whom Eikenella corrodens, in addition to mixed flora, was recovered. No disturbance in thyroid function was observed. We review the pathogenesis of acute bacterial infections of the thyroid gland and the literature regarding the specific cause of these infections.
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Epistaxis and bullae occurred in 35 of 54 cynomolgus macaques (Macaca fascicularis). Individual cases developed randomly during a 3 to 4 week period in the winter, and resolved within a week of onset. Clinical signs included nasal and eyelid swelling, bloody nasal discharge, sneezing, and bullous areas above the eyes. Affected animals remained active and alert. Staphylococcus aureus and Neisseria catarrhalis were isolated from nasal swabs. Hemagglutination inhibition titers for measles were negative. Biopsies of the bullous areas disclosed acute inflammatory edema and cellulitis.
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During 1979, an outbreak of mixed enterovirus infections occurred in Kansas City and adjacent communities. Sixty-six enteroviruses and 7 adenoviruses were recovered from 73 persons in a survey hospital population. Twenty-eight persons yielded echovirus type 11, 22, echovirus type 6, and 16 either echovirus type 9 or Coxsackieviruses group B, types 2 and 3. This study describes some of the clinical, virologic and epidemiologic characteristics of the outbreak. A major finding relates to the recovery of enteroviruses from cerebrospinal fluids with essentially normal leukocyte counts.
The susceptibilities of several Pasteurella multocida strains to serum bactericidins and to killing by rabbit polymorphonuclear neutrophils (PMN) were investigated, using in vitro assays. Strain Bunia II (serotype 5,12:E) was killed by both immune and normal rabbit sera containing active complement, and strains R1 (serotype 3,12:A) and 656 (serotype 12:B) were serum resistant. Strain R1 opsonized with immune or normal rabbit serum with complement or with immune antibody alone was phagocytized by neutrophils, and strain 656 was ingested only after opsonization with immune antibody in the presence or absence of complement. Complement alone was ineffective as an opsonin for the last 2 serotypes. Neither isolate was resistant to PMN killing. Growth of strain R1 in subcutaneously implanted chambers in rabbits did not increase the resistance of this organism to PMN. Comparison of phagocytosis and killing of this isolate with 2 virulent rabbit strains of P multocida--strains L-A (serotype 12:A) and 7228 (serotype 14:D)--demonstrated that strain L-A was resistant to destruction by neutrophils, whereas strains 7228 and R1 were killed. Resistance of strain L-A was not associated with the hyaluronic acid capsule.
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Chylothorax associated with the use of indwelling intravenous catheters was diagnosed in 13 Macaca mulatta. Clinical signs were marked respiratory embarrassment or sudden death. Lesions at necropsy included large quantities of sterile pleural fluid, pulmonary atelectasis and chronic fibrinous pleuritis. Lipid was present in the effusion and in tissue sections of visceral pleura.
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We investigated the clinical posttransplant effect of allopurinol on preserved kidneys. Thirty-four paired kidneys from brain-dead cadavers were preserved by hypothermic pulsatile perfusion with silica gel fraction in separate cassettes. Allopurinol was added to one perfusate and omitted from the other in a randomized, double-blind, prospective plan. There was no difference in the short-term or long-term function of either group of kidneys. Allopurinol does not appear to have as consistent a beneficial effect on non-ischemically damaged human kidneys as that observed experimentally on ischemically damaged canine organs.
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Perfusion of cadaver kidneys up to 48 hours did not adversely affect the long-term renal allotransplant function and did not result in an increased rate of rejection. In fact, cadaver kidneys perfused for longer periods of time had a slightly better functional survival rate than did kidneys perfused for shorter periods. From 100 perfused cadaver kidneys, we can conclude that the length of perfusion had little if any effect on the immunogenicity of the renal allograft in the immunosuppressed transplant patient.
The long-term function of 110 cadaver kidney transplants preserved by hypothermic perfusion was compared with that of 79 fresh cadaver kidneys. The one-month failure rate was 4 percent in the perfused kidneys in contrast to a 32 percent one-month failure rate reported by one cooperative group. These data were again confirmed in a prospective, paired study comparing perfused and fresh cadaver kidneys from the same donor. Thus, perfusion of kidneys was not harmful for cadaver transplantation. In fact, of 83 first cadaver transplants, less than 30 percent of perfused kidneys failed in the first year. There appears to be no evidence supporting the idea that bloodless hypothermic perfusion permanently damages human kidneys or increases the chances of rejection.
Mice develop age-dependent resistance to intraperitoneal infection with Wesselsbron virus, but not with Germiston virus. This resistance correlates with the capacity of peritoneal macrophages from older mice rapidly inacativated the infectivity of Wesselsbron virus, whereas Germiston virus replicated in these cells. Peritoneal macrophages from older mice protected cell cultures against Wesselsbron virus infection, but macrophages from newborn mice did not. Electron microscopic observations suggested that Wesselsbron virus was actively phagocytosed by macrophages, whereas Germiston virus entered the cells by other means and thus, presumably, circumvented the normal killing mechanisms of these cells. Germiston virus may also have directly impaired these killing functions, however, in that the ability of macrophages to kill phagocytosed Diplococcus pneumonaie was significantly less after macrophages were exposed to the virus.
Pertussis as an infectious disease exhibits a number of unusual features, both with respect to its epidemiology and to the interaction of the bacteia with the infected host. Evidence that a virus may in some cases be the etiology of the syndrome has been reviewed and seems to be have been established in certain instances. Pertussis caused by a virus would not be difficult to accept insofar as the respiratory manifestations of the disease are concerned. It is difficult, however, to reconcile the hematologic changes of pertussis with what is presently known about the usual virus infection of humans. The clinical syndrome itself is suficiently unique as to be recognized in most cases. The use of antibiotics has considerably reduced the mortality of the disease by allowing treatment of complications. The other serious complication of disease, pertussis encephalopathy, remains a problem. The possible occurrence of hypoglycemia during pertussis has been noted and deserves further documentation especially in that it may contribute to the encephalopathy...