Bacillary dysentery.
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Anti-Bacterial Agents↗
Biomedical subjects
R H Gilman
Publications and source records attributed to R H Gilman.
Intestinal fluid loss in Shigella dysentery: role of oral rehydration therapy.
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Administration, Oral↗
A competitive approach to journal publication.
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Peer Review↗
The adverse consequences of heavy Trichuris infection.
Sixty-seven children with heavy Trichuris trichiura infection (Group A) were compared to 73 control children of similar socio-economic status but with light or no T. trichiura (Group B), for nutritional status, rates of concomitant bacterial and protozoal, and symptoms and clinical signs associated with heavy T. trichiura infection. Anoscopy was used to determine heavy T. trichiura infection. Measurements and physical examination were done on Group A on admission to and discharge from hospital; 46% were seen on follow-up visit two to eight months later. Children in Group B were seen only once. There were significant differences for nutritional status (p less than 0.01) and rates of bacterial and protozoal co-infection (p less than 0.01) and a significantly greater rate of invasive amoebiasis in Group A. After treatment, nutritional parameters of Group A children improved significantly, symptoms and clinical signs decreased and there was also a significant decrease in the rate of concomitant bacterial and protozoal infection. Subgroups of Group A children, with and without concomitant enteropathogens, revealed that infection with Entamoeba histolytica and bacterial enteropathogens had had no significant impact on clinical and nutritional status.
Amebiasis↗
Gigantic obstructing laryngeal polypi.
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Airway Obstruction↗
Colonization of the oropharynx with Gram-negative bacilli in children with severe protein-calorie malnutrition.
Oral pharyngeal isolation of Gram-negative bacteria was compared in four groups of Bengali children; acutely ill, severely malnourished outpatients swabbed on hospital admission; ill but less severely malnourished outpatients from the same area as the malnourished children; orphans also less severely malnourished but not acutely ill; and well controls drawn from a priviledged socioeconomic group. The expected weight for height percentage (National Center Health Statistics/Center for Disease Control median) of the four groups was respectively 67, 91, 97, and 97%. Isolation of Gram-negative bacteria from 74 of 87 (85%) severely malnourished children was significantly greater (p less than 0.01) compared to 43 of 113 (38%) outpatients, to 20 of 93 (22%) orphans, and to five of 51 (10%) controls. A total of 71 malnourished children under 5 yr of age (90%) had higher rates of Gram-negative throat colonization than did 16 older children (63%) (p less than 0.01). Thus there was an increased rate of Gram-negative colonization in severely malnourished children especially among the younger age group. In the subset of ill children, Gram-negative pharyngeal colonization was significantly associated inversely with nutritional indices and age. The high rate of such carriage may be partly responsible for the increased susceptibility of Gram-negative infection demonstrated in these children.
Body Height↗
A solitary bone cyst of the mandibular condyle.
A review of the literature concerning solitary bone cysts of the jaws is presented. Our patient is typical except for the location of the cyst. No previous case of a solitary bone cyst confirmed to the mandibular condyle has been reported. No precise etiology for solitary bone cyst is known. The use of routine panoramic radiography has made detection of such cysts more common. Surgical exploration is indicated for diagnosis and treatment.
Child↗
Anatomical and immunological responses of rabbit gallbladders to bacterial infections.
To study the sequential morphological and immunological response of the rabbit gallbladder to bacterial infection and to compare the inflammatory responses with different pathogens, gallbladders were infected with Streptococcus faecalis and two strains of Escherichia coli, one of which produced enterotoxin. Gallbladder infection was produced either by intravenously injecting bacteria into rabbits with a small liver infarct or by injecting bacteria directly into the gallbladder of normal rabbits. The percentage of gallbladders infected intravenously with a nonenterotoxigenic E. coli strain was 86% at 1 week, 70% at 3 weeks, and 15% at 6 weeks. Epithelial necrosis and leukocyte infiltration were prominent 1 week after infection. At 3 and 6 weeks after infection, there was crypt distortion and increased mucus secretion in the epithelium as shown by periodic acid-Schiff staining. The lamina propria was infiltrated with mononuclear cells, many of which were plasma cells. Myofibroblasts (contractile fibroblasts) were also identified on transmission microscopy, In addition to these changes, toxigenic E. coli produced subepithelial capillary dilation in the villus core. Morphological changes (excluding toxin-associated changes) were related to the duration of infection rather than to the specific species of infecting bacteria. Infected gallbladders studied by immunofluorescence had a greater than 50-fold increase in plasma cells compared with control cells. In addition, the number increased with the duration of infection. Immunoglobulin A cells were the major cell type in gallbladders infected by intravesical injection, whereas immunoglobulin G cells predominated in gallbladders infected intravenously. The gallbladder appears to mount a local immune response to bacterial infection.
Animals↗
Amebic colitis: correlation of proctoscopy before treatment and barium enema after treatment.
Twenty-seven patients with severe acute amebic dysentery were studied at the International Centre for Diarrhoeal Diseases Research Hospital in Dacca, Bangladesh. Patients were divided into two groups according to their pretreatment proctoscopic mucosal pattern. Those with mild lobular patterns (five patients) had a milder illness; posttreatment air-contrast barium enema examinations were normal except for subtle mucosal abnormalities in two (40%). In contrast, patients with necrotic ulceration proctoscopic patterns (22 patients) had a more severe illness; 19 (86%) had ulcerations, haustral abnormalities, and/or strictures demonstrated on posttreatment barium enema examinations. Persistent strictures were found in eight of 10 patients with necrotic ulceration patterns who had sequential barium enema examinations up to 9 months after treatment. These observations indicate that despite successful therapy with metronidazole, there is a high incidence of persisting colonic abnormalities in patients with the necrotic ulceration pattern. Since proctoscopy has a useful predictive value, it should be performed in all patients with severe amebic dysentery.
Barium Sulfate↗
Endemic focus of Fasciolopsis buski infection in Bangladesh.
Stool surveys were conducted on children 2--10 years of age in 27 villages within Dacca District and around this index area (1,668 children were sampled), revealing an endemic focus of Fasciolopsis buski infection to the south and the east of Dacca District. In order to determine the seasonal variation in the total snail populations and the natural rate of F. buski infection in the snails, two species of planorbid snails, Segmentina (Trochorbis) trochoideus and Hippeutis (Helicorbis) umbilicalis, were periodically sampled for 12 months from a village endemic for F. buski infection. Gymnocephalous cercariae were found in S. (T.) trochoideus snails during August, September and October. The size of the snail population (n = 1,275) was significantly correlated with inches of rainfall (r = +0.62; P less than 0.05) and water temperature (r = +0.59; P less than 0.05). The natural infection rate of F. buski in the snails ranged from 0.5--2%. Snails from non-endemic areas were exposed to 3--10 miracidia. A total of 13 of 49 (27%) of H. (H.) umbilicalis and 6 of 14 (43%) of S. (T.) trochoideus had gymnocephalous cercariae present 4 to 6 weeks after exposure to miracidia. Thus, snail strain variation is unlikely to be a barrier to F. buski transmission.
Animals↗
Single dose piperazine therapy for Ascaris lumbricoides: an unsuccessful method of promoting growth.
One-hundred eighty-five Bangladeshi children age 1 1/2 to 8 yr with no Ascaris lumbricoides infection or with light, moderate, or heavy infection were randomly assigned to treatment of placebo groups, with treatment given in a double-blind fashion. The groups were comparable for nutritional and socioeconomic parameters. Treatment consisted of a single dose of piperazine citrate administered twice within a 2-wk period. The cure rates for the low, moderate, and heavy A. lumbricoides infected subgroups were 53, 31, and 36%, respectively. With more severe infections, worm eradication was more difficult and the rate of reinfection after treatment was more rapid. The rate of reinfection was significantly different for the low A. lumbricoides infected treatment and placebo subgroups for 5 months after treatment, for the moderate treatment and placebo subgroups for 3 months after treatment, and for the heavy A. lumbricoides infected treatment and placebo subgroups there was a difference, although not significant, for 1 month after treatment. Anthropometric measurements were obtained for a period of 11 months. Analysis of covariance revealed no significant difference for change of weight, change of height, weight-for age, weight-for-height, height-for-age, triceps skinfold, midarm circumference, and the abdominal girth to chest circumference ratio between the treatment and placebo groups after drug administration. The results of this study do not support single dose worm therapy as a means to enhance growth.
Anthelmintics↗
Single-dose ampicillin therapy for severe shigellosis in Bangladesh.
To evaluate a more economical regimen for severe shigella dysentery, treatment with single-dose (SD) ampicillin (100 mg/kg) was compared in a randomized trial with results obtained in a conventional five-day (100 mg/kg per 24 hr) multiple-dose (MD) course. Clinical relapse occurred in one of 23 SD children, no SD or MD adults, and none of 18 MD children. Bacteriologic failures were observed in six of 26 adults compared with one of 24 MD adults (P = 0.05). Four of 10 SD children younger than four years of age failed bacteriologically, compared with one MD child. In SD children, lower ampicillin levels were significantly associated with bacteriologic failure and younger age. Resistance of Escherichia coli to ampicillin, although transiently less in SD patients, was equal in MD and SD patients two weeks after therapy. Thus, in highly endemic areas SD ampicillin is clinically effective therapy for ampicillin-sensitive shigellosis in patients older than four years of age.
Adult↗
Circulating immune complexes in bacillary and amebic dysentery.
In order to study the relationship between the presence of circulating immune complexes (CIC) and the severity and duration of acute dysentery, we studied 11 adults and 45 children in Bangladesh with bacillary and amebic dysentery, using the Raji cell and solid-phase C1q (C1q-SPA) assays. CIC were found in 70% of patients with shigellosis and in all eight cases of amebic dysentery. Mild shigellosis was associated with positive samples in the first week of clinical illness, whereas severe cases, including those with the hemolytic-uremic syndrome, had negative admission assays but positive convalescent assays. Samples positive in the first two weeks of illness were more likely positive by the Raji cell assay alone whereas samples in the third and fourth weeks of illness were positive more often by the C1q-SPA assay. Only one shigellosis sample was positive by both assays. In amebiasis 11 of 13 samples were positive by the Raji assay alone. In dysenteric disease circulating immune complexes probably represents the failure of the inflamed mucosa to exclude microbial and dietary antigens, and suggests that the presence of CIC in any intestinal disease must be interpreted with caution.
Anemia, Hemolytic↗
Invasive E. coli and V. parahaemolyticus a rare cause of dysentery in Dacca.
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Adult↗
Absorption of macronutrients from a rice-vegetable diet before and after treatment of ascariasis in children.
The apparent absorption of nitrogen (N), fat, and total energy from a rice and vegetable diet was measured in 13 children of similar nutritional status but infected with varying loads of Ascaris lumbricoides. Apparent N absorption was modestly decreased initially in subjects with heavy infections as compared to those with light infections (57.2% of intake versus 64.1% of intake, 0.05 < P < 0.1). After antihelminthic therapy there ws a significant improvement in apparent N absorption (P < 0.02), apparent N retention (P < 0.05), and apparent fat absorption (P < 0.05) for the group as a whole, particularly for those with heavy infections. Total energy absorption improved slightly, but not significantly, after treatment, and there was no change in xylose excretion tests. Treatment of ascariasis may be nutritionally advantageous for children with heavy worm burdens and marginal protein availability.
Ascariasis↗
Randomized trial of high- and low-dose ampicillin therapy for treatment of severe dysentery due to Shigella dysenteriae type 1.
To establish optimal therapy for severe dysentery due to Shigella dysenteriae type 1 and Shigella flexneri, we compared in a prospective randomized trial two oral ampicillin doses (50 and 150 mg/kg per day) in 57 children and 39 adults in Dacca, Bangladesh. Clinical failure did not occur in either group, indicating that conventional doses need not be increased even in severe disease. Among children 3 years of age or under, bacteriological relapses tended to be more frequent in the low-dose group and were not related to serum levels of ampicillin, nutritional status, or the severity of colitis on admission. Therefore, we recommend that younger children be treated with 100 mg/kg per day of oral ampicillin.
Administration, Oral↗
Seroepidemiology of rotavirus infection in rural Bangladesh.
A prospective seroepidemiological study of rotavirus infection was performed in children in a village in rural Bangladesh. Ninety-three percent of the children had detectable antibodies during the study, and there were 66 significant rises in titer occurring in 57 of the 85 children. Antibody titer rises occurred in older children and younger children with equal frequency. Nine children (11%) had evidence of multiple infections during the 16-month period. Winter infections were most frequent, although one summer (monsoon) season was also associated with a large cluster. Subjects with high titers (greater than 1:8) of antibody less frequently developed a titer rise than did subjects with lower titers.
Antibodies, Viral↗
Identification of gallbladder typhoid carriers by a string device.
The efficiency of a gelatin capsule containing a nylon string for collection of duodenal specimens was investigated in carriers of Salmonella typhosa (typhi). Cultures of duodenal specimens obtained by means of the string capsule were compared with cultures of duodenal specimens obtained by a conventional duodenal tube and with stool cultures Duodenal contents obtained with either the string or tube were more often positive for S. typhosa than were stool cultures. The string, which is as efficient as tube collection but simpler and more comfortable, may be useful in identifying carriers of S. typhosa.
Adult↗