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Biomedical subjects

S L Berk

Publications and source records attributed to S L Berk.

At least 55 records · Page 3Linked to original sources

Selective medium with DNase test agar and a modified toluidine blue O technique for primary isolation of Branhamella catarrhalis in sputum.

A selective medium with DNase test agar and incorporating vancomycin (10 micrograms/ml), trimethoprim (8 micrograms/ml), and amphotericin B (2 micrograms/ml) supported the growth of 305 Branhamella catarrhalis isolates. A modified toluidine blue O technique was used after 48 h of incubation in CO2 to overlay suspected B. catarrhalis colonies. A metachromatic color change was observed in 15 min, indicating DNase production. In 200 unselected sputum samples of hospitalized patients, this method was compared with routine microbiologic procedures; 31 B. catarrhalis isolates were recovered with the method, compared with 22 isolated from the clinical laboratory. This medium will be particularly useful for culture of sputum, which shows inflammatory cells and gram-negative diplococci on Gram-stained smears.

Amphotericin B↗

In vitro interactions of amikacin and beta-lactam antibiotics against amikacin-resistant gram-negative bacilli.

We tested 42 strains of amikacin-resistant gram-negative bacilli with amikacin in combination with six beta-lactam antibiotics using the checkerboard and time-kill curve techniques. Synergism was demonstrated with time-killing curve in 43-68% of the strains tested. Ceftazidime plus amikacin was the most active combination by the checkerboard technique, while amikacin-cefoperazone was the most active combination by the time-killing curve technique against Pseudomonas aeruginosa. Discrepancies were found between the results of the two methods used.

Amikacin↗

Diagnosis of pulmonary strongyloidiasis by bronchoalveolar lavage.

Bronchoalveolar lavage was performed on a patient with disseminated strongyloidiasis and 4.5 X 10(7) cells/65 ml of lavage fluid were recovered. Eighty-five percent of cells were polymorphonuclear leukocytes; 15 percent were pulmonary alveolar macrophages. Rhabditiform larvae (1 X 10(4)) were recovered in 65 ml of lavage fluid. This is the first report of bronchoalveolar lavage used in diagnosing disseminated strongyloidiasis.

Bronchoalveolar Lavage Fluid↗

Parasitic pneumonia.

With few exceptions, the parasitic pneumonias most commonly encountered in the Western Hemisphere are diseases of compromised hosts; patients with AIDS are at particular risk. Pneumocystis carinii pneumonia occurs eventually in 80% of AIDS patients; bronchoalveolar lavage is quite sensitive in establishing this diagnosis. Toxoplasma gondii pneumonia, seen most often in the patient with AIDS, is characterized by multisystem involvement. Strongyloides stercoralis infection is endemic in the Southeastern United States. Pulmonary strongyloidiasis is seen in patients receiving glucocorticoids or chemotherapy, and in patients with AIDS or other causes of T cell dysfunction. Larvae may be seen on Gram's stains or wet mounts of sputum. Ascaris and hookworm infections may present with pulmonary infiltrates and eosinophilia during the larval migration phase. Dirofilaria, Paragonimus, and Entamoeba histolytica involvement of the lung are less common and require a good epidemiologic history and clinical suspicion for diagnosis.

Acquired Immunodeficiency Syndrome↗

Listeria monocytogenes peritonitis.

Listeria monocytogenes peritonitis in a patient with cirrhosis and simultaneous soft tissue infection is reported. Six previously documented cases are reviewed. All seven patients were bacteremic, suggesting hematogenous seeding to the peritoneum as the pathogenic mechanism. Clinical and laboratory characteristics of L. monocytogenes peritonitis are compared with peritonitis of other bacterial etiologies.

Female↗

Pulmonary tuberculosis in elderly men.

The clinical manifestations, predisposing factors, and diagnostic approach to 29 young men and 35 elderly men with pulmonary tuberculosis admitted to a Veterans Administration hospital were compared. Elderly men had a higher number of underlying conditions such as atherosclerosis, previous gastrectomy, and malignancy, whereas alcoholism was more prevalent in the younger group. The classic symptoms and signs of tuberculosis were noted in a significantly higher proportion of the younger group: fever (62 percent versus 31 percent), weight loss (76 percent versus 34 percent), night sweats (48 percent versus 6 percent), sputum production (76 percent versus 48 percent), and hemoptysis (40 percent versus 17 percent) (p less than 0.05). Abnormal mentation was more common in the elderly group (31 percent versus 10 percent) (p less than 0.05). Radiographic findings were similar in both groups. Mortality related to tuberculosis was 20 percent in elderly men versus 3 percent in the younger men (p less than 0.05). Tuberculosis is frequently not considered in the differential diagnosis when elderly patients present with multiple medical problems and nonspecific complaints. Since there are differences in the clinical presentation and the outcome of pulmonary tuberculosis in elderly patients, a high index of suspicion for the disease should be maintained.

Adult↗

Enterobacter pneumonia.

Enterobacter species have not been well recognized as important lower respiratory tract pathogens. We describe 11 cases of Enterobacter pneumonia, seven diagnosed by transtracheal aspiration and four by simultaneous blood and sputum cultures. The infections were usually nosocomial, and were fatal in five patients. Our patients were old (mean age 65 +/- 12.3 years) with chronic obstructive pulmonary disease (COPD) as a common underlying disease. Enterobacter species are important pathogens causing nosocomial pneumonias, especially in elderly patients with COPD.

Adult↗

Clinical and epidemiologic features of strongyloidiasis. A prospective study in rural Tennessee.

Hospitalized and domiciliary patients were studied to determine the incidence of the endemic nematode Strongyloides stercoralls in stool samples. Strongyloides was found in 14 (6.1%) of 229 hospitalized patients and in nine (2.6%) of 346 domiciliary patients. Clinical symptoms, laboratory data, and underlying diseases were compared for stool-positive and stool-negative patients. Infected patients were more likely to complain of abdominal bloating. They had a higher incidence of eosinophilia and guaiac-positive stools. They were more likely to have been treated with corticosteroids, cimetidine, and antacids. Efficacy of treatment with thiabendazole was studied in all stool-positive patients; a relapse rate of 15% was noted with standard thiabendazole therapy.

Aged↗

Courvoisier's law.

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Common Bile Duct Diseases↗

Corynebacterium minutissimum bacteremia in a patient with chronic myeloid leukemia in blast crisis.

Serious infections and sepsis due to nondiphtheria Corynebacteria have been well described. A patient with chronic myeloid leukemia in blast crisis, who developed Corynebacterium minutissimum bacteremia, is described in this report. Corynebacterium minutissimum is the causative agent of erythrasma and to our knowledge, this is the first published report of septicemia due to this organism.

Blast Crisis↗

Progressive pulmonary disease caused by Mycobacterium gordonae.

Mycobacterium gordonae has been considered a true saprophyte of the respiratory tract, unable to produce pulmonary disease. We have reported a case of progressive pulmonary disease due to Mycobacterium gordonae which has failed to improve with multiple combinations of antituberculous drugs over a period of eight years.

Antitubercular Agents↗

Branhamella catarrhalis pneumonia in patients with immunoglobulin abnormalities.

The importance of Branhamella catarrhalis pneumonia has only recently been appreciated. Predisposing underlying illness associated with this organism have not yet been clarified. We report five cases of Branhamella catarrhalis pneumonia occurring in patients with diseases associated with documented quantitative immunoglobulin deficiencies. Normal immunoglobulins appear to be important host defense mechanisms in preventing infection with this organism.

Adult↗