Reactive arthritis associated with campylobacter enteritis.
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Biomedical subjects
Publications and source records attributed to T M Reid.
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Campylobacter jejuni was isolated from the stools of 148 patients with symptoms and 57 symptomless subjects, and from a milk sock filter, following an outbreak of enteritis associated with consumption of unpasteurized milk. The incubation period ranged from 2-11 days with a peak at 5 days. There were no secondary cases. The attack rate was around 50%. Cases occurred in all age groups but were maximal in the 1-10 age group. Recovery from symptoms was complete in the majority in less than 1 week. No long term excretors were identified. There were no differences between culture positive individuals, with or without symptoms, in age or sex distribution or duration of excretion.
Group B streptococcus is now recognized as a major cause of serious neonatal infection. Between January 1973 and July 1979 35 infants with 'early onset' group B streptococcal infection were admitted to the Special Nursery, Aberdeen Maternity Hospital. Ten infants died, nine of whom were of low birth weight. Current research is directed towards defining 'high risk' groups and establishing an effective means of prevention. The concept of early administration of antibiotics to 'high risk' infants, particularly those of low birth weight, is recommended. While there is already evidence in support of the effectiveness of such an antibiotic policy, the nature of protective immunity and the place of immunoprophylaxis have yet to be clarified. Analysis of our data suggests that vaginal carriage of group B streptococcus is not associated with the mother's blood group but there appears to be an increased incidence of neonatal group B streptococcal infection in infants of mothers of blood group B.
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A retrospective study of group B streptococcal endocarditis during 1965-74 in Aberdeen General Hospitals revealed that group B streptococci how principally affect patients in the older age groups with or without a history of antecedent heart disease. Despite recent reports of increased group G infections in obstetric and perinatal practice there were no cases of post-puerperal endocarditis. Although aortic valve involvement would appear to be increasing, group B streptococci still show a marked predilection for the mitral valve.
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A case of common variable hypogammaglobulinaemia with associated impairment of cell mediated immunity and severe wart virus infection is described. The defect of cell mediated immunity is thought to have predisposed this patient to the development of persistent wart infection which in turn grossly depressed the body's cellular immunity and thus allowed widespread dissemination of the warts. The rapid restoration of cell mediated immunity which followed the reduction in the antigenic load of wart virus by diathermy treatment was followed by the spontaneous regression of all the patient's warts. This unusual case may provide some insight into the complex relationship between wart virus infection and the immune system of the host.
Recent reports indicate that the group B haemolytic streptococcus has now assumed a major role in neonatal septicaemia in the United Kingdom. Of particular concern are the absence of premonitory signs, the fulminating nature of the infection and the high mortality. 31 cases from which this organism was isolated during the first week of life included 5 cases of neonatal septicaemia, 4 of which proved fatal. An attempt was made (a) to identify the group of neonates at greatest risk and (b) to formulate guidelines for early detection and treatment. Study indicates the importance of apnoea as a sign of infection particularly in those infants who are preterm, of low birth weight and asphyxiated. There is need for aggressive bacteriological screening and early administration of antibiotics to prevent the high mortality from group B streptococcal infection.
A retrospective study of obstetric and perinatal illness due to group B streptococci during 1972-4 based on bacteriological referrals from Aberdeen Maternity Hospital and Special Nursery disclosed (1) a wide spectrum of maternal morbidity, particularly associated with amniotomy and a prolonged rupture-delivery interval, and (2) the emergence of the group B streptococcus as a major cause of serious neonatal infection in infants of low birth weight, often in the absence of maternal pyrexia. The group B isolates appeared to show a previously undocumented increased resistance to the aminoglycosides gentamicin and kanamycin. A prospective study of 369 random deliveries in Aberdeen Maternity Hospital showed a group B vaginal carriage rate of 49/1000; a neonatal colonization rate of 19/1000; maternal and neonatal morbidity rates of 16 and 2-7/1000, respectively; and an overall neonatal mortality of 1/1000 live births.
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In a prawn-processing factory, workers were exposed to an aerosol of prawn. Nearly 40% of those exposed developed wheezing and other respiratory symptoms.