Editorial: Methylene blue for eczema herpeticum.
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Biomedical subjects
Publications and source records attributed to T W Chang.
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Kaposi varicelliform eruption due to herpes simplex virus (eczema herpeticum) is a serious disease in infants, with occasional fatal outcome. Photoinactivation therapy consisting of local application of methylene blue followed by light exposure resulted in rapid improvement both clinically and virologically. Methylene blue, at a concentration of 10(-5)M was found to be viricidal to herpesvirus in the light but not in the dark.
A case of subclinical rubella reinfection during pregnancy with serologic findings in the offspring initially led to an erroneous diagnosis of fetal infection. Laboratory diagnosis of congenital rubella infection, based on finding hemagglutination-inhibition (HI) activity in immunoglobulin M (IgM) fractions of newborn's serum after sucrose gradient fractionation, was questioned when apparent IgM-HI activity was to be probably due to nonspecific inhibitors, which resulted from bacterial action on the beta-lipoprotein in the serum. These findings emphasize some pitfalls encountered in arriving at a diagnosis based soley on serologic data. This case also illustrates the importance of keeping serum samples sterile when performing serologic tests.
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Silver sulfadiazine, an anti-infectious agent for the prevention and treatment of burn sepsis, has been found to possess antitreponemal activity against Treponema pallidum. At 28 C, complete inactivation of the organism was produced by exposure of the organism to a concentration of 50 mug of the drug per ml for 1 to 5 min, 12 to 25 mug/ml for 10 to 15 min, and 6.2 mug/ml for 30 min. At 37 C, the amounts of silver sulfadiazine required for inactivation were two- to fourfold less.
Silver sulfadiazine, at a concentration of 10 mug/ml when applied immediately after infection by Herpesvirus hominis, prevented the development of acute herpetic keratoconjunctivitis in rabbits. The efficacy was inversely related to the size of inoculum. Subclinical infections were observed in the drug-treated eyes.
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Methylene blue, in a concentraion of 10-5M was virostatic in the presence of light but not in the dark for 31 of 37 strains of fresh isolates of herpesvirus hominis. Resistance to the dye developed during treatment. This photodynamic pattern was almost identical to that of neutral red which produced an identical effect. This was not ture for proflavine which was active in the dark in many instances. Cross insensitivity between proflavine and methylene blue was not observed.
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Eighteen strains of Pseudomonas maltophilia and eight strains of P. cepacia were tested for susceptibility to sulfamethoxazole, trimethoprim, and colistin in different combinations. A synergistic effect was found against most of the strains.