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U Neubert

Publications and source records attributed to U Neubert.

At least 55 records · Page 3Linked to original sources
PubMed1986

Treatment of gram-negative folliculitis with isotretinoin.

The clinical and bacteriological findings are reported in 13 patients with gram-negative folliculitis before, during, and after treatment with isotretinoin (13-cis-retinoic acid). Patients were treated for 14-36 weeks with a daily dose of 0.5-1.5 mg isotretinoin/kg body weight. Inflammatory lesions were counted before and during weeks 2, 4, 8, 12, 16, 20, 24, 28, and 30 of therapy and again up to 172 weeks after cessation of treatment. In all patients there was an impressive improvement in clinical symptoms, especially a decrease in seborrhea and inflammatory lesions. Simultaneously, the gram-negative bacteria disappeared from the facial skin. Full clinical bacteriological remission was achieved in 9 patients within a period of up to 43 months, with minor recurrences of the disease in the remaining 4 patients.

Adolescent↗
PubMed1986

Clinical features of early erythema migrans disease and related disorders.

104 patients with erythema migrans disease (EMD), 7 patients with borrelia lymphocytoma (BL), and 21 patients with acrodermatitis chronica atrophicans (ACA) were prospectively followed for a median of 20, 14, and 12 months, respectively. 99 patients with EMD and 6 with BL were treated with antibiotics early for their illness. 72 patients with EMD had 1 to 10 constitutional symptoms besides the erythema migrans, 32 had erythema migrans alone, and a child with BL had urticaria. Out of 39 patients with EMD, 23 acquired arthralgia, 18 signs and symptoms consistent with neurologic manifestations and 8 with cardiac involvement before or after therapy. 4 patients with EMD and 1 with BL had up to 10 multiple erythema migrans lesions. 3 patients with EMD experienced a reinfection and 1 with ACA a relapse. Several patients with ACA developed signs and symptoms consistent with neurologic, cardiac and joint involvement, and 2 had a history of EMD. Elevated antibody titers against Borrelia burgdorferi were present in 48% of 69 patients with EMD, 5 with BL and 11 with ACA, and in 93% of another group with EMD, 2 with BL and 10 with ACA, when tested against other borreliae. Increased values of the ESR, IgG, IgA and IgM were found in more patients with ACA than with EMD. The median of IgA and IgM was significantly higher in ACA than in EMD. Borreliae were found in brain and liver of a newborn. Early EMD appears to be quite similar to early Lyme disease.

Acrodermatitis↗
PubMed1986

Microbiological findings in erythema (chronicum) migrans and related disorders.

In order to evaluate the virtual advantage of proving borrelial infection in dermatoses clinically diagnosed as erythema (chronicum) migrans (ECM), acrodermatitis chronica atrophicans (ACA) or lymphadenosis cutis benigna (LCB) by means of histological, cultural or serological trials, skin and serum samples obtained from altogether 99 patients suffering from these dermatoses were examined. Serum and--to some extent--skin specimens gained from healthy individuals (n = 36), patients with not tick bite associated disorders of skin, internal organs and nervous system (n = 121) were used as controls. In addition, serum specimens from patients enduring circumscribed scleroderma (morphea), n = 31, and sera of Bavarian forest workers (n = 211) were proven for the presence of borrelial antibodies. Using an indirect immunofluorescence assay with borrelial strains, propagated in inbred mice, as antigens, elevated IgM- and/or IgG antibody titers were found in 51 (84%) out of 61 ECM-, in 17 (100%) ACA- and in 2 (33%) out of 6 LCB-sera. Antibody titers decreased significantly after adequate antibiotic therapy. The groups in comparison yielded spirochetal serum antibodies as follows: Healthy individuals and patients with various diseases 7 out of 157 (4.5%), morphea patients 7 out of 31 (23%) and forest workers 71 out of 211 (34%). Borrelia burgdorferi was cultivated from 6 out of 32 skin and from 1 blood specimen obtained from ECM patients and from 1 out of 5 ACA skin specimens. Borreliae could also be detected in the blood of 3 out of 11 thymusaplastic nude mice after intraperitoneal implantation of ECM-tissue. More frequently than borreliae spindle-shaped bacteria resembling fusobacterium sp. were detected not only by in vitro cultivation of ECM and ACA skin samples, but also in the blood of thymusaplastic mice after implantation of ECM-tissue. By Warthin-Starry silver strain borrelia-like structures were detected in 9 out of 28 ECM, in 3 out of 12 ACA and in 1 out of 5 LCB skin specimens. Therefore in our experience serological examinations turned out to be the most productive diagnostic tool.

Adolescent↗
PubMed1986

The susceptibility of Neisseria gonorrhoeae strains to different cephalosporins and penicillin G depends on the auxotype.

The relatively broad range of minimum inhibitory concentrations (MICs) of different cephalosporins and penicillin G with Neisseria gonorrhoeae results from the differing susceptibility of various subsets, i.e. auxotypes. While prototrophic and proline-dependent strains are especially resistant (p less than or equal to 0.001), AHU strains are especially susceptible. The bimodality of MIC values with penicillin G and the older cephalosporins, cephalothin and cefazoline, results from quite a big subset of relatively resistant prototrophic strains. As the newer cephalosporins from generation (e.g. cefotiam) to generation (e.g. cefmenoxime and ceftizoxime) tend to have less special problems with these strains, the general distribution of MIC values changes to monomodality.

Cephalosporins↗
PubMed1986

Evaluation of cefotetan in uncomplicated gonorrhea.

Cefotetan is a newly developed cephamycin especially resistant to bacterial beta-lactamase. Therefore both its in vitro activity against Neisseria gonorrhoeae and its clinical efficacy in uncomplicated gonorrhea are investigated. The minimal inhibitory concentrations (MIC) lie in the range of 0.016-2 micrograms/ml, 90% of the strains being inhibited by 0.5 microgram/ml. Of 52 finally evaluable patients who were treated by a single intramuscular injection of 1 g, 48 (92.3%) were cured bacteriologically. Thus the present treatment protocol may prove useful in individual cases. It should, however, not be advocated for gonorrhea treatment in general.

Adult↗
PubMed1985

Treatment of gonorrhoea with cefotiam: activity in vitro and clinical results of a 1-gram single-dose regimen.

Cefotiam is clearly more active against Neisseria gonorrhoeae in vitro than penicillin. This applies especially to strains producing beta-lactamase but also to those which do not. No strain requires more than 0.25 micrograms/ml for inhibition. 1 g of cefotiam dissolved in 3 ml of 1% lidocaine solution cures 90.0% of patients suffering from uncomplicated genital gonorrhoea if injected once intramuscularly. Tolerance of this regimen is very good, no major side-effect being found.

Cefotaxime↗
PubMed1985

Gonoblennorrhoea adultorum (gonococcal conjunctivitis)--a "disappearing disease" which does not disappear.

Gonoblennorrhoea adultorum (GA) still occurs in spite of contrary statements. During the last 10 years, 4 cases were seen in the Munich Clinic of Dermatology (constituting 0.19% of all patients with gonorrhoea). While the conjunctivae alone were involved in 3 of them, in 1 the cornea showed alterations as well. Thus, the disease has not lost its potential danger. Yet the newer cephalosporins seem to cure GA rapidly, even if given in a single dose (together with local treatment).

Adult↗
PubMed1985

Preputial abscesses caused by beta-lactamase-producing gonococci.

Preputial abscesses occurred in three men who had had sexual intercourse with prostitutes in Thailand. Neisseria gonorrhoeae could be grown from the lesions. Two of the strains were tested for beta-lactamase production and proved positive. While all three patients showed no clinical signs of urethritis, urethral swabs were positive for gonococci in two.

Abscess↗
PubMed1985

[Importance of the auxotyping of Neisseria gonorrhoeae for evaluating gonorrhea therapy studies].

So far, there was no absolutely reliable way to distinguish between failure and reinfection in clinical trials on the treatment of gonorrhoea. If one, however, analyzes the auxotypes of the gonococcal strains isolated before and after application of the drug from non-cured patients, reinfection can clearly be demonstrated in cases with a changed auxotype. Thus, in a trial on the single intramuscular application of cefotiam 1 g for uncomplicated gonorrhoea, the bacteriological cure rate increased from 90 to at least 95%.

Clinical Trials as Topic↗
PubMed1984

Susceptibility of Neisseria gonorrhoeae to ceftizoxime in vitro and in vivo.

Ceftizoxime - a new beta-lactamase-resistant cephalosporin - was tested for its potential efficacy in the cure of uncomplicated gonorrhea. While more than a half of the 102 freshly isolated Neisseria gonorrhoeae strains examined was partially or totally resistant to penicillin (MIC greater than or equal to 0.06 microgram/ml), most of these strains proved highly susceptible to ceftizoxime (as well as cefotaxime). The MIC90% amounted to 0.004 micrograms/ml, while serum levels after the intramuscular application of as little as 0.5 g exceed 1 microgram/ml for more than 6 h. The clinical results were excellent. 105 male or female patients suffering from uncomplicated gonorrhea were treated with a single intramuscular application of 1 g of ceftizoxime. 61 of them reattended our clinic twice for follow-up. All of them were cured. Anaphylactic shock or rashes were not observed. Thus, we consider the intramuscular application of 1 g of ceftizoxime as a reliable and safe treatment for uncomplicated gonococcal urethritis and cervicitis.

Adolescent↗
PubMed1984

Repeated exposition to subinhibitory concentrations of antibiotic in vitro readily decreases susceptibility of Neisseria gonorrhoeae to rifampicin, but not to new cephalosporins and penicillin G.

Repeated subcultivation of Neisseria gonorrhoeae in the presence of subinhibitory concentrations of antibiotic has turned out as a reliable model to predict the low potential for development of resistance with respect to the beta-lactam antibiotic penicillin. Before large-scale introduction of the new cephalosporins we exposed 5 N. gonorrhoeae strains of different susceptibility to penicillin repeatedly to subinhibitory concentrations of cefotiam, ceftizoxime, rifampicin and penicillin G incorporated into chocolate agar. each time the most resistant representatives of a strain were propagated, on the whole 25 times. While resistance to rifampicin increased readily (all strains became relatively resistant, MIC = 4 micrograms/ml), the same was not true of the cephalosporins. Although their susceptibility decreased, too, no strain acquired partial or even total resistance (final MIC less than or equal to 0.128 with cefotiam and ceftizoxime). The cephalosporins thus rather parallelled penicillin G which hardly induced any increase of resistance. Thus, a quick loss of clinical efficacy need not be feared after large-scale introduction of the new cephalosporins into the therapy of gonorrhea.

Anti-Bacterial Agents↗
PubMed1984

[Etiology of erythema migrans disease and Lyme disease. Review and results of personal study].

Erythema chronicum migrans (ECM), lymphadenosis cutis benigna and acrodermatitis chronica atrophicans (ACA) have been well known in Europe for a long time as skin diseases induced by tickbites. Earlier hints that these inflammatory dermatoses and associated disorders (erythema migrans disease) might be of spirochetal origin are now supported by the findings of several groups in the USA and Europe. In the United States the endemic occurrence of a new inflammatory disease which seems to be closely related to the European erythema migrans disease was first seen in Lyme, Connecticut, in 1975. This "Lyme disease" is also induced by tick bites and affects mainly skin and joints. In 1982 the isolation of a new spirochetal species cultivated from Ixodes dammini ticks was reported. Antibodies against these Ixodes dammini spirochetes (IDS) were detected by indirect immunofluorescence in patients with Lyme disease. In 1983 spirochetes were shown by Warthin-Starry silver stain in skin biopsies of erythema chronicum migrans, and nearly simultaneously the isolation of spirochetes similar to the IDS from skin, blood and cerebrospinal fluid of Lyme patients was reported in a few cases. Also, in Europe Borrelia-like spirochetes morphologically very similar to the IDS have been isolated from ticks of the indigenous species Ixodes ricinus by transmission to laboratory animals and cultivation in vitro. Antibodies against Ixodes ricinus spirochetes (IRS), but also against known Borrelia species have been shown in most sera of patients with erythema migrans disease, including meningoradiculitis Bannwarth, acrodermatitis chronic atrophicans and lymph-adenosis cutis benigna.(ABSTRACT TRUNCATED AT 250 WORDS)

Acrodermatitis↗
PubMed1983

Distribution of auxotypes and correlation to antibiotic susceptibility of 169 recent clinical Neisseria gonorrhoeae isolates from Munich.

In Munich 169 isolates of Neisseria gonorrhoeae were investigated with respect to nutritional profiles (auxotypes) and antibiotic susceptibility. Of the 165 penicillin-susceptible strains 97 proved to be prototrophic (auxotype 1), 42 proline-dependent (auxotype 2). Only 3 arginine-, hypoxanthine- and uracil-dependent strains (auxotype 14) were found. A total of 10 different auxotypes were identified among the non-penicillinase-producing strains and one among the penicillinase producers. The minimal inhibitory concentrations of penicillin G ranged from 0.01 to 1 microgram/ml, those of cefuroxime from 0.001 to 4 mg/ml; tetracycline and kanamycin had a narrow spectrum of effective concentrations, from 0.25 to 8 micrograms/ml and from 4 to 64 micrograms/ml respectively. The type 14 strains showed the well-known high susceptibility to penicillin G.

Cefuroxime↗
PubMed1983

Cultural proof of Neisseria gonorrhoeae in synovial fluid in disseminated gonococcal infection.

Disseminated gonococcal infection is not too rare, and joint involvement is one of its prominent features. Although diagnosis in general is based on clinical findings and microbiological examination of the genitals and sometimes blood, there are cases in which exact diagnosis can only be made after the investigation of synovial effusion. An observation of this kind is presented, and the general value of the aspiration of synovial fluid in disseminated gonococcal infection is discussed. Special interest is also given to the possible coincidence of disseminated gonococcal infection and other sexually transmitted diseases as for example trichomoniasis, both of which were found in our case.

Adult↗
PubMed1983

[Determination of pathogens in blood in disseminated gonococcal infection. Case report and overview of the literature].

Although Neisseria gonorrhoeae has been recognized as causative agent of infectious disease not only of the genital region but also of other organs already at the end of the 19th century, disseminated gonococcal infection as a clinical entity has been defined fairly recently, i.e., during the last decade. In particular, it has been very difficult for a long time to detect Neisseria gonorrhoeae in the blood of patients suffering from this form of gonorrhea. Therefore, the case of a 22-year-old woman is presented who developed fever, arthritis, and pustules and from whose cervix, rectum, and blood Neisseria gonorrhoeae could be grown. Based on the reports in the literature and our own experience indispensable and further desirable diagnostic measures to be adopted in such cases are discussed.

Adult↗
PubMed1982

[Triple bacterial infection of the cervix uteri in benign gonococcal sepsis].

Benign gonococcal sepsis or disseminated gonococcal infection is a well defined clinical entity. Although the coincidence of several sexually transmitted diseases in the same patient has recently gained interest no case has been reported so far in which benign gonococcal sepsis was combined with further bacterial infections of the genitals. Therefore the case of a 25-year-old woman is reported who suffered from cervicitis, arthritis, and dermatitis due to neisseria gonorrhoeae infection and also harboured chlamydia trachomatis and ureaplasma urealyticum in her cervix. Facing this coincidence certain therapeutical and epidemiological conclusions must be drawn.

Adult↗