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Biomedical subjects

W L Drew

Publications and source records attributed to W L Drew.

At least 91 records · Page 5Linked to original sources
PubMed1982

Transfusion-related cytomegalovirus infection following noncardiac surgery.

Clinically evident cytomegalovirus (CMV) infections developed in five patients after noncardiac surgery. Each of them had received several blood transfusions and had evidence of primary CMV infection. These five cases were identified in a single eight-month period, suggesting that this syndrome must be occurring with greater frequency than is commonly appreciated. Three of five patients had undergone splenectomy, and review of the literature for documented cases of posttransfusion CMV mononucleosis following non-cardiac-bypass surgery disclosed an additional nine patients, five of whom had had splenectomies. This striking association suggests the possibility that the spleen plays a role in controlling the incidence or clinical manifestations of posttransfusion CMV infections. Alternatively, this association may only reflect the frequent requirement for many blood transfusions in this type of surgery.

Adult↗
PubMed1982

Lymphogranuloma venereum and acute ulcerative proctitis.

The lymphogranuloma venereum (LGV) L2 serotype of Chlamydia trachomatis has been isolated from the rectums of three homosexual men with acute, primary ulcerative proctitis that responded to appropriate anti-chlamydial therapy. LGV is still present in the urban United States and must be considered in cases of acute ulcerative proctitis.

Acute Disease↗
PubMed1982

An outbreak of Pneumocystis carinii pneumonia in homosexual men.

Pneumocystis carinii pneumonia has rarely been reported in previously healthy persons over the age of 6 months. Five cases of P. carinii pneumonia in adult homosexual men, confirmed by biopsy results, are reported. All five patients were seropositive when tested for antibodies to cytomegalovirus and four had evidence of active concurrent cytomegalovirus infections. Kaposi's sarcoma was shown in two of the patients and one had possible Pneumocystis infection of the central nervous system as well as P. carinii pneumonia. Three patients had second episodes of Pneumocystis pneumonia. Four of the five patients have died. Past or concurrent cytomegalovirus infection and homosexuality were the only common epidemiologic features in all five patients.

Adult↗
PubMed1981

Prevalence of cytomegalovirus infection in homosexual men.

Cytomegalovirus (CMV) was cultured from the urine of 14 of 190 homosexual but none of 101 heterosexual men attending a venereal disease clinic (P less than 0.005). Viruria was confined to men less than 30 years of age and was present in 14% of this group. Antibody to CMV was measured in the sera of 139 homosexual and 70 heterosexual men attending the same clinic and in 103 male volunteer blood donors. Titers were found in 94% of homosexual patients but in only 54% of heterosexual patients (P less than 0.005) and 43% of male volunteer blood donors (P less than 0.005). The data suggest that sexual transmission is an important mode of spread of CMV among adults and the homosexual men are at greater risk for CMV infections than are heterosexual men. Homosexual men might considered candidates for the evaluation of the efficacy of CMV vaccines in preventing horizontal transmission of infection.

Adolescent↗
PubMed1981

Comparative synergistic activity of cefoperazone, cefotaxime, moxalactam, and carbenicillin, combined with tobramycin, against Pseudomonas aeruginosa.

A broth dilution checkerboard synergy assay was used to assess the activity of cefoperazone, cefotaxime, moxalactam, and carbenicillin, in combination with tobramycin, against 38 strains of Pseudomonas aeruginosa. Synergy occurred significantly more often (P less than 0.001) when tobramycin was combined with cefotaxime (63%) than when it was combined with carbenicillin (26%), cefoperazone (21%), or moxalactam (18%). Of the 25 synergistically inhibited strains, the combination cefotaxime-tobramycin was synergistic against 24 and was the only synergistic combination against 10. Of six strains initially resistant to cefotaxime, five were susceptible to this agent (minimum inhibitory concentration, less than or equal to 32 micrograms/ml) when it was combined with tobramycin. Clinical trials are needed to determine the therapeutic efficacy of cefotaxime-aminoglycoside combinations in the treatment of serious Pseudomonas infections.

Anti-Bacterial Agents↗
PubMed1981

Branhamella (Neisseria) catarrhalis--a lower respiratory tract pathogen?

Branhamella (Neisseria) catarrhalis was identified as a probable respiratory tract pathogen in seven patients, four with pneumonia and three with bronchitis. Five of the B. catarrhalis isolates produced beta-lactamase. Production of beta-lactamase correlated with penicillin resistance by the standardized disk diffusion method and also with high minimal inhibitory concentrations of penicillin for the two strains which were tested.

Aged↗
PubMed1980

Rapid diagnosis of varicella-zoster virus infection by direct immunofluorescence.

Laboratory results were reviewed for 47 patients who had skin lesions that had been simultaneously examined by viral culture and direct immunofluorescence for the presence of varicella-zoster virus. Immunofluorescence established the diagnosis in 24 of 28 patients (86%) strongly suspected on clinical grounds of having varicella-zoster infection. Viral culture was positive in only 10 of 28 patients (36%). Skin lesions in 19 patients who had other diagnoses were negative by both tests. Direct immunofluorescence appears to be a highly sensitive and specific technic for the rapid diagnosis of cutaneous varicella-zoster virus infections.

Chickenpox↗
PubMed1980

Relation of culture site to the recovery of nonpolio enteroviruses.

The relative utilities of rectal swab, throat swab, stool, and cerebrospinal fluid cultures for the recovery of nonpolio enteroviruses were retrospectively evaluated for 81 patients who had one or more positive cultures. Of 33 stool cultures submitted, 32 (97%) were positive; of 52 throat swabs submitted, 35 (67%) were positive; of 29 rectal swabs, 20 (69%) were positive. Of 16 patients for whom both sites were simultaneously sampled, stool cultures were positive for 15, but throat cultures were positive for only six. Seven other patients who had positive throat cultures had simultaneous rectal swab cultures that were negative. For patients who had aseptic meningitis, cerebrospinal fluid was positive in only nine of 21 cultures, whereas stool was positive in all of 12 cultures. Stool should be cultured for all patients suspected of having nonpolio enterovirus infections; rectal swabs are inadequate substitutes for stool cultures.

Adult↗
PubMed1980

Age-dependent resistance of human alveolar macrophages to herpes simplex virus.

Studies in mice demonstrate an age-dependent susceptibility to disseminated herpesvirus infection which is mediated. at least in part, by a defect in macrophage antiviral function. We examined the growth of herpes simplex virus within human alveolar macrophages obtained by bronchopulmonary lavage from neonates, adults with a variety of immunosuppressive disorders, and healthy adult volunteers. At 24 h postinfection, mean viral titers in neonatal macrophages increased 19-fold over adsorbed virus levels, a highly significant increase when compared to either immunosuppressed or normal adult macrophages (P less than 0.0005). These findings indicate that human macrophages, like those of mice, exhibit age-dependent permissiveness for the replication of herpes simplex virus. This permissiveness may at least partially account for the clinical observation that human newborns are highly susceptible to disseminated herpes simplex virus infections, whereas adults are not.

Adult↗
PubMed1979

Acquired cytomegalovirus infection in preterm infants.

Small sick preterm infants requiring care in a neonatal intensive care unit for more than 28 days were cultured for cytomegalovirus in urine and/or nasopharynx during two periods lasting a total of 13 months. Sixteen of 51 such infants began excreting the virus at 28 to 148 days of age (mean, 55 days). In 14 of the 16, a recognizable, self-limited symptom complex developed that consisted of respiratory deterioration, hepatosplenomegaly, a remarkable gray pallor, and both an atypical and absolute lymphocytosis. All of the infants with the clinical symptom complex had underlying chronic lung disease and all had received multiple blood transfusions during their hospitalization. Acquired cytomegalovirus may be relatively common in sick preterm infants and should be distinguished from other causes of rapid deterioration.

Cytomegalovirus Infections↗
PubMed1979

Growth of herpes simplex and cytomegalovirus in cultured human alveolar macrophages.

In laboratory animals, macrophages play a central role in controlling certain viral infections. Because the adult human lung is more susceptible to infection with cytomegalovirus than herpes simplex virus, we compared the replication of these two viruses in vitro in human alveolar macrophages. The growth of herpes simplex virus in alveolar macrophages was extremely limited, peak titers being only 1.8-fold greater than adsorbed virus titers. Cytomegalovirus, on the other hand, replicated in normal adult alveolar macrophages to the same extent as in permissive tissue culture cell. These data suggest that the human alveolar macrophage may play a central role in the control of lung infection with herpes simplex virus.

Cells, Cultured↗
PubMed1979

Nosocomial respiratory syncytial virus infections in an intensive care nursery: rapid diagnosis by direct immunofluorescence.

A nosocomial outbreak of respiratory syncytial virus infections involved 8 of 17 infants in an Intensive Care Nursery and one additional infant in the adjoining Newborn Nursery. Immunofluorescent staining of nasopharyngeal specimens was positive in six of seven virologically confirmed cases (86%). One additional case with negative viral cultures was also identified by this technique. Viral isolation in tissue cultures required an average of 4.9 days, whereas results of immunofluorescent studies were available in two to four hours. Rapid identification of infected infants by immunofluorescence permitted prompt institution of infection control measures.

Cross Infection↗
PubMed1978

Radiographic aspects of occult pulmonary haemorrhage.

Patients with leukaemia, on anticoagulant therapy, or with disseminated intravascular coagulation may develop occult pulmonary haemorrhage; it will mimic pulmonary oedema, pulmonary hemosiderosis or opportunistic infections. It can be diagnosed by bronchopulmonary lavage. The radiographic changes are described and the differential diagnosis discussed in a series of 12 such patients.

Adolescent↗
PubMed1977

Value of sputum culture in diagnosis of pneumococcal pneumonia.

In our laboratory, culture of sputum was extremely useful in diagnosing the etiology of pneumococcal pneumonia. Of 31 consecutive patients with bacteremic pneumococcal pneumonia, 29 (94%) had Streptococcus pneumoniae cultured from sputum. Recovery of pneumococci in culture was enhanced by anaerobic incubation as well as by a plate bile test and an optochin disk on a primary blood agar plate.

Anaerobiosis↗
PubMed1977

Diagnostic lavage and occult pulmonary hemorrhage in thrombocytopenic immunocompromised patients.

Twenty consecutive thrombocytopenic immunocompromised patients with pulmonary infiltrates underwent diagnostic bronchopulmonary lavage. Nine patients were found to have occult pulmonary hemorrhage as evidenced by increased stainable hemosiderin within alveolar macrophages. Other diagnoses established included Pneumocystis carinii pneumonia in 2 patients and metastatic carcinoma in 1. No hemorrhage was precipitated by the procedure, even in 7 patients whose platelet counts were less than or equal to 20,000 per mm3. We concluded that bronchopulmonary lavage is a safe and effective diagnostic procedure in thrombocytopenic immunocompromised patients and that occult pulmonary hemorrhage is a common cause of diffuse pulmonary infiltrates in such patients.

Adolescent↗
PubMed1975

Occult pulmonary haemorrhage in leukaemia.

Through gleeding into the lung parenchyma is responsible for morbidity and mortality in patients with leukaemia pulmonary haemorrhage is seldom diagnosed during life. We diagnosed occult pulmonary haemorrhage in five leukaemic patients with unexplained infiltrates on chest roetgenograms by examining alveolar macrophages retrieved by bronchopulmonary lavage. Macrophage haemosiderin content was greatly increased in the patients with pulmonary haemorrhage as compared to normal and thrombocytopenic control subjects. Haemoglobin and intact erythrocytes in alveolar macrophages were taken as evidence of recent haemorrhage. Intrapulmonary bleeding may occur often in patients with leukaemia, and bronchopulmonary lavage offers a safe approach to diagnosis and allows for concomitant identification of pulmonary infection.

Autopsy↗