PubMed · 10874847
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P B Almeida, L Moura, N Pardal, F Macedo. 2000. Aortic ring abscess.. https://pubmed.ncbi.nlm.nih.gov/10874847/
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Renal abscess is uncommon in pediatrics and is rarely a cause of fever of unknown origin. We recently cared for a patient who presented with a 3-week history of fever. An indium scan ultimately led to the diagnosis of a renal abscess. Aspiration yielded Peptostreptococcus asaccharolyticus. This unusual case prompted a review of the clinical and microbiologic features of renal abscess in pediatric patients at our hospital over the past 10 years. Seven additional patients with a discharge diagnosis of renal abscess were identified. Only 2 of the patients had identifiable risk factors (diabetes mellitus and polycystic kidneys). Staphylococcus aureus or Enterobacteriaceae were responsible for most infections, consistent with hematogenous and urinary tract sources, respectively. No other cases of anaerobic abscess were identified. This case highlights the importance of considering a renal abscess in the differential diagnosis of fever of unknown origin and of processing specimens for both aerobic and anaerobic organisms.
Zwitterionic capsular polysaccharides from pathogenic bacteria have peculiar immunological properties. They are capable of eliciting T-cell proliferation and modulating the course of abscess formation. To understand the molecular basis of this characteristic immune response, we are conducting detailed structure-function studies on these polysaccharides. We have identified, purified, and characterized an abscess-modulating polysaccharide, PS A2, from the clinical strain Bacteroides fragilis 638R. Here, we report the elucidation of both the chemical and three-dimensional structures of PS A2 by NMR spectroscopy, chemical methods, gas chromatography-mass spectrometry, and restrained molecular dynamics calculations. PS A2 consists of a pentasaccharide repeating unit containing mannoheptose, N-acetylmannosamine, 3-acetamido-3,6-dideoxyglucose, 2-amino-4-acetamido-2,4,6-trideoxygalactose, fucose, and 3-hydroxybutanoic acid. PS A2 is zwitterionic and carries one cationic free amine and one anionic carboxylate in each repeating unit. It forms an extended right-handed helix with two repeating units per turn and a pitch of 20 A. Positive and negative charges are exposed on the outer surface of the polymer in a regularly spaced pattern, which renders them easily accessible to other molecules. The helix is characterized by repeated large grooves whose lateral boundaries are occupied by the charges. The three-dimensional structure of PS A2 explicitly suggests mechanisms of interaction between zwitterionic polysaccharides and proteins.
Drug addiction is linked with increased prevalence of various illnesses. Of major importance are skin diseases which often have a powerful influence on the health. Analysis of the situation in Switzerland at the outset of the 1990s showed that not all drug addicts could be reached with the existing range of treatments. For this reason, heroin-supported treatment was examined as a new therapy option from 1994 on. The influence on the skin's health are examined in this study. The minimum age of those admitted was set at age 20. Heroin addiction had to date back at least two years, and several treatment efforts had to have failed. Data of 1,035 patients was based on tests at admission and after six, 12, and 18 months of treatment. Some 18% of drug consumers indicated abcesses at admission, and almost 30% showed phlegmones. The prevalence of all skin diseases examined show significant declines over the 18 months of treatment. The relative risk resulting from puncture points fell to 0.35 (SD: 0.26-0.47), from phlegmones to 0.24 (SD: 0.14-0.41), from absesses to 0.31 (SD: 0.15-0.60). This study shows that skin diseases are a frequent and important complication among intravenous drug addicts. Heroin-supported treatment led to favourable progress of the dermatological situation among patients.