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PubMed1976

Acute orbital cellulitis.

A review of 104 patients with acute orbital cellulitis during the past decade showed that the frequency of hospital admissions for this disease has increased recently. Roentgenograms showed paranasal sinus in 77 of 91 patients. Haemophilus influenzae and Diplococcus pneumoniae were recovered from the blood of 20 and 6 patients, respectively. Four children had concomitant H influenzae meningitis. Bacteremia was demonstrated in 29% and more common in those with extensive orbital involvement, those not receiving antibiotics at the time of culture, and those less than 2 years old. Some of the 26 patients with less extensive involvement were bacteremic (17%), had leukocytosis, or roentgenographic evidence of sinusitis. Most children received large doses of ampicillin sodium and methicillin sodium intravenously until signs and symptoms had almost abated. With this regimen, there were no orbital, ocular, or other complications.

Acute Disease↗

PubMed1979

Pneumococcal sepsis and pneumonia in the neonate.

Two neonates had early onset Diplococcus pneumoniae septicemia and pneumonia. Both recovered after intensive respiratory and antibiotic therapy, although a review of the literature indicates that early pneumococcal septicemia has been associated with an extremely high mortality. Pneumococcal septicemia in a one-year period accounted for 12% of all documented neonatal bacteremias. This may indicate an increasing incidence of this organism in newborns.

Asphyxia Neonatorum↗

PubMed1976

Concomitant pneumococcal appendicitis, peritonitis, and meningitis.

A 9-year-old boy developed pneumococcal meningitis and peritonitis following appendectomy. Subsequent pathologic examination showed Gram-positive diplococci in the appendix. Cultures of the peritoneal fluid, blood, and spinal fluid showed Diplococcus pneumoniae. The experience illustrates the danger of assuming that all pneumococcus peritonitis is the primary variety and the advisability of routine Gram stain of the peritoneal fluid at operation in order to select the appropriate antibiotic.

Appendicitis↗

PubMed1977

Nosocomial bacteremia. Potential for prevention of procedure-related cases.

During a six-month period, 187 inpatients had bacteremia associated with community-acquired infection and 91 patients had bacteremia from a nosocomial infection. The most frequently identified sites of infection in both types of bacteremia were the respiratory and urinary tracts. Escherichia coli and Diplococcus pneumoniae were the organisms most frequently isolated from cultures of patients with community-acquired bacteremia, and E coli, Staphylococcus aureus, and Klebsiella were most frequently isolated from patients with nosocomial bacteremia. Bacteremic nosocomial infections were related to urinary catheters, respiratory and intravenous therapy, or hyperalimentation in 32 of the 91 cases. Even assuming the unproved hypotheses that rigid adherence to current guidelines would prevent all of these procedure-related cases, 59 cases of bacteremia would still have occurred. This emphasizes the need for further research into prevention of nosocomial infection.

Adult↗

PubMed1977

Overwhelming postsplenectomy infection.

One of the more intriguing aspects of the spleen is the protection against certain bacterial infections afforded by its unique vascular and immune function. There have been extensive clinical surveys which indicate an incidence of overwhelming postsplenectomy infection (OPSI) above that of the disease for which the splenectomy was done. In the absence of the spleen, either congenital or subsequent to surgical removal, this overwhelming sepsis has a 50% case fatality rate. The most common infective organism has been Diplococcus (tstreptococcus) pneumoniae (D. pneumoniae). Intensive investigations indicated loss of phagocytic function of the spleen, depression of serum IgM levels, a possible suppression of the lymphocyte responsiveness, and changes in opsonin-alternative complement system as potential causes of OPSI. Preventive measures against OPSI include trials of prophylactic Phenoxymethyl Penicillin (penicillin) and pneumococcal vaccine.

Adolescent↗

PubMed1979

[Antimicrobial activity of derivatives of 1,2,4-benzothiadiazine-1,1-dioxide. VIII].

The antimicrobial activity of a series of fluoro derivatives of benzothiadiazine and sulfonamides was studied. The compounds tested can be grouped as: a) 3-alkylmercapto derivatives of 6-trifluoromethyl-1,2,4-benzothiadiazine-1,1-dioxide (III leads to VI); the 3-mercapto precursor (VII) and the related 3-picolinic salt (VIII); b) 3-trifluoromethyl derivatives of 1,2,4-benzothiadiazine-1,1-dioxide and of its benzene substituted derivatives (IX leads to XVI); c) trifluoroacetylaminobenzenesulfonamides (XVII leads to XXV). Two of the 3-alkylmercapto compounds [(V) and (VI)] showed marked inhibitory activity against some strains of Staphylococcus, Streptococcus and Diplococcus. None of the compounds tested proved active against Gram-negative schizomycetes (genera Salmonella, Shigella, Escherichia, Proteus, Pseudomonas, Enterobacter, Klebsiella, Serratia, Yersinia, Providencia) or against yeasts (Candida).

Benzothiadiazines↗

PubMed1976

Antibacterial activity and pharmacokinetics of bacampicillin and ampicillin.

Single equimolar oral doses of bacampicillin and ampicillin were given to 9 healthy subjects on a crossover randomized basis. Data were interpreted in terms of a 3-compartment pharmacokinetic open model. Intestinal absorption of bacampicillin was found to be faster and more complete than that of ampicillin, yielding an increase in bioavailability of 30% to 40% as measured by the area under serum levels curve, the urinary excretion and absorption rate constants. After the administration of bacampicillin, much higher and sharper peaks were achieved in the serum and in the "tissue" water than after the administration of ampicillin. The maximum bactericidal dilution (MBD) of the serum samples taken 1 hr after the administration of the antibiotics against 10 strains of Diplococcus pneumoniae was higher following bacampicillin (p less than 0.01), as was the MBD of the 0 to 2 hr urine specimens against 10 strains of Escherichia coli. Further clinical trials are required to accurately assess the possible greater therapeutic effectiveness of bacampicillin than of ampicillin.

Ampicillin↗

PubMed1977

The "patchy" immunodeficiency of CBA/N mice.

The in vivo responses of CBA/N (which have an X-linked defect of B lymphocyte differentiation) and CBA/J normal mice to 2,4,6-trinitrophenylated (TNP) bacteriophage T4 and Diplococcus pneumoniae CS variant have been compared. Both antigens are thymus-independent (TI), and TNP-CS additionally contains the phosphorylcholine (PC) epitope, CBA/N and CBA/J mice give TNP plaque-forming cell responses similar in magnitude and avidity although only CBA/J give a PC response when challenged with TNP-CS. These results indicate that CBA/N mice have a "patchy" defect of antigen-induced humoral responses. This defect is manifested only in certain subpopulations of B cells and is not restricted to TI responses.

Animals↗

PubMed1999

A convenient microscale colorimetric method for terminal galactose on immunoglobulins.

A new approach for quantitative determination of terminal galactose (Gal) residues of immunoglobulins was developed by combining exoglycosidase digestion with the classical colorimetric estimation of reducing sugars. The ferricyanide colorimetric method was modified to increase the stability of the chromophore (Prussian blue) and adapted to determine the amount of terminal Gal residues present in immunoglobulins. The method involves the release of covalently bound Gal from immunoglobulins by Diplococcus pneumoniae beta-D-galactosidase (specific for beta(1,4) linked galactose), removal of the glycoprotein and enzyme from the reaction mixture by heat denaturation or ethanol precipitation, followed by colorimetric measurement of the released sugar using the ferricyanide assay. The ferricyanide method was modified to enhance the solubility and stability of the chromophore by increasing the concentration of aqueous sulfuric acid and sodium dodecyl sulfate (SDS). The linear range of the modified method was from approximately 11 to 111 microM Gal. Typical variation in assay results was on the order of 5%. Using the modified method, the terminal Gal content of a recombinant chimeric monoclonal antibody (anti-CD20, rIgG) expressed in Chinese hamster ovary (CHO) cells was determined and evaluated for batch-to-batch consistency. The method was used to optimize pH, time, temperature, and enzyme concentration for beta-galactosidase digestion for maximal release of terminal Gal residues from rIgG.

Animals↗

PubMed1980

[Concentrations of mezlocillin in cerebrospinal fluid in vira meningitis (author's transl)].

The concentrations of mezlocillin in the cerebrospinal fluid were measured in ten patients with viral meningitis after a single infusion of 5 g lasting 30 minutes. One to two hours after infusion the CSF concentrations were between 0.1 mcg/ml and 1.6 mcg/ml, and thus exceeded the minimal inhibitory concentrations of Neisseria meningitidis and Diplococcus pneumoniae, the most common pathogens in bacterial meningitis in adults. The minimal inhibitory concentration of ampicillin-sensitive strains of Haemophilus influenzae was also attained. Further investigations must be carried out, in order to ascertain whether higher CSF concentrations are attained in bacterial meningitis.

Adolescent↗

PubMedDate not supplied

Pyogenic meningitis in Ahmedabad.

One hundred and thirty five cerebrospinal fluid (CSF) samples from children clinically diagnosed Pyogenic meningitis (in and around Ahmedabad) were subjected to physical, bacteriological, cytological and biochemical examinations. It was found that all CSF specimens were turbid, the culture positivity varied form 12.12 to 56%. The highest percentage was found in children of less than one year of age. The average percentage of culture positivity was 28.68%. The result of gram stain was more than that of cultural examination. Gram stain of CSF was specific, accurate and highly valuable in the diagnosis of pyogenic meningitis. Among gram positive organisms isolated, Staphylococcus aureus was highest (8.8%) followed by Diplococcus pneumoniae (3.7%), but Klebsiella was predominant (6.6%) among gram negative bacilli. Staph. aureus was 100% sensitive to erythromycin, gentamycin, kanamycin and ampicillin. The results of cytological and biochemical tests correlated (67.1%). There was increase in polymorphs and protein, sugar levels decreased.

Child↗

PubMed1996

[Involvement of the central nervous system in hemolytic uremic syndrome/thrombotic thrombocytopenic purpura].

Cerebral involvement is typical for thrombotic microangiopathies like haemolytic uremic syndrome (HUS) and thrombotic-thrombopenic purpura (Moschcowitz disease or TTP). Symptoms are irritation, restless behaviour, disorientation, disturbance of consciousness, seizures, and focal neurological deficits. The lack of typical imaging changes or pathological observations may explain the unknown pathophysiological cascade leading to the neurological symptoms. We describe the development of HUS/ TTP in a 52-year-old woman after acute pneumonia caused by Diplococcus pneumoniae. The patient showed an increasing psycho-organic syndrome with disorientation, followed by severe loss of consciousness and coma. Initially, computed tomography showed slight diffuse brain oedema, which was not found in later follow-up images. Magnetic resonance imaging was normal. The TCD examination revealed general velocity increases and vasospasms (especially MCA, ACA and PCA bilateral and BA). The reduction in blood flow velocities in the basal arteries was accompanied by a marked clinical improvement. The development of vasospasms may be an explanation for the neurological deficits in HUS/TTP. The origin of the vasospasms may be found in disturbed prostacyclin production, increased serotonin or platelet factor IV release, and leucocyte activation with consecutive endothelial damage.

Blood Flow Velocity↗

PubMed1975

Infections in 92 splenectomized patients with Hodgkin's disease. A clinical review.

Infections that occurrred in 92 previously untreated patients with Hodgkin's disease were reviewed from the time of laprotomy and splenectomy. Pneumonias occurred in nine patients with urinary tract infections in twelve during the immediate postoperative period. Severe bacterial infections did not occur in any patients during initial radiation therapy, adjuvant chemotherapy (stages I through IIIA), initial intensive chemotherapy (stages IIIB and IV) or during remission. Severe infections occurred in eight profoundly granulocytopenic patients with recurrent Hodgkin's disease. Streptococcus (Diplococcus) pneumoniae and Hemophilus spp infections were distinctly uncommon during the remission period. Herpes zoster, however, was very common developing in 22 of 92 (24 per cent) patients. Predisposing factors to herpes zoster included sex (female more than male), therapy (radiation plus chemotherapy more than chemotherapy alone), and age (less than 30 years of age more often than 30 to 50 years of age). Severe infection was uncommon in these patients except in ascociation with specific predisposing factors such as the immediate postoperative state of prolonged granulocytopenia associated with recurrent Hodgkin's disease or its therapy. Splenectomy per se did not affect either the incidence or the severity of infection during this period of 12+ months of observations per patient.

Adolescent↗

PubMed1976

Idiopathic late-onset immunoglobulin deficiency. Clinical observations in 50 patients.

Fifty patients with late-onset idiopathic immunoglobulin deficiency were studied and the frequency of various clinical associations and complications was observed. Men and women were equally affected, although the age at onset in men peaked in the third decade whereas it was more uniformly distributed in women. Sinobronchopulmonary infections were common and were caused by Haemophilus influenzae. Diplococcus pneumoniae, Streptococcus pyogenes and Staphylococcus aureus: bronchiectasis occurred in 28 per cent. Thirty patients (60 per cent) had diarrhea, which was often associated with steatorrhea, giardiasis, achlorhydria, abnormal Schilling tests and morphologic abnormalities on small bowel biopsy specimens, including nodular lymphoid hyperplasia; three patients had pernicious anemia. In the 20 patients without diarrhea these abnormalities were not observed except for giardiasis in one patient and achlorhydria in two patients. Cholelithiasis occurred in both groups in about a third of the patients tested. A high degree of susceptibility to neoplasia was noted. Thyroid abnormalities, including primary hypothyroidism and Graves' disease, were observed in six patients. Additional occasional findings were vitiligo, keratoconjunctivitis sicca and arthritis. Splenomegaly occurred in 14 (28 per cent) patients. The percentage of B lymphocytes in the blood was determined in 10 patients; it was normal or slightly decreased in eight patients and low in two patients.

Adolescent↗

PubMed1987

Myopericarditis as an initial presentation of meningococcemia. Unusual manifestation of infection with serotype W135.

Acute meningococcemia is a dramatic clinical syndrome from infection with the gram-negative diplococcus, Neisseria meningitidis. Although pericarditis may complicate the course of meningococcemia, it is distinctly unusual as a presenting sign. A case of disseminated meningococcemia presenting as acute myopericarditis is reported. The serotype isolated, type W135, was a sporadic cause of N. meningitidis in the Boston area. Although the patient had meningitis, bacteremia, and myopericarditis, his course was uncomplicated with early institution of antibiotic therapy.

Humans↗

PubMed1975

Secondary ocular bacterial infection in hypovitaminosis a xerophthalmia.

Extraocular bacterial culture was performed in 100 patients with hypovitaminosis A xerophthalmia. There was corneal ulceration in 29 cases and corneal perforation in 22 cases. Eighty-six percent of the patients harbored frankly pathogenic bacteria (46 patients) and potentially pathogenic bacteria (40 patients). All but two patients with either cornal ulceration or perforation harbored potentially pathogenic or frankly pathogenic bacteria. Pseudomonas aeruginosa, Diplococcus pneumoniae, and Moraxella species were isolated in 37% (19 patients) of cases with corneal ulceration and perforation. I cultured P. aeruginosa from 36% (eight patients) of cases with corneal perforation. The many ocular secondary bacterial infections in the early stages of xerophthalmia seem to suggest that bacterial action plays a major role in causing the corneal ulceration and perforation in hypovitaminosis A xerophthalmia.

Adolescent↗

PubMed1978

Action of endo-alpha-N-acetyl-D-galactosaminidase on synthetic glycosides including chromogenic substrates.

The synthetic glycosides, p-nitrophenyl- and o-nitrophenyl-2-acetamido-2-deoxy-3-O-beta-D-galactopyranosyl-alpha- D-galactopyranosides, were found to be effective chromogenic substrates for an endo-alpha-N-acetyl-D-galactosaminidase. We did not experience any problems when these substrates were used for the screening of column fractions during the purification of the endoenzyme from Diplococcus pneumoniae culture filtrates. However, it should be pointed out that a combination of exo-beta-galactosidase, capable of cleaving beta 1-->3 linkages, and an exo-alpha-N-acetyl galactosaminidase would also liberate nitrophenol from the above substrates. The enzyme had no action on several other synthetic glycosides tested indicating the strict specificity of this enzyme for the disaccharide Gal beta-->GalNAc linked via an alpha-linkage to the aglycone. The enzyme was inactive when the aglycone was methanol but shows activity against the glycosides of phenol, nitrophenols, serine, and threonine. The use of p-nitrophenyl-2-acetamido-2-deoxy-3-O-beta -D-galactopyranosyl-beta-D-galactopyranoside, which is a competitive inhibitor of the endoenzyme, as an affinity ligand for the purification of the enzyme is described.

Affinity Labels↗

PubMed1987

Diplococcal beta-galactosidase with a specificity reacting to beta 1-4 linkage but not to beta 1-3 linkage as a useful exoglycosidase for the structural elucidation of glycolipids.

Diplococcal beta-galactosidase, which is known to be useful for the structural studies of glycoprotein-linked oligosaccharides, was found to show the same substrate specificity in cleaving Gal beta 1-4 linkages of glycolipids as that of the oligosaccharides. The optimum conditions of beta-galactosidase in the 80% ammonium sulfate precipitates of the culture medium of Streptococcus (Diplococcus) pneumoniae were determined with nLcOse4Cer radiolabeled by the galactose oxidase-NaB3H4 procedure. Detergent was required for the highest activity, and different combinations of several buffers and detergents showed different properties in stimulating beta-galactosidase, and in enhancing or suppressing N-acetyl-beta-hexosaminidase which was contaminated in the enzyme preparation. The optimum pH was found to be at 6.5, and specific activity and Km were 8.1 nmol/mg protein/h and 1 nmol, respectively. While more than 70% of beta-galactose was liberated from LacCer and nLcOse4Cer within 1 h under the optimum conditions to form GlcCer and nLcOse3Cer, respectively, none was liberated from LcOse4Cer, GalCer, GgOse4Cer, GbOse3Cer, IV3 alpha GalnLcOse4Cer, and Il3NeuAcGgOse4Cer, showing the substrate specificity solely to Gal beta 1-4 linkage.

Carbohydrate Conformation↗