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Nosocomial meningitis due to Campylobacter fetus subspecies fetus in a neonatal intensive care unit.

We experienced a nosocomial outbreak of Campylobacter fetus subspecies fetus (C. fetus) meningitis in a neonatal intensive care unit. A cluster of three infants developed meningitis approximately 1-1.5 months after the index patient was admitted. Two asymptomatic intestinal carriers of C. fetus were detected during the outbreak. Our experience indicates that C. fetus can cause nosocomial meningitis in neonates, and asymptomatic carriers may play a role in the transmission of the organism.

Campylobacter Infections↗

[A case of Campylobacter fetus subspecies fetus meningitis].

A 40-year-old male with no history of underlying disease was admitted to Hokusho Central Hospital on May 25, 1991, complaining of high fever and headache. Physical examination on admission revealed a temperature of 38.5 degrees C, a pulse rate of 84 beat/min (relative bradycardia) and no abnormal findings for the chest or abdomen. Slight neck stiffness without Kernig's sign was observed at neurological examination. Laboratory data were: ESR 11 mm/lh, WBC 12000/mm3, C-reactive protein positive. Lumbar puncture showed an initial pressure of 230 mmH2O; CSF revealed a cell count of 2633/3 mm3 with mononuclear pleocytosis, total protein of 76 mg/dl and sugar of 54 mg/dl (CSF:blood glucose ratio 0.47). We initially suspected tuberculous or cryptococcal meningitis, but Campylobacter fetus subsp. fetus (C. fetus) was isolated from the CSF and venous blood on the 27th hospital day. IPM/CS 1 g/day, MINO 200 mg/day and FOM 4 g/day were intravenously administered. This antibiotic therapy was very effective: the patient was soon afebrile, and gradually all signs and symptoms were resolved. C. fetus was sensitive to IMP/CS, MINO, KM, GM, EM, OFLX, CP. The patient was discharged with no complication. He has eaten raw beef frequently before admission, but stool culture for C. fetus was negative.

Adult↗

Control of gonadotropin secretion in the ovine fetus. IV. Male-specific entrainment of the hypothalamic control of luteinizing hormone secretion by testosterone in the female ovine fetus.

The role of testosterone (T) in the sex-specific entrainment of hypothalamic LH regulation was studied in five castrate and four sham-castrate chronically catheterized female fetuses androgenized by the prior administration of T cypionate (200 mg, im, every 2 weeks) to pregnant ewes from 30-86 days gestation (term = 147 days). Eight female and three male castrate fetuses served as controls. After a 2-week washout period all fetuses were operated upon in utero between 106-116 days and were studied longitudinally over a 2- to 35-day period. LH pulsatility was determined from blood samples obtained every 15 min over a standard 3-h observation period and assayed for LH by RIA (NIH LH-S16 standard). LH pulse frequency in the castrate androgenized females (41 pulses in 19 observation periods; 1 pulse/1.4 h) was significantly higher than that in non-androgenized female controls (18 pulses in 28 observation periods; 1 pulse/4.7 h observation), but was similar to that in castrate males (23 pulses in 28 observation periods; 1 pulse/1.3 h). Furthermore, LH pulse frequency in the sham castrate androgenized females (26 pulses in 13 observation periods; 1 pulse/1.5 h) was comparable to that in castrate androgenized females as well as that in castrate males. The enhanced LH pulsatility in androgenized female fetuses strongly suggests that T exposure between 30-86 days results in male-specific entrainment of hypothalamic LH regulation. Moreover, the comparable enhancement of LH pulse frequency in both sham castrate and castrate androgenized female groups suggests that in the T-exposed fetus T withdrawal alone is sufficient to result in enhanced LH pulsatility. These findings strongly suggest that T of fetal testicular origin results in male-specific entrainment of hypothalamic function and may be an important feature of male neural organization in this species.

Animals↗

Effects of Mycoplasma spp, Trichomonas fetus, and Campylobacter fetus on ciliary activity of bovine uterine tube organ cultures.

Microscopic observations were made of sections of normal bovine uterine tube (oviduct) and fimbriae maintained in vitro and exposed to agents known to localize in the bovine genital tract, i.e., mycoplasma, Trichomonas fetus, and Campylobacter fetus (Vibrio fetus). Only C fetus stopped ciliary activity. Scanning electron microscopy (SEM) revealed loss of most cilia. Sterile filtrate of C fetus culture had no effect.

Animals↗

Abdominal aortic aneurysm infected with Campylobacter fetus subspecies fetus.

We report a survivor of Campylobacter fetus septicemia from an infected abdominal aortic aneurysm who was successfully treated with an anatomic graft reconstruction and antibiotics. According to a survey of the English-language medical literature this was the fourth such patient successfully treated. C. fetus sepsis associated with an abdominal aortic aneurysm was first reported in 1971. The first patient to survive reconstruction of an aortic tube graft aneurysm infected with C. fetus was reported in 1983. Because the natural history of an aneurysm infected by C. fetus appears to be rapid progression to rupture, patients should be operated on promptly. All patients reported in the literature who were operated on before rupture survived. Survival was independent of the type of reconstruction. When the aneurysm ruptured all patients died. Whereas extraanatomic bypass is generally considered the procedure of choice for an infected abdominal aneurysm, the aneurysms of our patient and three other patients cited in the literature were reconstructed with anatomically placed prosthetic grafts. In the absence of other contraindications such as a grossly evident purulent infection, an abdominal aortic aneurysm infected by C. fetus may represent a subset of infected aneurysms that can be treated successfully with an anatomically placed prosthetic graft and antibiotics.

Amoxicillin↗

[Campylobacter fetus fetus bacteremia. Review of the literature apropos of 2 cases].

The authors report two cases of bacteremia due to Campylobacter fetus fetus (also called C. fetus intestinalis). One was a 22-year-old female, under treatment for active systemic lupus erythematosus, who died. The other was a fifty-year-old male, in a poor general condition, who had a self-limited acute febrile dysentery. In this patient, C. fetus fetus was found in stools after apparent recovery, raising the problem of healthy carriers. A review of the literature shows 64 other such cases.

Adult↗

Fetal atrioventricular valve junction in normal fetuses and in fetuses with complete atrioventricular septal defect assessed by 4D volume rendering.

OBJECTIVES: To assess the feasibility and clinical potential of 4D volume rendering of the atrioventricular (AV) valve junction, to standardize the acquisition method, and to display the AV valve junction morphology in normal fetuses and in those with a complete atrioventricular septal defect (AVSD). METHODS: We performed sonography in 40 normal fetuses and 10 fetuses with complete AVSD, and volume datasets were acquired from apical and lateral four-chamber views. The render box was placed systematically. First, it included the AV valves, with the reference dot at the level of the crux of the heart. Then, it included the papillary muscles, with the reference dot in the interventricular septum at the level of the distal opening of the tricuspid valve leaflet. RESULTS: Volume acquisition and rendering were technically possible in all cases. Volume rendering of the left ventricle showed the position of the anterolateral and posteromedial papillary muscles in 36/40 normal fetuses (90%). At the level of the right ventricle, the septal, anterior and posterior papillary muscles were visualized in 33/40 normal fetuses (82%). In cases of complete AVSD, the AV valve has five leaflets, with anterosuperior and posteroinferior bridging leaflets straddling the septa. The morphology of the anterosuperior bridging leaflets and the abnormal position of the papillary muscles could be displayed in all cases. CONCLUSIONS: Our study suggests that some of the components of the AV junction can be reconstructed easily from sonographic volumes acquired from an apical or lateral four-chamber view. This new technique may have a role in obtaining views that are not easily accessible by standard sonography, enabling a rapid complementary assessment of normal and abnormal intracardiac anatomy.

Adult↗

The antenatal blood gas and acid-base status of normal fetuses and hydropic fetuses with Bart hemoglobinopathy.

Funipuncture offers direct access to the fetal circulation. The blood gas and acid-base status of the fetus can be studied, and fetal hypoxia and acidosis can be diagnosed directly. To establish normal ranges of fetal blood gas and acid-base status, we analyzed umbilical venous blood samples obtained by funipuncture from 62 normal fetuses (20-35 weeks). These fetuses were studied because of suspected fetal diseases and were subsequently proved to be normal by the fetal blood examinations. Umbilical vein pH and pO2 decreased whereas pCO2 and bicarbonate increased with gestational age. The umbilical vein base excess did not correlate with gestational duration, but oxygen saturation tended to decrease with gestational age. Twenty hydropic fetuses with Bart hemoglobinopathy were also studied; they were found to be more acidotic, hypoxic, and hypercarbic than normal fetuses.

Acid-Base Equilibrium↗

Infected abdominal aortic aneurysm caused by Campylobacter fetus subspecies fetus: report of a case.

A 45-year old man with fever, abdominal pain, and a pulsating mass underwent an aneurysmectomy, with in situ reconstruction using a bifurcated knitted Dacron graft, for a saccular abdominal aortic aneurysm (AAA). A culture taken postoperatively grew Campylobacter fetus subspecies fetus. The administration of antibiotics sensitive to this organism was continued for 3 months, and no infection has been encountered in the 1 year since his operation. This is only the 13th documented case of AAA infected by C. fetus subspecies fetus.

Aneurysm, Infected↗

An examination of Campylobacter fetus subsp. fetus by restriction endonuclease analysis and serology.

Restriction endonuclease analysis was used to examine 70 different strains of Campylobacter fetus subsp. fetus, which were isolated from aborted sheep foetuses. The strains could be divided into seven types based on the DNA fragment patterns obtained by electrophoresis after digestion with the enzyme BstEII. With one exception, digestion with the enzyme XhoI allowed the strains to be grouped identically to that for BstEII. Antisera were made against formalized whole cells representative of each of the seven different restriction types. Analysis of these sera by tube agglutination tests using whole cells revealed five different serogroups. Examination of the 70 strains with absorbed antisera demonstrated a complex relationship between the restriction type and the external antigens of C. fetus subsp. fetus.

Agglutination Tests↗

A case of perinatal sepsis by Campylobacter fetus subsp. fetus infection successfully treated with carbapenem--case report and literature review.

Infection due to Campylobacter fetus subsp. fetus during pregnancy is uncommon in humans. We report a case of a pregnant woman who experienced premature labor. The infant was diagnosed with neonatal sepsis due to C. fetus subsp. fetus, and was successfully treated with carbapenem. Maternal clinical symptoms and severe villitis suggested that the route of fetal infection was hematogenous spread. We also review previous reports in the literature that describe this infection during pregnancy.

Adult↗

[Septicemia caused by enteritis due to Campylobacter fetus subspecies fetus].

In a 55 year old man with renal insufficiency requiring hemodialysis after bilateral nephrectomy who had been hospitalized with febrile illness and enteritis, Campylobacter fetus subspecies fetus could be isolated from the blood and feces. Antibodies against the homologous strain (isolated from the blood) could be detected in the serum by means of the Widal test and the indirect immunofluorescence test. Culturing of Campylobacter fetus subspecies fetus (especially from blood cultures) may be difficult because of the poor growth conditions for microaerophilic bacteria. It is quite possible that this organism occurs more frequently in blood and feces than suggested by the routine investigations carried out so far.

Campylobacter Infections↗

Campylobacter fetus subspecies fetus infection of an abdominal aneurysm.

We report a case of aneurysm of the abdominal aorta with spontaneous rupture in a 64-year-old man with emphysema and chronic alcoholism. Campylobacter fetus subspecies fetus was repeatedly recovered from the blood and from specimens of the excised aneurysm. The patient died in spite of early diagnosis, intravenous erythromycin and surgical intervention. The bacteriology and epidemiology of campylobacteriosis in man is briefly discussed and eight other published cases of aneurysm, infected with the same organism, are tabulated. C. fetus ssp. fetus should be added to the list of bacteria having a tropism for vascular endothelium.

Aorta, Abdominal↗

Antimicrobial susceptibility of Campylobacter jejuni and Campylobacter fetus subsp. fetus to eight cephalosporins with special reference to species differentiation.

Agar dilution antimicrobial susceptibility testing showed that Campylobacter jejuni was significantly more resistant than Campylobacter fetus subsp. fetus (intestinalis) to cephalosporin C, cephaloridine, cephalothin, cefazolin, and cefamandole. No species differences in susceptibility were noted with cephalexin, cefotaxime, and cefoxitin. Rapid species differentiation on the basis of an antibiogram could be achieved with the disk diffusion method. C jejuni failed to produce a zone of inhibition around a 30-microgram cephalothin disk but produced a significant zone around a 30-microgram nalidixic acid disk. C. fetus subsp. fetus (intestinalis) produced exactly the reverse pattern.

Campylobacter↗

Role of S-layer protein antigenic diversity in the immune responses of sheep experimentally challenged with Campylobacter fetus subsp. fetus.

Surface layer proteins (SLPs) are essential for induction of abortion by Campylobacter fetus subsp. fetus in experimentally challenged ewes. These proteins are encoded by multiple sap genes and vary in size and antigenicity. The role of SLP antigenic variation during experimental ovine infection was investigated. Following subcutaneous challenge, the SLPs were highly antigenic, and antibodies were detected in serum, milk, bile, and urine. Fecal anti-SLP antibodies were detected only in animals challenged orally. Ewes challenged with wild-type strain 23D with variable SLPs developed detectable circulating anti-SLP immunoglobulin G (IgG) antibodies by 2 weeks postchallenge. In contrast, ewes challenged with mutants of 23D that had fixed expression of a single SLP developed antibodies within 1 week postchallenge, suggesting that antigenic variation in SLPs may delay the host antibody response. Although not statistically significant, the data from challenge experiments in which vaccinated ewes were used suggested that SLP-expressing vaccines could protect animals from abortion and that this effect was independent of the SLP expressed, indicating involvement of conserved epitopes in the SLP. The conserved 184-amino-acid N-terminal region of the SLP, identified from previously published sequences, was epitope mapped with rabbit anti-SLP antisera by using overlapping synthetic 20-mer peptides. Two putative epitopes were identified at amino acids 81 to 110 and 141 to 160. Amino acids 81 to 100 also bound serum IgG antibodies from experimentally challenged sheep. Conserved antigenic regions of the SLP that induce protective immune responses may enable development of synthetic vaccine candidates for C. fetus subsp. fetus-associated ovine abortion.

Abortion, Veterinary↗

Probable Campylobacter fetus subsp. fetus gastroenteritis.

Three strains of Campylobacter fetus subsp. fetus isolated from cases of gastroenteritis are reported. DNA-DNA hybridizations in addition to biochemical tests were used to confirm the identification of the isolates as C. fetus since all strains grew at 42 degrees C. These isolates, like other C. fetus strains, are susceptible to cephalothin and thus would not have been detected in laboratories with Campylobacter isolation media containing this component.

Campylobacter Infections↗

Cranial base growth and morphology in second-trimester normal human fetuses and fetuses with cleft lip.

OBJECTIVE: The present radiographic study describes the size and shape of the cranial base from the sagittal aspect for a sample of 77 second-trimester "normal" control fetuses (n = 61) and fetuses (n = 16) exhibiting isolated, unilateral clefts of the lip (CL), ranging in fertilization age from 10 to 22 weeks. METHODS: Fetuses were placed in a cephalostat, and standardized, lateral head radiographs were taken. The radiographs were traced, and 15 cephalometric landmarks were identified and digitized for analysis. Growth curves for cranial base lengths, angles, and areas were compared between control and CL groups. Also, cranial base triangles were constructed and shape comparisons were made using tensor biometric analysis. RESULTS: No significant differences (p >.05) in regression line slopes were noted for any comparisons between the control and CL samples. Tensor biometric analysis also revealed no significant differences in the shapes of various cranial base triangles between the control and CL samples. CONCLUSION: This report presents second-trimester baseline growth curves for various cranial base components in CL human fetal specimens, and these data suggest that CL fetuses may also be used as an appropriate control sample for prenatal growth comparison studies of cleft lip and palate and cleft palate.

Biometry↗