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PubMed1977

Subcutaneous exposure of calves to Myobacterium paratuberculosis compared with intravenous and oral exposures.

Three groups of calves, 21 days of age, were exposed to Mycobacterium paratuberculosis by oral, intravenous, and subcutaneous routes. Fecal cultural examination and intradermal tests were made, and at 150 days after exposure, the calves were euthanatized and tissues were collected for histopathologic and bacteriologic cultural examination. Calves in the 3 groups were infected. Those exposed intravenously had significantly higher colony counts than did either of the other groups. There was no significant difference between colony counts of cultures from tissues of calves exposed orally and those of calves exposed subcutaneously.

Administration, Oral↗
PubMed1996

[Immune complex detection in nasal mucosa of patients with chronic and permanent nasal obstruction].

Thirty patients with rhinologic problems and in which the main symptom was "Permanent Nasal Blockade" were studied. We found that they presented a "Permanent and Total Chronic Nasal Blockade"-an entity defined by us as a permanent chronic obstruction of the nasal cavities that would be the clinical and anatomopathologic expression and the immunological terminal phase of "Chronic Rhinitis", leading to Chronic Respiratory Nasal Insufficiency. The main symptoms of these "buccal breathers" were: throat dryness, night snores, nasal resonance of the voice, mechanic and secondary disturbances derived from mouth breathing, such as pharingitis, laryngitis, bronchitis, bronchial asthma and a tendency towards emphysema; dystrophia of the facial bones, disminution of the intellectual capacity, irritability, lack of concentration; disturbances of the circulatory function (alterations of the cardiac rhythm and of the blood pressure). The patients were adolescents and young adults in which allergic and infectious causes dominated the etiology, showed by family allergic and personal atopic antecedents, positive intradermic tests for aeroallergenes and bacteria and corroborated by increase of immunoglobulin E and of blood eosinophiles. The methods of diagnosis used to verify the "Permanent and Total Chronic Nasal Blockade" were: X-rays, lineal tomography; rhinomanometry and rhinofibrolaringoscopy. The anatomopathologic results obtained by nasal biopsy showed a lymphomonocitary infiltrate around arterioles and venules: signs of vasculitis. All this led us to search for immunocomplexes. The presence of positive immunocomplexes surrounding the vessels contributed to a more precise focusing of the physiopathology, diagnosis and treatment of "Permanent and Total Chronic Nasal Blockade".

Adolescent↗
PubMedDate not supplied

Anaphylactic reaction to oral prednisone: a case report and review of the literature.

Reports of corticosteroid anaphylactic reactions are rare in the medical literature. We describe the case of a nonatopic 17-year-old girl with bronchial asthma and aspirin intolerance who developed a dramatic anaphylactic reaction to oral prednisone. She recovered with shock therapy and intravenous administration of diphenhydramine and hydrocortisone. Intradermal testing with a wide range of steroid preparations gave positive results to prednisone. No reactions occurred to methylprednisolone and hydrocortisone. This case and the brief review of the literature which follows emphasize the danger of prednisone administration in patients who have asthma and a history of drug intolerance.

Administration, Oral↗
PubMed1997

Epidemiology of paragonimiasis in Korea.

In Korea, soybean-sauce soaked freshwater crabs (kejang) have been a favorite delicacy when eating a bowl of rice. This traditional food has been a main source of human paragonimiasis. Until the late 1960s, human paragonimiasis had been prevalent; at least two million people had contracted the infection as determined by intradermal tests. About 40% of these were egg positive. In the turmoil of the green revolution and industrialization in the 1970s/1980s, ecological damage occurred widely. In many streams, populations of snail and crustacean hosts were reduced to levels almost of extinction. Population reduction of the intermediate hosts was followed by lowered endemicity. Attitudes of people, changed during the period, also reduced chances of paragonimiasis. Survey data in the 1990s indicated that prevalence of human paragonimiasis has lowered to about one 100th of that in the early 1970s. In a referral system, however, about one hundred clinical cases have been diagnosed annually by antibody test (ELISA), undertaken for clinical differentiation from tuberculosis. At least 10% of freshwater crabs sold in local markets are infected with the metacercariae. Paragonimiasis control has benefited in Korea mainly by the untoward effects of water pollution. To place P. westermani infections as enzootic, health education and surveillance systems should have a priority.

Animals↗
PubMedDate not supplied

[Role of chlamydia in chronic renal and urogenital diseases in man].

Serological examinations by the CFT with the group-specific ornithosis antigen were carried out with 1910 sera from patients with chronic diseases of the kidneys, urinary tracts and male sexual organs, as well as with 556 control sera from patients with cardio-vascular and other diseases for elucidation of the role of chlamydia (OLT group) in the infectious pathology of the kidneys and urinary tracts of man. No complement-fixing antibody was detected with the group-specific ornithosis antigen in control sera. The antibody was found in 5.2% of sera from patients with chronic diseases of the kidneys and upper urinary tracts and in 6.2% of cases with the involvement of the proximal part of the urinary tracts and male sexual organs. The intradermal test (IDT) with ornithosis allergen was performed for those patients whose sera contained complement-fixing antibody. The results of CFT and IDT coincided in 82.8% of the patients, thus confirming the etiological role of chlamydia in human urogenital pathology. Studies on the positive sera with the species-specific ornithosis antigen gave negative results, indicating that a distinct species of chlamydia is the agent of urogenital diseases.

Adolescent↗
PubMed1976

Therapeutic equivalency of two lidocaine preparations.

Twenty-five volunteers were studied as to the onset and duration of action of two commercial brands of lidocaine. One and two percent concentrations of the preparations were tested intradermally using a double-blind, cross-over protocol. Both needle-drop and electrical stimulation techniques were employed as the source of pain stimulus. Five additional subjects were studied in a dose-ranging study using a placebo and lidocaine concentrations of 0.25%, 0.50%, 0.75% and 1.0%; this experiment was conduced to determine the sensitivity of the experimental methods. Both the needle-drop and electrical stimulation techniques were able to distinguish the 0.25% preparation from placebo and from the other concentrations of 1% and 2%. The two preparations were found to be statistically equivalent at concentrations of 1% and 2% and could be used interchangeably in clinical procedures.

Analysis of Variance↗
PubMed2001

Delayed hypersensitivity to cefazolin: report on a case involving lymphocyte transformation studies with different cephalosporins.

BACKGROUND: A cell-mediated immunopathogenic mechanism has been demonstrated in only a few cases of cutaneous reactions to systemically administered cephalosporins. OBJECTIVE: The aim was to investigate the pathogenic mechanism of a maculopapular rash experienced by a subject during cefazolin therapy. METHODS AND RESULTS: Prick, intradermal, and patch tests were carried out using penicillin determinants, ampicillin, amoxicillin, cefazolin, cephalothin, cefuroxime, ceftazidime, and ceftriaxone. Those tests for penicillin G and its determinants, as well as for ampicillin and amoxicillin, were negative. The patient displayed patch-test and delayed intradermal-test positivity to all the cephalosporins tested. No specific immunoglobulin E antibodies were found for penicillins or cefazolin. The lymphocyte-transformation-test results were negative for all the penicillins tested and showed a positive concentration-effect curve for cefazolin, ceftazidime, and ceftriaxone at concentrations up to 50 microg/mL. At 100 microg/mL the responses decreased with all the cephalosporins tested. Challenges with penicillin G and amoxicillin were well tolerated, but the challenge with cefazolin was positive. CONCLUSIONS: The data of this case demonstrate delayed hypersensitivity to cefazolin. Patch tests and delayed-reading intradermal tests can be a simple and effective means of diagnosing this type of reaction. Both in vivo and in vitro studies indicate that the responses were directed toward a determinant shared by all cephalosporins, but not by penicillins. The concentration of the cephalosporins used for the in vitro lymphocyte stimulation was critical, because at the concentrations normally used to test other beta-lactams the response decreased. This phenomenon may be attributable to an immunosuppressive, rather than toxic, effect.

Adult↗
PubMed1975

Comparative sensitivity and specificity of the Casoni intradermal and the immunoelectrophoresis tests for the diagnosis of hydatid disease.

The Casoni intradermal (ID) test, using two antigens, was compared with the immunoelectrophoresis (IEP) test for diagnosis in 47 surgically confirmed cases of hydatid disease and 73 non-hydatid persons. An antigen prepared from boiled hydatid cyst fluid (HF) was markedly more sensitive in the ID test than another prepared from whole HF but both produced false-positive reactions in three persons with other disease conditions. The IEP test yielded no false positives and its sensitivity was similar to the ID test using the more sensitive boiled HF antigen. Some patients were ID-positive and IEP-negative and vice-versa. Diagnostic sensitivity of both tests varied according to the localization and condition of the cyst. A detectable immune response was more frequent in patients with liver cysts than in those with lung cysts. Regardless of cyst localization, lowest diagnostic sensitivity was observed in patients whose cysts were intact and of the hyaline type, whereas recently broken cysts were associated with the most consistently detectable immune response. The limitations of the ID test are discussed and it is suggested that, until more specific antigens are available, there appears to be little value in utilizing this test where the more specific serological techniques are available.

Animals↗
PubMed2005

T cell-mediated reactions to iodinated contrast media: evaluation by skin and lymphocyte activation tests.

BACKGROUND: In addition to immediate reactions, late adverse reactions to iodinated contrast media (ICM) were reported in 2% to 5% of patients exposed to ICM and, as a consequence, have recently gained more attention. A few well-documented case reports postulate a hypersensitivity mechanism. OBJECTIVE: The aim of this study is to demonstrate a T cell-mediated mechanism to the ICM by using in vitro and ex vivo tests. METHODS: We analyzed 12 patients with 13 adverse ICM reactions, 9 of whom were women. Clinical history suggested an immune reaction to ICM. Skin tests (skin prick, intradermal, and patch tests) were performed with various ICM and read after 15 minutes and 24 and 48 hours. Skin biopsy specimens of positive test sites of 11 patients were evaluated by means of immunohistology. T-cell reactivity to ICM in vitro was analyzed with lymphocyte activation tests. RESULTS: Seven patients showed generalized maculopapular eruptions, one of them with fever; 4 had a so-called drug hypersensitivity syndrome with exanthema, eosinophilia, and fever; 1 had maculopapular eruptions and fever; 1 had late-onset urticaria with loss of consciousness; and 1 had facial edema and respiratory distress. An immune reaction to ICM was inferred from positive skin prick test (2 patients), positive patch test (10 patients), and positive intradermal test (9 patients) at 24 and 48 hours. Skin biopsy specimens revealed a T-cell infiltrate in the dermis with predominantly CD4 + T cells in 8 patients, CD8 + T cells in 1 patient, and equal numbers in 1 patient. Cross-sensitivities to several ICM were observed (9/12). Other drug allergies were noted in 6 of the 12 patients. CONCLUSIONS: Delayed reactions to ICM are most likely caused by immune reactions to these drugs and can elicit different clinical features. The involvement of T cells is suggested by positive skin test, as well as positive proliferative responses, to the drugs in vitro . A high degree of cross-reactivity with other than the eliciting ICM was observed. Moreover, 50% of these patients reported another drug hypersensitivity, suggesting a predisposition to immune reactivity in some patients.

Adult↗
PubMed1986

Positive skin tests and Prausnitz-Küstner reactions in metabisulfite-sensitive subjects.

Sulfiting agents have been reported to cause anaphylaxis, asthma, urticaria/angioedema, seizure, nausea, abdominal pain and diarrhea, and death. There is no consensus regarding the pathogenesis of these reactions. The possible role of IgE-mediated mechanism has been debated. To clarify the pathogenesis of these reactions, we studied 53 patients with a variety of symptoms related to either restaurant meals or alcoholic beverages. Food allergy was excluded as a cause of their symptoms by means of skin testing and elimination diet. Symptoms included urticaria/angioedema (32), asthma (nine), headache (eight), rhinoconjunctivitis (two), and abdominal pain (one), and one patient with anaphylaxis. Twenty normal control subjects were studied as well. Prick and intradermal skin testing with potassium metabisulfite (K2S2O5, 1 mg/ml) were carried out on all subjects. Single-blind oral provocative challenge tests were conducted with placebo (lactose) and with 1, 5, 10, 25, and 50 mg of K2S2O5 in all nine subjects with asthma, nine patients with urticaria/angioedema (excluding one subject with severe coronary insufficiency and positive skin testing to 1 mg of K2S2O5), four subjects with headache, one subject with rhinoconjunctivitis, and one patient with anaphylaxis. Pulmonary function tests (FEV1 and FVC) were measured in all subjects with asthma. Five patients had positive skin tests. One subject with asthma had a positive prick test. Four positive intradermal tests occurred (two subjects with asthma, one subject with urticaria/angioedema, and one subject with anaphylaxis). Single-blind oral provocative challenge testing was positive in the subject with anaphylaxis, as was intradermal skin testing, and also in three subjects with asthma, two of whom had positive skin testing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Culture of nocardioform bacilli from leprosy patients & clinical evaluation of nocardioform bacilli derived antigen.

An antigen derived from cultured nocardioform bacilli was compared with Mitsuda lepromin in intradermal skin test reactions. Nocardioform bacilli were cultured in gelatin minimal medium from the tissue fluid of 85 lepromatous patients (56 M, 29 F). Of these, 65 samples showed uncontaminated growth of the organism, which were pooled for the manufacture of the test antigen. This antigen was intradermally tested in 50 untreated leprosy patients irrespective of the type, together with Mitsuda lepromin and sterile gelatin minimal media, which served as a control. No early reaction was observed at 72 h, while the late reaction at 28 days was positive in all patients in the Tuberculoid (TT) group with both antigens. Eighteen patients (81.8%) in the Borderline tuberculoid (BT) group reacted strongly to Mitsuda lepromin at 28 days, while 21 patients (95.5%) in this group showed a strong late reaction with the test antigen. The lepromatous (LL) group did not show any reaction with the two antigens. It is inferred that nocardioform bacilli are easy to cultivate, and that the test antigen compares well with Mitsuda lepromin.

Actinomycetales↗
PubMed1995

[Anesthesia in a patient with history of multiple drug allergies].

A 38-year-old woman was admitted for intranasal ethmoidectomy. She had a history of serious anaphylactic reactions, including respiratory distress, hypotension and unconsciousness, to nonsteroidal anti-inflammatory drugs (Loxonin, Niflan) and antibiotics (Kefral, Minomycin). Preoperative intradermal skin tests against anesthesia-related drugs showed positive reactions to succinylcholine and vecuronium. After bilateral maxillary nerve block with 0.5 % bupivacaine (negative intradermal test) 3 ml, anesthesia was induced with diazepam, nitrous oxide, oxygen and sevoflurane. Trachea was intubated smoothly without muscle relaxants. Anesthesia was maintained with nitrous oxide, oxygen and sevoflurane 0.5-1 %. The anesthesia and postoperative course of this patient were uneventful. To confirm the initiation of allergic reaction to anesthetics used in the patient, serum histamine, tryptase, and complement 1, 3 and 4 factors were measured at 3 points: preoperatively, immediately after the induction, and after extubation. They showed normal levels. These results showed that no allergic reaction occurred perioperatively. In conclusion, the valuable information was provided for the choice of anesthetics by thorough evaluation of the past history and intradermal testing.

Adult↗
PubMed1999

Field evaluation of the single intradermal cervical tuberculin test and the interferon-gamma assay for detection and eradication of bovine tuberculosis in Spain.

A field comparison of the interferon-gamma (IFN-gamma) assay and the single intradermal cervical tuberculin (SICT) test for the diagnosis of bovine tuberculosis was conducted. A total of 1136 cattle belonging to 85 herds placed in 'Castilla y León' (northwestern Spain) were chosen, and 21 of these herds were subjected to the diagnostic assays two or three times at intervals of at least 4 months. All the animals positive to any of the tests were slaughtered and tuberculosis was confirmed by culture isolation method (CIM) and further identification by means of PCR. Only 10.6% of cattle reacted with the bovine PPD in the SICT test, a percentage that increased to 12.8% in the IFN-gamma assay. The sensitivity of the IFN-gamma assay compared to CIM was shown to be higher (84.9%) than that of the SICT test (80.2%), but the combination of both tests offered the highest sensitivity (92.9%). The number of false positive reactors (those animals in which CIM was negative) was considerably higher for the IFN-gamma assay than for the SICT test and, conversely, the number of false negative animals (M. bovis isolation but negative immunological result) was higher for the skin test than for the interferon assay. In the herds tested twice, tuberculosis was eradicated after the second cycle of testing in 50%, and in 75% after the third cycle in herds tested three times. The combination of these two techniques instead of separately seems, therefore, to be useful in eradication programmes against bovine tuberculosis.

Animals↗
PubMed1981

Skin testing in farmers' lung disease.

Intradermal skin tests with a culture filtrate antigen of Micropolyspora faeni grown on a synthetic medium were performed on patients with farmers' lung disease (FLD) and well farmers with and without antibodies to a panel of FLD antigens. Seventy-five percent of the FLD patients, 79% of the well farmers with M. faeni antibody, and 5% of well farmers without M. faeni antibody had a 2+ or greater intradermal immediate skin-test reaction. Prausnitz-Küstner (P-K) reactions were positive using serum of M. faeni immediate skin test-positive FLD patients. IgG-rich fractions from a staphylococcal protein A-Sepharose column of such serum contained the sensitizing factor whereas IgG-depleted fractions did not. M. faeni-specific IgE could not be detected in serum by a polystyrene radioimmunoassay. Positive late-onset (6-hr) skin tests occurred only in FLD patients and farmers with precipitating antibody. Biopsy specimens of the 6-hr reactions revealed a generalized dermal and perivascular polymorphonuclear infiltrate with deposits of immunoglobulin and complement about blood vessels. The skin-sensitizing factor noted in FLD patients and well farmers with antibody is not disease specific. This factor appears to be associated with the IgG-rich fraction of serum, and its role in the pathogenesis of FLD is unclear.

Enzyme-Linked Immunosorbent Assay↗