Biomedical subjects
Publications and source records attributed to A C Dopp.
We recently diagnosed and treated an unusual case of primary endocarditis due to Bacteroides fragilis, for which no underlying etiology was found. Antibiotic treatment involved multiple parenteral and oral antibiotics, and sensitivity studies allowed choice of antibiotics. Despite complications, the patient was cured. Few cases of Bacteroides fragilis endocarditis have been reported, and therapy has changed with newer antibiotics.
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Peripheral blood "total" and "avid" thymus-dependent (T) lymphocytes were enumerated in 45 patients with Crohn's disease (CD) and in 23 patients with ulcerative patients (UC) by using the spontaneous rosette technique (ER). The in vitro effect of thymosin fraction 5, a polypeptide extract of the thymus gland, on avid ER formatin was also determined in these patients. The proportion and number of "total" ER were lower in patients with CD (P < 0.02), but not with UC, when compared with controls. More impressive differences were observed when "avid" ER were determined in patients with CD (P < 0.001) and UC (P < 0.05). Incubation with thymosin resulted in a significant increase in "avid" ER in patients with CD and UC, with no such effect observed in the controls. These results indicate that the determination of "avid" rather than "total" ER provides a more sensitive method for detecting alterations in T-cell immune competence. In addition, it is suggested that there is an increased number of circulating T-lymphocytes in CD and UC capable of responding to exogenous thymic factors. This may indicate the presence of a thymosin-responsive immunodeficiency state in these diseases.
Thymus-derived (T) rosette-forming cells were enumerated in patients with alcoholic liver disease and in patients with inflammatory bowel disease using variable sheep red blood cell (SRBC)/lymphocyte ratios. SRBC/lymphocyte ratios of 60:1 and 32:1 did not reveal significant differences from controls in Crohn's disease. The percentage, but not absolute count, of T cells was significantly reduced in alcoholic hepatitis at the 60:1 ratio. Both the percentage and absolute count of T cells were reduced in alcoholic hepatitis and Crohn's disease with the 8:1 ratio. No significant reduction in T cells was seen at any ratio in patients with compensated alcoholic cirrhosis or ulcerative colitis. Use of a SRBC/lymphocyte ratio of 8:1 indentifies T cells which demonstrate an avidity for SRBC. This avidity may be related to the density of SRBC receptors on the surface of T cells and/or the affinity of these receptor sites for SRBC. Use of the 8:1 ratio may provide a more sensitive means by which to monitor changes in T-cell rosettes in patients suspected of having an altered cellular immune state.
A 24-year-old man developed coma and many neurologic abnormalities for 2 weeks after ingesting phencyclidine. On admission, pulmonary aspiration occurred, for which he was given large doses of methylprednisolone, clindamycin, and gentamicin. These antimicrobial drugs were continued for 2 weeks until new pulmonary infiltrates were recognized. Neisseria meningitidis was subsequently isolated from cultures of conjunctival discharge, sputum, and blood and found to be resistant to clindamycin and gentamicin. N. meningitidis as a cause of nosocomial pneumonia in the setting of broad spectrum antimicrobial drugs is discussed.