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Biomedical subjects

D M Granoff

Publications and source records attributed to D M Granoff.

At least 145 records · Page 8Linked to original sources
PubMed1978

Haemophilus influenzae type b osteomyelitis.

Three children had osteomyelitis due to Haemophilus influenzae type b. They were seen with signs and symptoms indistinguishable from infection caused by other organisms. One child was initially misdiagnosed as having septic arthritis because of failure to appreciate that Hemophilus may also cause bone infection. In the second patient osteomyelitis and arthritis developed during ampicillin sodium therapy for treatment of Hemophilus meningitis. His initial infection was caused by an ampicillin-sensitive isolate but his orthopedic infection subsequently responded to therapy only after changing to a regimen of chloramphenicol. In the third patient, bone scintigraphy was helpful in diagnosis since serial roentgenograms were not diagnostic of osteomyelitis. The anticapsular antibody responses of these patients were measured by radioimmune assay. The levels found were low but comparable to age-matched control children with H influenzae type b meningitis.

Antibodies, Bacterial↗
PubMed1978

Experimental Haemophilus influenzae type b meningitis: immunological investigation of the infant rat model.

Infant rats inoculated intraperitoneally with Haemophilus influenzae type b develop bacteremia and meningitis. Rats were infected at 10 to 12 days of age and studied for the development of serum anticapsular antibody and bactericidal and opsonizing activity. Seven and 11 weeks after inoculation, convalescent animals showed a higher frequency of anticapsular antibody responses than uninfected controls, but 35 to 40% of the infected group had undetectable levels of anticapsular antibody (<0.10 mug/ml). In contrast, all of the convalescent animals, but none of the controls, showed moderate titers of serum bactericidal activity; and bactericidal activity persisted after absorption of the convalescent sera with type b capsule. Bactericidal activity was detected primarily in the eluted fraction corresponding to a molecular weight of 150,000 and was present in the offspring of convalescent females. Offspring of convalescent females were protected against challenge with H. influenzae type b, and control offspring could also be protected by passive immunization with convalescent serum which lacked detectable anticapsular antibody. Convalescent serum samples efficiently opsonized H. influenzae type b, and this activity persisted after absorption of the serum with capsular antigen. These data are consistent with the hypothesis that antibody to the noncapsular surface antigens of H. influenzae type b play an important role in host defenses.

Animals↗
PubMed1978

Ampicillin-resistant Hemophilus influenzae.

Ampicillin-resistant Hemophilus influenzae had not been identified in Fresno, California, before June 1976. In the 12 months that followed, eight resistant type B strains and three resistant nontypable isolates were cultured from patients treated at two hospitals that provide nearly all of the acute pediatric inpatient care for the area. Two of the resistant strains were obtained from patients with invasive infections and represented 4.2 percent of Hemophilus influenzae isolated from blood, cerebrospinal fluid or joint aspirates during the 12 months. The remaining six resistant type B strains were obtained from 117 patients, and were the predominant organism in cultures of other sites, primarily respiratory secretions. In two of three patients infected with nontypable organisms, resistance appeared to emerge during therapy with ampicillin. Measurement of beta lactamase was a practical and accurate method for differentiating between ampicillin-sensitive and resistant strains. All ten of the beta lactamase-positive isolates tested had minimal inhibitory concentrations (MIC) for ampicillin of 15 mug per ml, or less. In contrast 30 beta lactamase-negative strains had MIC's of 1.5 mug per ml, or less, of ampicillin. Our results indicate that ampicillin resistance has become a significant problem in the Central Valley of California and probably the entire state.

Adolescent↗
PubMed1977

Circulating capsular antigen in infant rats infected with Haemophilus influenzae type b.

The kinetics of bacteremia and capsular antigenemia in infant rats infected with Haemophilus influenzae type b were measured by quantitative bacterial counts in blood and counterimmunoelectrophoresis of plasma. After intraperitoneal inoculation with 10(4) colony-forming units (cfu) of H. influenzae type b, bacteremia was detected in 100% of animals at 12 hr after inoculation (mean, 16,500 cfu/ml) and by two days exceeded 10(5) cfu/ml in most animals. Despite these high levels of bacteremia, capsular antigen was detected infrequently during the early phase of experimental infection; it was present in 20% of animals at 12 hr and in 50% at one day. Peak levels of antigen in blood occurred two to three days after inoculation and coincided with the histologic appearance of meningitis. Thereafter, the frequency of antigenemia declined and paralleled the decline in quantitative bacterial counts in blood. Since detection of antigen was dependent on the occurrence of prolonged infection, counterimmunoelectrophoresis proved to be an insensitive method for early diagnosis.

Animals↗
PubMed1976

Cellulitis due to Haemophilus influenzae type B. Antigenemia and antibody responses.

The techniques of serum countercurrent immunoelectrophoresis, hemagglutinating (HA), and bactericidal (BC) antibody determinations were applied to seven patients with Haemophilus influenzae type B cellulitis. Capsular antigen was detected (greater than or equal to 10 ng/ml) in two patients at the time of admission and was found in two additional patients two days following hospitalization. Antibody responses in the patients with cellulitis were deficient, similar to those in children under 2 years of age with H influenzae type B meningitis. One of the patients with cellulitis had HA and BC antibody present in convalescent serum, and two additional patients demonstrated BC activity. The clinical presentations of our patients were typical except that violaceous discoloration of overlying skin was noted in only one of the seven. Two additional patients had atypical facial swelling that closely resembled angioneurotic edema and initially led to incorrect diagnosis. Countercurrent immunoelectrophoresis may be helpful in the diagnosis of patients with Haemophilus cellulitis, particularly if serial serum determinations are performed. Bacterial cultures obtained from blood and aspirates of the lesion appear to be more sensitive in determining the cause of H influenzae type B cellulitis.

Antibodies, Bacterial↗
PubMed1975

Infectious arthritis in the neonate caused by Haemophilus influenzae.

Two newborns had hematogenous pyarthrosis due to Haemophilus influenzae. One infant had signs of sepsis and dactylitis involving several fingers and toes. She also developed a soft tissue abscess, meningitis, and a septic hip, and was found to be infected with a nontypable organism. In the second infant, a shoulder traumatized at birth became infected with a type b strain. In both cases, the patients were successfully treated, but delays occurred in selecting the optimal therapeutic agent because of failure to appreciate that Haemophilus may cause systemic infection in the newborn. In the first infant the source of the infection was identified as the mother's endocervical canal. This patient is also of interest because in contrast to previous reports of Haemophilus infection in the newborn, bactericidal activity was present in the maternal serum.

Anti-Bacterial Agents↗