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Biomedical subjects

D W Kannangara

Publications and source records attributed to D W Kannangara.

At least 19 recordsLinked to original sources
PubMed1984

Comparative efficacy of four antibiotics in anaerobic pulmonary infection. An experimental model in rabbits.

The efficacy of cefoxitin, mezlocillin, latamoxef and metronidazole in anaerobic lung infection was studied using a rabbit model. A mixture of Bacteroides fragilis, Peptococcus morbillorum, Eubacterium lentum and Fusobacterium nucleatum was inoculated transtracheally to produce infection within the lung. Mezlocillin was most effective, achieving bacteriologic cure in 5 out of 8 animals. With cefoxitin therapy, 4 out of 8 became bacteriologically sterile. Severe diarrhea with elevated titers of Clostridium difficile toxin was noted in most cefoxitin-treated animals. Latamoxef- and metronidazole-treated animals had apparently healed lesions, but cultures were positive in 6 and 7 out of 8 in each group, respectively. The commonest pathogen isolated in the last two groups was P. morbillorum. The therapeutic superiority of mezlocillin over metronidazole and latamoxef was statistically significant (p less than or equal to 0.05).

Animals↗
PubMed1984

Effectiveness of cefotaxime in gram-negative meningitis.

We treated 12 adult patients who had gram-negative bacillary meningitis with cefotaxime administered intravenously at a dose of 2 g every 4 hours. The etiological organisms included Haemophilus influenzae (3 cases), Serratia marcescens (3 cases), Klebsiella pneumoniae (3 cases), Escherichia coli (2 cases), and Enterobacter (1 case). The infection followed a neurosurgical procedure in 6 cases. The mean inhibitory and bactericidal concentrations of cefotaxime for the isolates ranged from 0.125 to 0.25 microgram/ml. The cerebrospinal fluid (CSF) concentrations of cefotaxime ranged from 5.0 to 15.2 micrograms/ml, and the CSF bactericidal titers were 1:64 to 1:128. The CSF in all patients was sterilized within 96 hours. All 12 patients recovered, and there were no relapses.

Adult↗
PubMed1984

Hot tub-associated dermatitis due to Pseudomonas aeruginosa. Case report and review of the literature.

A healthy, 27-year-old man had development of a maculopapular, pustular rash due to Pseudomonas aeruginosa, serotype 0:4, after bathing in a hot tub. Two persons sharing the same tub manifested a similar rash. In the first patient, the eruption was distributed mainly over the back, buttocks, and upper arms, appearing abruptly within 24 to 72 hours after use of the hot tub. Pruritus, malaise, and low-grade fever were the main associated features. The rash subsided spontaneously within ten days. This article reviews the literature on this form of cutaneous infection due to P aeruginosa.

Adult↗
PubMed1983

Cerebral chromomycosis.

A 52-year-old man was admitted to the hospital with headache, confusion, and early papilledema. He was receiving prednisone and azathioprine for interstitial pulmonary fibrosis. A right temporoparietal cerebral abscess was diagnosed by computed tomographic scan, brain scan, and cerebral angiography. Fungal cultures of pus obtained at operation grew a pigmented fungus, Cladosporium trichoides. Three additional abscesses were found in the right cerebellar hemisphere at autopsy after the patient died of an unrelated cause. Chromomycosis occurring at sites other than skin is extremely rare. No lesions were detected outside the CNS in our patient. C trichoides has not been previously recognized as an agent causing disease in compromised hosts.

Brain Diseases↗
PubMed1983

Penicillin failure in the treatment of Bacteroides fragilis lung abscess. Experimental study in rabbits.

Carbenicillin, chloramphenicol, doxycycline, and clindamycin were compared with penicillin for the treatment of lung abscess in an animal model produced by transtracheal inoculation of a mixture of anaerobes: Bacteroides fragilis, Peptococcus morbillorum, Eubacterium lentum and Fusobacterium nucleatum. Both chloramphenicol and doxycycline eliminated the bacteria but failed to close the abscess cavity. Carbenicillin, although it eradicated B. fragilis, failed to close the abscess cavity in 3 of 6 animals. In all animals tested, clindamycin sterilized the abscess cavities and healed the lung abscesses, while penicillin failed to eradicate the infection. Clindamycin was significantly more effective than penicillin in the elimination of anaerobic bacteria from the lung (p less than 0.05). Clindamycin also closed the abscess cavity faster than penicillin (p less than or equal to 0.02). The superior efficacy of clindamycin may have been the result of accumulation in the lung tissue in concentrations four- to eightfold higher than in the serum.

Animals↗
PubMed1982

Chemoprophylaxis of anaerobic pulmonary infections. An experimental study in rabbits.

Chemoprophylaxis of anaerobic pulmonary infection due to aspiration was studied in a rabbit model with the view of comparing the efficacy of procaine penicillin, clindamycin, chloramphenicol, doxycycline and cefoxitin. The antibiotic treatment was commenced immediately following transtracheal inoculation of a mixture of Bacteroides fragilis, Streptococcus morbillorum, Fusobacterium nucleatum and Eubacterium lentum. Treatment was stopped after 48 h and lungs were examined for evidence of infection on the 10th day. Only clindamycin and carbencillin were highly efficacious in chemoprophylaxis and both drugs prevented pulmonary infection in 7 of 8 (87%) of the animals tested.

Anaerobiosis↗
PubMed1982

Exfoliative dermatitis during cefoxitin therapy.

An 84-year-old man was admitted to the hospital with a diabetic foot ulcer and osteomyelitis of the calcaneum. While being treated with cefoxitin sodium, he experienced generalized exfoliative dermatitis, which subsided on discontinuation of therapy. To our knowledge, this is the first report of exfoliative dermatitis with a cephalosporin or related drug.

Aged↗
PubMed1981

Animal model for anaerobic lung abscess.

There are no satisfactory animal models for the study of anaerobic lung abscess. Aspiration of food, gastric mucin, or hydrochloric acid, or any combination of these, along with oropharyngeal bacteria, is commonly believed to cause aspiration pneumonia and lung abscess. In the animal model described, none of the adjuvants was effective in producing anaerobic lung abscesses. Anaerobic bacteria derived from dental scrapings of a healthy adult (Peptococcus morbillorum, Fusobacterium nucleatum, Eubacterium lentum, and Bacteroides fragilis), when inoculated transtracheally without any adjuvants into New Zealand male white rabbits, consistently produced lung abscesses. Neither B fragilis by itself nor a mixture of P. morbillorum, F. nucleatum, and E. lentum without the addition of B. fragilis produced lung abscesses. The bacterial isolates used in this study were stored in prereduced chopped-meat-glucose medium and subcultured several times and were found effective in reproducing anaerobic lung abscesses repeatedly. This animal model is suitable for the study of pathogenesis, diagnosis, and treatment of B. fragilis-associated anaerobic lung abscess.

Aerosols↗
PubMed1981

Spinal epidural abscess due to Actinomyces israelii.

A 31-year-old man had back pain, weight loss, fever, and paraplegia, with radiographic evidence of a left upper lobe lesion and lytic lesions in ribs and vertebral bodies. Gallium uptake was increased over the spine. At surgery we found a paraspinal abscess due to Actinomyces israelii. The patient responded to surgery and penicillin therapy. This is the first report of a case of actinomycotic spinal epidural abscess necessitating emergency surgery since the advent of penicillin.

Abscess↗
PubMed1980

Bacteriology and treatment of dental infections.

The microbiologic and therapeutic aspects of sixty-one cases of pyogenic dental infection were studied through the use of modern anaerobic culture methods. Forty-five (74 percent) patients had anaerobic infections. Among them, eighteen (29.5 percent) had Bacteroides fragilis, of which six were resistant to penicillin at 16 microgram/ml. but all were susceptible to clindamycin at less than 2 microgram/ml. Of twenty-five patients treated with 4 to 20 million units of penicillin per day, twenty were cured and did not suffer relapse. The five patients in whom treatment failed had mandibular fractures infected with B. fragilis. Of ten patients treated with clindamycin (600 mg. intravenously every 6 hours), which included five patients with B. fragilis infections, all were cured. The presence of B. fragilis in dental infections has not been recognized. Dental infections associated with mandibular fracture that fail to respond to conventional penicillin therapy should be routinely cultured for B. fragilis.

Adolescent↗
PubMed1975

A comparison of post-mortem analysis of helminths with faecal egg counts.

Intestinal helminth infections are very common amongst residents of the Colombo area. Most common by post-mortem examination of 104 cases of sudden death were Trichuris trichiura (97.1%), Necator americanus (88.5%), Enterobius vermicularis (77.9%) and Ascaris lumbricoides (40.4%). Trematode and cestode infections were not encountered except a single case of H. diminuta infection. A comparison of the results obtained by the direct smear method for examining stools missed cases harbouring gravid females of up to 3 Ascaris lumbricoides, 29 Trichuris trichiura and 66 Necator americanus. The direct smear revealed all the helminths present except threadworms in only 30% of the cases. The correlation between worm loads calculated from ova counts and actual numbers harboured was fairly close in 19 out of 35 cases for Ascaris and 37 out of 78 cases for Necator americanus. Highly erroneous results were obtained in many instances when worm loads were calculated from the results of ova counts.

Adolescent↗