PubMed Health⌕ Search

Biomedical subjects

H D Pohle

Publications and source records attributed to H D Pohle.

At least 91 records · Page 5Linked to original sources

Fatal legionellosis in patients with malignant hematologic diseases.

Pneumonia was present in 70/157 (44.6%) autopsied patients with malignant hematologic diseases. In 16/70 patients (22.9%), legionellae were found to be the causative agents by screening lung tissue specimens with the direct fluorescent antibody method. In 5/16 patients with Legionella pneumonia, in whom legionellosis had been suspected clinically, the diagnosis had already been established by serology, urinary Legionella antigen detection, and culture. These results provide evidence that legionellosis is an important pneumonia etiology in patients with malignant hematological diseases. Thus, Legionella diagnostics should be applied routinely, and antibiotics effective in the treatment of legionellosis should be added to the usual therapy in patients with etiologically unexplained pneumonias. In view of the common occurrence of relapses of Legionella pneumonia, antibiotic therapy should be continued for an extended period.

Aged↗

Ultrastructural and immunohistochemical findings in oral hairy leukoplakia.

Three cases of HL from the lateral border of the tongue of male homosexual AIDS patients were investigated by thin section electron microscopy. Keratinocytes contained condensed chromatin in their pyknotic nuclei and a few organelles in the oedematous cytoplasm. Chromatin was in close association to the nuclear membrane and showed a punched-out appearance. Particles typical of the herpes virus group were abundant in the upper two thirds of the epithelium in all three cases. Virus particles were seen frequently in the nuclei of the ballooned keratinocytes, but rarely in cells containing Candida albicans. Viral nucleocapsids were observed budding at the inner nuclear membrane, thereby acquiring the prospective viral envelope. Complete, enveloped virions were found in the endoplasmic reticulum and in the extracellular space. These virions were identified immunohistochemically as Epstein-Barr virus (EBV) using two monoclonal antibodies directed against EBV capsid and membrane antigen, respectively. Candida albicans was observed in the stratum corneum and in the upper layer of the stratum spinosum. Special cytoplasmic tubular structures arranged in parallel bundles were found in koilocytotic cells in addition to characteristic membrane structures composed of undulating convoluted membranes. Epithelial basement membranes were always intact.

Acquired Immunodeficiency Syndrome↗

Impairment of cranio-facial nerves due to AIDS. Report of 2 cases.

2 cases of disorders of craniofacial nerves resulting from progressive multifocal leucoencephalopathy are described. Clinical symptoms occurred as facial paralysis, hypaesthesia, hemianopsia and deafness. In both patients, the impairment of the central nervous system (CNS) preceded indicative AIDS symptoms. Both patients died about 3 months after the first CNS symptoms had been diagnosed. Clinical and neurohistopathological findings as well as differential diagnoses are discussed.

Acquired Immunodeficiency Syndrome↗

Nosocomial legionella pneumonia: demonstration of potable water as the source of infection.

From January 1983 until December 1985, 35 cases of sporadic nosocomial legionella pneumonia, all caused by Legionella pneumophila, were diagnosed in a university hospital. L. pneumophila serogroup (SG) 1 was cultured from 12 of the 35 cases and compared to corresponding L. pneumophila SG 1 isolates from water outlets in the patients' immediate environment by subtyping with monoclonal antibodies. The corresponding environmental isolates were identical to 9 out of 12 (75%) of those from the cases. However, even in the remaining three cases identical subtypes were found distributed throughout the hospital water supply. From the hospital water supply four different subtypes of L. pneumophila SG 1 were isolated, three of which were implicated in legionella pneumonia. Of 453 water samples taken during the study 298 (65.8%) were positive for legionellae. Species of Legionella other than L. pneumophila have not been isolated. This may explain the exclusiveness of L. pneumophila as the legionella pneumonia-causing agent. Our results suggest that the water supply system was the source of infection.

Antibodies, Monoclonal↗

Fatal Legionella pneumonia: retrospective examination of lung tissue using direct and indirect fluorescent-antibody methods.

Lung tissue sections of patients who died of pneumonia within one year were screened retrospectively for Legionnaires' disease bacteria using simultaneously a direct fluorescent antibody test (DFA) and an indirect fluorescent antibody system (IFA). The IFA has shown to provide a rapid screen for the increasing number of known Legionella species and serogroups recently. In 10/168 (6%) of our cases legionellae were the pneumonia causing agents detected with both methods. Although we should have been able to detect 25 serological variants of Legionella species and serogroups with the IFA, we found Legionella pneumophila serogroup 1 only. The IFA test has proven to be a reliable means for the screening of lung tissue sections.

Aged↗

[Disseminated cryptococcosis in 2 AIDS patients. A contribution to cryptococcosis diagnosis in AIDS].

In two AIDS patients (homosexual men) microscopical demonstration of Cryptococcus neoformans in samples obtained by puncture of the liver (n = 1) and additionally of the spleen (n = 1) led to the diagnosis of systemic cryptococcosis. Using the India ink method capsulated Cryptococcus neoformans cells could also be detected in cerebrospinal fluid (CSF) and urine. Concomitant culture of the fungus from tracheal secretion, CSF, urine and faeces confirmed the diagnosis of a disseminated infection; the identification and germ count of C. neoformans was achieved by means of the differential-selective medium Guizotia-abyssinica-creatinine agar. The C. neoformans antigen titres in serum and CSF corresponded to the stage of the mycosis as detected by microscopy and culture. After a six-week course of treatment with amphotericin B and flucytosine (Ancotil), the fungus could no longer be isolated from the materials examined in one patient. Mycological monitoring aiming at the detection of C. neoformans in the tracheal secretions by means of the mentioned differential-selective medium is therefore recommended as a prophylactic measure in AIDS patients and persons at risk.

Acquired Immunodeficiency Syndrome↗

Demonstration of spermatozoa in the lung of an AIDS patient.

Using the DNA-binding fluorochrome, DAPI, spermatozoa and Pneumocystis carinii were easily demonstrated in postmortem lung sections of an AIDS patient. The possible practical significance of these findings is discussed.

Acquired Immunodeficiency Syndrome↗

[Neurologic symptoms in Legionella infection. A case report of the clinical aspects and diagnosis of legionellosis].

In patients with infection from Legionella pneumophila, it must be taken into consideration that the nervous system may be involved. This involvement can precede the pneumonia by several days. Headache, acute mental status changes and cerebellar dysfunctions are the most common neurological symptoms. In the case reported, extrapyramidal disturbances were also observed that are rarely found in association with Legionella infection. There are grounds for the assumption that Legionella toxins cause impairment to the nervous system. The neurological symptoms are not specific enough to allow differentiation of this infection from pneumonia of other etiologies.

Athetosis↗