Biomedical subjects
Publications and source records attributed to H Ersgaard.
A 36-year-old male with systemic lupus erythematosus developed aseptic meningitis after ingestion of ibuprofen. He was unconscious, had a universal rash, high fever and a pathological CSF. Being severely ill he was treated with high doses of corticosteroids and plasmapheresis and recovered within a week.
A 71-year-old man with a permanent, subcutaneously implanted, intra-cardial pacemaker suffered from prolonged bacteremia with an antibiotic-susceptible group JK diphtheroid rod. He died in spite of the formation of specific serum antibody and parenteral treatment with ampicillin, cephradine and gentamicin. A second multi-resistant, but otherwise similar group JK strain was isolated post-mortem from the aseptically removed pacemaker electrode tip. The susceptible and the multi-resistant strains differed antigenically in crossed immunoelectrophoresis assays, and fatty acid isomer patterns were dissimilar. The theory that a multi-resistant group JK clone emerged by simple mutation in susceptible, indigenous group JK skin flora is rejected. The concept of major structural differences among group JK bacteria, possibly affecting cell-wall permeability, is supported. Crossed immunoelectrophoresis is suggested as a means for strain comparison in epidemiological surveys. Vancomycin is regarded as the antibiotic of choice for the treatment of potentially fatal, deep-seated infections.
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Ninety-seven strains of clinically isolated Corynebacterium strains, probably identical with Corynebacterium JK, are described especially in regard to growth in relation to different lipid substances. The corynebacteria formed a homogeneous group of strict aerobic slow-growing, catalase-positive, urease-and-nitrate-negative typical coryneform rods. Acid was produced from glucose and maltose. Growth was stimulated in the presence of different lipid substances and lipodependence was suggested by satellite growth only around oleic acid drops on otherwise lipid-depleted agar plates. Generally the isolated corynebacteria were resistant to clinically achievable concentrations of penicillins, cephalosporines and aminoglucosides but uniformly sensitive to vancomycin and rifamycin.
A case of fatal meningitis and septicemia with group JK Corynebacterium species in a leukopenic patient is reported. The strain was susceptible to rifampicin and vancomycin only. The finding of diphtheroids in bacteriological samples from immunocompromised patients should not be ignored. The literature regarding meningitis caused by diphtheroid bacilli is reviewed.
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