A 69-year-old male was admitted because of constipation and abdominal distension. A colon fiberscopic examination revealed the formation of ulceration. The trophozite of Entamoeba histolytica was detected from from the specimens of colon mucosal biopsy of the ulcer. The stool was positive for the cysts of E. histolytica too. He had been in China and Southeast Asia during World War II. He returned home and experienced amoebic dysentry, and was treated with Emethin hydrochlolide. He suffered from amoebic disentry in 1970 and was treated with Emethine hydrochrolide again. After the War he had not gone abroad, and was not a homosexual. So this case was considered a latent infection of E. histolytica from the War. This time he was treated with metronidazol and minocycline. After the therapy, cysts were negative in the stool and the ulcer was cured on the colon fiberscopic examination.

Aged↗

PubMed1996

[Effect of prolonged administration of erythromycin on the drug sensitivity and the biological properties of Streptococcus pneumoniae].

From April 1990 to February 1992 two hundred and ten strains of Streptococcus pneumoniae were isolated in the laboratory of Nara Medical University Hospital. Frequency of erythromycin resistant Streptococcus pneumoniae, prescription mode of macrolide antibiotics and biological properties were investigated. 1. Erythromycin resistant Streptococcus pneumoniae was predominantly isolated from the wards of the respiratory unit of Inter- nal Medicine and Pediatrics. 2. Patients with erythromycin resistant Streptococcis pneumoniae were treated with macrolide antibiotics frequently in the respiratory unit of Internal Medicine and Pediatrics. 3. MIC90 of EM, CLDM, MINO and ABPC for Streptococcus pneumoniae was 8.0, 8.0, 8.0 and 1.0 micrograms/ml, respectively, indicating moderate resistance to penicillin derivatives and high resistance to macrolides, particularly EM; some strains showed high levels of MIC over 400 micrograms/ml. 4. Investigations on biological properties using VITEK GPI cards revealed that some erythromycin resistant strains showed less responsiveness to DEX, LAC, PUL and MEL. 5. The survival rate of mice infected with erythromycin resistant strains was longer than that with erythromycin sensitive strains. These findings suggested that the prolonged administration of erythromycin causes a virulence reduction of the organism.

Adult↗

PubMed1996

[A case of the greater omentum abscess due to Peptostreptococcus ssp].

A case of the greater omentum abscess due to Peptostreptococcus ssp. is reported. A 63-year-old male was admitted to Heisei Memorial Hospital with a complaint of abdominal pain. An intraperitoneal mass measuring 6 cm in diameter was detected by CT and ultrasonogram. He was diagnosed as having an intraperitoneal abscess. After antibiotics therapy by cefotiam, laparotomy was performed and an abscess about 7 cm in diameter at the edge of the greater omentum was found. There was no evidence of perforation in the intestine wall. The abscess was removed and Peptostreptoccocus spp. was isolated from the dark red pus drained from the abscess.

Abdominal Abscess↗

PubMed1996

[A case of AIDS with intractable cryptococcal meningitis].

A 38-year-old hemophiliac, who had been infected with HIV by the administration of blood products and had been diagnosed as AIDS by the onset of Pneumocystis carinii pneumonia, was admitted to our hospital with the complaints of headache and vomiting. After he was diagnosed as cryptococcal meningitis using the microscopy, cryptococcal antigen detection and culture of cerebrospinal fluid, treatment with amphotericin-B and fluconazole was started. As there was no clinical improvement, spinal drainage was performed and acetazolamide administered in order to reduce the intracranial pressure. Treatment was changed from AMPH-B and FLCZ to a combined therapy of AMPH-B and itraconazole. As his clinical features showed improvement, he was discharged home on a maintenance dose of ITCZ and acetazolamide after having been hospitalized for three months. This case-report may be of use in the management of cryptococcal meningitis in patients with AIDS.

AIDS-Related Opportunistic Infections↗

PubMed1996

[A clinical features of acute respiratory infection with Haemophilus influenzae by transtracheal aspiration].

We performed a clinical study of 26 cases (27 episodes) of acute respiratory infection with H. influenzae by trans tracheal aspiration (TTA) from May 1987 to April 1995. 15 episodes (14 cases) were bronchitis and 12 episodes (12 cases) were pneumonia. 8 episodes were monomicrobial infection and 19 episodes were polymicrobial infection. Compared to the group of patients of monomicrobial infection, the number of elderly patients and the levels of WBC and CRP were higher in the group of patients of monomicroibal infection. In bronchitis cases, monomicrobial infections of H. influenzae were 7 episodes and polymicrobial infection containing H. influenzae were 8 episodes. In the latter group, PaO2 level was lower and CRP was higher on average. All patients recovered, but the period for treatment was longer in the latter group. In the pneumonia group, only one episode was monomicrobal infection and 11 episodes were polymicrobial infection. Inspite of treatment, one patient died. It was considered that polymicrobial infection was an important factor of acute respiratory infection with H. influenzae.

Acute Disease↗

PubMed1996

[A clinical study of chronic lower respiratory infection with Haemophilus influenza by transtracheal aspiration].

We have performed a clinical study on chronic lower respiratory tract infection (CLRTI) with Haemophilus influenzae (H. influenzae) by transtracheal aspiration (TTA) and analyzed clinical factors of the acute exacerbation. In 40 episodes (38 cases) of H. influenzae isolated from CLRTI, monobacterial infection with H. influenzae were 21 episodes and polymicrobial infection were 19 episodes. We classified the disease into acute exacerbated (27 episodes) and stable (13 episodes) phase and the former episodes were divided into bronchitis type (7 episodes) and pneumonia type (20 episodes). Polymicrobial infections were seen more in the pneumonia type (13 episodes) than in the bronchitis type (2 episodes). The principal organism detected with H. influenzae were alpha-Streptococcus and Neisseria sp. in the bronchitis type and S. pneumoniae in the pneumonia type. The acute exacerbated cases were divided into the following 4 patterns; 1. polymicrobial infection with continuous infection of P. aeruginosa, 2. monomicrobial infection after acute upper respiratory tract infection, 3. polymicrobial infection with S. pneumoniae after continuous infection of H. influenzae, 4. bacterial replacement by P. aeruginosa after acute exacerbation. The results of the study suggests that polymicrobial infection is an important chronic lower respiratory tract infection when caused H. influenzae.

Acute Disease↗

PubMed1995

Murine tumorlytic factor, immunologically distinct from tumor necrosis factor-alpha and -beta, induced in the serum of mice treated with a T-cell mitogen of Corynebacterium kutscheri.

Murine tumorlytic factor (TF), immunologically distinct from murine tumor necrosis factor (TNF)-alpha and -beta, was purified to a homogeneity from the serum of mice injected with a T-cell mitogen of Corynebacterium kutscheri. The treated mouse serum was purified by Lentil lectin-Sepharose chromatography, DEAE-cellulose chromatography, preparative isoelectric focusing, and high-pressure liquid chromatography to the specific activity of 1.5 x 10(6) U/mg protein. TF was 42 kDa in its oligomeric form and 14 kDa in its monomeric form. TF activity was not impaired with hamster monoclonal antibody (mAb) to recombinant murine TNF-alpha and -beta and, reciprocally, rabbit antibody to TF neutralized the bioactivity of neither murine TNF-alpha nor -beta. TF was not precipitated with the mAb to murine TNF-alpha and -beta in Western blot analysis. The partial amino acid sequence of TF was at most 33% homologous to the 46-63 sequence of mouse TNF-beta. Thus, these results suggest that TF might be a novel tumorlytic factor which is immunologically distinct from mouse TNF-alpha and -beta.

Amino Acid Sequence↗

PubMed1995

[A case of sepsis due to Escherichia coli isolated from blood, transtracheal aspiration and urine].

We reported a 53-year-old female who was admitted due to partial loss of consciousness. She had been diagnosed as old pulmonary tuberculosis and diabetes mellitus. She was diagnosed as diabetic keto-acidosis on admission. We isolated Escherichia coli in the blood, transtracheal aspiration (TTA) and from the urine. We have experienced 6 cases where the same bacteria was isolated from the blood and TTA at the same time. In all 6 cases, we have found single bacteria in the blood and a few other bacteria in TTA. Blood culture is the most certain method to detect the origin of infectious diseases. But the compromised host, as in this case, has multifocal infections in many cases. In order to understand the pathological aspects of the infection, we must obtain many kinds of samples and as many as possible.

Blood↗

PubMed1995

[Determination of the neutrophil function in the respiratory infection by chemiluminescence (CL). III: Changes in neutrophil and whole blood CL after chemotherapy against the acute respiratory infection].

We measured the chemiluminescent activity (CL-index) in both the whole blood and isolated neutrophils from 12 patients with acute respiratory infection (7 cases; pneumonia, 4 cases; in the exacerbated phase, chronic lower tract infection, and one; acute bronchitis) two times per each case: before and after chemotherapy. Before the initiation of chemotherapy, neutrophil and whole blood CL was high but whole blood CL was higher. After the completion of chemotherapy, whole blood CL was decreased more significantly than neutrophil CL. There was no correlation between neutrophil CL and whole blood CL. However the neutrophil CL-index.N (neutrophil numbers x neutrophil CL-index) was correlated with the whole blood CL. Thus, we think the number of neutrophils is a critical factor for phagocytic function of neutrophils as determined by CL.

Acute Disease↗

PubMed1995

Clinical aerosol inhalation cine-scintigraphy to evaluate mucociliary transport system in diffuse panbronchiolitis.

UNLABELLED: This study evaluates the mucociliary transport system in patients with diffuse panbronchiolitis using aerosol inhalation cine-scintigraphy (AICS). METHODS: Forty-one subjects, 10 healthy controls and 31 patients with diffuse panbronchiolitis, were studied. In addition, the mucociliary transport system was evaluated in 11 patients who had received erythromycin therapy for 3-8.3 yr. Following inhalation of 99mTc-human serum albumin aerosol for 3-5 min in a sitting position, the subjects were placed on the imaging table in the supine position and posterior images were obtained dynamically for 20 sec/frame over 2 hr with a gamma camera linked to a digital computer. The 360 20-sec serial frames were edited into a cinematographic presentation at 200-msec intervals. Clinical evaluation of the mucociliary transport system was based on the bolus movement of radioactive aerosol from the main bronchi to the trachea and the movement patterns, which were divided into four types using the movement in the controls as a standard (type I): type I, rapid and smooth movement; type II, slow movement; type III, stagnation at the carina; and type IV, complete stasis. RESULTS: All patients with diffuse panbronchiolitis had types III and IV, indicating that mucociliary transport system was severely impaired. Of the 11 patients on erythromycin therapy, 8 had movement pattern type IV and 3 had movement pattern type III before erythromycin therapy. In eight patients (72.7%), movement pattern was improved to type I or II after therapy. CONCLUSION: Aerosol inhalation cine-scintigraphy helps evaluate the clinical usefulness of erythromycin therapy in diffuse panbronchiolitis.

Aerosols↗

PubMed1995

[A case of varicella pneumonia in an adult with moss-like substance in the bronchial mucosa].

A 33-year-old man complained of fever, cough and eruptions, and was admitted to our hospital. Chest X-ray films showed diffuse small nodular shadows. A moss-like substance in the bronchial mucosa was seen bronchoscopically. Transbronchial lung biopsy specimen showed infiltration of lymphocytes in the alveolar septa and peribronchiolar area. Transbronchial biopsy specimen of the bronchial lesion showed epithelial hyperplasia and necrosis. Immunohistochemical staining revealed VZV antigen.

Adult↗

PubMed1994

[Suppression of the Pseudomonas aeruginosa-induced biofilm formation on human epithelial cells by erythromycin].

In the present study, were examined the inhibitory effect of erythromycin on the biofilm formation by a temperature-sensitive mutant (Ts25) of Pseudomonas aeruginosa N-42 on the surface of Ishikawa cells which can produce a mucin-like glycoprotein physicochemically similar to mucoproteins produced in the human airway. Usually, 38-45 microcolonies (biofilms) were formed after 10 days of incubation in cultures of Ishikawa cells and P. aeruginosa Ts25. Erythromcin suppressed the adhesion to Ishikawsa cells of P. aeruginosa and its subsequent biofilm formation at doses as low as 0.2 microgram/ml. Erythromycin also exhibited the suppressive effect on the production of glycoproteins by Ishikawa cells at doses higher than 1 microgram/ml and the production of elastase and exoenxyme A from P. aeruginosa at doses higher than 2 micrograms/ml. These results suggest that erythromycin can inhibit the biofilm formation in culture of human epithelial cells and P. aeruginosa and the in-vivo bacterial biofilm formation may be attributed to host cell-derived factors rather than bacterial products.

Biofilms↗

PubMed1994

[An evaluation of pathogens in patients with bronchopulmonary infection by transtracheal aspiration: December 1978-March 1993].

We performed transtracheal aspiration (TTA) in 1165 patients, who were suspected to have bronchopulmonary infection, from December 1978 to March 1993. We isolated pathogens from TTA in 806 patients (69.2%). We isolated H. influenzae (62 cases), S. pneumoniae (39 cases) and M. catarrhalis (24 cases) in patients with acute bronchitis, S. pneumoniae (65 cases), alpha-Streptococcus sp. (52 cases), H. influenzae (32 cases) and S. aureus (29 cases) in patients with pneumonia or lung abscess and H. influenzae (174 cases), S. pneumoniae (84 cases), P. aeruginosa (81 cases) and M. catarrhalis (42 cases) in patients with chronic lower respiratory tract infection. Anaerobic bacteria isolated from TTA included Peptostreptococcus sp. (19 cases), Bacteroides sp. (19 cases) and others. Mycoplasma pneumoniae was isolated from TTA in 8 patients with pneumonia without other organisms. Virus isolated from TTA included Rhinovirus (6 cases) and others. These results suggest that various pathogens affect the pathogenesis of bronchopulmonary infection. Therefore, we must diagnose the bronchopulmonary infection by the correct methods such as TTA.

Adult↗

PubMed1994

[A clinical study of respiratory infections due to mucoid Pseudomonas aeruginosa diagnosed by transtracheal aspiration].

We performed a clinical study of 20 cases (33 episodes) of respiratory infections due to mucoid Pseudomonas aeruginosa by transtracheal aspiration (TTA) in the recent 10 years. There was only one pneumonia without underlying chronic lower respiratory infection (CLRTI) case positive for mucoid P. aeruginosa and others were all CLRTI among 33 TTA trials. In contrast, nonmucoid P. aeruginosa was recovered from 9 cases of respiratory infections without underlying CLRTI among 46 TTA trials. Monomicrobial infection of mucoid P. aeruginosa was 69.7%, and polymicrobial infection containing mucoid P. aeruginosa was 30.3%, and Haemophilus influenzae was the most frequent microorganism recovered with mucoid P. aeruginosa. The recovery rate of mucoid P. aeruginosa among P. aeruginosa-colonized cases was 56.3% in diffuse panbronchiolitis, and that was 42.9% and 40.0% in bronchiectasis and chronic bronchitis, respectively. Mortality due to pneumonia with nonmucoid P. aeruginosa was 46.1%, but there was no fatal pneumonia case with mucoid P. aeruginosa. In CLRTI, laboratory data were not remarkably different between mucoid and non-mocoid P. aeruginosa-colonized cases. Thus, these results suggest that mucoid P. aeruginosa is a more important organism in persistent infections in the lower respiratory tract compared with nonmucoid P. aeruginosa, and further investigations is required on the mechanism and clinical role of this infection.

Adult↗