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Biomedical subjects

L B Givner

Publications and source records attributed to L B Givner.

48 records · Page 3Linked to original sources
PubMed1987

Type III group B Streptococcus: functional interaction with IgG subclass antibodies.

The functionally active IgG subclasses and the portion of the antibody molecule mediating opsonophagocytosis of type III, group B Streptococcus (III-GBS) have not previously been investigated. Serum from a healthy adult immunized with III-GBS vaccine was subjected to ion exchange chromatography, yielding 2,950 mg of IgG/dl and 1,440 micrograms of III-GBS-specific antibody/ml. Papain digestion for selective cleavage of IgG1 and IgG3 yielded an IgG2-rich pool that contained 31% of the initial IgG but 69% of the antibody to III-GBS. This pool retained opsonophagocytic activity of antibody to III-GBS at levels similar to that for the initial IgG pool. Analysis of F(ab')2 fragments of pepsin-digested IgG revealed that the level of alternative pathway-mediated opsonophagocytosis of III-GBS was similar to that mediating functional activity in the initial IgG preparation. Therefore, IgG2 is an active opsonin for III-GBS, but divalency appears to be required for alternative pathway-mediated opsonophagocytosis.

Antibodies, Bacterial↗
PubMed1985

Immune globulin for intravenous use: enhancement of in vitro opsonophagocytic activity of neonatal serum.

Neonates born with less-than-protective levels of transplacentally derived specific antibody are at risk for the development of disease due to type III, group B Streptococcus (III-GBS). The effect of immune serum globulin modified for intravenous use (MISG) on in vitro opsonophagocytosis of III-GBS was evaluated. Cord blood was obtained from 13 healthy, full-term neonates, and bactericidal activity for III-GBS was measured. Before the addition of MISG, one of three serum specimens with moderate levels of antibody to III-GBS, and eight of 10 specimens with low antibody levels demonstrated no bactericidal activity. The mean bactericidal index increased from 27.1% before the addition of MISG to 96.5% with MISG added in a volume equal to that of serum. The effect of MISG on opsonophagocytosis decreased with its dilution in buffer, and no effect was shown at dilutions greater than or equal to 1:4. Thus, MISG can substantially increase in vitro opsonophagocytosis of III-GBS in sera from newborns.

Antibodies, Bacterial↗
PubMed1984

Necrotizing fasciitis of the parapharyngeal space with carotid artery occlusion and acute hemiplegia.

Necrotizing fasciitis is characterized by necrosis with extension over fascial planes and mixed aerobic-anaerobic etiologies. Necrotizing fasciitis is uncommon in children and seldom involves the head and neck area. An infant who developed necrotizing fasciitis involving the parapharyngeal space is described. Chronic dental pathology was probably the initial focus of infection. The patient had a left hemiparesis due to a right middle cerebral artery infarct. Carotid angiography demonstrated complete occlusion of the right internal carotid artery, probably secondary to inflammatory arteritis or direct compression along its course through the parapharyngeal space. Mixed aerobic-anaerobic etiologies predominate in infections of the potential spaces of the head and neck as was demonstrated in this patient. The patient recovered, but had neurologic sequelae. Prompt and aggressive therapy is necessary in patients with necrotizing fasciitis syndromes in order to avoid such severe complications.

Acute Disease↗
PubMed1983

Myocarditis as a complication of infantile Chlamydia trachomatis pneumonitis.

The case is presented of an infant with chlamydia pneumonitis who developed clinical and electrocardiographic signs of myocarditis. No significant antiviral antibodies developed. Elevated antichlamydial IgG titers were demonstrated during the initial phase. These declined during convalescence. This report provides further evidence associating C. trachomatis with infectious myocarditis.

Chlamydia Infections↗
PubMed1981

Chlamydia trachomatis infection in infant delivered by cesarean section.

Neonatal Chlamydia trachomatis infection is thought to be acquired as a result of contact with infected cervical secretions during vaginal delivery. An infant, delivered by cesarean section, who was infected with C trachomatis has been described. At 31 days of age he had conjunctivitis and respiratory distress. Nasopharyngeal aspirate grew C trachomatis and serum IgM antibody titer was 1:32 for serotype J. The patient's mother had serum IgG antibody against C trachomatis serotype J. Her cervical culture was negative for Chlamydia; however, cultures were not taken until two months after delivery and she had received antibiotics for postpartum fever and abdominal pain. The literature has been reviewed and possible modes of transmission have been discussed.

Antibodies, Bacterial↗
PubMedDate not supplied

Meningitis due to Haemophilus influenzae type b resistant to ampicillin and chloramphenicol.

Invasive disease due to Haemophilus influenzae type b (Hib) resistant to chloramphenicol and ampicillin is rare in the United States. Review of the literature reveals that all previously reported cases occurred in children with meningitis. These children were treated initially with ampicillin and chloramphenicol and had complicated courses characterized by delayed sterilization of the cerebrospinal fluid. The present report describes an infant who developed meningitis due to ampicillin- and chloramphenicol-resistant Hib. The patient received cefotaxime from the onset of therapy and had an uncomplicated course. The presence of Hib strains resistant to chloramphenicol and ampicillin should be considered in patients with meningitis due to Hib who respond poorly to treatment with these two drugs. Furthermore, the in vitro susceptibility of all Hib isolates to chloramphenicol (as well as to other antimicrobial agents) should be evaluated routinely. If the incidence of such resistant organisms increases, a change will be warranted in the commonly recommended combination of ampicillin and chloramphenicol as empiric therapy for bacterial meningitis in pediatric patients.

Ampicillin Resistance↗
PubMedDate not supplied

Obturator internus muscle abscess in children.

The authors describe four cases of obturator internus muscle (OIM) abscess in children, including their clinical presentations and treatment. This was a retrospective chart review. Children and adolescents younger than 18 years discharged between July 1, 1985, and September 30, 1998, from Brenner Children's Hospital with the diagnosis of muscle abscess or pelvic abscess were identified. A total of 56 patients were identified with the diagnosis of muscle abscess or pelvic abscess. OIM abscess was defined by radiologic findings of an inflammatory process with fluid collection in the OIM, along with the clinical findings suggestive of an OIM abscess. Four of the patients met the definition of OIM muscle abscess. The common presenting features were fever, limp, and hip pain. Computed tomography or magnetic resonance imaging was diagnostic in all four patients, and Staphylococcus aureus was the causative agent in each. All the patients recovered, one after surgical drainage and the other three after antimicrobial therapy alone or with needle aspiration. The presentation of OIM pyomyositis is similar to that of psoas muscle pyomyositis and other infectious processes of the pelvis and hip. The S. aureus is the most common etiologic agent but not the only one reported. Most patients can be managed without open surgical drainage, but needle aspirations may be helpful both therapeutically and diagnostically.

Abscess↗