Influence of rejection therapy on fungal and nocardial infections in renal-transplant recipients.
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Biomedical subjects
Publications and source records attributed to M C Bach.
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A method for preparing uniformly dispersed cultures of Nocardia asteroides for use in tests for susceptibility to antimicrobial agents is described. The minimal inhibiting concentration (MIC) of 45 agents for cultures thus prepared was determined with the use of a replica-inoculating apparatus. Minocycline at a concentration of 3.1 mug or less/ml inhibited 90% of the strains tested, and all were inhibited by 6.3 mug/ml. An erythromycin concentration of 0.8 mug or less/ml inhibited 40% of the strains, but the MIC for most of the others was > 100 mug/ml. The other agents were generally less active. Chemically related analogues varied in activity to different degrees. Also, the MIC of each antibiotic against different strains generally varied over a wide range. Sulfonamides and trimethoprim were not active against most strains in the method used. The size of the inoculum markedly affected the MIC of sulfonamides and had variable effects on other agents. Marked synergy of erythromycin with ampicillin was demonstrated for nearly all strains tested.
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Anaerobic gram-negative bacillary bacteremia and multiple septic pulmonary emboli developed rapidly in two previously healthy young men after an episode of pharyngitis. One patient developed proptosis and subsequent uniocular blindness. In both cases facial swelling was an early sign of jugular vein involvement. In patients not responding to antibiotic therapy, systemic anticoagulation or surgical venous ligation may be potentially useful as an additional therapeutic measure. Septic jugular vein phlebitis is a serious condition that requires early recognition and rapid institution of appropriate therapy.
A previously healthy man developed a progressive neurologic illness characterized by an "aseptic meningitis syndrome," progressive hypoglycorrhachia, and severe brain-stem dysfunction. Initial dramatic response to antituberculosis therapy supported the diagnosis of tuberculous basilar meningitis; however, Listeria monocytogenes eventually grew in a blood culture, and the patient recovered following intravenous ampicillin therapy. The entity of listerial rhombencephalitis should be considered as a treatable cause of acute, progressive brain-stem meningoencephalitis.