Biomedical subjects
Publications and source records attributed to M L Horowitz.
Reported herein is a second case of a patient who developed adult respiratory distress syndrome secondary to babesiosis. The features of acute lung injury after babesiosis will be described.
We present three new cases of Pneumocystis carinii in pleural effusions of patients with AIDS, bringing the total number of reported cases to six. In our patients, diagnosis was made by visualization of Pneumocystis in pleural fluid stained with Gomori methenamine silver. LDH was greater than 400, and pleural fluid to serum LDH ratio was greater than 1.0 in all cases at time of presentation. All six reported patients have been associated with aerosolized pentamidine, and five of the six had documented underlying Pneumocystis pneumonia. The sixth patient, which we report, presented with primary pleural infection with Pneumocystis. Although we could not document underlying pneumonia, we suspect it was present. Pneumocystis pleural disease appears to be an anatomic extension of smoldering subpleural Pneumocystis pneumonia, and prognosis is not worse than with pneumonia alone.
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The distributions of the incubation periods for infectious and neoplastic diseases originating from point-source exposures, and for genetic diseases, follow a lognormal distribution (Sartwell's model). Conversely, incubation periods in propagated outbreaks and diseases with strong environmental components do not follow a lognormal distribution. In this study Sartwell's model was applied to the age at onset and age at death of foals with Rhodococcus equi pneumonia. The age at onset of clinical signs and age at death were compiled for 107 foals that had been diagnosed with R. equi pneumonia at breeding farms in Argentina and Japan. For each outcome (disease and death), these data followed a lognormal distribution. A group of 115 foals with colic from the University of California were used as a comparison group. The age at onset of clinical signs for these foals did not follow a lognormal distribution. These results were consistent with the hypothesis that foals are infected with R. equi during the 1st several days of life, similar to a point-source exposure.
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