Biomedical subjects
Publications and source records attributed to R Malowitz.
We describe a case of catheter-associated Wangiella (Exophiala) dermatitidis fungemia in a human immunodeficiency virus-infected child who was successfully treated with antifungal therapy and catheter removal. Catheter-associated W. dermatitidis fungemia appears to be distinct from previously described cases of disseminated infection with organ involvement.
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Fungal infections are characteristic of severely immunocompromised patients. Noncandidal yeasts represent a growing proportion of such infections. Risk factors for developing fungal infections include the use and abuse of central venous catheters. Two patients with gynecologic malignant neoplasms became fungemic with Hansenula anomala, a yeast of the Ascomycetes class, after insertion of central venous catheters. Frequent catheter manipulation and prolonged use favored the development of fungemia in both patients. A review of the literature revealed 19 additional cases over the course of four decades, all in hosts with underlying diseases. Thirteen of these cases have been described in the last 18 months, suggesting either increased recognition or increased frequency of infection with this organism. All tested isolates have been susceptible to amphotericin B. Patients have generally responded to catheter withdrawal and amphotericin B administration. Hansenula anomala is an opportunistic pathogen, whose clinical behavior resembles that of Candida species.
The carbohydrate composition of the cell walls of Paecilomyces persicinus P-10 M1 was monitored daily for 6 days to detect any changes during growth and cephalosporin C production. Walls were isolated after mechanical breakage, sonication, and exposure to detergent. Major quantitative changes in cell wall carbohydrate composition accompanied a decrease in both cell weight and antibiotic production. Glucosamine content remained relatively constant in the 24- to 96-h cell walls and increased markedly in the 120- and 144-h preparations. The non-nitrogenous carbohydrate cell wall component, however, decreased significantly in the 48- and 120-h cell walls. Gas-liquid chromatographic analysis of the non-nitrogenous carbohydrate cell well fraction revealed the presence of glucose, the major component, mannose, galactose, and minute quantities of arabinose. Except for glucose, which was found to decrease moderately in the 120- and 144-h cell walls, the neutral sugars did not vary significantly with time.
The rhodamine-auramine O stain was compared with the Kinyoun carbolfuchsin acid-fast stain for detection of Cryptosporidium oocysts in samples from patients infected with the human immunodeficiency virus (HIV). A total of 283 fecal specimens from HIV-infected patients were examined for the presence of Cryptosporidium oocysts. Duplicate smears of the fecal concentrates, prepared by the formalin ethyl acetate procedure, were stained by the Kinyoun carbolfuchsin and fluorescent rhodamine-auramine O acid-fast methods. The Kinyoun stain detected 13 positive specimens, while the rhodamine-auramine O stain detected 14 positive specimens. The average time required to survey a stained smear was 2.5 minutes with the fluorescent method, compared with 6.0 minutes with the Kinyoun technique. The rhodamine-auramine O stain is a dependable and efficient method of examining fecal smears for the presence of Cryptosporidium oocysts in a high-risk population.