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[Studies On The Transmissibility Of Pathogenic-Organisms To Liver By Migrating Larvae Of Liver Fluke And Hookworm]

In order to confirm whether the migrating larvae of parasites could carry pathogenic organisms into liver and cause hepatitis, a series of experiments has been carried out. A. Clonorchis sinensis: Recovery rate of larvae in the abdominal cavity of rabbits: One to seven days after the administration adolescariae were recovered from the abdominal cavity in less than l % of the total number of metacercariae given. Generally, 1~6 larvae were found from each animal which was given 900~1,000 metacercariae, though many larvae were already found in the common bile ducts or remained still in intestine. Fate of Clonorchis sinensis in abdominal cavity: The young or mature worms which were introduced directly into the abdominal cavity were examined l5, 32, 40 and 42 days after the inoculation. Several larvae were found on the surface of liver in four animals. All the worms on the surface of the liver were dead and the biopsied liver tissues on the area where the worms were attached showed no pathological changes. Two of them were between bile duct and liver tissue but pus cell infiltration surrounding them was observed. In every case, pus cell infiltration was found in the peripheral portion of the liver and pus nodules on the surface of intestine and mesentery. The nodule in the intestinal wall contained the eggs of Clonorchis sinensis. Two worms in the abdominal cavity were still alive. From the above results it is suggested that the larvae of Clonorchis sinensis were capable of penetrating the intestinal wall and reaching the organs in the abdominal cavity and surviving for l5~42 days, but they were unable to penetrate the organs. No bacterial flora appeared from the lesion by culture method. Fate of Clonorchis sinensis which was inoculated into the peripheral region of liver: Small abscess was observed at the same area. Microscopically, the area became edematous and the vessels in the peripheral region were dilated. The parasites became necrotic and amorphous. Pathologically the lesions appeared as eosinophilic masses and neutrophile leukocytes were infiltrated surrounding the masses. In some cases, the dead worms were found apart from the original place of inoculation but no leukocyte infiltration was found. There was linear infiltration between the original site and the portion where the dead worm was found. The distance from the capsule varied from 0 to 4 mm. Sometimes, the eggs of Clonorchis sinensis were also found. In all cases, there were no living worms in liver tissues and hepatic ducts. In all case,. the bacteriological examination was negative. Do clonorchis sinensis transfer the microorganism? Five adult worms of clonorchis sinensis were incubated in the saline solution containing Staphylococcus aureus. The intestinal contents of these worms were cultured in the Nutient-agar plate and examined by Methylene Blue and Gram's stain. The area of liver tissue where the Clonorchis sinensis were inoculated showed no inflammatory changes after the 3 days of inoculation but no living Staphylococcus aureus was found in the culture media with which the pieces of liver tissues were smeared. B. Hookworm: Cutaneous infection: Four to eight days after the cutaneous infection of Ancylostoma caninum, the mice were sacrificed. Grossly, there was no abnormal finding in liver. The pieces of liver tissues were smeared on the Nutrient-agar plate, and cocci were found in four out of six examined. The microorganism were confirmed as the same species of Diplococcus pneumoniae which were grown in the hookworm culture media. Oral infection: 1,000 filariform larvae of Ancylostoma caninum were given orally. 24 hours later, the mice were sacrificed and the pieces of liver tissue were smeared on the Nutrient-agar plate. After 50 hours at 36 C, the bacterial colonies were examined bacteriologically. Staphylococcus albus was found from two out of four samples. Grossly there was no abnormality on the surface of liver, but microscopically there were spots like microabscesses which were infiltrated by leukocytes. The larvae were also found from other portions of liver tissues and they were surrounded by yellow colored material. In another experiment, a combination of Ancylostoma duodenale and Staphylococcus aureus was fed to mice. The mice sacrificed five days after the oral administration of Ancylostoma duodenale cultivated in the media containing Staphylococcus aureus. The liver pieces were examined routinely. The larvae cultivated in normal tap water which contained no Staphylococcus aureus was used as control. In the experimental mouse, the cocci appeared in the liver. Pathologically, microabscesses infiltrated with neutrophile leukocytes were found, but there was no manifestation of inflammatory change due to Staphylococcus aureus. There was only mechanical trauma due to the larvae penetration. Haemorrhage appeared only where the larvae were found.

Journal Article↗

Platelet functions in patients with meningococcal meningitis at the Kenyatta National Hospital, Nairobi.

OBJECTIVE: To determine platelet abnormalities in patients with menigococcal meningitis. DESIGN: Case control study. SUBJECTS: Fifty seven cases of mennigococcal meningitis based on a cerebrospinal fluid gram stain for gram negative diplococcus or positive culture were recruited. Fifty-seven controls matched for age and sex were also recruited. The following platelet functions tests were performed; platelet counts, platelet adhesiveness, platelet aggregation and clot retraction. RESULTS: Fifty seven patients (41 males and 16 females) with meningococcal meningitis were studied. Their mean age was 25.5 +/- 8.32 years with a range of 15 to 45 years. Five patients had purpura, four peripheral gangrene, eight conjunctival haemorrhages and one was in shock. There was a statistical significant difference in the platelet aggregation and clot retraction between the patients and controls at p-values of 0.0001 and 0.0002 respectively. There was no significant difference in the platelet count and adhesiveness between the patients and the controls at a p-value of 0.203 and 0.22 respectively. No association was found between the platelet functions and the clinical presentations. CONCLUSION: Patients with meningococcal meningitis have abnormalities in the platelet functions mainly in aggregation and adhesiveness.

Adolescent↗

Comparative inhibitory activity of BL-S640 and two other cephalosporins.

In vitro antibacterial activity of BL-S640 was compared to that of cephalothin and cephalexin against Gram-negative and Gram-positive bacteria isolated from clinical specimens. BL-S640 demonstrated the best activity on nearly all microbial species studied, except for Haemophilus influenzae and Diplococcus pneumoniae against which cephalothin was slightly more active.

Cephalexin↗

[Results of catheter biopsy and catheter aspiration in various lung diseases (author's transl)].

Results of 415 catheter biopsies and catheter aspirations in patients with various lung diseases are reported. Among 263 patients with suspected carcinoma of the lung, in 79% neoplastic cells could be obtained histologically from catheter biopsy specimens. Among 52 patients with suspected pulmonary tuberculosis but without positive sputum, tubercle bacilli were found in 23% by aspiration biopsy. The bacteriological examination of bronchial secretion in various lung diseases showed a prevailing growth by diplococcus pneumoniae, and more sterile conditions in the peripheral bronchial airways of 56 patients. Catheter biopsy proves to be a valuable diagnostic method for the detection of peripheral bronchial carcinomas and the catheter aspiration for the bacteriological examination in specific and non-specific lung diseases.

Adult↗

The antimicrobial efficiency of Piper betle Linn leaf (stalk) against human pathogenic bacteria and phytopathogenic fungi.

The in vitro antimicrobial activity of different varieties of Piper betle Linn, leaf stalk extracts were studied against human pathogenic bacteria and phytopathogenic fungi by comparing the results with standard microbial susceptibility testing biodiscs. The ethyl acetate and ethanol extracts of all the four varieties have shown significant activity against bacteria Vibrio cholerae ogawa, Staphylococcus aureus, Diplococcus pneumoniae and Klebsiella aerogenes. The hexane and benzene extracts have shown moderate activity, while other extracts have shown poor or no activity. In the same way ethyl acetate and ethanol extracts of all the varieties have shown moderate to significant activity against most of the fungi tested, while other extracts showed poor or moderate activity.

Anti-Bacterial Agents↗

Rabbit lymphoid cells. II. Anti-allotype antisera, lipopolysaccharide and other bacterial and fungal mitogens as probes for the identification of B-cell subpopulations.

Removal of adherent cells or complement-mediated killing of rabbit thymus lymphocyte antigen (BTLA) bearing rabbit T lymphocytes did not abolish the responsiveness (increased thymidine incorporation) of lymphoid cells to antibody against immunoglobulin allotype, Nocardia water-soluble mitogen (NWSM), pneumococcal polysaccharide SIII (PPSIII), S. abortus lipopolysaccharide (LPS), lipid A conjugated to bovine serum albumin and a crude preparation containing C polysaccharide from the cell wall of Diplococcus pneumoniae. Isologous and heterologous antisera, directed against different portions of the Ig receptor, differed in their capacity to enhance thymidine incorporation. The difference in mitogenicity of these antisera was discussed in terms of the accessibility of cell-bound immunoglobulin receptor sites. Spleen cells, responsive to anti-allotype (Ab4) antiserum and B-cell mitogens, NWSM and PPSIII, were characterized by velocity sedimentation. The mean volume of NWSM- and PPSIII-responsive cells was larger than that of the cells responsive to anti-allotype antiserum. Fractionation of spleen cells on glass bead columns yielded a population of non-adherent cells which were two to six times as responsive to anti-Ab4 antiserum as the original spleen cell suspension. The responsiveness of peripheral blood lymphocytes to anti-Ab4 antiserum was significantly greater than that of spleen cells. On the other hand, spleen cells were more responsive to PPSIII than were cells from the peripheral blood, the popliteal and the mesenteric lymph nodes.

Animals↗

[Acute meningococcemia in a 4-month-old infant].

INTRODUCTION: What causes meningococcial diseases (MD) is a Gramm-negative diplococcus Neisseria meningitidis (meningococcus). Most frequently it manifests itself in the form of meningitis and meningococcemia. The mortality rate of those suffering from MD has not significantly changed for three decades and ranges from 7% to 19%, and for meningococcemia from 18% to 53%. According to the data presented by domestic authors, of the total of the diseased with bacterial meningitis 75% are children with mortality rate from 6% to 15%. Severe forms of meningococcemia sometimes have extremely rapid development and lethal outcome within a few hours. Key elements for establishing the diagnosis of meningococcemia are presence of hemorrhagic rash with high fever, loss of interest in the environment, loss of consciousness and paleness. CASE REPORT: The boy was admitted to hospital as an emergency case on 29 December 1988 at 11:45. The disease manifested abruptly the day before. He burst into tears easily, would take very little food and in the evening his temperature rose T degree 40.8 degrees C. Before midnight, in the village he was given injections of: lincomycin 300 mg and lasdol 250 i.m. During admittance the infant was agitated, kept moaning. His skin was pail gray with dot-like and spot-like hematoma which were more numerous and intense on the left ear, lower part of the body, scrotum and legs. The infant breathed heavily and fast (FR: 100/min) Cardiologist's finding showed: tahicardia over 200/min, buffled tones, gallop rhythm, pulsating neck veins and edema point to acute heart failure. Large fontanelles remained swollen even after lumbar puncture (LP) and extraction of 15 ml of clear cerebro-spinal fluid. Soon after admittance the boy stopped moaning but didn't cry when pricked and slipped deeper into coma. During the third hour of treatment generalized convulsions began which lasted approximately 10 minutes and stopped after i.v. administered diazepam. The boy remained in coma the second day in lethargy and with swollen fontanelles on the third day, so the first subdural puncture was then performed bilaterally. On that occasion only from the right side 8 ml of reddish liquid was obtained. Right after he was admitted we began permanent transfusion, which lasted 17 days. On the first day he received fresh blood transfusion. He was administered benzinpenicilline, chloramphenicol-succinate, lanatoside, human albumins, dexamethasone.... Blood oxygenation was carried out in the first few days of illness during the exhibited cardio-respiratory failure. DISCUSSION: Among risk factors, which contribute to occurrence of meningococcemia, is also artificial infant food. The reported boy was incorrectly fed with overdiluted cow milk. That and apparent hemostasis brake-down only worsened anemia and increased susceptibility to infections. Although LP was performed when the boy was admitted and the nutritious foundation was soaked with cerebro-spinal fluid, no bacteria were isolated or their presence confirmed in cerebro-spinal fluid colored after Gramm's method, because the child was given linkomycin the previous night. CONCLUSION: On the basis of clinical findings, hemorrhagic rush, convulsions, coma and acute heart failure as well as the laboratory findings it was concluded that it was a case of severe meningococcemia, meningitis and subdural effusion. Listed therapy and six subdural punctures led to full recovery of the patient. Further examination by a pediatrician and a psychologist eliminated the possibility of mental deficiency. The boy is now a good fifth grade elementary school pupil.

Acute Disease↗

Use of high-dosage trimethoprim-sulfamethoxazole in sinusitis.

The combination trimethoprim-sulfamethoxazole was given in high dosage (four tablets twice daily) for either 2 or 5 days to 20 patients with sinusitis diagnosed on clinical grounds. In 11 the infection was improved or cured. Swabs cultured from 18 patients of the series produced no growth in 8. The organisms most likely to be isolated are Hemophilus influenzae and Diplococcus pneumoniae.

Adolescent↗

[Prevalence pneumococcal meningitis in Spanish children].

OBJECTIVE: To determine the prevalence of pneumococcal meningitis in the pediatric population in Spain. Material and methods Retrospective multicenter study performed in five autonomous communities (Catalonia, Galicia, Madrid, Navarre and the Basque Country) between January 1998 and December 2000. All patients aged between 0 and 14 years old with a diagnosis of pneumococcal meningitis (Streptococcus pneumoniae isolation or presence of Gram-positive diplococcus in the cerebrospinal fluid (CSF) and CSF with more than 20 cells) in all the hospitals of the five autonomous communities were included in the study. The pediatric population in these communities aged between 0 and 14 years old was 2,327,079. RESULTS: We detected 107 cases in 64 boys and 43 girls with a mean age of 1.19 years old (p 25-0.57; p 75-3.34). The incidence was higher in the first 2 years of life [72/107 (67 %)]. The overall annual prevalence in the five autonomous communities in the first 24 months of life was 8.26 per 100,000 children aged under 2 years (95 % CI: 3.45-15.76). The highest number of cases was detected in Catalonia and Madrid but the highest annual prevalence was found in the Basque Country with 15.52 cases per 100,000 children younger than 2 years old (95 % CI: 8.38-24.74). In the first 12 months of life the prevalence was high in all the autonomous communities, especially in the Basque Country with 22.76 cases per 100,000 newborn infants aged under 12 months (95 % CI 14.58-34.5). In the first 5 years of life the annual global adjusted prevalence per 100,000 children was as follows: Catalonia 3.21 (95 % CI: 1.31-5.11), Galicia 2.65 (95 % CI: 0.35-5.64), Madrid 3.49 (95 % CI: 1.36-5.61), Navarre 3.36 (95 % CI 5,08-11,81), the Basque Country 5.63 (95 % CI: 1.08-10.18). CONCLUSION: The prevalence of pneumococcal meningitis in children from different autonomous communities is high and is greatest in the Basque Country and in children aged under 2 years. This prevalence is similar to that of other European countries and the USA.

Adolescent↗

[Clinical experience with amoxicillin in otorhinolaryngology (author's transl)].

This paper reports the clinical trial of amoxicillin. (1) A daily dose of 750 approximately 1,000 mg of amoxicillin was orally administered for 3 approximately 12 days to 20 patients, 7 of which were with acute suppurative tympanitis, 3 with furuncle of the ear, 2 with furuncle of the nose and 8 with acute amygdalitis. As a result, amoxicillin proved remarkably effective or effective in 17 patients (85.0%). (2) Amoxicillin was effective against: Staphylococcus aureus in 10 of 11 patients (90.9%) Staphylococcus epidermidis in 2 of 2 patients (100%) Streptococcus hemolyticus in 3 of 4 patients (75%) Streptococcus viridans in 1 of 1 patient (100%) Diplococcus pneumoniae in 1 of 1 patient (100%) (3) Although one patient developed drug eruption, there were no side effects that necessitated cessation of administration. From the above results, it is concluded that amoxicillin can be used in the treatment of otorhinolaryngologic infections.

Adolescent↗

Blood culture isolates from children admitted to Medical Unit III, Yangon Children's Hospital, 1998.

A one year study (August 1998-July 1999) of bacteremia in febrile children was carried out in the Medical Unit (III), Yangon Children's Hospital (YCH), Myanmar, to determine: (1) the bacteria responsible for fever of five days or more in children; (2) the antibiotic sensitivity pattern of these bacteria. Children aged one month to 12 years who had fever for five days or more and who did not receive antibiotics within the first 48 hours irrespective of the diagnosis were included in this study. A total of 120 patients fulfilled the criteria. Bacteria could be isolated from 65 cases (54.2%). The commonest organism isolated was Salmonella typhi (43.1%). Others included Escherichia coli (12.3%), Staphylococcus aureus (7.7%), Pseudomonas aeruginosa (7.7%); Streptococcus, Shigella, Diplococcus, Klebsiella and Acinetobacter were also isolated. The Salmonella typhi were resistant to conventional antibiotics (ampicillin, amoxicillin, chloramphenicol, and co-trimoxazole); however, they were sensitive to amikacin, netilmicin, nalidixic acid, and cephalothin. A cluster of enteric fever cases from Mingalartaungnyunt township was noticed and was reported to the Directorate of Health. Changes in the incidence and etiology of bacteremia in hospitals are well documented. Sentinel surveys of bacteremia in major hospitals should be carried out in order to detect the changing patterns of bacteremia and antibiotic sensitivity; such surveys will be of great help in establishing local antibiotic policies.

Age Distribution↗

[Invasive infection with Moraxella catarrhalis in two children with lymphatic leukemia and granulocytopenia].

In two young children with leukaemia, a girl and a boy aged 5 and 4 years, respectively, an invasive infection due to Moraxella catarrhalis was diagnosed at the time of granulocytopenia. They were treated with antibiotics. The first child developed pneumonia and recovered, the other developed severe septic shock and died. M. catarrhalis is a Gram-negative diplococcus, frequently colonising the upper respiratory tract in young children. In childhood this pathogen mainly causes infections such as otitis media and sinusitis, while in adults it primarily causes laryngitis, bronchitis and pneumonia. Immunocompromised patients or patients with chronic cardiopulmonary disease have an increased risk of severe infections.

Agranulocytosis↗

[Evaluation of treatment outcome for bacterial meningitis and encephalitis at the provincial hospital of infectious diseases in Wrocław during 1985-1989].

Data about 848 patients treated in the years 1985-1989 in the Province Hospital of Infectious Diseases were analyzed. Among them were 98 patients with bacterial meningitis and encephalitis. The most frequent etiological agents were Neisseria meningitidis and Diplococcus pneumoniae. In none case Haemophilus influenzae was isolated. The average time of hospitalization was limited to 45 days. Treatment introduced at once was based on the results of bacteriological tests. Crystalline penicillin, cephalosporins of the II and the III generation and in some cases metronidazole were antibiotics of choice. Serious complications were observed in 25% of patients. 5% of patients died.

Adolescent↗

[Clinical and experimental study of xiao er ke cuan ling oral liquid in the treatment of infantile bronchopneumonia].

UNLABELLED: Xiao Er Ke Chuan Ling Oral Liquid (KCL) is a Chinese herbal preparation consisted of 10 herbs such as Prunus armeniacae, Scutelaria baicalensis, Lonicera japonica etc. 30 children suffering from bronchopneumonia and/or acute bronchitis were treated with KCL (treated group) and another 30 cases were treated with penicillin and aminophylline (control group). RESULTS: cure rate and effective rate in treated group was 26.6%, and 93.3% respectively. While in control group was 30% and 96.6% respectively. No significant differences were seen between them(P > 0.05). The pharmacodynamic experiment showed KCL had potent pharmacological action. The experiment on tracheal fragment of Guinea pig in vitro showed it caused moderately strong smooth muscle relaxation, through inhibition the effect of histamine and acetylcholine. Asthma induction experiment of Guinea pig in vivo showed KCL could significantly prolong the latent period of asthma and alleviate asthmatic symptom. Ammonium water cough induction experiment in mice showed it may apparently prolong cough latent period and reduce times of cough relapse and alleviate cough symptom. KCL had potent antipyretic effect on fever model induced by triple vaccine in rabbits. Bacteriostatic and antiviral experiment in vitro showed the drug had quite strong inhibitory effects for Streptococcus hemolyticus, Staphylococcus aureus, Flexners Dysentery bacillus, Diplococcus pneumoniae and Pseudomonas aeruginosa, and it could potently inhibit the respiratory syncytial virus. KCL is an effective drug in treating bronchopneumonia and acute bronchitis.

Animals↗

Branhamella catarrhalis respiratory infections.

Branhamella catarrhalis is an aerobic Gram-negative diplococcus. It has been traditionally regarded as an oropharyngeal commensal and until recently was only identified as a pathogen in cases of bronchopulmonary infections. The aim of this study was to analyse the characteristics of the respiratory infections caused by B. catarrhalis and to know the antibiotic susceptibility of this microorganism. We retrospectively studied 32 lower respiratory tract infections, caused by B. catarrhalis (20 cases of bronchial infection and 12 cases of pneumonia), diagnosed between 1988-1989 in our hospital. All patients had an underlying disease; chronic obstructive pulmonary disease (COPD) and chronic heart disease being the most frequent. The aetiological diagnostic procedures were: sputum culture in 28 cases (15 in pure culture and 13 mixed), protected specimen brush (PSB) in three cases and transthoracic needle aspiration (TNA) in one case. Twenty B. catarrhalis isolates were penicillin and ampicillin-resistant, 11 in the pneumonia group and 9 in the bronchial infection group. All isolates were sensitive to amoxycillin-clavulanic acid and second generation cephalosporin. In our group four patients died. We conclude that B. catarrhalis is a not infrequent cause of respiratory infection, particularly in COPD patients, and that the high incidence of antibiotic resistance to penicillin and ampicillin should be taken into account before considering an empirical antibiotic treatment.

Aged↗

A profile of pyogenic meningitis in children.

Clinical profile of pyogenic meningitis was studied in 256 cases over a period of 8 years. The male to female ratio was 1.46: 1 and 83.6% of the patients were less than 3 years of age. Fever, altered sensorium, refusal to feed, convulsions and vomiting were the common presenting symptoms. Six (2.3%) of them had subnormal temperature and the sensorium was normal in 12.5% of cases. Cerebrospinal fluid was clear in 9.4%, cell count was less than 100/cmm in 8.2%, sugar was more than 40 mg% in 24.2% and protein was less than 50 mg% in 12.5% of cases. Diplococcus pneumoniae was the commonest causative agent. The overall mortality was 30.5%. It is concluded that young children suffering from this disease may not have the typical features and one should have the highest suspicion to make an early diagnosis so that the morbidity and mortality from this condition can be reduced.

Child, Preschool↗

[Sudden death in Sanarelli-Shwartzman phenomenon with an unusual pathogen].

The classical generalized Sanarelli-Shwartzman phenomenon (SSP) in animal experiments is induced by two conservative endotoxin injections. The experimental animals mostly die within 24 hours in irreversible shock. They show numerous microthrombi with as high fibrin content in the peripheral vessels of many organs (especially the kidneys) in the context of a consumption coagulopathy. In a 49-year-old man who died within one day of a condition associated with high fever, the clinical picture could be defined on the basis of the clinical and morphological findings as a human equivalent of SSP. The detection of a gram-positive bacterium (Diplococcus pneumoniae), which has been described as the causative organism of SSP only in a few exceptional cases, was noteworthy. The special features of the pathophysiology are described.

Death, Sudden↗