Clinical and laboratory study of a newly observed viral infection in the Philippines: A preliminary report

@#Eighteen (18) cases of Chikungunya (or a very close related virus) infection, a newly observed clinical entity in the Philippines, are presented. Diagnosis was established by serological studies consisting of hemagglutination- inhibition (HI) and complement fixation (CF) tests. The clinical picture is characterized by a symptom-complex consisting essentially of fever, severe, incapacitating, recurrent joint pains and a rash. There is no involvement of the respiratory system and no bleeding tendencies were observed. The erythrocyte sedimentation rate was elevated, more so towards the later part of the illness. The platelet counts were normal. No residual joint deformity morbidity or mortality was encountered.

Antibiotic screening of urinary tract infections

In this study we picked at random 51 cases suffering principally or secondarily from infection of the urinary tract of at least two months duration. Eighty percent of them had received some form of therapy for the urinary tract infection at one time or the other. The number of cases is fair enough to warrant some observations. It is interesting to note that the organisms encountered are the usual pathogens of the urinary tract. Their distribution however, did not exactly follow the pattern observed by investigators abroad. This is the first time this investigation was carried out here so that we have no way of comparing these results with previous observations.In vitro antibiotic screening of these pathogens of the urinary tract did not follow any stereotyped pattern in their susceptibility to the various therapeutic agent tested which included the most commonly accepted and employed medications for urinary tract infection. The results of these in vitro studies point strongly to the emergence of new strains of the usual bacterial pathogens in the urinary tract such that the usual antibiotics and sulfonamide agents employed even in supposedly adequate doses can not be implicitly relied upon. It is observed that the newer antibiotics, like Tetracycline and Furadantin, and the less commonly employed broad spectrum antibiotics, like Chloromycetin, seem to be far more effective than the antibiotics which have long been in use like Penicillin and Streptomycin. The same can be said of the various sulfonamide preparations. We feel that close clinical follow-up of patients under these various therapeutic agents must be made before we can utilize these in vitro observations more widely. It is possible that in vitro behavior of these agents may not necessarily reflect their behavior in the body.In spite of this, however, we feel that more careful attention as to the choice of the therapeutic agent and their dosages should be made; and a reexamination of the sensitivity to the various antibiotics and sulfonamide preparations of various organisms commonly pathogenic in the urinary tract is in order.We wish to emphasize the need for antibiotic screening in the proper management of these cases, since this procedure will enable us to choose more wisely the necessary agent to employ. Lastly, we call attention to the emergence of antibiotic resistant gram negative bacilli in the urinary tract. (Comment)