Sphingobacterium multivorum septicemia: a case report.

A 47-year-old man presented with a history of fever, chills and weight loss for 3 months. He had been treated for diabetes mellitus during the past 3 years. He developed high fever with abnormal liver function tests. Both Widal and Weil-Felix reactions were negative with normal roentgenogram of the chest. His anti-HIV tests were positive. The cultures from the blood and sputum yielded pure Sphingobacterium multivorum sensitive to sulfamethoxazole-trimethoprim, chloramphenicol, tetracycline, cefotaxime, ceftazidine and ceftriaxone. On the next day, the patient developed signs and symptoms of meningitis with the CSF containing chronic and acute inflammatory cells but revealed no growth on culture. The patient was treated with a combination of ceftriazone and trimethoprim-sulfamethoxazole but he died on the 6th day after admission. This patient was the fifth reported case infected with S.multivorum. It illustrates that this potentially pathogenic organism can cause septicemia in an immunodeficient patient.

Incidence of bacteremia in patients with opisthorchiasis during recurrent cholangitis.

A total of 257 haemocultures were performed in 50 patients with opisthorchiasis when they presented signs and symptoms of biliary tract infection. 19 patients showed positive haemoculture. There are no significant relationship between the age of the patient and the incidence of positive haemoculture. Septic shock occurred in 5 patients, one patient died. Out of 221 aerobic cultures, 14% were positive and of the 36 anaerobic cultures 11% were positive. The most common organism was Staphylococcus followed by Klebsiella and Bacillus spp. Anaerobic bacterias were Streptococcus spp. Clostridia spp. was not found in this study. Most organisms were sensitive to cefotaxime, cephalothin, kanamycin and chloramphenicol, and the least sensitive to ampicillin.

Serological studies on possible causes of intra-uterine infections in Thai infants.

Serological tests for toxoplasmosis, rubella, cytomegalovirus (CMV), Herpesvirus hominis (HVH) infections syphilis (TORCHES) were carried out in 49 infants with showed signs of possible intrauterine infections and in 212 mothers and their newborn infants. The tests employed were ELISA for rubella and CMV infections, indirect haemagglutination for HVH infection and toxoplasmosis and RPR Macro-vue card test for syphilis. The immunoglobulin class of the antibody was also determined, and only infants with IgM antibody was considered indicative of intrauterine infection. It was found that 36.7% and 10.2% of infants with signs of intrauterine infections were positive for rubella and CMV antibodies and 19% had mixed infections of rubella, CMV, toxoplasma, syphilis and HVH. In contrast, only 6.1% of normal newborn infants had rubella antibody, 6% had HVH antibody and less than 1% had toxoplasma antibody, and none of them had CMV and treponema antibodies. Higher rate of seropositivities were found in their mothers, the percentage seropositivities for rubella, HVH, CMV infections, syphilis and toxoplasmosis were 19%, 12%, 2% and 1% respectively.

Susceptibility of Salmonella typhi to chloramphenicol, ampicillin and cotrimoxazole.

Salmonella typhi isolated from the patients admitted to the Hospital for Tropical Diseases, Bangkok, were tested by the tube dilution method and the disc diffusion method against chloramphenicol, ampicillin and cotrimoxazole. Forty-five percent of the S.typhi were resistant to chloramphenicol (MIC greater than or equal to 50 microgram/ml) while 5% were resistant to ampicillin (MIC greater than or equal to 12.5 microgram/ml). Only 1% of the S. typhi was found to be resistant to cotrimoxazole (MIC greater than or equal to 168 microgram of trimethoprim + sulfamethoxazole per ml.) Based on these results, the drug of choice for typhoid fever would be cotrimoxazole, especially when drug sensitivity test is not immediately available.