[The clinical picture of legionnaires' disease]. / O klinike bolezni legionerov.

The results of the clinico-laboratory study of 12 cases of acute pneumonia of Legionella etiology are presented. The laboratory diagnosis of Legionella infection was carried out by the study of paired sera in the passive hemagglutination test with the use of Legionella pneumophila (serotype 1) erythrocyte diagnosticum. The clinical picture of pneumonia was characterized by a severe and moderate course of the disease. Characteristic symptoms indicating the presence of indurations and infiltrations in the lung tissue were registered. Roentgenological examination revealed that the foci of pulmonary tissue infiltration appeared in the segments of the lower lobes of both lungs. In 6 patients neutrophil leukopenia, in 4 patients relative lymphocytopenia, in 5 patients monocytopenia, in 11 patients the increase of the erythrocyte sedimentation rate and in 4 patients normochromic anemia were registered. More seldom changes in the levels of residual nitrogen, urea, fibrinogen and transaminases were observed. In most cases the resolution of pneumonia was observed on weeks 2-3 of treatment. In this treatment erythromycin, rifampicin and oleandomycin, used in combination, used in combination with detoxication and infusion therapy, vitamins, vascular and other symptomatic remedies, proved to be most effective. The cases of Legionella infection under study were sporadic and epidemiologically unrelated. The severity of the course of the disease depended mainly on the general state of the patient prior to infection, age and concomitant diseases.

[Microbiologic and histomorphologic characteristics of experimental Mycoplasma-pneumococcus infection]. / Mikrobiologicheskaia i gistomorfologicheskaia kharakteristika éksperimental'noi mikoplazma-pnevmokokkovoi infektsii.

The specific features of the development of Mycoplasma pneumoniae and Streptococcus pneumoniae infections in mice have been studied in cases of mixed and monoinfections. As shown in this study, mixed infection is characterized by the mutual inhibition of the proliferation of both pneumococci and mycoplasmae in the lungs, the liver and the spleen of the animals, while the associative interaction of these infective agents in isolated mouse lung tissue is characterized by the inhibition of pneumococcal proliferation only. In mixed infection the early activation of cells of the immunocompetent system is observed, which is accompanied by the development of mainly cell-mediated immune processes manifested as delayed hypersensitivity with the late formation of fibrillogenesis. During the development of mixed mycoplasmal-pneumococcal infection the histopathology of mycoplasmal infection prevails, which is probably due to the early formation of delayed hypersensitivity to M. pneumoniae in the animals.

[Accelerated laboratory diagnosis of bacterial pneumonia]. / Uskorennaia laboratornaia diagnostika bakterial'nykh pnevmonii.

The effectiveness of countercurrent immunoelectrophoresis (CIE) used for the accelerated differential diagnosis of pneumococcal, staphylococcal, mycoplasmal and Legionella infections in cases of pneumonia has been shown. The presence of correlation between the results obtained in the bacterial study of sputa and bronchial washings and in CIE has been revealed, which gives grounds for recommending CIE for the accelerated diagnosis of pneumococcal pneumonia on the basis of the analysis of sputa, bronchial washings and blood sera obtained from patients. In Legionella infection the passive hemagglutination test with antigenic diagnostica has proved to be more effective for accelerated diagnosis than CIE.

[Activity of the glycoprotein antigenic fractions of Mycoplasma pneumoniae in immunological reactions]. / Izuchenie aktivnosti glikoproteidnykh antigennykh fraktsii Mycoplasma pneumoniae v immunologicheskikh reaktsiiakh.

Glycoprotein fractions exhibiting pronounced antigenic properties in immunological in vitro reactions have been isolated from sonicated M. pneumoniae cells by extraction with glacial acetic acid and ethanol. Glycoprotein fraction 3 of M. pneumoniae antigen shows the highest blood-sensitive and precipitating activity and may be recommended as a diagnosticum for serological tests.

[Etiological structure of pneumonias in children and adults]. / Etiologicheskaia struktura pnevmonii u detei i vzroslykh.

The bacteriological study of sputa, nasopharyngeal smears and bronchial washings taken from pneumonia patients has shown that the leading etiological agent was Streptococcus pneumoniae isolated in the diagnostic titre (10(7) bacteria per ml) in 78.1% of the cases. Staphylococcus aureus, Haemophilus influenzae, enterobacteria and yeast-like fungi have been found to play an insignificant role in the etiology of acute pneumonia (2.5 +/- +/- 0.9%). The results of the serological diagnosis by means of the complement fixation test have revealed that, alongside S. pneumoniae, the following infective agents are of etiological importance in cases of acute pneumonia: respiratory viruses (more than 50%), Mycoplasma pneumonia (10%), Chlamydia psittaci (6.4%) and Legionella pneumophila (3.8%). The study has first revealed that, under the conditions of Alma-Ata, serotypes 19, 23, 8 and 4 prevail among circulating pneumococci. This study has also shown that the use of M. pneumoniae antibody erythrocyte diagnosticum enhances the detection rate of mycoplasma infections in pneumonia patients.

[Circulating immune complexes in the diagnosis of Mycoplasma pneumoniae infection]. / Issledovanie tsirkuliruiushchikh immunnykh kompleksov pri diagnostike infektsii Mycoplasma pneumoniae.

The possibility of detecting M. pneumoniae antigen and antibodies to it, incorporated into immune complexes, in the sera of patients with acute pneumonia by means of erythrocyte diagnosticums was studied, and the immunological characterization of these complexes was made. In patients with mycoplasmal pneumonia M. pneumoniae antigen and specific antibodies, both free and incorporated into immune complexes, were found to circulate in the blood. In children, antigenemia was detected twice as frequently as in adults. Dissociated M. pneumoniae antigens had different molecular weight, their location on the gel chromatogram of the serum being in fractions 7S and 19S. The dissociation of immune complexes permits the detection of M. pneumoniae antigen and antibodies to it in a bound state by means of the passive hemagglutination test, thus increasing the frequency of positive results in the diagnosis of M. pneumoniae infection.

[Serum immunoglobulin in Mycoplasma pneumoniae infection]. / Izuchenie syvorotochnykh immunoglobulinov pri infektsii Mycoplasma pneumoniae.

The dynamics and nature of serum antibodies in experimental and natural M. pneumoniae infection have been studied. The synthesis of specific IgM, IgA and IgG has been found to occur in the course of infection. During repeated M. pneumoniae infection in guinea pigs, as well as in cases of acute and chronic mycoplasmal pneumonia in humans (at the acute period of the disease), the prevalence of the synthesis of specific IgM is observed. At the acute period of the disease a rise in the quantitative levels of IgM and IgG occurs in patients. High titers of specific IgM (1:32 and greater) determined at the acute period of the disease can serve as the diagnostic criterion of the mycoplasmal etiology of pneumonia.

[Submicroscopic organization of M. pneumoniae studied by means of negative contrasting, ultrathin sections and scanning electron microscopy]. / Izuchenie submikroskopicheskoi organizatsii M. pneumoniae metodami negativnogo kontrastirovaniia, ul'tratonkikh srezov i skaniruiushchei élektronnoi mikroskopii.

The ultrastructure of M. pneumoniae, grown on a solid culture medium and in a liquid one, was studied by a number of methods. Two types of cells were shown to prevail in the culture: spherical cells (0.5--1 micrometer) forming chains of different configurations and filamentous cells (5 micrometer long and greater) with spherical enlargements along their whole length. The absence of microcapsules made M. pneumoniae different from other species of mycoplasms, and the organism proliferated by division into 2 daughter cells, equal or unequal in size, by the segmentation of the cytoplasm and the formation of elementary bodies inside the cell and on its surface.

[Immunological diagnosis of Mycoplasma pneumonias]. / Immunologicheskaia diagnostika mikoplazmennykh pnevmonii.

A complex of immunological cell tests with M. pneumoniae antigen (the lymphocyte blast-cell transformation test, the allergic neutrophil alteration test) was carried out in order to establish the correlation between the results of positive seroconversion and the sepcific immunological reactivity of lymphoid cells in pneumonia patients. Mycoplasmic cutireactive allergen, when used for the accelerated diagnosis of mycoplasmic pneumonia in humans, was shown to be specific and safe. Cuti-allergic tests with mycoplasmic allergen allowed to diagnose mycoplasmic pneumonia at early stages (beginning from days 5--7), which ensures the possibility of indicating etiotropic treatment to patients in due time.

[Immunologic and morphologic characteristics of experimental infection with Mycoplasma pneumoniae]. / Immunologicheskaia i morfologicheskaia kharakteristika éksperimental'noi infektsii Mycoplasma pneumoniae.

Pathomorphology of experimental M. pneumoniae infection in 3-week-old guinea pigs was characterized by an early cytopathic action of the causative agent on the bronchial and the alveolar epithelium, and also by progressive infiltrative-proliferative changes in the bronchovascular and interstitial tissue of the lungs against the background of morphological reconstruction in the immunogenesis organs. Immunological and histomorphological study of reinfected guinea pigs pointed to the presence of delayed hypersensitivity features in the response cellular-tissue reactions.