ABSTRACT
Fungemia is a rare complication of Sporothrix schenckii infection and has always been associated with disseminated sporotrichosis. We describe an immunocompetent patient with localized lymphocutaneous sporotrichosis from whose blood the fungus was isolated. A lysis-centrifugation blood culture system may have improved our ability to detect low-level S. schenckii fungemia.
Subject(s)
Fungemia/diagnosis , Sporotrichosis/diagnosis , Adult , Dermatomycoses/diagnosis , Dermatomycoses/drug therapy , Fungemia/drug therapy , Humans , Lymphatic Diseases/diagnosis , Lymphatic Diseases/drug therapy , Male , Mycology/methods , Potassium Iodide/therapeutic use , Sporothrix/isolation & purification , Sporotrichosis/drug therapyABSTRACT
In this retrospective report, four male intravenous cocaine users are described with thrombocytopenia temporally related to the use of the drug. Mucosal bleeding and megakaryocytic hyperplasia occurred in all patients. The cocaine-thrombocytopenia relationship was especially apparent in one individual who developed thrombocytopenia on two separate occasions after intravenous cocaine use. Three patients were treated successfully with high doses of intravenous gamma globulin and steroids, while one patient required splenectomy. Along with the widespread use of cocaine in our society has come the recognition of a number of adverse effects of the drug. Thrombocytopenia may be added to a list that includes myocardial infarction and central nervous system complications.
Subject(s)
Cocaine , Substance-Related Disorders/complications , Thrombocytopenia/chemically induced , Adult , Gingival Hemorrhage/chemically induced , Humans , Male , Thrombocytopenia/therapySubject(s)
Coronary Artery Bypass , Ischemic Attack, Transient/etiology , Myocardial Infarction/surgery , Postoperative Complications/etiology , Smoking/adverse effects , Female , Heart Septal Defects, Atrial/complications , Heart Septal Defects, Atrial/diagnosis , Heart Valve Diseases/complications , Heart Valve Diseases/diagnosis , Humans , Intracranial Embolism and Thrombosis/etiology , Middle Aged , Postoperative Complications/diagnosisABSTRACT
Cardiac tumors are great imitators in cardiovascular disease. Common clinical presentations include arrhythmias, congestive heart failure, pericardial effusion, pulmonary or systemic embolic disease, valvular dysfunction and constitutional symptoms, such as fever, malaise and weight loss. M-mode and two-dimensional echocardiography have simplified diagnosis, but the physician must have a high index of suspicion.
Subject(s)
Heart Neoplasms , Female , Heart Neoplasms/diagnosis , Heart Neoplasms/pathology , Heart Septum , Heart Ventricles , Humans , Middle Aged , Neurilemmoma/diagnosis , Neurilemmoma/pathologyABSTRACT
To examine the use of the laboratory in the diagnosis of Rocky Mountain spotted fever and to determine the specificity and sensitivity of the Weil-Felix test, hemagglutination, complement fixation, and skin biopsy immunofluorescence in the hospital, we reviewed our experience during th year 1978. Sera were submitted from 142 patients and skin biopsies from 16 patients suspected of having RMSF. Sensitivity rates of methods in the acute phase were skin biopsy, 70%; Proteus OX-19 agglutination, 65%; hemagglutination, 19%; Proteus OX-2 agglutination, 18%; and CF, 0%. Overall specificity rates were skin biopsy, 100%; hemagglutination, 99%; and agglutination of Proteus OX-2 96% and OX-19 78%. Major problems were failure to submit convalescent serum and nonspecificity of Weil-Felix titer of 1:160. Two cases illustrate the importance of skin biopsy and serologic results. Immunofluorescent examination of skin biopsies for Rickettsia rickettsii is the best procedure currently available for early diagnosis.
Subject(s)
Rocky Mountain Spotted Fever/diagnosis , Serologic Tests , Adolescent , Adult , Agglutination Tests , Biopsy , Child, Preschool , Complement Fixation Tests , False Negative Reactions , Female , Fluorescent Antibody Technique , Hemagglutination Tests , Humans , Rickettsia rickettsii/immunology , Skin/pathologyABSTRACT
1. The effect of carbon source variation in bacterial growth media on their growth rate, inducible enzyme and cyclic AMP synthesis was examined: an inverse relationship between the culture's growth rate and its differential rate of inducible enzyme (tryptophanase and beta-galactosidase), and cyclic AMP synthesis was found. 2. The effect of the culture's growth phase on its sensitivity or resistance to glucose catabolite repression was determined in the wild type and a catabolite insensitive mutant (ABDROI): the wild type's sensitivity to glucose repression was not affected, whereas the insensitivity of the mutant was found to be limited to its early logarithmic phase of growth. At late log, or stationary phase, the mutant was found to be sensitive to glucose repression. 3. Examination of the kinetics of glucose uptake by the mutant, using alpha-[1 4-C] methyl-glucoside showed evidence for two transport systems each with a different affinity to glucose. A low affinity transport system (apparent Km of 3.4-10-minus 5 M) which appears mostly at the early logarithmic phase of growth. A high affinity transport system (apparent Km of 1.2-10-minus 5 M) which appears mostly at the late log and stationary phases of growth. 4. The effect of the culture density variation on its sensitivity to glucose repression showed that sensitivity to glucose catabolic repression is primarily a reflection of the formation of an allosteric effector molecule between glucose and its specific transport molecule which in turn regulates the activity of the adenylate cyclase.
