ABSTRACT
Micronema, normally free-living in soil and humus, rarely invades and reproduces in the central nervous system, kidneys, lungs, maxillae and nasal cavity of equines. Two Micronema infections causing fatal meningoencephalomyelitis in man have been reported from Canada and Texas. Here we report a third infection in a 54-year-old black man, resident of Washington, D.C., who probably acquired the infection from decubitus ulcers. The worms in this patient were in the liver, heart and brain. The Micronema species was not identified.
Subject(s)
Nematode Infections/parasitology , Brain/parasitology , Heart/parasitology , Humans , Liver/parasitology , Male , Meningoencephalitis/etiology , Middle Aged , Nematode Infections/pathologyABSTRACT
An adult drug abuser with endocarditis due to a group II Staphylococcus aureus developed the staphylococcal scalded skin syndrome (SSSS). Studies of the patient's immune function found cell-mediated immunity (CMI) to be essentially normal; thus, previous suggestions that deficient CMI is required in adults who develop SSSS seem unfounded. Pathogenesis, diagnosis, and therapy of SSSS and its differentiation from drug-induced hypersensitivity reaction are discussed in detail.
Subject(s)
Staphylococcal Infections/diagnosis , Stevens-Johnson Syndrome/diagnosis , Adult , Aged , Diagnosis, Differential , Drug Hypersensitivity/diagnosis , Female , Humans , Immunity, Cellular , Male , Middle Aged , Staphylococcal Infections/immunology , Staphylococcal Infections/pathology , Stevens-Johnson Syndrome/immunology , Stevens-Johnson Syndrome/pathology , Substance-Related Disorders/complications , SyndromeABSTRACT
Relative toxicities of methicillin and nafcillin were compared in 70 patients with serious infections caused by Staphylococcus aureus. Of the 29 patients treated with nafcillin, four had fever, rash, and leukopenia and 1 had absolute neutropenia. Of the 41 patients treated with methicillin, 16 experienced 27 reactions. In addition to fever and skin rash, neutropenia and urinary tract abnormalities were common. Methicillin and nafcillin are equally effective in treating S aureus infections, but methicillin was significantly and more frequently associated with adverse drug reaction that was nafcillin.
Subject(s)
Methicillin/adverse effects , Nafcillin/adverse effects , Staphylococcal Infections/drug therapy , Adult , Dose-Response Relationship, Drug , Female , Humans , Male , Methicillin/therapeutic use , Middle Aged , Nafcillin/therapeutic use , Time FactorsABSTRACT
Twenty-six strains of Staphylococcus aureus obtained from patients with endocarditis were studied for the production of alpha- and/or beta-ribitol teichoic acid (TA), using highly specific anti-TA antibodies prepared in rabbits. A counterimmunoelectrophoretic assay was used. Beta-TA was the predominant residue produced by all strains; alpha-TA was found in all strains, but in smaller amounts and with much strain-to-strain variations. Antibodies in patients' sera were found against beta-TA in higher titers and for longer periods than were anti-alpha-TA antibodies. Antibodies against one or both TA residues were present in all but one of 26 patients.
Subject(s)
Endocarditis, Bacterial/microbiology , Staphylococcal Infections/microbiology , Staphylococcus aureus/metabolism , Teichoic Acids/biosynthesis , Antibodies, Bacterial/analysis , Cell Wall/metabolism , Counterimmunoelectrophoresis , Endocarditis, Bacterial/immunology , Humans , Staphylococcal Infections/immunology , Staphylococcus aureus/immunology , Teichoic Acids/immunologyABSTRACT
Forty patients had staphylococcal endocarditis and a history of parenteral drug abuse. Clinical and microbiologic features of their cases were evaluated. None of our patients were known to have had preexisting valvular disease. The tricuspid valve lesions and their pulmonary complications were the predominant findings. Systemic complications in the form of meningitis, glomerulonephritis, empyema, arthritis, and nosocomial Gram-negative septicemia occurred in 33% of our patients. Of interest was the high incidence of reactions to therapy especially with methicillin sodium, which occurred in 30% of patients. Correlation of phage type and group with the antibiotic sensitivities of individual staphylococci showed that group 3 and phage types 6, 42E, 54, and 75 were much more resistant to penicillin than other groups and types. The clinical outcome did not relate to phage type and group or to antibiotic sensitivity of the organism.
