ABSTRACT
The isolation of a Leptotrichia buccalis-like bacterium from the blood of a patient with endocarditis associated with a prosthetic aortic valve is reported. The organism was isolated from different blood cultures. It was similar but not completely identical to Leptotrichia buccalis. The microbiological identification was confirmed independently by three laboratories, including two reference institutions. The case and the characteristics of the microorganism are reported.
Subject(s)
Bacteroidaceae Infections/microbiology , Bacteroidaceae/isolation & purification , Endocarditis, Bacterial/microbiology , Heart Valve Prosthesis/adverse effects , Prosthesis-Related Infections/microbiology , Aged , Aortic Valve , Bacteremia/microbiology , Bacteroidaceae/drug effects , Female , HumansABSTRACT
Ten patients (two with normal, eight with impaired renal function) on their usual diet were treated with cefodizime (HR 221) for seven days. The dosage was 4 g/day, adapted to renal function as appropriate. Platelet function, plasma coagulation and vitamin K metabolism were investigated before and on day 7 of therapy. Platelet function and plasma coagulation remained unchanged, regardless of the size of the serum antibiotic trough levels, in both normal and impaired renal function. Vitamin K1 metabolism remained unaffected, since no increase in vitamin K1 2,3 epoxide in the circulation was observed during the therapy. Cefodizime (HR 221), a parenteral aminothiazole cephalosporin, does not affect hemostasis.
Subject(s)
Bacterial Infections/drug therapy , Cefotaxime/analogs & derivatives , Hemostasis/drug effects , Kidney Diseases/blood , Adult , Aged , Bleeding Time , Blood Coagulation/drug effects , Cefotaxime/pharmacology , Cefotaxime/therapeutic use , Chemical Phenomena , Chemistry , Female , Humans , Male , Middle Aged , Platelet Aggregation/drug effects , Platelet Count/drug effects , Vitamin K/metabolismABSTRACT
HDCS vaccine has been in official use in the F.R.G. for pre- and post-exposure vaccination of man, after having shown its superiority to the Hempt and duck embryo vaccine--as far as compatibility, antigenicity and protective capacity is concerned--since February 1977. HDCS vaccines of both manufacturers, Mérieux/Lyon and Behring/Marburg, did not produce any severe side effects in about 5000 vaccinees in West Germany when conditions of vaccine production were properly observed. The lack of neuropathogenicity of vaccines is stressed. Contamination by bacterial lipopolysaccharides, however, resulted in endotoxin shock in 32 out of 35 vaccinees with one vaccine lot. Testing for pyrogenicity of every vaccine lot should be carefully observed in future. When comparing antigenicity of different vaccine lots of both manufacturers, individual titers of complement-fixing and neutralizing antibodies were correlated with the antigenic values of the vaccines. Duration of immunity after one course of vaccination is approximately 2 years and can be extended by only 1 booster injection for an additional 3 years. Protective capacity of HDCS vaccine (using Essen scheme, 6 applications) seems to be very pronounced. So far, between 1973-1977, 68 individuals under severe risk were vaccinated post-exposure in West Germany and 45 individuals in Iran from 1975-76. No cases of rabies occurred in the vaccinees. HDCS vaccine in man induces a very early antibody response with appearance of IgM rabies specific antibodies on day 3, and IgG rabies specific antibodies on day 7 and an early IgM/IgG antibody conversion at that time.
Subject(s)
Rabies Vaccines/therapeutic use , Rabies/prevention & control , Antibody Formation , Culture Techniques , Follow-Up Studies , Humans , Immunization Schedule , Rabies/therapy , Rabies Vaccines/administration & dosage , Rabies Vaccines/immunology , Time FactorsABSTRACT
Since 1973 a total of 365 individuals between 4 and 74 years of age were vaccinated with the HDCS-rabies-vaccine produced by Mérieux/Lyon. Only minor local side reactions were observed in some patients. No adverse systemic reactions due to the vaccine occurred in any of the vaccinees. Seroconversion was observed in 100% of the vaccinated subjects. Neutralizing antibodies could be demonstrated in all 365 vaccinees in titers ranging from 1:10 to 1:2238 (0.35 to 72.5 I.U) employing 200 LD 50 of rabies virus in the mouse neutralization test. The persistence of antibodies has been followed up for 2 years. The efficacy of the HDCS-vaccine in post-exposure treatment proved to be reliable. Sixteen patients suffered bites, scratches, cuts und abrasions by proven rabid animals. Another 8 patients had come into close contact with saliva of confirmed rabid animals. None of these patients developed clinical rabies during an observation period now covering 1-3 years. The HDCS-rabies-vaccine, thus, proved to be well tolerated, innocuous and highly protective. Under those aspects, this vaccine must be considered superior to the duck-embryo-vaccine currently licensed in Germany and should be preferred for propylactic and post-exposure vaccination as well. The postexposure schedule elaborated in our laboratory has been adopted and recommended by a WHO expert group on rabies. The data presented here constitute the first report on post-exposure application of HDCS-rabies-vaccine in man.
