Septicemia from biliary tract infection.

One hundred four strains of microorganisms were isolated from the blood in 76 episodes of septicemia originating from biliary tract infection. The 70 patients involved included 40 with acute cholecystitis without previous surgery, 17 with cholangitis following previous surgery, and 13 patients with malignant disease, with or without previous surgery. The most common organisms were Escherichia coli, Klebsiella, Streptococcus, and Proteus. Various streptococci, most of them from group D, were involved in 21% of the episodes. Twenty-five patients underwent surgery following the bacteremia. In ten of 12 operations performed shortly after the septicemia, bile culture yielded the same organism(s) as in the blood. The types of organisms in blood, and especially the important role of streptococci, must be taken into consideration when choosing antibiotics for therapy for and prevention of biliary septicemia.

Dorfman-Chanarin syndrome. A case report and a review.

Dorfman-Chanarin syndrome in two sisters of Jewish Iraqi origin is reported. This heritable disorder of the metabolism of neutral lipids was manifested by congenital ichthyosis, vacuoles in the leukocytes, and variable involvement of liver, muscle, central nervous system, and the auditory system. In two asymptomatic members of the family leukocyte vacuoles were found as the only sign of the syndrome. Clinical, pathologic, ultrastructural, and biochemical findings are described. Previous reported cases are reviewed.