ABSTRACT
We report two cases of pneumonia caused by Legionella cincinnatiensis, a species previously identified as a pathogen in only one other instance. Both infections occurred in renal transplant recipients who were receiving only moderate doses of immunosuppressive drugs several years after transplantation; both patients had no recent episodes of rejection. Their clinical courses varied from mild symptoms to multisystem organ failure and death. Species identification by direct fluorescent antibody testing was misleading; initial results revealed infection due to Legionella longbeachae for one patient and infection due to Legionella dumoffii for the other patient. Slide agglutination testing eventually identified both isolates as L. cincinnatiensis. Infection with Legionella species, including L. cincinnatiensis, should be considered not only in the first months after transplantation but also later in the posttransplantation period as either a nosocomial or community-acquired infection.
Subject(s)
Kidney Transplantation/adverse effects , Legionellosis/diagnosis , Legionellosis/etiology , Opportunistic Infections/diagnosis , Opportunistic Infections/etiology , Adult , Agglutination Tests , Bronchoalveolar Lavage Fluid/microbiology , Community-Acquired Infections/diagnosis , Community-Acquired Infections/etiology , Cross Infection/diagnosis , Cross Infection/etiology , Humans , Legionella/classification , Legionella/isolation & purification , Legionellosis/microbiology , Male , Middle AgedABSTRACT
Carpaine is one of the major components of alkaloid of papaya leaves. Circulatory effects of carpaine were studied in Wistar male rats weighing 314 +/- 13 g, under pentabarbital (30 mg/kg) anesthesia. Increasing dosages of carpaine from 0.5 mg/kg to 2.0 mg/kg resulted in progressive decrease in systolic, diastolic, and mean arterial blood pressure. Selective autonomic nervous blockade with atropine sulfate (1 mg/kg) or propranolol hydrochloride (8 mg/kg) did not alter the circulatory response to carpaine. Carpaine, 2 mg/kg, reduced cardiac output, stroke volume, stroke work, and cardiac power, but the calculated total peripheral resistance remained unchanged. It is concluded from these results that carpaine affects the myocardium directly. The effects of carpaine may be related to its macrocyclic dilactone structure, a possible cation chelating structure.
