ABSTRACT
The effect of the addition of dialyzable leukocyte extract (DLE)(transfer factor) to tuberculostatic drugs in the treatment of superinfected fistulating tuberculosis of bones and joints was evaluated in a controlled study. Eleven patients whose disease had persisted for a mean of 20 +/- 4.8 years and had proved to be resistant to antibiotics and tuberculostatic drugs were treated with an additional combined tuberculostatic drug regimen consisting of isoniazide, ethambutol, and rifampin for a control period of 2 years; after this therapy had failed as judged by the persistence of the superinfected fistulae and of the symptoms, DLE was added to the regimen. The result of this therapeutic approach was evaluated after another 2 years. Through this therapy, a closure of the fistulae was achieved in 9 out of the 11 patients (P less than 0.001) with a concomitant decrease of symptoms. DLE may prove beneficial in the treatment of patients with superinfected fistulating tuberculous osteomyelitis.
Subject(s)
Fistula/therapy , Transfer Factor/therapeutic use , Tuberculosis, Osteoarticular/therapy , Adult , Antitubercular Agents/therapeutic use , Drug Therapy, Combination , Female , Fistula/complications , Fistula/drug therapy , Gram-Negative Bacteria/drug effects , Humans , Male , Middle Aged , Staphylococcal Infections/complications , Staphylococcal Infections/drug therapy , Tuberculosis, Osteoarticular/complications , Tuberculosis, Osteoarticular/drug therapyABSTRACT
The authors present a retrospective study of 492 cases of chronic osteomyelitis treated with active immunotherapy to complement surgical and antibiotic treatment. The systematic application of this treatment, which is based on the use of antistaphylococcal vaccines and/or auto-vaccines resulted in the osteomyelitic process being cured in 80 per cent of cases, with complete closure of the fistulae maintained for at least three years. The authors also report the preliminary results obtained with passive immunotherapy in twenty-six patients with chronic osteomyelitis that had proved resistant to all other forms of treatment. Sero-immunological investigations in these patients revealed a deficiency in the opsonifying capacity of the serum. Treatment with opsonin precursors produced complete recession of symptoms and clinical signs, maintained for at least a year, in 50 per cent of these patients.
Subject(s)
Immunotherapy/methods , Osteomyelitis/therapy , Adolescent , Adult , Aged , Child , Child, Preschool , Chronic Disease , Female , Humans , Immunity, Active , Immunization, Passive , Infant , Infant, Newborn , Male , Middle Aged , Opsonin Proteins/therapeutic use , Osteomyelitis/surgery , Retrospective Studies , Staphylococcal Vaccines/therapeutic useSubject(s)
Immunotherapy , Osteomyelitis/therapy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Osteomyelitis/surgery , gamma-Globulins/therapeutic useABSTRACT
The author presents 360 patients with chronic osteomyelitis, treated with auto genous staphylococcus inoculation. In several cases there was additional surgery. The probable therapeutic effects of inoculation related to the special pathogenicity of staphylococcus aureus is discussed. The results shown in two different series encourage the author to recommend autogenous inoculation. In his clinic it has been in use for over 10 years.
