ABSTRACT
Magnetic resonance imaging (MRI) offers a sensitive alternative to computed tomography (CT) for lesion localization. Patients with subacute necrotizing encephalomyelopathy (SNE) may be diagnosed by finding focal lesions on CT that correspond to sites of anatomical involvement. We report serial CT and MRI scanning findings in a patient with clinical, radiographic, and laboratory evidence of SNE. MRI was more sensitive in detecting lesions involving the basal ganglia, brainstem, and cortex. We believe MRI is a valuable and sensitive means to establish an antemortem diagnosis of SNE.
Subject(s)
Brain Diseases, Metabolic/diagnosis , Leigh Disease/diagnosis , Child , Humans , Magnetic Resonance Spectroscopy , Male , Tomography, X-Ray ComputedABSTRACT
The Bacteroides fragilis group of bacteria are the most numerous microorganisms in the colon and the most common anaerobic isolates from human infections. Although clindamycin hydrochloride is still considered the antibiotic of choice for treatment of infections with these bacteria, resistant strains are becoming more common. To determine the clinical significance of clindamycin-resistant bacteroides, we reviewed the charts of 14 patients with resistant isolates. Clindamycin resistance was a major factor in the clinical course of at least four patients. Three of these did not recover until they were treated with effective antimicrobials. Seven patients had been treated with either erythromycin or clindamycin before isolation of the resistant strain. These observations underscore the importance of antimicrobial sensitivity testing of the B fragilis group and of considering the possibility of resistance when patients infected with Bacteroides fail to respond to clindamycin treatment.
Subject(s)
Abscess/drug therapy , Bacteroides fragilis/drug effects , Clindamycin/pharmacology , Sepsis/drug therapy , Abdomen/microbiology , Adult , Aged , Bacteroides fragilis/isolation & purification , Clindamycin/therapeutic use , Drug Resistance, Microbial , Erythromycin/therapeutic use , Female , Humans , Male , Pelvis/microbiologyABSTRACT
Albino rats were each treated with a single intraperitoneal injection of dimethylformamide (DMF) or dimethysulfoxide (DMSO). The doses of DMF administered were 0.6, 0.9, and 1.2 ml. per kg. and those of DMSO were 1.2, 2.4, 3.6, and 4.8 ml. per kg. The animals were sacrificed at 24, 48, 72, and 120 hours following administration of each dose. The liver was investigated in all cases. Treatment with DMF at 0.6 ml. per kg. indicated some histologic lesions of the liver which became well defined at 0.9 and 1.2 ml. per kg. causing severe central phlebitis with centrilobular coagulative necrosis of the cells associated with a heavy inflammatory infiltrate. Maximal liver lesions occurred at 48 hours and started to regress after 72 hours. However, cellular atypism became a consistent finding after this inflammatory phase. DMSO-treated animals showed minimal histologic lesions of the liver at 1.2 and 2.4 ml. per kg. Higher doses caused fatty infiltration with a predominatly periportal distribution. It tended to produce its maximal effect in 12 hours which then regressed rapidly after 24 hours. The development of histologic lesions in the liver even at 0.6 ml. per kg. suggests that DMF is not a suitable solvent for aflatoxin studies, and hence the results obtained from such studies need cautious interpretation. DMSO appears to be an ideal alternative for toxicologic studies at a much higher dose level compared to DMF.
