An unusual form of motor neuron disease following a cat bite.

A case of motor neuron disease with clinical and pathological resemblance to amyotrophic lateral sclerosis (ALS) in a woman who was severely bitten on the ankle by a cat is described. Weakness first appeared at the ankles and relentlessly advanced proximally, terminating in death from pulmonary failure in a year. A number of unusual features that are uncharacteristic of ALS were found that included a markedly elevated antinuclear antibody titre in the serum and the presence of prominent oligoclonal bands in the cerebrospinal fluid. The spinal cord showed loss of anterior horn cells and pyramidal degeneration that are characteristic of ALS, but an extraordinary finding was the presence of transmural granulomatous inflammation of numerous small and medium sized vessels, especially veins, in the subarachnoid space around the cord. There were also inflammatory changes in the brainstem and spinal cord consisting of microglial and astrocytic nodules and perivenous cuffing by mononuclear cells. Ill-defined hyaline eosinophilic cytoplasmic inclusions were seen in some remaining anterior horn cells. No viral particles were found by electron microscopy despite an extensive search. Virological studies were inconclusive but there is reason to believe that this patient's illness was caused by an as yet unidentified virus.

Experimental herpetic keratitis in rabbit corneal organ cultures.

An in-vitro method for maintaining rabbit corneal organ cultures for short periods of time is described. These cultures supported replication of strains of type 1 and 2 herpes simplex virus, and changes typical of herpetic infections of the cornea in vivo were observed by light microscopy, and by scanning and transmission electron microscopy. Infectious virus was readily recovered from inoculated corneal organ cultures. For practical, economic and humanitarian reasons, the full potential of this system warrants further investigation.

Leptomeningitis and polycaryocyte formation in the CNS of rats inoculated subcutaneously with herpes simplex virus.

Wistar rats were inoculated subcutaneously with either type 1 (HSV1) or type 2 (HSV2) Herpes simplex virus at 5 days of age. Animals were killed in extremis or at the end of the 14-day observation period postinoculation. Acute destructive meningoencephalitis with hemorrhage and leukocytic infiltration was observed in both groups. Polycaryocytes comprised of cells of the internal granular layer of the cerebellum were observed in some animals inoculated with HSV1. These multinucleated cells appeared to be formed by fusion of virus-infected cells, and intranuclear inclusion bodies were observed. Lesions in the leptomeninges were particularly striking in animals inoculated with HSV2. Viral replication in resident cells of the leptomeninges was demonstrated by electron microscopy.

Use of a topical triple-antibiotic spray to reduce morbidity from pelvic infection after gynecologic operations.

To study the effect of a topical antibiotic spray in reducing postoperative morbidity when used during surgery, a randomized, double-blind study was done on 150 women who had a vaginal hysterectomy with or without colporrhaphy. The spray contained neomycin sulfate, polymyxin B sulfate and zinc bacitracin and was used in 75 patients; a placebo spray was used in the other 75 patients. The antibiotic spray significantly (P < 0.01) decreased the frequency of pelvic infections postoperatively--14.7% in the antibiotic group compared with 37.3% in the placebo group.

Experimental type 2 herpes simplex ophthalmitis in the newborn rat.

An animal model for the study of type 2 herpes simplex virus (HSV2) ophthalmitis is described. Wistar rats were inoculated intracerebrally with HSV2 at 0, 5, 10, 15, 20, or 30 days of age. Eyes and brain from all animals, whether they survived or succumbed with encephalitis, were collected for microscopic and virologic studies. Up to 20% or more of the HSV2-inoculated rats had lesions in the cornea, uveal tract, and/or retina. Herpetic keratiis occurred in a few animals while the eyelids were still fused, indicative of internal spread of HSV2. Intranuclear inclusions were observed in corneal epithelium and neural retina, and herpesvirus particles were demonstrated in the cornea, iris, and retina. Lesions of the cornea and iris were also visualized by scanning electron microscopy. Virus was isolated from over 40% of the eyes tested. In general, titers of the virus in the eyes were less than those in the brains of HSV2-inoculated rats. The newborn rat thus represents another animal model to study herpetic ophthalmitis. Unlike most studies, ocular lesions were produced by a route other than the usual topical or intraocular inoculation of the virus.

Pseudomonas maltophilia bacteremia associated with a prolapsed mitral valve.

A 53-year-old man had had recurrent episodes of transient visual loss, malaise and a heart murmur. Blood cultures repeatedly grew Pseudomonas maltophilia, a frequent opportunistic pathogen, and echocardiogram documented mitral-valve prolapse. The risk of bacterial endocarditis is stressed.

Experimental infection with herpes simplex virus type 2 in newborn rats: Effects of treatment with iododeoxyuridine and cytosine arabinoside.

Sprague-Dawley rats were inoculated, within 36 hr of birth, with either of two strains of herpes simplex virus type 2. The effects of treatment for five days with either 5-iododeoxyuridine or cytosine arabinoside in near toxic doses were studied. Evaluation of treatment based on rate of survival, incidence of lesions, and isolation of virus from the central nervous system showed no appreciable difference between treated and untreated littermates. Drug-related effects of retardation of growth and defective development of the cerebellum and retina were found. The validity of therapy with either of these drugs in generalized herpetic infections is questioned because activity was minimal against the infecting agent even when the dosage of the drug was sufficient to produce serious defects in certain developing tissues.