Streptococcus milleri causing infection in man.

We describe the microbiological and morphological characteristics of 151 strains of Streptococcus milleri isolated during the course of routine bacteriological investigations. Although these strains formed a fairly heterogeneous group, several constant features were identified which typify the species. Strept. milleri emerged as a major cause of pyogenic infection, clinical disease being characterized by localized collections of pus in almost every organ system. Bacteraemia due to Strept. milleri was a significant indicator of the presence of an occult abscess. Endocarditis was rare. The penicillins or erythromycin remain the drugs of choice for treating infections caused by this organism.

Infections due to Actinobacillus actinomycetemcomitans. A report of 3 cases.

Three cases are described which show the typical range of infections which may be caused by Actinobacillus actinomycetemcomitans, namely an actinomycosis-like infection, a prosthetic cardiac valve endocarditis and a post-traumatic soft-tissue infection. Cultural studies are detailed, and a short review of the disease-producing potential of this organism and its treatment is presented.

Isolation of Haemophilus ducreyi from genital ulcerations in white men in Johannesburg.

An analysis of sexually acquired genital ulcerations in 31 White patients who were examined microbiologically in Johannesburg showed Haemophilus ducreyi to be the causative agent in 23 (74%), whereas syphilis was the confirmed diagnosis in only 6 (19%). All the H. ducreyi isolates produced beta-lactamase. Previously, chancroid was considered to be an infrequent cause of genital ulceration in this population group. Unlike those with syphilitic ulceration, patients with chancroid usually do not respond to penicillin. The improved isolation procedures for H. ducreyi now enable the laboratory to confirm most cases.

Problems in the diagnosis of lymphogranuloma venereum. A review of 6 cases.

Six cases of lymphogranuloma venereum are described in White South Africans. All initially presented diagnostic problems. This sexually transmitted disease is uncommon in South Africa, and 5 of the 6 patients presented with inguinal lymphadenopathy without a primary lesion. The value of serological tests in the diagnosis of this disease is emphasized.

Antimicrobial susceptibility of 103 strains of Haemophilus ducreyi isolated in Johannesburg.

Of 103 strains of Haemophilus ducreyi isolated in Johannesburg, 96 produced beta-lactamase and were resistant to penicillin and ampicillin. Most strains showed resistance to tetracycline, sulfisoxazole, and sulfamethoxazole. All isolates were susceptible to rifampin, erythromycin, and cefoxitin, moderately susceptible to trimethoprim-sulfamethoxazole (1:19) and minocycline, and somewhat less susceptible to doxycycline.

Campylobacter enteritis in Johannesburg.

In order to establish a reasonable protocol for a diagnostic laboratory we conducted a survey during which we confined the routine culture of stool samples for Campylobacter fetus to two groups--all infants under 2 years of age, and older children and adults with obviously diarrhoeic stools. Camp. fetus was isolated from 100 of 2323 stool specimens (4,3%). This is within the 3 - 8% isolation rates previously reported from surveys in which all specimens were cultured. Camp. fetus isolates represented 16,9% of all bacterial pathogens isolated, and Black infants showed a significantly greater isolation rate than White infants. We feel that culture for Camp. fetus is an essential part of any routine bacteriological investigation of diarrhoea. A partially selective culture policy for Camp. fetus will result in a recovery rate at least equal to that of Salmonella and enteropathogenic Escherichia coli.

The Crithidia luciliae immunofluorescent test for the detection of antibodies to native DNA.

The Crithidia luciliae test was compared with the radioimmunoassay technique for n DNA antibodies on 93 randomly selected sera submitted for antibody testing, and was found to be a highly specific, reproducible and economical test. It appeared to be less sensitive than the radio-immunoassay technique in sera from some of the patients, but analysis of the clinical findings showed that the C. luciliae test correlated better with the clinical assessment of these patients.

Acute brucellosis in Johannesburg.

Seven cases of acute brucellosis seen in Johannesburg during a 9-month period are discussed. Five of these patients probably contracted their infection at the by-products plant of the new abattoir. A survey of culture isolates and serological studies shows a low incidence of acute brucellosis in Johannesburg. The persistently positive serological tests 18 - 24 months after successful therapy emphasize that caution is necessary when interpreting the significance of positive findings. Successful therapy with tetracyline is largely dependent on dosage and length of treatment.

Legionnaires' disease in Johannesburg.

Legionnaires' disease (LD) was first identified as an epidemic pneumonia occurring in the USA in 1976. Sporadic cases have since been identified in many countries. This report describes the first 2 cases in South Africa of LD with pneumonia in patients in whom the diagnosis was established by the finding in early acute and follow-up convalescent sera of a greater than fourfold rise in titre with the immunofluorescent antibody test. The microbiological investigations are discussed in some detail and the clinical, radiological and laboratory features of LD are briefly reviewed.

Yersinia enterocolitica biotype 1 in South Africa.

Two clinical isolates of Yersinia enterocolitica biotype 1, positive for indole and lecithinase production, xylose and salicin fermentation, and aesculin hydrolysis, are reported. One strain, serotype 0 6, was recovered from a healthy food handler, while the other, serotype 0 5, was associated with a diarrhoeal illness in a 1-year-old child. This is the first report of either of these serotypes from human material in South Africa.