RESUMO
A 66-year-old woman complained of right-sided headache and was found to have progressive dysfunction of cranial nerves V and VIII through XII on the right side. At autopsy, there was a granulomatous pachymengitis involving the floor of the right middle and posterior cranial fossae due to Candida tropicalis infection. Inflammatory tissue compressed the clinically affected cranial nerves.
Assuntos
Candidíase/complicações , Meningite/complicações , Doenças do Sistema Nervoso Periférico/etiologia , Idoso , Candidíase/patologia , Nervo Facial/patologia , Feminino , Humanos , Meningite/patologia , Paralisia/etiologia , Paralisia/patologia , Doenças do Sistema Nervoso Periférico/patologia , Nervo Trigêmeo/patologiaRESUMO
Legionella feeleii has been implicated by serologic studies as the causative agent in an outbreak of Pontiac fever and has been recovered from an institutional water source. Pneumonia caused by this agent has not been described previously. The authors have isolated L. feeleii from two immunosuppressed patients with community-acquired pneumonia and from an institutional water source. One patient survived after treatment with erythromycin. The other patient was leukopenic and died of pneumonia. Isolates exhibited typical cultural and biochemical features of L. feeleii and reacted with L. feeleii serogroup 1 antiserum. L. feeleii serogroup 1 is now known to cause not only Pontiac fever but also pneumonia in humans.
Assuntos
Legionella/isolamento & purificação , Doença dos Legionários/microbiologia , Pneumonia/microbiologia , Infecção Hospitalar , Eritromicina/uso terapêutico , Feminino , Febre , Humanos , Terapia de Imunossupressão , Doença dos Legionários/tratamento farmacológico , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Pneumonia/tratamento farmacológico , Microbiologia da ÁguaRESUMO
A commercial DNA probe kit (Gen-probe) for the detection of rRNA from legionellae was evaluated for its accuracy in diagnosing Legionnaires' disease in 167 patients with pneumonia. The test was performed on freshly obtained clinical respiratory tract samples. Cultures and direct immunofluorescence antibody (DFA) staining of the samples and serological tests were performed simultaneously for all patients. The probe assay result was positive in six patients; five of them had other laboratory evidence of disease (positive cultures or positive serological results or both). Depending on the diagnostic criteria, the probe test had a sensitivity of 31-67%, a specificity of 99% and positive predictive values of 67-83%. The diagnostic performance of the DNA probe assay in this study was superior to that of the DFA test. The results indicate that the examination of respiratory tract secretions by the Gen-probe kit is a suitable screening test for the diagnosis of Legionnaires' disease.
Assuntos
Sondas de DNA , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/diagnóstico , Estudos de Avaliação como Assunto , Reações Falso-Negativas , Reações Falso-Positivas , Imunofluorescência , Humanos , Legionella pneumophila/genética , Valor Preditivo dos Testes , Estudos Prospectivos , RNA Bacteriano/análise , RNA Ribossômico/análise , Kit de Reagentes para Diagnóstico , Escarro/microbiologiaAssuntos
Glicosaminoglicanos/metabolismo , Síndrome de Turner/metabolismo , Adolescente , Aorta/metabolismo , Autopsia , Vasos Sanguíneos/metabolismo , Hemorragia Cerebral/complicações , Condroitina/metabolismo , Citogenética , Feminino , Histocitoquímica , Humanos , Ácido Hialurônico/metabolismo , Hipertensão/complicações , Cariotipagem , Leucócitos , Cromossomos Sexuais/análise , Sulfatos/metabolismo , Radioisótopos de Enxofre , Síndrome de Turner/patologia , Ácidos Urônicos/metabolismoAssuntos
Alcoolismo/complicações , Fígado Gorduroso/complicações , Cirrose Hepática/complicações , Pasteurella/isolamento & purificação , Sepse/etiologia , Idoso , Ampicilina/uso terapêutico , Animais , Mordeduras e Picadas/complicações , Humanos , Masculino , Pasteurella/crescimento & desenvolvimento , Sepse/complicações , Sepse/diagnóstico , Sepse/tratamento farmacológico , Síndrome , Fatores de TempoAssuntos
Anormalidades Múltiplas/genética , Cromossomos Humanos 6-12 e X , Trissomia , Adulto , Feminino , Humanos , Cariotipagem , Masculino , Síndrome , Translocação GenéticaRESUMO
An unusual, naturally occurring strain of Staphylococcus aureus is characterized. It is typical in colony and cellular morphology, coagulase production, and other biochemical reactions as compared to S. aureus (ATCC-25923), except that it is catalase negative and fails to ferment mannitol anaerobically.
Assuntos
Catalase/biossíntese , Infecções Estafilocócicas/microbiologia , Adulto , Aerobiose , Feminino , Fermentação , Variação Genética , Humanos , Manitol/metabolismoRESUMO
During a two-month period, six patients in an intensive care unit (ICU) were colonized or infected with Pseudomonas paucimobilis, a newly described bacterial species. To our knowledge, the epidemic organism has not been found previously in these units. The bacterium was usually recovered from the sputum of persons receiving ventilatory assistance and represented transient colonization. One patient had a symptomatic urinary tract infection. The outbreak was confined to two of the ICUs. Cultures of respiratory equipment were negative, but P paucimobilis was recovered from the ICU hot water line. Water bottles used for rinsing tracheal suction connecting tubing were found to contain P paucimobilis organisms. This resulted from refilling with tap water. No further cases were found during a 20-month follow-up period, when a uniform tracheal suctioning policy was developed.
Assuntos
Surtos de Doenças/epidemiologia , Unidades de Terapia Intensiva , Infecções por Pseudomonas/diagnóstico , Abastecimento de Água , Adulto , Infecção Hospitalar/diagnóstico , Resistência Microbiana a Medicamentos , Feminino , Bactérias Aeróbias Gram-Negativas/classificação , Hospitais com mais de 500 Leitos , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Pseudomonas/isolamento & purificação , Microbiologia da Água , Abastecimento de Água/normasRESUMO
Pneumonia is the most important manifestation of disease caused by Legionella species. However, it is still not known for certain how these organisms actually enter the lungs. During a 5-month period 318 hospitalized patients without clinical or radiologic features of pneumonia were enrolled in a survey of sputum colonization with Legionella. Diagnostic tests included cultures, direct fluorescent antibody test (DFA) and DNA probe assay of sputum. Colonization was considered to occur when at least one of these tests was positive. According to our definitions, 1.2-10% of of these patients could have been colonized by Legionella spp. However, all cultures were negative and in all but one of these patients the DFA was the only positive test. A case-control study comparing test-positive and test-negative patients failed to identify any different features of disease or epidemiologic characteristics. These findings suggest that a high rate of false-positive DFA results occurred in our study rather than any new evidence of colonization of the respiratory tract with Legionella.