Gram-negative infection as an unusual cause of endocarditis in a hemodialysis patient.

Gram-negative endocarditis is rare and it has high mortality if there is a delay in diagnosis and treatment. Gram-negative organisms should be considered in the differential diagnosis of IE in hemodialysis patients. Central lineassociated bloodstream infections (CLABSIs) can be prevented by following sterile measures during catheter insertion and proper management of catheter site.

Fibroblasts that reside in mouse and frog injured peripheral nerves produce apolipoproteins.

Apolipoprotein synthesis and secretion is upregulated in wallerian degenerating peripheral nerves. A commonly expressed view has been that macrophages are solely responsible for their production. In the present study we provide evidence that (1) nerve-derived fibroblasts contribute to apolipoprotein production, (2) apolipoprotein production is confined to regions where myelin destruction and phagocytosis occur, and (3) some experimental procedures are detrimental for the production of apolipoproteins. Apolipoprotein production was studied in C57BL/6/NHSD (N) and C57/BL/6-WLD/OLA/NHSD (W) mice that display, respectively, rapid and slow progression of wallerian degeneration. In N nerves, apolipoprotein E (apo-E) is produced during in vitro and in vivo degeneration, and in vivo after freeze damage. In W nerves, apo-E is produced at the injury region where degeneration occurs but not farther distally where degeneration fails to develop. Apo-E is also produced in W nerves during in vitro degeneration and in vivo after freeze damage. In culture, N and W mice nerve-derived fibroblasts, but neither macrophages nor Schwann cells produced apo-E. Two apolipoproteins are produced in in vivo wallerian degenerating and freeze-damaged frog nerves, i.e., apo-39 and apo-29. Only apo-39 is produced in in vitro degenerating nerves. Neither apo-39 nor apo-29 is produced during in vivo degeneration in diffusion chambers. In culture, apo-39 is produced by nerve-derived fibroblasts and macrophages but not by Schwann cells.