Extensive sino-orbital zygomycosis after heart transplantation: a case report.

BACKGROUND: Zygomycosis is an opportunistic fungal infection mainly affecting patients with diabetes mellitus, immunodeficiency, and malignancies. The majority of cases in which it has been reported as a posttransplantation complication have been after renal or liver transplantation. There are few instances of rhino-sinusitis and orbital mucormycosis complicating heart transplantation. CASE REPORT: A 38-year-old diabetic man who had undergone heart transplantation returned to the transplantation follow-up clinic 20 days after a successful operation with unilateral periorbital swelling, nasal discharge, and multiple cranial nerve dysfunctions. Multidisciplinary investigations resulted in detection of mucormycosis in the paranasal sinuses and the orbital space, as well as a thrombosis of the cavernous sinus. Surgical ablation of the infected parts, along with antifungal treatment and adjustment of immunosuppressive maintenance, restricted extension of the craniofacial involvement. Allograft function remained undisturbed. CONCLUSION: Early detection of opportunistic infections in transplant recipients plays a big role in preventing dissemination. Fungal infections, including zygomycosis, should be considered for recipients, especially those with risk factors, such as diabetes, who present with local unusual manifestations. Sinonasal and orbital mucormycosis, if diagnosed in timely fashion, can be managed to reduce mortality. Although devastation of one-side facial and ophthalmic structures was inevitable in this case, the overall outcome was acceptable.

Comparative evaluation of two combined measles-mumps-rubella vaccines based on AIK and Edmonston- Zagreb strains of measles virus.

In a previous paper, we have noticed the effectiveness of two further attenuated measles vaccines, i.e. AIK-HDC and Edmonston- Zagreb- HDC. In the present study the same strains are comparatively used for immunization of a limited number of children under 9 months of age. A seroconversion of 100% was observed. Following reimmunization, a significant increase of circulating antibodies for both strains was recorded. Two combined measles-mumps-rubella (MMR) vaccines were also produced by using the same measles strains. The seroconversion following utilisation of MMR prophylactics in susceptible children was 98.8 and 97.3 for AIK and Edmonston- Zagreb strains respectively.

Development of a new live attenuated mumps virus vaccine in human diploid cells.

A new live attenuated mumps vaccine was developed in human diploid cells. The S-12 virus was isolated from a 10-year-old girl showing typical symptoms of mumps infection, the diagnosis was confirmed by a pediatrician. The virus was isolated in green monkey kidney cells, without passage in chick embryo cavity or chick embryo fibroblasts. Attenuation of the wild virus was performed by serial passages in human diploid cells (MRC-5). The attenuated virus was characterized by identity tests, as well as by a reduction in plaque size, as marker tests. The virus was free from adventitious agents and safe for laboratory animals as well as for monkeys. The reactogenicity and immunogenicity of the S-12 virus for man was investigated by administration of a monovalent vaccine to 20 seronegative adult male volunteers and 30 children aged 1 to 5 years without history of mumps infection or vaccination. Seroconversion was obtained in 95% of the vaccinees. The new vaccine has the advantage of not requiring specific pathogen-free eggs, and being free from avian proteins and therefore can be used in sensitized patients.

Isolation and characterization of a defective measles virus from brain biopsies of three patients in Iran with subacute sclerosing panencephalitis.

Three cytopathic strains of subacute sclerosing panencephalitis (SSPE) virus were isolated from brain biopsies of three patients. These strains were isolated and maintained by cocultivation of infected brain cells with fresh Vero cells. The biological characteristics of two strains were studied. It was found that these strains remain cell-associated after repeated cocultivations with Vero cells and produce plaques under fluid medium or tragacanth overlay. The correlation with measles virus was demonstrated by the plaque reduction test as well as by the immunofluorescence test. Large numbers of nucleocapsids were observed in the cytoplasm of infected cells but none in nuclei. Intracerebral inoculation of monkeys, adult guinea pigs, newborn and adult hamsters or mice was followed by acute encephalitis and death.