Transient bacteremia associated with barium enema.

A group of 175 patients had barium enema. Pour-plate blood cultures were obtained immediately before and after the procedure and 5, 10, 15, and 30 minutes later. Bacteremia was demonstrable in 20 (11.4%) patients. In some, blood cultures were positive for as long as 15 minutes after barium enema; all were negative at 30 minutes. Among the bacteria associated with the 20 episodes of bacteremia were Escherichia coli, Klebsiella, enterococci, Proteus morganii, Bacteroides, and Veillonella. The incidence of bacteremia among patients with ulcerative colitis, regional enteritis, rectal polyps, colonic or rectal carcinoma, nonspecific diarrhea, or other lower intestinal tract disorders was not much different from patients free of rectosigmoid disease. The results of this study suggest that a history of recent barium enema may be important in patients who have endocarditis.

Evaluation of ten anaerobic blood culture media.

Selection of an anaerobic blood culture based upon clinical findings that have compared the isolation rates of bacteremic agents from different blood culture media. No agreement has been reached as to which of the commercially available blood culture media is optimal for detection of bacteremia. The purpose of this study was to determine the rates of recovery of anaerobic microorganisms from various anaerobic blood culture media. The blood culture media were inoculated with a small inoculum of microorganisms in the presence or absence of an erythrocyte-serum mixture. The results demonstrated that the type of medium and the erythrocyte-serum mixture influenced the ability of blood culture media to support the growth of microorganisms. The majority of the media failed to support the growth of 87% or more of the microorganisms within four days after inoculation. Pre-reduced brain-heart infusion broth supported the growth of a larger proportion of microorganisms than the other types of blood culture media.

Listeriosis.

Four patients with Listeria monocytogenes infection are presented; three of whom had associated lymphoproliferative disorders. Two of the four patients had Listeria meningitis. Meningitis is the most common manifestation of listeriosis in humans. Specific diagnosis depends on demonstrating Listeria monocytogenes in the cerebral spinal fluid; differentiation from other forms of acute meningitis cannot be made clinically. Although listeriosis is recognized as a major global problem in both human and animal health, the epidemiology of human infection is poorly understood. Animals and animal products may serve as reservoirs for human infection. Antibiotic therapy resulted in recovery in three of the patients. The history, epidemiology, laboratory diagnosis, clinical manifestations, and therapy of listeriosis are reviewed.

Pseudomonas aeruginosa infections in the podiatric patient.

Pseudomonal infections of the skin, soft tissue, bone, and toe web may often be very difficult to treat. This article reviews the microbiology, pathogenesis, and treatment of pseudomonal infections that are related to podiatric medicine and surgery.

Edwardsiella tarda bacteremia.

Presented are two case reports of patients with Edwardsiella bacteremia who survived after chloramphenicol and gentamicin therapy in one case and cephalothin and kanamycin therapy in the other case. Of four previously reported patients, only one survived. One of our two patients presented with subarachnoid hemorrhage associated with bacterial endocarditis and, to our knowledge, this is the first reported case of E tarda endocarditis. The clinical and laboratory features of disease due to this unusual pathogen are reviewed.

Evidence for depletion of Ia+ macrophages and associated immunosuppression in African trypanosomiasis.

The percentage of Ia antigen-bearing (Ia+) macrophages was significantly lower in mice infected with Trypanosoma rhodesiense than in normal controls. The degree of difference varied with the source of macrophages and time course of infection. The percentage of Ia+ macrophages isolated from spleens 10 days after infection was 71% of that in the controls, and depletion continued until Ia+ macrophages were almost undetectable 30 days after infection. The rate of depletion was slower in the peritoneal cavity. In contrast, Ia+ macrophages were not significantly depleted from the lymph nodes until 30 days after infection. The ability of macrophages from trypanosome-infected mice to present listerial antigen to sensitized T cells was significantly lower than in controls. Immune T cells had significantly less ability (43% of controls) to incorporate thymidine when exposed to splenic macrophages from infected mice during the early stage of disease. This loss of antigen presentation increased during the course of infection. Peritoneal macrophages also exhibited an early loss of ability to present antigen, but no significant decline occurred thereafter. No significant loss of antigen had occurred in the lymph node macrophages 10 days after infection, but during the later stages of the disease a significant loss was detected. Treatment of macrophages from infected and control mice with anti-Iab serum and complement inhibited their ability to present antigen. Our results demonstrate that Ia+ macrophages and their distribution can influence the ability of infected animals to process antigens and may therefore account in part for the immunosuppression observed in trypanosomiasis.

Antimicrobial activity of cefmetazole compared with those of other cephalosporins.

The antimicrobial activity of cefmetazole was compared with those of cefmenoxime, ceftizoxime, cefamandole, cefoperazone, cefotaxime, cephalothin, and latamoxef. In general, the activity of cefmetazole was less than those of the other cephalosporins. The in vitro activity of cefmetazole suggests that it will not prove useful as a broad-spectrum antimicrobial against gram-positive and gram-negative pathogens.

Nitrofurantoin polyneuropathy: report of two cases.

Two case reports of patients who developed a toxic neuropathy associated with nitrofurantoin are presented. In each case the patient had normal renal function and the symptoms abated upon withdrawal of the drug. Although the specific mechanism by which nitrofurantoin causes the neuropathy is still not known, various hypotheses are discussed and the literature is reviewed. The danger of nitrofurantoin administration in patients with impaired renal function is emphasized, and it is stress that early signs and symptoms of peripheral neuropathy be reported and the drug immediately discontinued. Even in the presence of normal renal function, the recommended dosage and duration of therapy should not be exceeded.

Endemic syphilis: passive transfer of resistance with serum and cells in hamsters.

Serum or spleen cells from hamsters immune to infection with Treponema pallidum strain Bosnia A conferred partial protection against syphilitic infection by the same strain on recipient hamsters. Cutaneous lesions did not develop, and in the lymph nodes the average weight and number of treponemes detected were significantly lower than in normal and control hamsters. Treatment of the immune spleen cells with antithymocyte serum and complement abolished their ability to transfer resistance. This is the first direct evidence that thymus-derived cells are involved in resistance to syphilitic infection.