Bacilli In Patients Research Articles

Acute Respiratory Distress Related to Chemotherapy of Advanced Pulmonary Tuberculosis: A Study of Two Cases and Review of the Literature

Two patients with non-miliary pulmonary tuberculosis developed a syndrome resembling adult respiratory distress following initiation of drug treatment. They were studied clinically and with a representative range of in vitro and in vivo tests of immune function. Both were alcoholic, malnourished and presented with radiologically widespread, smear-positive disease and lymphocytopenia. One had cutaneous anergy in vivo and profound reduction on mononuclear cell proliferative and interferon responses to tuberculoprotein (PPD) in vitro; the other patient, who died two weeks after starting treatment, had relatively normal values for these measures of cell-mediated immunity. In both cases there was a progressive increase during treatment, in peripheral blood lymphocyte counts, skin reactions and in vitro cellular responses to PPD, and a sudden rise in ESR at the time of their deterioration. We propose that the reactions may represent local manifestations of heightened delayed hypersensitivity, mounted by increasing numbers of 'resuscitated' lymphocytes against immunogenic cell wall substances released from dying tubercle bacilli in patients whose level of cellular immunity is being enhanced as a result of chemotherapy. The likelihood of an acute respiratory reaction during treatment may therefore depend on the bacillary load, the extent of lung disease present, and its severity may be related to the pre-treatment immune status of the patient.

Mycobacterial isolations in young adults with cystic fibrosis.

In 223 patients admitted to hospital with cystic fibrosis mycobacteria were found in the sputa of seven. All of these cases were identified over a six year period after the introduction of routine examination and culture of sputum for acid fast bacilli in patients with cystic fibrosis. The organisms isolated were Mycobacterium tuberculosis in three patients, M chelonei in one, M fortuitum in one, and unidentified mycobacteria in two. The diagnosis was not suspected on clinical grounds in any of the cases; in one patient, however, night sweats were a prominent feature before diagnosis. In four of the patients direct sputum smear examination did not reveal the organism, which was grown subsequently in culture. An unusual phenomenon of liquefaction of the Lowenstein-Jensen culture medium was encountered in five of the seven patients described, which in one case made identification and sensitivity testing of the organism impossible. This phenomenon has been observed in sputum cultures from other patients with cystic fibrosis but not in other pulmonary diseases. Immunological studies performed in three of the patients showed normal numbers of peripheral blood T and B lymphocyte in all three; in vitro lymphocyte transformation to tuberculin PPD was, however, reduced in the patient with extensive M fortuitum infection, which proved fatal. Mycobacteria may be present in the sputa of patients with cystic fibrosis more often than previously recognised and therefore sputum examination and culture for mycobacteria should be performed periodically in these patients.

Detection of tubercle bacilli in patients with Pulmonary Tuberculosis by Sampling of Bronchial Sputum, Percutaneoeus Trephine Lung Biopsy -(Evolving Role)- Kohei Hara

Detection of tubercle bacilli in patients with Pulmonary Tuberculosis by Sampling of Bronchial Sputum, Percutaneoeus Trephine Lung Biopsy -(Evolving Role)- Kohei Hara

In Vitro Antibiotic Susceptibility of Pseudomonads Other than Pseudomonas aeruginosa Recovered from Cancer Patients

The increase in occurrence of infections due to opportunistic gram-negative bacilli in patients with impaired host defenses emphasizes the need for information on the antibiotic susceptibility of the organisms that colonize such patients. During a 20-month period, more than 100 pseudomonads which were not Pseudomonas aeruginosa were recovered from cancer patients at the Baltimore Cancer Research Center. These included P. fluorescens, P. putida, P. multivorans (cepacia), P. maltophilia, P. stutzeri, P. alcaligenes, and P. pseudoalcaligenes. Susceptibility tests with 12 antibiotics indicated that the intraspecies antibiograms for many of these species were more uniform than those of P. aeruginosa. The stability of susceptibility patterns allowed the antibiograms to be used as aids in the preliminary differentiation of these organisms. Variable antibiogram patterns were noted among certain species, i.e., P. fluorescens, P. stutzeri, and P. multivorans, whereas each of the other species had essentially one pattern. These in vitro studies showed that some of the Pseudomonas species other than P. aeruginosa were resistant to a number of antibiotics. Among these were antibiotics that are in general use for P. aeruginosa infections. Such differences in antibiotic susceptibilities emphasize the necessity for careful speciation of this group of microorganisms to assure proper epidemiological documentation of colonization and infection, as well as to ensure therapy with an antimicrobial agent to which the organism is susceptible in vitro.

Severe Liver Disease Complicated by Bacteremia

In 1950, Whipple and Harris1reported 4 cases of Laennec's cirrhosis in which there was bacteremia due to Escherichia coli. Spellberg2and Beeson3have commented on infections of the blood stream due to colon bacilli in patients with cirrhosis of the liver. In 1954, members of our group4noted cases of severe hepatic disease complicated by bacteremia due to E. coli. These were among the 4 such cases separately reported,5and also were described in our study of 137 patients with bacteremia due to Gram-negative bacilli encountered in a 15-year period extending through 1954.6Subsequently, other reports of this coincidence of diseases have been made.7-12 Although bacteremia due to Gram-positive microorganisms may complicate severe hepatic disease, our experience to date suggests that it may occur less commonly than Gram-negative bacteremia. Only 1 of 143 patients with bacteremia due to Gram-positive organisms who were

Drug-Resistance of Tubercle Bacilli In Patients with Pulmonary Tuberculosis at the Time of Entering Hospital

Drug-Resistance of Tubercle Bacilli In Patients with Pulmonary Tuberculosis at the Time of Entering Hospital

Severe liver disease complicated by bacteremia due to gramnegative bacilli.

A recent review1of the records of 137 patients with bacteremia due to Gram-negative bacilli disclosed that 4 of the 137 patients had severe disease of the liver. This association seems more than coincidental and supports the views of Whipple and Harris.2These authors reported four cases of Laennec's cirrhosis in which there was septicemia due to Escherichia (Bacterium) coli and postulated that a deficiency of effective reticuloendothelium in the cirrhotic liver, or changes in hepatic circulation, may account for the occurrence of septicemia in cirrhosis. Spellberg3and Beeson4have also commented on infections of the blood stream due to colon bacilli in patients with cirrhosis of the liver. The purpose of our report is to describe four cases of severe hepatic disease complicated by bacteremia due to Gram-negative bacilli, in order to emphasize this complication further. Report of Cases Case 1. —A 45-year-old man was

LARYNGEAL SWABS FOR THE DETECTION OF TUBERCLE BACILLI IN PATIENTS WITHOUT SPUTUM

Medical Journal of AustraliaVolume 2, Issue 25 p. 1045-1046 Correspondence LARYNGEAL SWABS FOR THE DETECTION OF TUBERCLE BACILLI IN PATIENTS WITHOUT SPUTUM First published: 01 December 1955 https://doi.org/10.5694/j.1326-5377.1955.tb49266.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume2, Issue25December 1955Pages 1045-1046 RelatedInformation

The Development of Agglutinins for Aerobic, Gramnegative Bacilli in Patients with Diffuse Peritonitis or Abscess Formation Following Appendicitis

peritonitis and abscess formation. The bacteria most frequently isolated from these lesions are members of the B. coli group, certain streptococci, particularly of the enterococcus group, and sporulating anaerobic bacilli, such as B. welchii. It is only fair to assume that the outcome of these infections is directlydependent upon two factors, namely: (1) The virulence, invasiveness, and toxicity of the micro-organisms and (2) the normal and immune defence factors of the host. Because of the second factor, we undertook a study of the immune response of patients with diffuse peritonitis or abscess formation subsequent to perforated appendicitis. The results of this investigation on the development of agglutinins against aerobic, gram-negative bacilli in patients presenting these conditions, are reported in this communication.