Incidence Of Mixed Infections Research Articles

Fatal imported case of Plasmodium mixed infection: cerebral malaria, thrombocytopenia and multi organ dysfunctions (MODs)

Background: Plasmodium falciparum accounts for nearly all severe malaria cases among European travellers, even though, in areas of endemicity, Plasmodium vivax seems to cause severe malaria to a degree which is comparable with P. falciparum. Furthermore, unlike countries at high risk, the incidence of mixed infections among imported cases is very low. We report the case of a man from non-endemic country with a mixed infection diagnosed after a two-year stay in Guinea. Case Presentation: A 43-year-old male Italian patient developed hyperpyrexia and chills the day after his return to Italy. Within 7 days from fever onset, he was found unresponsive with vomiting and seizures. On admission to Emergency Room, the patient was hypotonic with flaccid tetraparesis, with a GCS score of 7. On the basis of personal and working history and clinical features, after exclusion of viral encephalitis, acute pyogenic meningitis, tubercular meningitis and pontine infarct, cerebral malaria infection was suspected. Rapid diagnostic test and peripheral blood smear were positive for plasmodium mixed infection (P. falciparum, P. vivax, Plasmodium ovale). Over the first 30 hours from admission, thrombocyte count dropped, and the patient developed disseminated intravascular coagulation. Renal failure required renal replacement therapy. Death occurred after 48 hours of ICU admission. Conclusion: The fatal course of the severe malaria with related cerebral impairment, lung and kidney failure, disseminated intravascular coagulation, severe acidosis, circulatory collapse with refractory septic shock and subsequent multi organ failure was likely due to delayed medical presentation by the patient and the mixed plasmodium infection. Diagnosis could only be established nine days after onset of symptoms.

Outcomes of M. pneumoniae pneumonia with mixed infection

Background: Mycoplasma pneumoniae pneumonia (MPP) is often complicated with mixed infections that worsen the prognosis, but the outcomes in pediatric cases are unclear. The aim of this study is to investigate the association of mixed infection and outcomes in severe MPP that occurs in childhood. Methods: This retrospective study included 184 pediatric cases of severe MPP that were managed at our hospital (between January 2014 and December 2017). The cohort was divided into the single Mycoplasma pneumoniae infection, mixed infection with a noxa other than M. pneumoniae, and mixed infection with two or more noxae other than M. pneumoniae groups. The demographic and clinical information of the patients was compared via statistical analysis. Results: The incidence of mixed infections was high at 64.1%. Cytomegalovirus and Epstein-Barr virus were the most common causes of mixed infection. According to the findings of binary logistic regression analysis, the presence of more than one pathogen (other than M. pneumoniae) was positively associated with the score determined from Pediatric Risk of Mortality III (β = 0.760, odds ratio [OR] = 2.139, 95% confidence interval [CI] = 1.391-2.390, P = 0.001), Pediatric Critical Illness Score (β = 1.203, OR = 3.328, 95%CI = 1.723-6.731, P = 0.000), and total length of hospital stay (β = 0.730, OR = 2.075, 95% CI = 1.404-3.066, P = 0.000). Conclusion: Viral and bacterial mixed infection in pediatric cases of severe MPP is positively associated with hospitalization period and disease severity, and ultimately, may increase the chances of severe illness and death among children.

Analysis of risk factors of pulmonary infection in patients over 60 years of age after radical resection for gastric cancer

To investigate the risk factors of postoperative pulmonary infection (PPI) in patients over 60 years of age with gastric cancer after radical gastrectomy. Clinicopathological data of 373 patients over 60 years of age who underwent radical gastrectomy at Department IV of Gastrointestinal Cancer Center, Peking University Cancer Hospital, from April 2009 to December 2016 were retrospectively collected in this case-control study. The clinicopathological characteristics of patients with postoperative pulmonary infection (including postoperative atelectasis) and those without pulmonary infection were compared. A Student t-test (reported as Mean±SD if data matching normal distribution) or Mann-Whitney U test [reported as median (quartile) if data did not conform to normal distribution] was used to analyze continuous variables. A χ² test or Fisher exact tests (reported as number and percentage) was used for categorical variables. Multivariable logistic regression was used to analyze the risk factors for pulmonary infection after operation of gastric cancer.PPI was defined as postoperative patients with elevated body temperature (>38.0 degrees centigrade) for more than 24 hours; cough and expectoration; positive sputum bacteria culture;recent infiltration, consolidation or atelectasis confirmed by chest imaging examination. Among 373 patients, 50 cases had PPI(13.4%, PPI group), 323 cases had no PPI(86.6%, non-PPI group). There were 39 (78.0%) and 178(55.1%) patients with comorbidities (including hypertension, diabetes and cardiopulmonary disease) preoperatively in PPI and non-PPI group, respectively. The difference between two groups was statistically significant (χ²=9.325,P=0.002). The incidence of preoperative hypoalbuminemia in PPI group was also significantly higher than that in non-PPI group [10.0%(5/50) vs. 3.1% (10/323),χ²=4.098, P=0.048]. Compared to non-PPI group, the rate of total gastrectomy [54.0%(27/50) vs. 34.4% (111/323), χ²=12.501, P=0.002], postoperative wound pain [34.0%(17/50) vs. 11.8% (38/323),χ²=16.928, P<0.001], secondary operation [6.0%(3/50) vs. 0.6% (2/323), χ²=6.032, P=0.014] and the rate of gastric tube removal later than 7 days postoperatively [96.0%(48/50) vs. 84.5%(273/323),χ²=4.811, P=0.028] were significantly higher in PPI group, respectively. The postoperative hospital stay was also prolonged in PPI group [16.0(9.5) days vs. 12.0(5.0) days, U=4 275.0, P<0.001]. Multivariate logistic regression analysis showed that preoperative comorbidities (OR=4.008, 95%CI:1.768-9.086, P=0.001), abdominal infection (OR=3.164, 95%CI:1.075-9.313, P=0.037), and wound pain (OR=3.428, 95%CI:1.557-7.548, P=0.002) were independent risk factors for PPI in patients over 60 years of age with gastric cancer. Furthermore, 50 patients with pulmonary infection were classified according to the length of latency and the type of infection. The patients with PPI latency ≤ 3 days were classified as early onset (34 cases, 68.0%), and those with latency ≥ 4 days as delayed onset (16 cases, 32.0%); PPI combined with surgical infection (including anastomotic leakage, abdominal infection, duodenal stump leakage, wound infection, etc.) was classified into mixed infection group (13 cases, 26.0%), with non-surgical infection as simple infection group (37 cases, 74.0%). The results showed that the pulmonary infection occurred 0 to 12 days (median 3 days) before surgical infection in mix infection group. The incidence of previous chronic obstructive pulmonary disease (COPD) in patients with early onset was significantly higher than that in patients with delayed onset [17.6%(6/34) vs. 0, χ²=5.005, P=0.025], and the incidence of mixed infection in patients with delayed onset was significantly higher than that in patients with early onset [50%(8/16) vs. 14.7%(5/34), χ²=6.730, P=0.009],but there was no significant difference in postoperative hospital stay between the two groups[17.0(9.8) days vs. 14.0(9.5) days, U=224.0, P=0.317]. Postoperative pulmonary infection is common in gastric cancer patients over 60 years of age. Preoperative comorbidities, abdominal infection and wound pain are independent risk factors for postoperative pulmonary infection. Pulmonary infection within 3 days after operation is associated with preoperative COPD. For patients suffering from PPI after the 4th day,attentions should be paid to abdominal infection and anastomotic leakage.

Molecular characterization of Trichinella species from wild animals in Israel

Trichinellosis is a worldwide disease caused by nematode worms of the genus Trichinella, frequently diagnosed in Israel. However, the identity of the Israeli isolates have not been studied. Here we describe the molecular characterization of 58 isolates collected from jackals (Canis aureus), wild boar (Sus scrofa), foxes (Vulpes vulpes) and a wolf (Canis lupus) in central and northern Israel. Isolates were analyzed using the multiplex PCR analysis encompassing expansion segment V (ESV) and internal sequence 1 (ITS-1) markers, which identified 52 of the 58 samples. Out of the six unidentified samples, four were successfully identified using extended PCR assays for ESV and ITS-1, developed in this study. Our analysis identified 44 isolates as T. britovi, 8 as T. spiralis, four mixed infections, and two isolates were not identified. Clonal analysis of the ITS-1 sequences from six isolates confirmed the initial identification of four mixed infections. These results show that the prevalent species in Israel are T. britovi and T. spiralis, with nearly 7% (4 of 58) incidence of mixed infection.

Patterns of mixed Plasmodium species infections among children six years and under in selected malaria hyper-endemic communities of Zambia: population-based survey observations.

BackgroundAlthough malaria is preventable and treatable, it still claims 660,000 lives every year globally with children under five years of age having the highest burden. In Zambia, malaria rapid diagnostic tests (RDTs) that only detect Plasmodium falciparum are the main confirmatory means for malaria diagnosis in most health facilities without microscopy services. As a consequence of this P. falciparum species diagnostic approach, non-falciparum malaria is not only under-diagnosed but entirely missed, thereby making the exact disease burden unknown. We thus investigated the prevalence of various Plasmodium spp. and associated burden of infection in selected communities in Zambia.MethodsData from two malaria hyper-endemic provinces (Eastern and Luapula) of the 2012 National Malaria Indicator Survey (MIS), conducted between April and May 2012, were used. The MIS is a nationally representative, two-stage cluster survey conducted to coincide with the end of the malaria transmission season. Social, behavioural and background information were collected from households as part of the survey. Thick blood smears, RDTs and dried blood spots (DBS) were collected from children below six years of age. Slides were stained using Giemsa and examined by microscopy while polymerase chain reaction (PCR) was used to analyse the DBS for malaria Plasmodium spp. Multivariate logistic regression was employed to examine the association between background factors and malaria.ResultsOverall, 873 children younger than six years of age were surveyed. The overall prevalence of Plasmodium spp. by PCR was 54.3% (95% CI 51–57.6%). Of the total Plasmodium isolates, 88% were P. falciparum, 10.6% were mixed infections and 1.4% were non-falciparum mono infections. Among the mixed infections, the majority were a combination of P. falciparum and P. malariae (6.5% of all mixed infections). Children two years and older (2–5 years) had three-fold higher risk of mixed malaria infections (aOR 2.8 CI 1.31–5.69) than children younger than two years of age.ConclusionThe high prevalence of mixed Plasmodium spp. infections in this population stresses review of the current malaria RDT diagnostic approaches. The observed less incidence of mixed infections in children under two years of age compared to their older two-to-five-year-old counterparts is probably due to the protective maternal passive immunity, among other factors, in that age group.

Mixed infection of pineapple and grassy shoot diseases on commercial sugarcane varieties in Uttar Pradesh, India

Infection of sugarcane grassy shoot and pineapple diseases were observed in sugarcane varieties CoS 07250 and CoS 97264 grown in Tilhar and SRI Farm of Shahjahnapur district of Uttar Pradesh, India. The growth of the plant was severely affected by both diseases. However, the incidence of the pineapple disease was 2–5%, while grassy shoot symptomatology was recorded up to 30%. The incidence of mixed infection was 4% in popular varieties of sugarcane namely CoS 97264 & CoS 07250. Symptoms, culture characteristics and molecular detection (according with the different organims) confirmed the association of Ceratocytis paradoxa and sugarcane grassy shoot phytoplasma in mixed infection. This disease was responsible for serious growth and yield losses in affected commercial varieties in Uttar Pradesh.

Incidence of Intestinal Parasites among Food Handlers (Hawkers) around the University of Nigeria Teaching Hospital Enugu, Enugu State, Nigeria

Incidence of intestinal Parasites has been described as one of the most common problems of developing countries like Nigeria. World Health Organization estimated that 3.5 billion people worldwide are infected with some types of intestinal parasites, and as many as 450 million of them are sick as a result. This work therefore is carried out to access the carrier status of food handlers around the University of Nigeria Teaching Hospital Enugu in Enugu State of Nigeria as well as to ascertain the common offending parasite. Three hundred and six (306) stool samples were randomly collected between January and August, 2001 from food vendors occupying the zones around the Teaching Hospital which include: UNTH Road, Railway track, Prison old park and Dean’s cook. The samples were transported to the University of Nigeria Teaching Hospital Parasitology Laboratory within 1 hour of production and analysed Parasitologically using Physiological saline and iodine direct mount and formal ether concentration techniques. Out of the 306 stool samples analysed, 126 representing 41.2% tested positive to parasites. Entamobe histolytica showed the highest incidence of 52.4% followed by Ascaris lumbricoidis with 23.8% and the least was Tricharis trichura with 40%. The incidence of mixed infection was 44.4%. Female food handlers were more infected 44.2% than the male food handlers 36.8%. Whereas Meat handlers were most infected 66.7% among other food handlers. From the result of the work, it can be inferredthat the incidence of intestinal parasites among food handlers around the University of Nigeria Teaching Hospital Enugu is high and this can be attributed mainly to poor sanitary condition of this area. We therefore recommend that Enugu State Government should intensify her sanitation programme especially where public foods are being handled, as well as provide enlightenment campaign for food handlers to save the lives of her citizenry.

Geographic distribution of Theileria sp. (buffalo) and Theileria sp. (bougasvlei) in Cape buffalo (Syncerus caffer) in southern Africa: implications for speciation

Strict control measures apply to movement of buffalo in South Africa including testing for Theileria parva, the causative agent of Corridor disease in cattle. The official test is a real-time hybridization PCR assay that amplifies the 18S rRNA V4 hyper-variable region of T. parva, T. sp. (buffalo) and T. sp. (bougasvlei). Mixed infections with the latter organisms affect diagnostic sensitivity due to PCR suppression. While the incidence of mixed infections in the Corridor disease endemic region of South Africa is significant, little information is available on the specific distribution and prevalence of T. sp. (buffalo) and T. sp. (bougasvlei). Specific real-time PCR assays were developed and a total of 1211 samples known to harbour these parasites were screened. Both parasites are widely distributed in southern Africa and the incidence of mixed infections with T. parva within the endemic region is similar (∼25-50%). However, a significant discrepancy exists in regard to mixed infections of T. sp. (buffalo) and T. sp. (bougasvlei) (∼10%). Evidence for speciation between T. sp. (buffalo) and T. sp. (bougasvlei) is supported by phylogenetic analysis of the COI gene, and their designation as different species. This suggests mutual exclusion of parasites and the possibility of hybrid sterility in cases of mixed infections.

Mixed infections in children with Mycoplasma pneumoniae pneumonia

To investigate the incidence and clinical features of mixed infections in children with Mycoplasma pneumoniae (MP) pneumonia. A total of 201 cases diagnosed as MP pneumonia were investigated for mixed infections by sputum bacterial culture, respiratory virus antigen detection and serum Chlamydia pneumoniae antibody test. For those with the indications for bronchoscopy, we also did bronchoalveolar lavage and lavage bacterial culture. A high incidence (103/201, 51.2%) of mixed infections in children with MP pneumonia was revealed. The most frequent co-infected pathogen was Chlamydia pneumoniae (52, 25.9%), followed by viruses (29, 14.4%), and bacteria (22, 10.9%). Among viruses, respiratory syncytial virus was the most common (17, 8.5%), followed by adenovirus (6, 3.0%), parainfluenza virus type III (4, 2.0%) and influenza virus type B (2, 1.0%). Sputum bacterial culture was positive in 14/201 (7.0%) cases, Streptococcus pneumonia being most common (6, 3.0%). BALF culture yielded positive results in 11.6% (8/69), Streptococcus pneumonia was also common (5, 7.3%). Among 29 cases with MP and virus coinfection, 26 were younger than 3 years (89.7%), while for MP and Chlamydia pneumoniae coinfection, most of them were older than 3 years (40/52, 76.9%). Compared with non-mixed infections, those with mixed infections had longer fever duration (24.5% and 40.8% longer than 10 d), more frequently developed pleural effusion (11.2%, 23.3%) and large area of shadow in chest imaging (35.7%, 51.5%). White blood cell [(14.28 ± 4.99) × 10(9)/L], C-reactive protein (CRP) [69(32.5 - 99.5) mg/L] and neutrophil ratio in BALF [0.86 (0.63 - 0.91)] were much higher in children with mixed bacterial infections than that in non-mixed infections [(9.06 ± 3.47) × 10(9)/L, 3 (0 - 31.0) mg/L, 0.44 (0.03 - 0.88)]. But no significant difference was found in peripheral blood neutrophil proportion between mixed bacterial infections (0.38 ± 0.25) and non-mixed infections (0.51 ± 0.19). More than half of cases with MP pneumonia had mixed infections, most commonly caused by Chlamydia pneumonia followed by viruses. The incidence of mixed infections with bacteria was low. Mixed infections with virus were more common in young children, while mixed infection with Chlamydia pneumoniae was more common in older ones. Bacterial infections should be paid more attention, especially those caused by Streptococcus pneumoniae, for those with high peripheral white blood cell counts, high CRP levels and high proportion of neutrophils in BALF.

Changing Patterns of Rotavirus Genotypes in Turkey

To describe the circulation dynamics of human rotavirus genotypes and to understand the epidemiological changes of rotavirus infection in Turkey, one of the countries where the highest mortality rates are seen due to rotavirus in Europe. Stool samples of children under 5 years of age which gave positive results for rotavirus antigen were stored at -20°C and then genotyped using multiplex reverse transcription polymerase-chain reaction. Of the 494 stool samples, 137 (28.1%) were positive for rotavirus antigen and 100 (73%) samples which could be genotyped successfully were included in the study. 42 (42%) samples were from inpatients, and 58 (58%) were from outpatients. The median age of the children was 16 months (5 days-59 months). G9 and P[8] were the most frequent G and P genotypes, and were detected in 30 (30%) and 55 patients (55%), respectively. In 90 samples for which both G and P genotypes could be determined, 34 different combinations were found. G9P[8] was the most frequent genotype detected in 19 patients (19%), followed by G1P[8] and G4P[6] each in 7 (7%) patients. The incidence of mixed infection was found to be 26%. Novel strains like P2A[6] and P[5] and unusual reassortant strains were detected. Distribution of rotavirus genotypes exhibited distinctive changes in this study. When the ever-changing epidemiology of rotaviruses is taken into account, ongoing surveillance studies are important before the inclusion of rotavirus vaccines in national immunization program of Turkey.

MixedTheileriainfections in free-ranging buffalo herds: implications for diagnosingTheileria parvainfections in Cape buffalo (Syncerus caffer)

Buffalo-adapted Theileria parva causes Corridor disease in cattle. Strict control measures therefore apply to the movement of buffalo in South Africa and include mandatory testing of buffalo for the presence of T. parva. The official test is a real-time hybridization PCR assay that amplifies the V4 hypervariable region of the 18S rRNA gene of T. parva, T. sp. (buffalo) and T. sp. (bougasvlei). The effect that mixed T. parva and T. sp. (buffalo)-like infections have on accurate T. parva diagnosis was investigated in this study. In vitro mixed infection simulations indicated PCR signal suppression at 100 to 1000-fold T. sp. (buffalo) excess at low T. parva parasitaemia. Suppression of PCR signal was found in field buffalo with mixed infections. The T. parva-positive status of these cases was confirmed by selective suppression of T. sp. (buffalo) amplification using a locked nucleic acid clamp and independent assays based on the p67, p104 and Tpr genes. The incidence of mixed infections in the Corridor disease endemic region of South Africa is significant, while the prevalence in buffalo outside the endemic area is currently low. A predicted increase of T. sp. (buffalo)-like infections can affect future diagnoses where mixed infections occur, prompting the need for improvements in current diagnostics.

Analysis of etiology and drug resistance of infectious diarrhea among children in Beijing area in 2009

Objective To investigate the etiology, epidemiologic features and drug resistance tendency of acute infectious diarrhea among children in Beijing area. Methods Enteric pathogenic bacteria were isolated, cultured and identified for serotype from the stool specimens of children with the initial clinical diagnosis of acute bacterial diarrhea in the intestinal clinic from January to October in 2009 ,and the antibiotic susceptibility of bacteria was tested by disk diffusion method. The cluster A rotavirus antigen was also detected by the qualitative technique of immunochromatographic double-antibody sandwich assay. Results Of the 256 stool specimens, 87 strains of 4 species of pathogenic bacteria were detected with the detectable rate of 34. 0% ,of which 2 strains were detected in one stool sample ,including 40 strains of salmonella (46. 0%) ,23 strains of shigella (26. 4%) ,2 strains of diarrheogenic escherichia coli (2. 3%) and 22 strains of staphylococcus aureus (25.3%). The positively detected patients consisted of 54 males and 32 females with the ratio of 1.69∶1 ,of whom 55 cases (64. 0%) were under 2 years of age. Of the 13 strains of shigella, 13 were sonnei shigella (56. 5%). And of the 22 strains of staphylococcus aureus,20 were detected among the infants under 1 year of age. The rates of crug resistance to certain antibiotics were lower in salmonella than in shigella (ampicillin :65. 0% vs. 95.7% ;compound sulfamethoxazole:20. 0% vs. 78. 3% ;ciprofloxacin:7.5% vs.8. 7% ;ceftriaxone: 15.0% vs. 73.9%). Of the 256 stool specimens ,47 were found positive for cluster A rotavirus,of whom 13 were also positive in stool bacteria culture. Conclusion Salmonella is the major pathogen among children with bacterial diarrhea in Beijing in 2009, and sonnei shigella is the main epidemic strains of shigella diarrhea. lnfants under 2 years of age are the susceptible population of the above two species of bacteria, while staphylococcus aureus mainly infect the infants under 1 years of age. Multi-resistance in shigella is still serious. The incidence of mixed infections of bacteria and rotavirus increases in children with infectious diarrhea. Key words: Infectious diarrhea; Etiology; Drug resistance; Rotavirus; Children

Emergence of G3 and G9 rotavirus and increased incidence of mixed infections in the southern region of Ireland 2001-2004

Two hundred and thirty fecal specimens were collected from children (up to 5 years of age) admitted with suspected rotaviral gastroenteritis at four Irish hospitals (Cork University Hospital, Mercy Hospital, Cork, Waterford Regional Hospital, and Kerry General Hospital) in the southern region of Ireland, between 2001 and 2004. Following laboratory confirmation of the aetiological agent, the rotavirus G-type was determined in all positive samples by reverse transcriptase-polymerase chain reaction (RT-PCR). The distribution of the G-types (n=230) over the 3 year period was G1 (31%), G9 (21.8%), G3 (8.7%), G4 (6.5%), and G2 (3.5%). There were many mixed infections which accounted for 28.5% of the collection. G9 emerged as the most prevalent G type (30.1%) in 2001-2002, whilst G3 first emerged in 2002-2003 and accounted for 15.8% of the collection. Notably, G2 strains were present at a very low frequency (3.5%) during 2001-2004, compared to an earlier study (1997-1999), where they accounted for 28.5% of the specimens. A smaller subset of the study collection was similarly P-typed (n=139). P[8]-type was identified as the most prevalent P-type, accounting for 97.4% (n=186), while P[4] accounted for just 2.6% (n=5) of the collection. The low frequency of P[4] coincided with the decrease in G2 strains in circulation. The key finding in this study was the emergence of G3- and G9-serotypes as epidemiologically important rotavirus strains since 1999, and the low prevalence of the previously common G2 strains in Ireland. The profile of rotavirus is changing continuously in Ireland and the implications for a successful vaccination program are discussed.

Comparative Analysis of the Dark Ground Buffy Coat Technique (DG) and Enzyme-Linked Immunosorbent Assay (ELISA) in the Diagnosis of Trypanosomosis in Cattle

The prevalence of typanosome infection in 65 cattle reared under expensive system of management was determined using the dark ground buffy coat (DG) technique and the enzyme-linkedimmunisorbent assay (ELISA). The DG technique showed that there were 18 positive cases (27.69%) of total number of animals, made up of 6 of Trypanosoma congolense, 7 of T. Vivax and 3 of T. Brucei. Other cases were those of mixed infections mainly one case of which all of 3 Trypansomes species were present, and another in which T. vivax, 12 of T. brucei and 2 cases of T. brucei were 30, (46.15%) positive cases made up of 6 of T. congolense, 7 of T. vivax, 12 of T. brucei and 2 cases of T. brucie mixed with t. Conglolese. The ELISA technique did not detect any incidence of mixed infections in which 3 species of trypanosomes were present. Key words: ELISA, Buffy coat, Trypanosomosis, cattle

Differential Staining of Schistosome Ova in Biopsies

The significance of identifying the infecting schistosome species has been highlighted recently by the availability of specific chemotherapeutic agents and an awareness that the tissue response – and therefore the prognosis – may be species-dependent. Moreover, human interference with the ecological systems in parts of the developing world has modified the epidemiological map of schistosomiasis resulting in a rising incidence of mixed infections. Differentiation between the ova of Schistosoma mansoni and S. haematobium, the two species commonly seen in immigrants to Kuwait and to other non-endemic areas of the world, usually poses no problems in urinary and faecal specimens. However, in histopathological samples, their distinctive morphological features cannot often be assessed reliably. We obtained satisfactory differentiation by using a modified Ziehl-Neelsen method on 81 routinely fixed and processed biopsy samples. Moreover, on destained sections previously stained with haematoxylin and eosin, the differences were equally evident. Details of the method and its applications both in routine histopathological practice and for research are discussed.

Viral etiology of idiopathic facial palsy (author's transl)

It is of great importance to know the incidence of viral infection on Bell's palsy and to establish an early differential diagnosis, not only for elucidating the causes of Bell's palsy but also for deciding the proper treatment, in 11 research facilities located throughout Japan were studied on 257 cases diagnosed as Bell's palsy and compared with the result on a healthy control group and a Ramsay Hunt's syndrome group. Antibody titers to eight viruses: varicella-zoster virus, herpes simplex virus, influenza A and B virus, mumps virus, adenovirus (all the above by complement-fixing reaction), rubella virus, and Japanese encephalitis virus (the last two by hemoagglutination inhibitation test). Viral infection was judged positive in such a case that titer differerence between the acuteand convalescent-phase specimens was four times or more. For the Ramsay Hunt's syndrome group (47 cases), all except the extremely mild cases exhibited significant increase in the antibody titer to varicella-zoster virus, re-confirming that V-Z virus caused Ramsay Hunt's syndrome. Out of the 257 cases of Bell's palsy, 94 cases (37%) showed significant increase in one or more of the types of virus by repetitive examination. Forty-five cases (18%) in the patients showed a significant rise in V-Z antibody titers. There were 14 cases (5%) for which herpes simplex virus can be the cause of paralysis. The fact that the incidence of mixed infection with influenza A virus, influenza B virus, or adenovirus in patients of zoster sine herpete (27%) was markedly greater than in the case of Ramsay Hunt's syndrome (4%) may indicate that owing to mixed infection with these viruses, lowvirulence varicellazoster virus may interact to generate facial paralysis

ON THE INCIDENCE OF MIXED INFECTIONS WITH INTESTINAL PROTOZOA1

Journal Article ON THE INCIDENCE OF MIXED INFECTIONS WITH INTESTINAL PROTOZOA Get access DONALD C. BOUGHTON, DONALD C. BOUGHTON Search for other works by this author on: Oxford Academic PubMed Google Scholar ELON E. BYRD ELON E. BYRD Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 27, Issue 1, January 1938, Pages 88–94, https://doi.org/10.1093/oxfordjournals.aje.a118383 Published: 01 January 1938 Article history Received: 26 July 1937 Published: 01 January 1938