Infection Of Other Organs Research Articles

Treponemes and endodontic infections

The pathogenic potential of spirochetes and their significance in the development of oral diseases, as well as in infections in other organs, have gained new interest for several reasons. First, these bacteria have the potential to be pathogenic because of their number and frequency at infected sites, their production of tissue irritants, their ability to invade tissues, their abundance in mixed infections, and their methods to evade host defense mechanisms. Second, of the microbial species that are associated with oral infections, spirochetes are infectious agents that cause severe diseases in other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about spirochetes at the genetic level. Thereby, we have gained better knowledge of these bacteria, even though many cannot be cultured in the laboratory yet. Such knowledge includes the diversity of oral species as well as antigenic similarities between the species commonly found in the oral cavity and known pathogens such as the syphilis agent Treponema pallidum subsp. pallidum, Lyme disease agents Borrelia burgdorferi sensu lato group, and the swine dysentery agent Brachyspira (Serpulina) hyodysenteria. This review covers the main areas of what is known to date about Treponema. It focuses especially on factors related to their taxonomy, epidemiology, and biology, with special emphasis on their presence and possible role in endodontic infections.

Parvovirus infects cardiac myocytes in hydrops fetalis.

Parvovirus infection during pregnancy is an important cause of hydrops fetalis. It is attributed to anemia caused by viral-induced destruction of red blood cells. Infection of other organs has been reported including the heart, liver, and lungs. Few of these reports, however, convincingly demonstrate virions within the functional parenchyma of the tissue. This is of particular concern regarding myocardium in the context of hydrops fetalis which is, in part, due to cardiac failure. The problem in routine pathology practice is that most fetuses with the infection are macerated. This, in part, probably explains the paucity of published information on cardiac involvement. This study examined five cases of fatal hydrops fetalis with variable maceration with serologically proven parvovirus B19 infection. Transmission electron microscopy of cardiac tissue demonstrated intranuclear virions in both erythroid precursor cells and in cardiac myocytes in three of these cases. In each of these, immuno-gold electron microscopy provided confirmatory evidence of parvovirus infection. Virions were not identifiable where maceration had caused disintegration of nuclei in the myocytes. In addition, virions were absent in the three negative control cases where retroplacental hemorrhage was confirmed as the cause of death. This study suggests that parvovirus infection of cardiac myocytes may play a more important role in causing hydrops fetalis than previously realized. It also demonstrates that maceration should not discourage the use of electron microscopy.

Probiotics and non-intestinal infectious conditions.

Orally ingested probiotic micro-organisms do not exert health effects exclusively in the intestine. Some strains can alleviate or prevent bacterial, fungal or viral infections in other organs by stimulation of the immune system. By preservation or improvement of the barrier function of the intestinal mucosa, they may inhibit translocation of potential pathogens and thus prevent infections of the blood stream and other tissues and organs. Modulation of the intestinal microflora can affect the local microflora of the urogenital tract and possibly of the oral cavity. Finally, some strains of orally ingested bacteria reach target organs like the urogenital tract in a viable state; alternatively they can be applied locally. Despite the infection-preventing properties of probiotic bacteria, lactic acid bacteria have rarely been identified in infections of the blood stream, heart valves and other organs, usually only in patients with severe disease. It is the general opinion that in most cases the source of infection was the commensal microflora of the intestine or the oral cavity. Until now only one case of infection associated with administration of a probiotic strain has been published. The most promising health-promoting effects have been seen in vaginosis, urinary tract infections, Helicobacter pylori gastritis and infections of the respiratory tract in children. More controlled clinical trials with sufficient numbers of participants are needed to determine the scientific basis for the use of probiotic bacteria in infections in locations of the body other than the intestine.

Role of Cat‐Scratch Disease in Lymphadenopathy in the Head and Neck

Bartonella henselae is the causative agent of cat-scratch disease (CSD), which usually manifests as acute regional lymphadenopathy. The causes of cervical lymphadenopathy, with special regard to CSD, were investigated in a study of 454 patients who presented with unclear masses in the head and neck from January 1997 through January 2001. Sixty-one patients (13.4%) experienced CSD; 54 (11.9%) had primary lymphadenopathy due to other infectious agents, and 41 (9.0%) had lymphadenopathy that occurred in association with primary infections of other organs. For 171 patients (37.7%), the cause of the cervical lymph node enlargement could not be found. B. henselae DNA was detected in extirpated lymph nodes only during the first 6 weeks of lymphadenopathy, which indicates that the results of polymerase chain reaction strongly depend on the duration of illness. CSD should be included in the differential diagnosis of adenopathy in the otorhinolaryngologic patient population, to avoid unnecessary treatment.

Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum.

The pathogenic potential of Fusobacterium nucleatum and its significance in the development of periodontal diseases, as well as in infections in other organs, have gained new interest for several reasons. First, this bacterium has the potential to be pathogenic because of its number and frequency in periodontal lesions, its production of tissue irritants, its synergism with other bacteria in mixed infections, and its ability to form aggregates with other suspected pathogens in periodontal disease and thus act as a bridge between early and late colonizers on the tooth surface. Second, of the microbial species that are statistically associated with periodontal disease, F. nucleatum is the most common in clinical infections of other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about F. nucleatum on the genetic level, thereby also gaining better knowledge of the structure and functions of the outer membrane proteins (OMPs). OMPs are of great interest with respect to coaggregation, cell nutrition, and antibiotic susceptibility. This review covers what is known to date about F. nucleatum in general, such as taxonomy and biology, with special emphasis on its pathogenic potential. Its possible relationship to other periodontal bacteria in the development of periodontal diseases and the possible roles played by OMPs are considered.

Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum.

The pathogenic potential of Fusobacterium nucleatum and its significance in the development of periodontal diseases, as well as in infections in other organs, have gained new interest for several reasons. First, this bacterium has the potential to be pathogenic because of its number and frequency in periodontal lesions, its production of tissue irritants, its synergism with other bacteria in mixed infections, and its ability to form aggregates with other suspected pathogens in periodontal disease and thus act as a bridge between early and late colonizers on the tooth surface. Second, of the microbial species that are statistically associated with periodontal disease, F. nucleatum is the most common in clinical infections of other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about F. nucleatum on the genetic level, thereby also gaining better knowledge of the structure and functions of the outer membrane proteins (OMPs). OMPs are of great interest with respect to coaggregation, cell nutrition, and antibiotic susceptibility. This review covers what is known to date about F. nucleatum in general, such as taxonomy and biology, with special emphasis on its pathogenic potential. Its possible relationship to other periodontal bacteria in the development of periodontal diseases and the possible roles played by OMPs are considered.

Cytomegalovirus colitis in patients with acquired immunodeficiency syndrome.

The spectrum of presentation of complications in patients with human immunodeficiency virus (HIV) disease is changing, in line with their improved survival. Infection of the colon with cytomegalovirus (CMV) is now more commonly encountered in clinical practice. We have reviewed the medical records of eleven patients with clinical and pathological evidence of CMV colitis. The clinical presentation, endoscopic and histological findings, and simultaneous infection of other organs with CMV are discussed. Diarrhoea in association with abdominal pain is the most frequent symptom complex in these patients and should raise the clinical index of suspicion for CMV colitis.

Ribavirin efficacy in an in vivo model of Crimean-Congo hemorrhagic fever virus (CCHF) infection

After intraperitoneal (i.p.) infection of infant mice with CCHF virus, virus titers in liver remained significantly higher than in other organs except blood (serum). Within the liver, virus antigen was first found by immunofluorescence (IFA) in Kupffer cells followed by more extensive hepatic spread. Later, virus was found in other organs including brain and heart. Ribavirin treatment significantly reduced infant mouse mortality and extended the geometric mean time to death. Ribavirin treatment reduced CCHF virus growth in liver and significantly decreased, but did not prevent, viremia. Despite a substantial viremia, infection of other organs including brain and heart was not detected in ribavirin-treated mice. A hepatotropic virus subpopulation with less neurovirulence than the parent was isolated from liver of ribavirin-treated mice (single dose, 100 mg/kg). After serial passage in placebo-treated mice, the exclusive hepatotropism was lost.

Ocular toxoplasmosis in the immunocompromised host.

Disseminated toxoplasmosis is a well-known complication of immunodeficiency states, including those induced by malignancies, steroid and cytotoxic drug therapy, and AIDS. In immunodeficient patients, toxoplasmic infections of the eye are less common than toxoplasmic infections of other organs for unknown reasons. When ocular toxoplasmosis does occur in the immunodeficient host, or if immunosuppressive therapy is administered to patients with active disease, widespread tissue destruction by proliferating organisms may result. Immunodeficiency alone may not be sufficient, however, to cause reactivation of encysted organisms in retinochoroidal scars. Ocular toxoplasmosis in the immunocompromised host presents difficult problems in diagnosis and management. There may be a variety of clinical lesions, including single foci of retinochoroiditis in one or both eyes, multifocal lesions, or diffuse areas of retinal necrosis. The majority of lesions do not arise from the borders of preexisting scars, which suggests that they result from acquired infection or dissemination of organisms from nonocular sites of disease. Toxoplasma gondii may infect iris, choroid, and vitreous-tissues that are not usually infected in the immunocompetent host. Ocular lesions appear to respond to standard antiparasitic drug therapies, but continued treatment is probably necessary to prevent reactivation of disease in the most immunocompromised patients. The best treatment regimens have yet to be determined. Histopathologic studies show little retinal inflammation; therefore anti-inflammatory drugs, such as oral steroids, probably have no role in the management of infection.

Ganciclovir therapy in iatrogenically immunosuppressed patients with cytomegalovirus disease

A study of ganciclovir used on compassionate grounds in the treatment of severe cytomegalovirus disease in iatrogenically immunosuppressed and AIDS patients in Europe, commenced in June 1985. The results of 120 iatrogenically immunosuppressed patients treated between May 1986 and February 1988 are reported. Patients presented with systemic infection (58), pneumonia (58), retinitis (9) and infection of other organs (9). There was a favourable clinical response (as rated by the local physician) in 40 of 57 (70%) evaluable patients with systemic infection, 38/58 (65%) with pneumonia, 6/8 (75%) with retinitis, and 4/9 (44%) of those with CMV infection of other organs. Of particular note was the relatively high rate of short term survival (up to 12 days post therapy) in bone marrow transplant patients with CMV pneumonia, 10/19 (52%), compared to the 10% survival reported by Shepp et al., (1985). Adverse events were frequent (26%) and haematological effects necessitated discontinuation of treatment in 13/120 (11%) patients. The use of ganciclovir should be confined, therefore, to the treatment of severe cytomegalovirus disease.

A meatworks survey of bovine hydatidosis in southern Queensland.

A meatworks survey was undertaken in 1981-82 to define the distribution and prevalence of hydatidosis in beef cattle in southern Queensland. Hydatid cysts, mostly degenerate, were found in 14.6% of the 22,916 animals examined. The endemic area was to the east of a line approximating the 500 mm isohyet. Prevalence varied with age and origin of cattle, but not sex. Prevalence increased linearly with age, at least up to 4 years. Prevalence on the east coast ranged from 4.3% in yearlings to 52.2% in 4-year-old cattle. At the western limit of the endemic area, the prevalence ranged from 1.4% in yearlings to 10.8% in 4-year-olds. On the Darling Downs, prevalence was highest in areas where cattle raising is the main industry. On the south western Downs, where sheep-farming predominates, the prevalence in cattle was much lower, probably because of fewer dingoes. Livers only were affected in 46.5% of infected cattle, lungs only in 17.7%, and 35.8% of infected animals had both organs affected. Infection in other organs was uncommon. A detailed study of 133 infected cattle showed that 3.8% had lesions misdiagnosed as hydatid cysts at slaughter.

Prevention of central nervous system infections in patients at risk

Infections of the central nervous system in patients at risk are relatively uncommon when compared with pneumonia, bacteremia, and soft tissue infection. However, they carry serious morbidity and are frequently fatal. Each of the diverse conditions that can place a patient at risk for central nervous system infection is associated with a fairly predictable spectrum of etiologic organisms. Various forms of trauma (including blunt and penetrating injuries and neurosurgery, especially when a cerebrospinal fluid shunt is implanted) predispose to infection with common pathogenic bacteria. Defects of cellular immunity including congenital immune deficiencies, immunosuppressive drug therapy, leukemia, lymphoma, and the acquired immune deficiency syndrome are more likely to give rise to infection with a distinctive spectrum of opportunistic viruses, fungi, and protozoa. Other underlying conditions include sinus, ear, and mastoid infections, congenital heart disease, intrathoracic suppuration, endocarditis, and bacteremia, hypogammaglobulinemia, and complement deficiencies. Some preventive measures including vaccines, antibiotics, and surgical procedures are available. However, for many of these central nervous system infections, preventive measures are lacking or less effective than those for infections in other organs. In the future, opportunistic central nervous system infections will increase in frequency as the number of patients at risk continues to grow.

Current Approach to Prevention and Treatment of Pseudomonas aeruginosa Infections in Burned Patients

The extensively burned or severely injured patient is at increased risk of wound infection as well as of infection of other organs as a result of various degrees of impairment of host defense mechanisms. The incidence of burn wound and other infections increases as the severity of injury increases. The ease with which gram-negative, opportunistic organisms, especially Pseudomonas aeruginosa of either endogenous or exogenous origin, can colonize and invade the immunosuppressed patient demands an active infection-surveillance program. Topical therapy for burn wounds with any of three available agents has significantly reduced the occurrence of invasive pseudomonas burn-wound sepsis, but none of the agents sterilize the burn wound, and the microbial flora of the burns of any given patient may escape from control and invade viable tissue. Clinical identification and biopsy confirmation of invasive burn-wound sepsis necessitates changes in both wound and general care, with surgical and antibiotic treatment guided by the extent and depth of wound invasion. Immunologic prophylaxis and treatment of pseudomonas infections, although attractive, remain of unverified clinical effectiveness. Effective treatment of pseudomonas septicemia secondary to invasive burn-wound sepsis and of pseudomonas infections in other organs is dependent on early diagnosis, appropriate antibiotic therapy guided by sensitivity testing, and adequate surgical intervention when required.

Role of the spleen in the pathogenesis of marek's disease12

The importance of the spleen for the pathogenesis of Marek's disease (MD) was investigated. The spleen was not required for infection of other organs or for the development of latently infected peripheral blood lymphocytes (PBL). Splenectomised (Sx) chickens had infected lymphocytes in the thymus, bursa and PBL by 6 or 7 days after intratracheal exposure to MDV. However, splenectomy did delay the spread of infection since intact birds had positive cells in these tissues 2 to 3 days earlier. Splenectomy reduced the number of visceral tumours in JM-10- but not in GA-5-infected chickens. Splenectomy did not influence the degree of protection by vaccination with SB-1.

Chronic pruritic dermatitis in asthmatic monkeys: a subhuman primate analogue of atopic dermatitis?

In a group of adult normal rhesus monkeys and monkeys with IgE-mediated asthma observed over a period of 15 years, 2 of the latter group were found to have chronic, generalized pruritus and dermatitis. The skin lesions were recurrent and located on the flexural surfaces of the forearms leading to the thickened, scaling, lichenified dermatitis in that area in the skin of 1 monkey. The pruritus and skin lesions subsided following therapy with depot methylprednisolone but recurred after this therapy was discontinued. Both animals had recurrent severe cutaneous infections in excoriated lesions following scratching without infections in other organs. The cutaneous infections responded to penicillin therapy but recurred with scratching. No deficiencies in immunoglobulin levels, or lymphocyte responses to phytohemagglutinin were found in these 2 monkeys. The 2 animals differed from normal animals by their high titers of immediate skin reactivity to ascaris antigen, persistent and severe asthmatic responses to ascaris antigen, high IgG antibody levels to ascaris antigen but all of the latter findings were also present in asthmatic monkeys without dermatitis. Cutaneous biopsies of lesions were nonspecific but provided no evidence for other explanations for the dermatitis which appears to be an analogue of human atopic dermatitis.

Neurologic complications of bacterial endocarditis.

(1) Neurologic complications remain a significant problem in bacterial endocarditis. Of 218 patients with endocarditis, 84 (39%) had a neurologic complication and 58% of these 84 patients died. In contrast, the mortality rate was only 20% among those endocarditis patients without neurologic complications. (2) Of the neurologic complications, cerebral embolism is the most frequent and important. An embolic stroke occurred in 37 (17%) of our patients, with 30 of these patients dying. Emboli are important not only in terms of the direct morbidity and mortality they cause via cerebral infarction, but also because of their role in the causation of mycotic aneurysms, brain abscesses, and abnormal CSF formulae. (3) Cerebral emboli are particularly common in patients with mitral valve infection, and in patients with infection due to virulent organisms, particularly S. aureus and enteric gram-negative bacilli. (4) Mycotic aneurysms occur more frequently in the course of acute endocarditis rather than late in the course of subacute disease. Management of angiographically demonstrated mycotic aneurysms is dependent upon the presence or absence of hemorrhage, the anatomic location of the aneurysm, and the clinical course of the patient. Healing of mycotic aneurysms can occur during the course of effective antimicrobial therapy, thus obviating the need for neurosurgical intervention in all such patients. (5) Macroscopic brain abscess is a rare complication of bacterial endocarditis. Miliary microscopic abscesses are more common than larger abscesses, particularly in patients with acute disease and miliary infection in other organs of the body. (6) Focal seizures occur most commonly in endocarditis patients with acute embolic disease; generalized seizures are of diverse etiologies, with metabolic factors being most important. Penicillin neurotoxicity should be considered in patients with impaired renal function who are receiving high dose penicillin. (7) With the exception of hemorrhagic complications, lumbar puncture results tend to reflect the nature of the infecting organism rather than the nature of the neurologic complication. Endocarditis due to virulent organisms such as S. aureus is usually associated with a purulent CSF formula while nonvirulent organisms, such as viridans streptococci, susually have aseptic or normal CSF formulae.

Virus diseases of the mouth mucosa

In accordance with the system of viral species, viral disorders of the oral mucosa may be classified with regard to their intensity of affection. There are but few viral infections exclusively affecting the oral mucosa like e.g. 1. Glossitis papulosa of Michelson, representing a special form of vaccinia inoculata, 2. Gingivo-stomatitis herpetica and 3. warts of the mucosa or condyloma-like papillomas of the oral mucosa including oral papillomatosis, that, itself shows morphological and clinical similarities to laryngeal papilloma. A second group of disorders mainly affecting the oral mucosa includes the "Aphthoid of Pospischill and Feyrter", Zahorsky's herpangina and other viral infections by the Coxsackie group, like vesicular stomatitis. The 3rd group represents viral infections of other organs in which affection of the oral mucosa is a prerogative, e.g. smallpox, varicella, foot-and-mouth disease and pharyngo-conjunctival fever. A 4th group includes those viral infections of the organs in which co-affection of oral mucosa occurs frequently or once in a while (at occasions). Here, we find eczema vaccinatum, herpes zoster, herpes simplex of the oral mucosa mostly on the hard palate, eczema herpeticatum, post-herpetic Erythema exsudativum multiforme, Mononucleosis infectiosa Pfeiffer, viral flu, German measles, parotitis epidemica, rubeola and ECHO-exanthema. A 5th and last group is made up by viral infections of other organs, in which affection of the oral mucosa hardly occurs at all. This group contains paravaccinal Ecthyma contagiosum, poliomyelitis, viral infection of the city of Marburg and some Arbovirus infections. Relatively few viral disorders never co-exist with lesions on the oral mucosa like e.g. Virus-hepatitis or some viral encephalitides. Groups 1 and 2, most important of all, are presented in detail regarding clinics, diagnostics, differential-diagnosis and therapy. The disorders within the other 3 groups are discussed only regarding their importance in the field of ENT-related symptoms of the oral mucosa. A number of pictures and tables completes important clinical details and give further hints to their differential-diagnosis.

Active Histoplasma Meningitis of 22 Years' Duration

HISTOPLASMA meningitis without infection of other organs is an exceedingly rare disease. We have had the opportunity to follow-up a case of Histoplasma meningitis, previously reported 11 years ago, 1 that has now been active for 22 years without major sequelae, a degree of chronicity unique for meningeal infection due to any cause. This case suggests that histoplasmosis that is confined clinically to the meninges may follow a much more chronic course than Histoplasma meningitis with other organ involvement. Report of a Case A 58-year-old man was first hospitalized in 1952 for severe headaches. Lumbar puncture and analysis of cerebrospinal fluid (CSF) disclosed an elevated protein level, lymphocytosis, and hypoglycorrhachia. Cultures on this and on subsequent admissions were negative until 1959, when culture of 30 ml of CSF, removed during pneumoencephalography, was positive for Histoplasma capsulatum . Physical examination, roentgenograms, and cultures from multiple sites, including sputum, blood, urine, and bone

Chronic localized brucellosis of the spleen.

Chronic localized brucellosis of the spleen possibly may exist as a clinical entity apart from detectable brucellar involvement of other reticuloendothelial organs. Apparently the infection may be restricted to the spleen in some cases, and antibiotic therapy may eradicate the infection in other organs but not in the spleen. Six cases are reported, and a series of 10 cases is reviewed.