Positive Hemoculture Research Articles

Aneurismas micóticos: diagnóstico radiológico y alternativas terapéuticas

AimTo review mycotic aneurysms, their radiological diagnosis and therapeutic alternatives. Material and methodosFive men and a woman between 69 and 84 years old were diagnosed during the last 4 years with mycotic aneurysms. Three were in the aorta, one in the throracic and two in the abdominal region; one was affecting the left primitive iliac artery, another the left popliteal artery and, in the last case, the medial cerebral artery. Hemocultures were done on all patients. The surgical specimen was cultivated in 4. CAT was done on 5 patients, angiography on another five and Doppler ultrasound scan on two ResultsFive patients showed positive hemocultures and in two the surgical specimen culture was positive. The findings of the CAT were decisive in being able to suspect that the lesions were mycotic in nature. Three patients had to undergo emergency surgery, expiring either in surgery or in postoperative care. One case was treated by means of aortic endoprosthesis, and one year later the patient remains asymptomatic. The cerebral aneurysm was embolized with metal coils and the patient remains asymptomatic three years later. The popliteal aneurysm underwent surgical intervention using an established protocol with good results. ConclusionsCAT is decisive in the diagnosis of mycotic aneurysms. Once detected, they must be treated without delay as their natural evolution is one of rapid expansion and rupture. Angiographies help in planning the treatment. Radiological intervention plays an important role in the treatment.

Trypanosoma cruzi: Infectivity of Clonal Genotype Infections in Acute and Chronic Phases in Mice

Lana, M. de, Silveira Pinto, A. da, Bastrenta, B., Barnabé, C., Noël, S., and Tibayrenc, M. 2000. Trypanosoma cruzi: Infectivity of clonal genotype infections in acute and chronic phases in mice. Experimental Parasitology96, 61–66. Eight Trypanosoma cruzi stocks pertaining to the clonal genotypes 19/20, 32, and 39 have been characterized for three experimental parameters of infectivity in Balb/c mice: (i) percentage of mice with a patent parasitemia (% MPP), (ii) maximum parasitemia (MP), and (iii) percentage of mice with positive hemoculture (% MPH). By order of decreasing values, the values recorded for the clonal genotypes ranked as follows: 19/20, 32, and 39, except for the % MPP parameter, for which 19/20 and 32 were not statistically different. The rate of successful reisolation after infection in mice, analyzed by multilocus enzyme electrophoresis and random amplified polymorphic DNA typing, was statistically different according to the clonal genotype and was different for uniclonal infections and for mixed infections by two different clonal genotypes. These results confirm that T. cruzi clonal genotypes differ significantly in their infectivity in mice.

Trypanosoma cruzi infection in Leontopithecus rosalia at the Reserva Biológica de Poco das Antas, Rio de Janeiro, Brazil.

Wild golden lion tamarins (Leontopithecus rosalia) - endangered primates that are native to the Brazilian Atlantic coastal forest - were surveyed for the presence of Trypanosoma cruzi with the use of Giemsa-stained blood smears, hemocultures and an indirect immunofluorescence assay (IFAT). Positive IFAT with titers ranging from 1:20 to 1:1280 were observed in 52% of the 118 wild tamarins examined and the parasite was isolated from 38 tamarins. No patent parasitemia was observed among the tamarins from which T. cruzi was isolated. Serum conversion and positive hemoculture was observed for three animals that had yielded negative results some months earlier, which indicates that T. cruzi is actively transmitted among tamarins. In contrast to observations with other sylvatic isolates, those from the tamarins were significantly more virulent and most of them produced mortality in experimentally infected Swiss mice. Some variation in the kDNA restriction profiles among the isolates was observed. Electrophoresis with GPI, G6PDH, IDH, MDH and ME enzymes showed a Z2 profile.

High rates of positive hemocultures in children and teenagers seropositive for Trypanosoma cruzi in the State of Rio Grande do Sul, Brazil.

High rates of positive hemocultures in children and teenagers seropositive for Trypanosoma cruzi in the State of Rio Grande do Sul, Brazil.

Tratamento cirúrgico da endocardite infecciosa

RAvaliaram-se as indicações, as alterações e os resultados cirúrgicos de 28 pacientes, operados por endocardite infecciosa (EI) no período de 1983 a 1994. O diagnóstico clínico foi confirmado pela ecocardiografia e pela cineangiocardiografia. Dos pacientes, 65% eram do sexo masculino e 25% do feminino, com média de idades de 35,21 (14 a 67) anos. Noventa e três por cento dos pacientes estavam em classe funcional III e IV (NYHA). O tempo decorrido entre o diagnóstico e a cirurgia foi em média de quatro semanas e meia (1 a 363 dias). A hemocultura foi positiva em 25% dos casos e os germes mais freqüentemente encontrados foram estreptococos e estafilococos. A valva aórtica foi a mais acometida e as vegetações foram as lesões mais comumente encontradas. O tratamento cirúrgico utilizado foi a plastia valvar em 2 casos e a substituição valvar por prótese em 26.Complicações ocorreram em 39,28% dos casos, com 5(18%) mortes. Conclui-se que, embora rara, a EI é doença grave e, se não prevenida com adequada antibiótico-profilaxia ou tratada em tempo hábil, o paciente terá conseqüências graves, podendo, até mesmo, falecer.

THERAPEUTIC EFFECTIVENESS OF INTRAVENOUS IMMUNOGLOBULINE (IVIG) IN VERY LOW BIRTH WEIGHT NEWBORNS WITH SEPSIS

Preterm newborns are susceptible of invasion by microorganisms due to immaturity of their immune system. This study aimed at assessing the effect of IV immunoglobulins as supportive treatment in neonatal sepsis. Subjects and methods: 32 preterm newborns whose weight at delivery was under 1500 grams were prospectively studied for two years after they had developed sepsis in the Neonatal ICU of G.Grant B.Hospital in Concepción. Sepsis was defined as the presence of positive hemoculture, compatible clinical signs and/or symptoms and corroborating laboratory tests. The 32 newborns had been randomly assigned to two groups: 16 newborns received the regular antibacterial treatment (Group I) and the remaining 16, were given 500mg/kg/day IVIG for 7 days (Group II) in addition to antibiotics. Serum IgG levels were tested during and at the end of treatment by Group I, and on a daily basis in those in Group II. Collateral effects from IVIG infusion were monitored by clinical observation and laboratory tests (CBC, transaminases blood, creatinine). Results: Average delivery weights were 1124 grams and 1095 grams for Group I and II, respectively. No sex predominance occurred in either group. Average basal serum IgG level was 486 mg in Group II and increased to 852 mg (p<0.01) after the first IVIG dosage. Significant correlation (r = 0.94) was found between IgG levels in serum and days of treatment. The mortality rate was 31.356 in Group I and 6.3% in Group II (p<0.03). No untoward effects were observed after IVIG infusion.IVIG administration may be an efficient, low risk supportive therapy in the treatment of neonatal sepsis.

Production of Specific Monoclonal Antibodies to Salmonella typhi Flagellin and Possible Application to Immunodiagnosis of Typhoid Fever

Four murine monoclonal antibodies (MAbs) to Salmonella typhi flagellin were produced. These MAbs did not react with eight other enterobacterial strains tested: Salmonella enteritidis, Salmonella typhimurium, Salmonella paratyphi A, Escherichia coli, Shigella flexneri, Shigella sonnei, Yersinia enterocolitica, and Campylobacter jejuni. All four MAbs cross-reacted with Salmonella muenchen flagellin indicating specificity for d antigenic flagellar epitope. One MAb (C4) was selected to develop a double antibody sandwich enzyme-linked immunosorbent assay (ELISA) to detect S. typhi flagellin in serum samples. By use of this assay S. typhi flagellar antigen was detected in 95.5% of serum samples from patients with positive hemoculture for S. typhi, in 93.6% of samples from patients with positive serodiagnosis of typhoid fever, in 26% of samples collected from patients who were initially hemoculture-positive for S. typhi and who had undergone 7-8 d of chemotherapy, in 8.5% of samples from healthy persons from an endemic area, and in no samples from healthy persons from a nonendemic area. The presence of high levels of flagellin antibody titers did not interfere with the antigen detection. The detection of S. typhi flagellar antigen in patient serum may have practical value for rapid diagnosis of typhoid fever.

Study of the etiology of acute lung diseases of childhood by transthoracic lung aspiration. São Paulo, Brazil

No período de abril de 1979 a julho de 1980 foram estudadas 45 crianças, de ambos os sexos, na faixa etária de 2 meses a 5 anos de idade, selecionadas entre as atendidas no Instituto da Criança "Pedro Alcântara" do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, e acometidas de pneumopatias agudas. Dos 45 pacientes estudados, a maioria (46,7%) encontrava se na faixa de 2-12 meses de idade e, quanto ao estado nutricional, 42,2% eutróficos e 57,8% desnutridos, variando essa desnutrição do grau I ao grau III. Empregando amostras obtidas por aspiração pulmonar e examinando-as pelo método de coloração de Gram e cultura, foi possível identificar o agente etiológico de 26 (57,7%) pneumonias bacterianas nos 45 casos estudados. A identificação direta pelo método de Gram mostrou-se útil como orientação inicial para antibioticoterapia em 44,4% dos casos. Houve nítida predominância do Streptococcus pneumoniae como agente etiológico bacteriano nas pneumopatias agudas da criança nas várias faixas etárias estudadas seguido do Haemophilus influenzae e o Staphylococcus aureus. O estudo comparativo da cultura do aspirado pulmonar e da hemocultura permitiu maior precisão diagnostica (56,7%), revelando-se a hemocultura positiva em apenas 30,0% dos casos. Não foi constatada nenhuma participação de germes anaeróbios nas pneumopatias da amostragem estudada.

Double development cycle of Trypanosoma cruzi in the opossum.

cance. T. cruzi was found to grow abundantly as eprmtilgotes and to transform Into trypomastrgotes Identical to metacyclic forms, in the lumen of the anal glands of a high proportion of laboratory reared opossums (Didelphis marsupialis) that had been subcutaneously inoculated with faeces of infected trratomine bugs. No intracellular amastlgotes were found In the various layers of the gland wall, not even in the thick striated muscular layer. The developmental phases in the lumen of the anal glands appear to mimic the parasite’s developmental cycle In the intestinal tract of the insect vectors (Figs I and 2). At the same time, a classic intracellular cycle, with trypomastigotes In the bloodstream, was shown by patent parasltaemia, positive haemoculture and xenodiagnosls, and by findtng amastrgotes tn myofibres of several muscles. All the opossums were positive in indirect fluorescent antibody tests. Parasites taken directly from the anal glands were cultivated in axenic media, Infected triatomine bugs, mice and opossums, and were typed to the same schizodeme and zymodeme of those derived from the blood and those of the inoculated strain. No doubt the population that developed In the lumen of the anal glands was part of

Side effects of immunization with liver attenuated Trypanosoma cruzi in mice and rabbits.

Immunity against lethal, bloodstream forms of Trypanosoma cruzi was achieved in mice by preinoculation of approximately equal to 10(5) culture epimastigotes of an attenuated T. cruzi strain (TCC). The risks of TCC inoculation in terms of pathogenicity or eventual increase in virulence of TCC progeny were evaluated. No pathogenic parasites could be selected from TCC progeny by either mouse, triatome, or culture passages. Immunizing doses of live TCC did not induce in adult mice alterations resembling chronic Chagas' disease, as judged by patterns of mortality, tissue damage, autoantibodies, or parasite recovery. On the basis of the same criteria, However, a remarkable similarity could be established between the disease caused in mice by inoculation of low numbers (10(2)) of pathogenic trypomastigotes and human chronic Chagas' disease. Although patent parasitemias were never revealed in fresh blood mounts obtained from TCC-inoculated mice, a few hemocultures and xenodiagnoses gave positive results, particularly soon after inoculations at birth. The parasites recovered by either method remained in the attenuated, epimastigote stage. In rabbits, no local lesions, fever, weight loss, or histopathological alterations were detected after subcutaneous inoculation of 10(7) TCC organisms, although one fifth of the animals yielded positive hemocultures of epimastigotes. The contrasting host response to cultured epimastigotes as compared with blood trypomastigotes indicates that, in experimental Chagas' disease, immunoprotection is not necessarily associated with immunopathology.

Über das vorkommen von positiven blutkulturen, positiven urinkulturen und hohen antikörper-titern bei infektionen mit enteritis-salmonellen

Abstract In the last two decades the classic typhoid and paratyphoid A and B became rare also in Istria being substituted by infections of salmonellas of the “minor group”. Basing on observations on 418 patients (1970–1979) it was established that in 48.5% of them a significant increase of titers of antibodies, not only for group antigens but also for phasis antigens developed. This, together with positive hemocultures and urine cultures in a number of them, did lead the authors to the conclusion that the invasitivity of these salmonellas (e.g. S. enteritidis, typhi murium, hadar, agona, abony) is greater than previously presumed and that the diagnosis “Salmonella-Fever” or “Paratyphoid” also in infections of these salmonellas is more justified.

Chagas' disease and trypanosomiasis rangeli in 3 ranchs of the Departmento Francisco Morazán, Honduras

Observations in three Rhodnius prolixus infected thatch-roofed huts in the Departamento Francisco Morazan, Honduras, revealed that of their 22 inhabitants, 11 were positive serologically for Chagas’ disease, four of them with the Romana sign, and positive Trypanosoma cruzi hemoculture and xenodiagnosis. Another five persons (two serologically positive for Chagas' disease) were positive only for Trypanosoma rangeli in hemoculture, two of which were also positive for the same parasite by xenodiagnosis. Pure and mixed infections by both trypanosomes were found in 1230 R. prolixus captured in the three huts. In T. rangeli , examination of the feces, hemolymph and salivary glands is necessary to determine the number of infected insects. Precipitin tests showed the avidity of R. prolixus for biting man; one insect was found positive for human and opossum blood concomitantly.