Influenza virus infection of the guinea pig: immune response and resistance.

Guinea pigs were inoculated by intranasal inoculation with unadapted, influenza virus A/England/42/72, and virus was recovered from nasal washings between 3 and 10 days post-inoculation. Infected animals did not exhibit a febrile response to infection, did not produce local antibody and produced only relatively low levels of serum antibody. However, they developed delayed-type hypersensitivity to influenza virus, demonstrable by both skin tests and macrophage migration inhibition tests, which was similar to that of man.

Case report: invasive pulmonary aspergillosis in a nonimmunosuppressed patient.

A patient with no known underlying immunosuppressive disorder who developed invasive pulmonary aspergillosis is described. A review of the English literature revealed ten other presumably nonimmunosuppressed patients with invasive aspergillosis. All had evidence of necrotizing pneumonitis with frequent cavity formation.

Failure to respond to influenza vaccine in the aged: correlation with B-cell number and function.

Failure to respond to influenza vaccination correlated with a decreased number and percentage of IgD-bearing PBL and a dampened lymphocyte response to PWM in a subset of healthy aged volunteers. These subjects had normal levels of serum immunoglobulins, intact T cell function, and normal numbers of E-rosetting cells.

Cellular immune response to cytomegalovirus infection after renal transplantation.

A prospective study of 15 patients who received renal transplants defined the effect of renal transplantation on the cellular immune response to cytomegalovirus infection. Of 15 patients, 14 developed cytomegalovirus infection, usually in the first 2 months after transplantation, and all infections were accompanied by a normal humoral immune response. After the initiation of immunosuppressive therapy and transplantation, there was a general depression of lymphocyte transformation, as reflected in the response to phytohemagglutinin, accompanied by a specific defect in cellular immunity, as indicated by lymphocyte transformation to cytomegalovirus antigen.

Amphotericin B and 5-fluorocytosine: in vitro effects on lymphocyte function.

The effects of amphotericin B, 5-fluorocytosine, and the combination of both drugs on lymphocyte function in vitro were investigated. Amphotericin B, alone or in combination with 5-fluorocytosine, significantly suppressed both spontaneous lymphocyte transformation and the response of lymphocytes to stimulation with streptokinase-streptodornase. 5-Fluorocytosine had no effect on spontaneous or antigen-induced transformation.

Host defenses in the aged: evaluation of components of the inflammatory and immune responses.

Host defenses were evaluated in 70 healthy aged volunteers. Individuals who had diseases or who were taking medication known to affect the inflammatory and immune responses were excluded from the study. Volunteers were followed for 24 months to correlate their state of health with the evaluation of host defenses.

Surveillance of gentamicin-resistant gram-negative bacilli in a general hospital.

Aerobic gram-negative bacilli isolated from clinical specimens from 1 January to 31 December 1976 were tested for gentamicin and tobramycin resistance by standardized disk testing. For Pseudomonas isolates, gentamicin resistance was 17.1% and tobramycin resistance was 2.

Histoplasmosis in immunosuppressed patients.

Infection with Histoplasma capsulatum in 58 patients whose immune responses were suppressed (Immunosuppressed patients) (16 from the present series and 42 described previously) was analyzed. The most common underlying diseases were Hodgkin's disease (29 per cent), chronic lymphocytic leukemia (19 per cent) and acute lymphocytic leukemia (17 per cent). Sixty-three per cent of the patients had received cytotoxic drugs, and 57 per cent had taken corticosteroids.

Multiple pneumococcal pyarthrosis complicating rheumatoid arthritis.

Pneumococcal pyarthrosis was documented in seven and ten joints, respectively, in two patients with rheumatoid arthritis. The recognition of multiple pyarthrosis superimposed upon rheumatoid arthritis can be difficult. The present cases are compared with eight previously reported cases of pneumococcal arthritis in patients with rheumatoid arthritis.

Streptococcal endocarditis initially seen as septic arthritis.

Two patients were initially seen with culture-positive streptococcal arthritis as an early manifestation of bacterial endocarditis. The organisms were an alpha-hemolytic, nongroup D streptococcus and a beta-hemolytic, group b streptococcus. One patient had a persistent septic monarthritis; the other had migratory arthritis in which a positive synovial culture was followed by a negative culture from the same joint before antimicrobial treatment was started.

Influenza in ferrets and guinea pigs: effect on cell-mediated immunity.

Two different animal models were studied to determine whether localized upper respiratory tract viral infection was associated with suppression of systemic cell-mediated immunity. During influenza infection in ferrets, there was no significant decrease in lymphocyte responsiveness to phytohemagglutinin (PHA). Guinea pigs given influenza showed no significant change in their response to PHA or to picryl human serum albumin (picHSA), to which they had been immunized previously.

Carbenicillin nephrotoxicity.

A patient with biopsy-proven interstitial nephritis associated with nafcillin and dicloxacillin therapy developed fever, hematuria, pyuria, and renal insufficiency after the administration of carbenicilin five months later. Cephalosporin therapy was given to this patient without signs of renal toxicity. This is the first reported case of probable carbenicillin-induced interstitial nephritis and serves to emphasize the danger of giving any penicillin analogue to patients with a history of pencillin-induced interstitial nephritis.

Children of depressed and schizophrenic mothers.

A sample of psychotic mothers and their children who were five years or younger when first recruited for our study of high risk children was followed up five years later. The current sample, obtained from our previous work, consisted of 18 schizophrenic, 12 depressed and psychotic, and 22 well mothers and their six to 12 year old children. The mothers were equated for education and age, and the children for sex and age.

In vitro susceptibility of gentamicin and/or tobramycin resistant gram-negative bacilli to seven aminoglycosides.

The in vitro activity of gentamicin, tobramycin, sisomicin, netilmicin, amikacin, kanamycin and streptomycin was tested simultaneously by the agar dilution method against 584 clinical isolates of gram-negative bacilli that were resistant to gentamicin and/or tobramycin. About half of the gentamicin-resistant Pseudomonas were susceptible to tobramycin but cross-resistance was virtually complete between gentamicin and tobramycin for Enterobacteriaceae. Sisomicin was much more active than gentamicin against Klebsiella, Escherichia and Citrobacter species.

Survival of Streptococcus pneumoniae in sputum from patients with pneumonia.

The isolation rate of Streptococcus pneumoniae in sputum cultures from patients with pneumococcal pneumonia is low. An investigation was made to determine whether this low yield might be due to loss of pneumocci and/or overgrowth by pharyngeal flora before the specimen is plated. Pneumococcal survival times and pharyngeal overgrowth at 4 degrees C and at room temperature were determined in sputum obtained from 42 patients with pneumococcal pneumonia.

Evaluation of the 21-day outpatient heroin detoxification.

There is a paucity of studies in the literature documenting failure rates of outpatient detoxification from heroin. This study reports on the results of the 21-day ambulatory treatment program at the Miami Veterans Administration Hospital. Heroin users with less than a 2-year history of opiate use must complete the detoxification process within 21 days according to federal regulations.

Bone marrow toxicity associated with 5-fluorocytosine therapy.

Bone marrow toxicity occurred in 4 of 15 patients treated with 5-fluorocytosine (5-FC) for serious fungal infections. The development of marrow toxicity appeared to be related to serum 5-FC levels of 125 mug/ml or greater. In three patients, accumulation of toxic levels of 5-FC was related to diminished renal function.

Pneumococcal arthritis.

Twelve patients with pneumococcal arthritis are described. Seven of the 12 patients had underlying diseases which predisposed them to pneumococcal infections; five were alcoholics and two had hypogammaglobulinemia. Five patients had pre-existing joint disease prior to the onset of septic arthritis.

Nosocomial infection with gentamicin-carbenicillin-resistant Pseudomonas aeruginosa.

Pseudomonas aeruginosa resistant to both gentamicin and carbenicillin was isolated with increasing frequency at the Cincinnati Veterans Administration Hospital during the period 1971 to 1974. A comparison of patients from whom P. aeruginosa was isolated during this period failed to reveal any significant clinical differences between the patients colonized or infected with resistant organisms and those colonized or infected with susceptible organisms.

Detection of precipitating antibodies to Histoplasma capsulatum by counterimmunoelectrophoresis.

The technique of counterimmunoelectrophoresis was evaluated for its usefulness in the detection of precipitating antibodies to Histoplasma capsulatum, designated h and m precipitin bands. Forty-four patients with active histoplasmosis had either m bands or both h and m bands. The h precipitin band occurred primarily in patients with disseminated disease, chronic pulmonary disease, or mediastinal lymphadenopathy of several months' duration; with resolution of the infection, this antibody disappeared.

Simple assay for 5-fluorocytosine in the presence of amphotericin B.

A simple method for the measurement of 5-fluorocytosine in the presence of amphotericin B is described. The antifungal activity of amphotericin B is abolished by heating serum at 100 C for 45 min. 5-Fluorocytosine is unaffected by this treatment, and serum levels can be subsequently assayed by either tube dilution or disk diffusion methods.

Effect of viral and bacterial pneumonias on cell-mediated immunity in humans.

Cell-mediated immunity (CMI) was assessed during infection and after convalescence in 12 patients with influenza pneumonia and 10 patients with bacterial pneumonia. The patients with influenza pneumonia had a marked impairment of skin test reactivity, and their lymphocytes showed a diminished response to phytohemagglutinin and streptokinase-streptodornase stimulation in vitro. Suppression of CMI was related to the severity of the pneumonia.