Multiple organ dysfunction syndrome induced by whole-body hyperthermia and polychemotherapy in a patient with disseminated leiomyosarcoma of the uterus.

Objective: Whole-body hyperthermia (WBH) in combination with chemotherapy is a relatively new promising treatment modality for patients with cancer. The objective of this report is to present the development of an acute systemic inflammatory response syndrome (SIRS) with multiple organ dysfunction syndrome (MODS) following WBH in combination with chemotherapy. Although WBH can also induce cytokine production, MODS has not been described before in association with WBH.

Assessment of complement deficiency in patients with meningococcal disease in The Netherlands.

The frequency of complement deficiency in 176 of 7,732 patients with meningococcal disease in the Netherlands from 1959 through 1992 was assessed. Complement deficiency was found in six patients (3%): 3 (7%) of the patients with Neisseria meningitidis serogroup C disease, 1 (2%) of the patients with N. meningitidis serogroup A disease, and 2 (33%) of the patients with infections due to uncommon serogroups and nongroupable strains of N.

Protection against meningococcal serogroup ACYW disease in complement-deficient individuals vaccinated with the tetravalent meningococcal capsular polysaccharide vaccine.

Individuals with properdin, C3 or late complement component deficiency (LCCD) frequently develop meningococcal disease. Vaccination of these persons has been recommended, although reports on efficacy are scarce and not conclusive. We immunized 53 complement-deficient persons, of whom 19 had properdin deficiency, seven a C3 deficiency syndrome and 27 had LCCD with the tetravalent (ACYW) meningococcal capsular polysaccharide vaccine.

Endotoxin release and cytokine production in acute and chronic meningococcaemia.

Chronic meningococcaemia is a relatively benign manifestation of meningococcal disease. Whether bacterial virulence factors are responsible for this benign course has not been studied. We compared the in vitro endotoxin-liberating ability and cytokine-inducing potential of 31 Neisseria meninigitidis isolates obtained from children with acute septic shock with that of nine isolates obtained from patients with chronic meningococcaemia and 12 isolates obtained from carriers with respiratory symptoms.

Association of human Fc gamma RIIa (CD32) polymorphism with susceptibility to and severity of meningococcal disease.

Phagocytosis of bacteria constitutes an important defense mechanism against invasive bacterial diseases. Efficacy of phagocytosis by polymorphonuclear neutrophils is known to vary between allotypes of Fc gamma RIIa (a class of Fc receptors for immunoglobulins that is constitutively expressed on neutrophils). We compared the distribution of Fc gamma RIIa-R131 and Fc gamma RIIa-H131 allotypes in 98 Slavic complement-sufficient patients with meningococcal disease with that of the allotypes in 107 healthy controls.

Mycobacterium xenopi in HIV-infected patients: an emerging pathogen.

Background: Mycobacterium xenopi is associated with pulmonary disease in patients with loss of local or general host defence.

Objectives: To determine the occurrence of M. xenopi in our hospital during 1987-1992 and 1993-1996, as well as the association of M.

Characterization of Neisseria meningitidis strains causing disease in complement-deficient and complement-sufficient patients.

Serotyping and serosubtyping of meningococci showed no difference between isolates from 44 complement-deficient persons and from 50 complement-sufficient persons with meningococcal disease. Multilocus enzyme electrophoretic typing of the meningococci revealed 54 electrophoretic types that were equally distributed among isolates from complement-deficient and complement-sufficient patients. Analysis of strains isolated from eight complement-deficient persons with 11 recurrences of meningococcal disease showed that one strain was identical to the strain previously isolated from the same individual.

[Mycobacterium genavense infection in 2 HIV seropositive patients in Amsterdam].

Two patients with an HIV-I infection, a man aged 47 with confusion, aphasia and diarrhoea, and a man aged 32 with dysphagia, a non-productive cough and diarrhoea, were diagnosed as having a disseminated Mycobacterium genavense infection. Both had low counts of CD4+ T lymphocytes. They responded to antimycobacterial treatment.

[Infections with Mycobacterium kansasii in the Academic Medical Center in Amsterdam: the changing clinical spectrum since the start of the HIV epidemic].

Objective: Inventory of patients with a Mycobacterium kansasii infection.

Design: Descriptive, retrospective.

Setting: Academic Medical Centre, Amsterdam, the Netherlands.

[Immunology in clinical practice. XI. IgG receptors: the role of polymorphism in autoimmune and infectious diseases].

Receptors for the constant part of IgG (Fc gamma R) are implicated in the pathogenesis of a number of diseases. Children from mothers with an Fc gamma RIIIb deficiency may suffer from neonatal neutropenia due to an alloimmune reaction. Interindividual differences (polymorphisms) for a number of Fc gamma R represent risk factors for several infectious and autoimmune diseases.

The effect of mannan-binding lectin on opsonophagocytosis of Neisseria meningitidis.

Mannan-binding lectin (MBL), an acute phase protein with a structure and a function very similar to that of C1q, is known to act as an opsonin binding to a number of microorganisms. In order to investigate the effect of MBL on the phagocytic killing of meningococci, a serogroup B meningococcal strain (H44/76) and its unencapsulated variant v24, as well as a serogroup A meningococcal strain were opsonized with MBL (purified from normal human plasma at the State Serum Institute, Denmark) and used in a phagocytic killing assay at a density of 7 x 10(3) CFU/ml. Polymorphonuclear cells (PMNs) from one healthy donor were isolated by density gradient centrifugation over Percoll and added to the system (7 x 10(6) cells/ml).

Meningococcal disease and polymorphism of FcgammaRIIa (CD32) in late complement component-deficient individuals.

Late complement component-deficient (LCCD) individuals lack plasma bactericidal activity and are highly susceptible to meningococcal disease. Phagocytosis plays a significant role in immune defence against meningococci and involves FcgammaRIIa (CD32) on leucocytes. Two allotypic forms are currently recognized: FcgammaRIIa-R131 and RIIa-H131.

Fatal Scedosporium prolificans infection in a leukemic patient.

The case is described of a 42-year-old patient with acute myeloid leukemia who received two courses of chemotherapy complicated by prolonged bone marrow depression. He was admitted to hospital with fever, hepatosplenomegaly and bilateral nodular pulmonary infiltrates. After admission diffuse cutaneous skin nodules, and hypodense lesions in the hemispheres and cerebellum developed.

Seven-year experience with a 'quarantine and isolation unit' for patients with burns. A retrospective analysis.

In the burns unit of the Red Cross Hospital, Beverwijk. The Netherlands we performed a retrospective analysis to evaluate whether the spread of multi-resistant micro-organisms (MRMO) in burn victims with a high risk of contamination can be prevented by isolation in a quarantine and isolation unit (QIU). We analysed 1006 patients who where consecutively admitted to the burns unit between 26-03-1985 and 31-12-1992.

Prevalence of Campylobacter-associated diarrhea among patients infected with human immunodeficiency virus.

We performed a cross-sectional study at an outpatient AIDS clinic to assess the prevalence of Campylobacter species in stool specimens from 201 consecutive patients infected with human immunodeficiency virus (HIV). We characterized campylobacters phenotypically and genetically by using primers for the group of common species (i.e.

Pneumocystis carinii pneumonia in HIV-negative patients with haematologic disease.

Since 1990, Pneumocystis carinii pneumonia (PCP) was diagnosed in 15 adult HIV-negative haematologic patients in our hospital. None of them had received PCP prophylaxis. All except one had been treated with prednisone.

Two patients with recurrent melioidosis after prolonged antibiotic therapy.

Melioidosis is a tropical infectious disease caused by Burkholderia (Pseudomonas) pseudomalleï. Clinically manifest melioidosis occurs mostly in people with underlying disorders. Melioidosis is a disease with protein manifestations and a high rate of relapse.

No increase in endotoxin release during antibiotic killing of meningococci.

Endotoxin is liberated following antibiotic killing of Gram-negative rods, and antibiotics may differ in this respect. Although the amount of filterable endotoxin has also been reported to increase following antibiotic killing of meningococci, it is unknown how this influences the host response. We investigated the influence of three antibiotics on levels of free endotoxin in culture medium and cytokine production in whole blood ex vivo during killing of four strains of meningococci.

Relapse of Legionella longbeachae infection in an immunocompromised patient.

We describe the first known case of Legionella longbeachae infection in the Netherlands in a patient with myasthenia gravis. Infection with L. longbeachae relapsed after prolonged therapy with erythromycin.