An Unusual Case of Blastomycosis and Severe Lung Necrosis in a Hmong Woman With Preexisting Liver Cirrhosis.

Predisposing factors that lead to blastomycosis remain unknown, although like other fungal infections, blastomycosis is an opportunistic infection. Here, we report on an unusual presentation in a Hmong woman with preexisting liver disease. This case highlights genetic and medical factors that may increase susceptibility to blastomycosis.

Effect of thioridazine on experimental cutaneous staphylococcal infections.

Background: Some non-antibiotic drugs, such as the phenothiazine antipsychotic agents, may have antimicrobial activity.

Materials And Methods: We sought to determine the in vivo antimicrobial effects of the phenothiazine thioridazine in two mouse models of Staphylococcus aureus skin infection.

Results: Thioridazine significantly suppressed dissemination from skin to spleen and kidney after inoculation of the skin surface.

Direct translocation of staphylococci from the skin surface to deep organs.

Background: Staphylococcus aureus can invade the bloodstream and cause bacteremic infections, but this organism frequently produces serious deep infections without bacteremia or an identifiable portal of entry.

Methods: We used experimental cutaneous S. aureus infections in mice to determine if the bacteria could reach deep organs without travel through the bloodstream.

Clearance of experimental cutaneous Staphylococcus aureus infections in mice.

Staphylococcal skin infections are quite common in human patients. These infections often clear spontaneously, but may also progress locally and/or disseminate to cause serious and sometimes fatal deep infections. The present studies were undertaken to examine the clearance phase of experimental cutaneous Staphylococcus aureus infections in a mouse model system.

Systemic dissemination and cutaneous damage in a mouse model of staphylococcal skin infections.

Serious staphylococcal infections frequently begin in the skin. The present study used a mouse model of such infections to evaluate the ability of Staphylococcus aureus to disseminate from the skin and to determine if cutaneous damage from the infections was required for dissemination. The mice were inoculated with S.

Resistance of athymic nude mice to experimental cutaneous Bacillus anthracis infection.

Background: Previous studies in a murine cutaneous anthrax model have demonstrated that hairless and haired HRS/J mice are extremely resistant to Bacillus anthracis. Because these mice are relatively thymus deficient, we used C57BL/6 athymic nude and euthymic mice to evaluate the relationship between T cell deficiency and this heightened resistance.

Methods: Animals were epicutaneously inoculated with 1 X 10(7) B.

Progressive and destructive hair follicle infections in a murine cutaneous anthrax model.

Hair follicles may allow pathogen entry because they represent potential barrier defects and because there is immunological privilege within actively growing follicles. Experimental cutaneous Bacillus anthracis infections in mice have previously shown prominent organism invasion and proliferation within hair follicles. For the present study, C57BL/6 mice were inoculated with B.

Superficial exudates of neutrophils prevent invasion of Bacillus anthracis bacilli into abraded skin of resistant mice.

Skin window procedures in humans have shown rapid accumulation of neutrophils into the exuded fluids above abraded skin. The present study was undertaken to determine if similar epicutaneous neutrophil accumulation might explain the extreme resistance of HRS/J mice, both hairless (hr/hr) and haired (hr/+), to experimental cutaneous Bacillus anthracis Sterne infections on abraded skin. In this study, very early (6 h) biopsies demonstrated a lack of bacilli in skin from the HRS/J hr/hr mice, indicating that the organisms never did invade in these animals as opposed to early skin entry and then efficient clearance by host responses in the tissues.

Characteristics of spore germination in a mouse model of cutaneous anthrax.

Background: Cutaneous infection is the most common form of human anthrax, but little is known about Bacillus anthracis spore germination in these infections.

Methods: We used experimental inoculations of B. anthracis Sterne spores or vegetative bacilli onto intact or abraded mouse flank skin, followed by evaluation of the infections and enumeration of germinating spores and vegetative bacilli.

Experimental cutaneous Bacillus anthracis infections in hairless HRS/J mice.

Previous studies of experimental Bacillus anthracis cutaneous infections in mice have implicated hair follicles as a likely entry site. Hairless HRS/J mice were used to investigate this possibility because of their non-functional hair follicles that lack penetrating hair shafts. These mice also have diminished macrophage function, increased susceptibility to Listeria, and enhanced neutrophil responses.

Analysis of epidermal entry in experimental cutaneous Bacillus anthracis infections in mice.

Cutaneous infection is the most common form of human anthrax, but little is known of Bacillus anthracis-epidermal interactions. To study the latter, we used experimental inoculations of B. anthracis Sterne spores onto mouse flank skin.

Fungal susceptibility to zinc deprivation.

Calprotectin is a neutrophil-derived antimicrobial protein that competes with microorganisms for zinc. The zinc-specific effect of calprotectin against Candida albicans appears to be related to this organism's marked susceptibility to deprivation of this metal. However, it is not known whether this susceptibility is particular to C albicans or whether it is a characteristic of pathogenic fungi in general.

Inefficient delivery of yeast cells as an explanation for reduced plating efficiency of Candida albicans.

The plating efficiency for fungal yeast cells is usually less than that expected from microscopic counts, and a number of explanations for this phenomenon have been proposed. The present study was undertaken to explore possible reasons for reduced plating efficiency of Candida albicans. Explanations that we evaluated and found unlikely included: ineffectiveness of different culture media and/or incubation temperatures for growing colonies, insufficient area of the plate available for expression of individual colonies, production of microcolonies, and inaccurate counting of the organisms in the inoculum.

Effect of prolonged fluconazole treatment on Candida albicans in diffusion chambers implanted into mice.

Fluconazole is an azole agent with primarily fungistatic activity in standard in vitro susceptibility tests. The present study was undertaken to develop a diffusion chamber model system in mice in order to study the in vivo effects of prolonged fluconazole treatment on Candida albicans. Chambers containing 100 C.

Effect of bone biopsy in guiding antimicrobial therapy for osteomyelitis complicating open wounds.

Background: Osteomyelitis associated with infected overlying wounds represents a difficult diagnostic and therapeutic problem; bone biopsies can be done during debridement of the overlying wounds, but it is unclear how often the results of these bone cultures actually affect subsequent antibiotic decisions. The present study was undertaken to evaluate the usefulness of bone biopsies in guiding antibiotic therapy for this type of osteomyelitis.

Methods: Culture results of 44 bone biopsies taken during surgical debridement in 41 patients over the period from June 1994 to August 1998 were compared with those from the overlying wounds to determine whether the data affected the subsequent choice of antibiotics.

Effect of metals on Candida albicans growth in the presence of chemical chelators and human abscess fluid.

Calprotectin is a calcium- and zinc-binding protein that is present in abscess fluid supernatants and appears to inhibit microbial growth through competition for zinc. In the present study, growth inhibition by chemical chelators was compared with that produced by human abscess fluid to determine whether other chelators, perhaps with different metal specificities, would have the same or different patterns of metal reversibility as abscess fluid. Zinc was found to be more potent than the other metals tested in reversing C.

Zinc-reversible antimicrobial activity of recombinant calprotectin (migration inhibitory factor-related proteins 8 and 14).

Recombinant calprotectin, consisting of 2 individual peptide chains also called migration inhibitory factor-related protein (MRP)-8 and MRP14, was tested for antimicrobial activity in a Candida albicans growth inhibition assay. Both chains contain HEXXH zinc-binding sites and might be expected to manifest zinc-reversible, antimicrobial activity similar to that of native calprotectin. When tested alone, neither MRP8 nor MRP14 showed activity in the Candida growth assay.

Effect of zinc-reversible growth-inhibitory activity in human empyema fluid on antibiotic microbicidal activity.

Abscess fluid supernatants have zinc-reversible microbial growth-inhibitory activity that is mediated by calprotectin, a zinc-binding protein. Because it inhibits microbial growth, this activity might interfere with killing by antibiotics that require their target organisms to be proliferating. In the present study, we cultured bacteria in human empyema fluid and used zinc to overcome the growth-inhibitory effect of calprotectin.

Dermatophytes and host defence in cutaneous mycoses.

Dermatophytosis is the infection of keratinized tissues such as hair, nails and the stratum corneum of the skin by dermatophyte fungi. These fungi are onygenalean anamorphs and anamorphic species belonging to the genera Trichophyton, Microsporum and Epidermophyton. An important characteristic of the dermatophytes as parasites is their restriction to the dead keratinized tissues, except in rare cases where the patient is immunosuppressed.

Comparison of fungal viability assays using Candida albicans yeast cells undergoing prolonged incubation in the absence of nutrients.

Staining methods for determining fungal viability are usually assessed by comparisons with enumeration of colony-forming units (CFU) on solid media. The purpose of the present study was to compare viability as assessed by the acridine orange (AO) and MTT methods with the numbers of CFUs obtained for Candida albicans yeast cells undergoing prolonged incubation in distilled water. In initial assessments of the assays using various proportions of control and heat-killed C.

Analysis of fluconazole effect on Candida albicans viability during extended incubations.

Fluconazole is an azole agent with primarily fungistatic activity in standard in vitro susceptibility tests. However, recent work has demonstrated that this drug can reduce Candida albicans viability during prolonged incubations under non-growing conditions. The present study was undertaken to examine more closely some of the parameters of this killing activity.

Histidine-based zinc-binding sequences and the antimicrobial activity of calprotectin.

Calprotectin is a protein in neutrophil cytoplasm and abscess fluids that appears to inhibit microbial growth through competition for zinc. This study was undertaken to identify specific sites that might be responsible for the protein's zinc-binding antimicrobial activity. A review of published calprotectin amino acid sequences revealed the HEXXH motif of thermolysin-type metalloproteases and an HHH polyhistidine sequence near the C-terminus of the protein's heavy chain.

The use of dimethylsulfoxide for fixation of yeasts for electron microscopy.

Conventional methods of chemical fixation are often inadequate for preserving yeast ultrastructure. The thick cell wall severely limits penetration of fixatives rendering poor detail of the cell wall, membranes, and overall anatomy. Dimethylsulfoxide (DMSO) enhances penetration of chemicals and has been added to fixatives to improve cell preservation.

Inhibition of Candida albicans growth by calprotectin in the absence of direct contact with the organisms.

Calprotectin is a calcium- and zinc-binding protein that is present in neutrophil cytoplasm and abscess fluid supernatants. This protein appears to inhibit microbial growth through competition for zinc; however, experiments to show that calprotectin can inhibit growth of microorganisms across filter membranes have yielded conflicting results to date. To prevent recontamination of the filtrate by zinc in this type of experiment, Candida albicans was cultured on filter membranes placed on top of an agarose gel containing calprotectin.

Effect of fluconazole on viability of Candida albicans over extended periods of time.

The treatment of chronic mycoses may expose the infecting organisms to antimicrobial agents for extended periods of time. It is possible that an azole antifungal drug such as fluconazole, with primarily fungistatic activity in standard in vitro susceptibility tests, might be able to damage the fungal cells and reduce their viability over prolonged incubations under nonproliferating conditions. To test this possibility, Candida albicans yeast cells were exposed to various concentrations of fluconazole in RPMI 1640 tissue culture medium for 4 h at 37 degrees C, washed free of the drug, and then incubated at 37 degrees C for a 28-day period; enumeration of the remaining CFU at various times during this period revealed no increased loss of viability for the fluconazole-exposed organisms.