Malignant Tumors Associated with Granulomatous Enterocolitis

Three cases of malignant tumor associated with Crohn's disease of the large intestine are reported.
The reasons for a low incidence of carcinoma associated with Crohn's disease have been postulated.     

Enterocolitis Associated With Cocaine Use

PURPOSE Cocaine use has been reported to cause gastrointestinal complications. This retrospective review describes the presentation and clinical course of cocaine-associated enterocolitis. METHODS Charts with a diagnoses of colitis or abdominal pain, between 1991 to 2001, were reviewed for a positive urine drug screen or documented cocaine use. Data about the patients' symptoms and physical findings, results of clinical studies, and outcome were collected. RESULTS There were 18 patients identified. The interval from last use to the onset of pain was fewer than one day for seven patients, one to three days for seven patients, and more than three days for four patients. Physical examination demonstrated diffuse peritonitis in 2 patients, tenderness localized to a single quadrant in 11 patients, and tenderness in two or more quadrants in 5 patients. Computed tomography was obtained in 11 patients with 10 demonstrating signs of inflammation or ischemia. The anatomic locations of disease were proximal colon (14 patients), small bowel/gastric (1 patient), and distal colon (3 patients). The initial management was nonoperative in 15 patients. One patient presented in shock and died. Another developed peritonitis and underwent laparotomy. Surgical intervention occurred in four patients (3 initially, 1 on Day 4) for peritonitis. Two died postoperatively, a 50-percent surgical mortality. CONCLUSIONS Cocaine-associated enterocolitis usually presents within three days of cocaine use. Inflammatory or ischemic changes are most common in the proximal colon. The majority of patients will recover with nonoperative therapy; however, those who develop peritonitis and undergo laparotomy have a 50 percent mortality. Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Chicago, Illinois, June 3 to 8, 2002, and the Tripartite Colorectal Meeting, Melbourne, Australia, October 27 to 30, 2002 . Reprints are not available.     

Necrotising Enterocolitis Associated with Invasion by Clostridium septicum Complicating Cyclic Neutropaenia

Summary: Necrotising enterocolitis associated with invasion by clostridium septicurn complicating cyclic neutropaenia. L. P. Bignold and H P B. Harvey, Ausf. N.Z. J. Med., 1979, 9, pp. 426–429.
A fatal case of necrotising enterocolitis complicating cyclic neutropaenia in a 17-year-old boy is reported. The episode of enterocolitis was characterised by fulminant, generalised peritonitis associated with necrosis and gas formation in the wall of the ileum and caecum. Clostridium septicum was grown from pre-mortem blood cultures and Gram positive bacilli typical of this organism were present in histological sections of the bowel wall. Necrotising enterocolitis in this and previously reported cases of cyclic neutropaenia resembles the agranulocytic form of intestinal necrosis which occasionally complicates leukaemia.     

Virulence of antibiotic-resistant Salmonella typhimurium

We show that most Salmonella typhimurium mutants resistant to streptomycin, rifampicin, and nalidixic acid are avirulent in mice. Of seven resistant mutants examined, six were avirulent and one was similar to the wild type in competition experiments in mice. The avirulent-resistant mutants rapidly accumulated various types of compensatory mutations that restored virulence without concomitant loss of resistance. Such second-site compensatory mutations were more common then reversion to the sensitive wild type. We infer from these results that a reduction in the use of antibiotics might not result in the disappearance of the resistant bacteria already present in human and environmental reservoirs. Thus, second-site compensatory mutations could increase the fitness of resistant bacteria and allow them to persist and compete successfully with sensitive strains even in an antibiotic-free environment.     

Epidemiologic markers of Salmonella typhimurium and Salmonella agona]

Among S. typhimurium and S. agona strains isolated during the period from 1971 to 1987, the biotypes, colicine types and resistance patterns were determined for 734 S. typhimurium and 631 S. agona strains. Among 734 S. typhimurium strains 65 biotypes were disclosed with prevalence of biotypes 1a (28.34%), 1b (29.84%) and 9 bi (18.28). Concerning S. agona, the biotype 1a represented by 87.16%, was the commonest clone among our strains. Although colicine typing added little information to characterize these serotypes, it should be usefull when applied in epidemiological study of outbreaks. It was observed multiply antimicrobial resistance mainly among human strains, particularly from nosocomial origins.     

Reiter's Syndrome Associated with Salmonella muenchen Infection

Abstract: Reiter's syndrome associated with Salmonella muenchen infection. I. B. Puddey, Aust. HZ. J. Med., 1982, 12, pp. 290–291.
In 1979 there was a major outbreak of food-borne Salmonella muenchen infection in Perth, Western Australia and the southern areas of the State. A case of Reiter's syndrome following this infection is reported, together with a discussion of post-dysenteric Reiter's syndrome.     

Salmonella typhimurium bacteremia: association with the virulence plasmid.

Virulence plasmids, which are found in a small number of Salmonella serotypes, greatly enhance the extraintestinal growth of salmonellae and lower the LD50 by 2-5 logs in experimental murine infections. To determine if virulence plasmids are important in the pathogenesis of Salmonella bacteremia in humans, blood and fecal isolates of Salmonella typhimurium from California were examined for the presence of a virulence plasmid. Colony blots were done using a labeled probe made from the highly conserved EcoRI fragment of the Salmonella dublin virulence plasmid. A total of 42% of the fecal and 76% of the blood isolates hybridized with the probe. This is the first evidence that the virulence plasmid is important in the pathogenesis of Salmonella bacteremia in humans.     

Recurrent Salmonella typhimurium bacteremia associated with the acquired immunodeficiency syndrome

Seven Haitian and one white patient with the acquired immunodeficiency syndrome and Salmonella typhimurium bacteremia were identified over a 28-month period. In three patients bacteremia developed concurrently with an opportunistic infection associated with the acquired immunodeficiency syndrome. The remaining five patients had their initial episodes of bacteremia 3 to 11 months before the diagnosis of the acquired immunodeficiency syndrome. These five patients had signs suggestive of the syndrome, plus evidence of disordered cellular immune function (lymphopenia, anergy, decreased T-helper cells, decreased proliferative responses, and a deficiency in mononuclear-cell alpha interferon production). Salmonella typhimurium bacteremia in the appropriate clinical setting may be an opportunistic pathogen associated with the acquired immunodeficiency syndrome.     

N-terminal methionine-specific peptidase in Salmonella typhimurium.

Crude extracts of a multiply peptidase-deficient strain of Salmonella typhimurium contain an aminopeptidase that specifically removes N-terminal methionine from peptides. This activity shows pronounced specificity for the peptide's second amino acid. Methionine is removed from peptides with alanine, threonine, or glycine in this position but not when the second amino acid is leucine or methionine. The activity is stimulated by Co2+ and is inhibited by EDTA. Mutations that lead to overproduction (up to 30-fold) of the activity have been obtained by selecting for growth on Met-Gly-Gly as a methionine source. These mutations map at approximately 3 map units, phage P22 cotransducible with leu. The overproducer mutations are dominant to wild type, and duplication of the wild-type allele of the locus leads to a gene dosage effect on peptidase levels. This suggests that the locus of the overproducer mutations may be the structural gene for the peptidase. NaDodSO4/PAGE shows an increased level of a single protein (34 kDa) in the overproducer mutant. This protein is highly enriched in a purified preparation of the peptidase. The specificity of this enzyme suggests that it is involved in the cleavage of methionine from newly synthesized peptide chains. This activity can specifically remove methionine from the N terminus of a completed protein. Treatment of purified, unprocessed (N-terminal methionine) interleukin 1 beta with the purified peptidase results in removal of N-terminal methionine with no additional alterations. N-terminal processing of at least this protein can occur after translation is complete. We propose to call this enzyme peptidase M (methionine-specific aminopeptidase).