Actinomyces infection associated with intra-uterine device

Since 1926 numerous cases of Actinomyces genital infection have been reported. An association with the IUD, metallic or polyethylene, has become evident after several severe complications in patients using this contraceptive method. The route of entry, in addition to direct spread from the bowel, may be direct extention across the anal area and perineum upward through the vagina, endometrial cavity to the fallopian tubes and ovaries. The vaginal string of the IUD is thought to break the protective barrier of the cervical mucus, permitting transit of organisms from the vagina into the uterus and from there to the tubo-ovarian complexes. Vascular spread is another possible route of infection. The uterine cavity in these patients becomes a good culture medium for these organisms. In patients wearing IUDs for 1 year, 13% presented with chronic endometritis and 65% showed recognizable endometrial change, manifested by diffuse or focal round-cell infiltration. Lower abdominal pain, heavy yellow discharge, and fever and weight loss were the symptoms most frequently presented with infection by Actinomyces. A new cytologic approach of preparing smears from freshly removed Lippes loops from symptomatic patients has been reported. Resulting samples have numerous macrophages and fibroblasts. This could prove a good method for identifying Actinomyces in the patients harboring this orgasm. The case of a 54-year-old black female having worn an IUD for 12 consecutive years is summarized.     

Actinomyces turicensis infection mimicking ovarian tumour

This case report explores an unusual presentation of a commensal organism, Actinomyces, which mimicked a presentation of ovarian cancer. A 73-year-old woman presented to a tertiary level hospital with persistent left iliac fossa abdominal pain, anorexia and fever lasting over one week, with a three-month history of bright rectal bleeding. Imaging was suggestive of malignancy. Fine needle aspiration of an enlarged lymph node was non-diagnostic. Blood cultures taken at presentation became positive after two days for Gram-positive rods, which were most likely Actinomyces. The patient was treated with penicillin 1.8 g four hourly with rapid improvement. Actinomycosis is frequently misdiagnosed as malignancy initially due to its relatively indolent course. Lesions often resolve with antibiotics, without the need for surgical intervention.     

Actinomyces infection of the mastoid: a rare entity

A rare case of mastoid infection caused by actinomyces israelii is presented. This patient underwent exploratory mastoidectomy followed by long term oral pencillin. She responded well to the treatment and has been asymptomatic on follow up to date.     

Systemic infection with Alaria americana (Trematoda).

Alaria americana is a trematode, the adult of which is found in mammalian carnivores. The first case of disseminated human infection by the mesocercarial stage of this worm occurred in a 24-year-old man. The infection possibly was acquired by the eating of inadequately cooked frogs, which are intermediate hosts of the worm. The diagnosis was made during life by lung biopsy and confirmed at autopsy. The mesocercariae were present in the stomach wall, lymph nodes, liver, myocardium, pancreas and surrounding adipose tissue, spleen, kidney, lungs, brain and spinal cord. There was no host reaction to the parasites. Granulomas were present in the stomach wall, lymph nodes and liver, but the worms were not identified in them. Hypersensitivity vasculitis and a bleeding diathesis due to disseminated intravascular coagulation and a circulating anticoagulant caused his death 8 days after the onset of his illness.     

Systemic cytomegalovirus infection complicating ulcerative colitis: a case report and review of the literature

Cytomegalovirus is a common infection worldwide and in the immunocompromised individual it can be a major cause of morbidity and mortality. In patients with inflammatory bowel disease cytomegalovirus infection has been described in both immunocompetent and immunocompromised individuals. A 34 year old man with an exacerbation of his colitis was diagnosed as having both cytomegalovirus colitis and hepatitis. The diagnosis was made on the classical appearance of "owl's eye" inclusion bodies on colonic and hepatic biopsies and, in addition, viral serology and polymerase chain reaction (PCR) analysis of the cytomegalovirus DNA copy number. Fourteen days of treatment with ganciclovir led to a prompt improvement in the symptoms of colitis, resolution of the pyrexia, normalisation of the liver function tests, and clearance of the virus, as measured by a negative cytomegalovirus DNA PCR. Cytomegalovirus infection is a potentially fatal complication of treatment induced immunosuppression in patients with inflammatory bowel disease. As in this case, infection may be systemic and not confined to the intestine. Prompt diagnosis using histology, serology, and PCR analysis allows prompt introduction of therapy and an improved prognosis.     

Polymicrobial brain abscess involving Haemophilus paraphrophilus and Actinomyces odontolyticus.

A case of brain abscess involving Haemophilus paraphrophilus and Actinomyces odontolyticus is presented. This combination of organisms has not previously been described. All brain abscess specimens should routinely be processed rapidly and cultured for a prolonged period to ensure recovery of fastidious organisms which may have implications for antibiotic therapy.     

Suppurative Thyroiditis: An Unusual Case Caused by Actinomyces naeslundi

A case of suppurative thyroiditis due to A.naeslundi is recorded. The clinical features (including the difficulty in establishing a clinical diagnosis) have been noted. This is the first instance of A.naeslundi being considered the etiological agent of actinomycosis of the thyroid. It is also the first report incriminating A.naeslundi as a pathogen, since up to now it was considered only a saprophyte.

The etiological role of A.naeslundi in this case of suppurative thyroiditis is strongly supported by the following findings:

1. A.naeslundi was isolated without the presence of other pathogenic micro-organisms.

2. A sulphur granule was demonstrated in the caseous pus after incision of the abscess.

3. There was a favourable response to specific antibiotic therapy.

     

对氨基苯甲酸对粘性放线菌表面疏水性的影响

目的　研究血链球菌合成的生态调节因子——对氨基苯甲酸 ( PABA)对粘性放线菌细胞表面疏水性的影响 ,进一步了解 PABA影响细菌粘附的机制。方法　在含不同浓度 PABA( 10 - 9g/ L、10 - 7g/ L、10 - 4 g/ L)的改良Carlsson液体培养基中厌氧培养粘性放线菌 ,并采用微生物粘着碳氢化合物法 ( MATH)测试细胞表面疏水性。结果　随着培养基中 PABA浓度的增高 ,粘性放线菌细胞表面疏水性随之逐渐降低 ,其疏水率分别为 0 .3 890 0±0 .0 0 0 2 6,0 .2 5 462± 0 .0 0 168,0 .163 60± 0 .0 0 0 2 6( P均 <0 .0 5 )。结论　 PABA可能通过降低细菌非特异性疏水作用而抑制粘性放线菌的粘附     

对氨基苯甲酸对粘性放线菌生长影响的研究

目的　探讨对氨基苯甲酸 (PABA)对牙根面龋致病菌之一的粘性放线菌生长的影响。方法　在加入不同浓度 PABA的改良 Carlsson培养基中采用厌氧培养技术 (80 % N2 ,10 % H2 ,10 % CO2 )培养细菌 48小时 ,通过 UV- 16 0 1紫外可见分光光度仪测定细菌浓度 OD值 (λ=5 40 nm) ;并用平板倾注法对细菌进行计数及琼脂平板培养观察细菌生长的情况。结果　 10 - 1 0～ 10 - 4 g/ L 浓度的 PABA有促进粘性放线菌生长的能力 ,且当 PABA浓度增加到 10 - 6g/ L 时 ,促进生长的作用达最强 ;当 PABA浓度增加到 10 - 3 g/ L 时 ,对粘性放线菌的生长无明显的促进作用。结论　 PABA可促进粘性放线菌的生长 ,在 PABA浓度为 10 - 6g/ L 时 ,促进生长的能力达最强     

Systemic multifocal fibrosclerosis

We describe a case of hydronephrosis as a result of retroperitoneal fibrosis in a patient who had previous sclerosing lobulitis of the breast. To the best of our knowledge this is the first reported association between these two conditions in the english literature. We presume these conditions are linked and unify them under the general heading of systemic multifocal fibrosclerosis.     

粘液放线菌生物膜结构中细菌和胞外多糖关系的初步研究

目的探讨粘液放线菌形成的单菌种生物膜的结构以及胞外多糖在生物膜中的分布。方法采用微生物厌氧培养技术将粘液放线菌在玻璃片上形成24h单菌种生物膜,用荧光染料Fluorescein、BODIPY和Calcofluor进行荧光染色,激光共聚焦扫描显微镜观察其形成的生物膜结构和其中胞外多糖的分布。结果玻璃表面粘液放线菌粘附形成致密的生物膜,大量微菌落和沟壑间隙是其所形成生物膜的特征。临近粘附表面的生物膜基底部位细菌密度较低,而中部则较致密。生物膜中胞外多糖分布与菌落中的细菌分布一致。结论粘液放线菌依靠其合成的胞外多糖聚集形成了生物膜。