Hypocomplementaemia caused by C3 nephritic factors (C3 NeF): clinical findings and the coincidence of C3 NeF type II with anti-C1q autoantibodies

Abstract. Skattum L, MBrtensson U, Sjoholm AG (Lund University, Lund, Sweden). Hypocomple-mentaemia caused by C3 nephritic factors (C3 NeF): clinical findings and the coincidence of C3 NeF type I1 with anti-Clq autoantibodies. 1 Intern Med 1997; 242: 455-64.
Objectives: The main purposes were to document manifestations associated with prolonged or clinical ly unexplained C3 deficiency and to approximate how often hypocomplementaemia of this kind is caused by C3 nephritic factors (C3 NeF), i.e. autoantibodies to alternative pathway C3 convertases. We also wished to distinguish between C3 NeF types I and I1 and to assess coincident autoantibody responses to the collagen-like region of Clq (ClqCLR).
Setting: The investigation was based on serum Samples referred to a specialized laboratory for complement analysis in the course of several years.
Subjects: Twenty-five persons with C3 concentrations lower than 0.43 g L', a third of the normal, were included in the study.
Results: Analysis using three methods provided evidence of C3 NeF in 20 persons with equal frequencies of C3 NeF types I and 11. We also gave evidence of antibody specificity differences for the two types of C3 NeF. Six patients with C3 NeF type I1 showed antibodies to C1 qCLR. Membranoproliferative glomerulonephritis was the predominant diagnosis and two patients had partial lipodystrophy reflecting the wellknown association between these diseases and C3 NeF. Anaphylactoid purpura, systemic lupus erythematosus, and severe infection, mainly meningococcal disease, were also observed.
Conclusions: The study group was probably fairly representative of C3 deficiency syndromes as encountered in clinical practice. The findings emphasize the heterogeneity of C3 NeF, and that acquired C3 deficiency syndromes caused by C3 NeF should perhaps be considered more often in diagnostic work.     

The efficacy of fluconazole in treating prosthetic valve endocarditis caused byCandida glabrata: Report of a case

A case of active prosthetic valve infective endocarditis (PVE) due toCandida glabrata was successfully treated by the systemic administration of fluconazole. A 66-year-old Japanese man with infective endocarditis of unknown etiology underwent aortic and mitral valve replacement to treat severe aortic and mitral regurgitation associated with multiple organ failure. Postsurgical cultures of arterial blood were repeatedly positive forC. glabrata, and therefore fluconazole was administered either intravenously or orally at a dose of 400 mg/day for 46 days. During that time the signs of inflammation including fever such as an elevated white blood cell count and the presence of C-reactive protein (CRP) all improved while the blood cultures became negative. Fluconazole is thus considered to be effective in treating PVE caused byC. glabrata. When administering this treatment, it is also important to monitor the patient's renal and liver function.     

医院感染及漏报率统计分析

目的　了解我院医院感染发生及漏报率。方法　将我院 2 0 0 3年 1～ 12月出院的所有病例进行回顾性调查。结果　医院感染率 7.3 2 %、漏报率 14 .93 %,均符合国家卫生部要求。结论　做好医院感染监测工作 ,严格执行各项工作制度 ,掌握医院感染与手术并发症的鉴别诊断 ,提高医院感染诊断的准确率     

全身麻醉插管术后院内获得性肺部感染探讨

全身麻醉气管插管术后下呼吸道感染具有较高发生率。分析５２６例手术时间超过４小时普外科病例，经ｕ检验发现全身麻醉气管插管术后患者肺部感染率明显高于持续性硬膜外麻醉术后患者，影响因素主要与全麻插管用具及麻醉机消毒情况有关，也与术前存在慢性阻塞性肺部疾患和术后保留气管插管有关。降低全麻术后肺部感染应重视无菌操作，尽可能对麻醉机管道进行常规消毒。     

新生儿病房铜绿假单胞菌的血清学分型,质粒分析研究

新生儿病房１９８９年１０月～１９９０年１２月、１９９６年３～６月两个时间段分离４０株铜绿假单胞菌，血清学分型率９７．５％，第一时间段以Ｏ１１型最多，占３０．４％，集中在１９９０年６～１０月，第二时间段Ｏ３型占９３．８％，集中在１９９６年３～６月，表明该病房发生两次铜绿假单胞菌医院感染流行。质粒检出率４２．９％，Ｏ１１型菌株质粒谱为８．１、４６．５、１７９．１ｋｂ，并经ＨｉｎｄⅢ酶切进一步证实为同一克隆。对氟哌酸、阿米卡星及头孢他啶的敏感率分别为１００％、９７．３％和９５％。对庆大霉素耐药率明显上升，提示控制铜绿假单胞菌医院感染的重要性。     

重症急性胰腺炎并发深部真菌感染21例分析

目的探讨SAP并发深部真菌感染的易感因素以及防治的方法。方法分析1998年9月至2004年10月收治的81例SAP患者资料，其中并发深部真菌感染的21例作为真菌感染组，其余60例作为非感染组，比较两组患者的诊治方法与措施，分析真菌感染的危险因素。结果经糖皮质激素应用、腹腔灌洗、胃肠减压等一系列诊治措施，真菌感染组19例患者病愈出院，2例死亡。两组在糖皮质激素应用、中心静脉置管、全胃肠外营养、空肠营养、呼吸机支持、腹腔灌洗和囊肿穿刺等方面差异显著（P〈0．05）。结论糖尿病、老年、呼吸机支持和重症监护客观因素等为真菌感染的危险因素。合理应用抗生素和预防性应用抗真菌药物可以减少感染机会，提高SAP的救治存活率。     

Abdominal zygomycotic thromboangiitis in a patient with AML and t(1;13;14)

 The case report of a 61 year-old man with AML M2 FAB, t(1; 13; 14) and zygomycotic mesenterial thromboangiitis is presented. Two induction cycles of chemotherapy were administered due to primary drug resistance. They were complicated by pneumonia, colonic pseudo-obstruction and perforation with peritonitis. The patient died on the 40th day of therapy, 4 days after undergoing palliative surgery. Zygomycotic thromboangiitis, which very probably contributed to the intestinal perforation, was confirmed morphologically at necropsy. The novel complex chromosomal translocation t(1; 13; 14) (q31; q32; q24) and the problems connected with the diagnosis of invasive fungal infections are discussed. Received: 26 January 1996 / Accepted: 12 June 1996     

Quantification of risk factors in Hospital infection at a surgical service

In this paper we have analyzed several risk factors for developing nosocomial infections at a Surgical Service of the Hospital Clinico Universitario San Cecilio 2>, based on a retrospective follow-up program designed specifically for this study. Of all patients admitted to the Service from January 1 to June 17, 1987, we examined the following variables: age, sex, cause of admission, emergency or non-emergency admission, operation and related variables. The overall rate of nosocomial infections was 16.46%. The most significant risk factors we found were operation , which had a linear correlation coefficient of '0.929 (p < 0.01) with hospital infection when stratified by its lenght, advanced age ( >60 years old), especially in non-operated patients, and chemoprophylaxis. Such risk factors were ascertained taking into account the confounding effect produced by the variables studied in this survey.Corresponding author.     

Tinea corporis caused by Microsporum canis: Report of a Nosocomial outbreak

In an unusual nosocomial outbreak, 13 staff and 11 patients in an acute and chronic health care facility were infected with the zoophilic dermatophyte, Microsporum canis. The dermatophyte was apparently introduced into the facility by a single infected patient. Likely modes of subsequent disease transmission include person-to-person contact, handling of contaminated laundry, and use of a shared razor. Infection control measures for managing such outbreaks are discussed.     

儿童急性白血病伴侵袭性肺部真菌感染的临床特点、真菌分布及影响因素分析

目的 分析儿童急性白血病伴侵袭性肺部真菌感染（IPFI）的临床特点、真菌分布及影响因素。方法 回顾性分析2018年1月—2022年12月安徽省儿童医院82例急性白血病患儿的临床资料,按照是否合并IPFI分为IPFI组（18例）和非IPFI组（64例）。比较两组患儿的一般临床资料;采用多因素一般Logistic回归模型分析儿童急性白血病伴IPFI的危险因素;分析IPFI组患儿的临床特征、真菌菌种分布。结果 18例IPFI患儿均有不同程度的发热,体温>38.5℃占比72.22%,咳嗽咳痰/白色黏痰占比83.33%;18例IPFI患儿中5例表现为结节实变影,7例表现为多发斑片状阴影,8例表现为散在斑片状阴影合并小结节,2例表现多发云雾状毛玻璃样高密度影、间质病变为主。16例获得真菌微生物学证据,血培养2例,肺泡灌洗液涂片1例,血或者肺泡灌洗液NGS检测13例,其中以毛霉菌（31.25%）、曲霉菌（25.00%）、近平滑假丝酵母菌（18.75%）为主;多因素一般Logistic回归分析结果显示,化疗方案含激素■、中性粒细胞缺乏时间≥10 d[■]、抗菌药物使用种类≥2种■均是儿童急性白血...