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Berlin Brandenburg

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  • 1
    Language: English
    In: Hawaii medical journal, July 2010, Vol.69(7), pp.161-3
    Description: Lemierre's syndrome is a suppurative thrombophlebitis involving the internal jugular vein, most commonly associated with Fusobacterium necrophorum, usually a complication of oropharyngeal infections. This syndrome is rare and is often overlooked. We present a case of sepsis mimicking initially severe leptospirosis (Weil's disease) due to acute febrile illness with multiorgan failure and hyperbilirubinemia. Finally, blood cultures revealed Fusobacterium necrophorum and computed tomography (CT) demonstrated bilateral pulmonary nodules and a thrombus in the right internal jugular vein. Early clinical suspicion is crucial so that appropriate diagnostic investigation and antibiotic therapy can be initiated to minimize the risk of life-threatening complications.
    Keywords: Fusobacterium Infections -- Diagnostic Imaging ; Fusobacterium Necrophorum -- Isolation & Purification ; Leptospirosis -- Diagnostic Imaging ; Lung Diseases -- Diagnostic Imaging ; Sepsis -- Microbiology ; Thrombophlebitis -- Microbiology
    ISSN: 0017-8594
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 2
    Language: English
    In: Hawaii medical journal, August 2005, Vol.64(8), pp.216-7
    Description: We report a rare case of cervical spinal epidural abscess due to Klebsiella pneumoniae. While the most likely pathogen is Staphylococcus aureus, 2.5% of CNS infections have been attributed to Klebsiella pneumoniae. The source of infection in this case is suspected to be from cervical vertebra osteomyelitis/discitis that expanded to epidural space. Prompt drainage of the abscess by decompression with debridement is the key of management that is shown to decrease morbidity and mortality in epidural abscess patients.
    Keywords: Klebsiella Pneumoniae ; Cervical Vertebrae -- Microbiology ; Epidural Abscess -- Microbiology ; Klebsiella Infections -- Diagnosis
    ISSN: 0017-8594
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 3
    In: Infection and Immunity, 2000, Vol. 68(11), p.6441
    Description: Haemophilus ducreyi expresses a peptidoglycan-associated lipoprotein (PAL) that exhibits extensive homology to Haemophilus influenzae protein 6. We constructed an isogenic PAL mutant (35000HP-SMS4) by the use of a suicide vector that contains lacZ as a counterselectable marker. H. ducreyi 35000HP-SMS4 and its parent, 35000HP, had similar growth rates in broth and similar lipooligosaccharide profiles. 35000HP-SMS4 formed smaller, more transparent colonies than 35000HP and, unlike its parent, was hypersensitive to antibiotics. Complementation of the mutant in trans restored the parental phenotypes. To test whether expression of PAL is required for virulence, nine human volunteers were experimentally infected. Each subject was inoculated with two doses (41 to 89 CFU) of live 35000HP and one dose of heat-killed bacteria on one arm and with three doses (ranging from 28 to 800 CFU) of live 35000HP-SMS4 on the other arm. Papules developed at similar rates at sites inoculated with the mutant or parent but were significantly smaller at mutant-inoculated sites than at parent-inoculated sites. The pustule formation rate was 72% (95% confidence interval [CI], 46.5 to 90.3%) at 18 parent sites and 11% (95% CI, 2.4 to 29.2%) at 27 mutant sites (P 〈 0.0001). The rates of recovery of H. ducreyi from surface cultures were 8% (n = 130; 95% CI, 4.3 to 14.6%) for parent-inoculated sites and 0% (n = 120; 95% CI, 0.0 to 2.5%) for mutant-inoculated sites (P 〈 0.001). H. ducreyi was recovered from six of seven biopsied parent-inoculated sites and from one of three biopsied mutant-inoculated sites. Confocal microscopy confirmed that the bacteria present in a mutant inoculation site pustule lacked a PAL-specific epitope. Although biosafety regulations precluded our testing the complemented mutant in humans, these results suggest that expression of PAL facilitates the ability of H. ducreyi to progress to the pustular stage of disease.
    Keywords: Bacterial Outer Membrane Proteins ; Proteoglycans ; Haemophilus Infections -- Etiology ; Haemophilus Ducreyi -- Pathogenicity ; Lipoproteins -- Metabolism ; Peptidoglycan -- Metabolism;
    ISSN: 0019-9567
    ISSN: 00199567
    E-ISSN: 10985522
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  • 4
    In: Infection and Immunity, 2001, Vol. 69(6), p.4180
    Description: The lipooligosaccharide (LOS) of Haemophilus ducreyi contains a major glycoform that is immunochemically identical to paragloboside, a glycosphingolipid precursor of major human blood group antigens. We recently identified the gene responsible for the glucosyltransferase activity and constructed an isogenic mutant (35000glu-) deficient in this activity. 35000glu- makes an LOS that consists only of the heptose trisaccharide core and 2-keto-deoxyoctulosonic acid (KDO). For this study, the mutant was reconstructed in the 35000HP (human passaged [HP]) background. Five human subjects were inoculated with 35000HP and 35000HPglu- in a dose-response trial. The pustule formation rates were 40% (95% confidence interval [CI], 13.7 to 72.6%) at 10 sites for 35000HP and 46.7% (95% CI, 24.8 to 69.9%) at 15 sites for 35000HPglu-. The histopathology and recovery rates of H. ducreyi from surface cultures and biopsies obtained from mutant and parent sites were similar. These results indicate that the expression of glycoforms with sugar moieties extending beyond the heptose trisaccharide core is not required for pustule formation by H. ducreyi in humans.
    Keywords: Mutation ; Chancroid -- Physiopathology ; Glucosyltransferases -- Metabolism ; Haemophilus Ducreyi -- Pathogenicity ; Lipopolysaccharides -- Metabolism;
    ISSN: 0019-9567
    ISSN: 00199567
    E-ISSN: 10985522
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  • 5
    In: Infection and Immunity, 2001, Vol. 69(3), p.1938
    Description: Haemophilus ducreyi makes cytolethal distending toxin (CDT) and hemolysin. In a previous human challenge trial, an isogenic hemolysin-deficient mutant caused pustules with a rate similar to that of its parent. To test whether CDT was required for pustule formation, six human subjects were inoculated with a CDT mutant and parent at multiple sites. The pustule formation rates were similar at both parent and mutant sites. A CDT and hemolysin double mutant was constructed and tested in five additional subjects. The pustule formation rates were similar for the parent and double mutant. These results indicate that neither the expression of CDT, nor that of hemolysin, nor both are required for pustule formation by H. ducreyi in humans.
    Keywords: Bacterial Toxins -- Biosynthesis ; Chancroid -- Pathology ; Haemophilus Ducreyi -- Pathogenicity ; Hemolysin Proteins -- Biosynthesis;
    ISSN: 0019-9567
    ISSN: 00199567
    E-ISSN: 10985522
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  • 6
    In: Infection and Immunity, 1999, Vol. 67(12), p.6335
    Description: The lipooligosaccharide (LOS) of Haemophilus ducreyi, the etiologic agent of chancroid, chemically and immunologically resembles human glycosphingolipid antigens. To test whether LOS that contains paragloboside-like structures was required for pustule formation, an isogenic mutant (35000HP-RSM2) was constructed in losB, which encodes D-glycero-D-manno-heptosyltransferase. 35000HP-RSM2 produces a truncated LOS whose major glycoform terminates in a single glucose attached to a heptose trisaccharide core and 2-keto-3-deoxyoctulosonic acid. Five human subjects were inoculated with 35000HP and 35000HP-RSM2 in a dose-response trial. For estimated delivered doses (EDDs) of greater than or equal to 25 CFU, the pustule formation rates were 80% for 35000HP and 58% for 35000HP-RSM2. Preliminary data indicated that a previously described Tn916 losB mutant made a minor glycoform that does not require DD-heptose to form the terminal N-acetyllactosamine. If 35000HP-RSM2 made this glycoform, then 35000HP-RSM2 could theoretically make a sialylated glycoform. To test whether sialylated LOS was required for pustule formation, a second trial comparing an isogenic sialyltransferase mutant (35000HP-RSM203) to 35000HP was performed in five additional subjects. For EDDs of greater than or equal to 25 CFU, the pustule formation rates were 30% for both 35000HP and 35000HP-RSM203. The histopathology and recovery rates of H. ducreyi from surface cultures and biopsies obtained from mutant and parent sites in both trials were similar. These results indicate that neither the expression of a major glycoform resembling paragloboside nor sialylated LOS is required for pustule formation by H. ducreyi in humans.
    Keywords: Haemophilus Ducreyi ; Mutants ; Empyema ; Antigens ; Genetic Analysis ; Chancroid ; Lipopolysaccharide Composition ; Carbohydrates;
    ISSN: 0019-9567
    ISSN: 00199567
    E-ISSN: 10985522
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  • 7
    Language: English
    In: Hawaii medical journal, January 2007, Vol.66(1), pp.9-11
    Description: Oriental cholangiohepatitis, also known as recurrent cholangitis is exclusively endemic in Asian countries. Sporadic cases have been reported in the United States, however almost all cases have been seen in the Asian immigrants to the United States. We report a 31-year-old male from outside of Asia who developed oriental cholangiohepatitis.
    Keywords: Cholangitis -- Diagnosis ; Hepatitis -- Diagnosis
    ISSN: 0017-8594
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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