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Lapushin, R W; Baughn, R E; Musher, D M; Gyorkey, P
doi: 10.1136/sti.55.3.168pmid: 466381
In an electron microscopy study of lymph nodes from syphilitic rabbits plasmablasts and plasma cells were unequivocally identified in germinal centres. Up to 20% of the plasma cells possessed unusual cytological features. Paracortical hypoplasia was shown to be associated with actively phagocytic histiocytes. These findings may reflect morphological correlates of the aberrant immune regulation which has been observed in infection with Treponema pallidum.
doi: 10.1136/sti.55.3.173pmid: 466382
Treatment monitoring in syphilis using the automated Reiter protein complement fixation test and the automated reagin test was investigated over a two-year period. Clearly defined response patterns were demonstrated in primary and secondary syphilis and, to a lesser extent, in latent syphilis, thus facilitating the assessment of treatment and the identification of treatment failures and reinfection. No obvious treatment failures were detected in those patients receiving penicillin, but two failures were noted in a group of patients with secondary syphilis treated with doxycyline. The combination of two automated tests overcame some of the disadvantages inherent in the use of a single reagin test.
Spagna, V A; Prior, R B; Perkins, R L
doi: 10.1136/sti.55.3.179pmid: 466383
In an evaluation of the limulus assay as a method for detecting endotoxin in urethral exudates, positive results of urethral samples at a 1/200 dilution were obtained from 73 out of 73 patients with culture-positive gonococcal urethritis while negative results were obtained from 26 out of 27 patients with cuture-negative urethral specimens. A specimen from one patient, which gave negative results on Gram stain and culture, gave positive results to the limulus test. The overall accuracy of the limulus test for predicting culture results was 99% (p less than 0.001). Thus, in preliminary studies of otherwise healthy men, the results of the limulus assay correlated with those of biological methods for diagnosing urethral gonorrhoea; the test may, therefore, be of use in identifying cases of nongonococcal urethritis.
doi: 10.1136/sti.55.3.183pmid: 111763
Specimens of urethral pus from 312 men with gonorrhoea were diluted and inoculated on to non-selective and selective media, the latter containing vancomycin, colistin, nystatin, and trimethoprim. Although three (1%) isolates of Neisseria gonorrhoeae were inhibited by trimethoprim 4 mg/1 and 10 by vancomycin 2 mg/1, only two failed to grow on a selective medium from large inocula but eight strains sensitive to vancomycin failed to grow on a selective medium from a light inoculum. These few failures do not appear to negate the value of the selective medium.
doi: 10.1136/sti.55.3.186pmid: 111764
Among 228 women with gonorrhoea (confirmed by culture), swabs taken blindly from the anal canal gave positive results in 26.3% and those taken from the rectum under direct vision in 27.6%. Swabs from both sites gave positive results in 23.2% of patients, from the anal canal alone in 3.1%, and from the rectum alone in 4.4%. Thus, culuture of anal canal swabs seems to give as reliable results as rectal swabs when proctoscopy cannot be carried out.
Young, H; Harris, A B; Robertson, D H
doi: 10.1136/sti.55.3.188pmid: 111765
Specimens from genital, anorectal, and pharyngeal sites from 1671 men and 1419 women were cultured for Neisseria gonorrhoeae. Pharyngeal specimens were also cultured for Neisseria meningitidis, N. gonnorrhoeae was isolated from a genital site 2.7 times more often in men and 1.8 times more in women who also carried meningococci in their pharynx than from those who did not; the meningococcus was isolated 3.4 times more often from men and 2.0 times more often from women with genital gonorrhoea than from those without. In both men and women the association of each organism with the other was statistically significant (p less than 0.001) and may be related to sexual behaviour rather than to individual susceptibility to neisserial infection.
doi: 10.1136/sti.55.3.191pmid: 111766
A single, intramuscular dose of 2 g of mezlocillin was used for the treatment of 158 patients with gonorrhoea. In only three out of 144 patients with urogential gonorrhoea who were re-examined did the treatment fail. Of 12 patients with pharyngeal gonorrhoea who were examined after treatment 10 were treated successfully with the same dose. The sensitivities of the gonococci to mezlocillin and penicillin G correlated well, although mezlocillin seemed to be active at lower concentrations on both highly sensitive and less sensitive isolates.
Hutchinson, G. R.; Taylor-Robinson, D.; Dourmashkin, R. R.
doi: 10.1136/sti.55.3.194pmid: 223717
Organ cultures of 10 Fallopian tubes were inoculated with a genital strain of Chlamydia trachomatis and seven were infected. Infection was enhanced by centrifuging the organisms on to the tissues, larger numbers of organisms being reisolated from the tissues after this procedure. There was evidence of chlamydial multiplication because the number of organisms which were recovered from the tissues three to five days after inoculation had increased. Recovery was rare, however, after the sixth day, thus suggesting a self-limiting infection. Organ cultures of two bovine oviducts were infected with the bovine abortion strain of Chlamydia psittaci, but in these experiments centrifugation of the inocula did not enhance infection. The organisms were found in both the tissue and medium of cultures up to 18 days after inoculation and in much greater numbers than in the C. trachomatis-infected Fallopian cultures. Chlamydial infection was not entirely host-tissue specific, because C. trachomatis organisms were isolated from bovine oviduct cultures. Inclusions, however, were not detected histologically or electron microscopically in the epithelium of C. trachomatis-infected cultures, but they were detected by these means in C. psittaci-infected bovine cultures. All the elements of the chlamydial growth cycle were seen by electron microscopy, organisms being found in ciliated and possibly non-ciliated cells, and shedding of some infected epithelial cells was observed. No evidence of extensive epithelial cell damage was observed, however, and no loss of ciliary activity was detected in cultures infected with either C. trachomatis or C. psittaci when compared with uninoculated cultures. Thus acute salpingitis, when caused by chlamydial infection, is probably immunologically mediated.
Paavonen, J; Saikku, P; Vesterinen, E; Aho, K
doi: 10.1136/sti.55.3.203pmid: 111767
In a study to evaluate the possible role of Chlamydia trachomatis and Neisseria gonorrhoeae in acute salpingitis, 26% of 106 patients with severe symptoms had positive culture results for C. trachomatis; 43% of the 72 patients from whom paired sera were obtained had either positive culture results for or seroconversion in the single antigen immunofluorescence test to C. trachomatis. Twenty-six per cent of patients harboured N. gohorrhoeae and 14% had gonococcal complement-fixing antibody titres greater than or equal to 8. Intrauterine devices were used by 48% of patients, no difference being found in the frequency of use between patients harbouring C. trachomatis or N. gonorrhoeae. The possible role of C. trachomatis should be considered in the treatment of acute salpingitis.
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