Duodenal perforation in a cheetah (Acinonyx jubilatus)

An 11-yr-old female cheetah (Acinonyx jubilatus) from a privately owned breeding center for endangered species was referred for evaluation with a history of vomiting and depression of 10 days' duration. After anesthetic induction with tiletamine and zolazepam and anesthetic maintenance with isoflurane, a complete diagnostic workup was performed, including hematology, serum chemistry, and radiography. The clinical diagnosis was septic suppurative inflammation and hemorrhage in the abdomen, consistent with perforation or rupture of the gastrointestinal tract. An exploratory laparotomy showed a perforated duodenal ulcer, which was resected. Subsequent endoscopy revealed no further evidence of ulceration in the upper gastrointestinal tract. Biopsy of the ulcerated tissue collected from the duodenum revealed Gastrospirillum-like organisms. Histologic examination revealed widespread infiltration of lymphocytes and plasma cells into the lamina propria and submucosa. Intraepithelial leukocytes were present along with attenuation, erosion, and ulceration of the superficial epithelium. Fourteen days after surgery, this cheetah was returned to its breeding compound, and no subsequent vomiting has been observed for 4 yr.

A cluster of invasive pneumococcal disease in young children in child care

OBJECTIVE

To investigate a cluster of invasive pneumococcal disease in children 8 to 26 months of age, using standard microbiological procedures and ribosomal DNA gene-restriction patterns to characterize the outbreak strain.

DESIGN

Outbreak investigation.

SETTING

A family child-care home with six children in Baltimore, Md.

RESULTS

During an 8-day period, three of the six children in the family child-care home had febrile illnesses with pneumococcal bacteremia, and a fourth had purulent pneumococcal conjunctivitis. Type 12F Streptococcus pneumoniae was isolated from the four ill children and from the nasopharynges of the two healthy children. Ribotyping revealed all outbreak isolates had an identical ribotype pattern. Administration of rifampin to the children did not eradicate carriage of the organism.

CONCLUSIONS

Our data demonstrate that child care provides an opportunity for outbreak of invasive pneumococcal disease in young children. This observation suggests a need for increased alertness for clusters of pneumococcal disease in young children in child-care facilities and underscores the necessity for a pneumococcal vaccine that is effective in infants and young children.

Effect of fetal protein malnutrition on the postnatal structure and function of alveolar macrophages

To test the hypothesis that intrauterine malnutrition may alter ontogeny of the host defense system, an animal model of fetal protein deprivation was developed. Young adult female rats were fed either a deficient (8% protein) diet or a normal (25% protein) diet for 10 days before insemination and throughout gestation. Offspring of the malnourished animals showed significant growth retardation and were hypoproteinemic. Lavageable pulmonary cells from both groups of neonates were similar with respect to number (2.05 x 10(5) cells per animal), type (95% macrophages), size (approximately 10-micrometer diameter), ultrastructure, and presence of surface receptors for IgG. Despite these similarities, alveolar macrophages from malnourished neonates were significantly impaired in their ability both to ingest and to kill Candida tropicalis. Nutritional supplementation of nursing females reversed these functional macrophage defects in their offspring by the time that weaning occurred. These data indicate that fetal protein malnutrition affects macrophage function but that with postnatal nutritional supplementation these defects are rapidly reversed.

Bacteriology of the maxillary sinus of rhesus monkeys

Quantitative cultures of transantral aspirates of the maxillary sinuses of rhesus monkeys were performed to determine whether the sinuses have a normal bacterial flora. Of 13 sinus aspirate cultures 11 (85%) were sterile. The two positive sinus aspirate cultures had extremely low colony counts of the same bacteria present on the nasal mucosa prior to the sinus puncture. The maxillary sinuses of rhesus monkeys are sterile.

Microbiology of chronic and recurrent otitis media with effusion in young infants

Chronic otitis media with effusion (OME) has been assumed to be sterile, since several reports in the literature have described unsuccessful attempts to culture bacteria from it. However, several recent studies have confirmed an earlier report that there is a significant frequency of bacteria in the middle ears of children with chronic and/or recurrent OME. Similar studies in young infants with chronic and/or recurrent OME have not been previously reported. In this study, cultures were obtained at the time of myringotomy and tympanostomy tube insertion from 50 infants aged 1-12 months who had chronic and/or recurrent OME. From the 80 ears of 40 infants without cleft palate, 32% had bacteria isolated from their middle ears; 22% had Streptococcus pneumoniae or Haemophilus influenzae. In 21 of these ears, no effusion was apparent at myringotomy, but in 28% bacteria were isolated from middle ear washings. From the 20 ears of 10 infants with an unrepaired cleft palate, 55% had bacteria present in their middle ear aspirates; 50% had S. pneumoniae or H. influenzae. Even though the significance of bacteria in chronic OME in children, and now in young infants, is unclear at present, a therapeutic trial with an antimicrobial agent prior to surgical intervention would appear to be reasonable until such therapy is tested in a randomized, clinical trial.