A case of pleuropulmonary infection caused by Eikenella corrodens is reported, followed by a review of clinical cases reported in the English-language literature since 1970. On the basis of this review, the predisposing factors, clinical features, and principles of diagnosis and treatment of this infection are outlined. Although infection may occur at any age, it seems to occur most often in patients less than or equal to 14 or greater than or equal to 44 years of age. Adult patients commonly have some underlying medical illness, pleuropulmonary malignancy being the most common. Patients present with a variable combination of fever, cough, and pleuritic chest pain. Four radiographic patterns may be seen: pleural effusion, pneumonia, cavitation, or a combination of these. Ampicillin and penicillin G are effective therapeutic agents; although the susceptibility of E. corrodens to penicillin G has been accepted as the rule, it may not always prevail. The need for increased awareness of this organism as a cause of pleuropulmonary disease is stressed because it is resistant to clindamycin, an agent that is increasingly used to treat anaerobic pleuropulmonary infections.
During 1988 and 1989 the prevalence of serum IgG antibodies to pertussis toxin in a sample of 3,875 unvaccinated, apparently healthy persons between the ages of 1 year to 19 years was estimated by enzyme-linked immunosorbent assay. The participants were recruited by means of systematic cluster sampling from public and private schools in five geographic areas of Italy. The overall prevalence of IgG antibodies was 80.8%, with a steady increase from 33.5% among 1- to 3-year-old children to 95% among 17- to 19-year-old individuals. The prevalence of natural immunity was 50% and 75% at the ages of 4 and 6 years, respectively. No gender-related difference in immunity was observed. For children greater than 10 years of age, the seroprevalence of pertussis antibodies was significantly higher in northern regions than in southern regions until the age of 17-19 years, when the pattern reversed. There was no association of a child's immune status with the father's number of years of schooling or with family size. For children aged 1-3 years, serologic studies showed that the history of pertussis reported by parents in questionnaires was highly specific (97.6%) in predicting antibody status, with positive and negative predictive values of 90.5% and 79.2%, respectively. However, 20.8% of children had antibodies to pertussis toxin even though they had no history of whooping cough.
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