Immunitat und Infektion最新文献

Erysipelothrix rhusiopathiae only seldom causes cases of endocarditis. Contact with infectious animals leads to endocarditis of the left heart with high lethality. Vancomycin and aminoglycosides, which are often used in gram-positive endocarditis, show no effect.

230 clinical isolates of Acinetobacter species were characterized according to genospecies (new taxonomy), relative frequency of isolation, distribution in clinical samples and resistance pattern. A.baumannii was more frequently found than any other species (42%), followed by A.lwoffii (28%), although only 60% of the former "A.lwoffi" corresponds to the new A.lwoffii. The other 40%, formerly A.lwoffi, were shared by A.junii and A.haemolyticus. Concerning habitat and resistance pattern, remarkable differences between the new biotypes were found. A.baumannii and A.lwoffii were isolated mainly from swabs. A.calcoaceticus was most frequently cultivated from samples of the upper respiratory tract, and from blood cultures preferably A.baumannii and, more rarely, A.lwoffii and A.haemolyticus were isolated. A.baumannii showed multidrug resistance against beta-lactam antibiotics, most of the tested penicillins and cephalosporins. The two most susceptible species in our study were A.junii and A.lwoffii. Resistance to imipenem, aminoglycosides and quinolones was rare with all strains.

Campylobacter fetus subsp. fetus infections are very rare in adults but can occur in immunocompromised elderly people and in patients with chronic disease. We describe the clinical case of a 52-year-old woman with alcoholic liver cirrhosis, where we isolated C.fetus subsp. fetus from blood culture.

The avian mycobacteria have been identified first in relation to their virulence for hens. But this property was not definitely to correlate with serovars. Furthermore, this heterogenicity was to confirm on molecular level. Therefore it was necessary to introduce a M.avium complex beside true M.avium. M.avium has special relevance to AIDS patients. This fact shows that the reasons for infections by these facultatively pathogenic mycobacteria are more complicated as accepted.

The discovery of H. pylori as the etiologic agent of chronic antral type B gastritis and the finding that H.pylori is involved in the pathogenesis of gastroduodenal ulcer disease and gastric carcinoma have triggered intensive research about this organism. After overcoming considerable initial difficulties, researchers succeeded in adapting the instruments of molecular biology to the study of this highly fastidious organism. This has led to a rapid increase of knowledge concerning the basis of H.pylori virulence (as well as that of the related animal pathogens H. mustelae and H. felis) and to the development of molecular methods for the purposes of diagnosis and epidemiological research. The latest application of molecular biology in this area is the use of recombinant proteins for the development of an H.pylori vaccine. This review gives an overview of this rapidly developing field.

Cytokines play an essential role in normal and malignant B-cell proliferation and isotype-switching. Therefore we determined serum levels of different B-cell activating cytokines including IFN gamma, IL-4 and IL-10, IgG subclasses, further immunoglobulins and the soluble B-cell activation marker sCD23 in 68 patients with recently diagnosed and previously untreated IgG myelomas in comparison with age- and sex-matched healthy controls. Our results demonstrated that 16% of the myeloma patients had elevated IL-10 levels up to 1000 pg/ml and 8% showed increased IFN gamma serum concentrations. By contrast, only 7% of the controls showed detectable IL-10 levels and 3% had measurable IFN gamma levels. While in men 67% of the paraproteins were of the kappa light chain type, we found an equal occurrence of kappa and lambda light chains in women. In addition, the distribution of IgG subclasses differed in men and women. In comparison with the controls, no alteration of sCD23 was detected in myeloma patients. We found an apparent correlation of elevated IL-10 levels and the IgG1 subclass.

The hyper-IgE syndrome (HIS) is a complex immunologic disease, caused by an unknown basic defect. We report on two cases showing complications, which have not been described so far. Case 1: A 15-year-old boy suffering from HIS developed a liver tumour with severe eosinophilic infiltration and degranulation. The transformation process of the liver histologically resembled focal nodular hyperplasia. Therapy with cyclosporine A did not lead to clinical benefit. Now, a therapeutic attempt with interferon gamma is made. Case 2: In a 17-year-old female HIS patient, multiple papillomas and ulcers of the mucous membrane, caused by infection with human papilloma virus, emerged in the ENT region. Under treatment with interferon alpha, papillomatosis could be restrained. As therapy of the hyper-IgE syndrome only symptomatic treatment has been recommended so far. Future therapies should strive for systemic immunomodulation by application of cytokines or soluble cytokine receptors like interferons or sIL-4R.

We developed an enzyme immunoassay for the estimation of candida-specific IgA antibodies in saliva. In patients with stomatitis prothetica (n = 46) we found a higher concentration (p < 0.05) before therapy in comparison to normal controls.

The lethal midline granuloma and limited Wegener's granulomatosis show clinical similarity, although they are of different etiology. The following case of a 53-year-old woman shows how difficult it is to establish the precise diagnosis of lethal midline granuloma. The diagnosis depends on the pathological finding of a lymphoma. The lymphoma can be differentiated in a T- or a B-cell lymphoma by immunostaining. However, the diagnostic yield of biopsies from the nose is not perfect. It would be, therefore, important to find other diagnostic criteria. The presence of the c-ANCA is a helpful tool, but in the case of limited Wegener's granulomatosis, it has a sensitivity of 50%. The prognosis of the lethal midline granuloma is poor even if an adequate radiation therapy is instituted.