This report describes the case of a patient with chronic lymphocytic leukemia in whom septicemia caused by a nontoxigenic strain of Corynebacterium diphtheriae developed. Numerous abscesses were present in sections of liver and spleen taken at autopsy. The case is discussed, and the literature on infections caused by organisms of the genus Corynebacterium is briefly reviewed.
A prospective study was performed to evaluate four culture methods for the diagnosis of bacterial peritonitis in patients on continuous ambulatory peritoneal dialysis. Peritonitis was present in 44 of 85 patient admissions (52%). The overall sensitivity of the culture methods in detecting peritonitis was 66%. The sensitivities of the individual methods were as follows: bag culture method, 61%; blood culture broth method, 51%; filter method, 54%; and plate method, 39%. Our broad definition of peritonitis resulted in lower sensitivities. A combination of the bag and blood culture broth methods detected all positive cultures.
The effectiveness and safety of parenterally administered ceftazidime were assessed in 20 patients with infections caused by Pseudomonas aeruginosa or Serratia marcescens. There were six infections involving the urinary tract, six wound infections, one respiratory tract infection, three septicaemias, one empyema, one mastoiditis and two infections of the epididymis. Sixteen of the isolates were resistant to at least one aminoglycoside antibiotic. Fifteen patients were clinically and bacteriologically cured, two patients improved, but had relapses and three patients showed no response. The lack of clinical response was due to the development of resistance by P. aeruginosa in two patients with osteomyelitis, one of whom also had diabetes mellitus. The third patient who had chronic lymphocytic leukaemia developed post-operative osteomyelitis and septicaemia with serratia. She did not respond to treatment. Side effects consisted of a positive direct Coomb's test without evidence of haemolysis in two patients and a mild maculopapular rash in one patient.
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