David N. Gilbert

Methicillin Hemorrhagic Cystitis

Interstitial nephritis is a recognized complication of methicillin therapy. Hemorrhagic cystitis due to methicillin has not been emphasized. Evidence of hemorrhagic cystitis developed in six patients receiving methicillin therapy and was confirmed by cystoscopy in three of them.

Escherichia coli bacteremia in the squirrel monkey. I. Effect of cobra venom factor treatment.

Squirrel monkeys were significantly depleted of complement by a nontoxic protein constituent of cobra venom, and the influence of cobra factor (CoF) treatment on the course of Escherichia coli bacteremia was studied. Striking neutropenia occurred rapidly in control animals while the rate of occurrence of neutropenia was 20 to 30 times slower in the CoF-treated animals, suggesting that the E. coli-induced neutropenia was at least partially a complement-mediated response. In the CoF-treated monkeys, the initial rate of clearance of the E. coli from the circulation tended to be slower and the resultant levels of bacteremia were higher than in control animals. These observations are consistent with a hypothesis that complement-mediated neutrophilic leucocyte function is an important host defense mechanism in gram-ngeative bacillary bacteremia.

Microbiologic study of wound infections in tornado casualties

Cultures for aerobic, anaerobic, fungal, and mycobacterial organisms were performed on 59 tornado-associated wounds in 47 patients. Most impressive was the frequent identification of aerobic gram-negative bacilli. Seventy-five percent of the wounds cultured organisms, yet the infections were generally benign and self-limited. Evidence is presented which favors a soil, rather than nosocomial, source for the bacteria in the wounds of the hospitalized patients. The guidelines for treatment of tornado-induced wounds include removal of environmental debris, antitetanus prophylaxis, and delayed primary wound closure.