James D. Cherry

Allergic bronchopulmonary aspergillosis in a child.

The syndrome of allergic bronchopulmonary aspergillosis is exceedingly rare in the United States. We have studied a 9-year-old child who fulfills all of the clinical and laboratory criteria of this syndrome, and who is believed to be the first patient in the pediatric age range reported in this country. Clinical and laboratory features include wheezing with fever, transient pulmonary infiltrates, eosinophilia of blood and sputum, septate hyphae and positive culture for Aspergillus fumigatus in the sputum, and skin-sensitizing antibody and precipitating antibody to Aspergillus fumigatus . Successful treatment included administration of corticosteroids orally and of amphotericin B by aerosol.

Amphotericin B therapy in children. A review of the literature and a case report.

The basis for the dosage of amphotericin B in adult patients is usually governed by toxicity rather than by therapeutic effect. A similar approach to therapy has been adopted in pediatric practice. In an attempt to determine amphotericin B nephrotoxicity in children and a more rational approach to therapy, a review of the literature was conducted. This review points out the disappointing lack of data on toxicity in children. It is suggested that amphotericin B dosage in pediatric patients should be based on the amount necessary to combat effectively the infecting organism, rather than on the basis of data on adult toxicity.

MYCOPLASMA PATHOGENICITY STUDIES IN ORGAN CULTURES

Several mycoplasmas cause respiratory illnesses in animals. The pathology and clinical symptomatology of many of these infections have been extensively studied in both natural and experimental infections. The results of laboratory in vitro studies with the various mycoplasmas associated with respiratory illnesses have suggested several factors that could be responsible for the pathogenesis of these infections under natural conditions. At present, however, very little is known about the in vivo pathophysiology of respiratory illnesses due to mycoplasmas. Since pulmonary infections are usually the result of downward spread of microbial agents, it would seem likely that the study of living respiratory epithelium during infection would offer valuable information relating to pathogenesis. Recently several including our~elves ,~-~l have shown that organ cultures of ciliated tracheal epithelium are useful in the study of mycoplasma pathogenicity factors. In particular, we have shown that many mycoplasmas will grow in a chicken embryo tracheal organ culture system and that this system is well suited for quantitative ~tudies.7-l~ It is the purpose of this presentation to: (1) review our published and unpublished studies utilizing the chicken embryo tracheal organ culture system; (2) present our studies with other organ cultures; (3) review the studies of others; and (4) point out difficulties of methodology encountered and areas that deserve further investigation.

The inhibition of ciliary activity in tracheal organ cultures by sera from children with cystic fibrosis and control subjects

The cilioinhibitory effect of sera from patients with cystic fibrosis and control subjects was studied in chicken and rabbit trachel organ cultures. All sera were markedly ciliotoxic and no difference was noted between sera from cystic fibrosis patients and those of control subjects. The serum ciliotoxic factor was found to be heat labile, nondialyzable, removable by kaolin, and lost during Sephadex G-200 gel filtration.

A clinical trial with live attenuated rubella virus vaccine (Cendehill 51 strain)

Twenty-one subjects were inoculated with Cendehill strain, rubella virus vaccine; 21 other patients were uninoculated contact subjects. Vaccinees and contacts were intimately associated for a 45 day study period. All but one of the immunized patients developed HAI antibody titer to rubella virus, whereas no contact subjects developed rubella antibody. Rubella virus was recovered from the nose or throat of 81 per cent of the vaccinated subjects and viremia was noted in one vaccinee on study day 11. No clinical illness could be attributed to the rubella vaccine.

Chromosomal analysis of cultured skin fibroblasts from patients with infectious mononucleosis

In the present study, skin fibroblasts and leukocyte cultures from patients with acute infectious mononucleosis were examined to determine if any in vitro marker chromosomes could be detected. No alterations in chromosomes could be found in fibroblasts either from the region of the typical rash or from other areas of skin. This would tend to suggest but does not necessarily prove that this tissue was not extensively involved in the disease process.