Robert J. Glaser

Effect of penicillin on the bacteremia following dental extraction

Abstract The administration of large doses of penicillin for twenty-four hours prior to dental extraction caused a significant decrease in incidence of bacteremia following extraction but failed to prevent it in a large number of cases. The agent was particularly effective in decreasing bacteremia after extraction of teeth from infected gums. The possible modus operandi of prophylactic penicillin in preventing subacute bacterial endocarditis is suggested and the recommendation made that this agent be given to all patients with rheumatic and congenital heart disease before and after dental extraction.

Orthostatic Hypotension, Anhidrosis, and Impotence

Anhidrosis and impotence occur frequently with idiopathic orthostatic hypotension. Two new cases of this syndrome, which occurs chiefly in males over 40 years of age, are herewith described. Postural vertigo and/or syncope, weakness, and anhidrosis or hypohidrosis are common symptoms, and a marked fall in systolic and diastolic blood pressure is noted when the patients stand. The pathologic physiology of the syndrome is discussed and various forms of therapy, none of them especially satisfactory, are reviewed.

Cardiac Lesions in Rabbits after Pharyngeal Infections with Group A Streptococci.

Summary The majority of rabbits subjected to single intrapharyngeal infections with group A streptococci developed cardiac lesions characterized by muscle necrosis, cellular infiltration with mononuclear cells and Anitschkow myocytes and disruption of collagen. After multiple infections, fibrosis occurred and giant cells were also observed. Bacteria could not be demonstrated in any lesion. In 3 control groups, comparable lesions were absent in the hearts of all but one rabbit. The appearance of myocardial lesions within 24 hours of induction of pharyngeal infection suggests that a non-immunologic mechanism is involved.

Production of Streptococcal Infections in Pharynx of the Rabbit.

Summary 1. A method is described for production of Group A streptococcal pharyngeal infections in rabbits. 2. After intrapharyngeal inoculation, transient bacteremia usually occurred, followed by temperature elevations to 48 hours and significant rises in ASO titers 4 weeks later. 3. Bacteria were demonstrable in pharyngeal tissues at 48 hours, and in some instances small abscesses were seen. 4. The method described affords another means of studying effects of repeated group A infections under conditions simulating those which obtain in man.

Production of Group A Streptococcal Cervical Lymphadenitis in Mice.

The fact that hemolytic streptococcal infections are implicated in the causation of rheumatic fever is well documented (1-3). Further, there is much evidence to suggest that rheumatic fever occurs as a result of an inappropriate immune response on the part of the host to the streptococcus or its products (4,5). Nevertheless, the pathogenesis of rheumatic fever remains obscure, its elucidation being seriously handicapped by the lack of a suitable experimental analog. The development, therefore, of an affection in experimental animals, bearing sufficient resemblance to rheumatic fever in man to satisfy the most stringent criteria, might well constitute a significant advance toward definition of the mechanism by which the human disease arises. One avenue of attack on this problem is represented by the attempt to simulate in experimental animals a sequence of events comprable to that which is assigned importance in human rheumatic fever; namely, repeated infections of the upper respiratory tract with group A streptococci (6). In order to pursue this particular investigate approach, it is essential to develop a method by which group A streptococcal infection can be achieved via the upper respiratory route in an experimental animal. The present paper describes the successful production of group A cervical lymphadenitis in mice by means of a modification of the intranasal technic described by Sonkin (7). In addition, the pathogenesis of the infection is delineated on the basis of systematic histologic observations. Methods. Swiss mice of the Webster strain, weighing between 15 and 20 g, were injected intraperitoneally with 0.3 ml of a 2.5% solution of chloral hydrate, and then allowed to inhale ether until deeply anesthetized.

Immunity in Group A Streptococcal Infections I. Non-Specific Protective Effect in Repeated Pulmonary Infections.

Summary 1. It was noted that after pneumonic infection with group A streptococci and treatment with procaine penicillin, rats exhibited a degree of protection against a second pulmonary infection, induced in a different lobe with a strain of different type, not demonstrable in previously uninfected animals. This non-specific protective effect was of limited degree and could be obscured when the challenging infections were especially virulent. 2. Evidence is presented which indicates that the protective effect noted is not due (a) to the presence of phagocytes and/or structurl alterations prior to the induction of the second infection, or (b) to the persistence of inhibitory levels of penicillin in the lung tissue per se. 3. The implications of these observations are discussed.

Destructive osseous lesions in early syphilis; response following penicillin therapy.

Abstract A case report of destructive osseous lesions of the skull in early syphilis is presented. Penicillin therapy (4.8 million units in 7.5 days) afforded prompt symptomatic relief and complete healing of the involved areas within a seven month period. The results in this patient compare favorably with those reported during prolonged treatment with the arsenicals and bismuth.