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The activity of norfioxacin was compared to that of nalidixic acid, cinoxacin trimethoprim, trimethoprim/sulphamethoxazole, ampicillin, cephalexin, doxycycline, amikacin, and gentamicin against 205 isolates of Gram-negative and Gram-positive bacteria. Norfloxacin was the most effective agent against all of the organisms tested except enterococci and . The minimal inhibitory concentrations at which at least 90% of the organisms were inhibited (MIC were 0·5 mg/l for all Enterobacteriaceae and , 1·0 mg/l for all staphylococci, and 4·0 mg/l for enterococci. In addition, the activity of norfloxacin was compared to that of penicillin G, ampicillin, cefonicid, cefoxitin, cefuroxime, doxycycline, and spectinomycin against 104 clinical isolates of . Norfloxacin was the most active with an MIC of 0·03 mg/l. [ABSTRACT FROM PUBLISHER]

In cases of advanced infection with human immunodeficiency virus, mycobacterial blood cultures are frequently used to diagnose disseminated infection with the Mycobacterium avium complex (MAC). However, no prospectively validated guidelines exist for the use of such cultures. In this study, a two-part model for predicting MAC bacteremia was developed and then validated prospectively. First, a CD4+ cell count of ⩽50/µL was used to predict bacteremia. then, among patients with ⩽50 CD4+ cellS/µL, the documentation of fever on more than 30 days during the preceding 3 months, a hematocrit of <30%, or a serum albumin concentration of <3.0 g/dL was used to predict bacteremia. This model had a sensitivity of 89% and positive and negative predictive values of 30% and 98%, respectively, for the identification of patients with bacteremia. Had the model been applied to patients in this study, the number of blood cultures performed would have decreased by 61%, but 11% of the positive cultures would have been missed. In short, this model can predict MAC bacteremia and can potentially guide the use of mycobacterial blood cultures. [ABSTRACT FROM PUBLISHER]

Forty patients with the acquired immunodeficiency syndrome (AIDS) and their first episodes of Pneumocystis carinii pneumonia were assigned at random to receive either trimethoprim-sulfamethoxazole or pentamidine isethionate. The two groups did not differ significantly in the severity of pulmonary or systemic processes at enrollment. Five patients treated initially with trimethoprim-sulfamethoxazole and one patient treated initially with pentamidine died during the 21-day treatment period (p = 0.09, Fisher's exact test). No significant differences were seen between groups in rates of improvement, pulmonary function tests, or 67Ga uptake by the lungs in the survivors at completion of therapy. Adverse reactions necessitated changing from the initial drug in 10 patients in the trimethoprim-sulfamethoxazole group and 11 in the pentamidine group. Minor reactions occurred in all patients. In patients with AIDS, trimethoprim-sulfamethoxazole and pentamidine do not have statistically significant differences in efficacy or frequency of adverse reactions. [ABSTRACT FROM AUTHOR]

Reports several cases of Pneumocystis carinii pneumonia in adult homosexual men which were confirmed by biopsy in San Francisco, California between November 1980 and June 1981. Categories of pulmonary disease due to interstitial plasma cell pneumonia; Characteristics of the patients; Results of culture and serologic testing for cytomegalovirus.

Examines several case reports of infection with Edwardsiellla tarda, an organized member of the Enterobacteriaceae. Environmental sources of E. tarda; Medical records of the patients; Results and discussion.

The value of the smear for acid-fast bacilli in predicting pulmonary tuberculosis is unclear in a setting where there is a high prevalence of Mycobacterium avium complex in respiratory specimens. To evaluate the impact of a high prevalence of M. avium complex on the predictive value of the acid-fast bacilli smear for tuberculosis, we reviewed findings on smears and results of cultures over a 3-year period at a hospital where M. avium complex is the predominant mycobacterial isolate. In this setting, the predictive value of the acid-fast bacilli smear for Mycobacterium tuberculosis was 92% for expectorated sputum specimens, 71% for induced sputum specimens, and 71% for bronchoalveolar lavage specimens. When multiple specimens collected from the same patient were excluded from the data base, the predictive values were 87%, 70%, and 71%, respectively, Smears of sputum samples were positive at the same rate for patients with tuberculosis who had AIDS and for patients with tuberculosis who did not have AIDS. [ABSTRACT FROM PUBLISHER]

The article presents information on a 41-year-old HIV-seropositive woman with a history of intravenous drug use. Physical examination revealed a thin, acutely ill woman with rigors. Oropharyngeal candidiasis was present, and crackles and dullness to percussion were detected over the right lung base. The neurologic examination was normal, and dermatologic evaluation revealed no petechiae, bruises, or rashes. The serum sodium, potassium, chloride, bicarbonate, urea nitrogen, glucose, alanine aminotransferase, alkaline phosphatase, bilirubin, and albumin concentrations were within normal limits. A presumptive diagnosis of pneumocystis carinii pneumonia and zidovudine-induced pancytopenia was made. She was treated with a combination of trimethoprim and sulfamethoxazole.