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A Gram-negative bacillus that defies identification was isolated from blood cultures of 17 patients with fever. Fifteen patients were male adults, and 14 patients had underlying diseases, including previous splenectomy in five, which impair host defenses against infection. Illnesses occurred in the summer and autumn in 14 cases and had been recently preceded by dog bites in 10 cases. Clincal syndromes included cellulitis in seven cases, primary bacteremia without localization in four, purulent meningitis in four, and endocarditis in three. Three patients died. The organism grows slowly on blood or chocolate agar in 10% CO, is oxidase- and catalase-positive, and is negative for nitrate reduction, indole production, and urease. It produces acid from glucose, lactose, and maltose. These features distinguish it from all previously described and classified bacteria. Furthermore, the epidemiologic features of the patients suggest that this organism is an opportunistic invader and may have an animal reservoir in nature. [ABSTRACT FROM AUTHOR]

One hundred and fifty-two consecutive cases of cholelithiasis were studied. The gallbladder stones were analyzed to determine the constituents, the bile specimens were cultured and correlated with the cultures when wound infection occurred. Mixed gallstones were the commonest type (58.5%), pigment stones (27%) and cholesterol stones (14.5%). Positive bile cultures were found in 41 patients (27%) and Escherichia coli was the commonest organism isolated. The rate of wound infection was 14.5% and the most common organism cultured from the wound was staphylococcus epidermidis.

We report a fatal case of lipoid pneumonia in a two and one half month old Saudi female caused by aspiration of animal fat, ghee and complicated by Mycobacterium fortuitum infection. It highlights the need to look for M. fortuitum in lipoid pneumonia and suggests the prevention of the condition through health education.

The present study included 337 patients, presenting to Asir Central Hospital with fever of more than two weeks duration, or symptoms associated with brucellosis but without fever. Of the 337 subjects examined for knowledge about methods and means of transmission of brucellosis, 309 (92%) were ignorant while only 28 (8%) appeared to possess some knowledge as to the source, type of animal contact and presentation of illness. None of the 337 subjects was able to link the disease with a microbial infection. The most important common practices associated with brucellosis included raw milk consumption, close animal contact and the slaughtering and disposal of wastes. Illiteracy, ignorance and faulty behaviours emphasize the importance of health education of the community, to raise the KAP standard of the full spectrum of brucellosis in the community would be valuable in its prevention and control.

Avulsion fractures of the tibial tubercle prior to epiphyseal closure are being treated with greater frequency. Watson-Jones Types I and III fractures are the most common; both require open reduction and internal fixation. Type II fractures respond to closed reduction and plaster immobilization. The authors have found only 76 fractures reported in the literature since 1935. Four cases were bilateral. Fifty-nine patients were boys, and two were girls; the sex was not reported for 11 patients. Type III fractures occurred most often in older adolescents. Types I and II fractures occurred in younger patients. No reports of growth disturbance of the proximal tibial epiphysis occurring after a Type III fracture were found.

This report describes a case of septicemia and meningitis secondary to dog bites by two different dogs on two consecutive days. The case is noteworthy because of the unusual characteristics of the etiologic agent and the inability to place the etiologic agent into any currently defined genus or to identify it by the existing systems of classification. The organism is a small, thin, Gram-negative bacillus after 24 hours of incubation on blood agar; after prolonged incubation, it becomes filamentous. The organism is catalase- and oxidase-positive, hydrolyzes esculin, and forms acid in glucose, xylose, and maltose after 21 days' incubation. The organism does not manifest lysis on sheep blood agar, and does not grow on MacConkey, Salmonella-Shigella, Centrimide, nutrient, or Kligler iron agars. The tests for urea, nitrate reduction, and indol are negative. The unidentified Gram-negative bacillus showed susceptibility to all antimicrobials tested except gentamicin.

The lipid content of the proximal jejunum, as studied by light microscopy with lipid histochemical staining methods, is determined in 14 fasting children with juvenile-onset diabetes mellitus. The results show that four children had greatly increased amounts of lipid, while six others had a mildly to moderately increased amounts of lipid present. The amount of lipid present appears to correlate most closely with the quality of control of the diabetes. These results indicate either that the clearance of exogenous lipid is impaired or that there is an increased endogenous synthesis of lipid within the intestine of the diabetic child, especially in those under poor control.

Infections due to Serratia marcescens were studied in 23 different hospitals. A retrospective study was done in 4 hospitals; all isolates were compared by serological typing, antibiograms, bacteriocin production, and bacteriocin sensitivity. 2 of the hospitals were having cross-infection problems due to antibiotic-resistant strains, but the other 2 had little or no cross-infection. Outbreaks were studied in 19 other hospitals. 9 of these outbreaks were classified as "common source" since contaminated "sterile solutions" were incriminated as the cause in each. One hospital had a "pseudo-outbreak," in which Serratia from E.D.T.A. blood-collecting tubes contaminated blood-cultures as they were collected. All 10 of these strains from common-source outbreaks were generally sensitive to antibiotics. Outbreaks in 9 other hospitals resulted from cross-infection and were caused by strains which were very resistant to antibiotics. Guidelines for detecting outbreaks are given and control measures are suggested.

Antibiotic-resistant lactose-fermenting bacteria were recovered from the feces of 20 of 25 burn patients studied. Of the Escherichia coli isolated from patients receiving antibiotic treatment, 81.5% were shown to be infectiously resistant; only 32% of the E. coli recovered from patients not receiving antibiotics were shown to be harboring R factors. Three resistance patterns, ampicillin-chloramphenicol-streptomycin-kanamycin, ampicillin-tetracycline, and ampicillin-streptomycin, accounted for 25.2, 20.3, and 15.4%, respectively, of the total R factors identified.