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Pathogenesis Clinical Microbiology and Infection, Volume 12, Supplement 4, 2006 Pathogenesis R1885 microbial products (bacterial superantigens) may play a major Concurrent nasopharyngeal squamous cell role in the pathogenesis of disseminated, life-threatening carcinoma and lymphoproliferative disorder S. aureus infection. Methods: An exceptional case report of community-acquired, during HIV infection. Possible pathogenetic severe infection caused by a methicillin-resistant S. aureus strain, interactions among retroviral infection, Epstein- responsible for pneumonia, septic shock, and scattered septic Barr virus infection, and inhalatory cocaine abuse embolism, and accompanied by diffuse polyvisceritis and R.Manfredi,S.Sabbatani,U.Gianelli,F.Chiodo (Bologna, Milan, IT) thrombophlebitis as signs of an extensive immune system activation, was observed in a otherwise healthy 40-year-old man. Introduction: Only two human cells types allow the replication of Results: The striking features of S. aureus polyvisceral disease EBV: B-lymphocytes and squamous epithelium. Burkitt lym- (pneumonia, sepsis, and pulmonary and hepato-splenic septic phoma recognizes a pathogenetic role for both EBV and multiple embolism) were associated with multiple immune-mediated co-factors influenced by geographic issues, too. The nasopharyn- focal manifestations (massive pleuric-pericardial effusion, geal carcinoma predominates in South-Eastern Asia where the mycocarditis, and multiple lower limb thrombophlebitis). exposure to some inhalants (i.e. phenoles) seems more frequent, In vitro resistance to all beta-lactams, fluoroquinolones, macro- but antibodies against the early EBV antigen VCA are commonly lides, and aminoglycosides, apparently did not justify the found, as well as the isolation of EBV genomic sequences from clinical-microbiological failure of a glycopeptide-based combi- neoplastic cells. The staging of rhinopharyngeal carcinoma also nation therapy. Only the administration of linezolid-rifampicin- includes a poorly differentiated variety with a prominent lym- tetracycline together with intensive care support, achieved a phoid infiltrate, which may raise the suspect of an extranodal slowly progressive ameliorement, while the polyvisceritis lymphoma, although the resident T-cells are not malignant. During (associated by an immune-activation syndrome documented HIV disease, malignant lymphomas and EBV-associated lympho- by increased CD4+, CD34+ and CD4-CD8- T-lymphocyte proliferative disorders prove more frequent than in the general subsets), caused directive disease at multiple body sites, and population, but nasopharingeal carcinoma remains an extremely required a prolonged high-dose steroid therapy. A complete infrequent occurrence with only anecdotal cases reported. clinical, laboratory, and instrumental recovery was reached only Case report: Our patient, HIV-infected since 20 yr and with a long three months after admission. history of inhalatory cocaine abuse, 18 months ago developed a Conclusions: This report raises multiple questions about the remarkable laterocervical lymphadenopathy, whose histopatho- epidemiology, pathogenesis, manifestations, and management logic study disclosed a polymorphic EBV-associated B-cell lympho- of complicated S. aureus infection, with special focus on the proliferative disorder. A TC scan concurrently showed a right immune system activation triggered by microbial antigens, and nasopharyngeal mass and detected multiple cervical, axillary, and the therapeutic role of steroids and novel antibiotics targeted ilar-mediastinal lymphadenopathies. A biopsy of rhinopharingeal against resistant Gram-positive cocci. lesion disclosed a poorly differentiated squamous carcinoma also EBV-positive at biomolecular testing. A cytotoxic chemotherapy was performed with ten consecutive cycles of cisplatinum-fluor- R1887 ouracil-bleomycin, associated with HAART, which achieved dis- Status of interleukin-5 and interleukin-13 in ease remission. A CT re-staging performed four months later peripheral blood of adults with bronchial asthma showed sparse parapharyngeal and paravertebral infiltrates so that K. Bedewy, N.G. Rizk, Y.N. Ibrahim, E. Hasaneen (Alexandria, the suspected recurrence prompted a still ongoing radiotherapy EG) course, while the immune recovery was not attained, as expressed by a CD4+ count of 83 cells/lL despite HIV virologic control. Objectives: To explore the possible role of IL-5 and IL-13 in the Conclusions: Our patient suffered from two distinct malignant and pathophysiology of asthma, and to define the source of these pre-malignant disorders with some intriguing pathogenetic associ- cytokines in peripheral blood. ations mainly linked to EBV but also HIV and related immunode- Methods: Forty-two patients with acute asthma, 25 patients ficiency and perhaps the chronically inhaled cocaine. Both with asymptomatic asthma (4 weeks or more without exacer- squamous carcinoma and lymphoproliferative disorder of the bation) and 20 healthy controls were subjected to quantitative nasopharynx are more frequent in the immunocompromised host measurements of serum IL-5 and IL-13. In addition, IL-5 and and deserve further pathogenetic investigation to clarify and IL-13 mRNA expression in peripheral blood mononuclear cells eventual shared or addictive role of some viral and environmental was defined by reverse transcription-polymerase chain reaction risk factors. (RT-PCR). Spirometric parameters including: forced vital capa- city (FVC), forced expiratory volume in one second (FEV1), R1886 forced expiratory flow rate at 25%, 50%, and 75% of the vital capacity (FEF 25, 50, 75) and peak expiratory flow rate (PEFR) Community-acquired septicaemic pneumonia were recoded in acute asthma patients. caused by a multiresistant Staphylococcus aureus Results: Serum IL-5 and IL-13 levels were significantly higher strain, resulting in multiple organ involvement in patients with acute asthma than asymptomatic asthma and exacerbated by extensive immune activation healthy controls, and in asymptomatic asthma patients than R. Manfredi, S. Sabbatani, G. Marinacci, F. Chiodo (Bologna, IT) healthy controls. Serum IL-5 and IL-13 levels were significantly and positively correlated with each other in patients with acute Background: Antibiotic-resistant Gram-positive cocci are of asthma but significantly and inversely correlated with the increasing concern, and immune activation promped by spirometric parameters. The frequencies of IL-5 and IL-13 2006 Clinical Microbiology and Infection, Volume 12, Supplement 4 ISSN: 1470-9465 Abstracts mRNA in PBMC from patients with acute asthma (90.9% and development and for application of plant origin antihelminthic 81.8% respectively) were significantly higher than that from during the therapy of helminthosies especially trichinellosis. patients with asymptomatic asthma (27.3% P = 0.0024 and 36.4% P = 0.03 respectively) and healthy controls (0.0%, P = 0.00003 and 0.0%, P = 0.0002 respectively). However, the R1889 difference between asymptomatic asthmatic and healthy con- Soft tissue infections by Stenotrophomonas trols was insignificant regarding the frequency of positive PBMC- based IL-5 mRNA expression but significant regarding maltophilia in immunocompromised rats. the frequency of positive PBMC- based IL-13 mRNA expression Implication of bacterial translocation (P = 0.034). I. Koutelidakis, T. Tsaganos, A. Papadopoulos, P. Koutoukas, Conclusion: Serum levels of IL-5 and IL-13 may be useful in E.J. Giamarellos-Bourboulis, H. Giamarellou, K. Atmatzidis monitoring of bronchial asthma particularly as they correlated (Athens, GR) significantly with severity of the disease as indicated by Objectives: The aim of the present study was to investigate the Spirometric parameters. PBMC contribute to serum levels of role of bacterial translocation in the overall mortality in an IL-5 and IL-13 and that spill over from the airways might be an animal model of soft tissue infection by Stenotrophomonas additional source of these cytokines in serum of patients with maltophilia. acute asthma. Methods: Soft tissue infection was induced in twenty-seven immunocompromised Wistar rats. Neutropenia was achieved by the intramuscular infusion of cyclophosphamide at a dose of R1888 100 mg/kg on day 1 and 150 mg/kg on day 3. Animals were The study of cellular and tissue mechanisms of challenged in the left thigh by an 8log10 cfu/kg inoculum of homeostasis of the system ‘‘helminth – host’’ S. maltophilia on day 5 and randomised into three groups. Group during muscular trichinellosis and the A consisted of eight rats observed for survival; group B of 10 animals sacrificed two hours post inoculation and group C of phytoorigin antihelminthic effect nine rats sacrificed four hours post inoculation. Through a H. Zanginyan, A. Asatryan, L. Ghazaryan, L. Melkonyan, midline incision 4 ml of blood were drawn from the inferior R. Mkrtchyan (Yerevan, AM) vena cava vein of rats in groups B and C for quantitative culture Objectives: The purpose of our work was the study of the upon euthanasia; liver, spleen and lung samples were collected and quantitatively cultured. For the evaluation of culture influence of phytoantihelminthic on the structure and functional activity of tissues of larva of trichinella and on the structure and results, stool specimens were obtained from five healthy rats. Results: micromorphofunctional condition of muscles and barrier-organs Mean ± SE survival of group A was 34.6 ± 5.56 hours; of their hosts during mixed invasion by larvas of T. spiralis and all
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