Diseases Caused by Malleomyces Leighton E. Chuff
Diseases Caused mitomycin is given soon after intradermal infection (before the onset of clinical illness), an attack may be aborted fully. Immunity does not develop, agglutinins fail to appear, and such subjects are prone to further infection. This phenomenon is of little practical significance, as patients are usually encountered after about a week of incubated disease. Partial to complete resistance to infection follows such antigenic stimulation. Control Measures. General. In infected areas, those measures designed to repel ticks, mosquitoes, or deer should be employed. Gloves should be used for handling all potentially infected animals, particularly rabbits, and animals to be consumed should be cooked thoroughly. Laboratory workers exposed to infected aerosols should exercise care by wearing suitable masks and utilizing other protective devices. Vaccination.
The available killed vaccines afford only partial protection to men against tularemia. Viable attenuated preparations have been used with considerable success in the Soviet Union. The vaccine is administered intradermally – and provokes a reaction similar in severity to that following smallpox immunization. Significant protection has been demonstrated in volunteers in the United States vaccinated with a similar viable product and who subsequently were exposed to virulent strains of F. tularensis by the respiratory or cutaneous routes. In those subjects who have developed clinical illness after immunization, the disease has been mild.
Foshay, L.: Tularemia. Ann ev. 3facrobiol., 4:313, 1950. McCrumb, F. R.: Aerosol inf:=%ion of a man with Pasteurella Tula-resist. Bach. Rev., 25:264 1961. Meyer, K. F.: Pasteurella and Francisella. In Dubos, R., and Hirsch, J. G. (eds.): Bacterial and Mycotic Infections of Man. 4th ed. Philadelphia, J. B. Lippincott Company, 1965, Chap. 27, p. 659.
DISEASES CAUSED BY MALLEOMYCES Leighton E. Chuff
Definition. Glanders, or farcy, is an infectious disease of horses, Mules, and donkeys Diseases caused by Malleomyces mallei. Farcy refers to the nodular abscesses observed in skin, lymphatics, and subcutaneou§ tissues. Etiology. Glanders was described by Aristotle about 330 B.C., and the occurrence of the disease in horses was observed by Apeyrtos about 375 A.D.
It is a gram-negative bacillus cul-table aerobically on ordinary nutrient media. It is variously called Malleomyces mallei, Bacillus mallei, or Pfeiferella mallei. M. mallei are nonmotile. It elaborates a specific antigen (mullein) upon lysis that is used as a skin test material for diagnostic purposes. The bacillus is antigenically separable from M. pummelled, which causes melioidosis. mallei produce a brown pigment resembling that of Pseudomonas ae-genoa. Incidence and Prevalence. Glanders has probably never been a common disease in man.
It has been eradicated in the United States and the United Kingdom, but may still occur in Asia and South America. Epidemiology. Glanders is a communicable dis-ease among horses, and it may occur sporadically in other animal species in contact with horses. Pathology and Pathogenesis. Healing occurs by fibrosis, and, rarely, by calcification. Clinical Manifestations. Glanders may occur as a fulminant acute febrile disease, as a chronic indo-lent and relapsing disease, or as a subclinical occult infection detectable incidentally at post-mortem examination or by serologic test. When glanders becomes disseminated, the dest notion of the feces will reveal a predominance of mononuclear cells. Sigmoidoscopy reveals under-mined ulcers with normal intervening mucosa.
Blood cultures are often positive. Staphylococcal food poisoning and many forms of viral gastroenteritis are more prominently associated with nausea and vomiting than with diarrhea. Treatment. Sulfonamides were effective in the treatment of shigellosis when they were first used. The resistance of Shigella to multiple antimicrobials has been induced by episomal transfer from other enteric bacilli. streptomycin given orally has been used to treat shigellosis, but strains resistant to this drug have also been identified.
At present, ampicillin in a dosage of 2 or more grams orally each day in divided doses for five days is the preferred agent in the treatment of shigellosis in adults. Fluid and electrolyte replacement should be given to the patient who is in collapse or who is dehydrated. Opiates such as paregoric or morphine may alleviate the abdominal discomfort and tenesmus but should be used cautiously. Prognosis. The mortality rate in untreated bacillary dysentery is about 0.1 percent or less, but it may be higher during famine or starvation. In addition, the fatality rate with dysentery Diseases caused by Shigella dysenteriae (Shiga) is higher than that attributed to other Shigella. Death rarely occurs when appropriate treatment is prescribed.
Dammin, G. The pathogenesis of acute diarrhea! disease in early life. Bull. WHO, 31:29, 1964. Gordon, J. E., Behar, M., and Scrimshaw, N. S.: Acute diarrhea! disease in less developed countries: I. An epidemiological basis for control. Bull. WHO, 31:1, 1964. Ramos-Alvarez, M., et al.: Diarrhea! the disease of children. The occurrence of enteropathogenic viruses and bacteria. Amer. J. IDs. Child., 107:218, 1964. Reller, L. B., et al.: Shigellosis in the United States, 1964-1968. J. Infect. Dis., 120:393, 1969. Watanabe, T.: Infective heredity of multiple drug resistance in bacteria, Back. Rev., 27:87, 1963. Wilson, G. S., and Miles, A. A.: Tapley and Wilson's Principles of Bacteriology and: Immunology. 5th ed. Baltimore; Williams and Wilkins Company, 1964; Vol. II. p. 1876.