BACTERIA IN PYOGENIC INFECTIONS mixed flora of the intestinal tract participates in infections that originate from lesions of the bowel, such as appendicitis, cholangitis, diverticulitis, and perforation (from ulcerative colitis, ileitis, or carcinoma). These may lead to subdiaphragmatic hepatic, and pelvic abscesses, which are frequent causes of fever of unknown origin in the patient recovering from abdominal surgery or trauma to this region.
BACTERIA IN PYOGENIC INFECTIONS Because enteric bacteria grow luxuriantly in both aerobic and anaerobic media and therefore are likely to predominate in cultures, their relative importance tends to ‘be exaggerated_ There is a good reason to believe that anaerobic bacteria Bacteroides, Clostridia and anaerobic streptococci play more important roles in this kind of process. It should be pointed out here that a “fecal” odor of pus, though often ascribed to coliforms is doubtless caused by associated anaerobic bacteria’. Anaerobic bacteria are usually present as mixtures of two or more species. They should be suspected when there is foul pus and when organisms can be visualized microscopically bait fail to grow under routine conditions.
BACTERIA IN PYOGENIC INFECTIONS 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 man 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.