- Email: [email protected]
329
329 lesions and enanthem have been previously reported in association with Coxsackie A9 infection.2 Lastly, it is very apparent that many more enteroviruses than those mentioned by the authors can cause herpangina.2 Department of Pediatrics, Saint Louis University School of Medicine, and Infectious Disease Unit, Cardinal Glennon Memorial Hospital for Children, St. Louis, Missouri 63104, U.S.A.
JAMES D. CHERRY.
but and
brachycephaly, oblique palpebral fissures, simian creasej!, clinodactyly were recognised. The infant was in severe respiratory distress and cyanotic, and died at five hours. Postmortem
examination disclosed duodenal atresia in addition
to
hydrops. No abnormality of the heart, lungs, or kidneys was found. A chromosome analysis demonstrated trisomy G (47,XX,G+) consistent with Down’s syndrome. The second infant was a Spanish-American male born to a 22-year-old gravida-2 para-2 mother at 39 weeks’ gestation. He weighed 4000 g. and was 44 cm. in length. The mother noted a the
great increase in abdominal size at the end of pregnancy and was carrying twins because there were many twins in her family. The infant was delivered by emergency cxsarean section because of polyhydramnios and fetal distress. Except for severe generalised oedema, no unusual physical features were recognised at birth. The infant died at two hours. The necropsy showed duodenal stenosis. The heart, lungs, and kidneys were normal. The cord had three vessels and the placenta was normal grossly and microscopically. A chromosome analysis showed trisomy G (47,XY,G+).
thought that she
INITIAL CHOICE OF ANTIBIOTIC TREATMENT FOR PYOGENIC HAND INFECTIONS
SIR,-In an interesting paper Mr Nicholls (Feb. 3, 225) presented the results of antibiotic-sensitivity tests on bacteria isolated from pyogenic hand infections. Of 69 isolates of Staphylococcus aureus, 19 were recorded as being sensitive to penicillin and 24 as sensitive to ampicillin (table 11 of Mr Nicholls’s article). It is probable that the 19 penicillin-sensitive strains were also ampicillin-sensitive, leaving 5 strains recorded as penicillin-resistant and ampip.
The association of Down’s syndrome with non-immunofetalis might be looked for by other
logical hydrops investigators. This
cillin-sensitive. Resistance" to penicillin in staphylococci usually results from the production of bacterial penicillinase, which "
destroys ampicillin as well as benzylpenicillin. Apparent sensitivity to ampicillin by penicillinase-producing staphylococci is seen not infrequently when using disc-diffusion methods of sensitivity testing, but it seems wise practice to record all such strains as being ampicillin-resistant. To do otherwise is to encourage the use of ampicillin in the treatment of infections caused by bacteria capable of destroying this drug. To avoid the inadvertent reporting of ampicillin sensitivity in penicillinase producing staphylococci it is our practice to omit ampicillin from the range of antibiotic-sensitivity discs that we use in staphylococcal sensitivity testing. Group Laboratory, Royal Albert Edward Infirmary, Wigan.
study was supported in part by U.S.P.H.S. grant 286. Department of Pediatrics, 1200 N. State Street,
Los
Angeles County-U.S.C. Medical Center,
Los Angeles, California 90033, U.S.A.
ATSUKO FUJIMOTO ALLAN J. EBBIN MIRIAM G. WILSON.
FAILURE TO INDUCE MALFORMATIONS IN FETAL RATS BY FEEDING BLIGHTED POTATOES TO THEIR MOTHERS
SIR,-As a follow-up to Renwick’s suggestionthat might be a causal relationship between maternal consumption of potatoes infected with late blight (Phytophthora infestans) and human anencephaly and spina bifida, we made the following observations in Wistar strain rats. there
RESULTS OF GAVAGING PREGNANT WISTAR RATS WITH RAW AND
A. R. EVANS.
BOILED BLIGHTED-POTATO HOMOGENATE
DOWN’S SYNDROME AND NONIMMUNOLOGICAL HYDROPS FETALIS
SIR,-Although hydrops fetalis is most commonly associated with erythroblastosis, a significant number of hydropic infants are born without any evidence of bloodgroup incompatibility between mother and fetus. Nonimmunological hydrops has occurred with fetal infections, pulmonary lymphangiectasia, congenital lung malformations, maternal diabetes mellitus and toxxmia, congenital nephrosis, congenital heart-disease, including prenatal closure of foramen ovale, umbilical-vein thrombosis, fetal neuroblastoma, twin transfusions, placental hasmangioendothelioma, and homozygous rL-thalassaemia.3-5 Hydrops has also been reported in achondroplasia.6 We have seen two hydropic infants who had Down’s syndrome with trisomy G. In both instances the blood types of the mothers and the infants were A-positive and the direct Coombs test on the infants’ blood was negative. Serological test for syphilis was negative in both. The first infant
was
a
Caucasian female born
at
35 weeks’
gestation to a 20-year-old gravida-2 para-2 mother. The infant weighed 2381 g. and was 40-5 cm. in length. The mother was exposed to mumps during the fifth month, but was not ill. There was no mumps antibody detected at 18 dilution. The infant’s physical features were distorted by generalised cedema, Potter, E. L. in Pathology of the Fetus and the Infant. Chicago, 1961. Driscoll, S. G. New Engl. J. Med. 1966, 275, 1432. Daniel, S. J., Cassady, G. Pediatrics, 1968, 42, 828. 6. Morrison, J. E. Fœtal and Neonatal Pathology. Washington, 1963. 3. 4. 5.
*
1 died of
pneumonia.
Pregnant rats (6 animals) were gavaged with either raw or boiled homogenate of blighted potatoes (Katahden strain derived from the State of Maine) twice daily (2-5 g. per kg. per day) for seven consecutive days of pregnancy (days 5-11). On the same schedule, 2 animals were gavaged with homogenate from apparently normal areas of blighted potatoes, and 3 animals (controls) with normal potatoes bought from the market. All animals were also provided with standard rat chow and water ad libitum. They were weighed on alternate days and there was no significant difference in the maternal weight-gain in the four groups. The animals were examined at necropsy on day 21 of gestation, and implantation sites were recorded; all fetuses 1.
Renwick, J. H. Br. J. prev.
soc.
Med. 1972,
26,
67.
JAMES D. CHERRY.
but and
brachycephaly, oblique palpebral fissures, simian creasej!, clinodactyly were recognised. The infant was in severe respiratory distress and cyanotic, and died at five hours. Postmortem
examination disclosed duodenal atresia in addition
to
hydrops. No abnormality of the heart, lungs, or kidneys was found. A chromosome analysis demonstrated trisomy G (47,XX,G+) consistent with Down’s syndrome. The second infant was a Spanish-American male born to a 22-year-old gravida-2 para-2 mother at 39 weeks’ gestation. He weighed 4000 g. and was 44 cm. in length. The mother noted a the
great increase in abdominal size at the end of pregnancy and was carrying twins because there were many twins in her family. The infant was delivered by emergency cxsarean section because of polyhydramnios and fetal distress. Except for severe generalised oedema, no unusual physical features were recognised at birth. The infant died at two hours. The necropsy showed duodenal stenosis. The heart, lungs, and kidneys were normal. The cord had three vessels and the placenta was normal grossly and microscopically. A chromosome analysis showed trisomy G (47,XY,G+).
thought that she
INITIAL CHOICE OF ANTIBIOTIC TREATMENT FOR PYOGENIC HAND INFECTIONS
SIR,-In an interesting paper Mr Nicholls (Feb. 3, 225) presented the results of antibiotic-sensitivity tests on bacteria isolated from pyogenic hand infections. Of 69 isolates of Staphylococcus aureus, 19 were recorded as being sensitive to penicillin and 24 as sensitive to ampicillin (table 11 of Mr Nicholls’s article). It is probable that the 19 penicillin-sensitive strains were also ampicillin-sensitive, leaving 5 strains recorded as penicillin-resistant and ampip.
The association of Down’s syndrome with non-immunofetalis might be looked for by other
logical hydrops investigators. This
cillin-sensitive. Resistance" to penicillin in staphylococci usually results from the production of bacterial penicillinase, which "
destroys ampicillin as well as benzylpenicillin. Apparent sensitivity to ampicillin by penicillinase-producing staphylococci is seen not infrequently when using disc-diffusion methods of sensitivity testing, but it seems wise practice to record all such strains as being ampicillin-resistant. To do otherwise is to encourage the use of ampicillin in the treatment of infections caused by bacteria capable of destroying this drug. To avoid the inadvertent reporting of ampicillin sensitivity in penicillinase producing staphylococci it is our practice to omit ampicillin from the range of antibiotic-sensitivity discs that we use in staphylococcal sensitivity testing. Group Laboratory, Royal Albert Edward Infirmary, Wigan.
study was supported in part by U.S.P.H.S. grant 286. Department of Pediatrics, 1200 N. State Street,
Los
Angeles County-U.S.C. Medical Center,
Los Angeles, California 90033, U.S.A.
ATSUKO FUJIMOTO ALLAN J. EBBIN MIRIAM G. WILSON.
FAILURE TO INDUCE MALFORMATIONS IN FETAL RATS BY FEEDING BLIGHTED POTATOES TO THEIR MOTHERS
SIR,-As a follow-up to Renwick’s suggestionthat might be a causal relationship between maternal consumption of potatoes infected with late blight (Phytophthora infestans) and human anencephaly and spina bifida, we made the following observations in Wistar strain rats. there
RESULTS OF GAVAGING PREGNANT WISTAR RATS WITH RAW AND
A. R. EVANS.
BOILED BLIGHTED-POTATO HOMOGENATE
DOWN’S SYNDROME AND NONIMMUNOLOGICAL HYDROPS FETALIS
SIR,-Although hydrops fetalis is most commonly associated with erythroblastosis, a significant number of hydropic infants are born without any evidence of bloodgroup incompatibility between mother and fetus. Nonimmunological hydrops has occurred with fetal infections, pulmonary lymphangiectasia, congenital lung malformations, maternal diabetes mellitus and toxxmia, congenital nephrosis, congenital heart-disease, including prenatal closure of foramen ovale, umbilical-vein thrombosis, fetal neuroblastoma, twin transfusions, placental hasmangioendothelioma, and homozygous rL-thalassaemia.3-5 Hydrops has also been reported in achondroplasia.6 We have seen two hydropic infants who had Down’s syndrome with trisomy G. In both instances the blood types of the mothers and the infants were A-positive and the direct Coombs test on the infants’ blood was negative. Serological test for syphilis was negative in both. The first infant
was
a
Caucasian female born
at
35 weeks’
gestation to a 20-year-old gravida-2 para-2 mother. The infant weighed 2381 g. and was 40-5 cm. in length. The mother was exposed to mumps during the fifth month, but was not ill. There was no mumps antibody detected at 18 dilution. The infant’s physical features were distorted by generalised cedema, Potter, E. L. in Pathology of the Fetus and the Infant. Chicago, 1961. Driscoll, S. G. New Engl. J. Med. 1966, 275, 1432. Daniel, S. J., Cassady, G. Pediatrics, 1968, 42, 828. 6. Morrison, J. E. Fœtal and Neonatal Pathology. Washington, 1963. 3. 4. 5.
*
1 died of
pneumonia.
Pregnant rats (6 animals) were gavaged with either raw or boiled homogenate of blighted potatoes (Katahden strain derived from the State of Maine) twice daily (2-5 g. per kg. per day) for seven consecutive days of pregnancy (days 5-11). On the same schedule, 2 animals were gavaged with homogenate from apparently normal areas of blighted potatoes, and 3 animals (controls) with normal potatoes bought from the market. All animals were also provided with standard rat chow and water ad libitum. They were weighed on alternate days and there was no significant difference in the maternal weight-gain in the four groups. The animals were examined at necropsy on day 21 of gestation, and implantation sites were recorded; all fetuses 1.
Renwick, J. H. Br. J. prev.
soc.
Med. 1972,
26,
67.