Enterococci are important human pathogens that are increasingly resistant to antimicrobial agents. These organisms were previously considered part of the genus Streptococcus but have recently been reclassified into their own genus, called Enterococcus. To date, 12 species pathogenic for humans have been described, including the most common human isolates, Enterococcus faecalis and E. faecium. Enterococci cause between 5 and 15% of cases of endocarditis, which is best treated by the combination of a cell wall-active agent (such as penicillin or vancomycin, neither of which alone is usually bactericidal) and an aminoglycoside to which the organism is not highly resistant; this characteristically results in a synergistic bactericidal effect. High-level resistance (MIC, greater than or equal to 2,000 micrograms/ml) to the aminoglycoside eliminates the expected bactericidal effect, and such resistance has now been described for all aminoglycosides. Enterococci can also cause urinary tract infections; intraabdominal, pelvic, and wound infections; superinfections (particularly in patients receiving expanded-spectrum cephalosporins); and bacteremias (often together with other organisms). They are now the third most common organism seen in nosocomial infections. For most of these infections, single-drug therapy, most often with penicillin, ampicillin, or vancomycin, is adequate. Enterococci have a large number of both inherent and acquired resistance traits, including resistance to cephalosporins, clindamycin, tetracycline, and penicillinase-resistant penicillins such as oxacillin, among others. The most recent resistance traits reported are penicillinase resistance (apparently acquired from staphylococci) and vancomycin resistance, both of which can be transferred to other enterococci. It appears likely that we will soon be faced with increasing numbers of enterococci for which there is no adequate therapy.

The life and times of the Enterococcus.

The recent marked increase in incidence of gonorrhea prompted this analysis of the systemic manifestations of gonococcal infection. Of 42 patients with disseminated infection, 79% were wom...

Disseminated gonococcal infection.

Mumps is caused by the mumps virus (MuV), a member of the Paramyxoviridae family of enveloped, non-segmented, negative-sense RNA viruses. Mumps is characterized by painful inflammatory symptoms, such as parotitis and orchitis. The virus is highly neurotropic, with laboratory evidence of central nervous system (CNS) infection in approximately half of cases. Symptomatic CNS infection occurs less frequently; nonetheless, prior to the introduction of routine vaccination, MuV was a leading cause of aseptic meningitis and viral encephalitis in many developed countries. Despite being one of the oldest recognized diseases, with a worldwide distribution, surprisingly little attention has been given to its study. Cases of aseptic meningitis associated with some vaccine strains and a global resurgence of cases, including in highly vaccinated populations, has renewed interest in the virus, particularly in its pathogenesis and the need for development of clinically relevant models of disease. In this review we summarize the current state of knowledge on the virus, its pathogenesis and its clinical and pathological outcomes.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/path.4445

Molecular biology, pathogenesis and pathology of mumps virus

Thirty-three cases of enterococcal endocarditis encountered during the decade from January 1944 through December 1953 are reviewed. In vitro studies indicate that penicillin and streptomycin are the best antibiotic pair for bactericidal effect. Twelve of the last 14 patients were cured (86 per cent), 10 with combined therapy. The cure rate in enterococcal endocarditis now approximates that of endocarditis caused by penicillin-sensitive streptococci. A maximal number of cures is achieved by individualization of therapy. The daily dosage of penicillin and the duration of combined penicillin-streptomycin therapy should be guided by in vitro bactericidal tests employing the patient's strain of enterococcus.

Antibiotic therapy of bacterial endocarditis. VI. Subacute enterococcal endocarditis; clinical, pathologic and therapeutic consideration of 33 cases.

Enterococcal endocarditis on native and prosthetic valves: a review of clinical and prognostic factors with emphasis on hospital-acquired infections as a major determinant of outcome.

Excerpt The recent valuable reports of Zelman1and Applebaum2on serum amylase in mumps appeared while we were engaged in carrying on studies of mumps and its complications. We became particularly in...

Serum amylase and serum lipase in mumps.

Excerpt A peculiarly anomalous situation exists in present day medicine. A mass of evidence has been collected by the pathologist to justify the recognition of an entity characterized by an acute i...

Acute non-specific myocarditis

Excerpt Despite the uniformly favorable results following the use of antibiotics in the therapy of subacute bacterial endocarditis due toStreptococcus viridans,1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12...

Therapy of subacute enterococcus (streptococcus fecalis) endocarditis

Excerpt In the original determinations on the velocity of blood flow in man by Blumgart and Weiss,1a method was employed in which radium was injected. This required an elaborate apparatus for the d...

Determination of the normal circulation time from the antecubital veins to the pulmonary capillaries by a new technic

Excerpt The heart is well adapted to study because of its anatomical position and the numerous expressions of its activity. It may be easily observed as to size, shape, the state of its valves and ...

Blood velocity rate and venous pressure in the prognosis of heart disease

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