No abstract

The effect of fever on serum concentrations and urinary excretion of gentamicin sulfate was studied in humans and dogs. Endotoxin-induced fever in dogs resulted in a decrease of approximately 25% in levels of gentamicin in serum 30 and 60 min after intravenous injection of the antibiotic (1.5 mg/kg) when compared with corresponding afebrile values. In six volunteers with etiocholanolone-stimulated fever, serum concentrations of gentamicin was reduced by an average of 40% in all measurements made 1.2, and 3 hr after intramuscular injection (1.5 mg/kg) as compared with afebrile control values in the same subject. Fever was thought to be the principal factor associated with lower levels of gentamicin, although the half-life of gentamicin in serum and renal clearance of the antibiotic were not significantly affected. These findings emphasize the need for frequent measurements of gentamicin in serum as a guide to adjustment of gentamicin treatment in febrile subjects, and perhaps in all patients receiving the antibiotic.

In a female patient with unexplained anemia, ascorbic acid ingestion and apparent false-negative occult blood tests were related. When she stopped ascorbic acid, her stools became strongly reactive ("4+") by three tests for occult stool blood; this association was observed repeatedly. A test developed to measure stool occult blood in the presence of ascorbic acid remained reactive throughout this observation, and the observation was confirmed by in-vitro studies. Current tests for occult blood depend on the pseudoperoxidase activity of heme and are inhibited by low levels of ascorbic acid. Reducing substances chemically similar to ascorbic acid also inhibits occult blood tests; oxidized ascorbic acid and sulfhydryl reducing agents do not inhibit them at physiologic levels.

Sepsis with a previously undescribed species of Corynebacterium was documented in four patients. All patients had predisposing illness at the time of infection, three patients having leukemia in relapse and one having a porencephalic cyst and a ventriculoatrial shunt. The isolates from blood cultures had a characteristic metallic sheen when grown on blood agar. They were resistant to most antibiotics tested, including the penicillins, but were uniformly sensitive to vancomycin. Common biochemical characteristics, the metallic sheen, and the unusual antibiotic sensitivity pattern suggest that these isolates comprise a new species or group of closely related species of Corynebacterium that is capable of infection in man.