SUMMARY Twenty-one strains of Legionella pneumophila, representing the six known serotypes of the organism, cultured on various bacteriological media and in the yolk sacs of fertile hens' eggs were examined by negative stain electron microscopy for flagella and pili. These appendages were usually observed after cultivation on media capable of inducing an early profuse growth of the organisms.
mode of action of the clostridial toxin is not yet clear but it may elicit a local Schwartzman reaction, usually resulting in mucosal changes identical with those of acute ischaemia.i In our patient the location of the vascular damage differed from that postulated in classical drug-associated pseudomembranous enterocolitis because the small vessels of the entire bowel wall were affected. Whether this was due to the specific pharmacokinetics of clindamycin or modification of the vascular reaction to putative bacterial toxin by steroids or immunological dysfunction associated with sarcoid, or both, remains speculative.
Some new methods for the isolation of Legionella pneumophila are described which have been successful in recovering this organism from 6/10 patients with clinical evidence of Legionnaires' disease. The increased sensitivity of these methods combined with speedier isolation of the organisms than has hitherto been possible will hopefully lead to eventual isolation of this organism as a routine procedure in diagnostic microbiology laboratories.
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