Aluminium hydroxide granuloma.

Abstract

(anteroposterior view) showing small uterine arteries (arrowed).escape of about 2 litres of infected liquor amnii and a volume of gas. A subtotal hysterectomy and excision of the sac was performed. The patient was maintained on intravenous fluids and antibiotics and she made a good recovery. She was discharged frI hospital after six weeks, and six weeks later she was welL Cases 3, 4, and 5 These three cases were identical in presentation and were all extrauterine pregnancies complicated by a pyogaseous infec The pregnancies were all postmature, with subsequent fetal death and failed induction of labour. The radiological findings (Fig. 3) confirmed pyogaseous infections similar to that in Case 2. CommentIn early cases of gas gangrene or pyogaseous infection of the uterus the features are those of septicaemia, which may lead to circulatory failure and death, as in Case 1. Extension of gas gangrene from the uterus to the peritoneum leads to peritonitis. Other complications are emphysematous vaginitis, thrombophlebitis, lymphangitis, and renal failure (Adams and Adams, 1931; Holly et al., 1960). The principles of treatment are early diagnosis, prompt prophylaxis, early elimination of the focus of infection, massive antisera administration, and systemic antibiotic therapy.The prognosis depends mainly on the extent and duration of the infection, early diagnosis and treatment, and the degree of kidney damage. Hill (1936) reported a mortality of 63% in 30 cases of postabortal and puerperal gas gangrene. Russel and Roach (1939) were the first to report the use of x-ray examination in the diagnosis of gas gangrene of the uterus. The presence of air and fluid in large amounts, as in the present cases, indicates sepsis by gas-forming organisms, since the gas is more than would be seen in cases of uncomplicated fetal death. Radiography is the diagnostic method of choice. It 1S quick and reliable, and thus ensures early and prompt surgical intervention to eliminate the focus of infection. Bacteriological examination of vaginal discharge or of a vaginal swab and blood cultures, though useful, may prove negative. Moreover, the results are usually delayed.We are grateful to Professors J. P. Hendrickse and 0. A. Ojo for permission to report these cases, and to Professor S. P. Bohrer for the use of the radiological museum and for his helpful criticisms.

Iatrogenic Compressive Lumbar Myelopathy and Radiculopathy in Adult Cattle following Injection of an Adjuvanted Bacterin into Loin Muscle: Histopathology and Ultrastructure

“…Attempts to stain tissues immunocytochemically for the two major antigenic constituents in the vaccine (C. fetus and E. coli) were unsuccessful (D. Haines, personal communication), probably because of extraction of vaccine components during routine tissue processing for light microscopy. Amorphous or crystalline material suggestive of aluminum oxide particles 15,36,42 was absent in giant cells, and histologic lesions in loin muscle and epidural fat were more consistent with published descriptions of tissue reactions to water-in-oil adjuvants 1,6,17,24,29,41,52,55 which have been variously described as "oil granulomas"…”

“…14,28 Adjuvants such as Freund's incomplete adjuvant (IFA), peanut oil, and aluminum hydroxide may cause persistent lesions at the site of injection. 1,2,15,17,18,23,25,36,41,46, The histologic nature of these lesions has been de- Received for publication May 21, 1994. appears to be higher in vaccines that contain bacterial components 14 and objectionable localized granulomas may occur in cattle following the use of water-in-oil adjuvanted Campylobacter fetus ssp. venerealis bacterms.…”

“…Adverse reactions following vaccination include anaphylaxis, iatrogenic infections, 45,56,58 injection site granulomas, 15 endotoxin-induced tissue damage, 14 acute inflammatory demyelinating polyradiculoneuropathy, 4 and neoplasia. 22,48 Adjuvants act nonspecifically to increase immune responsiveness to antigens and are a key component of many veterinary vaccines that contain inactivated bacteria and viruses.…”

Papulo-Nodular Reactions in Black Tattoos as Markers of Sarcoidosis: Study of 92 Tattoo Reactions from a Hospital Material

“…Aluminium forms foreign body clusters in the injection site, which clinically may result in cumbersome granulomatous reactions resembling sarcoidosis [21][22][23][24] . Also, other particulates are used to promote allergic sensitisation, as exemplified by the classical Freund adjuvant composed of inactivated and dried mycobacteria [25] .…”

Development of Vaccine Adjuvants: A Historical Perspective

“…Alum was observed not to be useful in boosting immunizations with diphtheria and tetanus antigens [36] or infl uenza hemagglutinin (HA) [37]. Granulomas were often observed at the injection site [38][39][40]. Occasional erythema was observed [31,32] as well as increases in IgE [41,42].…”