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Wegener's granulomatosis is a form of systemic vasculitis of unknown etiology that affects the small blood vessels. The disease is characterized by the formation of granulomas on small and medium blood vessels, and often affects the respiratory tract and renal system. In 86% of diagnosed cases, renal compromise is in the form of glomerulonephritis. Wegener's granulomatosis can occur at any age, principally during the 4th and 5th decades of life, and 85% of cases occur over the age of 19 years. In the United States about 3 per 100,000 cases are reported, with a major occurrence in males. The present report is about a case of a 12 year old female with Wegener's granulomatosis of 18 months of evolution, with symptoms such as epistaxis, generalized edema, cough, dyspnea, hemoptysis, high blood pressure and macroscopic hematuria. Out of the five criteria for the diagnosis of Wegener's granulomatosis, she had perinuclear anti-neutrophil cytoplasmic antibody positive to serum p-ANCA mark, which is the least frequent, which makes more difficult the diagnosis. Over a period of five years, in our hospital, we have diagnosed 11 patients with Wegener's granulomatosis, and the present case is the only pediatric case.

Cutaneous T-cell lymphomas define a spectrum of disorders associated with T-lymphocytic proliferation with clinical manifestations occurring in the skin during the course of the disease. This review has dealt with two rather uncommon disorders, namely mycosis fungoides and Sezary syndrome which are indolent malignant lymphomas, occurring primarily in the fifth decade, and affecting males most frequently. Historically, mycosis fungoides and Sezary syndrome have been described for a relatively short time. As witnessed by Table 2, little was known concerning these disorders, other than clinical and pathologic features, until the application of immunologic, cell biologic, and cytogenetic technology which burgeoned a multitude of questions. The discovery of TCGF has allowed for both continuous growth of normal and neoplastic T cells and for the clonal expansion of some malignant clones. The establishment of these continuous cultures allowed for: (1) investigation of the mechanism of TCGF production and stimulation of T-cell growth, and (2) identification of HTLV, a retrovirus found in cell cultures from two patients with CTCL, and subsequently from patients with Japanese adult T-cell lymphoma. In addition, the HTLV has been related to a more virulent form of T-cell malignancy. The exact etiologic role of this virus in the CTCL is presently the subject of intense investigation. Through the use of immunologic methods the malignant cell of CTCL has been pheno-typically and functionally characterized as a "helper/inducer" subtype (E rosette+, anti-T-cell antisera+, T11+, T1+, T3+, 3A1-, T6-, T8-) and usually Ia-, HLADR-. Clinical manifestations of the phenotype may be clinically apparent in the serologic abnormalities present in these disorders. Utilizing these methods to investigate these disorders may provide a key to the understanding of T-cell function and cellular immunity much as myeloma provided a model for the understanding of B cells and immunity. Clinically and pathologically, these disorders behave as malignant indolent lymphomas with spread from localized cutaneous lesions to extracutaneous involvement of the blood, lymph nodes, and viscera culminating in the death of the patient from either organ dysfunction or infectious complications. At autopsy, this extracutaneous involvement is more pronounced than what was expected ante-mortem. Application of prospective staging techniques employing such special procedures as E-rosette cytology, cytogenetics, and electron microscopy in addition to usual light microscopy studies has demonstrated a greater percentage of extracutaneous involvement than otherwise expected.(ABSTRACT TRUNCATED AT 400 WORDS)

At present, there is no drug marketed in the United States for the treatment of herpes simplex, except for idoxuridine for the treatment of herpetic keratitis. The recent enthusiasm for the use of heterocyclice fluorescent dyes in conjunction with exposure to light (photodynamic inactivation) has diminished, and the efficacy of all available topical measures is being questioned. Of the numerous antiviral drugs being investigated, the following seem to show promise: idoxuridine, adenin arabinoside, trifluorothymidine, phosphonoacetic acid, and ribavirin. There are no vaccines available. Measures to stimulate immune response concern the use of levamisole hydrochloride, Interferon, Inosiplex and Transfer factor. Only adenine arabinoside will be available in the near future, and then only to serious life threatening infections. The marketing of other medications is several years in the future.

Varicella-zoster (VZ) virus causes two diseases, varicella and zoster. Because it was recognized that, after varicella, latent VZ virus persisted in the host and because varicella was thought to be a milde disease, there was little impetus in North America to develop a live VZ vaccine. More recently, it has become apparent that currently available methods of prevention and treatment of severe varicella are not always efficacious. With the development of a live attenuated VZ vaccine by Takahashi and the successful use of the vaccine in immunocompromised children in Japan, there has been an increased interest in North America in immunization against varicella. In this article the natural history of VZ infections and the immunologic reactions to VZ virus are described, and the development and use of VZ vaccine in Japan are reviewed. Plans for trials of VZ vaccine in immunocompromised North American children are outlined. The major questions concerning the large-scale use of VZ vaccine are presented.

We give a thorough report on coccidioidomycosis, a systemic mycosis only occurring in the New World. We present microorganism, geography, epidemiology, diagnostic procedures, and therapy. A pilot study on German soldiers trained in the endemic areas of the USA demonstrated by means of a positive skin test that 3.73% of them had been infected.