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Penicillium marneffei is rarely pathogenic in humans. Most previously reported cases of P. marneffei infection were from Southeast Asia where patients were usually in an immunocompromised state due to human immunodeficiency virus (HIV) infection. The majority of the patients reported in Western countries were immunocompromised by malignancy, especially Hodgkin's lymphoma. In Taiwan, the first case of P. marneffei infection was reported in 1994 and involved an adult with HIV infection. We report a case of systemic P. marneffei infection in a child with common variable immunodeficiency (CVID). The patient, a 4-year, 5-month-old boy, had a 1-year history of oligoarthritis resembling juvenile rheumatoid arthritis (JRA). He developed a low grade fever (38 degrees C) and hepatosplenomegaly 1 month before admission to the hospital. Although cultures of synovial fluid obtained at the time of onset of oligoarthritis did not grow any organisms, cultures of blood, bone marrow, synovial fluid, and lymph node biopsy samples taken during this admission were positive for P. marneffei. Further immunologic studies revealed a profile characteristic of CVID. The fungal infection was finally eradicated by combined therapy with amphotericin B, fluconazole, itraconazole, and regular immunoglobulin replacement. This case reminds us that JRA or JRA-like arthritis should be differentiated from septic arthritis caused by rare pathogens in immunocompromised patients.

Two groups of smear positive ambulatory tuberculous patients were treated with the regimen of 2H2R3E3Z3/4H3R, 189 and 192 cases received full-management and full-course supervision respectively and the smear conversion rates at the completion of treatment are 98.9% and 96.9%. This suggests that it can get equal rate of successful chemotherapy with the standard full-course management compared with the full-course supervision.

Hormone-induced Ca2+ mobilization in rat parotid acinar cells is reportedly mediated via an as yet uncharacterized G protein. We have studied the sensitivity to pertussis toxin (PTx) of this signal transduction mechanism. When rats were treated with Ptx (1.3-1.5 micrograms per animal) for 72 h, a 41 kDa membrane protein was ADP-ribosylated. This PTx treatment regimen, also, resulted in a more than 80% block of the ability of the muscarinic agonist carbachol to inhibit beta-adrenergic receptor-stimulated parotid adenylyl cyclase activity. However, cytosolic Ca2+ levels, in response to either carbachol or AIF-4, were comparable in cells prepared from both untreated or PTx-treated rats, when incubated either in the absence or presence of extracellular Ca2+. Further, both the sensitivity of the Ca2+ response to carbachol and the ability of the agonist-sensitive intracellular Ca2+ stores to be refilled by extracellular Ca2+ were unaffected by PTx treatment. Parotid membranes also contained three low-molecular-weight GTP-binding proteins (25, 22 and 18 kDa) which were unaffected by PTx. These results show that there is only one detectable substrate in parotid membranes for a PTx-catalyzed ADP-ribosylation and that hormone-induced Ca2+ mobilization events in parotid acinar cells are not mediated via PTx-sensitive components.

The aim of this study was to reduce the prevalence of chronic infectious cases (CIC) in a rural area of China by fully supervised chemotherapy of newly diagnosed smear-positive cases and by reducing the number of existing old CIC through fully supervised retreatment. From 1980 to 1985, 83.3% of 1828 new, smear-positive cases were given fully supervised chemotherapy. In 1980, 95.2% of 565 old CIC started fully supervised retreatment. The prevalence of CIC had dropped from 40.5/100,000 in 1980 to 6.7/100,000 by the end of 1986.