technetium-tc-99m-sulfur-colloid and Escherichia-coli-Infections

The increased incidence of infection in cirrhotics may in part be attributable to dysfunction of the reticuloendothelial system (RES) in removing pathogens from the circulation. The portosystemic shunting (PSS) that results from portal hypertension in cirrhotics may compromise RES function by allowing enteric pathogens to be shunted away from the Kupffer cells. A well-characterized model of portal hypertension induced by partial portal vein ligation (PVL), in which there is no hepatic parenchymal cell damage, was used. Kupffer cell function is unaltered and the effect of PSS alone on overall RES function can be evaluated. In addition to the usual immunologically inert [99mTc]sulfur colloid, an actual pathogen was also evaluated. PVL and sham-ligated rats were given either [99mTc]sulfur colloid or E. coli via the ileocolic vein. The right femurs, lungs, livers and spleens of the animals receiving 99mTc were excised and the radioactivity counted. The lungs, livers, and spleens of the animals receiving E. coli were liquefied and the bacteria were quantified. For both groups the ratios of 99mTc or E. coli in the lung, spleen, and femur to liver were calculated. PVL rats had significantly more 99mTc in the lung, spleen, and femur than the sham rats. There were also significantly more E. coli in the lungs for PVL rats but no significant difference in the spleen counts. These results imply that even in the absence of Kupffer cell dysfunction, PSS alters reticuloendothelial system function by causing a greater distribution of pathogens to the periphery. This altered distribution may contribute to an increased susceptibility to infection in cirrhotics.

Topics: Animals; Escherichia coli Infections; Hypertension, Portal; Kupffer Cells; Male; Mononuclear Phagocyte System; Radionuclide Imaging; Rats; Rats, Sprague-Dawley; Technetium Tc 99m Sulfur Colloid; Tissue Distribution

We report on a case of multiple hepatic abscesses in an immunodeficient patient where initial radiologic evaluation by ultrasonography and computed tomography confused early management by failing to demonstrate the abscesses and by suggesting other diagnoses. Indium 111 (In-111) white blood cell (WBC) scanning with Tc-99 liver-spleen scan subtraction accurately demonstrated subcapsular hepatic abscesses in four out of four sequential studies, and later confirmed resolution of the abscesses. We suggest that In-111 WBC scanning may be used as a highly specific method of diagnosing suspected upper abdominal abscesses in children.

Topics: Child; Escherichia coli Infections; Humans; Indium Radioisotopes; Leukocytes; Liver Abscess; Male; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid; Wiskott-Aldrich Syndrome

Physical clearance is an important oral defense mechanism against gram-negative rods. We describe a simple technique that uses commercially available technetium-99m sulfur colloid to measure oral clearance. Technetium-99m sulfur colloid was sprayed into the mouth, and clearance was measured as the percent decrease in radiolabel counts over 2 hours using a radioisotope camera. Results using this technique compared favorably with clearance data using Tc-99m radiolabeled Escherichia coli. Atropine significantly decreased oral clearance rates of the colloid. Decreased clearance may be an important risk factor in the development of gram-negative rod colonization in hospitalized patients.

Topics: Atropine; Escherichia coli Infections; Humans; Immunity, Innate; Isotope Labeling; Kinetics; Mouth; Radionuclide Imaging; Risk; Salivation; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Sulfur Colloid; Xerostomia

Topics: Abscess; Adult; Aeromonas; Antineoplastic Agents; Escherichia coli Infections; Female; Gallium Radioisotopes; Humans; Immunosuppression Therapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Splenic Diseases; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Ultrasonography