The differences in specific antibody levels in the sera of patients with acute gastroenteritis due to Salmonella were studied in terms of bacterial agglutinin and of three immunoglobulin classes.
This paper is concerning with the results from serological investigation on 144 sera from 77 patients with acute gastroenteritis or dysentery-like diarrhea. The patients studied were hospitalized or treated as out-patients.
These include 27 cases of B-group of Salmonella, 24 of C₁-group, 19 of D-group and 7 of B- and K-group.
Bacterial agglutination test and indirect radioimmunoassay were used as serological tests.
The amounts of serum IgG, IgM and IgA absorbed on the surface of Salmonella organisms which have the somatic antigens identical to those of the bacteria causing infections were measured by the indirect radioimmunoassay have been reported by us.
The results are as follows:
1) Bacterial agglutination test.
a) In cases of the patients, isolated B-group Salmonella, 74.3% of sera tested had antibody level of 1: 80 or above after 6th day of illness.
b) In cases isolated C1-group Salmonella, 50.0% of sera tested had antibody level of 1: 160 or above at the same stage.
c) In cases isolated D-group Salmonella, 78.6% of sera tested had antibody level of 1: 80 or above at the same stage.
d) In cases of Salmonella-negative healthy subjects, less than 1.4% of sera tested had the antibody levels above-mentioned in a), b) and c).
These results lead to the conclusion that the critical levels of serum antibody for the diagnosis of acute gastroenteritis due to Salmonella are 1: 80, 1: 160 and 1: 80 for B-group, C₁-group and D-group respectively, by bacterial agglutination test.
2) Indirect radioimmunoassay.
a) By the indirect radioimmunoassay method, the critical amounts of specific serum antibody against B-group Salmonella were 1 mg/dl, for IgG, IgM and IgA classes each.
The similar results were obtained against C1- and D-group Salmonella.
Levels equal to or higher than these values were regarded as positive (P<0.001).
b) In cases isolated D-group Salmonella, IgM antibody response was found preced ing those of IgG or IgA, on the other hand, in cases of B- and C₁-group, these three kinds of antibodies appeared simultaneously.
c) As there were no case with positive antibody response detected by bacterial agglutination test at early stage, before 5th day of illness, detection of at least one of IgG, IgM or IgA antibody has a diagnostic value at this stage.
d) In cases of patients S. enteritidis isolated, the titer of bacterial agglutinin correlated closely to the amounts of IgM antibody determined by radioimmunoassay, while no correlation was detected to the amounts of IgG or IgA antibody.
e) In cases of patients S. typhimurium, S. thompson, S. bareilly and S. potsdam isolated, highly significant correlations were found between agglutinin titers and amounts of IgG, IgM or IgA antibody.

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Viable cells of Clostridium perfringens Types A were administered into the rabbit ileal loop in order to clarify the mechanisms involved in the diarrhea by these organisms.
1. Fluid accumulations were observed only by the strains producing, in vitro, enterotoxins of 640 MCD (2.4 μg)/ml or more, when 19 strains possessing various enterotoxin productivities were inoculated with 10% skim milk solution. Among the enterotoxin positive strans t eh more the enterotoxin production in vitro, the fewer the minimum number of cells required for the reaction. Little difference in reaction was observed between vegetative cells and spores as the initial form of inoculum, and enterotoxin levels from 800 to 92, 160 MCD (3 to 346 μg) were observed per positive loop. Rabbits seemed to be destined to death, when the enterotoxins more than 28, 880 MCD were recovered totally from the accumulated fluids.
2. When Osaka F4105, a strongly-enterotoxin-producing strain, was inoculated with various media, various degrees of fluid accumulation and enterotoxin production were observed in the loop, among which the liver extract was the most effective for both the sporulation and enterotoxin production.
3. No inhibition of the fluid accumulation in the loops was noted in the rabbits immunized with the purified enterotoxin before the viable cell inoculation.

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A 20-year-old male, a college student, was admitted for progressive anemia and bleeding tendency. Diagnosis of acute myeloblastic leukemia was made from findings in peripheral blood and bone marrow aspiration. Complete remission was achieved by combination of Arabinosyl cytosine and Daunorubicin. During the induction therapy, he was treated successfully with intensive antibiotics therapy and multiple granulocyte transfusion with Hemonetics model 30 for serious bacterial infection. However, he continued to have fever of about 38°C and vague pain in the right upper quadrant of the abdomen with slight elevation of serum transaminase activity. Through evaluation of cause of the fever by blood and urine cultures, chest X-ray, liver scintigram, esophagoscopy, upper G.I. series, barium enema and celiac angiography were negative, fever was refractory to large doses of carbenicillin, sulbenicillin, cephazolin and gentamicin. Percutaneous liver biopsy was performed following platelet transfusion and it revealed the lesion of microabscess due to Candida albicans proved by PAS stain.
Treatment with Amphotericin B was started. The dose was increased to 50 mg daily and maintained. Temperature was decreased and transaminase returned to normal in a week. After four weeks, the second biopsy revealed no lesion. The dose of Amphotericin B was decreased to 25 mg daily. However, two months later, he started having high fever again with redevelopment of abdominal pain and abnormal liver function test. The third biopsy was performed and revealed no lesion. I.V. cholangiogram did not visualize the gall bladder. Culture of bile grew Candida albicans. His general condition gradually deteriorated and expired on March 19th in spite of total dose of 3 gm Amphotericin B therapy. The state of leukemia remained in remission until his death. Autopsy revealed multiple microabscess lesions of the liver.

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