A slide co-agglutination test was perfomrd, using a serological identification reagent “Phadebact ^® Gonococcus Test”(Pharmacia Diagnostic AB: Sweden) with 120 strains of Neisseria gonorrhoeae, 42 strains of N. meningitidis, 19 strains of other Neisseria species, 6 strains of Branhamella catarrhalis and 2 strains of Haemophilus influenzae.
The Menck's direct colonies method, by which a few trypsin treated colonies of organisms grown on serum-free medium were mixed directly with the reagent, produced 10% of non-interpretable results among 80 strains of N. gonorrhoeae. All of the non-interpretable were predominated with T2 colony. In addition 11% of N. gonorrhoeae produced negative results by this method, and all the neagative strains were constituted of T4 colony only.
On the other hand, a new procedure of boiling colonies method, described by the manufacturer, by which the organisms suspended in distilled water were heated at 100°C for 5 min prior to testing, produced positive results in all strains of N. gonorrhoeae examined. No positive results were obtained with 69 sti ains of non-gonococcal isolate by either method. However the number of non-interpretable was reduced and that of negative was increased by boiling colonies method.
Using 120 strains of N. gonorrhoeae a comparison was made between co-agglutination (COA) test and conventional biological identification test by the Cystine Trypticase Agar (CTA) sugar degradation procedure. All strains of N. gonorrhoeae produced positive results by the COA test, while 2 strains 1.7% did not degrade glucose by the CTA procedure.
The fresh clinical isolates as well as stock strains of N. gonorrhoeae produced positive results by the COA test, excepting for some few strains constituting of T4 colony only which produced somewhat weak postitive reaction.
Using the colonies of oxidase positive and Gram-negative cocci primarily isolated on selective medium, or colonies transferred on non-selective media, a rapid identification by COA test alon was possible, except for a few non-gonococcal colonies with non-interpretable results which needed biological identification.
Though there are some problem with respect to price and supply route for the reagent, the COA test is considered to be a very convenient, practical and accurate serological identification method for N. gonorrhoeae even for small bacteriological laboratories.

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In foreign countries, Neisseria meningitidis occurs bacterial meningitis very often in all age with an incidence from 17 to 56 percent. According to the statistics, an incidence of meningococcal meningitis verying from 30 to 70 percent in bacterial meningitis which causes sepsis complicated with DIC.
In Japan, only 30 or 40 cases are reported every year including adult cases rarely, and a case of meningococcal sepsis complicated with DIC has not reported at all.
Our recent successfull case with meningococcal meningitis complicated with DIC was reported. The patient, 35 years old female, complained general fatigue at first, headache and nausea developed gradually and she fell in confusion at last.
When she was transfered to our hospital, fever, tachycardia and hypotension were noted. On physical examination, there were many petechiae all over the body, sever neck stiffness and Kernig's sign were positive. CSF pressure revealed over 200 mmH₂₀ and liquor was whitish purulent which included 30976/3 cells. Laboratory findings showed severe leukocytosis of 25600/mm3 with left shift, thrombocytopenia, increased FDP, decreased antithrombin III and positive protamine test definitely. And N. meningitidis group B was positive in CSF and blood. The patient was diagnosed to be purulent meningitis and DIC. The therapy was done by intravenous injection of antibiotics (ABPC 16 g/day, CP 8 g/day), steroid hormone, heparin, and FOY^® successfully. The patient became disease free 45 days after admission.

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Allogeneic bone-marrow transplantation for severe hematologic tdiseases is often followed by a variety of infectious complications, which are a major cause of morbidity and mortality occurring during the first 6 months after transplantation.
A patient with acute myelomonocytic leukemia was treated with bone-marrow transplantation from her HLA-matched brother on August 2, 1979 (day 0). She was entered on a protocol of laminar air flow isolation and decontamination (days-9 to +26). She developed herpes-simplex virus infection of the mouth and lips (day + 7) and Candida albicans septicemia (day + 30), and died of interstitial pneumonia and polymicrobial septicemia due to Klebsiella pneumoniae, Pseudomonas aeruginosa, Streptococcus faecalis and Bacteroides fragilis (day + 76). Prior to each infectious episode, there were conditioning with cyclophosphamide and irradiation for transplantation (days -5 to -1), successful engraftment followed by graft-versus-host disease (confirmed on day +21), and recurrence of leukemia (confirmed on day +68).
At autopsy, both cysts of Pneumocystis carinii and typical cytomegalovirus inclusion bodies were found in the lungs. Moreover, pseudomembranous colitis was recognized at the area from sigmoid colon to rectum.
Granulocytes rapidly returned to more than 1, 000/mm³ after successful engraftment, while lymphocytes remained at a low level of less than 1, 000/mm³ all through the posttransplantation period.
Complement fixation titers of antibodies to herpes-simplex virus and cytomegalovirus remained unchanged before and after. transplantation.
For keeping graft recipients from having infectious complications, prophylactic and therapeutic measures such as isolation and decontamination, granulocyte transfusions, γ-globulin preparations and interferon should be begun after marrow transplantation, and continued for at least 6 months, encompassing the major risk period for each of bacterial, fungal, viral and protozoan infections.

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