結核

Clinicopathological study of 11 cases of histiocytic necrotizing lymphadenitis was performed. Most of the Iymphadenopathies were found in young females, and they usually developed in bilateral cervival areas. Moderate fever with local tenderness was noticed in all cases. The anti-tuberculous drugs had been administered in three cases and antibiotics in 5 cases, but no effect was shown. The characteristic feature on microscopic findings was the focal necrosis without the infiltration of granulocytes. Ultrastructurally the tubulo-reticular structures were found occasionally in the cytoplasma of histiocytes. However, the aetiology of this disease is still unclear, some investigators emphasised in the past reports that the influence of EB virus infection might be considered.

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The in-vitro antimycobacterial activity of a new derivative of rifamycin SV, rifapentine, was compared with that of rifampicin which is a derivative of rifamycin SV. Rifapentine and rifampicin were dissolved in propylene glycol at concentration of 4mg/ml and then diluted with distilled water. One volume of antibiotic solution was added to 100 volumes of Ogawa egg medium before sterilization. The composition of Ogawa egg medium is as follows: Basal solution (1% KH₂PO₄ and 1% sodium glutamate), 100 ml; whole eggs, 200ml; glycerol, 6 ml; 2% aqueous solution of malachite green, 6 ml. Seven mililitre of the medium was poured into tubes with 165 mm in length and 16.5 mm in sige, and made as slopes by sterilization at 90°C for 60 minutes. Unless specially noted, test mycobacterial strains were suspended in a 0.9% NaCl solution at concentrations of 5 mg/ml (wet weight) and a 0.02 ml-sample of these suspensions was inoculated onto each medium by a spiral loop. The tubes inoculated were stoppered by gum cap with a slit of 3 mm in the bottom and incubated at 37°C (M. xenopi at 42°C and M. marinum, M. ulcerans and M. haemophilum at 28°C). The growth was read after incubation for 7 days (rapidly growing mycobacteria), 14 days (slowly growing mycobacteria) or 21 days (M. tuberculosis, M. bovis, M. xenopi, M. ulcerans and M. haemophilum).
1) The in-vitro grwoth-inhibitory activity of rifapentine against M. tuberculosis strains was ca. 2-times stronger than that of rifampicin. All rifampicin-susceptible strains were susceptible to rifapentine, and all rifampicin-resistant strains were resistant to rifapentine (Tables 1 and 2).
2) About 80% of M. avium complex strains, which were isolated from patients who did not receive administration of rifampicin were resistant to rifampicin, 40 μg/ml or more. Of these ‘naturally’ rifampicin-resistant strains, ca. 75% were resistant to rifapentine, 40 μg/ml or more. However, the remaining 25% of the strains were more or less susceptible to rifapentine (Table 4).
3) The strains of M. avium complex that had the serotypes 1 and 2 were often resistant to rifapentine, whereas those having the serotype 16 were often susceptible to rifapentine (Table 5).
4) Antimycobacterial spectra of rifapentine and rifampicin were almsot similar to each other. However, the growth-inhibitory activity of rifapentine against M. tuberculosis, M. kansasii and M. szulgai was about 2-times stronger than that of rifampicin against these mycobacteria.
We thank Prof. F. Parenti for his kind supply of rifapentine used in this study.

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