scholarly journals Cutaneous Disease as Sole Clinical Manifestation of Protothecosis in a Boxer Dog

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Emmanouil I. Papadogiannakis ◽  
Emmanouil N. Velonakis ◽  
Gregory K. Spanakos ◽  
Alexander F. Koutinas
Keyword(s):  
Clinical Manifestation ◽  
Systemic Therapy ◽  
Opportunistic Infections ◽  
Skin Lesions ◽  
Causal Organism ◽  
Cutaneous Disease ◽  
Prototheca Wickerhamii ◽  
Skin Nodules ◽  
Uncommon Case ◽  
Disseminated Disease

Prototheca wickerhamiiis ubiquitous, saprophytic achlorophyllous algae that cause opportunistic infections in the dog and cat and disseminated disease usually in immunocompromised animals. In this report an uncommon case of canine cutaneous protothecosis is presented. A 6-year-old female boxer was brought in with skin lesions that consisted of nodules and generalized footpad hyperkeratosis, depigmentation, and erosion. Cytology and histopathology showed pyogranulomatous inflammation along with organisms containing round sporangia with spherical sporangiospores. PCR and sequencing identified the causal organism asPrototheca wickerhamii. Therapy applied in this patient with either fluconazole alone or combination of amphotericin B and itraconazole proved effective only for footpad lesions but not for skin nodules. Systemic therapy seems to be ineffective for skin nodules, at least in chronic cases of canine cutaneous protothecosis. Although canine protothecosis usually presents with the disseminated form, cutaneous disease as sole clinical manifestation of the infection may also be witnessed.

scholarly journals The use of cyclosporine modifies the clinical and histopathological presentation of tuberculosis after renal transplantation

2000 ◽  
Vol 42 (4) ◽  
pp. 225-230 ◽  
Author(s):  
Eloir BIZ ◽  
Carlos Alberto Pires PEREIRA ◽  
Luis Antonio Ribeiro de MOURA ◽  
Ricardo SESSO ◽  
Maria Lucia dos Santos VAZ ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
General Population ◽  
Pulmonary Disease ◽  
Clinical Manifestation ◽  
Opportunistic Infections ◽  
Sao Paulo ◽  
Duration Of Treatment ◽  
Fluid Analysis ◽  
Disseminated Disease ◽  
Higher Doses

Tuberculosis is one of the most frequent opportunistic infections after renal transplantation and occurred in 30 of 1264 patients transplanted between 1976 and 1996 at Hospital São Paulo - UNIFESP and Hospital Dom Silvério, Brazil. The incidence of 2.4% is five times higher than the Brazilian general population. The disease occurred between 50 days to 18 years after the transplant, and had an earlier and worse development in patients receiving azathioprine, prednisone and cyclosporine, with 35% presenting as a disseminated disease, while all patients receiving azathioprine and prednisone had exclusively pulmonary disease. Ninety percent of those patients had fever as the major initial clinical manifestation. Diagnosis was made by biopsy of the lesion (50%), positivity to M. tuberculosis in the sputum (30%) and spinal cerebral fluid analysis (7%). Duration of treatment ranged from 6 to 13 months and hepatotoxicity occurred in 3 patients. The patients who died had a significant greater number of rejection episodes and received higher doses of corticosteroid. In conclusion, the administration of cyclosporine changed the clinical and histopathological pattern of tuberculosis occurring after renal transplantation.

scholarly journals Orbital metastasis as primary clinical manifestation of thyroid carcinoma: case report and literature review

2008 ◽  
Vol 52 (9) ◽  
pp. 1497-1500 ◽  
Author(s):  
Francisco Dário Rocha Filho ◽  
Gabrielle Gurgel Lima ◽  
Francisco V. de Almeida Ferreira ◽  
Michelle Gurgel Lima ◽  
Miguel N. Hissa
Keyword(s):  
Thyroid Carcinoma ◽  
Clinical Manifestation ◽  
Palliative Chemotherapy ◽  
Distant Metastases ◽  
Histopathological Analysis ◽  
Free T4 ◽  
Follicular Variant ◽  
Orbital Metastasis ◽  
Uncommon Case ◽  
The Right

Capillary thyroid carcinoma (PTC) is the most common neoplasm of thyroid. It usually grows slowly and is clinically indolent, although rare, its aggressive forms with local invasion or distant metastases can occur. Metastatic thyroid carcinoma rarely involves the orbit. We reported an uncommon case of orbital metastasis of PTC. A 66-years-old woman presented proptosis of the right eye. The biopsy of the tumor in orbit revealed metastatic thyroid carcinoma. The ultrasensitive TSH level was 1,34 mUI/L and free T4 level was 1,65 ng/dL. A total thyroidectomy was performed and histopathological analysis of the nodule revealed follicular variant of papillary thyroid carcinoma. Currently, the patient has been receiving palliative chemotherapy with Clodronate Disodium. The importance of the case is due to its unusual presentation, which emerged as a primary clinical manifestation. Although rare, thyroid carcinoma should be suspected in orbit metastasis.

scholarly journals Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 27 ◽  
Author(s):  
Wojciech Wołyniec ◽  
Małgorzata Sulima ◽  
Marcin Renke ◽  
Alicja Dębska-Ślizień
Keyword(s):  
Bone Marrow ◽  
Opportunistic Infections ◽  
Immunosuppressive Treatment ◽  
Parasitic Infection ◽  
Parasitic Infections ◽  
Solid Organ ◽  
Tropical Countries ◽  
Real Risk ◽  
Increased Risk ◽  
Disseminated Disease

Introduction. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are much less common than viral, bacterial and fungal ones. However, diseases caused by parasites are very common in tropical countries. In the last years the number of travellers with immunosuppression visiting tropical countries has increased. Methods. We performed a literature review to evaluate a risk of parasitic infections after Tx in Europe. Results. There is a real risk of parasitic infection in patients after Tx travelling to tropical countries. Malaria, leishmaniasis, strongyloidiasis and schistosomiasis are the most dangerous and relatively common. Although the incidence of these tropical infections after Tx has not increased, the course of disease could be fatal. There are also some cosmopolitan parasitic infections dangerous for patients after Tx. The greatest threat in Europe is toxoplasmosis, especially in heart and bone marrow recipients. The most severe manifestations of toxoplasmosis are myocarditis, encephalitis and disseminated disease. Diarrhoea is one of the most common symptoms of parasitic infection. In Europe the most prevalent pathogens causing diarrhoea are Giardia duodenalis and Cryptosporidium. Conclusions. Solid organ and bone marrow transplantations, blood transfusions and immunosuppressive treatment are associated with a small but real risk of parasitic infections in European citizens. In patients with severe parasitic infection, i.e., those with lung or brain involvement or a disseminated disease, the progression is very rapid and the prognosis is bad. Establishing a diagnosis before the patient’s death is challenging.

scholarly journals Clinical Characteristics of Multicentric Reticulohistiocytosis and Distinguished Features from Rheumatoid Arthritis: A Single-Centre Experience in China

2021 ◽  
Author(s):  
Xiao-juan Zou ◽  
Lin Qiao ◽  
Feng Li ◽  
Hua Chen ◽  
Yun-jiao Yang ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Disease ◽  
Clinical Manifestations ◽  
Metacarpophalangeal Joint ◽  
Skin Lesions ◽  
Multicentric Reticulohistiocytosis ◽  
Specific Distribution ◽  
Pathologic Features ◽  
Skin Nodules ◽  
Distal Interphalangeal

Abstract ObjectiveTo investigate the clinical features of multicentric reticulohistiocytosis (MRH). MethodsThe clinical manifestations, laboratory examination results and histologic characteristics of eleven patients with MRH were collected and compared with those of 33 patients with rheumatoid arthritis. ResultsIn total, 72.7% of the MRH patients were women. The median age was 46 years (range: 33-84 years). Diagnosed by specific pathologic features, all MRH patients exhibited cutaneous involvement. The dorsa of the hands, arms, face and auricle were the most commonly affected areas. Nodules were also located on the legs, scalp, trunk, neck, and even the hypoglossis and buccal mucosa. Ten MRH patients (90.9%) had symmetric polyarthritis. Compared with rheumatoid arthritis (RA) patients, MRH patients were more likely to have distal interphalangeal joint (DIP) involvement (63.6% vs 24.2%, P=0.017) and less likely to have elbow (36.4% vs 72.7%, P=0.003), ankle (45.5% vs 93.9%, P<0.001) and metacarpophalangeal joint (MCP) (36.4% vs 78.8%, P=0.009) involvement. The positivity for rheumatoid factor (RF) (36.4% vs 84.6%, P=0.001) and anti-CCP antibody (9.1% vs 81.8%, P=0.000), as well as the median RF titer [43.8 (31.7-61.0) vs 175.4 (21.3-940.3), P = 0.021], in MRH patients was lower than that in RA patients. Elevation of the erythrocyte sedimentation rate (ESR) was also less common in MRH patients than in RA patients (36.4% vs 72.7%, P=0.030). After treatment with median- to large-dose corticosteroids and disease-modifying antirheumatic drugs, 8 patients achieved complete remission, and 2 patients achieved partial remission (skin lesions ameliorated, joint lesions not ameliorated). ConclusionAlways pathologically diagnosed, MRH is a systemic disease involving RA-like erosive polyarthritis and a specific distribution of skin nodules characterized by "coral beads". More DIP involvement and less elbow, ankle and MCP involvement are seen in MRH than in RA. In addition, less positive and lower-titer RF, uncommon presence of anti-CCP antibodies and ESR elevation may be helpful to distinguish MRH from RA.

scholarly journals Entamoeba Histolytica: Updates in Clinical Manifestation, Pathogenesis, and Vaccine Development

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Micaella Kantor ◽  
Anarella Abrantes ◽  
Andrea Estevez ◽  
Alan Schiller ◽  
Jose Torrent ◽  
...  
Keyword(s):  
Immune Response ◽  
Entamoeba Histolytica ◽  
Clinical Manifestation ◽  
Vaccine Development ◽  
Current Knowledge ◽  
Developed Countries ◽  
Narrative Review ◽  
Amoebic Colitis ◽  
Causes Of Mortality ◽  
Disseminated Disease

Entamoeba histolyticais the responsible parasite of amoebiasis and remains one of the top three parasitic causes of mortality worldwide. With increased travel and emigration to developed countries, infection is becoming more common in nonendemic areas. Although the majority of individuals infected withE. histolyticaremain asymptomatic, some present with amoebic colitis and disseminated disease. As more is learned about its pathogenesis and the host’s immune response, the potential for developing a vaccine holds promise. This narrative review outlines the current knowledge regardingE. histolyticaandE. disparand insight in the development of a vaccine.

Skin Lesions as Another Possible Clinical Manifestation of Mitochondrial Toxicity in an HIV-Infected Patient

Dermatology ◽  
2007 ◽  
Vol 214 (2) ◽  
pp. 189-190
Author(s):  
C. Bachmeyer ◽  
V. Orlandini ◽  
D. Grimaldi ◽  
P. Bonnard ◽  
P. Moguelet ◽  
...  
Keyword(s):  
Clinical Manifestation ◽  
Infected Patient ◽  
Skin Lesions ◽  
Mitochondrial Toxicity

Cutaneous Metastases in Patients with Rectal Cancer: A Report of Six Cases

2008 ◽  
Vol 74 (2) ◽  
pp. 138-140 ◽  
Author(s):  
Leo M. Gazoni ◽  
Traci L. Hedrick ◽  
Philip W. Smith ◽  
Charles M. Friel ◽  
Brian R. Swenson ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cause Of Death ◽  
Metastatic Disease ◽  
Retrospective Review ◽  
Skin Lesions ◽  
Rectal Tumor ◽  
Cutaneous Metastases ◽  
History Of ◽  
Disseminated Disease ◽  
Visceral Malignancy

Cutaneous metastases from rectal cancer are rare manifestations of disseminated disease and uniformly represent dismal survival. A retrospective review of six patients with rectal cancer metastatic to the dermis was performed. The diagnosis of rectal cancer was made concurrently with the diagnosis of the dermal metastases in all six patients. A 100 per cent histopathologic concordance existed between the tissue of the dermal metastases and primary rectal tumor. The progression of systemic metastatic disease was the cause of death in 83.3 per cent of patients (5/6). No patient survived more than 7 months from the time of diagnosis. Recognition of suspicious skin lesions as possible harbingers of undiagnosed visceral malignancy is important in managing patients both with and without a history of previous cancer.

scholarly journals Response of Fibroblastic Rheumatism to Infliximab

2009 ◽  
Vol 2009 ◽  
pp. 1-2 ◽  
Author(s):  
Ricardo Romiti ◽  
Mauricio Levy Neto ◽  
Marcello Menta Simonsen Nico
Keyword(s):  
Skin Lesions ◽  
Infliximab Therapy ◽  
Continuous Treatment ◽  
Rapid Progression ◽  
Skin Nodules ◽  
Fibroblastic Rheumatism

Onset is usually sudden with symmetrical articular involvement of both small and large joints, occurrence of solid skin nodules, and rapid progression. Treatment is generally unrewarding. Here we report a severe and disabling case of FR responding favorably to infliximab therapy. After 32 weeks of continuous treatment, skin lesions dramatically improved and arthropathy partially regressed.

scholarly journals Successful treatment of multifocal pedal Prototheca wickerhamii infection in a feline immunodeficiency virus-positive cat with multiple Bowenoid in situ carcinomas containing papillomaviral DNA sequences

2017 ◽  
Vol 3 (1) ◽  
pp. 205511691668859 ◽  
Author(s):  
Allan E Kessell ◽  
Derek McNair ◽  
John S Munday ◽  
Richard Savory ◽  
Catriona Halliday ◽  
...  
Keyword(s):  
Dna Sequences ◽  
Feline Immunodeficiency Virus ◽  
Skin Lesions ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
First Case ◽  
Immunodeficiency Virus ◽  
Prototheca Wickerhamii

Case summary A 16-year-old, castrated male, feline immunodeficiency virus (FIV)-positive, domestic shorthair cat developed multiple skin lesions. Most of these were Bowenoid carcinoma in situ and contained DNA sequences consistent with Felis catus papillomavirus type 2. Two additional lesions that developed in the skin and subcutaneous tissues between the digital and carpal pads on the left forelimb and right hindlimb were shown by cytology, histology and culture to be caused by Prototheca wickerhamii. These lesions failed to improve in response to systemic therapy treatment with itraconazole, but excision by sharp en bloc resection with follow-up oral itraconazole therapy proved curative for one lesion, although the other lesion recurred, necessitating a second surgery. Relevance and novel information This is only the second reported case of feline protothecosis from Australia and the first case that has been cultured and identified to the species level. Also of great interest was the presence of multiple papillomavirus-associated neoplastic lesions, which may have afforded a portal of entry for the algal pathogen and the cat’s positive FIV status; the latter might have impacted on both viral and algal pathogenesis by effects on immunocompetence.

Analysis of T-cell proliferation and cytokine secretion in the individuals exposed to arsenic

2008 ◽  
Vol 27 (5) ◽  
pp. 381-386 ◽  
Author(s):  
R Biswas ◽  
P Ghosh ◽  
N Banerjee ◽  
JK Das ◽  
T Sau ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
T Cell ◽  
Opportunistic Infections ◽  
Arsenic Exposure ◽  
Skin Lesions ◽  
Cytokine Secretion ◽  
T Cell Proliferation ◽  
Internal Organs ◽  
Tnf Α ◽  
Dose Dependent

Over six million people in nine districts of West Bengal, India are exposed to very high levels of arsenic primarily through their drinking water. More than 300,000 people showed arsenic-induced skin lesions in these districts. This is regarded as the greatest arsenic calamity in the world. Chronic arsenicosis causes varied dermatological signs ranging from pigmentation changes, hyperkeratosis to non-melanocytic cancer of skin, and also malignancies in different internal organs. Higher incidences of opportunistic infections are found in the arsenic-exposed individuals, indicating that their immune systems may be impaired somehow. We have thus investigated the effect of arsenic on T-cell proliferation and cytokine secretion in 20 individuals with arsenic-induced skin lesions and compared the results with 18 arsenic-unexposed individuals. A marked dose-dependent suppression of Concanavalin A (Con A) induced T-cell proliferation was observed in the arsenic-exposed individuals compared with the unexposed ( P < 0.001) individuals. This correlated with a significant decrease in the levels of secreted cytokines by the T cells (TNF-α, IFN-γ, IL2, IL10, IL5, and IL4) in the exposed individuals ( P < 0.001). Thus it can be inferred that arsenic exposure can cause immunosuppression in humans.

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