Phlegmonous gastritis in 2 yearling horses

2022 ◽  
pp. 104063872110650
Author(s):  
Julie B. Engiles ◽  
Francisco A. Uzal ◽  
Mauricio A. Navarro ◽  
Virginia B. Reef ◽  
Susan J. Bender

Phlegmonous gastritis was diagnosed in 2 yearling fillies that were presented with a 1-wk history of fever, lethargy, and hypoproteinemia, associated with a previous diagnosis of equine proliferative enteropathy based on clinical signs and PCR assay detection of Lawsonia intracellularis in fecal samples. Abdominal ultrasound revealed enlargement of the stomach and expansion of its submucosal layer with hypoechoic fluid, as well as thickened hypomotile small intestinal segments. Given the poor prognosis and poor response to treatment, both horses were euthanized, one on the day of presentation and the other after 3 wk of intensive medical management including a combination of antimicrobials, analgesics, and intravenous colloids. At autopsy, acute mural gastritis characterized by severe submucosal edema with suppurative inflammation (i.e., phlegmonous gastritis) and necroulcerative enteritis compatible with the necrotizing form of equine proliferative enteropathy were identified in both horses. The gastric inflammation was associated with thrombosis and mixed bacterial populations, including Clostridium perfringens, that were confined to the submucosa without evidence of mucosal involvement; toxin genes compatible with C. perfringens type C were identified in one case. Human phlegmonous gastritis is an uncommon, often-fatal pyogenic infection that is often associated with mucosal injury, bacteremia, or immunocompromise. Our finding of this unusual gastric lesion in 2 horses with similar signalment, clinical disease, and spectrum of postmortem lesions suggests a similar etiopathogenesis that possibly involves local, regional, or distant hematogenous origin, and should be considered a potential complication of gastrointestinal mucosal compromise in horses.

2020 ◽  
Author(s):  
Ken Yamashita ◽  
miki hiraoka ◽  
Shintaro Sugita ◽  
Takatoshi Yotsuyanagi

Abstract Backgroud: Concretions of the lacrimal drainage system can cause dacryocystitis. In the present study, our patient developed dacryocystisis with lacrimal concretions of a white soft mass. Rebamipide ophthalmic suspension had been applied for treatment of dry eye. To evaluate the pathogenic mechanism of the case, histological and chemical studies were performed.Case presentation: Our case was woman in her seventies. She had a medical history of rheumatoid arthritis. She was referred to our hospital for dacryocystitis after showing a poor response to treatment with antibiotic agents. A head computed tomography (CT) scan showed ductal high-density deposits along the lacrimal sacs. During dacryocystotomy, the hypertrophy of the lacrimal sacs was found replete with pus and cottage cheese-like white substances. The extracts were surgically removed and histological and chemical analysis was performed. The histological examination showed granulation tissues and acellular amorphous material with crystal-like structures. Positive staining by Alcian blue and Kossa was found in crystal-like legions. The extract obtained from the concretions showed the same fluorescence band and UV absorption spectrum in thin layer chromatography (TLC) and spectrometry, respectively, as rebamipide.Conclusion: Our findings suggest that the obstruction by lacrimal concretions containing rebamipide resulted in dacryocystitis in this case. In addition, it is speculated that in patients who have impaired tear secretion, refractory dacryocystitis may be evoked following the accumulation of rebamipide in the lacrimal sacs.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Veronica M Figueredo ◽  
Alejandro Diaz ◽  
Pedro Pagan Banchs

Abstract Background: Hyperinsulinism is the most common cause of persistent hypoglycemia. It results from different genetic defects, the most common being recessive and dominant mutations in the ABCC8/KCNJ11 genes. The majority of recessive mutations have a poor response to Diazoxide, while dominant mutations are highly variable in both clinical presentation and response to treatment. Prompt recognition and management is critical to avoid irreversible brain damage. Clinical case: A 38-week gestation male, born via emergent c-section due to decreased fetal movement, presented with neonatal hypoglycemia. Pregnancy was uncomplicated and mother had a normal OGTT. Patient had a history of suspected sepsis, seizures, pulmonary hypertension and respiratory distress requiring intubation. Blood glucose was undetectable at birth and required multiple dextrose 10% boluses. A critical sample with a glucose of 47 mg/dL showed an elevated insulin at 30.3 m IU/mL with undetectable ketone levels. Lactic acid, ammonia, cortisol, GH, plasma amino acids, acylcarnitine profile and uric organic acids where all normal for a hypoglycemic state. He required intravenous glucose infusion with GIR up to 17 mg/kg/min to maintain normoglycemia. A brain MRI at 11 days of life showed findings of white matter injury. Subsequent genetic testing identified a heterozygous c.4051G>A (p.Val1351Met) variant in ABCC8, classified as “of uncertain significance”. However, an entry in the ClinVar database (RCV000714711.1) exists from a research lab and was classified as likely pathogenic. Analysis of parental samples showed that the mother was heterozygous for the same genetic variant. She did not have a history of hypoglycemia. Patient was started on diazoxide (8 mg/kg/day) and chlorothiazide with resolution of hypoglycemia. At a follow up visit at 5 months of age, there was no history of hypoglycemia, and no need for adjustments of the diazoxide dose by weight (dose at that time of 7.4 mg/kg/day). Conclusion: The ABCC8 reported here is a dominant mutation causing hyperinsulinemic hypoglycemia responsive to diazoxide with a milder phenotype later in infancy. Longitudinal follow up of the case is warranted to understand the long term progress in patients with this particular mutation. Reference: Adam MP, Ardinger HH, Pagon RA, Wallace SE, et al. None. 1993. Familial hyperinsulinism.


2020 ◽  
Vol 6 (2) ◽  
pp. 205511692095997
Author(s):  
Hannah Kwong ◽  
Darren Fry ◽  
Gemma Birnie

Case summary A 6-year-old female spayed Ragdoll presented with a 4-day history of acute onset non-productive retching, coughing and anorexia. A complete blood count, serum biochemistry, thoracic radiography and abdominal ultrasound were performed. Initially, aspiration pneumonia was suspected owing to an alveolar lung pattern in the right cranial ventral lung lobes seen on radiographs. The cat did not improve with empirical antibiotic therapy. Bronchoscopy and bronchoalveolar lavage were performed. An intraluminal tracheal mass was identified and removed via endoscopic guidance and gentle traction. Histopathology results were consistent with a fibrinous tracheal pseudomembrane. The cat was concurrently diagnosed with Pseudomonas aeruginosa pneumonia, which was confirmed on bronchoalveolar lavage. Pseudomonas aeruginosa was also cultured within the pseudomembrane. The cat was received antimicrobial therapy for his Pseudomonas pneumonia. In humans, fibrinous tracheal pseudomembranes occur uncommonly as a complication following endotracheal intubation and rarely due to infectious organisms. As there was no prior history of endotracheal intubation, the development of fibrinous tracheal pseudomembrane in this cat was suspected to be secondary to Pseudonomas aeruginosa aspiration pneumonia. Relevance and novel information The present case report is the first to describe a tracheal pseudomembrane in a cat. Bronchoscopy-guided gentle traction and subsequent removal of the tracheal pseudomembrane resulted in a complete resolution of the clinical signs.


2021 ◽  
Vol 3 (4) ◽  
pp. 1047-1052
Author(s):  
Ken Yamashita ◽  
Miki Hiraoka ◽  
Shintaro Sugita ◽  
Takatoshi Yotsuyanagi

AbstractConcretions of the lacrimal drainage system can cause dacryocystitis. In the present study, our patient developed dacryocystisis with lacrimal concretions of a white soft mass. Rebamipide ophthalmic suspension had been applied for treatment of dry eye. To evaluate the pathogenic mechanism of the case, histological and chemical studies were performed. Our case was woman in her seventies. She had a medical history of rheumatoid arthritis. She was referred to our hospital for dacryocystitis after showing a poor response to treatment with antibiotic agents. A head computed tomography (CT) scan showed ductal high-density deposits along the lacrimal sacs. During dacryocystotomy, the hypertrophy of the lacrimal sacs was found replete with pus and cottage cheese-like white substances. The extracts were surgically removed, and histological and chemical analysis was performed. The histological examination showed granulation tissues and acellular amorphous material with crystal-like structures. Positive staining by Alcian blue and Kossa was found in crystal-like legions. The extract obtained from the concretions showed the same fluorescence band and UV absorption spectrum in thin layer chromatography (TLC) and spectrometry, respectively, as rebamipide. Our findings suggest that the obstruction by lacrimal concretions containing rebamipide resulted in dacryocystitis in this case. In addition, it is speculated that in patients who have impaired tear secretion, refractory dacryocystitis may be evoked following the accumulation of rebamipide in the lacrimal sacs.


Biofeedback ◽  
2009 ◽  
Vol 37 (3) ◽  
pp. 92-95
Author(s):  
Ronald J. Swatzyna

Abstract The author discloses a personal history of undiagnosed mild traumatic brain injury (MBTI) and identifies a typical course and progression of this condition. He advocates a careful inquiry for possible head injury whenever the clinical history shows an original period of normal functioning, a progression of disturbance over time, multiple diagnoses, and poor response to treatment with medication. He discusses the use of quantitative electroencephalography (QEEG) in assessing possible mild traumatic brain injury, describes typical features of quantitative electroencephalography in mild traumatic brain injury, and cautions about the frequency of false negatives. He provides two case histories showing the progression of disturbing cognitive, personality, and impulse control problems following early head injuries.


2011 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Kei Hayashi ◽  
Joseph D. Frank ◽  
Paul A. Manley ◽  
Peter Muir

The clinical efficacy of oral doxycycline was evaluated in twelve dogs with stifle arthritis and a presumptive diagnosis of early cruciate disease. Doxycycline (2.5-4.5 mg/kg once daily) was administered orally for 3 to 8 weeks. Eight dogs, who presented prior to the treatment with clinical signs of 4 weeks or fewer duration (group B), had a good response to doxycycline, whereas four dogs with a longer history of lameness (group A) had a poor response. The follow-up periods ranged from 2 to 12 months after discontinuation of the doxycycline treatment (median=6.5 months, 3 months in group A, and 9.5 months in group B). There was a significant correlation between the duration of lameness and the subjective grading of clinical improvement. In 68% of these cases of dogs with stifle arthritis (8/12), the oral administration of doxycycline resulted in the improvement of lameness, even after discontinuation of doxycycline. Careful selection of patients based on the duration of their lameness appears to be crucial in order to achieve a positive outcome.


2006 ◽  
Vol 10 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Diya F. Mutasim

Background: Inflammatory linear verrucous epidermal nevus (ILVEN) is a relatively rare disorder that is characterized by an early age at onset; severely pruritic linear papules and plaques; histologic features resembling spongiotic dermatitis, psoriasis, or lichenified dermatitis; and poor response to treatment. Objective: To report the successful treatment of ILVEN with potent topical steroid and tacrolimus ointments. Methods: An 11-year-old girl presented with a 1-year history of markedly pruritic, progressive linear eruption that extended from the right foot to the right buttock. She had failed treatment with pimecrolimus, calcipotriol, mometasone furoate, triamcinolone, tazarotene, and alpha-hydroxy acid. Histologic examination revealed the findings of spongiotic dermatitis. Results: The lesions resolved with fluocinonide ointment and tacrolimus 0.1% ointment. Conclusion: The combination of two therapeutic agents with different mechanisms of action likely resulted in the successful treatment of this usually resistant condition.


2021 ◽  
Vol 14 (2) ◽  
pp. 142-144
Author(s):  
Alex dos Santos ◽  
◽  
Mariana Martins ◽  

Clinical History: This 8-month-old, male, mixed breed domestic shorthaired cat had a recent history of acute apathy and anorexia. It remained under hospital care for two days, during which it did not produce any urine. On the second day of hospitalization, another cat from the same household was brought in with similar clinical signs. These cats did not have any history of recent ingestion of antibiotics or other medication. Furthermore, they did not have any street or yard access since they were kept in an apartment. Both cats died spontaneously after a brief hospitalization period. Laboratory Findings: Marked increase of urea and creatinine in both cats was reported (values not informed). On abdominal ultrasound, both cats had perirenal edema, and small amount of free abdominal effusion was observed in this cat. Necropsy Findings: There was moderate amount of translucent, slightly yellowish fluid within the abdominal cavity, thoracic cavity and pericardial sac. There was moderate diffuse pulmonary edema. Moderate perirenal edema was observed bilaterally. The kidneys were diffusely swollen and pale (Fig. 1). On histopathologic exam, the cortical tubular epithelial cells were swollen, with hypereosinophilic cytoplasm and nuclear changes (karyolysis, pyknosis and karyorrhexis). These cells were frequently detached from the basement membrane. Some other tubular epithelial cells were swollen and markedly vacuolated. Accompanying these changes, multiple granular casts filled the tubular lumens in the cortical and medullar regions (Fig. 2).


1979 ◽  
Vol 134 (1) ◽  
pp. 14-23 ◽  
Author(s):  
G. D. Wiepert ◽  
P. T. D'Orbán ◽  
Thomas H. Bewley

Summary455 male and 120 female opiate addicts were treated at two London drug dependence clinics between 1968 and 1975. The delinquency pattern of 117 female addicts and of a systematic sample of 119 male addicts was analysed in relation to stages of their addiction career and outcome. Treatment had no effect on overall crime rate but there was a significant increase in the proportion of drug offences during the treatment stage. Comparisons between the sexes showed that the outcome of treatment was worse in women. In male addicts a history of delinquency had no prognostic significance, but in females convictions for non-drug offences before entering treatment might predict poor response to treatment of drug dependence.


2014 ◽  
Vol 59 (No. 9) ◽  
pp. 457-460 ◽  
Author(s):  
M. Fabbi ◽  
S. Manfredi ◽  
F. Di Ianni ◽  
C. Bresciani ◽  
AM Cantoni ◽  
...  

A six-year-old intact female Lagotto Romagnolo was referred with a two-day history of purulent vulvar discharge associated with fever, lethargy, polyuria, polydipsia and signs of abdominal pain. Abdominal ultrasound revealed a grass awn foreign body in the vaginal fornix. Culture swabs obtained from the vagina revealed the presence of Staphylococcus epidermidis as the preponderant organism. Ovariohysterectomy was performed, and the presence of the grass awn was confirmed. A chronic-active vaginitis was found at histological examination. The dog recovered with resolution of all clinical signs.  Differential diagnoses for acute vulvar discharge in bitches should include retention of vaginal foreign bodies. To the authors’ knowledge, this is the first reported case of a grass awn foreign body in the vaginal fornix of a dog.  


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