Salmonella enterica subspecies houtenae as an opportunistic pathogen in a case of meningoencephalomyelitis and bacteriuria in a dog

Abstract Background We report the first case of canine Salmonella meningoencephalomyelitis and second case of canine Salmonella bacteriuria, as well as the first reported case of Salmonella enterica subspecies houtenae in a dog. Case presentation Immunosuppressive treatment in a dog for a relapse of steroid-responsive meningitis and arteritis (SRMA) allowed for the opportunistic establishment of a bacteremia with Salmonella enterica subsp. houtenae, ultimately causing meningoencephalomyelitis and subclinical bacteriuria. The bacterial infections were treated with a four-month course of amoxicillin; clinical treatment success was determined by serial negative urine cultures and lack of clinical signs correlated to the meningoencephalomyelitis. Conclusions Both the bacteriuria and meningoencephalomyelitis represented opportunistic infections in a dog immunosuppressed for SRMA. The clinical course of this infectious meningoencephalitis emphasizes the importance of differentiating relapse of initial disease from opportunistic infection occurring in a compromised central nervous system. The novel Salmonella species identified in this case acts as a reminder that infectious disease diagnostics should not be curbed by anecdotal prediction of routine pathogenic suspects.

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Antiviral metabolite 3'-Deoxy-3',4'-didehydro-cytidine is detectable in serum and identifies acute viral infections including COVID-19

10.1101/2021.07.23.21260740 ◽

2021 ◽

Author(s):

Ravi Mehta ◽

Elena Chekmeneva ◽

Heather Jackson ◽

Caroline Sands ◽

Ewurabena Mills ◽

...

Keyword(s):

Bacterial Infections ◽

Viral Infections ◽

Characteristic Curve ◽

Case Identification ◽

Inflammatory Conditions ◽

Disease Diagnostics ◽

Infectious Disease Diagnostics ◽

Diagnostic Role ◽

Highly Correlated ◽

First Time

There is a critical need for improved infectious disease diagnostics to enable rapid case identification in a viral pandemic and support targeted antimicrobial prescribing. Here we use high-resolution liquid chromatography coupled with mass spectrometry to compare the admission serum metabolome of patients attending hospital with a range of viral infections, including SARS-CoV-2, to those with bacterial infections, non-infected inflammatory conditions and healthy controls. We demonstrate for the first time that 3'-Deoxy-3',4'-didehydro-cytidine (ddhC), a free base of the only known human antiviral small molecule ddhC-triphosphate (ddhCTP), is detectable in serum. ddhC acts as an accurate biomarker for viral infections, generating an area under the receiver operating characteristic curve of 0.954 (95% confidence interval 0.923-0.986) when comparing viral to non-viral cases. Gene expression of viperin, the enzyme responsible for ddhCTP synthesis, is highly correlated with ddhC, providing a biological mechanism for its increase during viral infection. These findings underline a key future diagnostic role of ddhC in the context of pandemic preparedness and antimicrobial stewardship.

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First Case of Autochthonous Equine Theileriosis in Austria

Pathogens ◽

10.3390/pathogens10030298 ◽

2021 ◽

Vol 10 (3) ◽

pp. 298

Author(s):

Esther Dirks ◽

Phebe de Heus ◽

Anja Joachim ◽

Jessika-M. V. Cavalleri ◽

Ilse Schwendenwein ◽

...

Keyword(s):

Developmental Stages ◽

Elevated Serum ◽

Clinical Signs ◽

Dermacentor Reticulatus ◽

Theileria Equi ◽

Amyloid A ◽

First Case ◽

Blood Smears ◽

Eastern Austria ◽

Iatrogenic Transmission

A 23-year-old pregnant warmblood mare from Güssing, Eastern Austria, presented with apathy, anemia, fever, tachycardia and tachypnoea, and a severely elevated serum amyloid A concentration. The horse had a poor body condition and showed thoracic and pericardial effusions, and later dependent edema and icteric mucous membranes. Blood smear and molecular analyses revealed an infection with Theileria equi. Upon treatment with imidocarb diproprionate, the mare improved clinically, parasites were undetectable in blood smears, and 19 days after hospitalization the horse was discharged from hospital. However, 89 days after first hospitalization, the mare again presented to the hospital with an abortion, and the spleen of the aborted fetus was also PCR-positive for T. equi. On the pasture, where the horse had grazed, different developmental stages of Dermacentor reticulatus ticks were collected and subjected to PCR, and one engorged specimen was positive for T. equi. All three amplicon sequences were identical (T. equi genotype E). It is suspected that T. equi may repeatedly be transmitted in the area where the infected mare had grazed, and it could be shown that transmission to the fetus had occurred. Due to the chronic nature of equine theileriosis and the possible health implications of infection, it is advised to include this disease in the panel of differential diagnoses in horses with relevant clinical signs, including horses without travel disease, and to be aware of iatrogenic transmission from inapparent carrier animals.

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Epstein-Barr Virus Versus Novel Coronavirus-Induced Hemophagocytic Lymphohistocytosis: The Uncharted Waters

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620950107 ◽

2020 ◽

Vol 8 ◽

pp. 232470962095010 ◽

Cited By ~ 1

Author(s):

Rawan Amir ◽

Asim Kichloo ◽

Jagmeet Singh ◽

Ravinder Bhanot ◽

Michael Aljadah ◽

...

Keyword(s):

Bacterial Infections ◽

Epstein Barr Virus ◽

Genetic Mutations ◽

High Grade ◽

The Novel ◽

Barr Virus ◽

First Case ◽

Epstein Barr ◽

Virus Versus ◽

Novel Coronavirus

Hemophagocytic lymphohistocytosis (HLH) is a hyperinflammatory syndrome characterized by fever, hepatosplenomegaly, and pancytopenia. It may be associated with genetic mutations or viral/bacterial infections, most commonly Epstein-Barr virus (EBV) and cytomegalovirus. As for the novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), also known as COVID-19 (coronavirus disease-2019), the cytokine storm it triggers can theoretically lead to syndromes similar to HLH. In this article, we report a case of a 28-year-old female who presented with high-grade fevers, found to have both SARS-CoV-2 and EBV infections, and eventually began to show signs of early HLH. To our knowledge, this is the first case reported in literature that raises the possibility of SARS-CoV-2–related HLH development.

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The Antiviral Properties of Cyclosporine. Focus on Coronavirus, Hepatitis C Virus, Influenza Virus, and Human Immunodeficiency Virus Infections

Biology ◽

10.3390/biology9080192 ◽

2020 ◽

Vol 9 (8) ◽

pp. 192 ◽

Cited By ~ 3

Author(s):

Paulina Glowacka ◽

Lidia Rudnicka ◽

Olga Warszawik-Hendzel ◽

Mariusz Sikora ◽

Mohamad Goldust ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Influenza Virus ◽

Hepatitis C ◽

Beneficial Effect ◽

Bacterial Infections ◽

Viral Infections ◽

Skin Diseases ◽

Current Knowledge ◽

Immunosuppressive Treatment ◽

Immunodeficiency Virus

This review updates current knowledge regarding the risk of viral infections, including COVID-19, in patients treated with cyclosporine. We also shortly refer to bacterial infections and parasitic infestations in patients treated with cyclosporin. Cyclosporine is an immunosuppressive drug, which is widely used in medicine, including in the treatment of autoimmune skin diseases in dermatology, rheumatology, ophthalmology and nephrology, and in organ transplantation. A usual concern associated with immunosuppressive treatment is the potential risk of infections. Interestingly, several data indicate a relatively low risk of infections, especially viral infections, in patients receiving cyclosporine. It was shown that cyclosporine exerts an inhibitory effect on the replication of some viruses, or may have a potentially beneficial effect on the disease course in infections. These include hepatitis C, influenza virus, rotavirus, human immunodeficiency virus and coronavirus infections. Available data indicate that cyclosporine may have a beneficial effect on COVID-19, which is caused by the coronavirus SARS-COV2.

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Acute upper airway obstruction as a life-threatening complication of ventral bulla osteotomy: report of two consecutive cases

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/20551169211005923 ◽

2021 ◽

Vol 7 (1) ◽

pp. 205511692110059

Author(s):

Michal Vlasin ◽

Richard Artingstall ◽

Barbora Mala

Keyword(s):

Airway Obstruction ◽

Clinical Signs ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Single Session ◽

Inflammatory Polyp ◽

Case Summary ◽

First Case ◽

Life Threatening

Case summary This paper presents two cases of acute postoperative upper airway obstruction following ventral bulla osteotomy (VBO) in cats. The first cat underwent a unilateral left-sided VBO for a suspected inflammatory polyp. The second cat underwent a single-session bilateral VBO procedure for bilateral otitis media. In the first case, immediate re-intubation and a gradual lightening of the anaesthetic plane resolved the clinical signs; in the second case, the patient deteriorated and went into acute cardiorespiratory arrest and received cardiopulmonary resuscitation. Both patients recovered well and were discharged home 3 days after surgery. Both cases were reported to show no further clinical signs on postoperative follow-up 3 weeks and 4 months after surgery, respectively. Relevance and novel information Upper airway obstruction should be regarded as a potential complication of VBO in cats.

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Portland Cement Use in Dental Root Perforations: A Long Term Followup

Case Reports in Dentistry ◽

10.1155/2014/637693 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Álvaro Henrique Borges ◽

Matheus Coelho Bandeca ◽

Mateus Rodrigues Tonetto ◽

Luis Augusto Faitaroni ◽

Elibel Reginna de Siqueira Carvalho ◽

...

Keyword(s):

Portland Cement ◽

Calcium Hydroxide ◽

Root Canal ◽

Clinical Signs ◽

Signs And Symptoms ◽

Clinical Aspects ◽

Iatrogenic Perforation ◽

Root Canals ◽

First Case ◽

Clinical Signs And Symptoms

Root canal and furcal perforations are causes of endodontic therapy failure and different materials that stimulate tissue mineralization have been proposed for perforation treatment. In the first case, a patient presented tooth 46 with unsatisfactory endodontic treatment and a periapical radiographic lesion. A radiolucent area compatible with a perforating internal resorption cavity was found in the mesial root. The granulation tissue was removed, and root canals were prepared. The intracanal medication was composed of calcium hydroxide and the perforation cavity was filled with Portland cement. The 11-year followup showed radiographic repair of the tissue adjacent to the perforation and absence of clinical signs and symptoms or periapical lesion. In the second case, a patient presented with edema on the buccal surface of tooth 46. The examination showed a radiolucent area in the furcation region compatible with an iatrogenic perforation cavity. The mesial root canals were calcified, and only the distal root canal was prepared. The cavity was filled with a calcium hydroxide-based paste and the distal root canal was obturated. In sequence, the perforation cavity was filled with Portland cement. The 9-year followup showed the tooth in masticatory function with radiographic and clinical aspects compatible with normality.

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Progressive multifocal leukoencephalopathy and immune reconstitution inflammatory syndrome in seven patients with sarcoidosis: a critical discussion of treatment and prognosis

Therapeutic Advances in Neurological Disorders ◽

10.1177/17562864211035543 ◽

2021 ◽

Vol 14 ◽

pp. 175628642110355

Author(s):

Maike F. Dohrn ◽

Gisa Ellrichmann ◽

Rastislav Pjontek ◽

Carsten Lukas ◽

Jens Panse ◽

...

Keyword(s):

Progressive Multifocal Leukoencephalopathy ◽

Immune Reconstitution Inflammatory Syndrome ◽

Immune Reconstitution ◽

Opportunistic Infections ◽

Jc Virus ◽

Immunosuppressive Treatment ◽

Interleukin 2 ◽

Cerebral Magnetic Resonance Imaging ◽

Virus Load ◽

Inflammatory Syndrome

Progressive multifocal leukoencephalopathy (PML) is a subacute brain infection by the opportunistic John Cunningham (JC) virus. Herein, we describe seven patients with PML, lymphopenia, and sarcoidosis, in three of whom PML was the first manifestation of sarcoidosis. At onset, the clinical picture comprised rapidly progressive spastic hemi- or limb pareses as well as disturbances of vision, speech, and orientation. Cerebral magnetic resonance imaging showed T2-hyperintense, confluent, mainly supratentorial lesions. Four patients developed punctate contrast enhancement as a radiological sign of an immune reconstitution inflammatory syndrome (IRIS), three of them having a fatal course. In the cerebrospinal fluid, the initial JC virus load (8–25,787 copies/ml) did not correlate with interindividual severity; however, virus load corresponded to clinical dynamics. Brain biopsies ( n = 2), performed 2 months after symptom onset, showed spotted demyelination and microglial activation. All patients had lymphopenia in the range of 270–1150/µl. To control JC virus, three patients received a combination of mirtazapine and mefloquine, another two patients additionally took cidofovir. One patient was treated with cidofovir only, and one patient had a combined regimen with mirtazapine, mefloquine, cidofovir, intravenous interleukin 2, and JC capsid vaccination. To treat sarcoidosis, the four previously untreated patients received prednisolone. Three patients had taken immunosuppressants prior to PML onset, which were subsequently stopped as a potential accelerator of opportunistic infections. After 6–54 months of follow up, three patients reached an incomplete recovery, one patient progressed, but survived so far, and two patients died. One further patient was additionally diagnosed with lung cancer, which he died from after 24 months. We conclude that the combination of PML and sarcoidosis is a diagnostic and therapeutic challenge. PML can occur as the first sign of sarcoidosis without preceding immunosuppressive treatment. The development of IRIS might be an indicator of poor outcome.

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Unusual deletion of the maternal 11p15 allele in Beckwith–Wiedemann syndrome with an impact on both imprinting domains

Clinical Epigenetics ◽

10.1186/s13148-021-01020-w ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Thomas Eggermann ◽

Matthias Begemann ◽

Lutz Pfeiffer

Keyword(s):

Clinical Signs ◽

Gene Content ◽

Paternal Inheritance ◽

Maternal Allele ◽

Heterozygous Deletion ◽

First Case ◽

Clinical Consequences ◽

Regulation Mechanisms ◽

Silver Russell Syndrome ◽

Deletion Carrier

Abstract Background Whereas duplications in 11p15.5 covering both imprinting centers (ICs) and their subordinated genes account for up to 1% of Beckwith–Wiedemann and Silver–Russell syndrome patients (BWS, SRS), the deletions in 11p15.5 reported so far only affect one of the ICs. In these cases, not only the size and gene content had an impact on the phenotype, but also the sex of the contributing parent influences the clinical signs of the deletion carrier. Results We here report on the first case with a heterozygous deletion within the maternal allele affecting genes which are regulated by both ICs in 11p15.5 in a BWS patient, and describe the molecular and clinical consequences in case of its maternal or paternal inheritance. Conclusions The identification of a unique deletion affecting both 11p15.5 imprinting domains in a BWS patient illustrates the complexity of the regulation mechanisms in these key imprinting regions.

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Key-Gaskell syndrome in Brazil: first case report

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/1678-6518 ◽

2014 ◽

Vol 66 (4) ◽

pp. 1046-1050

Author(s):

B.B.J. Torres ◽

G.C. Martins ◽

P.E. Ferian ◽

B.C. Martins ◽

M.A. Rachid ◽

...

Keyword(s):

Case Report ◽

Poor Prognosis ◽

Neuronal Degeneration ◽

Clinical Signs ◽

Definitive Treatment ◽

Autonomic Ganglia ◽

Nervous Systems ◽

First Case ◽

The World

Feline dysautonomia is a devastating disease characterized by neuronal degeneration in autonomic ganglia that results in clinical signs related to dysfunction of the sympathetic and parasympathetic nervous systems. The cause is unknown and this disease has a poor prognosis and no definitive treatment. Most reports have been described in few countries around the world, but the prevalence may be underestimated in countries like Brazil. This study describes the progression and clinicopathological changes of dysautonomia in a 17-month-old female Brazilian shorthair cat.

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Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients

Medicina ◽

10.3390/medicina54020027 ◽

2018 ◽

Vol 54 (2) ◽

pp. 27 ◽

Cited By ~ 1

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.

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