A Neglected Parasite: Macracanthorhynchus hirudinaceus, First Report in Feral Pigs in a Natural Park of Sicily (Southern Italy)

Sanitary management and population control of feral pigs remains a major problem in public health, particularly in natural parks where hunting is prohibited and the extensive farming of livestock is common. Macracanthorhynchus hirudinaceus is a zoonotic parasite species with a worldwide distribution of which the natural definitive hosts are primarily pigs and wild boars (Sus scrofa). The present study describes the main anatomo-pathological and parasitological findings in the first case of M. hirudinaceus in feral pigs in the Madonie park in Sicily (Southern Italy). Overall, 52 acanthocephalans were collected from the small intestine of four infected feral pigs. The prevalence among the 36 examined animals was 11.1% with a mean Abundance (mA) and mean Intensity (mI) of 1.4 and 13, respectively. Pathological examination revealed grossly visible nodules on the external surface of the intestines, corresponding to the proboscis of M. hirudinaceus attached deeply into the intestinal wall. In these sites, severe inflammatory reactions in the tissue involved and the destruction of normal intestinal architecture, as well as necrosis and ulceration in the mucosa, submucosa, and part of the muscolaris mucosae were described. This is the first official report of this neglected zoonosis in Italy, in particular in a natural park where the extensive farming of domestic pigs is practiced. This could favor the spread of this parasite in domestic animals and the environment, increasing the accidental risk of infection in human residents of these areas.

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Pyosalpinx due to Cronobacter sakazakii in an elderly woman

BMC Women s Health ◽

10.1186/s12905-021-01283-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Satoshi Ohira ◽

Eri Ikeda ◽

Kyosuke Kamijo ◽

Tomokuni Nagai ◽

Koji Tsunemi ◽

...

Keyword(s):

Abdominal Cavity ◽

Lower Abdominal Pain ◽

The Elderly ◽

Pathological Examination ◽

Milk Formula ◽

Adult Women ◽

Cronobacter Sakazakii ◽

Left Edge ◽

Powdered Milk ◽

First Case

Abstract Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

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A rare benign genitourinary tumor in a Japanese male: urinary retention owing to aggressive angiomyxoma of the prostate

Rare Tumors ◽

10.4081/rt.2010.e15 ◽

2010 ◽

Vol 2 (1) ◽

pp. 43-45 ◽

Cited By ~ 1

Author(s):

Yugo Sawada ◽

Fumio Ito ◽

Hayakazu Nakazawa ◽

Nobuhiko Tsushima ◽

Hikaru Tomoe ◽

...

Keyword(s):

Renal Dysfunction ◽

Urinary Retention ◽

Bladder Neck ◽

English Literature ◽

Pathological Examination ◽

Aggressive Angiomyxoma ◽

Urethral Meatus ◽

First Case ◽

Japanese Male ◽

Old Japanese

Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM) of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.

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ALK-positive Histiocytosis of Umbilicus Subcutaneous with KIF5B-ALK Fusion: a Case Report

10.21203/rs.3.rs-147658/v1 ◽

2021 ◽

Author(s):

Yili Zhu ◽

Jun Fan ◽

Bo Huang ◽

Ying Wu ◽

Heshui Shi ◽

...

Keyword(s):

Pathological Examination ◽

Older Children ◽

Anaplastic Lymphoma ◽

Molecular Tests ◽

Spindle Cells ◽

First Case ◽

Alk Positive ◽

Painless Mass ◽

Lymphocytic Infiltrates

Abstract Background: Since the discovery of the first case of Anaplastic lymphoma kinase (ALK) -positive histiocytosis in 2008, originally described as a systemic, self-limiting disease in infants, the range of ALK-positive histiocytosis has recently been expanded to include localized diseases in older children and young adults. Case presentation: We present the case of an 18-year-old female with periumbilical painless mass for 5 months, who underwent a resection of the mass. Pathological examination showed the tumor consists predominantly of fascicular to storiform growth of nonatypical spindle cells, admixed with lymphocytic infiltrates. The tumor spindle cells were diffusely positive for CD68, CD163 and ALK. Further, molecular tests revealed ALK gene fusion: Kinesin Family Member 5B (KIF5B) (E24)-ALK (E20), confirmed ALK-positive histiocytosis. The tumor has not recurred one and a half years after resection by follow-up examination.Conclusion: ALK-positive histiocytosis in local lesion can achieve remission by complete resection and clinical follow-up showed a favorable prognosis.

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Diagnosis of Neonatal Herpes Simplex Infection from the Placenta

Case Reports in Pediatrics ◽

10.1155/2020/8898612 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Amanda E. Smith ◽

Amy McKenney ◽

Laura Rabinowitz ◽

Anirudha Das

Keyword(s):

Herpes Simplex ◽

Intrauterine Infection ◽

High Rate ◽

Pathological Examination ◽

Neonatal Herpes ◽

Fetal Demise ◽

First Case ◽

Simplex Infection ◽

Neonatal Herpes Simplex ◽

Simplex Virus

Due to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neonatologist was informed of positive immunohistochemistry for the virus on the fifth day of life by the pathologist. Pathological examination of the placenta had revealed subacute necrotizing inflammation with stromal cell necrosis suggestive of intrauterine infection, possibly ascending due to prolonged rupture of membranes. To the best of our knowledge, this is the first case wherein placental pathology indicated exposure to HSV in utero before the infant presented with signs or symptoms of neonatal HSV resulting in a favorable outcome for the infant. Due to the variability of presentation of intrauterine HSV infection, pathological examination of the placenta in the first 2–5 days of life in premature infants can provide clues to the diagnosis of neonatal HSV which may significantly impact the outcome.

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Assessing Seismic Resilience of School Educational Sector. An attempt to establish the initial conditions in Calabria Region, Southern Italy

10.5194/egusphere-egu21-12678 ◽

2021 ◽

Author(s):

Cora Fontana ◽

Eleonora Cianci ◽

Massimiliano Moscatelli

Keyword(s):

Urban Areas ◽

Southern Italy ◽

Initial Conditions ◽

Risk Mitigation ◽

School Buildings ◽

Calabria Region ◽

Structural Improvement ◽

First Case ◽

School Sector ◽

Seismic Resilience

<p>School education constitutes one of the strategic functions to be recovered after an earthquake. The structural improvement of school buildings together with the strengthening of the administrators&#8217; capacity to react positively following an earthquake are key factors that contribute to social vulnerability&#8217;s reduction. Nevertheless, in Italy, the issue of risk reduction policies related to school sector is not yet consolidated in the institutional agendas. Observing the last major Italian earthquakes what remains predominant is school buildings&#8217; damage degree with consequent interruption of the system functionality. Among the causes: the building heritage vulnerability and the lack of risk mitigation policies, capable of building a resilient community for future earthquakes. That of resilience is considered a relevant paradigm to address the issue of how to strengthen the school sector&#8217;s capacity to ensure the buildings physical safety and to guarantee the maintenance of the school function, looking at pre and post-event phases.</p><p>The paper proposes a set of indicators and a methodology for a preliminary assessment of the educational sector&#8217;s seismic resilience, in terms of initial conditions. The method has been tested on a first case study: Calabria Region, Southern Italy. The results show that spatial differences in the educational sector&#8217;s seismic resilience are evident. Except for some large urban areas, the less resilient areas are grouped mainly in the southern part of the Region, while the most resilient ones are located mostly in the central-northern sector. The ambition is to identify a repeatable approach, useful as guidelines for school seismic prevention policies.</p>

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Cross-segment spinal plasma cell granuloma:a case report

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03759-4 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Renqin Lin ◽

Shenglin Wang ◽

Jianhua Lin ◽

Zhenzhen Zhang ◽

Xuanwei Chen

Keyword(s):

Plasma Cell ◽

Plasma Cells ◽

Osteolytic Lesion ◽

Thoracolumbar Spine ◽

Pathological Examination ◽

Complete Excision ◽

Surgical Specimen ◽

Osteolytic Lesions ◽

First Case ◽

Thoracolumbar Region

Abstract Background Plasma cell granuloma (PCG) is a rare non-neoplastic entity, with the precise etiology remaining unclear. Vertebra-affected spinal PCG has not been reported yet. This report presented a case with cross-segment spinal PCG in thoracolumbar region. Case presentation A 32-year-old male patient presented to the authors’ hospital since his health check-up results showed osteolytic lesions in the thoracolumbar spine. He felt asymptomatic throughout the course. Radiological examination revealed destructive changes at T12 and L1 vertebrae. Whereas laboratory examination excluded malignant tumor. The results of routine incisional biopsy remained inconclusive, thereby necessitating complete excision of the lesions. Finally, the infiltration of plasma cells observed by pathological examination of the surgical specimen confirmed the diagnosis of PCG. Conclusions To the authors’ knowledge, this was the first case of cross-segment spinal PCG with osteolytic property. The possibility of PCG should be considered for the diagnosis and differential diagnosis of an osteolytic lesion in the spine. Since the etiology of PCG is unknown, the disorder was confirmed based on excluded diagnosis. Surgical resection is recommended both for the definite diagnosis and treatment of spinal PCG.

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Anakinra in the treatment of protracted paradoxical inflammatory reactions in HIV-associated tuberculosis in the United Kingdom: a report of two cases

International Journal of STD & AIDS ◽

10.1177/0956462420915394 ◽

2020 ◽

Vol 31 (8) ◽

pp. 808-812 ◽

Cited By ~ 3

Author(s):

Alexander J Keeley ◽

Vivak Parkash ◽

Anne Tunbridge ◽

Julia Greig ◽

Paul Collini ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Therapeutic Option ◽

Interleukin 1 ◽

High Dose ◽

Inflammatory Reactions ◽

Amyloid A ◽

The United Kingdom ◽

First Case ◽

Life Threatening ◽

Dose Corticosteroid

Paradoxical reactions, including immune reconstitution inflammatory syndrome (IRIS), are common in patients co-infected with human immunodeficiency virus (HIV) and tuberculosis (TB). Paradoxical reactions may confer substantial morbidity and mortality, especially in cases of central nervous system (CNS) TB, or through protracted usage of corticosteroids. No high-quality evidence is available to guide management in this scenario. Interleukin-1-mediated inflammation has been implicated in the pathophysiology of TB–IRIS. We describe two cases where anakinra (human recombinant interleukin-1 receptor antagonist) was used as steroid-sparing therapy for life-threatening protracted paradoxical inflammation in HIV-associated TB. In the first case of disseminated TB with lymphadenitis, protracted TB–IRIS led to amyloid A amyloidosis and nephrotic syndrome. In the second case of disseminated TB with cerebral tuberculomata, paradoxical inflammation caused unstable tuberculomata leading to profound neuro-disability. In both cases, paradoxical inflammation persisted for over a year. Protracted high-dose corticosteroid use led to adverse events yet failed to control inflammatory pathology. In both patients, anakinra successfully controlled paradoxical inflammation and facilitated withdrawal of corticosteroid therapy. Following anakinra therapy, nephrotic syndrome and neuro-disability resolved, respectively. Anakinra therapy for protracted paradoxical inflammation in HIV-associated TB may be a viable therapeutic option and warrants further research.

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IgG4-Related Sclerosing Disease Causing Spinal Cord Compression: The First Reported Case in Literature

Case Reports in Immunology ◽

10.1155/2019/3618510 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Nooraldin Merza ◽

Ahmed Taha ◽

John Lung ◽

Anthony W. Benderman ◽

Stephen E. Wright

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cervical Spinal Cord ◽

Cord Compression ◽

Neurological Deficits ◽

Pathological Examination ◽

Tissue Mass ◽

Systemic Steroids ◽

First Case

Immunoglobulin G4-related disease (IgG4-RD) is known for forming soft tissue mass lesions that may have compressive effects. It is an extremely rare disease that most frequently affects the pancreas causing autoimmune pancreatitis. It can also affect the gallbladder, salivary glands, and lacrimal glands causing respective organ-specific complications. In our report, we describe an IgG4-RD case that affected the spinal cord. A 60-year-old female presented with cervical spinal cord compression caused by IgG4-RD leading to several neurological deficits. Pathological examination of the excisional biopsy of the mass revealed dense lymphoplasmacytic cells infiltration and stromal fibrosis with IgG4 and plasma cells. The patient showed a dramatic response to the administration of systemic steroids with almost resolution of her neurological symptoms. This case highlights the first case in literature for IgG4-RD of the extradural tissue causing spinal compression. Hereby, we also demonstrate the dramatic response of IgG4-RD to the administration of systemic steroids as the patient had no recurrence after 5 years of close follow-up, the longest reported period of follow-up reported in the literature to date.

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Isolated Central Nervous System Hemophagocytic Lymphohistiocytosis: Case Report

Neurosurgery ◽

10.1227/01.neu.0000146210.13318.e8 ◽

2005 ◽

Vol 56 (1) ◽

pp. E187-E190 ◽

Cited By ~ 31

Author(s):

Jun Shinoda ◽

Satoru Murase ◽

Katsunobu Takenaka ◽

Noboru Sakai

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Hemophagocytic Lymphohistiocytosis ◽

Complete Resolution ◽

Pathological Examination ◽

Magnetic Resonance Imaging Scan ◽

Corticosteroid Administration ◽

Surgical Specimen ◽

First Case ◽

The Central Nervous System

Abstract OBJECTIVE AND IMPORTANCE: The first case of histologically proven hemophagocytic lymphohistiocytosis (HLH) isolated to the central nervous system (CNS) is reported. HLH affecting the CNS mimics several neurological disorders and may be misdiagnosed. The diagnostic and therapeutic problems of this disease are discussed. CLINICAL PRESENTATION: We report a case of a 5-year-old girl with a 2-month history of right hemiparesis. The initial magnetic resonance imaging scan mimicked the appearance of malignant glioma or cerebral infarction. By use of neuroimaging alone, it was extremely difficult to reach an appropriate diagnosis. INTERVENTION: Pathological examination of a surgical specimen of the lesion revealed histological characteristics typical of HLH. Because of the absence of both physical and blood chemical findings of systemic HLH, the patient was diagnosed as having HLH isolated in the CNS without systemic HLH. Radiotherapy with corticosteroid administration led to complete resolution of the CNS lesions, but the duration of remission was only 3 months. The patient died secondary to refractory progression of the CNS lesion. CONCLUSION: Radiotherapy with corticosteroid administration led to a complete resolution of the lesions, although for only a transitory remission. Although HLH is extremely rare, the existence of this disease isolated in the CNS should be documented, and further case accumulation and therapeutic investigations are needed to clarify the pathophysiological characteristics of this disease.

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Successful Laparoscopic Resection of Gastric Lymphangioma Under the Intraoperative Guidance of Indocyanine Green Fluorescence Imaging: A Case Report

10.21203/rs.3.rs-117730/v1 ◽

2020 ◽

Author(s):

Ryosuke Umino ◽

Masayuki Urabe ◽

Yu Ohkura ◽

Akikazu Yago ◽

Shusuke Haruta ◽

...

Keyword(s):

Indocyanine Green ◽

Fluorescence Imaging ◽

Surgical Resection ◽

Gastric Volume ◽

Complete Resection ◽

Pathological Examination ◽

Abdominal Ultrasonography ◽

Residual Gastric Volume ◽

First Case ◽

Intraoperative Guidance

Abstract Background: Gastric lymphangioma (GLA) is an extremely rare tumor without an established therapeutic strategy. Surgical resection is considered the mainstay of treatment, although there is a high risk of local recurrence if negative margins are not achieved. Thus, it would be useful to develop tools and strategies to achieve safe and complete resection. We describe our experience with the first case involving GLA resection under the intraoperative guidance of indocyanine green (ICG) fluorescence imaging, which allowed us to achieve limited but complete resection with negative margins.Case Presentation: A 51-year-old Japanese man with a history of alcoholic liver disease underwent routine abdominal ultrasonography, which incidentally detected a 20-mm tumor adjacent to the lesser curvature of the stomach. The mass was suspected to be GLA based on its polycystic appearance. After a 16-month monitoring period, the patient was referred to our hospital for further assessment because of tumor growth and involvement of the left gastric artery. We selected surgical resection to facilitate a pathological diagnosis and treatment of potential invasion to the surrounding organs. Intraoperative use of a ICG navigation system revealed lymphatic drainage from the tumor, which we used to help determine the optimal excision line and minimize the loss of gastric volume. Pathological examination confirmed complete resection with negative margins and supported a diagnosis of lymphangioma.Conclusions: We performed laparoscopic radical resection of GLA under guidance from intraoperative ICG fluorescence imaging, which allowed us to maximize residual gastric volume. Although further cases are needed to validate this strategy, it may be useful for guiding the resection of GLA.

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