Hemorrhagic Meningoencephalomyelitis Due to Ectopic Localization of Aelurostrongylus abstrusus in a Cat: First Case Report

The lungworm Aelurostrongylus abstrusus is one of the main causes of respiratory diseases in cats worldwide. This report describes the unusual case of a kitten infected with A. abstrusus and presented to a veterinary clinic in Brazil with lethargy, dysphagia, non-ambulatory tetraplegia, and pelvic limbs bilateral myoclonus. The clinical picture of the kitten worsened with generalized flaccid tetraplegia and death a few days after hospitalization. At necropsy, hemorrhagic necrosis and subarachnoid hemorrhages were detected in several areas of the central nervous system. Nematode stages were found at post-mortem histological examinations in lungs, cerebellum, subarachnoid space of the brain and spinal cord. Microscopic and molecular (PCRs-coupled-sequencing protocols) examination showed the presence of A. abstrusus in histological samples. This study describes the first neurological aelurostrongylosis due to ectopic localization of adult worms in the central nervous system of a cat, causing acute hemorrhagic multifocal meningoencephalomyelitis. Further studies are necessary to elucidate whether unusual localizations and the migration of A. abstrusus are more frequent than expected.

Clinical and morphological features of SARS-COV-2 associated acute hemorrhagic necrotizing encephalopathy: case report

Background The current case report presents acute hemorrhagic necrotizing encephalopathy (AHNE) as an example of a fatal complication, the etiology of which could be coronavirus disease 2019 (COVID-19) with multiple organ damage along with the existing respiratory tuberculosis. Case presentation A male in his 20s had severe symptoms of central nervous system lesion, which developed against the background of COVID-19 and respiratory tuberculosis, for which he was treated in the intensive care unit. Autopsy confirmed that he died from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated AHNE in adults with severe fatal endothelial dysfunction and respiratory tuberculosis. The main morphological signs of brain damage were desquamative endotheliitis, thrombosis, parenchymal hemorrhagic necrosis, encephalitis, severe necrobiotic neuronal damage. Conclusion The defeat of endothelial cells with the development of generalized endotheliitis in COVID-19, especially in conjunction with comorbid pathology, in particular tuberculosis, can lead to a fatal complication that affects the nervous system—AHNE. Therefore, it is worth paying close attention to the appearance of neurological symptoms in patients with a similar combination of diseases.

Pathologic findings on ruminant enteric clostridial diseases reveal specificities and differences among iota and iota-like toxins

The iota toxin (ITX) is a binary enterotoxin produced as a protoxin by Clostridium perfringens (C. perfringens) type E that is activated by proteolytic enzymes in the small intestine of infected animals. By depolymerization of the actin filaments, ITX causes cytoskeleton disorganization of cells promoting the increase of the cell permeability. Here, we conducted this review aiming to advance the understanding of enteric clostridial diseases caused by C. perfringens toxins and the specificity of ITX in the intestinal mucosa lesions. ITX consists of an enzymatic component (Ia) and a binding component (Ib). We screened the recently published histological findings of the ITX effects and its relationship with intestinal enteric diseases. Histologically, hemorrhagic necrosis and multifocal hemorrhage have been observed in the jejunum-ileum mucosa, the small intestine, and the abomasum. Although the diagnosis is still based on the presence of toxins in the intestinal contents and the clinical and/or histological history, it is important to develop novel enterotoxemic indicators capable of establishing precise methods for differentiate the actions of ITX and other toxins involved in the infectious process of C. perfringens type E.

A rare case of combined thymoma and a multilocular thymic cyst discovered due to chest pain

Background A thymoma with chest pain and multilocular thymic cysts (MTCs) is very rare. Case presentation A 49-year-old man presented to another hospital complaining of an anterior chest pain. Chest computed tomography (CT) showed an anterior mediastinal tumor 60 × 30 × 55 mm in size. The boundary with the pericardium or left brachiocephalic vein seemed to be partially unclear while enhanced by the contrast medium, and so the tumor could have invaded them. No definitive diagnosis of myasthenia gravis was made although the serum anti-acetylcholine receptor antibody count was high. We performed an extended thymectomy with combined partial resection of left brachiocephalic vein, left upper lobe, and left phrenic nerve. He was discharged with no chest pain and no complications post-surgery. The tumor was pathologically type B2 thymoma with hemorrhage necrosis and MTCs, and we diagnosed Masaoka stage II because of no histological infiltration to the organs. Conclusions We speculated that hemorrhagic necrosis due to infarction in tumor caused the inflammation to spread to the surrounding organs, which was related to the chest pain and the development of MTCs.

Fatal Acute Hemorrhagic Leukoencephalitis Following Immunization Against Human Papillomavirus in a 14-Year-Old Boy

Human papilloma virus (HPV) is a prevalent pathogen whose persistent infection can lead to a variety of cancers. To protect against this threat, an HPV vaccine has been developed and is routinely administered to adolescents. The HPV vaccine has a reassuring safety profile, but reports have emerged of acute disseminated encephalomyelitis following its administration. Acute hemorrhagic leukoencephalitis (AHLE) is a severe inflammatory disease of the central nervous system and the most fulminant form of ADEM. We report a previously healthy 14-year-old boy who developed headache, fatigue, focal weakness, and confusion 3 weeks after receiving the HPV vaccine. Neuroimaging demonstrated multifocal demyelination. Despite treatment with high-dose steroids, his encephalopathy worsened. He developed severe cerebral edema and died of cerebral herniation. Postmortem histology revealed perivenular sleeves of tissue damage, myelin loss surrounding small parenchymal vessels, and diffuse hemorrhagic necrosis, consistent with AHLE. This is the first report of AHLE following HPV vaccination.

Spontaneous internal hemorrhage of a giant hepatic hemangioma with infection: a case report and literature review

Spontaneous internal hemorrhage from a hepatic hemangioma is rare. This case describes a 59-year-old woman who was hospitalized with recurrent cough and fever for 6 months. The doctor thought that she had pneumonia, but other infectious diseases could not be ruled out. Therefore, related tests were performed and strong antibiotics were used, but the symptom of fever was persistent and recurred. Enhanced computed tomography (CT) findings showed a right hepatic giant hemangioma with hemorrhage, while tuberculosis, liver abscess, and immune disease were excluded by the physician. Because the patient’s fever was associated with a large hepatic hemangioma, the patient was transferred to surgery. During treatment, the amount of bleeding increased, so she underwent a right hepatic hemangioma resection in the emergency department. Her postoperative fever symptoms subsequently resolved. Pathological examination confirmed hemorrhagic necrosis with infection in hepatic hemangioma. Follow-up showed that the patient was afebrile.

Effects of Aluminium Sulphates on Weight and Structure of Adrenal Gland of Adult Wistar Rats

This study evaluated the effects of aluminum sulphate exposure on the histology of adrenal gland of Wistar rats. Thirty adult Wistar rats were used for this study. The Wister rats were divided into three groups; group A was the control animals and tagged C, group B animals received 10g of alum dissolved in 1000cm3 of distilled water and were tagged T1, group C animals received 50g of alum dissolved in 1000cm3of distilled water and were tagged T2, via drinking water for duration of four weeks. Twenty-four hours after the last administration, the rats were sacrificed by cervical dislocation. The adrenal gland was excised and preserved in 10 % formosaline after which it was routinely processed for hematoxylin and eosin staining (H&E). Histological observations showed normal cell distribution in the control group but treated group revealed evidences of cellular obliteration& hemorrhagic necrosis. The results obtained from this study suggest that aluminum sulphate has a damaging effect on the structure of the adrenal gland.