Isolation and characterizations of a novel H6N1 avian influenza virus from Von Schrenck's Bittern (Ixobrychus eurhythmus) in Jiangxi province, China

In June 2013, the first case of human infection with an avian H6N1 virus was reported in a Taiwanese woman. Although this was a single non-fatal case, the virus continues to circulate in Taiwanese poultry. As with any emerging avian virus that infects humans, there is concern that acquisition of human-type receptor specificity could enable transmission in the human population. Despite mutations in the receptor-binding pocket of the human H6N1 isolate, it has retained avian-type (NeuAca2-3Gal) receptor specificity. An H6N1 AIV was isolated from a Von Schrenck's Bittern during national active surveillance project for avian influenza viruses (AIVs) in wild birds in Jiangxi province, China 2018. Phylogenetic analysis showed that this strain received its genes from H1, H2, H3, H4, H6 and H10 AIVs in different places. This strain was found to be minimally pathogenic in mice and was able to replicate in mice without prior adaptation. Considering that the reassorted H6N1 virus was isolated from Von Schrenck's Bittern in this study, it is possible that this bird can play an important role in the generation of novel reassorted H6 AIVs. In this study, H6N1 virus is a wild virus migration brought from different regions of the AIV gene into the natural gene pool, resulting in the production of a recombinant new virus. The H6N1 virus can be seen as a link in the evolution of the virus and the evolution of other viruses.

Proteus mirabilis thoracic vertebral osteomyelitis: a case report

Background Proteus mirabilis is the second most common pathogen that causes urinary tract infections after Escherichia coli. In rare cases, it is associated with vertebral osteomyelitis. The underlying mechanism of this relationship may be related to the retrograde dissemination of bacteria through the paravertebral venous plexus. Case presentation We report a case of an 80-year-old Taiwanese woman who had recurrent episodes of fever and chronic back pain for 1 year. All blood cultures were positive for P. mirabilis. Inflammation scans and magnetic resonance imaging revealed a previously undetected vertebral lesion between the seventh and eighth thoracic vertebra. She responded well to treatment with antibiotics, reporting considerable relief of back pain and no fever recurrence at the 4-month follow-up. Conclusions Chronic back pain is a common but often dismissed symptom among the older population; osteomyelitis should be considered in patients with recurrent fever or neurological symptoms. Old age, chronic renal failure, and diabetes mellitus are possible predisposing factors for osteomyelitis. Our findings suggest that long-term treatment with antibiotics is effective for osteomyelitis caused by P. mirabilis,, although surgery is required for abscess formation or serious vertebral destruction.

Exacerbation of myopathy triggered by antiobesity drugs in a patient with multiple acyl-CoA dehydrogenase deficiency

Background Multiple acyl-CoA dehydrogenase deficiency (MADD) is a treatable lipid metabolism disorder that presents as myopathy and episodic metabolic crisis. The metabolic crisis is typically associated with prolonged fasting or physical stress; however, the mechanism of metabolic crisis is not yet fully understood. Case presentation A 28-year-old Taiwanese woman presented with dyspnoea, poor appetite, and muscle weakness after using antiobesity drugs, including metformin, triiodothyronine, and topiramate. MADD was diagnosed, and her symptoms rapidly improved after treatment with riboflavin, carnitine, and ubiquinone. To date, antiobesity drugs have not been reported to be a provoking factor in fatty acid oxidation disorder. Conclusions The increase of β-oxidation activity due to antiobesity drugs supports the hypothetical substrate competition model for MADD metabolic crisis. Because the drugs our patient used are commonly prescribed, we report this case to increase the vigilance and proactivity of clinicians in recognising this treatable adult-onset myopathy.

Bilateral hemiballism-hemichorea presenting in a diabetes Taiwanese woman

Hemiballism-hemichorea (HB-HC) is a hyperkinetic disorder characterized by continuous involuntary movements of the extremities. It could be associated with non-insulin dependent diabetes mellitus. A very few cases of bilateral HB-HC have been reported until today. We describe here the case of a Taiwanese woman (85 years old) presenting with bilateral HB-HC and diabetes mellitus.