Ocular blastomycosis in a dog

Clinical History: A 2-year-old, female Poodle dog presented to the Emergency Service at the Veterinary Teaching Hospital (VTH), Louisiana State University School of Veterinary Medicine with a history of lethargy and anorexia. At clinical examination the dog was anemic and febrile. The dog was bilaterally blind. The right eye was buphthalmic and the intraocular pressure was elevated (42 mm Hg). During an ophthalmological consult, bilateral severe panuveitis and optic neuritis with secondary glaucoma in the right eye was diagnosed and treatment was instituted. Despite treatment, the intraocular pressure kept increasing (up to 72 mm Hg overnight), and the clinicians decided to enucleate the right eye due to poor prognosis. After one month, and no response to treatment, the left eye was also enucleated. Gross Findings: Right and left eyes: The vitreous chamber was filled with a yellow, gelatinous exudate while the anterior chamber was filled with a translucent, gelatinous fluid. The retina appeared detached and embedded within the exudate present in the vitreous chamber.

Parvovirus enteritis in a raccoon (Procyon lotor)

Clinical History: Two raccoons died in a pre-release rehabilitation pen in an interval of 1.5 weeks after appearing healthy. The second raccoon, a juvenile female, was submitted for postmortem examination. Necropsy Findings: In the small intestine, the subserosa is markedly hyperemic/congested (Fig. 1) with abundant watery, semi-translucid content and large amounts of tan-white mucus. The intestinal wall is thickened, and the mucosa is smooth and overlaid by thick mucus (Fig. 2). The large intestine contains moderate amounts of tan-yellow, mucoid digesta. Mesenteric lymph nodes are enlarged, the parenchyma is red and mildly protrudes on cut section.

Treatment with Micafungin in a Preterm Neonate with an Invasive Candida parapsilosis Infection after a Severe Terlipressin-Induced Skin Necrosis

Candida parapsilosis infections are increasingly reported in preterm neonates, but the optimal treatment remains uncertain. We report the clinical history of an extremely preterm neonate, who developed a devastating skin necrosis due to terlipressin administration, with subsequent superinfection by Candida parapsilosis. The infant underwent multiple curettages and skin grafts to resolve skin lesions and was treated with systemic micafungin administration at a high dose (8 mg/kg/day), with resolution of the fungal infection.

How to interpret skin prick tests and serum-specific IgE in children and young people with food allergy

Food allergy is common, it can lead to significant morbidity andnegatively impacts on quality of life; therefore, it is vitally important we get the diagnosis right. However, making the diagnosis can be complex. Clinical history is the most important diagnostic tool and subsequent investigation may help confirm the diagnosis. The investigations available to most paediatric departments are skin prick testing and specific IgE so we will focus on these. Within this article we explore the evidence related to targeted testing and how to interpret these within the clinical context.

Mesothelial cyst of the spleen mimicking a metastasis: a case report

Mesothelial cyst of the spleen is a developmental disorder. Previous reports have elaborated on the radiological features of splenic mesothelial cysts as being unilocular with a smooth and well-defined margin. However, due to its rarity, it is unclear whether these characteristics are representative and specific for the diagnosis of mesothelial cysts. Herein, this case report presents an atypical case of splenic mesothelial cyst mimicking a malignant tumour, especially splenic metastasis in a 66-year-old woman with ascending colon cancer. Due to an overlapping imaging finding of hypodense splenic lesions, and considering the clinical history, a mesothelial cyst that developed as a multilocular hypodense mass from an ill-defined small nodule was inevitably misdiagnosed as metastasis. Although rare, it is important to consider the possibility of mesothelial cyst in a patient with multilocular hypodense lesions of the spleen.

CLINICAL STUDY TO EVALUATE EFFECT OF MUSTADI KWATH IN MADHUMEHA

The dissertation is entitled “Clinical study to evaluate the effect of Mustadi kwath in Madhumeha. Diabetes mellitus has become a dreadful disease in the era. It is also described in Ayurvedic text in terms of Madhumeha. Diabetes Mellitus is a group of metabolic disease in which there are high blood sugar levels over a prolonged period, this high blood sugar produces the symptoms of frequent urination, increased thirst, and increased hunger. Untreated, diabetes can cause many complications. Sedentary lifestyle, lack of exercise, improper medication and urbanization precipitates the disease. In the present study, Mustadi kwath (mentioned in Bhaisjya Ratnawali) was selected for clinical trial. The study comprises of 40 patients of Madhumeha. These patients were randomly selected on the basis of inclusion and exclusion criteria with detailed clinical history, physical examination and other desired investigation. The duration of study is of 90 days with 15 days follow up. After evaluating therapy it was observed that the ‘Mustadi kwath’ provided better relief to the patients of Madhumeha.

Early access to physiotherapy for infants with cerebral palsy: A retrospective chart review

Aim This study aimed to investigate whether children with cerebral palsy (CP) had equal access to timely physiotherapy. Additionally, to learn more about clinical characteristics of infants with CP, we explored differences in neonatal clinical history and CP profile between children referred by a neonatologist or enrolled in neonatal follow-up and those referred by other healthcare professionals as well as those referred before and after 5 months corrected age. Methods We conducted a retrospective chart review study including children born in Uppsala County, Sweden, from 2010 to 2016, who had received a CP diagnosis by July 2019. Entries by doctors and physiotherapists working at Uppsala University Children’s Hospital were reviewed. Results Thirty-eight children were included (21 girls, 55.3%) in the study. Twenty-two (57.9%) were born at term. Twenty-five children (66%) had their first visit to a physiotherapist before 5 months corrected age, and this included all children (n = 22, 57.9%) referred by a neonatologist or enrolled in neonatal follow-up. The latter group had significantly earlier access to physiotherapy compared to children referred by other healthcare professionals, with a median of 1.9 (min-max: -1-4) and 7.6 (min-max: 1–24) months, respectively (p < 0.0001). Referral source explained unique variance in predicting time of referral to physiotherapist (R2 0.550, B 4.213, p < 0.0001) when controlling for both number of risk factors and severity of motor impairment. However, number of risk factor was vital for early access to physiotherapy for children referred by other health care professionals. Children referred by a neonatologist or enrolled in neonatal follow-up or referred before 5 months corrected age differed on all measured variables concerning neonatal clinical history and CP profile, compared to children referred by other healthcare professionals or after 5 months corrected age. The latter groups had milder forms of CP. In total, twenty-eight children (73.7%) were ambulatory at 2 years of age. Bilateral spastic CP was most common among those referred by a neonatologist or enrolled in neonatal follow-up or referred before 5 months corrected age, while unilateral spastic CP was most common among those referred by other healthcare professionals or after 5 months corrected age. Conclusion Infants with CP have unequal access to timely physiotherapy, and children considered at low risk for CP receive therapy later. Neonatal follow-up of infants considered at high risk for CP that involves an assessment of motor performance using an evidence-based method during the first months of life corrected age seems to be effective in identifying CP early. Conversely, measuring milestone attainment seems to be a less reliable method for early identification. To provide safe and equal care, all professionals performing developmental surveillance should receive proper training and use evidence-based assessment methods. Physiotherapy should be available prior to formal medical diagnosis.

COVID-19 Admission Screening, and Assessment of Infectiousness at an Academic Medical Center, Iowa 2020

Objective: Patients admitted to the hospital may unknowingly carry SARS-CoV-2 and hospitals have implemented SARS-CoV-2 admission screening. However, because SARS-CoV-2 RT-PCR may remain positive for months after infection, positive results may represent active or past infection. We determined the prevalence and infectiousness of patients who were admitted for reasons unrelated to COVID-19 but tested positive on admission screening. Methods: We conducted an observational study at the University of Iowa Hospitals & Clinics from July 7 to October 25, 2020. All patients admitted without suspicion of COVID-19 infection were included and medical records of those with a positive admission screening test were reviewed. Infectiousness was determined using patient history, PCR cycle threshold (Ct) value, and serology. Results: A total of 5,913 patients were screened and admitted for reasons unrelated to COVID-19. Of these, 101 had positive admission RT-PCR results. Thirty-six patient were excluded because they had respiratory signs/symptoms on admission on chart review. Sixty-five patients (1.1%) did not have respiratory symptoms. A total of 55 patients had Ct values available and were included in this analysis. The median age was 56 years, and (51%) were male. Our assessment revealed that 23 patients (42%) were likely infectious. The median duration of in-hospital isolation was five days for those likely infectious and two days for those deemed non-infectious. Conclusions: COVID-19 infection was infrequent among patients admitted for reasons unrelated to COVID-19. An assessment of the likelihood of infectiousness using clinical history, RT-PCR Ct values, and serology may help discontinue isolation and conserve resources.

Plasmodium matutinum Causing Avian Malaria in Lovebirds (Agapornis roseicollis) Hosted in an Italian Zoo

Avian malaria is a worldwide distributed, vector-born disease of birds caused by parasites of the order Haemosporida. There is a lack of knowledge about the presence and pathogenetic role of Haemosporida in Psittacidae. Here we report a case of avian malaria infection in lovebirds (Agapornis roseicollis), with the genetic characterization of the Plasmodium species involved. The birds were hosted in a zoo located in Italy, where avian malaria cases in African penguins (Spheniscus demersus) were already reported. Animals (n = 11) were submitted for necropsy after sudden death and were subjected to further analyses including histopathology, bacteriology, and PCR for the research of haemosporidians. Clinical history, gross lesions and histopathological observation of schizonts, together with positive PCR results for Plasmodium spp., demonstrated that avian malaria was the cause of death for one animal and the possible cause of death for the other nine. The sequences obtained were compared using BLAST and analyzed for similarity to sequences available at the MalAvi database. Genetic analyses demonstrated a 100% nucleotide identity to Plasmodium matutinum LINN1 for all the obtained sequences. To our knowledge, this is the first report describing avian malaria in lovebirds.