Clinical manifestations of canine babesiosis in Hungary (63 cases)

2006 ◽  
Vol 54 (3) ◽  
pp. 367-385 ◽  
Author(s):  
Á. Máthé ◽  
K. Vörös ◽  
L. Papp ◽  
J. Reiczigel

Clinical observations of Babesia canis infection in 63 dogs during a 1-year period are summarised, demonstrating the pathogenicity of the Babesia strain endemic in Hungary. Most patients had babesiosis in the spring and autumn, correlating with the seasonal activity of ticks. Male animals appeared in higher numbers, probably due to an overrepresentation of outdoor dogs. Uncomplicated babesiosis was diagnosed in 32 cases. The disease affected dogs of any age in this study. Symptoms were similar to those published from other parts of the world: lethargy, fever, splenomegaly, pallor, icterus, haemoglobinuria and presence of ticks were the most common observations. Thrombocytopenia, lymphopenia and neutropenia were frequent haemogram changes. Imidocarb appeared to be highly effective in eliminating the Babesia infection. Thirty-one animals demonstrated babesiosis with complications. Most Rottweilers (7/9) developed complicated disease. Old age was a risk factor for multiple complications. Multiple organ manifestations had poor prognosis. Hepatopathy (44%), pancreatitis (33%), acute renal failure (ARF; 31%) and disseminated intravascular coagulation (DIC; 24%) were frequent complications, while immune-mediated haemolytic anaemia (IMHA; 10%), acute respiratory distress syndrome (ARDS; 6%) and cerebral babesiosis (3%) were rarely observed. There was a significant difference between the mean age of dogs having uncomplicated disease, babesiosis with a single complication and babesiosis with multiple complications (3.4, 4.8 and 8.6 years, respectively, p < 0.001). The recovery rate (78, 68 and 25%, respectively, p = 0.005) and mortality rate (3, 21 and 67%, respectively, p < 0.001) also tended to differ significantly in these groups. Systemic inflammatory response syndrome (SIRS) and DIC are two possible pathways leading to multiple organ dysfunction syndrome (MODS) in babesiosis. DIC was found to predict MODS more sensitively in this study than SIRS: there were 6 animals developing MODS out of 11 identified with DIC, while only 5 dogs developed MODS out of 22 having SIRS.

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Wei-Ping Tai ◽  
Xiang-Chun Lin ◽  
Hong Liu ◽  
Cang-Hai Wang ◽  
Jing Wu ◽  
...  

Aim. To investigate the characteristic of hypertriglyceridemic- (HTG-) induced pancreatitis (HTG pancreatitis).Methods. We reviewed 126 cases of HTG pancreatitis and 168 cases of biliary pancreatitis as control.Results. The HTG group mean age was younger than biliary group. The number of females was a little higher than males in both groups. There were 18 cases that were recurrent in HTG group and 11 in billiary group. The mean hospitalization times were 13.7 ± 2.6 and 11.2 ± 2.3 days in two groups. Six patients received apheresis in HTG group. The proportion of severe AP was 31.0% and 26.2%, mortality 1.6% and 1.2%, comorbidity of diabetes mellitus (DM) 20.6% and 6.5% in two groups. The number of complications of gastrointestinal (GI) bleeding, sepsis, and multiple organ dysfunction syndrome (MODS) in HTG group and biliary group was 1, 1, and 2 versus 4, 12, and 4.Conclusions. The proportion of recurrent and severe AP and comorbidity of DM of HTG group was higher than billiary group. The proportion of the complications of GI bleeding, sepsis, and MODS of HTG group was less than biliary group. Apheresis could effectively reduce serum TG levels soon. There was no significant difference of the mortality between two groups.


2021 ◽  
Vol 8 (16) ◽  
pp. 1058-1063
Author(s):  
Akshay Hiryur Manjunatha Swamy ◽  
Girish Bandigowdanahalli Kumararadhya ◽  
Srinivas Hebbal Thammaiah ◽  
Nanda Karikere Siddagangaiah ◽  
Shiva Kumar K.G

BACKGROUND Multiple organ dysfunction syndrome (MODS) has recently been considered as a defining syndrome of sepsis and is responsible for a high mortality rate among the patients in the intensive care units (ICUs). Prognostication of the ICU patients is an integral part of the management of the critically ill patients and many scoring systems, for that matter, have been devised and compared for their efficiency at predicting mortality. This study was conducted to evaluate and compare the validity of sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE II) and APACHE IV as mortality predictors in intensive care unit (ICU) patients suffering from MODS in sepsis. METHODS Hundred patients diagnosed with MODS in sepsis were carefully examined, followed by relevant laboratory investigations. The SOFA score was calculated daily, and the APACHE II and IV scores were calculated on the day of admission. The scores were further compared among the survivors and the non-survivors, followed by receiver operating characteristic (ROC) curve analysis of the SOFA D1, D2, and D3 and the APACHE II and IV scores to estimate their capability of mortality prediction. RESULTS The means of the APACHE II, IV and SOFA D1 were 16.57 ± 6.49, 71.91 ± 16.19 and 8.75 ± 2.20, respectively. There was a statistically significant difference in the mean APACHE II scores (14.23 ± 5.20 vs. 21.12 ± 6.38) and the mean APACHE IV scores (67.27 ± 13.21 vs. 80.91 ± 17.77) in the survivors and the nonsurvivors. A statistically significant difference was also evident in the mean ages of the survivors and the non-survivors (52.82 ± 14.67 years vs. 63.25 ± 16.98 years). The SOFA score was high among the non-survivors than the survivors right from day-1 (10.24 ± 2.08 vs. 7.98 ± 1.86) to day-20 (15.00 ± 0.00 vs. 3.14 ± 0.38). Furthermore, ROC analysis showed that the best discrimination was provided by SOFA D3 followed by the APACHE II and SOFA D1 scores, with APACHE IV score showing the least. CONCLUSIONS SOFA score on day 3 provides the best mortality prediction in patients with MODS in sepsis, as compared to APACHE II and IV scores. KEYWORDS SOFA, APACHE II, APACHE IV, Multiple Organ Dysfunction Syndrome, Sepsis


2021 ◽  
Author(s):  
Shixiao Dong ◽  
Deyu Huang ◽  
Zheng Wang ◽  
Guanyou Zhang ◽  
Fengjuan Zhang ◽  
...  

Abstract Rotavirus was the an important causative agent of acute gastroenteritis in children. In China, rotavirus was positive in approximately 30% of the diarrhea children and become a serious public problem. This study was carried out to investigate the clinical and molecular epidemic characterization of rotavirus infection among children under 5 years old with acute diarrhea in Shandong province, China. From July 2017 to June 2018, a total of 1211 fecal specimens were detected and the prevalence of rotavirus infection was 32.12%. The mean age of positive children was 12.2 ± 10.9 months and the highest infection rate was observed in children aged 7–12 months with a rate of 41.64%. G9P[8] (76.61%) was the most prevalent combinations followed by G2P[4] (7.20%), G3P[8] (3.60%) and G9P[4] (2.06%). In addition to diarrhea, vomiting, fever and dehydration were the most common accompanied symptoms. In general, there was no significant difference in clinical manifestations among different age groups. However, the clinical manifestations between vaccinated and unvaccinated children were significantly different. Vaccinated children showed lower incidence and frequency of vomiting, lower incidence and degree of dehydration, lower incidence of severe cases than unvaccinated children. The findings suggested necessary to continue rotavirus strains surveillance in order to monitor the change of prevalent genotype. Moreover, introducing vaccine into national immunization program to prevent and control rotavirus infections is needed in China.


Author(s):  
A.J. Möhr ◽  
R.G. Lobetti ◽  
J.J. Van der Lugt

This retrospective study describes 4 cases of canine babesiosis with histologically confirmed acute pancreatitis. In addition, 16 dogs with babesiosis are reported with serum amylase (>3500 U/l ) and/or lipase (>650 U/l ) activity elevations of a magnitude that would support a diagnosis of probable acute pancreatitis, although extra-pancreatic sources of the enzymes could not be excluded in these cases. Median time of pancreatitis diagnosis was 2.5 days post-admission, with primarily young (median age 3 years), sexually intact dogs affected. The development of pancreatitis was unrelated to the degree of anaemia at time of admission. In addition to pancreatitis, 80 % of cases suffered from other babesial complications, namely icterus (13), acute respiratory distress syndrome (6), immune-mediated haemolytic anaemia (6), renal failure (3), haemoconcentration (2) and cerebral syndrome (2). Acute respiratory distress syndrome, renal failure and cerebral syndrome were associated with a poor prognosis, with 4 of the 5 dogs included in the overall 26 % mortality rate having at least 1 of these complications. Haemolytic anaemia with ischaemia-reperfusion injury to the pancreas is proposed as a possible primary pathophysiological mechanism in babesial pancreatitis. Hypotensive shock, immune-mediated haemolytic anaemia, haemoconcentration and possibly altered lipid metabolism in babesiosis may also be involved. The previously postulated pro-inflammatory cytokine milieu of complicated babesiosis may underlie the progression, if not the primary initiation, of pancreatic pathology. Acute pancreatitis may represent the previously reported 'gut' form of babesiosis.


2020 ◽  
Vol 8 (1) ◽  
pp. 65-68
Author(s):  
Sumit Jeena ◽  
Jaswinder Kaur ◽  
Nishant Wadhwa

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.


2021 ◽  
Vol 8 (7) ◽  
pp. 978
Author(s):  
Shabarini Srikumar ◽  
Shridharan Perumal

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a pandemic by the world health organization on March 11, 2020. The host immune response to SARS-CoV-2 appears to play a critical role in disease pathogenesis and clinical manifestations. SARS-CoV-2 causes direct activation of anti-viral immune responses and leads to the release of uncontrolled inflammatory mediators. These SARS-CoV-2-induced immune responses may lead to various other abnormalities like lymphopenia, thrombocytopenia and granulocyte and monocyte dysfunction, making the patient more prone to secondary infections by microorganisms, which may result in further further serious complications like septic shock, severe multiple organ dysfunction and eventually death. Therefore, mechanisms underlying immune abnormalities in patients with COVID-19 disease must be elucidated to guide clinical management of the disease. Rational management in combating the disease includes enhancing anti-viral immunity and inhibiting systemic inflammation, which is key to successful treatment.


Author(s):  
Sheila Adam ◽  
Sue Osborne ◽  
John Welch

Sepsis—a dysregulated systemic inflammatory response to infection—occurs at some point in most critical illnesses, and is the most common cause of multiple organ dysfunction syndrome (MODS). Patients with MODS always present great challenges to the critical care team and are often at high risk of death. This chapter discusses the latest thinking about the infective causes and complex evolution of sepsis, with details of how each of the main body systems can be affected (e.g. in the form of acute respiratory distress syndrome) and how different organ functions can be assessed and dysfunction recognized. The priorities, principles, and practicalities of holistic care and management of patients with sepsis and MODS, including adjunct therapies and blood purification, is also described.


2011 ◽  
Vol 39 (1) ◽  
pp. 119-124 ◽  
Author(s):  
MUHAMMAD S. SOYFOO ◽  
AHMED GOUBELLA ◽  
ELIE COGAN ◽  
JEAN-CLAUDE WAUTRECHT ◽  
ANNICK OCMANT ◽  
...  

Objective.To describe the clinical findings and prevalence of patients with cryofibrinogenemia (CF) and to determine whether CF is associated with primary Raynaud’s phenomenon.Methods.Between June 2006 and December 2009, 227 patients were tested for CF in a single university hospital. Forty-five patients with primary Raynaud’s phenomenon were tested for CF.Results.A total of 117 patients with CF without cryoglobulinemia were included. The main clinical manifestations included skin manifestations (50%) and arthralgia (35%). There were 67 patients with primary CF and 50 patients with secondary CF. There was no significant difference in the mean concentration of the cryoprecipitate in primary CF as compared to the secondary form (172 ± 18.6 vs 192 ± 20.9 mg/dl, respectively; p = 0.41). Highest concentrations of cryoprecipitate were observed in those containing fibrinogen only as compared to cryoprecipitates containing fibrinogen and fibronectin (301 ± 43.5 vs 125 ± 10.6 mg/dl; p < 0.001). Patients having skin necrosis (n = 3) had significantly higher values of cryofibrinogen compared to those without necrosis (638 ± 105 vs 160 ± 10.2 mg/dl; p = 0.0046). Among the 45 patients with primary Raynaud’s phenomenon, 36 had associated CF. There was no significant difference in the mean concentration of the cryoprecipitate in these patients compared to those with primary CF.Conclusion.There seems to be a significant correlation between cryofibrinogen concentration and the severity of the clinical signs, particularly when cryoprecipitate is composed of fibrinogen alone. CF might have a possible pathophysiological role in primary Raynaud’s phenomenon.


Author(s):  
Mahrokh Mahrokh Jalili ◽  
Ali Asghar Ebrahimi ◽  
Mohammad Hassan Ehrampoush ◽  
Fariba Abbasi ◽  
Eslami Hadi Eslami ◽  
...  

Introduction: Iodine deficiency and associated disorders, which lead to a wide range of clinical manifestations, have been raised as one of the health and nutritional problems in Iran. Therefore, this study was aimed to investigate the amount of iodine in distributed salts in Abarkouh city in 2017-2018. Materials and Methods: Random sampling was done by census on all 30 distributed brands in Abarkouh city in the different stores across the city. Sixty samples (30 samples after one month from the production date and 30 samples after 6 months from the production date) were collected and transferred to the laboratory. The measurement of iodine was done according to the British Pharmacopoeia recommended method. T-test was used to analyze the data. Results: The Mean iodine concentration in the salts supplied in the Abarkouh was 29.83 ± 19.9 ppm, which was 50% less than the Iran's standard, with a statistically significant difference (P ≤ 0.001). 66.6% of the studied brands did not contain adequate iodine. Six months after production date, the average iodine amount in salts was reduced to 24.26 ± 16.94 ppm, but the reduction was not statistically significant (P = 0.224). Conclusion: Average iodine amount in most of the salts supplied across the Abarkouh city was not acceptable and some salts lacked iodine. Therefore, careful and continuous supervision and monitoring the process of iodized salts production in factories is recommended.


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