Use of a Reverse Thermodynamic Gel to Manage Chronic Shedding in Equine Strangles

Mark Bowen

doi:10.18849/ve.v2i3.109

Mycetoma in Timor-Leste and first report of nocardiosis

Infectious Disease Reports ◽

10.4081/idr.2018.7804 ◽

2018 ◽

Vol 10 (3) ◽

Cited By ~ 1

Author(s):

Nicola Townell ◽

Thomas Locke ◽

Margaret Gibbons ◽

Dan Murphy ◽

Joshua Francis ◽

...

Keyword(s):

Causative Organism ◽

Molecular Testing ◽

High Morbidity ◽

Middle Income ◽

Diagnosis And Management ◽

Middle Income Countries ◽

First Case ◽

Soft Tissue Involvement ◽

Timor Leste ◽

Resource Issue

Mycetoma is a neglected tropical disease with an unknown global burden. Although considered endemic to South-east Asia, it has not previously been reported from Timor-Lest. We describe two cases in Timor-Leste, highlighting the challenges surrounding microbiological diagnosis and management shared by many low to middle-income countries. As characteristically described, both patients lived rurally and presented late with marked soft tissue involvement and multiple draining sinuses following a prolonged period of high morbidity. Nocardia brasiliensis, a beadedbranched, modified acid-fast, gram-positive bacilli, was isolated and confirmed by molecular testing in the first case. The causative organism in the second case could not be confirmed due to limited microbiological capabilities. Due to limited local laboratory capabilities, Nocardia spp. infection cannot be routinely confirmed in Timor- Leste. However, the microbiology laboratory is essential for the successful diagnosis and management of Mycetoma. In both cases, medical therapy alone resulted in cure and favorable outcomes, although supply of antibiotic remains an ongoing resource issue.

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Immunogenicity of Streptococcus equi subsp. equi recombinant SeM protein and bacterin in mice

Pesquisa Veterinária Brasileira ◽

10.1590/1678-5150-pvb-6910 ◽

2021 ◽

Vol 41 ◽

Author(s):

Matheus C. Rosa ◽

Neida Lucia Conrad ◽

Carina M. Moraes ◽

Fábio P.L. Leite

Keyword(s):

Indirect Elisa ◽

Vaccine Development ◽

Control Group ◽

High Morbidity ◽

Specific Antibodies ◽

Whole Cells ◽

Immunodominant Antigen ◽

Promising Target ◽

Streptococcus Equi ◽

Rapid Spread

ABSTRACT: The infection caused by Streptococcus equi, known as strangles, affects the respiratory system of horses, causing high morbidity and rapid spread among the herd. Bacterin vaccines, composed of inactivated whole cells of S. equi, have variable efficacy and duration. Infected animals produce specific antibodies against SeM, the immunodominant antigen of S. equi. This makes it a promising target for vaccine development. In this context, the objective of this work was to evaluate a vaccine combining S. equi bacterin and recombinant SeM protein. Mice were vaccinated with bacterin (S. equi ~1.2 × 108CFU/ml); rSeM protein (20μg); bacterin-rSeM combination; or PBS (Control Group) and challenged with a suspension of S. equi, containing 10 × LD50. All vaccinated mice survived the challenge and produced anti-rSeM and anti-S. equi antibodies, which were assessed by indirect ELISA. The Control Group reached endpoint criteria 96 h after infection. These results demonstrate that a vaccine combining the S. equi bacterin with rSeM protein protects mice against strangles. This combination vaccine could potentially protect horses and overcome the limitations of currently available strangle vaccines.

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Recombinant tissue plasminogen activator as a novel treatment option for infective endocarditis: a retrospective clinical study in 32 children

Cardiology in the Young ◽

10.1017/s104795111400273x ◽

2015 ◽

Vol 26 (1) ◽

pp. 110-115 ◽

Cited By ~ 2

Author(s):

Aviva Levitas ◽

Hanna Krymko ◽

Justin Richardson ◽

Eli Zalzstein ◽

Viktoriya Ioffe

Keyword(s):

Infective Endocarditis ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Recombinant Tissue Plasminogen Activator ◽

Blood Cultures ◽

Morbidity And Mortality ◽

Causative Organism ◽

High Morbidity ◽

Retrospective Clinical Study ◽

Tissue Plasminogen

AbstractInfective endocarditis is a life-threatening infectious syndrome, with high morbidity and mortality. Current treatments for infective endocarditis include intravenous antibiotics, surgery, and involve a lengthy hospital stay. We hypothesised that adjunctive recombinant tissue plasminogen activator treatment for infective endocarditis may facilitate faster resolution of vegetations and clearance of positive blood cultures, and therefore decrease morbidity and mortality. This retrospective study included follow-up of patients, from 1997 through 2014, including clinical presentation, causative organism, length of treatment, morbidity, and mortality. We identified 32 patients, all of whom were diagnosed with endocarditis and were treated by recombinant tissue plasminogen activator. Among all, 27 patients (93%) had positive blood cultures, with the most frequent organisms beingStaphylococcus epidermis(nine patients),Staphylococcus aureus(six patients), andCandida(nine patients). Upon treatment, in 31 patients (97%), resolution of vegetations and clearance of blood cultures occurred within hours to few days. Out of 32 patients, one patient (3%) died and three patients (9%) suffered embolic or haemorrhagic events, possibly related to the recombinant tissue plasminogen activator. None of the patients required surgical intervention to assist vegetation resolution. In conclusion, it appears that recombinant tissue plasminogen activator may become an adjunctive treatment for infective endocarditis and may decrease morbidity as compared with current guidelines. Prospective multi-centre studies are required to validate our findings.

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Case of retroperitoneal necrotising fasciitis: a rare and deadly spread

BMJ Case Reports ◽

10.1136/bcr-2018-228530 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228530

Author(s):

Saad Ikram ◽

Deepak Satyapal ◽

Geeta Kaur ◽

Ajay Dabra

Keyword(s):

Disease Process ◽

Retroperitoneal Space ◽

Necrotising Fasciitis ◽

Causative Organism ◽

High Morbidity ◽

Rare Presentation ◽

Spread Of Infection ◽

Symptoms And Signs ◽

Antimicrobial Administration

Necrotising fasciitis (NF) is a potentially lethal spread of infection that is uncommonly seen within the province of surgery. Seen mostly in the extremities and the perineal regions, it has been reported rarely to involve the retroperitoneal space and presents with a spectrum of symptoms and signs as such. Literature supports classification of NF based on the microbes involved. Irrespective of the aetiology and the causative organism, NF remains a serious surgical emergency with high morbidity and mortality not only associated with the disease process itself, but also with the extensive surgical debridement it requires in its management along with antimicrobial administration. We present a case of such an infection found in the retroperitoneal space secondary to a perineal infection forming a rare presentation of this deadly process, and how it was successfully managed secondary to timely surgical intervention.

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Development and Evaluation of an In-House Enzyme-Linked Immunosorbent Assay for Early Diagnosis and Monitoring of Human Pythiosis

Clinical and Vaccine Immunology ◽

10.1128/cdli.9.2.378-382.2002 ◽

2002 ◽

Vol 9 (2) ◽

pp. 378-382 ◽

Cited By ~ 11

Author(s):

Theerapong Krajaejun ◽

Mongkol Kunakorn ◽

Sopaporn Niemhom ◽

Piriyaporn Chongtrakool ◽

Roongnapa Pracharktam

Keyword(s):

Early Diagnosis ◽

Immunosorbent Assay ◽

Elisa Test ◽

Enzyme Linked Immunosorbent Assay ◽

Causative Organism ◽

High Morbidity ◽

Isolation And Identification ◽

Pythium Insidiosum ◽

Delayed Treatment ◽

Time Required

ABSTRACT Human pythiosis is an emerging, fatal, infectious disease caused by Pythium insidiosum and occurs in both tropical and subtropical countries. Thalassemic patients, farmers, and aquatic-habitat residents are predisposed to this disease. Delayed treatment due to the long time required for isolation and identification of the causative organism, as well as the difficulty in obtaining internal organ specimens, results in high morbidity and mortality. To facilitate rapid diagnosis, an in-house enzyme-linked immunosorbent assay (ELISA) for the detection of immunoglobulin G antibodies against P. insidiosum was developed and evaluated for the diagnosis and monitoring of human pythiosis. Sixteen sera were collected from seven culture-proven human pythiosis cases. A total of 142 sera from thalassemic patients, from patients with other infectious diseases, and from healthy blood donors served as controls. All sera were tested in duplicate. By choosing a suitable cutoff point to maximize sensitivity and specificity, sera from pythiosis cases were all determined to be positive, whereas sera from control groups were all determined to be negative. ELISA signals from serial samples of sera taken from treated patients showed gradually declining levels of antibodies to P. insidiosum. The ELISA test was highly sensitive (100%) and specific (100%) and was useful for early diagnosis and for monitoring the treatment for pythiosis.

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Combined Rothia dentocariosa and Streptococcus viridans Corneal Ulcer in an Immunocompromised Patient

Case Reports in Ophthalmological Medicine ◽

10.1155/2021/9014667 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Jamie Dietze ◽

Thomas Mauger

Keyword(s):

Corneal Ulcer ◽

Immunocompromised Patient ◽

Streptococcus Viridans ◽

Causative Organism ◽

Common Condition ◽

Comorbid Conditions ◽

Conjunctival Flap ◽

Flap Procedure ◽

Mucous Discharge ◽

Chemotherapy Agents

Keratitis is a very common condition seen by ophthalmologists. However, many factors can complicate the treatment of this depending on the causative organism and other patient comorbid conditions. The objective of this clinical case report is to highlight the treatment of keratitis caused by Rothia dentocariosa. It also looks at the unique considerations in keratitis presentations for patients immunocompromised by chemotherapy agents. Our patient is a 58 yo female undergoing chemotherapy with folinic acid, fluorouracil, irinotecan, and panitumumab who presented with several days of a red, painful right eye with mucous discharge. Cultures were positive for Rothia dentocariosa and Streptococcus viridans. The patient ultimately underwent a conjunctival flap procedure as medical therapy with proper oral and topical antibiotics failed to resolve keratitis. This case is unique as previously, only a couple of cases of keratitis caused by Rothia dentocariosa have been reported and none of those patients were immunocompromised nor failed antibiotic therapy.

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Characteristics of Adult Sepsis Patients in the Intensive Care Units in a Tertiary Hospital in Jordan: An Observational Study

Critical Care Research and Practice ◽

10.1155/2021/2741271 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Anas H. A. Abu-Humaidan ◽

Fatima M. Ahmad ◽

Maysaa’ A. Al-Binni ◽

Amjad Bani Hani ◽

Mahmoud Abu Abeeleh

Keyword(s):

Intensive Care ◽

Mortality Rate ◽

Demographic Data ◽

Tertiary Hospital ◽

University Hospital ◽

Causative Organism ◽

High Morbidity ◽

Icu Patients ◽

Middle Income ◽

Tertiary Teaching

Sepsis is a global health issue that is commonly encountered in the intensive care unit (ICU) and is associated with high morbidity and mortality. Available data regarding sepsis in low- and middle-income countries (LMIC) is lacking compared to higher income countries, especially using updated sepsis definitions. The lack of recent data on sepsis in Jordan prompted us to investigate the burden of sepsis among Jordanian ICU patients. We conducted a prospective cohort study at Jordan University Hospital, a tertiary teaching hospital in the capital, Amman. All adult patients admitted to the adult ICUs between June 2020 and January 2021 were included in the study. Patients’ clinical and demographic data, comorbidities, ICU length of stay (LOS), medical interventions, microbiological findings, and mortality rate were studied. Descriptive and inferential statistics were used to analyse data from patients with and without sepsis. We observed 194 ICU patients during the study period; 45 patients (23.3%) were diagnosed with sepsis using the Sepsis-3 criteria. Mortality rate and median ICU LOS in patients who had sepsis were significantly higher than those in other ICU patients (mortality rate, 57.8% vs. 6.0%, p value < 0.001, resp., and LOS 7 days vs. 4 days, p value < 0.001, resp.). Additionally, sepsis patients had a higher combined number of comorbidities (2.27 ± 1.51 vs. 1.27 ± 1.09, p value < 0.001). The use of mechanical ventilation, endotracheal intubation, and blood transfusions were all significantly more common among sepsis patients. A causative organism was isolated in 68.4% of sepsis patients with a prevalence of Gram-negative bacteria in 77.1% of cases. While the occurrence of sepsis in the ICU in Jordan is comparable to other regions in the world, the mortality rate of sepsis patients in the ICU remains high. Further studies from LMIC are required to reveal the true burden of sepsis globally.

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Community Hospital Experience With Bovine Tissue in Infected Vascular Fields

The American Surgeon ◽

10.1177/0003134820952819 ◽

2020 ◽

pp. 000313482095281

Author(s):

Patrick Sowa ◽

Michael Soult ◽

Matthew Blecha

Keyword(s):

Community Hospital ◽

Graft Infection ◽

Prosthetic Graft ◽

Causative Organism ◽

High Morbidity ◽

Wound Debridement ◽

Prosthetic Graft Infection ◽

Hospital Experience ◽

Bovine Tissue

Background Vascular prosthetic graft infections are rare but associated with high morbidity and mortality. Treatment involves removal of the infected graft requiring arteriotomy closure. Previously this was performed with autologous graft, but bovine tissue has increasingly been used. The objective of this paper is to review the community hospital experience with bovine tissue repair in an infected vascular field. Materials and Methods A retrospective review of all cases performed by a single surgeon in a community hospital for infected prosthetic grafts was completed. Sixteen cases were included where bovine tissue was used for repair. Presentation, location of graft, and causative organism were reviewed, and outcomes including reoperation and mortality were recorded. Results Of the 16 patients, 15 (94%) had positive cultures of the graft. Methicillin-Resistant Staph Aureus was the most commonly isolated organism (50%). There were 3 unplanned reoperations including a revision from below to above knee amputation, drainage of a hematoma, and a wound debridement within the first year. Over the 1 year follow up period, 3 patients died for a mortality of 19%. There were no reinfections during follow-up. Discussion Prosthetic graft infection is a rare but serious vascular surgery complication. The causative organism has shifted in the last few years to become increasingly drug resistant. Treatment requires excision, and bovine tissue has been demonstrated to provide a safe and durable method of repair.

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