Pigmented Purpuric Dermatoses: A Complete Narrative Review

Pigmented purpuric dermatoses (PPD) include several skin diseases characterized by multiple petechial hemorrhage as consequence of capillaritis. PPD generally present with red to purple macules that progressively evolve to golden-brown color as the hemosiderin is reabsorbed. These lesions, often asymptomatic or associated with mild pruritus, usually occur on the lower extremities and may be a diagnostic and therapeutic challenge both for general practitioners and specialists in internal medicine or flebology. Clinical presentations include many subtypes that have been described over the years, although histology is usually superimposable. Prompt recognition and patient reassurance on the benign nature of these diseases is crucial. In this comprehensive review, we focused on pathogenesis and clinical pictures.

Outbreak of cryptosporidiosis in African penguins Spheniscus demersus

Cryptosporidium spp. are parasitic intracellular protozoa that infect the digestive, respiratory, and urinary tracts of vertebrates. The disease affects many different avian species across all continents, and >25 species and genotypes of Cryptosporidium have been documented infecting birds. We report on an outbreak of cryptosporidiosis in African penguin Spheniscus demersus chicks admitted to a rehabilitation center in South Africa from February 2012 to October 2013. Eighteen cases were confirmed through histopathology. The most frequent clinical signs were regurgitation (78%), dyspnea (72%), decreased weight gain or weight loss (72%), and lethargy (50%). Clinical signs began 8-46 d after hatching or admission (median: 13 d), and death followed 1-41 d after the onset of clinical signs (median: 13.5 d). The most frequent necropsy findings were stomach distended with undigested food or gas (78%), mildly reddened lungs (56%), spleen petechial hemorrhage (44%), and kidney congestion (39%). The most frequent histopathological findings were necrotic bursitis (89%), necrotic enteritis (83%), and bursal atrophy (67%). Small round or oval basophilic bodies (3-5 µm diameter) consistent with Cryptosporidium sp. were closely associated with the surface of the epithelial cells or in the lumen of the bursa (89%), large intestine (61%), small intestine (44%), trachea (22%), and ventriculus (6%). Transmission electron microscopy of 1 case confirmed that these organisms were Cryptosporidium sp. To our knowledge, this is the first report of cryptosporidiosis in penguins, raising concern of the potential implications for the conservation of these species.

Pathological and molecular detection of diseases of cattle at slaughter

Background: This study was carried out to identify important zoonotic diseases of beef cattle at slaughter in Bangladesh. Methods: A total of 20 slaughtered cattle of both sexes, different ages and breeds were taken under investigation from Nilphamari, Rajshahi and Mymensingh district, Bangladesh during July to October, 2017. Detailed ante-mortem and post-slaughter lesions were inspected and the tissues from the lungs, liver, kidney and spleen were collected aseptically for histopathological examination. The tissue sections were processed and stained with hematoxylin and eosin (H&E) stain, acid fast stain and Gram stain. To detect the presence of specific microorganism in the tissues, the genomic DNA was extracted and polymerase chain reaction (PCR) was carried out. Results: Grossly, liver appeared as most affected organ followed by lungs, kidney and spleen. Wide spread necrosis and pipe steam liver due to fascioliasis (n=4), hydatidosis in lungs (n=3), congestion in the kidney (n=4) and petechial hemorrhage (n=2) in the spleen were the predominant lesions observed in the slaughtered cattle. H&E staining of tissue sections revealed granulomas in two liver and one lungs. Lung section stained with acid fast stain detected the acid fast bacilli in a case. Tissue sections stained with Gram stain showed cocci bacteria in the liver of two cattle. The PCR confirmed the presence of Mycobacterium tuberculosis in a cattle. Conclusions: Fascioliasis, hydatidosis and important zoonotic disease like tuberculosis are prevalent in the slaughtered cattle in Bangladesh. PCR technology appeared as a sensitive and specific screening test to diagnose tuberculosis. However, screening of large number of samples is necessary to detect the presence of important zoonotic diseases in cattle for safe beef production.

Outbreak of Mortality Associated with Acipenser Iridovirus European (AcIV-E) Detection in Siberian Sturgeon (Acipenser Baerii) Farmed in Sweden

Background: Infectious disease is a major challenge in aquaculture and poses a constraint for development of farming of new species. In 2017, Siberian sturgeon (Acipenser baerii) juveniles were imported from Italy to a Swedish farm. Due to stressful conditions, 30% died during transport and in the first days after arrival. Ten days after arrival, mortalities started to occur again. Within two months, only 5% of the juveniles were still alive. Methods: Diseased fish were transported live to the National Veterinary Institute (SVA) for necropsy and further analysis. Pathological and histopathological investigation was conducted. Virology was performed on gills and internal organs by cell culture isolation and specific PCR protocols. Results: The juveniles displayed neurological signs such as lethargy, inability to maintain upright position and erratic swimming. Body condition was low. Gills were pale. One fish had petechial hemorrhage on the abdomen and the snout. The ventricles were air-filled with, but swim bladders were deflated. One specimen had intestinal hemorrhage. Viral cell cultures were negative, but PCR of gills and internal organs detected the presence of Acipenser Iridovirus European (AcIV-E). Conclusions: AcIV-E was associated with disease and high mortality in the sturgeon juveniles. Stress probably aggravated the course of the infection.

A case of dengue fever in a health worker in university of Port-Harcourt teaching hospital

Dengue fever is a mosquito borne disease which can easily be missed or misdiagnosed in early stages as a result of poor surveillance, similarity with other febrile illness and unavailability of PCR necessary for its diagnosis. We hereby report a 44year old female nurse living around a bushy and swampy environment, who presented to university of Port-Harcourt teaching hospital (UPTH) with high grade fever of 1week duration, also developed joint pains, passage of coke colored urine, sensor neural deafness, hyperglycemia and petechial hemorrhage while on admission. Patient continued to have persistent fever despite having completed her anti-malaria and antibiotics, viral studies were subsequently done for her and she was found to have dengue virus. Patient was conservatively managed and discharged for follow-up in medical outpatient and Ear nose and throat clinic.

Improvement Effects of Wasabi (Wasabia japonica) Leaves and Allyl Isothiocyanate on Stomach Lesions of Mongolian Gerbils Infected with Helicobacter pylori

The relationship between Helicobacter pylori infection and gastric cancer associated with stomach lesions has been reported. Improvement of the adverse effects induced by H. pylori is required for human health. It has been reported that wasabi ( Wasabia japonica Matsum) leaves have various effects on bacteria and mammals. In this study, the effect was examined of wasabi leaf extract and allyl isothiocyanate (AIT), which is a main functional component of wasabi, on stomach lesions in Mongolian gerbils infected with H. pylori. After the gerbils infected with H. pylori were orally administrated with wasabi leaf extract and AIT for two weeks, colony forming units (CFU) of H. pylori, the degree of gastric mucosal erosion, and petechial hemorrhage in the stomachs of the gerbils were evaluated. Wasabi leaf extract and AIT exhibited a decreasing tendency of CFU in the stomachs. The degree of gastric mucosal erosion and petechial hemorrhage were significantly decreased by the intake of wasabi leaf extract and AIT. Wasabi leaf extract and AIT did not affect body weight, dietary intake, water intake, and the pH of the stomach. From these results, wasabi leaves and AIT may provide a natural remedy for stomach lesions induced by H. pylori.

Petechial Hemorrhage of Tympanic Membrane in a Case of Attempted Suicide by Hanging: A Sign of Severity

ABSTRACT Assessment of a patient who has attempted suicide by hanging is an important emergency room call for an otorhinolaryngologist. As a norm, it is the neck that is assessed first in such a patient. Here, we discuss the otoscopic findings of petechiae of the tympanic membrane in these patients, which will help in finding the severity of the hanging, which in turn will be helpful to provide round-the-clock careful vigilant care for these patients. How to cite this article Stephen V, Abraham SS, Naik PP, Kurien M. Petechial Hemorrhage of Tympanic Membrane in a Case of Attempted Suicide by Hanging: A Sign of Severity. Int J Otorhinolaryngol Clin 2017;9(1):15-16.

Hanging Fatalities in Central Bangkok, Thailand: A 13-Year Retrospective Study

Hanging is violent asphyxial death. The objective of this study is to assess the data of hanging cases. A descriptive-retrospective study was conducted. We studied 244 hanging cases autopsied in Forensic Division, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, between January 2001 and December 2013. The study included 197 men (80.7%) and 47 women (19.2%). Their age ranged from 14 to 93 years. Most of these cases were incomplete hanging (83.6%). Features of hanging victims, such as tongue protrusion; congestion of face; petechial hemorrhage of face, conjunctiva, and internal organs; and neck injuries, significantly correlated with complete hanging. The predominant occupation of hanging victims was in the service industry (63.1%). Suicides usually occurred in private homes or apartments (84.8%). A suicide note was found in 6.1% of cases. The most common ligature material used was nylon rope, found in 61.1% of cases. The most underlying diseases of the victims in hanging cases were tuberculosis and human immunodeficiency virus infection, 9 cases each. Blood ethanol levels of 29 cases (11.8%) were detected to be higher than 150 mg%. Methamphetamine and benzodiazepine were detected in 5.3% and 3.3% of cases, respectively. This study provides comprehensive baseline data of hanging cases in central Bangkok.