Radiation-Induced Myonecrosis: A Case Report of a Cervical Cancer Patient With a History of Systemic Lupus Erythematosus.

Radiation-induced myonecrosis is a rare but serious complication of radiation therapy. We present a case of a 49-year-old woman with systemic lupus erythematosus who developed radiation-induced myonecrosis after concurrent chemoradiation for cervical cancer. She underwent external-beam radiation therapy, weekly cisplatin chemotherapy (40 mg/m2), and intracavitary brachytherapy. One month later, she received one cycle of nedaplatin (80 mg/m2) and irinotecan (60 mg/m2). Two months after treatment, she experienced pain in the left inguinal region. An MRI revealed a mass in the left obturator externus muscle and right pectineus muscle suggestive of myonecrosis. A biopsy confirmed the diagnosis. She received hyperbaric oxygen therapy, and her symptoms improved. The masses resolved completely.

Multilocus Microsatellite Analysis of the Molecular Epidemiology of Microsporum canis Isolated in Japan.

Microsporum canis, a major causative agent of zoonotic dermatophytosis, has become prevalent in Japan. Molecular epidemiological surveys using multilocus microsatellite typing (MLMT), a sensitive genotyping tool for fungi, have been conducted to reveal intraspecies polymorphisms of M. canis.The present study utilized MLMT optimized for Japanese strains of M. canis to analyze epidemic trends of fungal infection. Six individual loci were targeted; namely, MS1, 2, 4, 5, 6, and 7. Analysis of data from 1974 through 2022 identified 416 strains, which were sorted into 60 genotypes by MLMT.The major genotypes showed changes in dominance during this period-changes that may reflect historical increases and decreases in the numbers of patients infected with M. canis patients. The main origins of infection included animal breeders and pet stores, as well as stray cat communities. Forty-nine episodes of familial outbreaks and cohabitant animal infections were recorded, and genotypes responsible for each episode were determined. MLMT analysis is not only a robust tool to understand population structures, but likely the most suitable method for tracking M. canis infections.

Change in dominant genotype of Microsporum canis, a causative fungus of zoonotic dermatophytosis, in Japan over the past 40 years.

Multilocus microsatellite typing was performed on 124 strains of Microsporum canis, which is the most prevalent causative fungus of zoonotic dermatophytosis, isolated in Japan between 1974 and 1981. The strains had been enclosed in glass ampoules by freeze dried process. Genotypes were detected by capillary electrophoresis targeted on six microsatellite regions, and 19 genotypes were found among these 124 strains. The most frequent genotype, which had been reported as genotype L in a previous study, comprised 56 of the 124 strains (45.2%), although genotype L was reported to comprise only six of 165 strains (3.6%) isolated between 2010 and 2017. A decrease in the prevalence of genotype L may have led to the retreat of M. canis infection in 1996 to 2006. On the other hand, genotype A, the second most predominant genotype in the aforementioned studies of strains isolated between 2010 and 2017, comprised just four of 124 strains (3.2%) in the present study. Thus, these studies reveal that prevalences of some major genotypes have changed over the last 40 years. Genotype consistency of strains was proven in all of 12 familial cases, each of which was infected with a single genotype. We emphasize the importance of fungal culture collection for further studies with new techniques in the future.

Molecular Epidemiology of Microsporum canis Isolated from Japanese Cats and Dogs, and from Pet Owners by Multilocus Microsatellite Typing Fragment Analysis.

Multilocus microsatellite typing (MLMT) was performed on 93 strains of Microsporum canis (M. canis) isolated between 2012 and 2017 from 75 cats, 8 dogs, and 10 pet owners. These strains were derived from 2 major reservoirs: commercial breeding facilities and pet shops (PS), and stray cats and pet cats that went outdoors and came in contact with stray cats (Outdoor). Six microsatellite markers were used for genotyping. These 93 strains included 22 genotypes; 11 had been previously detected in Japan while the other 11 were new. Strains belonging to the previously reported genotypes, P and A, were distributed widely throughout Japan. Genotype P was the most frequent, accounting for 37 (39.8%) of the 93 strains. Most were derived from Outdoor sources. Genotype A was the second most frequent (11 of 93 strains, 11.8%). Most of the genotype A strains were derived from the PS reservoir. All new genotypes were detected in isolates from cats. Many of these were derived from the Outdoor reservoir. Consistency of infection was observed in 18 of the 19 familial cases. These findings indicate that genotypes differ in strains derived from PS and Outdoor reservoirs. MLMT genotyping is useful for tracking the routes of spread and transmission of M. canis in Japan.

Case of acute onset ataxia caused by Klebsiella pneumoniae sepsis with the appearance of anti-GD1b antibody.

Various disorders can cause acute onset ataxia including those that have toxic/metabolic, traumatic, neoplastic, vascular, demyelinating/dysmyelinating, infectious, postinfectious and genetic features. We present a case of postseptic acute ataxia. A 72-year-old woman was diagnosed with septic shock secondary to acute obstructive suppurative cholangitis. A blood sample for bacterial culture was positive for Klebsiella pneumoniae Thus, we initiated antibiotics and intravenous immunoglobulin therapies to control the infection. We later added extracorporeal endotoxin removal with a polymyxin B immobilised fibre cartridge for endotoxin shock. The patient's condition improved soon after endotoxin removal. Mildly slurred and explosive speech with limb and truncal ataxia, which improved gradually, developed shortly afterwards. Serum samples obtained on day 15 after admission were positive for anti-GD1b IgG antibody. The clinical course of monophasic illness with good recovery, neurological findings and the appearance of anti-GD1b antibody suggest that this case is a variant of Miller-Fisher syndrome.

An Epidemiological Study of Feline and Canine Dermatophytoses in Japan.

In a 2012-2014 epidemiological study of feline and canine dermatophytoses in Japan, we investigated the prevalence of fungi among 296 cats and 170 dogs treated at a veterinary clinic and 51 cats and dogs at an animal shelter at Fukui City in Japan. Microsporum canis was isolated from only one cat out of the 517 animals. Also, from 2012 to 2017, we analyzed isolates from 76 cats and 15 dogs with dermatophytoses at 14 veterinary clinics across 10 prefectures in Honshu and Shikoku. M. canis was the cause for 85 of the cases and Microsporum gypseum for the other six. M. canis infection routes in cats are thought to include stray cats as well as breeding facilities and pet shops, whereas for dogs, only breeding facilities and pet shops. Tinea was found in 18.7% (14/75) of the owners of these animals. We showed that microsatellite genotyping is useful for molecular epidemiological investigations such as determination of infection routes of M. canis.

Masticator myopathy.

A 31-year-old woman developed low-grade fever and pain and swelling of the masticatory muscles. A T2-weighted magnetic resonance image showed high signal intensity in these muscles. Coxsackie B3 and echo 30 viruses were detected from a nasopharyngeal swab and feces, respectively. The clinical symptoms accompanied a marked decline in the serum immunoglobulin G level with progressive eosinophilia. Her symptoms disappeared by 8 weeks after onset. She was diagnosed as having masticator myopathy, which has rarely been reported in humans. The present case suggests that masticator myopathy is associated with coxsackie or echo virus infection.