Sonographic and histological udder parenchyma changes after intramammary infection of sheep with Mycoplasma agalactiae.

INTRODUCTION: The sonographic findings of the udder parenchyma and udder lymph nodes in 30 lactating sheep after experimental infection with Mycoplasma agalactiae are described. The objective of the study was to describe infection related changes in the udder parenchyma and udder lymph nodes using physical, sonographic, and histological examination and to detect associations between sonographic and histological changes of the tissues. Animals were intramammarily infected with different mutant cocktails and the wild type PG2. One group served as a negative control. A 15 MHz linear transducer (Esaote MyLab 30 CV, Esaote, Florence, Italy) was used for sonographic examinations. Compared with the uninfected control group with homogeneously granular parenchyma, the udder lymph nodes were larger and the udder parenchyma was more inhomogeneous and partially hyperechoic. The corresponding histological findings in infected mammary glands comprised proliferation of interstitial connective tissue, non-purulent interstitial mastitis, and purulent galactophoritis. The infected udder lymph nodes showed reactive hyperplasia. The findings obtained in this study may improve the diagnosis of Mycoplasma mastitis in sheep.

INTRODUCTION: Les constatations échographiques sur le parenchyme de la mamelle et des ganglions lymphatiques de la mamelle chez 30 brebis en lactation après une infection expérimentale avec Mycoplasma agalactiae sont décrits. L'objectif de l'étude était de décrire les modifications liées à l'infection dans le parenchyme mammaire et les ganglions lymphatiques de la mamelle à l'aide d'un examen physique, échographique et histologique et de détecter les associations entre les altérations échographiques et histologiques des tissus. Les animaux ont été infectés par voie intramammaire avec différents cocktails de mutants et le type sauvage PG2. Un groupe a servi de contrôle négatif. Une sonde linéaire de 15 MHz (Esaote MyLab 30 CV, Esaote, Florence, Italie) a été utilisé pour les examens échographiques. Comparativement au groupe témoin non infecté avec un parenchyme granulaire homogène, les ganglions lymphatiques de la mamelle étaient plus gros et le parenchyme de la mamelle était plus inhomogène et partiellement hyperéchogène. Les résultats histologiques correspondants dans les glandes mammaires infectées comprenaient une prolifération de tissu conjonctif interstitiel, une mammite interstitielle non purulente et une galactophorite purulente. Les ganglions lymphatiques de la mamelle infectée présentaient une hyperplasie réactive. Les résultats obtenus dans cette étude peuvent améliorer le diagnostic de la mammite à Mycoplasma chez le mouton.

Mycoplasma infection followed by time-lapse microscopy.

Early detection of mycoplasma infection is crucial for saving precious often irreplaceable data from the tissues of patients. Mycoplasma infections cause diseases in the upper and lower respiratory tracts, urethritis in men resulting in painful dysuria, urgency and urethral discharge. Cough, fever, headache, urethritis may persist for several weeks and convalescence is slow. The symptoms of these diseases are aggravated by the detection of mycoplasma infections, that takes either a long time, besides being expensive or is specific and restricted to only a limited number of contaminant strains. Mycoplasmas are hard to detect visually but could be seen and followed by time-lapse microscopy. Our hypothesis is that one can detect mycoplasma infection irrespective of its origin and type of mycoplasma. Main lines of supporting evidence are provided by the time-lapse microscopy showing dynamic morphological alterations caused by mycoplasmas before changes in human cell cultures become visible. Morphometric measurements of mycoplasma infections revealed four subphases: i) detachment of infected cells, ii) aggregation, iii) biofilm formation and iv) shrinkage of infected cells. The applicability of time-lapse microscopy for the detection of mycoplasma infection was validated by a mycoplasma test Kit. Most important implications related to morphometric parameters include the observation of mycoplasma infected cultures for an extended period of time instead of applying static snap-shot microscopy. A reliable method is offered to estimate the time of mycoplasma exposure that elapsed during the cell growth. This microphotometric approach served a more economical detection of mycoplasma contamination at its early stage of cell growth and spread, irrespective of the origin of contaminated serum, without defining the type of mycoplasma.

Meningitis in a Chinese adult patient caused by Mycoplasma hominis: a rare infection and literature review.

BACKGROUND: Mycoplasma hominis, a well known cause of neonatal infection, has been reported as a pathogen in urogenital infections in adults; however, central nervous system (CNS) infections are rare. We report here the first case of M. hominis meningitis in China, post neurosurgical treatment for an intracerebral haemorrhage in a 71-year-old male. CASE PRESENTATION: We describe a 71-year-old man who developed M. hominis meningitis after neurosurgical treatment and was successfully treated with combined azithromycin and minocycline therapy of 2 weeks duration, despite delayed treatment because the Gram stain of cerebrospinal fluid (CSF) yielded no visible organisms. The diagnosis required 16S rDNA sequencing analysis of the cultured isolate from CSF. Literature review of M. hominis CNS infections yielded 19 cases (13 instances of brain abscess, 3 of meningitis, 1 spinal cord abscess and 1 subdural empyema each). Delay in diagnosis and initial treatment failure was evident in all cases. With appropriate microbiological testing, antibiotic therapy (ranging from 5 days to 12 weeks) and often, multiple surgical interventions, almost all the patients improved immediately. CONCLUSIONS: Both our patient findings and the literature review, highlighted the pathogenic potential of M. hominis together with the challenges prompted by rare infectious diseases in particular for developing countries laboratories with limited diagnostic resources.

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion associated with Mycoplasma pneumoniae infection.

BACKGROUND: Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinico-radiological syndrome characterized by transient mild symptoms of encephalopathy and a reversible lesion in the splenium of the corpus callosum on magnetic resonance imaging (MRI). It is often triggered by infection. The common pathogens of MERS are viruses, especially influenza virus. However, Mycoplasma pneumoniae (M.pneumoniae) are relatively rare pathogens for MERS. CASE PRESENTATION: Here we report two paediatric cases of M.pneumoniae infection-induced MERS. The diagnosis of M.pneumoniae infection was established based on polymerase chain reaction (PCR) and specific serum antibodies (IgM). Both of the two patients presented with mild encephalopathy manifestations and recovered completely within a few days. The initial MRI showed a lesion in the central portion of the splenium of the corpus callosum, which completely resolved on the seventh and eighth day after admission for case 1 and case 2. Lumbar puncture was performed in both patients, which revealed no pleocytosis. In case 1, the patient had hyponatremia, peripheral facial nerve paralysis, and rash. To the best of our knowledge, it is the first MERS case associated with peripheral nerve damage. In case 2, interleukin-6(IL-6) was moderately increased in the cerebrospinal fluid (CSF). It suggested that IL-6 may play a role in the pathogenesis of M.pneumoniae-induced MERS. CONCLUSION: Our study enriches the available information on the pathogens of MERS and provides valuable data for better understanding of this syndrome.

A Rare Case of Infectious Multifocal Serpiginoid Choroiditis

Multifocal serpiginoid choroiditis is an infectious variety of serpiginous choroiditis. The disease is characterized by infectious etiology and overlapping clinical features in an intermediary form of acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis. In a 33-year-old patient, bilateral multiple placoid partially confluent chorioretinal lesions were diagnosed after a febrile flu-like episode. On the right eye, there was a progressive decrease in visual acuity. Later, the lesions had a prolonged progressive devastating clinical course and widespread distribution of placoid lesions, and took the form of serpiginoid choroiditis. We conducted extensive laboratory work-up and ancillary investigation for granulomatous diseases such as tuberculosis and sarcoidosis, and the results were not consistent with these entities. Systemic medical work-up revealed a history of exposure to the human immunodeficiency virus, herpes simplex virus 1, varicella zoster virus and cytomegalovirus. The titer of Mycoplasma pneumoniae IgM antibodies was positive. After serological analysis positive for Mycoplasma pneumoniae, systemic antibiotic therapy and anti-inflammatory doses of corticosteroids were administered. Improvement of visual acuity after the introduction of causal antibiotic therapy in combination with anti-inflammatory therapy confirmed our suspicion that Mycoplasma pneumoniae was the etiologic cause of multifocal serpiginoid choroiditis.

Acute hydrocephalus in a child with Mycoplasma cerebellitis.

Mycoplasma cerebellitis though rare, may rapidly progress to hydrocephalus needing surgical intervention. It has not been reported so far in children. We report a 6 year old girl with mycoplasma cerebellitis which progressed to acute hydrocephalus needing an emergency external ventricular drain. Magnetic Resonance Imaging is essential in making the diagnosis of cerebellar swelling as CT scan may be normal. Relapses can occur as in our case. Close monitoring for raised intracranial pressure and investigations to identify the organism including mycoplasma are indicated in all cases. Long-term outcome appears to be favorable if diagnosed and treated early.

Mycoplasma felis arthritis in two cats.

This report describes the occurrence of non-weightbearing lameness caused by Mycoplasma felis monoarthritis in two, immunocompetent, European, shorthair adult cats with a suspected history of trauma. Clinical signs recurred after conservative treatment. The joints were treated surgically and M felis was identified as the causative agent for the monoarthritis. Medication with 10 mg/kg doxycycline twice daily was initiated according to susceptibility testing. One cat underwent further joint flushing after two weeks; both the cats recovered completely after eight and nine weeks, respectively. The findings suggest that M felis, in addition to being an agent associated with conjunctivitis in cats, is able to act as a pathogen in other tissues and cause arthritis even in immunocompetent cats.

Seeding of a cavernous angioma with Mycoplasma hominis: case report.

OBJECTIVE AND IMPORTANCE: To describe a unique case of hematogenous seeding of a cavernous angioma with the commensal organism Mycoplasma hominis. CLINICAL PRESENTATION: A 40-year-old female patient presented with a severe headache and acute left facial nerve palsy. Imaging studies revealed a right frontal mass lesion with characteristics of a cavernous angioma. INTERVENTION: The patient underwent a craniotomy for cavernous angioma resection. Purulent material was noted at the time of resection, and no hemorrhage was observed. Despite antibiotic therapy, the patient required repeat craniotomies for subsequent abscess treatment. M. hominis was identified as the pathogen. CONCLUSION: M. hominis is a rare cause of brain abscesses and can be difficult to eradicate. Cavernous angiomas can be seeded hematogenously.

Antenatal mycoplasma infection, the fetal inflammatory response and cerebral white matter damage in very-low-birthweight infants.

We address the question as to whether Ureaplasma urealyticum or Mycoplasma hominis, cultured from the placenta of very-low-birthweight (VLBW) infants, are associated with an increased risk of (a) fetal vasculitis and (b) ultrasonographic cerebral white matter echolucency. The sample consisted of 464 VLBW infants for whom (i) the surface of the chorion was cultured for U. urealyticum and M. hominis; (ii) the placenta was examined histologically; and (iii) a cranial ultrasound scan was obtained close to days 1, 7 or 21. Infants with echolucency were compared with controls in univariable and stratified analyses and in multivariable logistic regressions. Fifty-three per cent of placentas from infants with fetal vasculitis harboured U. urealyticum compared with 18% of controls (P

Histopathology and doxycycline treatment in a previously healthy non-AIDS patient systemically infected by Mycoplasma fermentans (incognitus strain).

The newly recognized human pathogenic mycoplasma M. fermentans (incognitus strain) causes a fatal systemic infection in experimental monkeys, infects patients with AIDS, and apparently is associated with a fatal disease in previously healthy non-AIDS patients. An apparently immunocompetent male who lacked evidence of HIV infection developed fever, malaise, progressive weight loss, and diarrhea and had extensive tissue necrosis involving liver and spleen. M. fermentans (incognitus strain) was centered at the advancing margins of these necrotizing lesions. Following the treatment of 300 mg doxycycline per day for 6 weeks, he recovered fully. He has no fever or diarrhea, and his abnormal liver function tests have returned to normal. He regained all lost strength and 14 kg of lost weight and has remained disease free for more than 1 year.

[Neurologic ultrasonography in the diagnosis of infectious diseases of the brain in newborn infants]. / Neirosonografiia v diagnostike infektsionnykh porazhenii golovnogo mozga u novorozhdennykh detei.

The authors assess potentialities of ultrasonic scanning of the brain (neurosonography) in the diagnosis of infectious brain injuries. The data obtained have demonstrated a high information content of the method in recognition of purulent meningitis complications and advisability of the use of neurosonography in neonates with suspected specific intrauterine infection.

Respiratory failure secondary to Mycoplasma pneumoniae infection.

Three previously healthy patients presented with bilateral pulmonary infiltrates, hypoxemia, and respiratory failure associated with Mycoplasma pneumoniae infection. None had underlying pulmonary or immune deficiency diseases. One died with dense fibrotic reorganization of the lungs, and another survived after prolonged mechanical ventilatory assistance. Two developed pulmonary superinfections with Pseudomonas aeruginosa. All had extrapulmonary complications: one had Coombs'-positive hemolytic anemia, another myocarditis, and all three had abnormal results of liver function tests, consistent with hepatocellular dysfunction.

[Radiological aspects of infections due to mycoplasma pneumoniae in children (author's transl)]. / Aspects radiologiques des infections à mycoplasma-pneumoniae chez l'enfant. A propos de 69 cas.

The authors review 69 cases of infections due to mycoplasma pneumoniae in children, including the clinical, biological, and radiological aspects, and compare their results with those in the published literature. Clinical and radiological signs and non-specific, and diagnosis is made exclusively by serological tests.

A case of myocarditis caused by Mycoplasma pneumoniae.

A 16-year-old girl with myocarditis and hepatitis in the course of mycoplasma pneumoniae infection was reported. She had fever and coughed for ten days prior to admission. At the time of admission infiltrations of the left lower lung field were revealed on the chest X-ray films. The ESR was elevated and CRP+6. There were no leukocytosis and anemia, but S-GOT, S-GPT and LDH were moderately increased. On the 11th day of admission VPC in bigeminy appeared and the third sound was heard. Subsequently biphastic and inverted T waves in leads V2 and V3 and flattening of T waves in leads II and aVF appeared. At the same time, the cardiac shadow was enlarged. Antibody titer to mycoplasma pneumoniae increased to more than 1:640 two weeks after admission and then it decreased gradually. The cold agglutinin test was 1:64 on the 8th day of the disease and then it became normal. ASO, antibodies to DNA and immunoglobulins were normal; ANA, Coombs test and LE test were negative. The abnormal ECG-findings were normalized three months later.