Staphylococcus aureus-induced pyogranulomatous dermatitis, osteomyelitis, and meningitis with Splendore-Hoeppli reaction in a cat coinfected with the feline leukemia virus and Leishmania sp

This report describes a case of a pyogranulomatous dermatitis, osteomyelitis, and meningitis with Splendore-Hoeppli reaction caused by Staphylococcus aureus in a sheltered female adult cat coinfected with the feline leukemia virus (FeLV) and Leishmania sp. The cat had a mild anemia and marked increased total leukocytes, particularly band and segmented neutrophils. The cat had laboratorial diagnosis of FeLV and Leishmania sp. infections. Clinically, the cat had extensive and multifocal areas of ulceration in cranial region. Due to the progression of cutaneous lesions, progressive weight loss, and the risk for other sheltered animals, the cat was euthanized. Microscopically, there was marked pyogranulomatous ulcerative dermatitis, osteomyelitis and meningitis, with multiple large intralesional colonies of Gram-positive cocci associated with Splendore-Hoeppli reaction. Aerobic bacterial isolates were identified as S. aureus by MALDI-ToF MS. Leishmania sp. DNA sequences were detected in liver and spleen, and amastigotes were demonstrated in skin sections by immunohistochemistry. In conclusion, here we describe a case of S. aureus-induced pyogranulomatous meningitis with SH reaction in a cat naturally coinfected with FeLV and Leishmania sp(AU)

Clinical and pathological aspects of an outbreak of Streptococcus suis serotype 9 infection in pigs / Aspectos clínicos e patológicos de um surto de infecção por Streptococcus suis sorotipo 9 em suínos

Streptococcus suis is a Gram-positive pathogen that inhabits the upper respiratory tract and can cause severe systemic inflammatory disease in pigs, mainly during the nursery phase. Streptococcus suis is a reemergent pathogen, and outbreaks of its inducing disease represent significant economic losses for the pig industry worldwide. In this study, we described the clinical, pathological, and molecular aspects of an outbreak of S. suis infection with atypically high mortality. The outbreak occurred in nursery farms integrated into a cooperative in the state of Paraná, Brazil. Of the 30 nurseries, 10 were severely affected by the pathogen and had high economic losses. Clinical signs usually started approximately 10 days after weaning and were mainly characterized by acute nervous and locomotor disorders. The mortality of the affected batches usually ranged between 8% and 10%, but in some cases, it reached 18%. Nine piglets were submitted to post mortem examination. Macroscopically, the synovial joints were enlarged and contained fibrinous exudates. In the central nervous system, there was hyperemia of the leptomeningeal vessels associated with deposition of fibrin and purulent exudate in the leptomeninges. In three piglets, there was thickening of the choroid plexus associated with dilation of the lateral ventricles. Microscopic lesions were characterized mainly by fibrinosuppurative inflammation, which involved the synovial membranes, leptomeninges of the brain, and spinal cord. Furthermore, it also affects the choroid plexus, ependyma, nerve roots, and central canal of the spinal cord. S. suis was isolated from the cerebrospinal fluid, meningeal swabs, and/or synovial fluid of 8/9 piglets, and typified as serotype 9 by multiplex PCR.

Streptococcus suis é um patógeno Gram positivo que habita o trato respiratório superior e pode causar doença inflamatória sistêmica grave em suínos, principalmente durante a fase de creche. Streptococcus suis é um patógeno reemergente e surtos representam perdas econômicas significativas a suinocultura mundial. Neste estudo descrevemos os aspectos clínicos, patológicos e moleculares de um surto de infecção por S. suis com mortalidade atipicamente alta. O surto ocorreu em creches integradas a uma cooperativa do estado do Paraná, Brasil. Das 30 creches, 10 foram severamente afetadas pelo patógeno e apresentavam elevadas perdas econômicas. Os sinais clínicos iniciavam em torno de 10 dias após o desmame e eram caracterizados principalmente por sinais clínicos nervosos e locomotores agudos. A mortalidade dos lotes afetados variava entre 8% e 10%, mas em alguns casos ultrapassava 18%. Nove leitões foram submetidos ao exame post mortem. Macroscopicamente, as articulações sinoviais estavam aumentadas e continham exsudato fibrinoso. No sistema nervoso central havia hiperemia dos vasos leptomeníngeos associada a deposição de fibrina e exsudato purulento nas leptomeninges. Em três leitões havia espessamento do plexo coroide associado a dilatação dos ventrículos laterais. As lesões microscópicas eram caracterizadas principalmente por inflamação fibrinossupurativa que envolvia as membranas sinoviais, as leptomeninges do cérebro e medula espinhal. Além disso, também afetava o plexo coroide, epêndima, raízes nervosas e canal central da medula espinhal. S. suis foi isolado do líquido cefalorraquidiano, suabe de meninge e/ou líquido sinovial de 8/9 leitões e tipificado como sorotipo 9 por PCR multiplex.

Diseases of the central nervous system in swine in Southern Brazil / Doenças do sistema nervoso central de suínos no Sul do Brasil

Brazil is the fourth largest exporter of pork worldwide, with its production concentrated in the Southern region of the country. To reduce the economic impacts and increase herd health, an efficient diagnosis of diseases is necessary. The frequency, seasonal, and annual distribution of diseases that affecting the swine nervous system in Southern Brazil were determined through a retrospective study conducted from 2008 to 2018. A total of 231 pigs were evaluated, and distributed in the following phases: suckling piglets, nursery, growing, finishing, and adults. Piglets in the nursery phase were the most affected with 58.01%. Infectious diseases accounted for 87.01% (201/231) of lesions in the nervous system. Bacterial meningitis was observed in 58.87% of cases, presenting an endemic distribution, and a propensity to occur in the months of autumn/winter. The highest number of cases of porcine circovirus-2 were observed in 2008 and 2009, with a subsequent decline. Porcine circovirus, salt poisoning, and brain abscesses exhibited no association between the seasonal occurrence and annual distribution. Salt poisoning was observed more frequently in the last years of this study. Both, non-suppurative encephalomyelitis and selenium toxicosis exhibited an association between their occurrence and seasonal distribution in, the months of winter, and summer, respectively.(AU)

Brasil é o quarto maior exportador de carne suína do mundo, com sua produção concentrada na região Sul do país. Para reduzir os impactos econômicos e aumentar a saúde do rebanho, é necessário o diagnóstico eficiente das doenças. A frequência, distribuição sazonal e anual das doenças que afetam o sistema nervoso de suínos no Sul do Brasil foram determinadas através de um estudo retrospectivo no período de 2008 a 2018. Foram avaliados 231 suínos, distribuídos nas seguintes fases: maternidade, creche, crescimento, terminação e adultos. Leitões da fase de creche foram os mais afetados com 58,01%. As doenças de origem infecciosa foram responsáveis por 87,01% (201/231) das causas de lesões no sistema nervoso. Meningite bacteriana foi observada em 58,87% dos casos, apresentando distribuição endêmica, e uma tendência a ocorrer nos meses de outono/inverno. O maior número de casos de circovírus suíno foram observados em 2008 e 2009, com declínio posterior. Circovírus suíno, intoxicação por sal e os abscessos encefálicos não apresentaram associação entre a ocorrência sazonal e distribuição anual. A intoxicação por sal foi observada com maior frequência nos últimos anos deste estudo. A encefalomielite não supurativa e a intoxicação por selênio exibiram associação entre a sua ocorrência e distribuição sazonal, nos meses de inverno e verão, respectivamente.(AU)

Diseases of the central nervous system in swine in Southern Brazil / Doenças do sistema nervoso central de suínos no Sul do Brasil

Brazil is the fourth largest exporter of pork worldwide, with its production concentrated in the Southern region of the country. To reduce the economic impacts and increase herd health, an efficient diagnosis of diseases is necessary. The frequency, seasonal, and annual distribution of diseases that affecting the swine nervous system in Southern Brazil were determined through a retrospective study conducted from 2008 to 2018. A total of 231 pigs were evaluated, and distributed in the following phases: suckling piglets, nursery, growing, finishing, and adults. Piglets in the nursery phase were the most affected with 58.01%. Infectious diseases accounted for 87.01% (201/231) of lesions in the nervous system. Bacterial meningitis was observed in 58.87% of cases, presenting an endemic distribution, and a propensity to occur in the months of autumn/winter. The highest number of cases of porcine circovirus-2 were observed in 2008 and 2009, with a subsequent decline. Porcine circovirus, salt poisoning, and brain abscesses exhibited no association between the seasonal occurrence and annual distribution. Salt poisoning was observed more frequently in the last years of this study. Both, non-suppurative encephalomyelitis and selenium toxicosis exhibited an association between their occurrence and seasonal distribution in, the months of winter, and summer, respectively.(AU)

Brasil é o quarto maior exportador de carne suína do mundo, com sua produção concentrada na região Sul do país. Para reduzir os impactos econômicos e aumentar a saúde do rebanho, é necessário o diagnóstico eficiente das doenças. A frequência, distribuição sazonal e anual das doenças que afetam o sistema nervoso de suínos no Sul do Brasil foram determinadas através de um estudo retrospectivo no período de 2008 a 2018. Foram avaliados 231 suínos, distribuídos nas seguintes fases: maternidade, creche, crescimento, terminação e adultos. Leitões da fase de creche foram os mais afetados com 58,01%. As doenças de origem infecciosa foram responsáveis por 87,01% (201/231) das causas de lesões no sistema nervoso. Meningite bacteriana foi observada em 58,87% dos casos, apresentando distribuição endêmica, e uma tendência a ocorrer nos meses de outono/inverno. O maior número de casos de circovírus suíno foram observados em 2008 e 2009, com declínio posterior. Circovírus suíno, intoxicação por sal e os abscessos encefálicos não apresentaram associação entre a ocorrência sazonal e distribuição anual. A intoxicação por sal foi observada com maior frequência nos últimos anos deste estudo. A encefalomielite não supurativa e a intoxicação por selênio exibiram associação entre a sua ocorrência e distribuição sazonal, nos meses de inverno e verão, respectivamente.(AU)

Babesiose encefálica em cães: aspectos clínicos, epidemiológicos e patológicos / Encephalic babesiosis in dogs: clinical, epidemiological and pathological aspects

Background: Babesiosis is a hemolytic disease caused by protozoa of the genus Babesia spp. responsible for causinganemia, fever and splenomegaly in several animal species. The cerebral involvement of babesiosis in dogs manifests itselfin a hyperacute manner with neurological disorders such as motor incoordination, nystagmus, anisocoria and convulsions.In Brazil there still are no studies which describe the pathological aspects of cerebral babesiosis in dogs together withinformation relating to its clinical aspects and epidemiology. Therefore, this work had as an objective to describe sevencases of canine cerebral babesiosis, emphasizing its epidemiological, clinical and pathological aspects.Materials, Methods & Results: All the records of the necropsies performed in dogs at Animal Pathology Laboratory (LPA/HV) of the Federal University of Campina Grande (UFCG), Patos Campus, Paraíba, Northeast of Brazil were identified. In Theperiod from January 2003 to December 2017. Later, were selected all the cases of cerebral babesiosis. Were included in thestudy the cases in which was possible to detect structures that were morphologically compatible with Babesia spp. trophozoites,intra-erythrocyte in vessels, associated to the presence of lesions in the CNS. For the microscopical description all the histological slides of the cases were revised, in addition to new slides were made with the fragments stored in parafin blocks or withthe material fixed in a 10% formalin solution. The clinical course of the animals studied was hyperacute. In 4 cases, there wassudden death within 24 h, from the appearance of the first symptoms and case 7 presented an evolution of approximately 12 h.The main clinical symptoms described were vocalization, anorexia/hyporexia, jaundice and decubitus. Additionally, the mostconsistente macroscopical findings observed...

Babesiose encefálica em cães: aspectos clínicos, epidemiológicos e patológicos / Encephalic babesiosis in dogs: clinical, epidemiological and pathological aspects

Background: Babesiosis is a hemolytic disease caused by protozoa of the genus Babesia spp. responsible for causinganemia, fever and splenomegaly in several animal species. The cerebral involvement of babesiosis in dogs manifests itselfin a hyperacute manner with neurological disorders such as motor incoordination, nystagmus, anisocoria and convulsions.In Brazil there still are no studies which describe the pathological aspects of cerebral babesiosis in dogs together withinformation relating to its clinical aspects and epidemiology. Therefore, this work had as an objective to describe sevencases of canine cerebral babesiosis, emphasizing its epidemiological, clinical and pathological aspects.Materials, Methods & Results: All the records of the necropsies performed in dogs at Animal Pathology Laboratory (LPA/HV) of the Federal University of Campina Grande (UFCG), Patos Campus, Paraíba, Northeast of Brazil were identified. In Theperiod from January 2003 to December 2017. Later, were selected all the cases of cerebral babesiosis. Were included in thestudy the cases in which was possible to detect structures that were morphologically compatible with Babesia spp. trophozoites,intra-erythrocyte in vessels, associated to the presence of lesions in the CNS. For the microscopical description all the histological slides of the cases were revised, in addition to new slides were made with the fragments stored in parafin blocks or withthe material fixed in a 10% formalin solution. The clinical course of the animals studied was hyperacute. In 4 cases, there wassudden death within 24 h, from the appearance of the first symptoms and case 7 presented an evolution of approximately 12 h.The main clinical symptoms described were vocalization, anorexia/hyporexia, jaundice and decubitus. Additionally, the mostconsistente macroscopical findings observed...(AU)

Glässer's disease in swine from Northeastern Brazil / Doença de Glässer em suínos no Nordeste do Brasil

Glässer's disease is an important infectious disorder of swine caused by Haemophilus parasuis. Although well recognized in most regions of Brazil, outbreaks of Glässer's disease have not been described in Northeastern region. For this reason, three municipalities of the Pernambuco State were visited in order to identify histories of high mortality in growing and finishing pigs. The main clinical signs consisted of dry cough, apathy, fever, anorexia, paresis, muscle tremors, motor incoordination, seizures leading to high mortality rates. Nine pigs were necropsied, and fragments of the nervous system, organs of the abdominal and thoracic cavities were collected for histological analysis. In addition, lung and brain fragments were used for DNA extraction and molecular testing by real-time Polymerase Chain Reaction (PCR). Grossly, the main lesions consisted of petechial hemorrhages or ecchymosis on the skin of the face, abdomen, forelimbs, and hind limbs. The main severe lesions consisted of hydropericardium, hemopericardium, fibrinous pericarditis and pleuropneumonia. Microscopically, pericarditis, epicarditis and subepicardial myocarditis, followed by a moderate to severe multifocal pleuropneumonia, fibrinosuppurative and necrotizing were the most frequent lesions observed. Real-time PCR amplified H. parasuis infB gene in all samples analyzed, confirming the presence of this etiologic agent.(AU)

A doença de Glässer é uma importante enfermidade infecciosa de suínos causada pela bactéria Haemophilus parasuis. Embora bem reconhecida na maioria das regiões do Brasil, surtos de doença de Glässer não têm sido descritos na região Nordeste. Por este motivo, três regiões do Estado de Pernambuco foram visitadas com o objetivo de se identificar históricos de alta mortalidade em leitões e suínos em fase de terminação. Nove suínos foram necropsiados e fragmentos do sistema nervoso, órgãos das cavidades abdominal e torácica foram coletados para análise histopatológica. Além disso, fragmentos de pulmão e cérebro foram utilizados para extração de DNA e realização de teste molecular por meio da Reação em Cadeia da Polimerase (PCR) em tempo real. Os principais sinais clínicos consistiram em tosse seca, apatia, febre, anorexia, paresia, tremores musculares, incoordenação motora e convulsões levando a altas taxas de mortalidade. As lesões macroscópicas mais severas consistiam em petéquias e equimoses na pele da face, abdome, membros anteriores e posteriores, além de hidropericárdio, hemopericárdio, pericardite fibrinosa e pleuropneumonia. Microscopicamente, pericardite, epicardite e miocardite subepicárdica, seguidas de pleuropneumonia multifocal moderada a grave, fibrino-supurativa e necrosante foram as lesões mais frequentes observadas. A PCR em tempo real amplificou o gene infB de H. parasuis em todas as amostras analisadas, confirmando a presença deste agente etiológico.(AU)

Glässer's disease in swine from Northeastern Brazil / Doença de Glässer em suínos no Nordeste do Brasil

Glässer's disease is an important infectious disorder of swine caused by Haemophilus parasuis. Although well recognized in most regions of Brazil, outbreaks of Glässer's disease have not been described in Northeastern region. For this reason, three municipalities of the Pernambuco State were visited in order to identify histories of high mortality in growing and finishing pigs. The main clinical signs consisted of dry cough, apathy, fever, anorexia, paresis, muscle tremors, motor incoordination, seizures leading to high mortality rates. Nine pigs were necropsied, and fragments of the nervous system, organs of the abdominal and thoracic cavities were collected for histological analysis. In addition, lung and brain fragments were used for DNA extraction and molecular testing by real-time Polymerase Chain Reaction (PCR). Grossly, the main lesions consisted of petechial hemorrhages or ecchymosis on the skin of the face, abdomen, forelimbs, and hind limbs. The main severe lesions consisted of hydropericardium, hemopericardium, fibrinous pericarditis and pleuropneumonia. Microscopically, pericarditis, epicarditis and subepicardial myocarditis, followed by a moderate to severe multifocal pleuropneumonia, fibrinosuppurative and necrotizing were the most frequent lesions observed. Real-time PCR amplified H. parasuis infB gene in all samples analyzed, confirming the presence of this etiologic agent.(AU)

A doença de Glässer é uma importante enfermidade infecciosa de suínos causada pela bactéria Haemophilus parasuis. Embora bem reconhecida na maioria das regiões do Brasil, surtos de doença de Glässer não têm sido descritos na região Nordeste. Por este motivo, três regiões do Estado de Pernambuco foram visitadas com o objetivo de se identificar históricos de alta mortalidade em leitões e suínos em fase de terminação. Nove suínos foram necropsiados e fragmentos do sistema nervoso, órgãos das cavidades abdominal e torácica foram coletados para análise histopatológica. Além disso, fragmentos de pulmão e cérebro foram utilizados para extração de DNA e realização de teste molecular por meio da Reação em Cadeia da Polimerase (PCR) em tempo real. Os principais sinais clínicos consistiram em tosse seca, apatia, febre, anorexia, paresia, tremores musculares, incoordenação motora e convulsões levando a altas taxas de mortalidade. As lesões macroscópicas mais severas consistiam em petéquias e equimoses na pele da face, abdome, membros anteriores e posteriores, além de hidropericárdio, hemopericárdio, pericardite fibrinosa e pleuropneumonia. Microscopicamente, pericardite, epicardite e miocardite subepicárdica, seguidas de pleuropneumonia multifocal moderada a grave, fibrino-supurativa e necrosante foram as lesões mais frequentes observadas. A PCR em tempo real amplificou o gene infB de H. parasuis em todas as amostras analisadas, confirmando a presença deste agente etiológico.(AU)

Accuracy of heparin binding protein: as a new marker in prediction of acute bacterial meningitis

ABSTRACT Background: Cerebrospinal fluid bacterial culture is the gold-standard for confirmation of acute bacterial meningitis, but many cases are not culture confirmed. Antibiotics reduce the chance of a microbiological diagnosis. Objective to evaluate efficacy of Heparin-binding protein in diagnosis of bacterial meningitis. Patients: 30 patients diagnosed with acute bacterial meningitis, 30 viral meningitis, and 30 subjects with normal CSF findings. Design: Diagnosis was based on history, clinical criteria, CSF examination, latex agglutination & culture, and sensitivities and response to therapy. HBP was measured using enzyme-linked immunosorbent technique in both serum & CSF. Results: Cerebrospinal fluid HBP levels averaged 0.82 ± 0.3 ng/mL in controls, 3.3 ± 1.7 ng/mL in viral and 174.8 ± 46.7 ng/mL in bacterial meningitis. Mean serum level was 0.84 ± 0.3 ng/mL in the controls, 3.7 ± 1.9 ng/mL in viral, and 192.2 ± 56.6 ng/mL in bacterial meningitis. Both HBP levels were significantly higher in patients with bacterial meningitis. Cut-offs of 56.7 ng/ml and 45.3 ng/ml in cerebrospinal fluid & serum showed 100% overall accuracy. Even in patients who received prior antibiotics, remained elevated. Conclusion: Serum Heparin-binding protein serves as a non-invasive potential marker of acute bacterial meningitis even in partially treated cases.

Accuracy of heparin binding protein: as a new marker in prediction of acute bacterial meningitis

Background:Cerebrospinal fluid bacterial culture is the gold-standard for confirmation of acute bacterial meningitis, but many cases are not culture confirmed. Antibiotics reduce the chance of a microbiological diagnosis. Objective to evaluate efficacy of Heparin-binding protein in diagnosis of bacterial meningitis.Patients:30 patients diagnosed with acute bacterial meningitis, 30 viral meningitis, and 30 subjects with normal CSF findings.Design:Diagnosis was based on history, clinical criteria, CSF examination, latex agglutination & culture, and sensitivities and response to therapy. HBP was measured using enzyme-linked immunosorbent technique in both serum & CSF.Results:Cerebrospinal fluid HBP levels averaged 0.82 ± 0.3 ng/mL in controls, 3.3 ± 1.7 ng/mL in viral and 174.8 ± 46.7 ng/mL in bacterial meningitis. Mean serum level was 0.84 ± 0.3 ng/mL in the controls, 3.7 ± 1.9 ng/mL in viral, and 192.2 ± 56.6 ng/mL in bacterial meningitis. Both HBP levels were significantly higher in patients with bacterial meningitis. Cut-offs of 56.7 ng/ml and 45.3 ng/ml in cerebrospinal fluid & serum showed 100% overall accuracy. Even in patients who received prior antibiotics, remained elevated.Conclusion:Serum Heparin-binding protein serves as a non-invasive potential marker of acute bacterial meningitis even in partially treated cases.(AU)

Comparison of culture and PCR methods in the diagnosis of bacterial meningitis

Our aim in this study is to compare the standard culture method with the multiplex PCR and the Speed-Oligo® Bacterial Meningitis Test (SO-BMT) a hybridization-based molecular test method during the CSF examination of the patients with the pre-diagnosis of acute bacterial meningitis. For the purposes of this study, patients with acute bacterial meningitis treated at the Dicle University Medical Faculty Hospital, Infectious Diseases and Clinical Microbiology Clinic between December 2009 and April 2012 were retrospectively evaluated. The diagnosis of bacterial meningitis was made based on the clinical findings, laboratory test anomalies, CSF analysis results, and the radiological images. Growth was observed in the CSF cultures of 10 out of the 57 patients included in the study (17.5%) and Streptococcus pneumoniae was isolated in all of them. The CSF samples of 34 patients (59.6%) were positive according to the SO-BMT and S. pneumoniae was detected in 33 of the samples (97.05%), while Neisseria meningitidis was found in 1 sample (2.95%). In a total of 10 patients, S. pneumoniae was both isolated in the CSF culture and detected in the SO-BMT. The culture and the SO-BMT were negative in 23 of the CSF samples. There was no sample in which the CSF culture was positive although the SO-BMT was negative. While SO-BMT seems to be a more efficient method than bacterial culturing to determine the pathogens that most commonly cause bacterial meningitis in adults, further studies conducted on larger populations are needed in order to assess its efficiency and uses.(AU)

Suppurative infectious diseases of the central nervous system in domestic ruminants / Doenças infecciosas supurativas do sistema nervoso central de ruminantes domésticos

This study describes suppurative infectious diseases of the central nervous system (CNS) in domestic ruminants of southern Brazil. Reports from 3.274 cattle, 596 sheep and 391 goats were reviewed, of which 219 cattle, 21 sheep and 7 goats were diagnosed with central nervous system inflammatory diseases. Suppurative infectious diseases of the CNS corresponded to 54 cases (28 cattle, 19 sheep and 7 goats). The conditions observed consisted of listerial meningoencephalitis (8 sheep, 5 goats and 4 cattle), suppurative leptomeningitis and meningoencephalitis (14 cattle, 2 goats and 1 sheep), cerebral (6 cattle and 2 sheep), and spinal cord (7 sheep) abscesses, and basilar empyema (4 cattle and 1 sheep). Bacterial culture identified Listeria monocytogenes (9/54 cases), Escherichia coli (7/54 cases), Trueperella pyogenes (6/54 cases) and Proteus mirabilis (1/54 cases). All cases diagnosed as listeriosis through histopathology yielded positive immunostaining on immunohistochemistry, while 12/17 of the cases of suppurative leptomeningitis and meningoencephalitis presented positive immunostaining for Escherichia coli. Meningoencephalitis by L. monocytogenes was the main neurological disease in sheep and goats, followed by spinal cord abscesses in sheep. In cattle, leptomeningitis and suppurative meningoencephalitis was the most frequent neurological disease for the species, and E. coli was the main cause of these lesions. Basilar empyema, mainly diagnosed in cattle, is related to traumatic injuries, mainly in the nasal cavity, and the main etiologic agent was T. pyogenes.(AU)

Neste trabalho são descritas as doenças neurológicas infecciosas supurativas de ruminantes domésticos na Região Sul do Brasil. Foram avaliados laudos de 3.274 bovinos, 596 ovinos e 391 caprinos, dos quais 219 bovinos, 21 ovinos e sete caprinos foram diagnosticados como doenças inflamatórias no sistema nervoso central. As doenças neurológicas infecciosas supurativas corresponderam a 54 casos (28 bovinos, 19 ovinos e sete caprinos). As enfermidades observadas foram meningoencefalite por Listeria monocytogenes (oito ovinos, cinco caprinos e quatro bovinos), leptomeningite e meningoencefalite supurativa (14 bovinos, dois caprinos e um ovino), abscessos cerebrais (seis bovinos e dois ovinos) e medulares (sete ovinos); e empiema basilar (quatro bovinos e um ovino). Através do isolamento bacteriano foram identificados: L. monocytogenes (9/54 casos), Echerichia coli (7/54 casos), Trueperella pyogenes (6/54 casos) e Proteus mirabilis (1/54 casos). Todos os casos diagnosticados como listeriose por histologia foram positivos na imuno-histoquímica para L. monocytogenes, e 12/17 casos de leptomeningite e meningoencefalite supurativa foram positivos na imuno-histoquímica para E. coli. A meningoencefalite por L. monocytogenes representou a principal enfermidade neurológica em ovinos e caprinos, seguido dos abscessos medulares em ovinos. A leptomeningite e meningoencefalite supurativa foi a doença neurológica supurativa mais frequente em bovinos e o principal agente causador da lesão foi E. coli. O empiema basilar, frequentemente, diagnosticado em bovinos, foi relacionado com lesões traumáticas, principalmente, de cavidade nasal e o principal agente causador foi T. pyogenes.(AU)

Suppurative infectious diseases of the central nervous system in domestic ruminants / Doenças infecciosas supurativas do sistema nervoso central de ruminantes domésticos

This study describes suppurative infectious diseases of the central nervous system (CNS) in domestic ruminants of southern Brazil. Reports from 3.274 cattle, 596 sheep and 391 goats were reviewed, of which 219 cattle, 21 sheep and 7 goats were diagnosed with central nervous system inflammatory diseases. Suppurative infectious diseases of the CNS corresponded to 54 cases (28 cattle, 19 sheep and 7 goats). The conditions observed consisted of listerial meningoencephalitis (8 sheep, 5 goats and 4 cattle), suppurative leptomeningitis and meningoencephalitis (14 cattle, 2 goats and 1 sheep), cerebral (6 cattle and 2 sheep), and spinal cord (7 sheep) abscesses, and basilar empyema (4 cattle and 1 sheep). Bacterial culture identified Listeria monocytogenes (9/54 cases), Escherichia coli (7/54 cases), Trueperella pyogenes (6/54 cases) and Proteus mirabilis (1/54 cases). All cases diagnosed as listeriosis through histopathology yielded positive immunostaining on immunohistochemistry, while 12/17 of the cases of suppurative leptomeningitis and meningoencephalitis presented positive immunostaining for Escherichia coli. Meningoencephalitis by L. monocytogenes was the main neurological disease in sheep and goats, followed by spinal cord abscesses in sheep. In cattle, leptomeningitis and suppurative meningoencephalitis was the most frequent neurological disease for the species, and E. coli was the main cause of these lesions. Basilar empyema, mainly diagnosed in cattle, is related to traumatic injuries, mainly in the nasal cavity, and the main etiologic agent was T. pyogenes.(AU)

Neste trabalho são descritas as doenças neurológicas infecciosas supurativas de ruminantes domésticos na Região Sul do Brasil. Foram avaliados laudos de 3.274 bovinos, 596 ovinos e 391 caprinos, dos quais 219 bovinos, 21 ovinos e sete caprinos foram diagnosticados como doenças inflamatórias no sistema nervoso central. As doenças neurológicas infecciosas supurativas corresponderam a 54 casos (28 bovinos, 19 ovinos e sete caprinos). As enfermidades observadas foram meningoencefalite por Listeria monocytogenes (oito ovinos, cinco caprinos e quatro bovinos), leptomeningite e meningoencefalite supurativa (14 bovinos, dois caprinos e um ovino), abscessos cerebrais (seis bovinos e dois ovinos) e medulares (sete ovinos); e empiema basilar (quatro bovinos e um ovino). Através do isolamento bacteriano foram identificados: L. monocytogenes (9/54 casos), Echerichia coli (7/54 casos), Trueperella pyogenes (6/54 casos) e Proteus mirabilis (1/54 casos). Todos os casos diagnosticados como listeriose por histologia foram positivos na imuno-histoquímica para L. monocytogenes, e 12/17 casos de leptomeningite e meningoencefalite supurativa foram positivos na imuno-histoquímica para E. coli. A meningoencefalite por L. monocytogenes representou a principal enfermidade neurológica em ovinos e caprinos, seguido dos abscessos medulares em ovinos. A leptomeningite e meningoencefalite supurativa foi a doença neurológica supurativa mais frequente em bovinos e o principal agente causador da lesão foi E. coli. O empiema basilar, frequentemente, diagnosticado em bovinos, foi relacionado com lesões traumáticas, principalmente, de cavidade nasal e o principal agente causador foi T. pyogenes.(AU)

Suppurative infectious diseases of the central nervous system in domestic ruminants

ABSTRACT: This study describes suppurative infectious diseases of the central nervous system (CNS) in domestic ruminants of southern Brazil. Reports from 3.274 cattle, 596 sheep and 391 goats were reviewed, of which 219 cattle, 21 sheep and 7 goats were diagnosed with central nervous system inflammatory diseases. Suppurative infectious diseases of the CNS corresponded to 54 cases (28 cattle, 19 sheep and 7 goats). The conditions observed consisted of listerial meningoencephalitis (8 sheep, 5 goats and 4 cattle), suppurative leptomeningitis and meningoencephalitis (14 cattle, 2 goats and 1 sheep), cerebral (6 cattle and 2 sheep), and spinal cord (7 sheep) abscesses, and basilar empyema (4 cattle and 1 sheep). Bacterial culture identified Listeria monocytogenes (9/54 cases), Escherichia coli (7/54 cases), Trueperella pyogenes (6/54 cases) and Proteus mirabilis (1/54 cases). All cases diagnosed as listeriosis through histopathology yielded positive immunostaining on immunohistochemistry, while 12/17 of the cases of suppurative leptomeningitis and meningoencephalitis presented positive immunostaining for Escherichia coli. Meningoencephalitis by L. monocytogenes was the main neurological disease in sheep and goats, followed by spinal cord abscesses in sheep. In cattle, leptomeningitis and suppurative meningoencephalitis was the most frequent neurological disease for the species, and E. coli was the main cause of these lesions. Basilar empyema, mainly diagnosed in cattle, is related to traumatic injuries, mainly in the nasal cavity, and the main etiologic agent was T. pyogenes.

RESUMO: Neste trabalho são descritas as doenças neurológicas infecciosas supurativas de ruminantes domésticos na Região Sul do Brasil. Foram avaliados laudos de 3.274 bovinos, 596 ovinos e 391 caprinos, dos quais 219 bovinos, 21 ovinos e sete caprinos foram diagnosticados como doenças inflamatórias no sistema nervoso central. As doenças neurológicas infecciosas supurativas corresponderam a 54 casos (28 bovinos, 19 ovinos e sete caprinos). As enfermidades observadas foram meningoencefalite por Listeria monocytogenes (oito ovinos, cinco caprinos e quatro bovinos), leptomeningite e meningoencefalite supurativa (14 bovinos, dois caprinos e um ovino), abscessos cerebrais (seis bovinos e dois ovinos) e medulares (sete ovinos); e empiema basilar (quatro bovinos e um ovino). Através do isolamento bacteriano foram identificados: L. monocytogenes (9/54 casos), Echerichia coli (7/54 casos), Trueperella pyogenes (6/54 casos) e Proteus mirabilis (1/54 casos). Todos os casos diagnosticados como listeriose por histologia foram positivos na imuno-histoquímica para L. monocytogenes, e 12/17 casos de leptomeningite e meningoencefalite supurativa foram positivos na imuno-histoquímica para E. coli. A meningoencefalite por L. monocytogenes representou a principal enfermidade neurológica em ovinos e caprinos, seguido dos abscessos medulares em ovinos. A leptomeningite e meningoencefalite supurativa foi a doença neurológica supurativa mais frequente em bovinos e o principal agente causador da lesão foi E. coli. O empiema basilar, frequentemente, diagnosticado em bovinos, foi relacionado com lesões traumáticas, principalmente, de cavidade nasal e o principal agente causador foi T. pyogenes.

Avaliação do desempenho da PCR em tempo real para o diagnóstico de meningite por Enterovirus / Evaluation of a real-time PCR assay performance for the diagnosis of enteroviral meningitis

O gênero Enterovirus (EV) é o agente etiológico mais frequente e responsável pela ocorrência de meningite viral no mundo. O objetivo deste trabalho foi de avaliar resultados da implantação do ensaio de PCR em tempo real (RT-qPCR) para a detecção de EV. Foram selecionadas 616 amostras de líquido cefalorraquidiano (LCR) de pacientes com meningite, recebidas para realizar diagnóstico laboratorial no período de 1998-2013. Os RNAs foram extraídos diretamente do LCR pelo método QIAamp®, e o ensaio TaqMan® foi aplicado. A avaliação foi feita comparando-se resultados de RT-qPCR com os obtidos pelo método de isolamento em cultura de células. Das 616 amostras analisadas, 94 (15,2 %) foram positivas para EV no ensaio de RT-qPCR; e na cultura celular EV foi isolado de 58 (9,4 %) amostras. Valores de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo foram de 89,70 %, 92,40 %, 55,30 % e 98,90 %, respectivamente. O RT-qPCR foi ligeiramente superior à cultura viral para a detecção de EV no LCR. O RT-qPCR TaqMan® é um ensaio rápido e sensível, facilmente exeqüível e com potencial para melhorar o diagnóstico da meningite viral na rotina do laboratório de saúde pública no Estado de São Paulo.

Enterovirus (EV) genus is the most frequent etiological agent causing viral meningitis worldwide. This study aimed at evaluating the performance of real-time reverse transcription-PCR (RT-qPCR) assay for detecting EV. A total of 616 cerebrospinal fluid (CSF) samples from patients with meningitis were selected, among those received at EV diagnosis laboratory from 1998 to 2013. RNAs were directly extracted from CSF by using QIAamp® Viral RNA Mini Kit, and TaqMan® RT-qPCR assay was applied. Evaluation was made by comparing the RT-qPCR results with those found in the cell culture for viral isolation method. Of 616 analyzed samples, 94 (15.20%) were positive for EV RNA on the RT-qPCR assay; and in the cell culture EV was isolated from 58 (9.40 %) samples. The assay showed sensitivity, specificity, positive predictive value and negative predictive value of 89.70 %, 92.40 %, 55.30 % and 98.90 %, respectively. In the present study, the RT-qPCR assay was slightly superior when compared to the viral culture technique for detecting EV from CSF samples. The TaqMan® RT-qPCR assay shows to be a fast and sensitive assay, easy to perform, and it shows a potential to improve the viral meningitis diagnosis in the public health laboratory in São Paulo State.

Avaliação do desempenho da PCR em tempo real para o diagnóstico de meningite por Enterovirus / Evaluation of a real-time PCR assay performance for the diagnosis of enteroviral meningitis

O gênero Enterovirus (EV) é o agente etiológico mais frequente e responsável pela ocorrência de meningite viral no mundo. O objetivo deste trabalho foi de avaliar resultados da implantação do ensaio de PCR em tempo real (RT-qPCR) para a detecção de EV. Foram selecionadas 616 amostras de líquido cefalorraquidiano (LCR) de pacientes com meningite, recebidas para realizar diagnóstico laboratorial no período de 1998-2013. Os RNAs foram extraídos diretamente do LCR pelo método QIAamp®, e o ensaio TaqMan® foi aplicado. A avaliação foi feita comparando-se resultados de RT-qPCR com os obtidos pelo método de isolamento em cultura de células. Das 616 amostras analisadas, 94 (15,2 %) foram positivas para EV no ensaio de RT-qPCR; e na cultura celular EV foi isolado de 58 (9,4 %) amostras. Valores de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo foram de 89,70 %, 92,40 %, 55,30 % e 98,90 %, respectivamente. O RT-qPCR foi ligeiramente superior à cultura viral para a detecção de EV no LCR. O RT-qPCR TaqMan® é um ensaio rápido e sensível, facilmente exeqüível e com potencial para melhorar o diagnóstico da meningite viral na rotina do laboratório de saúde pública no Estado de São Paulo.(AU)

Enterovirus (EV) genus is the most frequent etiological agent causing viral meningitis worldwide. This study aimed at evaluating the performance of real-time reverse transcription-PCR (RT-qPCR) assay for detecting EV. A total of 616 cerebrospinal fluid (CSF) samples from patients with meningitis were selected, among those received at EV diagnosis laboratory from 1998 to 2013. RNAs were directly extracted from CSF by using QIAamp® Viral RNA Mini Kit, and TaqMan® RT-qPCR assay was applied. Evaluation was made by comparing the RT-qPCR results with those found in the cell culture for viral isolation method. Of 616 analyzed samples, 94 (15.20%) were positive for EV RNA on the RT-qPCR assay; and in the cell culture EV was isolated from 58 (9.40 %) samples. The assay showed sensitivity, specificity, positive predictive value and negative predictive value of 89.70 %, 92.40 %, 55.30 % and 98.90 %, respectively. In the present study, the RT-qPCR assay was slightly superior when compared to the viral culture technique for detecting EV from CSF samples. The TaqMan® RT-qPCR assay shows to be a fast and sensitive assay, easy to perform, and it shows a potential to improve the viral meningitis diagnosis in the public health laboratory in São Paulo State.(AU)

Malformações do sistema nervoso central de caprinos e ovinos e eimeriose cerebral e sistêmica em caprinos

Descrevem-se nesta tese três artigos científicos que abordam doenças do sistema nervoso central em caprinos e ovinos no Nordeste do Brasil. O primeiro capítulo reúne e descreve os casos de malformações do SNC em caprinos e ovinos durante o período de 2000 a 2019 de diagnóstico no Laboratório de Patologia Animal da Universidade Federal de Campina Grande. Durante o período de estudo foram recebidas 1012 caprinos e 834 ovinos para necropsia. Das quais, oito foram diagnosticados como malformações do SNC, três casos de lisencefalia com hipoplasia cerebela em caprinos, dois casos de anencefalia em caprinos, um caso de acefalia em ovino, um caso de microcefalia em ovino e um caso de diplomielia com diastematemilia em caprino. Para a maioria dos animais, a doença teve um curso clínico agudo e muito letal. O segundo capítulo descreve dois casos de lisencefalia-paquigiria e hipoplasia cerebelar em caprinos de um mesmo rebanho, filhos do mesmo reprodutor e matrizes diferentes. Os animais eram jovens e foram alimentado de forma artificial. No exame físico apresentava incoordenação e incapacidade de ficar em pé, decúbito esternal permanente, ataxia, ausência do reflexo de ameaça, tremores de intenção e nistagmo. Com evolução dos sinais clínicos os animais vieram óbito e foram necropsiados. Na necropsia, o cérebro de ambos os animais não apresentava giros nem sulcos e o cerebelo estava reduzido de tamanho. Histologicamente, em todo o córtex cerebral, a substância cinzenta estava mais espessa e a substância branca mais fina que o normal. Os neurônios estavam distribuídos de forma aleatória na substância cinzenta. No cerebelo, as camadas estavam desorganizadas, com localização heterotópica das células. Todas as lesões eram comum aos dois casos, variando apenas na intensidade. O terceiro capitulo descrever dois casos de eimeriose sistêmica em caprinos, um deles com envolvimento cerebral. Os dois caprinos eram fêmeas, com um mês de idade da raça Saanen. Os animais apresentavam quadros de diarreia evoluindo para sinais neurológicos. No exame físico de um dos animais observou-se letargia, relutância ao movimento, bruxismo, ataxia, andar em círculo, diminuição da acuidade visual, anorexia, distensão abdominal e dificuldades respiratórias. O exame parasitológico evidenciou acentuados oocistos de emeiridios. Com a evolução clinica o animal veio a óbito e foi necropsiado. Macroscopicamente as lesões eram restritas ao intestino delgado, que apresentava bastante muco e nódulos esbranquiçados multifocais e levemente elevados na mucosa. Microscopicamente observou-se leptomeningite mononuclear associada a oocistos de Eimeria intralesionais, enterite crônica acentuada e presença de acentuadas estruturas oocisticas na lamina própria, parênquima hepático e septos alveolares. As doenças do SNC são raras e esporádicas no entanto, médicos veterinários e produtores rurais devem conhecer as características clinicopatológicas dessas doença para melhor definir os controles e profilaxias.

This thesis describes three scientific articles that address central nervous system diseases in goats and sheep in Northeastern Brazil. The first chapter brings together and describes the cases of CNS malformations in goats and sheep during the period 2000 to 2019 of diagnosis at Laboratorio de Patologia Animal da Universidade Federal de Campina Grande. During the study period, 1012 goats and 834 sheep were received for necropsy, of which, eight were diagnosed as CNS malformations, three cases of lissencephaly with cerebellar hypoplasia in goats, two cases of anencephaly in goats, one case of acephaly in sheep, one case of microcephaly in sheep and one case of diplomyelia with diastematemyly in goats . For most animals, the disease had an acute and very lethal clinical course. The second chapter describes two cases of lissencephaly-pachygyria and cerebellar hypoplasia in goats from the same herd, offspring of the same sire and different breeders. The animals were young and fed from a bottle. On physical examination, they presented incoordination and inability to stand, permanent sternal decubitus, ataxia, absence of threat reflex, intention tremors and nystagmus. With evolution of clinical signs, the animals died and were necropsied. At necropsy, the brain of both animals did not show gyrus or sulci and the cerebellum was reduced in size. Histologically, throughout the cerebral cortex, the gray matter was thicker and the white matter thinner than normal. Neurons were randomly distributed in the gray matter. In the cerebellum, the layers were disorganized, with heterotopic location of the cells. All injuries were common to both cases, varying only in intensity. The third chapter describes two cases of systemic eimeriosis in goats, one of them with cerebral involvement. The two goats were female, one month old of the Saanen breed. The animals had diarrhea progressing to neurological signs. On physical examination of one of the animals, lethargy, reluctance to movement, bruxism, ataxia, walking in a circle, decreased visual acuity, anorexia, abdominal distension and respiratory difficulties were observed. The parasitological examination showed marked emeirid oocysts. With the clinical evolution, the animal died and was necropsied. Macroscopically, the lesions were restricted to the small intestine, which had a lot of mucus and whitish multifocal nodules and slightly elevated in the mucosa. Microscopically, mononuclear leptomeningitis associated with intralesional Eimeria oocysts, severe chronic enteritis and the presence of marked oocystic structures in the lamina propria, liver parenchyma and alveolar septa were observed. CNS diseases are rare and sporadic, however, veterinarians and rural producers must know the clinicopathological characteristics of these diseases to better define controls and prophylaxis.

DOENÇAS DO SISTEMA NERVOSO CENTRAL DE SUÍNOS

Doenças do sistema nervoso são frequentemente observadas na clínica de suínos e podem ser de origem infecciosa, não infecciosa ou multifatorial. As doenças infecciosas são a principal causa de morte em suínos e envolvem bactérias como Escherichia coli, Streptococcus suis (S. suis), Glaesserella (Haemophilus) parasuis e Salmonella choleraesuis. S. suis é um agente zoonótico, responsável por inflamação das meninges, válvulas cardíacas, pulmões e articulações de suínos e humanos. Nas lesões de suínos, o sorotipo 2 é o mais frequentemente isolado. Agentes virais como circovírus suíno apresentam elevado impacto na suinocultura e ocorre de forma endêmica nos rebanhos brasileiros. Foram realizados três estudos. No primeiro foi determinada, através de um estudo retrospectivo, a frequência, distribuição sazonal e anual das doenças que acometem o sistema nervoso central (SNC) de suínos no Sul do Brasil. Foram analisados 231 casos de suínos com lesão microscópica no SNC, distribuídos nas fases de maternidade, creche, crescimento, terminação e adultos. As doenças de origem infecciosa foram responsáveis por 87,01% das lesões no sistema nervoso de suínos. Leitões na fase de creche foram a categoria mais afetada (58,01%). A meningite bacteriana teve o maior número de observações no estudo, com tendência de ocorrência nos meses de outono/inverno e com caráter endêmico. Não foi observada associação sazonal ao número de diagnósticos nos casos de circovírus suíno, intoxicação por sal e abscessos encefálicos. Os casos de encefalomielite não supurativa e intoxicação por selênio tiveram maior número de observações no inverno e verão, respectivamente. No segundo estudo foram investigados agentes virais envolvidos em um surto de doença neurológica, na qual observou-se incoordenação motora, paresia e paralisia dos membros pélvicos. Nesse surto, ocorrido em uma granja no Sul do Brasil, 10 leitões com idade de 40 a 65 dias, foram submetidos ao exame post mortem. As lesões macroscópicas eram restritas a medula espinhal e caracterizadas por aumento de volume de raízes nervosas e gânglios, principalmente em região cervical e sacral. Microscopicamente as lesões eram caracterizadas por encefalomielite e ganglioneurite não supurativas. Amostras refrigeradas de SNC, líquido cefalorraquidiano e fezes foram analisadas molecularmente. A reação de polimerase em cadeia (PCR) de 10 amostras de SNC foram positivas para Teschovirus A, oito foram positivas para Sapelovirus A e sete para Enterovirus G. Mammastrovirus foi identificado em pool de fezes de leitões sadios. O terceiro manuscrito teve como objetivo descrever os aspectos clínicos, patológicos e moleculares de um surto de infecção por S. suis com elevada mortalidade. Os sinais clínicos iniciavam em torno de 10 dias pós-desmame e eram caracterizados por apatia, aumento de volume articular e relutância ao movimento. Em 24 horas, os sinais clínicos evoluíam para decúbito lateral, opistótono, nistagmo e movimentos de pedalagem. Macroscopicamente observava-se hiperemia dos vasos da leptomeninge e deposição de fibrina sobre a leptomeninge. Havia ainda espessamento de plexo coroide associado a dilatação de ventrículos laterais. Microscopicamente foi observada inflamação fibrinossupurativa em leptomeninges do cérebro e medula espinhal. Esse mesmo infiltrado era observado no plexo coroide, epêndima, raízes nervosas e no canal central da medula espinhal. A PCR identificou S. suis sorotipo 9 neste surto.

Nervous system diseases are frequently seen in the swine clinic and can be of infectious, non-infectious or multifactorial origin. Infectious diseases are the leading cause of death in pigs and involve bacteria such as Escherichia coli, Streptococcus suis (S. suis), Glaesserella (Haemophilus) parasuis and Salmonella choleraesuis. S. suis is a zoonotic agent, responsible for inflammation of the meninges, heart valves, lungs and joints of pigs and humans. In pig lesions, serotype 2 is the most frequently isolated. Viral agents such as porcine circovirus have a high impact on pig production and occur endemically in Brazilian herds. Three studies were carried out. In the first, it was determined, through a retrospective study, the frequency, seasonal and annual distribution of diseases that affect the central nervous system (CNS) of swine in southern Brazil. Two hundred thirty-one cases of pigs with lesions in the CNS were analyzed, distributed in the phases of suckling piglets, nursery, growing, finishing, and adults Infectious diseases were responsible for 87.01% of swine nervous system lesions. Piglets in the nursery phase were the most affected category (58.01%). Bacterial meningitis had the highest number of observations in the study, with a tendency to occur in the autumn/winter months and endemic character. There was no seasonal association with the number of diagnoses in cases of porcine circovirus, salt poisoning and brain abscesses. The cases of non-suppurative encephalomyelitis and selenium intoxication had the highest number of observations in winter and summer, respectively. In the second study, viral agents involved in an outbreak of neurological disease were investigated, which motor incoordination, paresis and paralysis of the posterior limbs were observed. In this outbreak, which occurred on a farm in southern Brazil, 10 piglets aged 40 to 65 days were submitted to post-mortem examination. Macroscopic lesions were restricted to the spinal cord and characterized by an increase in the volume of nerve roots and ganglia, mainly in the cervical and sacral regions. Microscopically, the lesions were characterized by encephalomyelitis and non-suppurative ganglioneuritis. Refrigerated samples of CNS, cerebrospinal fluid and feces were analyzed molecularly. The plymerase chain reaction (PCR) of 10 CNS samples were positive for Teschovirus A, eight were positive for Sapelovirus A and seven for Enterovirus G. Mammastrovirus was identified in a fecal pool of healthy piglets. The third manuscript aimed to describe the clinical, pathological and molecular aspects of an outbreak of S. suis infection with high mortality. The clinical signs started about 10 days after weaning and was characterized by acute nervous and locomotor disorders. Macroscopically, there was an increase in joint volume, hyperemia of the vessels of the leptomeninges and deposition of fibrin. There was also choroidal plexus thickening associated with dilation of lateral ventricles. Microscopically, fibrinosuppurative inflammation was observed in leptomeninges of brain and spinal cord. This same infiltrate was observed in choroid plexus, ependyma, nerve roots and in central canal of the spinal cord. PCR identified S. suis serotype 9 in this outbreak.

Epidemiological characterization and prognostic factors in patients with confirmed cerebral cryptococcosis in central Taiwan

BackgroundCryptococcal meningitis is a deadly fungal infection. This study aimed to characterize the epidemiology of cerebral cryptococcosis and to define its prognostic factors.MethodsThis cross-sectional study collected clinical information from cryptococcal meningitis patients with confirmed cerebral cryptococcosis from 2006 to 2012 at the Changhua Christian Healthcare System to access prognostic factors.ResultsFifty-nine adult cryptococcal meningitis patients were studied. The incidence at Changhua Christian Healthcare System was approximately 170 episodes per 100,000 patients within the studied period. Forty-one of 59 cryptococcal meningitis patients developed complications. Overall, 12 of 59 patients died, for a three-month mortality rate of 20.3 %. Prognostic factors positively associated with the three-month mortality included age (>55 years), patient delay, prolonged delay by the doctor in administering antifungal agent therapy, duration of intensive care unit stay, chronic lung disease, cryptococcemia, headache, altered mental status, positive blood cultures, and high cerebrospinal fluid opening pressure (>250 mm H2O).ConclusionsWe strongly recommend early administration of an antifungal agent to each suspected cryptococcal meningitis patient to decrease both the delay by doctors in administering therapy and the mortality risk. Aggressive and supportive care for severe cryptococcal meningitis patients is critical to decrease overall mortality from this infection.(AU)

Epidemiological characterization and prognostic factors in patients with confirmed cerebral cryptococcosis in central Taiwan

Background Cryptococcal meningitis is a deadly fungal infection. This study aimed to characterize the epidemiology of cerebral cryptococcosis and to define its prognostic factors. Methods This cross-sectional study collected clinical information from cryptococcal meningitis patients with confirmed cerebral cryptococcosis from 2006 to 2012 at the Changhua Christian Healthcare System to access prognostic factors. Result Fifty-nine adult cryptococcal meningitis patients were studied. The incidence at Changhua Christian Healthcare System was approximately 170 episodes per 100,000 patients within the studied period. Forty-one of 59 cryptococcal meningitis patients developed complications. Overall, 12 of 59 patients died, for a three-month mortality rate of 20.3 %. Prognostic factors positively associated with the three-month mortality included age (>55 years), patient delay, prolonged delay by the doctor in administering antifungal agent therapy, duration of intensive care unit stay, chronic lung disease, cryptococcemia, headache, altered mental status, positive blood cultures, and high cerebrospinal fluid opening pressure (>250 mm H2O). Conclusions We strongly recommend early administration of an antifungal agent to each suspected cryptococcal meningitis patient to decrease both the delay by doctors in administering therapy and the mortality risk. Aggressive and supportive care for severe cryptococcal meningitis patients is critical to decrease overall mortality from this infection.(AU)