Características epidemiológicas, clínico-patológicas e morfotintoriais de quatorze casos de nocardiose em cães / Epidemiological, clinical, pathological and morphotinctorial features of fourteen cases of nocardiosis in dogs

Este artigo descreve os aspectos epidemiológicos, clínicos, patológicos e características morfotintoriais em quatorze casos de nocardiose em cães. Para isso foi realizado um estudo retrospectivo durante o período de janeiro de 2005 a dezembro de 2015 e selecionados os casos sugestivos de nocardiose. A identificação e caracterização do agente foi realizada através de técnicas histoquímicas especiais de Metenamina nitrato de prata de Grocott (GMS), Ziehl-Neelsen modificado, coloração de Gram do tipo Brown-Brenn modificado e Giemsa. Foram afetados predominantemente filhotes e em doze casos havia associação com o vírus da cinomose canina (VCC). Os sinais clínicos variaram de alterações respiratórias, neurológicas e cutâneas, relacionadas principalmente à infecção concomitante pelo VCC. Macroscopicamente haviam áreas multifocais a coalescentes, branco-amareladas, firmes, elevadas na superfície e que se aprofundavam ao corte, por vezes com material purulento, entremeadas por áreas avermelhadas irregulares afetando principalmente pulmões, linfonodos, fígado, rins e encéfalo. As lesões cutâneas foram observadas predominantemente nas regiões cervical e inguinal e variaram de supurativas a piogranulomatosas. No exame histopatológico a lesão era caracterizada principalmente por inflamação piogranulomatosa, porém em algumas áreas havia predomínio de inflamação necrossupurativa, e frequentemente eram observados macrófagos epitelioides, formando aglomerados de forma radiada, muitas vezes lembrando pseudorosetas. Nas técnicas histoquímicas foram observadas estruturas filamentosas, ramificadas, não septadas, medindo aproximadamente 1µm de espessura, impregnadas na coloração de prata, coradas em vermelho no Ziehl-Neelsen modificado, em azul na coloração de Gram do tipo Brown-Brenn modificado e fracamente rósea pálido no Giemsa. A nocardiose deve ser considerada em animais jovens que apresentam sinais respiratórios e neurológicos progressivos, bem como em lesões cutâneas com envolvimento do subcutâneo e linfonodos regionais. Deve ser investigado ainda um provável fator predisponente, como a infecção pelo vírus da cinomose canina e hemoparasitoses. O diagnóstico foi estabelecido através do exame histopatológico baseando-se na morfologia da bactéria e suas características histoquímicas, distinguindo principalmente de outros agentes bacterianos e fúngicos, constituindo uma importante ferramenta para o diagnóstico, quando não é possível a coleta do material para cultivo e isolamento do agente.(AU)

This paper describes the epidemiological, clinical, pathological and morphotinctorial characteristics in fourteen cases of nocardiosis in dogs. A retrospective study for the period of January 2005 to December 2015 was made and selected suggestive cases of nocardiosis. The identification and characterization of the agent was performed by special histochemical techniques Methenamine silver nitrate Grocott (GMS), modified Ziehl-Neelsen, Gram stain type modified Brown-Brenn and Giemsa. Were affected predominantly young and in twelve cases were associated with canine distemper virus (CDV). Clinical signs vary from respiratory, neurological and skin changes, mainly related to concomitant infection by CDV. Macroscopically had multifocal areas coalescing, yellowish-white, firm, elevated in surface and deepened the court, sometimes with purulent material, intermixed by irregular reddened areas affecting mainly lungs, lymph nodes, liver, kidneys, and brain. The cutaneous lesions were predominantly observed in cervical and inguinal and ranged from suppurative well as pyogranulomatous. In the histopathologic examination the injury was mainly characterized by inflammation pyogranulomatous, but in some areas there was a predominance of necrossupurativa inflammation, epithelioid macrophages and were frequently observed, forming clusters radiated form, often reminding rosettes. In the histochemical techniques were observed filamentous structures, branched, non-septate, measuring approximately 1µm thick, impregnated on silver staining, stained in red on the modified Ziehl-Neelsen, in blue on Gram stain type modified Brown-Brenn and weakly pale pink in Giemsa. The nocardiosis should be considered in young animals with progressive respiratory and neurological signs, as well as skin lesions involving the subcutaneous tissue and regional lymph nodes. It should be further investigated a possible predisposing factor, such as infection by canine distemper virus and hemoparasites. The diagnosis was established by histopathological examination based on the morphology of the bacteria and their histochemical characteristics, distinguishing mainly from other bacterial and fungal agents and is an important tool for the diagnosis, when the collection of material for cultivation and isolation of the agent is not possible.(AU)

Estudio clínico y microbiológico de los micetomas observados en el Hospital de Infecciosas Francisco J. Muñiz en el período 1989-2004 / Clinical and microbiological study of mycetomas at the Muñiz Hospital of Buenos Aires between 1989 and 2004

Se presentan las características clínicas, microbiológicas y los resultados del tratamiento de 76 casos de micetomas observados en el período 1989-2004 en el Hospital Muñiz. Cuarenta y nueve fueron varones y 27 mujeres, con una edad promedio de 43,4 años. La mayor parte de los pacientes adquirió la infección en nuestro país, las provincias más afectadas fueron Santiago del Estero con 31 casos y el Chaco con 11; 8 enfermos procedían del exterior, 6 de Bolivia y 2 de Paraguay. El promedio de evolución de la enfermedad fue de 9,2 años. Las localizaciones más comunes fueron las de los miembros inferiores: pies 63, tobillos 3 y rodillas 2. Se comprobó compromiso óseo en 48 casos y adenomegalias en 5. Fueron identificados los siguientes agentes causales: Madurella grisea 29 casos, Actinomadura madurae 26, Scedosporium apiospermum 5, Nocardia brasiliensis 5, Acremoniun spp. 4 (Acremonium falciforme 2, Acremonium kiliense 1 y Acremonium recifei 1), Madurella mycetomatis 3, Fusarium solani 2, Nocardia asteroides y Streptomyces somaliensis 1 caso cada uno. Los tratamientos más frecuentemente utilizados fueron ketoconazol o itraconazol en los micetomas maduromicósicos y la asociación de cotrimoxazol con ciprofloxacina o amicacina en los micetomas actinomicéticos. La amputación del miembro afectado se realizó en 6 casos, 25 pacientes alcanzaron la remisión clínica completa y 34 presentaron mejorías importantes.

This work presents clinical, microbiological and outcome data collected from 76 patients with mycetomas at the Muñiz Hospital from 1989 to 2004. Forty-nine patients were male and 27 female; the mean age was 43.4 years. The majority of the patients acquired the infection in Argentina: the most affected provinces were Santiago del Estero with 31 cases, and Chaco with 11; 8 cases came from other countries (Bolivia 6 and Paraguay 2). The mean evolution of the disease was 9.2 years. The most frequently observed sites were: feet 63 cases, ankles 3, and knees 2. Forty-eight patients had bone lesions and 5, adenomegalies. The following etiological agents were identified: Madurella grisea 29 cases, Actinomadura madurae 26, Scedosporium apiospermum 5, Nocardia brasiliensis 5, Acremonium spp. 4 (Acremonium falciforme 2, Acremonium kiliense 1, Acremonium recifei 1), Madurella mycetomatis 3, Fusarium solani 2, Nocardia asteroides 1 and Streptomyces somaliensis 1. The main drugs used in the treatments were ketoconazole and itraconazole for maduromycotic mycetomas, and cotrimoxazole associated with ciprofloxacin or amikacin for actinomycetic mycetoma. Six patients had to undergo amputation, 25 cases achieved complete clinical remission and 34 showed remarkable improvement.

Nocardiosis en pediatría: caso clínico y revisión de la literatura / Nocardiosis in pediatrics: case report and brief review

Nocardiosis es una infección poco frecuente en pediatría, que se presenta habitual, pero no exclusivamente, en pacientes inmunocomprometidos, pudiendo producir cuadros localizados o diseminados. El diagnóstico se hace muchas veces mediante estudio histológico por visualización del microorganismo en los tejidos, dada la dificultad de confirmación bacteriológica, estudio que debe ser orientado por la sospecha clinica. Se presenta el caso de una preescolar inmunocompetente que cursó con un síndrome febril prolongado en que se descartaron múltiples causas infecciosas, tumores y mesenquimopatías; la histología de las lesiones nodulares hepato-esplénicas, aparecidas durante su estudio, confirmada con tomografía. Es importante considerar Nocardia sp entre las etiologías a estudiar en un cuadro febril de origen obscuro, ya que es posible su demostración mediante un estudio de laboratorio bien orientado frente a la sospecha clínica

Prevalence of nocardiosis and use of Modified Thayer Martin medium.

5 cases of pulmonary and 1 case of cerebral nocardiosis in the form of abscess caused by Nocardia asteroides were detected in a study of 498 clinical specimens from 428 patients of suspected tuberculosis and mycoses, giving an overall prevalence of 1.4 percent. Modified Thayer Martin Medium was useful for recovery of two isolates of N. asteroides from 100 patients. These isolates also grew on other media but on MTM, no hampering admixture of commensals occurred.

Nocardiosis pulmonar en un paciente con síndrome de inmunodeficiencia adquirida / Pulmonary nocardiosis in a male patient with AIDS

Se presenta un paciente de sexo masculino portador de una nocardiosis pulmonar asociada a SIDA. La radiografía de tórax mostró un infiltrado heterogéneo hilioapical izquierdo y se observaron signos de cavitación en la tomografía lineal. El recuento de linfocitos CD4 fue de 70/mm3. El diagnóstico se realizó por el hallazgo del agente etiológico en el esputo. Con el tratamiento con trimetropina-sulfametoxazol se logró la mejoría clínica y la negativización de los cultivos de esputo. En forma asociada presentó: sarcoma de Kaposi, candidiasis cutánea y esofagogástrica y bacteriemia por Salmonella O.S.A.

Nocardiosis pulmonar primaria: presentación de un caso

Informamos el caso de una mujer de 46 años con tos no productiva, disnea CF II, hipoxemia y pérdida de peso. Los Rx de tórax mostraban opacidades de tipo insterticial bilaterales. Se le diagnostica nocardiosis pulmonar primaria mediante cultivo del lavado broncoalveolar y de la biopsia pulmonar a cielo abierto. Presentamos los principales hallazgos clínicos, radiológicos, bacteriológicos y de patología.

A comparison of three media for isolation of Nocardia species from clinical specimens.

The study was carried out to compare the efficacy of three media namely Modified Thayer Martin medium, McClung's carbon free broth with paraffin bait and paraffin agar in isolating Nocardia species from clinical specimens. Two hundred and seventy six clinical specimens from 245 cases were studied which included cases of bronchopulmonary and systemic infections and cases of mycetoma. Paraffin agar was found to be an inexpensive and selective medium for isolation of Nocardia species when compared with Modified Thayer Martin medium and paraffin bait techniques.

Correlation between occurrence of leprosy and fossil fuels: role of fossil fuel bacteria in the origin and global epidemiology of leprosy.

On the basis of correlative data on the global distribution of leprosy, its bacteria metabolizing fossil fuels (FF), and the FF themselves, the origin of leprosy in the world as a whole, and in the leprosy-free countries, in particular, as indigenous cases, appeared to be primarily due to a soil-to-man, and secondarily due to a man-to-man infection. These findings helped to elucidate similar problems of animal leprosies and nocardial diseases.