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1.
Am J Dermatopathol ; 43(8): 567-573, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-33395043

RESUMO

BACKGROUND: A definite diagnosis of infectious granulomatous dermatitis (IGD) is difficult for both practicing dermatologists and dermatopathologists due to overlapping clinical and histomorphological features. We aimed to explore the role of multiplex polymerase chain reaction (PCR) for identifying a definite etiological agent for diagnosis and appropriate treatment in IGD in formalin-fixed paraffin-embedded tissue. MATERIALS AND METHODS: Sixty-two cases of IGD were included, excluding leprosy. The histochemical stains including Ziehl-Neelsen, periodic acid-Schiff, and Giemsa were performed in all cases. A multiplex PCR was designed for detection of tuberculosis (TB) (IS6110 and mpt64), fungal infections (ITS1, ITS2; ZM1, and ZM3), and leishmaniasis (kDNA). The results of histomorphology, histochemical stains, and multiplex PCR were compared. RESULTS: Among 62 cases, the sensitivity rate of PCR detection for organisms was 16.7%, 0%, 100%, 72%, 75%, and 66.7% in patients with TB, suggestive of TB, leishmaniasis, fungal infections, and granulomatous dermatitis not otherwise specified and granulomatous dermatitis suggestive of fungus, respectively. The TB PCR using IS6110 primers was negative in all cases; however, PCR using mpt64 primers was positive in 33.33% cases of scrofuloderma. The histochemical stains including Ziehl-Neelsen for acid-fast bacilli, periodic acid-Schiff for fungus, and Giemsa for Leishman-Donovan bodies showed positivity in 11.3%, 43.5%, and 3.2%, respectively. CONCLUSION: A multiplex PCR (Mycobacterium tuberculosis, Leishmania, and panfungal) is highly recommended in all cases of IGD where an etiological agent is difficult to establish by skin biopsy and histochemical stains along with a clinicopathological correlation. This will augment in appropriate treatment and will reduce empirical treatment and morbidity in such patients.


Assuntos
Dermatomicoses/diagnóstico , Granuloma/diagnóstico , Leishmaniose Cutânea/diagnóstico , Reação em Cadeia da Polimerase/métodos , Dermatopatias Infecciosas/diagnóstico , Tuberculose Cutânea/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Corantes , DNA/análise , Dermatomicoses/microbiologia , Feminino , Fungos/genética , Granuloma/microbiologia , Granuloma/parasitologia , Humanos , Índia , Lactente , Leishmania/genética , Leishmaniose Cutânea/parasitologia , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis/genética , Dermatopatias Infecciosas/microbiologia , Coloração e Rotulagem , Tuberculose Cutânea/microbiologia , Adulto Jovem
2.
Vaccine ; 38(48): 7629-7637, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33071000

RESUMO

This work demonstrates the presence of immune regulatory cells in the cervical lymph nodes draining Bacillus Calmette-Guérin (BCG) vaccinated site on the dorsum of the ear in guinea pigs. It is shown that whole cervical lymph node cells did not proliferate in vitro in the presence of soluble mycobacterial antigens (PPD or leprosin) despite being responsive to whole mycobacteria. Besides, T cells from these lymph nodes separated as a non-adherent fraction on a nylon wool column, proliferated to PPD in the presence of autologous antigen presenting cells. Interestingly, addition of as low as 20% nylon wool adherent cells to these, sharply decreased the proliferation by 83%. Looking into what cells in the adherent fraction suppressed the proliferation, it was found that neither the T cell nor the macrophage enriched cell fractions of this population individually showed suppressive effect, indicating that their co-presence was necessary for the suppression. Since BCG induced granulomas resolve much faster than granulomas induced by other mycobacteria such as Mycobacterium leprae the present experimental findings add to the existing evidence that intradermal BCG vaccination influences subsequent immune responses in the host and may further stress upon its beneficial role seen in Covid-19 patients.


Assuntos
Antígenos de Bactérias/farmacologia , Vacina BCG/farmacologia , Granuloma/imunologia , Linfonodos/imunologia , Linfócitos T/imunologia , Tuberculina/farmacologia , Animais , Células Apresentadoras de Antígenos/efeitos dos fármacos , Células Apresentadoras de Antígenos/imunologia , Células Apresentadoras de Antígenos/microbiologia , COVID-19 , Adesão Celular , Proliferação de Células , Infecções por Coronavirus/prevenção & controle , Orelha , Feminino , Granuloma/microbiologia , Cobaias , Humanos , Injeções Intradérmicas , Linfonodos/microbiologia , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/microbiologia , Masculino , Mycobacterium bovis/imunologia , Mycobacterium leprae/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Remissão Espontânea , Linfócitos T/classificação , Linfócitos T/efeitos dos fármacos , Linfócitos T/microbiologia
3.
J Infect Dis ; 216(6): 776-779, 2017 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-28934421

RESUMO

Understanding the pathogenesis of leprosy granulomas has been hindered by a paucity of tractable experimental animal models. Mycobacterium leprae, which causes leprosy, grows optimally at approximately 30°C, so we sought to model granulomatous disease in the ectothermic zebrafish. We found that noncaseating granulomas develop rapidly and eventually eradicate infection. rag1 mutant zebrafish, which lack lymphocytes, also form noncaseating granulomas with similar kinetics, but these control infection more slowly. Our findings establish the zebrafish as a facile, genetically tractable model for leprosy and reveal the interplay between innate and adaptive immune determinants mediating leprosy granuloma formation and function.


Assuntos
Modelos Animais de Doenças , Granuloma/microbiologia , Hanseníase/microbiologia , Mycobacterium leprae , Animais , Masculino , Peixe-Zebra
4.
Dermatol Ther ; 30(2)2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27891733

RESUMO

Mycobacterium w (Mw) vaccine is a heat-killed suspension derived from a nonpathogenic, cultivable, atypical mycobacterium named Mycobacterium indicus pranii. Mw immunotherapy has been reported to be efficacious as an adjunct to multidrug therapy multibacillary regimen in leprosy patients with high bacillary index. Cutaneous reactions are predominant adverse effects associated with the administration of vaccines. Cutaneous adverse effects ascribed to Mw vaccine are generally limited to the site of injection. We herein describe two cases of lepromatous leprosy who developed an unusual generalized cutaneous reaction following Mw immunotherapy. A high index of suspicion is needed to identify such manifestations in leprosy cases to avoid misdiagnosis of a relapse or a reaction and for appropriate treatment.


Assuntos
Vacinas Bacterianas/efeitos adversos , Dermatite/microbiologia , Granuloma/microbiologia , Imunoterapia/efeitos adversos , Hanseníase Virchowiana/terapia , Infecções por Mycobacterium não Tuberculosas/microbiologia , Dermatopatias Bacterianas/microbiologia , Pele/microbiologia , Adulto , Biópsia , Dermatite/diagnóstico , Granuloma/diagnóstico , Humanos , Imunoterapia/métodos , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/microbiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Pele/patologia , Dermatopatias Bacterianas/diagnóstico , Resultado do Tratamento , Adulto Jovem
5.
Dermatol Ther ; 30(2)2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27891740

RESUMO

Mycobacterium W (Mw) vaccine has been found to be effective in the treatment of leprosy and warts. Despite increasing use of Mw immunotherapy, data on its safety is limited. We report a series of eight patients who developed persisting injection site granulomatous reaction following Mw immunotherapy and were successfully treated with minocycline. Eight patients with persistent nodular swelling at the site of Mw injections were identified. Seven of them had received Mw immunotherapy for cutaneous warts and one for verrucous epidermal nevus. The lesions were firm, erythematous, succulent, non-tender nodules confined to the sites of Mw vaccine injections. In 6 of these patients nodules also involved the previously injected areas. Skin biopsy from all patients showed eosinophil rich inflammation admixed with histiocytes and lymphocytes. In addition granulomas were seen in all with septal and nodular panniculitis in four patients. Broken and granular acid-fast bacilli were identified in two cases. All patients were treated with oral minocycline 100 mg/day for a mean of 9 weeks and showed good clinical response. Granulomatous reaction is a rare but significant adverse effect of Mw immunotherapy at cosmetically and functionally imperative sites. Oral minocycline appears to be effective therapy in this situation.


Assuntos
Antibacterianos/administração & dosagem , Vacinas Bacterianas/efeitos adversos , Granuloma/tratamento farmacológico , Imunoterapia/efeitos adversos , Minociclina/administração & dosagem , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Dermatopatias Bacterianas/tratamento farmacológico , Administração Oral , Adolescente , Adulto , Vacinas Bacterianas/administração & dosagem , Esquema de Medicação , Feminino , Granuloma/diagnóstico , Granuloma/microbiologia , Humanos , Imunoterapia/métodos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/microbiologia , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/microbiologia , Fatores de Tempo , Resultado do Tratamento
6.
Indian J Pathol Microbiol ; 57(4): 574-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25308009

RESUMO

BACKGROUND: The diagnosis of tuberculosis (TB) depends on identification of the infecting organism. The diagnosis presents as a challenge due to its diverse clinical presentation and low yield of acid-fast bacilli (AFB) in tissue sections. AIM: The aim of the present study is immunohistochemical localization of tubercle bacilli or their components that persist in the granulomas, but have lost the property of staining with acid-fast stain, assess the advantage of immunostaining over conventional Ziehl-Neelsen (ZN) staining and further to study the staining pattern on immunohistochemistry (IHC). MATERIALS AND METHODS: The study population comprised 100 suspected cases of TB. Tissue sections from these were subjected to hematoxylin and eosin, ZN and IHC staining using polyclonal antibody to Mycobacterium tuberculosis followed by a comparative analysis of the results. Cases of lepromatous leprosy were used as a positive control. RESULTS: Acid-fast bacilli were identified by ZN stain in 23% of cases. IHC identified 72% cases. In the present study, IHC had higher sensitivity (95.56%) and negative predictive value (96.43%), but lower specificity (35.06%) and positive predictive value (30.56%) than ZN stain which had the sensitivity, specificity, positive predictive value and negative predictive values of 30.56%, 96.43%, 95.65% and 41.56% respectively. CONCLUSION: Immunohistochemistry is a simple and sensitive technique for localization of tubercle bacilli and their components on tissue sections. It can be easily incorporated in routine histopathology laboratory and serve as an efficient diagnostic adjunct to conventional ZN staining. This will help reduce the practice of prescribing empirical antitubercular treatment based on clinical suspicion alone.


Assuntos
Anticorpos Antibacterianos , Antígenos de Bactérias , Granuloma/microbiologia , Mycobacterium tuberculosis/imunologia , Tuberculose Pulmonar/diagnóstico , Adolescente , Adulto , Idoso , Anticorpos Antibacterianos/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Imuno-Histoquímica/métodos , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/microbiologia , Linfonodos/microbiologia , Masculino , Pessoa de Meia-Idade , Mycobacterium leprae/imunologia , Sensibilidade e Especificidade , Coloração e Rotulagem , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia , Adulto Jovem
7.
Biomed Res Int ; 2014: 623856, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24967387

RESUMO

Mycobacterium tuberculosis, Mycobacterium leprae, Mycobacterium bovis, and Mycobacterium avium subsp. paratuberculosis can survive within host macrophages in a dormant state, encased within an organized aggregate of immune host cells called granuloma. Granulomas consist of uninfected macrophages, foamy macrophages, epithelioid cells, and T lymphocytes accumulated around infected macrophages. Within granulomas, activated macrophages can fuse to form multinucleated giant cells, also called giant Langhans cells. A rim of T lymphocytes surrounds the core, and a tight coat of fibroblast closes the structure. Several in vivo models have been used to study granuloma's structure and function, but recently developed in vitro models of granuloma show potential for closer observation of the early stages of host's responses to live mycobacteria. This paper reviews culture conditions that resulted in three-dimensional granulomas, formed by the adhesion of cell populations in peripheral blood mononuclear cells infected with mycobacteria. The similarities of these models to granulomas encountered in clinical specimens include cellular composition, granulomas' cytokine production, and cell surface antigens. A reliable in vitro dormancy model may serve as a useful platform to test whether drug candidates can kill dormant mycobacteria. Novel drugs that target dormancy-specific pathways may shorten the current long, difficult treatments necessary to cure mycobacterial diseases.


Assuntos
Granuloma/imunologia , Granuloma/microbiologia , Interações Hospedeiro-Patógeno/imunologia , Infecções por Mycobacterium/imunologia , Mycobacterium/fisiologia , Animais , Granuloma/patologia , Humanos , Modelos Biológicos , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/patologia
8.
BMC Infect Dis ; 13: 279, 2013 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-23782413

RESUMO

BACKGROUND: Leprosy is a contagious and chronic systemic granulomatous disease caused by Mycobacterium leprae. In the pathogenesis of leprosy, granulomas play a key role, however, the mechanisms of the formation and maintenance of M. leprae granulomas are still not clearly understood. METHODS: To better understand the molecular physiology of M. leprae granulomas and the interaction between the bacilli and human host cells, we developed an in vitro model of human granulomas, which mimicked the in vivo granulomas of leprosy. Macrophages were differentiated from human monocytes, and infected with M. leprae, and then cultured with autologous human peripheral blood mononuclear cells (PBMCs). RESULTS: Robust granuloma-like aggregates were obtained only when the M. leprae infected macrophages were co-cultured with PBMCs. Histological examination showed M. leprae within the cytoplasmic center of the multinucleated giant cells, and these bacilli were metabolically active. Macrophages of both M1 and M2 types co-existed in the granuloma like aggregates. There was a strong relationship between the formation of granulomas and changes in the expression levels of cell surface antigens on macrophages, cytokine production and the macrophage polarization. The viability of M. leprae isolated from granulomas indicated that the formation of host cell aggregates benefited the host, but the bacilli also remained metabolically active. CONCLUSIONS: A simple in vitro model of human M. leprae granulomas was established using human monocyte-derived macrophages and PBMCs. This system may be useful to unravel the mechanisms of disease progression, and subsequently develop methods to control leprosy.


Assuntos
Granuloma/microbiologia , Hanseníase/microbiologia , Mycobacterium leprae/patogenicidade , Animais , Antígenos CD/imunologia , Antígenos CD/metabolismo , Técnicas de Cocultura , Citocinas/genética , Citocinas/metabolismo , Citometria de Fluxo , Granuloma/imunologia , Granuloma/metabolismo , Humanos , Leucócitos Mononucleares/imunologia , Macrófagos/imunologia , Macrófagos/metabolismo , Macrófagos/microbiologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Viabilidade Microbiana , Modelos Biológicos , RNA Mensageiro/genética , RNA Mensageiro/metabolismo
9.
Cell ; 152(1-2): 51-67, 2013 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-23332746

RESUMO

Differentiated cells possess a remarkable genomic plasticity that can be manipulated to reverse or change developmental commitments. Here, we show that the leprosy bacterium hijacks this property to reprogram adult Schwann cells, its preferred host niche, to a stage of progenitor/stem-like cells (pSLC) of mesenchymal trait by downregulating Schwann cell lineage/differentiation-associated genes and upregulating genes mostly of mesoderm development. Reprogramming accompanies epigenetic changes and renders infected cells highly plastic, migratory, and immunomodulatory. We provide evidence that acquisition of these properties by pSLC promotes bacterial spread by two distinct mechanisms: direct differentiation to mesenchymal tissues, including skeletal and smooth muscles, and formation of granuloma-like structures and subsequent release of bacteria-laden macrophages. These findings support a model of host cell reprogramming in which a bacterial pathogen uses the plasticity of its cellular niche for promoting dissemination of infection and provide an unexpected link between cellular reprogramming and host-pathogen interaction.


Assuntos
Interações Hospedeiro-Patógeno , Hanseníase/microbiologia , Hanseníase/patologia , Mycobacterium leprae , Células de Schwann/patologia , Células-Tronco/patologia , Animais , Movimento Celular , Sobrevivência Celular , Epigênese Genética , Transição Epitelial-Mesenquimal , Granuloma/microbiologia , Humanos , Hanseníase/genética , Macrófagos/microbiologia , Macrófagos/patologia , Camundongos , Camundongos Nus , Nervos Periféricos/patologia , Células de Schwann/microbiologia
10.
Vet Dermatol ; 24(1): 146-53.e32-3, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23331691

RESUMO

BACKGROUND: Mycobacterial granulomas of the skin and subcutis can be caused by one of a number of pathogens. This review concentrates on noncultivable species that cause diseases characterized by focal granuloma(s), namely leproid granuloma (in dogs) and feline leprosy (in cats). Clinically indistinguishable lesions can be caused by tuberculous organisms (Mycobacterium bovis and Mycobacterium microti) and members of the Mycobacterium avium complex. Rapidly growing mycobacterial species that cause infection of the subcutaneous panniculus associated with draining tracts are not discussed. Disease caused by Mycobacterium ulcerans is an important emerging differential diagnosis for ulcerated cutaneous nodules in certain localized regions. CLINICAL LESIONS: Lesions comprise one or multiple nodules in the skin/subcutis. These are generally firm and well circumscribed, and typically become denuded of hair. They may or may not ulcerate, depending on the virulence of the causal organisms and the immune response of the host. DIAGNOSIS: The most inexpensive, noninvasive means of diagnosis is by submission of methanol-fixed, Romanowsky-stained smears to a Mycobacterium Reference Laboratory after detecting negatively stained or acid-fast bacilli on cytological smears. Scrapings of material from slides usually provide sufficient mycobacterial DNA to enable identification of the causal organism using sequence analysis of amplicons after PCR using specific mycobacterial primers. THERAPY: Therapy relies upon a combination of marginal resection of easily accessible lesions and treatment using two or three drugs effective against slowly growing mycobacteria, choosing amongst rifampicin, clarithromycin, clofazimine and pradofloxacin/moxifloxacin.


Assuntos
Doenças do Gato/microbiologia , Doenças do Cão/microbiologia , Granuloma/veterinária , Infecções por Mycobacterium não Tuberculosas/veterinária , Úlcera Cutânea/veterinária , Animais , Antibacterianos/uso terapêutico , Doenças do Gato/patologia , Doenças do Gato/terapia , Gatos , Doenças do Cão/patologia , Doenças do Cão/terapia , Cães , Granuloma/microbiologia , Granuloma/patologia , Granuloma/terapia , Infecções por Mycobacterium não Tuberculosas/patologia , Infecções por Mycobacterium não Tuberculosas/terapia , Úlcera Cutânea/microbiologia , Úlcera Cutânea/patologia , Úlcera Cutânea/terapia
11.
World J Gastroenterol ; 18(35): 4855-65, 2012 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-23002357

RESUMO

Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease characterized by the immune-mediated destruction of biliary epithelial cells in small intrahepatic bile ducts. The disease is characterized by circulating antimitochondrial antibodies (AMAs) as well as disease-specific antinuclear antibodies, cholestatic liver function tests, and characteristic histological features, including granulomas. A variety of organisms are involved in granuloma formation, of which mycobacteria are the most commonly associated. This has led to the hypothesis that mycobacteria may be involved in the pathogenesis of PBC, along with other infectious agents. Additionally, AMAs are found in a subgroup of patients with mycobacterial infections, such as leprosy and pulmonary tuberculosis. Antibodies against species-specific mycobacterial proteins have been reported in patients with PBC, but it is not clear whether these antibodies are specific for the disease. In addition, data in support of the involvement of the role of molecular mimicry between mycobacterial and human mitochondrial antigens as triggers of cross-reactive immune responses leading to the loss of immunological tolerance, and the induction of pathological features have been published. Thus, antibodies against mycobacterial heat shock protein appear to cross-recognize AMA-specific autoantigens, but it is not clear whether these autoantibodies are mycobacterium-species-specific, and whether they are pathogenic or incidental. The view that mycobacteria are infectious triggers of PBC is intriguing, but the data provided so far are not conclusive.


Assuntos
Cirrose Hepática Biliar/microbiologia , Infecções por Mycobacterium/microbiologia , Mycobacterium/patogenicidade , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/imunologia , Autoanticorpos/sangue , Reações Cruzadas , Granuloma/imunologia , Granuloma/microbiologia , Humanos , Cirrose Hepática Biliar/imunologia , Mitocôndrias/imunologia , Mimetismo Molecular , Mycobacterium/imunologia , Infecções por Mycobacterium/complicações , Infecções por Mycobacterium/imunologia , Fatores de Risco
12.
Dermatol Online J ; 18(7): 3, 2012 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-22863625

RESUMO

We present a case of a 31-year-old male, a known patient with lepromatous leprosy with a type 2 lepra reaction, who presented with a slowly growing asymptomatic swelling with multiple discharging sinuses over the forehead that developed over 6 months. Smears of the serosanguinous discharge on Gram staining showed Gram-positive branching filamentous bacilli, which on culture on blood agar showed chalky-white colonies. Histology of the lesion showed suppurative granulomas with polymorphs surrounding characteristic grains. The isolate was identified as Nocardia nova by gene sequencing and the patient was started on combined antibiotic therapy that resulted in complete resolution of the infection in six months. To the best of our knowledge, this is the first report of mycetoma related to Nocardia nova in association with leprosy.


Assuntos
Granuloma/patologia , Hanseníase Virchowiana/complicações , Micetoma/patologia , Nocardiose/patologia , Dermatopatias Bacterianas/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Testa , Granuloma/tratamento farmacológico , Granuloma/microbiologia , Humanos , Hansenostáticos/uso terapêutico , Masculino , Micetoma/complicações , Micetoma/tratamento farmacológico , Nocardiose/complicações , Nocardiose/tratamento farmacológico , Dermatopatias Bacterianas/tratamento farmacológico , Dermatopatias Bacterianas/genética , Resultado do Tratamento
13.
Infect Immun ; 80(10): 3512-20, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22851747

RESUMO

SecA2 is an ATPase present in some pathogenic Gram-positive bacteria, is required for translocation of a limited set of proteins across the cytosolic membrane, and plays an important role in virulence in several bacteria, including mycobacteria that cause diseases such as tuberculosis and leprosy. However, the mechanisms by which SecA2 affects virulence are incompletely understood. To investigate whether SecA2 modulates host immune responses in vivo, we studied Mycobacterium marinum infection in two different hosts: an established zebrafish model and a recently described mouse model. Here we show that M. marinum ΔsecA2 was attenuated for virulence in both host species and SecA2 was needed for normal granuloma numbers and for optimal tumor necrosis factor alpha response in both zebrafish and mice. M. marinum ΔsecA2 was more sensitive to SDS and had unique protrusions from its cell envelope when examined by cryo-electron tomography, suggesting that SecA2 is important for bacterial cell wall integrity. These results provide evidence that SecA2 induces granulomas and is required for bacterial modulation of the host response because it affects the mycobacterial cell envelope.


Assuntos
Adenosina Trifosfatases/metabolismo , Proteínas de Bactérias/metabolismo , Granuloma/microbiologia , Proteínas de Membrana Transportadoras/metabolismo , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium marinum/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adenosina Trifosfatases/genética , Animais , Proteínas de Bactérias/genética , Células Cultivadas , Feminino , Humanos , Inflamação/metabolismo , Macrófagos , Proteínas de Membrana Transportadoras/genética , Camundongos , Camundongos Endogâmicos C57BL , Infecções por Mycobacterium não Tuberculosas/imunologia , Infecções por Mycobacterium não Tuberculosas/metabolismo , Mycobacterium marinum/genética , Mycobacterium marinum/patogenicidade , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fator de Necrose Tumoral alfa/genética , Virulência , Peixe-Zebra
14.
Int J Infect Dis ; 15(9): e620-6, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21696990

RESUMO

OBJECTIVE: To present the clinicopathological features and the practice of diagnosing infectious cutaneous granulomas in Egypt. METHODS: This study included all cases diagnosed with infectious cutaneous granuloma during the period 2004-2010 at Al-Hussein University Hospital, Cairo. Clinical and histological features were recorded, along with the positivity rate (PR) for each diagnostic method. RESULTS: This study included 233 cases (150 males and 83 females) with a mean age of 47 years. Three groups of infection were recorded: bacterial infections (73.8% Mycobacterium and 3.9% non-Mycobacterium), parasitic infestations (16.7%), and deep fungal infections (5.6%). Tuberculosis cases formed the largest granuloma group (40.8%), followed by leprosy (31.7%) and leishmaniasis (15.9%). A total of 36 cases were diagnosed by direct smear (PR 15.5%), 61 cases by skin biopsy (PR 31.0%), 84 cases by intradermal test (PR 63.6%), 26 cases by serological tests (PR 60.5%), 18 cases by tissue culture (PR 69.2%), and eight cases by PCR (PR 100%). CONCLUSIONS: Mycobacterial infections constitute the most common infectious cutaneous granulomas among Egyptians. Routine methods such as direct smear, skin biopsy, and intradermal tests remain the most commonly applied and economical methods for diagnosis in developing countries, although specific methods such as tissue culture and PCR have higher positivity rates in the diagnosis.


Assuntos
Granuloma/diagnóstico , Dermatopatias/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Infecções Bacterianas/parasitologia , Egito , Feminino , Granuloma/microbiologia , Granuloma/parasitologia , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/microbiologia , Micoses/parasitologia , Doenças Parasitárias/diagnóstico , Doenças Parasitárias/microbiologia , Doenças Parasitárias/parasitologia , Dermatopatias/microbiologia , Dermatopatias/parasitologia , Adulto Jovem
16.
PLoS Negl Trop Dis ; 4(12): e921, 2010 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-21200422

RESUMO

BACKGROUND: Leprosy is a chronic granulomatous infectious disease and is still endemic in many parts of the world. It causes disabilities which are the consequence of nerve damage. This damage is in most cases the result of immunological reactions. OBJECTIVES: To investigate the differences between a type 1 leprosy (reversal) reaction and relapse on using histopathology. METHODS: The histopathological changes in 167 biopsies from 66 leprosy patients were studied. The patients were selected when their sequential biopsies demonstrated either different patterns or maintained the same pattern of granulomatous reaction over more than two years during or after the treatment of leprosy. RESULTS: In 57 of the patients studied, a reactivation was seen which coincided with a decrease in the bacteriological index (BI), suggesting that this reactivation (reversal reaction or type 1 leprosy reaction) coincides with an effective capacity for bacteriological clearance. In nine patients, an increase of the bacteriologic index (IB) or persistence of solid bacilli occurred during the reactivation, indicating proliferative activity, suggestive of a relapse. The histopathological aspects of the granulomas were similar in both groups. CONCLUSION: Bacterioscopy provided the only means to differentiate a reversal reaction from a relapse in patients with granulomatous reactivation. The type 1 leprosy reaction may be considered as a part effective immune reconstitution (reversal, upgrading reaction) or as a mere hypersensitivity reaction (downgrading reaction) in a relapse.


Assuntos
Granuloma/microbiologia , Granuloma/patologia , Hanseníase/microbiologia , Hanseníase/patologia , Mycobacterium leprae/isolamento & purificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Granuloma/imunologia , Histocitoquímica , Humanos , Síndrome Inflamatória da Reconstituição Imune/microbiologia , Síndrome Inflamatória da Reconstituição Imune/patologia , Hanseníase/imunologia , Masculino , Microscopia , Pessoa de Meia-Idade , Mycobacterium leprae/imunologia , Recidiva
18.
Vet Ophthalmol ; 12(2): 97-101, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19261164

RESUMO

OBJECTIVE: To describe a case of a conjunctivo-corneal mass in a cat associated with acid-fast bacilli. METHODS: A 2-year-old female black European Short-Hair cat, living outdoors in a suburban environment in Italy, was referred for evaluation of a nodular, vascularized mass of 2 weeks duration. The mass involved the dorsal bulbar conjunctiva at the temporal canthus of OS and invaded the sclera and cornea. Routine ophthalmic and systemic examination, serologic testing, cytology and histology of the mass were performed. Mycobacterium specific polymerase chain reaction (PCR) of variable regions 1, 2 and 3 of the 16S ribosomal RNA (rRNA) gene was also performed. RESULTS: Neutrophils, lymphocytes, macrophages and giant cells with intracytoplasmic acid-fast bacilli were seen on cytological examination. The histological examination confirmed the presence of a granulomatous lesion with acid-fast bacilli within macrophages. Bacteriological culture of the material from the lesion was negative for Mycobacterium spp. Mycobacterium 16S rRNA gene specific PCR was positive. A diagnosis of feline leprosy was made. The owners refused any treatment, and 1 year later the lesion was still present. CONCLUSIONS: Veterinary ophthalmologists should be aware of conjunctivo-corneal leproma as an unusual symptom of leprosy.


Assuntos
Doenças do Gato/microbiologia , Doenças da Túnica Conjuntiva/microbiologia , Doenças da Túnica Conjuntiva/veterinária , Doenças da Córnea/veterinária , Granuloma/veterinária , Hanseníase Virchowiana/veterinária , Animais , Doenças do Gato/patologia , Gatos , Doenças da Túnica Conjuntiva/patologia , Doenças da Córnea/microbiologia , Doenças da Córnea/patologia , Feminino , Granuloma/microbiologia , Granuloma/patologia , Itália/epidemiologia , Hanseníase Virchowiana/patologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-18797050

RESUMO

BACKGROUND: In view of the relatively poor performance of skin smears WHO adopted a purely clinical operational classification, however the poor specificity of operational classification leads to overdiagnosis and unwarranted overtreatment while the poor sensitivity leads to underdiagnosis of multibacillary (MB) cases with inadequate treatment. Bacilli are more frequently and abundantly demonstrated in tissue sections. AIMS AND METHODS: We compared WHO classification, slit-skin smears (SSS) and demonstration of bacilli in biopsies (bacterial index of granuloma or BIG) with regards to their efficacy in correctly identifying multibacillary cases. The tests were done on 141 patients and were evaluated for their ability to diagnose true MB leprosy using detailed statistical analysis. RESULTS: A total of 76 patients were truly MB with either positive smears, BIG positivity or with a typical histology of BB, BL or LL. Amongst these 76 true-MB patients, WHO operational classification correctly identified multibacillary status in 56 (73.68%), and SSS in 43 (56.58%), while BIG correctly identified 65 (85.53%) true-MB cases. CONCLUSION: BIG was most sensitive and effective of the three methods especially in paucilesional patients. We suggest adding estimation of bacterial index of granuloma in the diagnostic workup of paucilesional patients.


Assuntos
Granuloma/microbiologia , Hanseníase/diagnóstico , Hanseníase/microbiologia , Mycobacterium leprae/isolamento & purificação , Pele/microbiologia , Organização Mundial da Saúde , Adolescente , Adulto , Feminino , Humanos , Hanseníase/classificação , Masculino , Sensibilidade e Especificidade , Adulto Jovem
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