RESUMEN
Background: Respiratory diseases, including the multifactorial "swine respiratory disease complex," have a significant impact on swine production. Recently, a condition manifesting primarily in the trachea, known as hemorrhagic tracheitis syndrome (HTS), has been described in pigs. HTS is characterized by severe coughing and high mortality in finishing pigs. Case Description: This report presents the first case of HTS in an adult male pig from a Portuguese farm. The animal died without any previous clinical signs. Necropsy revealed significant thickening of the trachea. Fibrinous necrotic hemorrhagic tracheitis was identified through histopathological analysis, but no bacterial infectious agents were detected during microbiological examination. Conclusion: This case underscores the need for comprehensive research, including systematic necropsies and histopathological assessments, to understand the actual prevalence of the disease, elucidate the etiology, and develop effective interventions for HTS in swine productions.
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Enfermedades de los Porcinos , Traqueítis , Animales , Porcinos , Masculino , Portugal/epidemiología , Enfermedades de los Porcinos/patología , Traqueítis/veterinaria , Traqueítis/patología , Resultado Fatal , Hemorragia/veterinaria , Hemorragia/patología , Hemorragia/etiología , SíndromeRESUMEN
Generalized and fatal felid alphaherpesvirus-1 (FeHV-1) natural infection with liver involvement is rarely reported in cats, and the occurrence of herpesvirus viraemia with internal organ histologic lesions in adult cats is unknown. A 1.5-year-old cat, female, mixed breed, positive for feline leukaemia virus (FeLV) presented in a veterinary teaching hospital with sneezing, nasal discharge, anorexia, and diarrhoea after two weeks, evolving to inspiratory dyspnoea. Complete blood count and serum biochemistry analysis showed marked leukopenia and thrombocytopenia. After clinical worsening and lack of treatment response, the cat was euthanized. Pathological findings included hepatic necrosis, fibrinonecrotic tracheitis, and bronchointerstitial pneumonia. Marked amounts of coccobacillary bacteria were observed covering the necrotic tracheal and bronchial mucosa, at the cytoplasm of alveolar macrophages, and free in alveoli lumen, mimicking a primary bacterial tracheitis and pneumonia. Both lung and tracheal bacteria exhibited marked immunolabeling in anti-Escherichia coli immunohistochemistry. In addition, rare epithelial cells of bronchi contained round, eosinophilic, intranuclear viral inclusion bodies (4-7 µm) that marginate the chromatin, characteristic of FeHV-1 infection. Strong multifocal anti-FeHV-1 immunolabeling was observed in necrotic epithelial cells of the liver, trachea, and lungs. Generalized herpesvirus infection with the occurrence of acute hepatic necrosis and severe respiratory illness is a potential differential diagnosis in FeLV-positive cats with respiratory signs. The immunodepression in these cats probably favours a FeHV-1 viraemia in addition to the development of opportunistic bacterial infections, such as Escherichia coli, and it is associated with a poor outcome.
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Enfermedades de los Gatos , Traqueítis , Gatos , Femenino , Animales , Virus de la Leucemia Felina , Traqueítis/patología , Traqueítis/veterinaria , Viremia/veterinaria , Viremia/patología , Hospitales Veterinarios , Hospitales de Enseñanza , Necrosis/patología , Necrosis/veterinaria , Hígado/patologíaRESUMEN
Radiation therapy can cause radiation pneumonitis, organizing pneumonia, and lung fibrosis. Radiation-induced pseudomembranous bronchitis is a rare condition. Here, we describe a rare case each of pseudomembranous tracheobronchitis and pseudomembrane with total bronchial obstruction which developed after thoracic radiotherapy. A 50-year-old man presented paroxysmal severe cough 1 month after concurrent chemoradiotherapy for small-cell lung cancer. Bronchoscopy revealed a whitish membrane in the trachea and bronchus, which were the fields of radiation. Another 60-year-old man complained of dyspnea 7 months after radiation therapy for metastatic lymph node adenocarcinoma. Bronchoscopy demonstrated a membrane with total obstruction of right lower lobar bronchus, which was the area of radiation. The pathological findings of histological examination in both cases demonstrated radiation-induced pseudomembranous tracheobronchitis. Patients in both cases responded well to steroids and the pseudomembrane disappeared. If patients who have received thoracic radiation therapy complain of persistent cough, bronchoscopy may be helpful.
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Adenocarcinoma , Bronquitis , Neumonitis por Radiación , Traqueítis , Adenocarcinoma/complicaciones , Bronquitis/complicaciones , Bronquitis/patología , Broncoscopía/efectos adversos , Tos , Humanos , Masculino , Persona de Mediana Edad , Traqueítis/etiología , Traqueítis/patologíaRESUMEN
Autopsy practice is one of the most well-defined procedures in medicine, with strict safety instructions in place to protect medical personnel from infectious agents. However, for various reasons, these precautionary measures are often overlooked. Herein we report two autopsy cases of patients who died during the COVID-19 pandemic and the national state of emergency declared in Bulgaria. One patient was a 77-year-old female who had a medical history of a viral respiratory tract infection in February 2020 but had not undergone any test. She had multiple comorbidities including hypertension, cerebral and cardiovascular disease, and type 2 diabetes. The other patient was a 53-year-old female with morbid obesity with previous medical history of malignancy, hypertension, and type 2 diabetes. Both patients were tested for COVID-19 during the autopsy. Gross and histological findings in both patients showed respiratory tract viral infection with severe complications, incompatible with life. The first patient had serous desquamative tracheitis, hemorrhagic pneumonia, pericarditis, meningitis, and acute necrotizing encephalitis. The second patient had serous tracheitis, interstitial pneumonia, and diffuse alveolar damage and pneumocyte cytopathic effect, the alveolar septi had undergone a fibrotic change, with serous meningitis and non-necrotizing encephalitis also noted histologically. Autopsy-wise, it is always important, against the backdrop of an epidemic, to use full precautionary measures and exclude epidemic strands in cases where gross findings are suggestive of a viral infection.
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COVID-19 , Diabetes Mellitus Tipo 2 , Hipertensión , Traqueítis , Virosis , Anciano , Autopsia , COVID-19/epidemiología , Causas de Muerte , Femenino , Humanos , Pulmón/patología , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Traqueítis/patologíaAsunto(s)
Broncoscopía , Colon/diagnóstico por imagen , Colonoscopía , Enfermedad de Crohn/diagnóstico por imagen , Traqueítis/diagnóstico por imagen , Colon/patología , Tos , Enfermedad de Crohn/tratamiento farmacológico , Enfermedad de Crohn/patología , Enfermedad de Crohn/fisiopatología , Fatiga , Fármacos Gastrointestinales/uso terapéutico , Glucocorticoides/uso terapéutico , Humanos , Infliximab/uso terapéutico , Masculino , Persona de Mediana Edad , Prednisona/uso terapéutico , Tomografía Computarizada por Rayos X , Traqueítis/tratamiento farmacológico , Traqueítis/patología , Traqueítis/fisiopatología , Pliegues Vocales/patología , Pérdida de PesoRESUMEN
BACKGROUND: Tracheobronchial fungal infections (TBFI) cause life-threatening complications in immunocompromised hosts but are rarely reported. Misdiagnosis and delayed antifungal treatment are associated with the high mortality rate of patients with TBFI. OBJECTIVES: This study analyzed the bronchoscopic features of TBFI and their roles in the early diagnosis of TBFI. METHODS: The demographic, clinical, radiologic, and bronchoscopic data of 53 patients diagnosed with TBFI in our department during a 15-year period were retrospectively analyzed. RESULTS: Most of the TBFI patients were male, and mass was the most common radiologic abnormality. Obvious predilection in primary bronchus distributions was observed. 41.9% of the 43 Aspergillus tracheobronchitis (AT) patients, 70% of the 10 tracheobronchial mucormycosis (TM) patients, and 100% of the 3 endobronchial cryptococcosis patients had been misdiagnosed as having cancer on bronchoscopy because of the presence of tumor-like lesions. The most common features of AT were bronchial occlusion with a mass or mucosal necrosis, bronchial stenosis with mucosal hyperplasia, or uneven mucosa. The main descriptions of TM were bronchial stenosis or obstruction due to mucosal necrosis, uneven mucosa, or a mass. The endoscopic characteristics of endobronchial cryptococcosis included occlusion due to uneven mucosa or mass, or external compressive stricture. CONCLUSION: Immunocompromised patients and immunocompetent patients with underlying disease displaying tumor-like lesions on bronchoscopy should be differentially diagnosed with cancer. Bronchial biopsy is indispensable for the early diagnosis of TBFI.
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Neoplasias de los Bronquios/diagnóstico , Bronquitis/diagnóstico , Broncoscopía , Criptococosis/diagnóstico , Mucormicosis/diagnóstico , Aspergilosis Pulmonar/diagnóstico , Traqueítis/diagnóstico , Adulto , Anciano , Bronquitis/inmunología , Bronquitis/patología , Constricción Patológica , Criptococosis/inmunología , Criptococosis/patología , Diagnóstico Diferencial , Femenino , Humanos , Hiperplasia , Inmunocompetencia , Huésped Inmunocomprometido , Masculino , Persona de Mediana Edad , Mucormicosis/inmunología , Mucormicosis/patología , Aspergilosis Pulmonar/inmunología , Aspergilosis Pulmonar/patología , Mucosa Respiratoria/patología , Estudios Retrospectivos , Traqueítis/inmunología , Traqueítis/patologíaRESUMEN
Extinct from nature, captive young Alagoas curassows (Pauxi mitu) were found agonizing or dead with respiratory disease. Intranuclear inclusion bodies were found in the epithelia of the trachea, associated with marked necrotic tracheitis. An Aviadenovirus was isolated in chicken eggs and characterized genetically with 99% identity to the fowl Aviadenovirus A, as based on the hexon protein gene. This is the first report of respiratory disease caused by Aviadenovirus in any cracid species in Brazil, recommending for stricter biosecurity in the conservation premises. RESEARCH HIGHLIGHTS Fatal tracheitis in curassows extinct from nature was associated with Aviadenovirus A. Seven-month-old Alagoas curassows (Aves: Cracidae) died with haemorrhagic tracheitis. Aviadenovirus A with 99% identity to fowl adenovirus 1 was detected in dead curassows. Fatal tracheitis by Aviadenovirus was described in Pauxi mitu (Aves: Cracidae).
Asunto(s)
Aviadenovirus/clasificación , Galliformes/virología , Enfermedades de las Aves de Corral/diagnóstico , Traqueítis/veterinaria , Animales , Aviadenovirus/genética , Aviadenovirus/aislamiento & purificación , Brasil , Resultado Fatal , Adenovirus A Aviar/genética , Cuerpos de Inclusión Viral/virología , Cuerpos de Inclusión Intranucleares/virología , Necrosis/veterinaria , Enfermedades de las Aves de Corral/patología , Enfermedades de las Aves de Corral/virología , Tráquea/patología , Tráquea/virología , Traqueítis/diagnóstico , Traqueítis/patología , Traqueítis/virologíaRESUMEN
Hydrogen sulfide (H2S) is well known to cause irritation and damage to airway following inhalation, but the mechanism by which H2S contributes to airway toxicity is unclear. In order to assess the respiratory toxicity of H2S inhalation in chicken trachea, we investigated the change of oxidative stress parameters, tracheal tissue structure and transcriptome profiles of chicken trachea exposed to H2S for 42 days. The results showed H2S exposure induced oxidative stress and inflammation in trachea. The ultrastructural analysis revealed loss of cilia and accumulation of mucus in tracheal epithelium. Differentially expressed genes (DEGs) analysis indicated 454 genes were significantly changed, including 136 genes upregulated and 318 genes downregulated. Gene ontology and KEGG analysis showed many genes involved in response to oxidative stress, inflammatory and immune response, which might contribute to H2S-induced tracheal inflammatory injury. Among those genes, N-acetyl-L-cysteine (NAC) treatment blocked the H2S-triggered expression of FOS and IL8. Silencing FOS by siRNA inhibited H2S-induced expression of IL8. Taken together, we concluded that H2S induced oxidative stress leads to tracheal inflammation through FOS/IL8 signaling, leading to excessive mucus secretion and absence of cilia. These results provide new insights for unveiling the biological effects of H2S in vivo and in vitro.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Sulfuro de Hidrógeno/toxicidad , Interleucina-8/metabolismo , Estrés Oxidativo/efectos de los fármacos , Proteínas Proto-Oncogénicas c-fos/metabolismo , Traqueítis/metabolismo , Animales , Línea Celular , Pollos , Células Epiteliales/efectos de los fármacos , Células Epiteliales/inmunología , Células Epiteliales/ultraestructura , Humanos , Exposición por Inhalación/efectos adversos , Interleucina-8/genética , Estrés Oxidativo/genética , Estrés Oxidativo/inmunología , Proteínas Proto-Oncogénicas c-fos/genética , Transducción de Señal , Traqueítis/inmunología , Traqueítis/patología , Transcripción Genética/efectos de los fármacosRESUMEN
Ventilator-associated tracheobronchitis (VAT) might represent an intermediate process between lower respiratory tract colonization and ventilator-associated pneumonia (VAP), or even a less severe spectrum of VAP. There is an urgent need for new concepts in the arena of ventilator-associated lower respiratory tract infections. Ideally, the gold standard of care is based on prevention rather than treatment of respiratory infection. However, despite numerous and sometimes imaginative efforts to validate the benefit of these measures, most clinicians now accept that currently available measures have failed to eradicate VAP. Stopping the progression from VAT to VAP could improve patient outcomes.
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Bronquitis/diagnóstico , Neumonía Asociada al Ventilador/complicaciones , Neumonía/diagnóstico , Traqueítis/diagnóstico , Antibacterianos/uso terapéutico , Bronquitis/etiología , Bronquitis/patología , Humanos , Neumonía/etiología , Neumonía/patología , Neumonía Asociada al Ventilador/patología , Traqueítis/etiología , Traqueítis/patologíaRESUMEN
Infectious laryngotracheitis (ILT) is a contagious viral respiratory disease of great economic importance for the global poultry industry caused by Gallid herpesvirus 1 (GaHV-1). Lesions of the upper digestive tract caused by this virus have not been reported before. Two small flocks of backyard chickens experienced an outbreak of ILT, one in 2006 and the other in 2014. These birds had typical ILT lesions, characterized by a necrohemorrhagic laryngitis and tracheitis but were also affected by a severe erosive and necrotic esophagitis and pharyngitis. On microscopic examination of the esophagus and pharynx, numerous individual epithelial cells were degenerated or necrotic. Syncytial cells were present in the mucosa or sloughed in the overlying inflammatory crust, and some of these cells contained an amphophilic intranuclear viral inclusion. GaHV-1 was detected in tissues, from respiratory and digestive tracts, either by PCR, immunohistochemistry, or both diagnostic assays. This case stresses the importance for veterinarians, owners, and technicians to pay attention to different or atypical clinical manifestations of ILT given its highly contagious nature.
Asunto(s)
Esofagitis/veterinaria , Infecciones por Herpesviridae/veterinaria , Herpesvirus Gallináceo 1/aislamiento & purificación , Faringitis/veterinaria , Enfermedades de las Aves de Corral/virología , Traqueítis/veterinaria , Animales , Pollos , Esofagitis/patología , Esofagitis/virología , Infecciones por Herpesviridae/patología , Infecciones por Herpesviridae/virología , Herpesvirus Gallináceo 1/clasificación , Herpesvirus Gallináceo 1/genética , Faringitis/patología , Faringitis/virología , Enfermedades de las Aves de Corral/patología , Traqueítis/patología , Traqueítis/virologíaRESUMEN
Aspergillus tracheobronchitis (AT) is a unique form of invasive pulmonary aspergillosis, which is commonly found in patients with impaired immunity. Early-stage AT presents in a nonspecific way, both clinically and radiographically, thereby delaying diagnosis and resulting in a high mortality. Owing to impaired mucociliary clearance, previous nonfungal infections, and administration of corticosteroids, among other aspects, patients with chronic obstructive pulmonary disease (COPD) are predisposed to AT, although they are mostly immunocompetent. AT in COPD patients has not been well recognized and the condition is often misdiagnosed or missed. We herein report a case of AT diagnosed in a male with past COPD, with the features of pseudomembranous AT upon bronchoscopy. This contradicts the opinion that pseudomembranous AT is found in severely immunocompromised hosts with hematologic malignancies.
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Aspergilosis/diagnóstico , Aspergilosis/patología , Aspergillus/aislamiento & purificación , Bronquitis/patología , Traqueítis/patología , Anciano , Aspergilosis/microbiología , Bronquitis/microbiología , Broncoscopía , Humanos , Masculino , Traqueítis/microbiologíaAsunto(s)
Eosinofilia/etiología , Eosinofilia Pulmonar/etiología , Fumar/efectos adversos , Traqueítis/etiología , Enfermedad Aguda , Broncoscopía , Eosinofilia/diagnóstico por imagen , Eosinofilia/tratamiento farmacológico , Eosinofilia/patología , Glucocorticoides/uso terapéutico , Humanos , Masculino , Prednisolona/uso terapéutico , Eosinofilia Pulmonar/diagnóstico por imagen , Eosinofilia Pulmonar/tratamiento farmacológico , Eosinofilia Pulmonar/patología , Radiografía Torácica , Tomografía Computarizada por Rayos X , Traqueítis/diagnóstico por imagen , Traqueítis/tratamiento farmacológico , Traqueítis/patología , Adulto JovenRESUMEN
During a primary influenza infection, cytotoxic CD8+ T cells need to infiltrate the infected airways and engage virus-infected epithelial cells. The factors that regulate T cell motility in the infected airway tissue are not well known. To more precisely study T cell infiltration of the airways, we developed an experimental model system using the trachea as a site where live imaging can be performed. CD8+ T cell motility was dynamic with marked changes in motility on different days of the infection. In particular, significant changes in average cell velocity and confinement were evident on days 8-10 during which the T cells abruptly but transiently increase velocity on day 9. Experiments to distinguish whether infection itself or antigen affect motility revealed that it is antigen, not active infection per se that likely affects these changes as blockade of peptide/MHC resulted in increased velocity. These observations demonstrate that influenza tracheitis provides a robust experimental foundation to study molecular regulation of T cell motility during acute virus infection.
Asunto(s)
Antígenos Virales/inmunología , Virus de la Influenza A/inmunología , Gripe Humana/inmunología , Traqueítis/inmunología , Animales , Linfocitos T CD8-positivos/inmunología , Linfocitos T CD8-positivos/virología , Movimiento Celular , Modelos Animales de Enfermedad , Células Epiteliales/inmunología , Células Epiteliales/virología , Humanos , Gripe Humana/patología , Gripe Humana/virología , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Linfocitos T Citotóxicos/inmunología , Linfocitos T Citotóxicos/virología , Tráquea/inmunología , Tráquea/patología , Tráquea/virología , Traqueítis/patología , Traqueítis/virologíaRESUMEN
Pseudomembranous aspergillus tracheobronchitis is an uncommon form of invasive pulmonary aspergillosis, and it is generally seen in immunocompromised patients. We report about a mildly immunocompromised case with pseudomembranous aspergillus tracheobronchitis, which caused tracheal perforation, and Horner's syndrome. A 44-year-old female with uncontrolled diabetes mellitus, complaining of fever and dyspnea, was admitted to the hospital. She was hospitalized with community-acquired pneumonia and diabetic ketoacidosis. Insulin infusion and empirical antibiotics were firstly commenced. Bronchoscopy showed left vocal cord paralysis with extensive whitish exudative membranes covering the trachea and the main bronchi. Liposomal amphotericin B was added due to the probability of fungal etiology. Mucosal biopsy revealed aspergillus species. Second bronchoscopic examination demonstrated a large perforation in the tracheobronchial system. Despite all treatments, respiratory failure developed on the 25th day and the patient died within 2 days. Pseudomembranous aspergillus tracheobronchitis is fatal in about 78 % of all cases despite appropriate therapy. Early diagnosis and efficient antifungal therapy may improve the prognosis.
Asunto(s)
Aspergilosis/diagnóstico , Aspergillus/aislamiento & purificación , Bronquitis/etiología , Síndrome de Horner/diagnóstico , Perforación Espontánea/diagnóstico , Traqueítis/etiología , Adulto , Anfotericina B/administración & dosificación , Antifúngicos/administración & dosificación , Aspergilosis/complicaciones , Aspergilosis/microbiología , Aspergilosis/patología , Biopsia , Bronquitis/complicaciones , Bronquitis/microbiología , Bronquitis/patología , Resultado Fatal , Femenino , Síndrome de Horner/patología , Humanos , Perforación Espontánea/patología , Tráquea/patología , Traqueítis/complicaciones , Traqueítis/microbiología , Traqueítis/patologíaAsunto(s)
Infecciones por Paramyxoviridae/complicaciones , Choque Séptico/etiología , Choque Séptico/patología , Infecciones Estafilocócicas/diagnóstico , Staphylococcus aureus/aislamiento & purificación , Traqueítis/complicaciones , Traqueítis/diagnóstico , Niño , Humanos , Masculino , Metapneumovirus/aislamiento & purificación , Infecciones Estafilocócicas/patología , Traqueítis/patologíaAsunto(s)
Aspergilosis/diagnóstico por imagen , Aspergillus fumigatus/aislamiento & purificación , Bronquitis/etiología , Traqueítis/etiología , Úlcera/etiología , Adenocarcinoma/complicaciones , Adenocarcinoma/terapia , Anciano , Anfotericina B/uso terapéutico , Antifúngicos/uso terapéutico , Aspergilosis/complicaciones , Aspergilosis/tratamiento farmacológico , Aspergilosis/microbiología , Biopsia , Bronquitis/microbiología , Bronquitis/patología , Broncoscopía , Quimioradioterapia , Humanos , Huésped Inmunocomprometido , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/terapia , Masculino , Tomografía Computarizada por Rayos X , Traqueítis/microbiología , Traqueítis/patología , Úlcera/microbiología , Úlcera/patologíaRESUMEN
Formaldehyde (FA) is an environmental pollutant widely used in industry. Exposure to FA causes irritation of the respiratory mucosa and is associated with inflammation and oxidative stress in the airways. This study aimed at investigating the oxidative effects on the inflammatory response in the trachea and the diaphragm muscle (DM) of rats exposed to different concentrations of formaldehyde. Twenty-eight Fischer male rats were divided into four groups: control group (CG) exposed to the ambient air; and three groups exposed to the following formaldehyde concentrations of 1% (FA1), 5% (FA5) and 10% (FA10), respectively. The exposure occurred for twenty minutes, three times a day for five days. Oxidative stress analyses were performed by carbonyl protein, lipid peroxidation and catalase activity. The assessment of inflammatory cell influx in both organs and the mucus production in the trachea was carried out. There was an increase of lipid peroxidation in the trachea and the DM of FA1 and FA5 groups compared to the CG and FA10. The oxidation of DM proteins increased in FA10 group compared to CG, FA1 and FA5. The catalase enzyme activity in the DM was reduced in FA1, FA5 and FA10 compared to the CG. Meanwhile, there was a reduction in the enzymatic activity of FA10 compared to the CG in the trachea. The morphometric analysis in the DM demonstrated an influx of inflammatory cells in FA10 compared to the CG. In FA10 group, the tracheal epithelium showed metaplasia and ulceration. In addition, the tracheal epithelium showed more mucus deposits in FA5 compared to CG, FA1 and FA10. The results demonstrated that the exposure to formaldehyde at different concentrations in a short period of time promotes oxidative damage and inflammation in the DM and the trachea and causes metaplasia, ulceration and increased mucus at the latter.
Asunto(s)
Diafragma/patología , Contaminantes Ambientales/toxicidad , Formaldehído/toxicidad , Inflamación/inducido químicamente , Inflamación/patología , Estrés Oxidativo/efectos de los fármacos , Traqueítis/inducido químicamente , Traqueítis/patología , Animales , Catalasa/metabolismo , Diafragma/enzimología , Diafragma/metabolismo , Relación Dosis-Respuesta a Droga , Contaminantes Ambientales/análisis , Formaldehído/análisis , Inflamación/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Masculino , Moco/efectos de los fármacos , Moco/metabolismo , Carbonilación Proteica/efectos de los fármacos , Ratas , Ratas Endogámicas F344 , Sustancias Reactivas al Ácido Tiobarbitúrico/metabolismo , Traqueítis/metabolismoAsunto(s)
Aspergillus/aislamiento & purificación , Bronquitis/microbiología , Aspergilosis Pulmonar Invasiva/microbiología , Enfermedades Pulmonares Fúngicas/microbiología , Ruidos Respiratorios/diagnóstico , Traqueítis/microbiología , Adulto , Antifúngicos/administración & dosificación , Biopsia , Bronquitis/patología , Broncoscopía/métodos , Femenino , Humanos , Aspergilosis Pulmonar Invasiva/diagnóstico , Aspergilosis Pulmonar Invasiva/tratamiento farmacológico , Aspergilosis Pulmonar Invasiva/patología , Enfermedades Pulmonares Fúngicas/patología , Periodo Posparto , Enfermedades Raras , Ruidos Respiratorios/etiología , Traqueítis/patología , Voriconazol/administración & dosificaciónRESUMEN
Three wild immature green sea turtles Chelonia mydas were found alive but lethargic on the shores of the Indian River Lagoon and Gulf of Mexico in Florida, USA, and subsequently died. Necropsy findings in all 3 turtles included partial occlusion of the trachea by a mass comprised of granulomatous inflammation. Pigmented fungal hyphae were observed within the lesion by histology and were characterized by culture and sequencing of the internal transcribed spacer 2 domain of the rRNA gene and D1/D2 region of the fungal 28s gene. The dematiaceous fungus species Veronaea botryosa was isolated from the tracheal mass in 2 cases, and genetic sequence of V. botryosa was detected by polymerase chain reaction in all 3 cases. Genetic sequencing and fungal cultures also detected other dematiaceous fungi, including a Cladosporium sp., an Ochroconis sp., and a Cochliobolus sp. These cases are the first report of phaeohyphomycosis caused by V. botryosa in wild marine animals.
Asunto(s)
Feohifomicosis/veterinaria , Traqueítis/veterinaria , Tortugas/microbiología , Animales , Resultado Fatal , Femenino , Florida/epidemiología , Feohifomicosis/epidemiología , Feohifomicosis/patología , Traqueítis/epidemiología , Traqueítis/patologíaRESUMEN
Talaromyces marneffei infection involving the trachea presents as diffuse irregular nodules that grow on the tracheal lumen and/or rarely present as concurrent severe eosinophilia. Herein, we report two patients without HIV infection whose main tracheal and/or principal bronchi were involved by T. marneffei infection, which manifested as diffuse proliferative nodules. In case 1, the infection primarily affected the main trachea, resulting in structural cartilage damage, tracheal stenosis, and tracheal absence. In case 2, there were diffuse proliferative nodules in the trachea and bronchi with marked eosinophilia. The final diagnosis was made based on a positive culture from bronchiolar lavage fluid, skin, and tracheal polyps. Case 1 was administered antifungal treatment combined with surgery, but relapse occurred during a 3-month follow-up period. Case 2 was treated by intravenous liposomal amphotericin B combined with atomized inhaled liposomal amphotericin B, and he later showed improvement; there was no relapse during the 12-month period of antifungal treatment. Importantly, atomized inhaled amphotericin B antifungal treatment for T. marneffei infection has never been previously reported.