Priapism: a three-phase concept of management according to aetiology and prognosis.

Priapism is a persistent, painful erection of the penis unassociated with sexual stimulation or desire, and detumescence does not occur following ejaculation. Prolonged pathological erections may occur and it is only when they are painful that the term priapism should be used. The erection is limited to the corpora cavernosa. Although the syndrome was named after Priapos, the mythical Greek god of fertility, impotence persists in one half of patients treated for priapism. The disease is rare; the literature consists mainly of case reports and comprehensive reviews are seldom found. Permanent sequelae cause a psychological and physical handicap and justify the present review, which is based upon recent literature as well as personal clinical experience of 15 patients. We have reviewed 170 reports describing 1400 cases of priapism and have based the analysis upon the 230 single case reports found in the literature.

Melioidosis with acute meningoencephalomyelitis in a horse.

A case of acute meningoencephalomyelitis caused by infection with Pseudomonas pseudomallei is described. Clinically there was inability to stand, opisthotonus, facial paralysis and nystagmus, rapidly progressing to violent struggling. Gross examination revealed malacia and haemorrhage in the medulla oblongata and adjacent spinal cord. Microscopically there were disseminated focal neutrophilic accumulations in affected areas, perivascular cuffing with mononuclear cells and lymphocytes and marked oedema. Intracellular bacteria were identified in sections stained by the Giemsa method.

Phycomycosis of the horse caused by Basidiobolus haptosporus.

A case of subcutaneous phycomycosis of a horse from which Basidiobolus haptosporu was isolated is described. Although some clinical signs were similar to the disease caused by Hyphomyces destruens, the gross and microscopic pathology were different in several respects. Main characteristics of the histopathology were the narrow eosinophilic sleeve around wide, frequently septate hyphae scattered throughout the affected tissue and found commonly at the advancing border of the lesion. A retrospective study of 63 cases of phycomycosis diagnosed at this laboratory since 1970 indicated a further 11 cases with similar histological features. The significance of this finding for the epidemiology and pathogenesis of equine dermal granulomas is discussed.

Melioidosis in a galah (Cacatua roseicapilla).

A second case of a natural infection of melioidosis in a native bird is described. Pseudomonas pseudomallei was isolated in pure culture from the liver, spleen and intestinal contents of a galah (Cacatua roseicapilla). The case was characterised by focal granuloma formation, often associated with necrosis, in the brain, lungs, liver, spleen and kidneys.

Metastatic phycomycosis in a horse.

Extensive subcutaneous phycomycosis of the lower hindlimb developed over a period of 8 months in a Thoroughbred filly. There was no response to treatments such as trichlorphon, sodium iodide, or etisazole. Extension of the limb lesion over the following 3 months was associated with an enlarged inguinal lymph node, which was removed. Characteristic phycomycotic lesions were observed in the node, and a fungus having the morphologic features of Hyphomyces destruens was isolated from both the limb and nodal lesions.