RESUMEN
Cutaneous leishmaniasis (CL) can present with various skin lesions ranging from a single ulcer to diffuse multiple nodules. Here, we present a case of a 67-year-old man with a large erythematous well-defined indurated plaque over the left face for a duration of 4 months. A slit skin smear was performed, and it was stained with Giemsa stain which showed multiple amastigotes confirming the diagnosis of CL. Oral miltefosine was started at a dose of 150 mg/day but had to be stopped after 20 days as the patient developed diarrhea, bipedal edema, and renal impairment. This case emphasizes an uncommon variant of CL and the role of systemic treatment with oral miltefosine and its associated adverse effects.
Asunto(s)
Antiprotozoarios/uso terapéutico , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/tratamiento farmacológico , Fosforilcolina/análogos & derivados , Administración Oral , Anciano , Anticuerpos Antiprotozoarios/sangre , Antiprotozoarios/administración & dosificación , Erisipeloide/tratamiento farmacológico , Erisipeloide/parasitología , Humanos , Leishmaniasis Cutánea/inmunología , Masculino , Fosforilcolina/administración & dosificación , Fosforilcolina/uso terapéuticoRESUMEN
BACKGROUND: Erysipelothrix rhusiopathiae is a widespread Gram-positive, nonsporulating rod bacterium predominantly associated with skin disease in swine and cetaceans. Cutaneous lesions have yet to be described in dogs. OBJECTIVE: To describe the clinical presentation, molecular and histopathological diagnosis, and treatment of a case of erysipeloid caused by E. rhusiopathiae in a dog. ANIMALS: A 6-month-old spayed female standard poodle dog presented with lethargy, fever, vomiting and diarrhoea. Skin lesions appeared 20 days post first examination. METHODS AND MATERIALS: Complete blood count, serum chemistry profile, urinalysis, urine culture, blood culture, computed topography, forelimb radiography, joint and cerebrospinal fluid aspiration were performed; samples were collected for skin cytological evaluation, culture and histopathological analysis. RESULTS: Blood cultures yielded Gram-positive, catalase-negative bacilli. Histopathological evaluation of skin biopsies revealed lymphoplasmacytic, neutrophilic and histiocytic perivascular and periadnexal dermatitis, and vasculitis. Cutaneous and blood PCR and sequencing of 16S rRNA identified the bacteria as E. rhusiopathiae. Clinical resolution was observed following the use of of amoxicillin/clavulanic acid and ciprofloxacin therapies. CONCLUSIONS AND CLINICAL IMPORTANCE: To the best of the authors' knowledge, this is the first confirmed case of erysipeloid caused by E. rhusiopathiae in a dog. Clinical resolution was attained with the extended use of antibiotics. After 13 months, no clinical signs had returned.
Asunto(s)
Enfermedades de los Perros/patología , Erisipeloide/veterinaria , Erysipelothrix/aislamiento & purificación , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Animales , Antibacterianos/uso terapéutico , Ciprofloxacina/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/microbiología , Perros , Erisipeloide/tratamiento farmacológico , Erisipeloide/microbiología , Erisipeloide/patología , Femenino , Complicaciones PosoperatoriasAsunto(s)
Erisipeloide/diagnóstico , Leishmaniasis Cutánea/diagnóstico , Enfermedades Nasales/diagnóstico , Adulto , Antiprotozoarios/uso terapéutico , Erisipeloide/tratamiento farmacológico , Erisipeloide/patología , Femenino , Humanos , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmaniasis Cutánea/patología , Meglumina/uso terapéutico , Antimoniato de Meglumina , Enfermedades Nasales/tratamiento farmacológico , Enfermedades Nasales/parasitología , Compuestos Organometálicos/uso terapéuticoAsunto(s)
Erisipeloide/diagnóstico , Leishmaniasis Cutánea/diagnóstico , Adulto , Antiinflamatorios no Esteroideos/efectos adversos , Antiprotozoarios/uso terapéutico , Erisipeloide/tratamiento farmacológico , Femenino , Humanos , Leishmaniasis Cutánea/tratamiento farmacológico , Meglumina/uso terapéutico , Antimoniato de Meglumina , Compuestos Organometálicos/uso terapéutico , PosmenopausiaAsunto(s)
Erisipeloide/etiología , Síndrome de Sweet/complicaciones , Anciano , Erisipeloide/diagnóstico , Erisipeloide/tratamiento farmacológico , Erisipeloide/patología , Humanos , Masculino , Prednisona/uso terapéutico , Síndrome de Sweet/diagnóstico , Síndrome de Sweet/tratamiento farmacológico , Síndrome de Sweet/patologíaRESUMEN
UNLABELLED: We report the epidemiological and clinical characteristics of the erysipeloid form of cutaneous leishmaniasis as well as its diagnostic and therapeutic challenges. CASE REPORT: A 63-year-old woman, with no medical history, presented with a one-month history of erythematous nasal swelling. The lesion appeared after an accidental trauma. Erythematous infiltrative plaque was noted on the center of the face. There were also crust formations on the traumatic region. Despite local treatment and oral antibiotherapy, there was no improvement. The diagnosis of cutaneous leishmaniasis was confirmed by positive skin smears. Histopathological examinations of a skin biopsy showed no malignancy. The patient was treated intramuscularly with 10mg/kg per day systemic meglumine antimoniate with partial regression of symptoms. CONCLUSION: The erysipeloid type is a rare and unusual presentation of cutaneous leishmaniasis that often causes late diagnosis. Diagnosis is confirmed by the demonstration of the parasite by skin smear, histopathological examination and polymerase chain reaction. There are various therapeutic options. The evolution is generally favourable.
Asunto(s)
Erisipeloide/diagnóstico , Leishmaniasis Cutánea/diagnóstico , Enfermedades Nasales/diagnóstico , Antiprotozoarios/uso terapéutico , Biopsia , Diagnóstico Diferencial , Erisipeloide/tratamiento farmacológico , Erisipeloide/epidemiología , Erisipeloide/patología , Dermatosis Facial/diagnóstico , Dermatosis Facial/tratamiento farmacológico , Dermatosis Facial/epidemiología , Dermatosis Facial/patología , Femenino , Humanos , Leishmaniasis Cutánea/tratamiento farmacológico , Leishmaniasis Cutánea/epidemiología , Leishmaniasis Cutánea/patología , Meglumina/uso terapéutico , Antimoniato de Meglumina , Persona de Mediana Edad , Nariz/lesiones , Enfermedades Nasales/tratamiento farmacológico , Enfermedades Nasales/epidemiología , Enfermedades Nasales/patología , Compuestos Organometálicos/uso terapéutico , Reacción en Cadena de la Polimerasa , Piel/patologíaRESUMEN
Erysipelothrix rhusiopathiae is the causative agent of swine erysipelas. Systemic infections caused by E. rhusiopathiae are rare, but often (90%) associated with endocarditis. In about 60% of cases endocarditis develops on normal heart valves, and despite appropriate antibiotic therapy about one-third of the patients requires valve replacement. We report the case of a housewife, who developed a mitral valve endocarditis due to E. rhusiopathiae after preparing meat for the Turkish "Festival of Sacrifice".
Asunto(s)
Emigrantes e Inmigrantes , Endocarditis Bacteriana/transmisión , Erisipeloide/transmisión , Erysipelothrix , Microbiología de Alimentos , Enfermedades de las Válvulas Cardíacas/microbiología , Vacaciones y Feriados , Carne/microbiología , Válvula Mitral , Animales , Antibacterianos/uso terapéutico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Bacteriemia/microbiología , Técnicas Bacteriológicas , Ceftriaxona/uso terapéutico , Ecocardiografía Transesofágica , Erisipeloide/diagnóstico , Erisipeloide/tratamiento farmacológico , Femenino , Traumatismos de los Dedos/complicaciones , Estudios de Seguimiento , Humanos , Infusiones Intravenosas , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Penicilina G/uso terapéutico , Ovinos , Suiza , Turquía/etnologíaRESUMEN
Erysipeloid is an occupational infection of the skin caused by traumatic penetration of Erysipelothrix rhusiopathiae. The disease is characterized clinically by an erythematous oedema, with well-defined and raised borders, usually localized to the back of one hand and/or fingers. Vesicular, bullous and erosive lesions may also be present. The lesion may be asymptomatic or accompanied by mild pruritus, pain and fever. In addition to cutaneous infection, E. rhusiopathiae can cause endocarditis, which may be acute or subacute. Endocarditis is rare and has a male predilection. It usually occurs in previously damaged valves, predominantly the aortic valve. Endocarditis does not occur in patients with valvular prostheses and is not associated with intravenous drug misuse. Diagnosis of localized erysipeloid is based on the patient's history (occupation, previous traumatic contact with infected animals or their meat) and clinical picture (typical skin lesions, lack of severe systemic features, slight laboratory abnormalities and rapid remission after treatment with penicillin or cephalosporin).
Asunto(s)
Erisipeloide , Enfermedades Profesionales , Crianza de Animales Domésticos , Animales , Diagnóstico Diferencial , Erisipeloide/tratamiento farmacológico , Erisipeloide/etiología , Erisipeloide/patología , Humanos , Control de Infecciones/normas , Enfermedades Profesionales/tratamiento farmacológico , Enfermedades Profesionales/etiología , Enfermedades Profesionales/patología , Exposición ProfesionalRESUMEN
We report a case of erysipeloid in a 73-year-old woman. The disease was characterized clinically by erythematous and erosive lesions on three fingers of the left hand. Diagnosis was made based on the patient's occupation (housewife), history of previous traumatic contact with a scorpion fish, typical inflammatory lesions located on one hand, lack of severe systemic features, mild laboratory abnormalities and rapid remission after specific treatment.
Asunto(s)
Erisipeloide/microbiología , Peces/microbiología , Dermatosis de la Mano/microbiología , Anciano , Animales , Antibacterianos/administración & dosificación , Ceftriaxona/administración & dosificación , Erisipeloide/tratamiento farmacológico , Femenino , Dedos , Dermatosis de la Mano/tratamiento farmacológico , Humanos , Inyecciones Intramusculares , Resultado del TratamientoRESUMEN
Erysipeloid is an acute, bacterial infection of traumatized skin in an individual who was in direct contact with meat or other animal products contaminated with a gram-positive bacillus Erysipelothrix rhusiopathiae. We present a case of a 50-year-old housewife whose hobby was fishing, with a reddish, tender patch on the fifth finger and dorsum of the left hand, which developed a week after she had sustained an injury while boning the fish. The patient was treated with orally administered penicillin V 1,500,000 IU t.i.d. for 7 days, with complete resolution.