RESUMEN
Lymph node tuberculosis is a of limited clinical suspicion form of Mycobacterium tuberculosis infection. After 15 days incubation in a cellular culture and directly from the supernatant, 11 minutes of Oxford Nanopore MinION sequencing provided a preliminary result of an antibiotic-susceptible M. tuberculosis Indo-Oceanic lineage strain. Oxford Nanopore MinION sequencing is a promising tool for optimising the laboratory diagnosis of lymph node tuberculosis.
Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Enfermedades Linfáticas/diagnóstico por imagen , Enfermedades Linfáticas/microbiología , Mycobacterium tuberculosis/genética , Tuberculosis/diagnóstico , Técnicas de Laboratorio Clínico/instrumentación , Secuenciación de Nucleótidos de Alto Rendimiento/instrumentación , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Pruebas en el Punto de Atención , Tomografía Computarizada por Rayos X , Tuberculosis/clasificación , Tuberculosis/microbiología , Adulto JovenRESUMEN
Neorickettsia helminthoeca (NH), the agent of salmon poisoning disease or canine neorickettiosis (CN), is a bacterial endosymbiont of the nematode Nanophyetus salmincola, and infections are spreading among specific fish-eating mammalians. This article describes the pathologic and immunohistochemical findings associated with spontaneous NH-induced infections in dogs from Southern Brazil. The principal pathologic findings were hypertrophy of Peyer patches and lymphadenopathy with lymphocytic proliferation, chronic interstitial pneumonia, and chronic enteritis associated with positive intralesional immunoreactivity to antigens of NH within macrophages and histiocytes. Positive immunoreactivity against canine parvovirus-2 (CPV-2) or/and canine distemper virus was not detected in the evaluated intestinal segments or in the samples from the cerebellum and lungs, respectively, from the dogs evaluated. These findings demonstrated that NH was involved in the enteric, pulmonary, and lymphoid lesions herein described, and provide additional information to confirm the occurrence of this bacterial endosymbiont within this geographical location. It is proposed that chronic pneumonia should be considered as a pathologic manifestation of NH-induced infections. Additionally, our results show that the occurrences of CN seem to be underdiagnosed in Southern Brazil due to the confusion with the incidence of CPV-2.
Asunto(s)
Infecciones por Anaplasmataceae/veterinaria , Enfermedades de los Perros/microbiología , Gastroenteritis/veterinaria , Enfermedades Pulmonares/veterinaria , Enfermedades Linfáticas/veterinaria , Neorickettsia/aislamiento & purificación , Animales , Anticuerpos Antibacterianos/sangre , Anticuerpos Antivirales/sangre , Antígenos Bacterianos/inmunología , Brasil/epidemiología , Reacciones Cruzadas , Virus del Moquillo Canino/inmunología , Enfermedades de los Perros/epidemiología , Enfermedades de los Perros/inmunología , Perros , Femenino , Gastroenteritis/epidemiología , Gastroenteritis/inmunología , Gastroenteritis/microbiología , Inmunohistoquímica , Enfermedades Pulmonares/epidemiología , Enfermedades Pulmonares/inmunología , Enfermedades Pulmonares/microbiología , Enfermedades Linfáticas/epidemiología , Enfermedades Linfáticas/inmunología , Enfermedades Linfáticas/microbiología , Masculino , Neorickettsia/inmunología , Parvovirus Canino/inmunología , SimbiosisRESUMEN
The objective is to study the clinical profile of tuberculosis (TB) in chronic kidney disease (CKD). This is retrospective study of CKD patients who were diagnosed to have TB over a period of seven years at a tertiary care hospital. TB was diagnosed in 115 patients with an incidence of 4200/100,000. Mean age of the patients was 46.9 ± 16 years. Sixty-two patients (53.9%) were male. Causes of CKD were diabetic nephropathy and hypertension in 11.3% each, chronic glomerulonephritis in 31.3%, chronic tubulointerstitial nephritis in 39.1%, autosomal dominant polycystic kidney disease, and post-renal transplant CKD in 3.5% each. About 68.7% of patients with TB had advanced CKD stage of 4-5D, whereas 31.3% of patients had early CKD stage 1-3. Twenty percent of patients were on dialysis. Three-fourths of the patients had extrapulmonary TB. Pleuropulmonary (41.8%), kidney and urinary tract (20%), and abdomen and lymph node (13% each) were the most common sites for TB. The main clinical presentation of TB was: fever/pyrexia of unknown origin in 24.3%, constitutional symptoms of anorexia, fever, night sweats, and weight loss in 27.8%, abnormal chest radiograph in 31.2%, ascites/peritonitis in 13.9%, pleural effusion in 25.2%, lymphadenopathy in 20%, and sterile pyuria/hematuria/chronic pyelonephritis in 13%. Microbiological and/or histopathological diagnoses were made in 45.2% and in the other 54.8%, diagnosis of TB was made on clinical grounds. Adverse effects of anti-TB drugs were seen in 9.6% of patients. Ninety-three percent completed the treatment and survived. Eight patients (7%), all in CKD stage 5D, died. The incidence of TB was high among CKD stages 4 and 5 and in those receiving dialysis. Extrapulmonary disease such as pleuropulmonary, renal, peritoneal, and lymph node were the common forms of TB.
Asunto(s)
Fallo Renal Crónico/epidemiología , Enfermedades Linfáticas/epidemiología , Enfermedades Peritoneales/epidemiología , Enfermedades Pleurales/epidemiología , Tuberculosis Pulmonar/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anorexia/microbiología , Antituberculosos/uso terapéutico , Comorbilidad , Enfermedades Endémicas , Femenino , Fiebre de Origen Desconocido/microbiología , Humanos , Incidencia , India/epidemiología , Fallo Renal Crónico/etiología , Fallo Renal Crónico/fisiopatología , Enfermedades Linfáticas/complicaciones , Enfermedades Linfáticas/microbiología , Masculino , Persona de Mediana Edad , Enfermedades Peritoneales/complicaciones , Enfermedades Peritoneales/microbiología , Enfermedades Pleurales/complicaciones , Enfermedades Pleurales/microbiología , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico , Pérdida de Peso , Adulto JovenRESUMEN
Cutaneous nocardiosis is an infrequent infection which has been increasingly reported in immunocompromised patients. Although trimethoprim-sulfamethoxazole is considered to be the agent of choice for treatment of nocardiosis, newer antimicrobials such as tigecycline have been proven to be effective in vitro, as well. We report the first case of primary cutaneous nocardiosis in a renal transplant recipient having corresponded well to treatment with tigecycline.
Asunto(s)
Antibacterianos/uso terapéutico , Trasplante de Riñón/efectos adversos , Enfermedades Linfáticas/tratamiento farmacológico , Nocardiosis/tratamiento farmacológico , Infecciones Oportunistas/tratamiento farmacológico , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Tigeciclina/uso terapéutico , Humanos , Huésped Inmunocomprometido , Inmunosupresores/efectos adversos , Enfermedades Linfáticas/diagnóstico , Enfermedades Linfáticas/inmunología , Enfermedades Linfáticas/microbiología , Masculino , Persona de Mediana Edad , Nocardiosis/diagnóstico , Nocardiosis/inmunología , Nocardiosis/microbiología , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/inmunología , Infecciones Oportunistas/microbiología , Enfermedades Cutáneas Bacterianas/diagnóstico , Enfermedades Cutáneas Bacterianas/inmunología , Enfermedades Cutáneas Bacterianas/microbiología , Resultado del TratamientoAsunto(s)
Absceso/diagnóstico , Infecciones por Bacteroidaceae/diagnóstico , Coinfección/diagnóstico , Fiebre/microbiología , Enfermedades Linfáticas/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Timo/microbiología , Absceso/complicaciones , Absceso/microbiología , Infecciones por Bacteroidaceae/complicaciones , Coinfección/complicaciones , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Enfermedades Linfáticas/complicaciones , Enfermedades Linfáticas/microbiología , Prevotella/aislamiento & purificación , Infecciones Estreptocócicas/complicaciones , Streptococcus anginosus/aislamiento & purificación , Streptococcus mitis/aislamiento & purificaciónAsunto(s)
Enfermedades Linfáticas/microbiología , Nocardiosis/microbiología , Nocardia/aislamiento & purificación , Enfermedades Cutáneas Bacterianas/microbiología , Piel/microbiología , Anciano , Antibacterianos/uso terapéutico , Biopsia , Humanos , Enfermedades Linfáticas/tratamiento farmacológico , Enfermedades Linfáticas/patología , Masculino , Nocardia/clasificación , Nocardia/efectos de los fármacos , Nocardia/genética , Nocardiosis/tratamiento farmacológico , Nocardiosis/patología , Ribotipificación , Piel/efectos de los fármacos , Piel/patología , Enfermedades Cutáneas Bacterianas/tratamiento farmacológico , Enfermedades Cutáneas Bacterianas/patologíaRESUMEN
No disponible
Asunto(s)
Humanos , Enfermedad por Rasguño de Gato/epidemiología , Bartonella henselae/patogenicidad , Enfermedades Linfáticas/microbiología , Azitromicina/uso terapéuticoRESUMEN
Generalized lymphatic anomaly is a multifocal lymphatic malformation that affects the skin, thoracic viscera, and bones. A 3year-old Japanese boy presented with right facial palsy due to cystic tumors in the ipsilateral petrous bone. Pericardial effusion had been found incidentally and generalized lymphatic anomaly had been diagnosed by pericardial biopsy. Petrous bone tumor had been followed up without surgery. At the age of seven he presented with fever and disturbance of consciousness, and bacterial meningitis due to Streptococcus pneumoniae was diagnosed. Computed tomography and magnetic resonance imaging revealed middle skull-base leakage due to lymphatic malformation. He achieved complete recovery under intensive care with antibiotics and mechanical ventilation. One year later, he presented with multiple cystic formations in bilateral femora. At the 3-year follow-up, the patient was healthy with no recurrence of meningitis and osteolytic lesions in the femora were non-progressive. Computed tomography and magnetic resonance imaging are useful for demonstration of skull-base leakage by generalized lymphatic anomaly. We should consider generalized lymphatic anomaly among the differential diagnoses for skull-base leakage.
Asunto(s)
Enfermedades Linfáticas/complicaciones , Enfermedades Linfáticas/microbiología , Tejido Linfoide/anomalías , Meningitis Bacterianas/etiología , Base del Cráneo/anomalías , Antibacterianos/uso terapéutico , Preescolar , Humanos , Estudios Longitudinales , Enfermedades Linfáticas/patología , Enfermedades Linfáticas/terapia , Tejido Linfoide/patología , Imagen por Resonancia Magnética , Masculino , Meningitis Bacterianas/tratamiento farmacológico , Respiración Artificial/métodos , Base del Cráneo/diagnóstico por imagen , Tomógrafos Computarizados por Rayos XRESUMEN
Sporotrichosis is a common subcutaneous mycosis in Latin America, produced by dimorphic fungi belong to Sporothrix schenckii complex of cryptic species. Infection is acquired by traumatic inoculation with contaminated organic material. Host immune response includes polymorphonuclear neutrophils chemotaxis and release of granular components. Lactoferrin is a protein member of the transferrin family of iron-binding proteins, present inside polymorphonuclear granular structure, and has been reported to affect growth and development of infectious agents, including fungal organisms. Nevertheless, lactoferrin expression in sporotrichosis infections has not been reported yet. OBJECTIVE: To determine the expression of lactoferrin using immunohistochemical staining in sporotrichosis human infection. MATERIAL AND METHODS: The dermatology department's files during a period of five years were reviewed; cases with a diagnosis of sporotrichosis were selected and lactoferrin immunostaining was performed when enough biological material was available. RESULTS: Three cases with a diagnosis of sporotrichosis and adequate biological material on paraffin block were identified. In all cases, lactoferrin immunostaining was positive around yeast cell.
Asunto(s)
Lactoferrina/metabolismo , Enfermedades Linfáticas/metabolismo , Esporotricosis/metabolismo , Linfocitos T CD4-Positivos , Humanos , Inmunidad Celular , Lactoferrina/análisis , Enfermedades Linfáticas/inmunología , Enfermedades Linfáticas/microbiología , Sporothrix , Esporotricosis/inmunología , Esporotricosis/transmisiónRESUMEN
Lymphadenopathy and fever that developed in a woman in Tbilisi, Georgia, most likely were caused by a ratborne Bartonella strain related B. tribocorum and B. elizabethae. The finding suggests that this Bartonella strain could be spread by infected rats and represents a potential human risk.
Asunto(s)
Infecciones por Bartonella/diagnóstico , Infecciones por Bartonella/microbiología , Bartonella , Enfermedades Linfáticas/diagnóstico , Enfermedades Linfáticas/microbiología , Adolescente , Animales , Bartonella/clasificación , Bartonella/genética , Infecciones por Bartonella/transmisión , Femenino , Georgia (República) , Humanos , RatasRESUMEN
Disseminated nontuberculous mycobacteria (NTM) infection with concurrent IgG4-related lymphadenopathy has not been reported. We described a patient with neutralizing autoantibodies to interferon-gamma (IFN-γ) and elevated levels of serum IgG4 presenting with generalized lymphadenopathy and reactive dermatosis. Histologically, lymph nodes (LNs) showed effaced nodal architecture with polymorphic infiltrates, mimicking angioimmunoblastic T-cell lymphoma. Both the absolute number and the ratio of IgG4+ plasma cells to IgG+ plasma cells were increased. Mycobacterium abscessus was isolated from cultures of LNs, and demonstrated by polymerase chain reaction-restriction fragment length polymorphism. The skin biopsy showed neutrophilic dermatosis, consistent with Sweet syndrome. The patient met the criteria of both adult-onset immunodeficiency syndrome and IgG4-related lymphadenopathy. This case provides evidence of disseminated NTM infection with concurrent type III IgG4-related lymphadenopathy in the patient with anti-IFN-γ autoantibodies.
Asunto(s)
Inmunoglobulina G/sangre , Enfermedades Linfáticas/microbiología , Infecciones por Mycobacterium no Tuberculosas/microbiología , Micobacterias no Tuberculosas/aislamiento & purificación , Pueblo Asiatico , Autoanticuerpos/sangre , Humanos , Inmunohistoquímica , Ganglios Linfáticos/microbiología , Enfermedades Linfáticas/sangre , Linfoma de Células T/metabolismo , Masculino , Persona de Mediana Edad , Infecciones por Mycobacterium no Tuberculosas/sangre , Micobacterias no Tuberculosas/crecimiento & desarrollo , Células Plasmáticas/metabolismo , Enfermedades de la Piel/sangre , Enfermedades de la Piel/microbiología , TaiwánRESUMEN
Cryptococcosis is a serious infection, possibly lethal, of worldwide distribution. It mainly affects immunosuppressed patients resulting with pulmonary and/or meningeal involvements or disseminated infections. Due to the rarity of visceral and osseous infections, and to the absence of specific clinical symptoms, this diagnosis is often deferred. Resulting of diagnostic errors, samples are often directed to the department of pathology and more rarely to the department of mycology. Histopathological examination appears crucial, highlighting encapsulated yeasts with alcian blue staining. Once the diagnosis is performed, an appropriate antifungal therapy must be quickly introduced because these infections are associated with a high mortality rate. The aim of our work was to report five extra-cerebral and extra-pulmonary cryptococcosis cases, to describe their histopathological features, to evoke diagnostic techniques and to discuss the differential diagnoses.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/patología , Criptococosis/patología , Dermatomicosis/patología , Discitis/patología , Absceso Hepático/patología , Enfermedades Linfáticas/patología , Sacro/patología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Adulto , Biopsia , Criptococosis/complicaciones , Cryptococcus/aislamiento & purificación , Dermatomicosis/microbiología , Discitis/microbiología , Hepatitis B Crónica/complicaciones , Humanos , Absceso Hepático/microbiología , Enfermedades Linfáticas/microbiología , Masculino , Meningitis Criptocócica/complicaciones , Especificidad de Órganos , Estudios Retrospectivos , Sacro/microbiologíaRESUMEN
A 75-year-old man with interstitial pneumonia and enlarged mediastinal lymph nodes underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). He developed a high-grade fever seven days after EBUS-TBNA was performed; laboratory and radiologic findings showed intense inflammatory reactions, with swelling of the mediastinal lymph nodes on chest computed tomography. Mediastinal lymph node abscess was diagnosed, and it worsened in spite of systemic antibacterial treatment. Surgical treatment using a median sternotomy was performed, and the cultivation of surgically obtained mediastinal lymph node abscess fluid revealed Streptococcus intermedius. Combined treatment with antibiotics and surgical treatment was effective, leading to remission.
Asunto(s)
Absceso/etiología , Biopsia con Aguja Fina/efectos adversos , Enfermedades Linfáticas/etiología , Mediastino , Absceso/microbiología , Anciano , Humanos , Ganglios Linfáticos/microbiología , Enfermedades Linfáticas/microbiología , Masculino , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/terapia , Streptococcus/aislamiento & purificación , Tomografía Computarizada por Rayos X , Ultrasonografía IntervencionalRESUMEN
Infections have been proposed as initiating factors for inflammatory disorders; however, identifying associations between defined infectious agents and the initiation of chronic disease has remained elusive. Here, we report that a single acute infection can have dramatic and long-term consequences for tissue-specific immunity. Following clearance of Yersinia pseudotuberculosis, sustained inflammation and associated lymphatic leakage in the mesenteric adipose tissue deviates migratory dendritic cells to the adipose compartment, thereby preventing their accumulation in the mesenteric lymph node. As a consequence, canonical mucosal immune functions, including tolerance and protective immunity, are persistently compromised. Post-resolution of infection, signals derived from the microbiota maintain inflammatory mesentery remodeling and consequently, transient ablation of the microbiota restores mucosal immunity. Our results indicate that persistent disruption of communication between tissues and the immune system following clearance of an acute infection represents an inflection point beyond which tissue homeostasis and immunity is compromised for the long-term. VIDEO ABSTRACT.
Asunto(s)
Microbioma Gastrointestinal , Enfermedades del Sistema Inmune/microbiología , Enfermedades del Sistema Inmune/patología , Enfermedades Linfáticas/patología , Infecciones por Yersinia pseudotuberculosis/inmunología , Yersinia pseudotuberculosis/fisiología , Movimiento Celular , Enfermedad Crónica , Células Dendríticas/patología , Femenino , Humanos , Enfermedades Linfáticas/microbiología , Tejido Linfoide/inmunología , Tejido Linfoide/patología , Masculino , Mesenterio/inmunología , Mesenterio/patología , Organismos Libres de Patógenos Específicos , Infecciones por Yersinia pseudotuberculosis/patologíaAsunto(s)
Enfermedad por Rasguño de Gato/complicaciones , Enfermedad por Rasguño de Gato/diagnóstico , Conjuntivitis/microbiología , Enfermedades Linfáticas/microbiología , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/microbiología , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Niño , Conjuntivitis/tratamiento farmacológico , Diagnóstico Diferencial , Femenino , Humanos , Ganglios Linfáticos/microbiología , Enfermedades Linfáticas/tratamiento farmacológico , Trastornos de la Motilidad Ocular/tratamiento farmacológicoRESUMEN
OBJECTIVES: To present a clinicocytopathologic correlation of an atypical case of cat scratch disease (CSD) involving retroperitoneal lymph nodes, with emphasis on communication between service teams for managing lymphadenopathy of unknown origin. We consider clinical and cytologic differential diagnoses and review the literature on atypical cases of CSD, with emphasis on abdominal presentation and cytologic findings. METHODS: Clinical services met with the cytology service to review clinical and pathologic features. Literature was reviewed via PubMed search (Harbor-UCLA subscriptions). Immunohistochemistry and Steiner silver stains were performed by Harbor-UCLA Department of Pathology. Enzyme-linked immunosorbent assay IgG and IgM Bartonella henselae titers were carried out by Quest Nichols Institute. RESULTS: Fine-needle aspirate Diff-Quik and Papanicolaou smears and H&E-stained cell block showed abundant histiocytes, monocytoid B cells, and numerous neutrophils associated with necrosis corresponding to a late stage of CSD infection. Silver stain was positive for clumps of pleomorphic organisms. IgM and IgG antibody titers were elevated. CONCLUSIONS: The cytologic findings of CSD in an atypical abdominal presentation are similar to those of a classic presentation. Laboratory workup for atypical CSD should include at least two other modalities aside from cytomorphologic features. Close clinical and cytologic correlation avoided potentially unnecessary and harmful surgery and enabled timely treatment.
Asunto(s)
Antibacterianos/uso terapéutico , Bartonella henselae/aislamiento & purificación , Enfermedad por Rasguño de Gato/diagnóstico , Enfermedades Linfáticas/diagnóstico , Anticuerpos Antibacterianos/sangre , Azitromicina/uso terapéutico , Bartonella henselae/inmunología , Enfermedad por Rasguño de Gato/tratamiento farmacológico , Enfermedad por Rasguño de Gato/patología , Diagnóstico Diferencial , Gentamicinas/uso terapéutico , Humanos , Inmunohistoquímica , Ganglios Linfáticos/patología , Enfermedades Linfáticas/tratamiento farmacológico , Enfermedades Linfáticas/microbiología , Enfermedades Linfáticas/patología , Masculino , Resultado del Tratamiento , Adulto JovenRESUMEN
Disseminated histoplasmosis (DH) is the most current revelation mode of AIDS in French Guiana. We describe the clinical and paraclinical presentation of DH, diagnostic tools, evolution and factors associated with 1-year mortality in HIV-infected patients from western French Guiana. Microbiologically proven AIDS-related DH in Saint Laurent du Maroni's hospital between May 2002 and May 2012 were retrospectively included. Among the 82 patients included, 58 (71%) were male, 44 (53%) presented concurrent histoplasmosis and HIV diagnosis and 63 (80%) had a CD4 cell count under 50 cells µL(-1). Almost all patients had weight loss (97%) and fever (95%), while 84% had digestive symptoms (63% diarrhoea), 55% lymphadenopathy, and 49% respiratory symptoms. Documented and presumed locations of H. capsulatum var capsulatum (Hcc) concerned almost all organs, with a particular affinity for the bone marrow and the digestive system. Co-infections were associated in 65%. Following treatment initiation, 10 patients (13%) died within 1 month and 17 patients (25%) died within a year. DH is a polymorphous systemic mycosis with haematological and digestive tropism. Co-infections are frequent and mortality rate is high.