Progression of human monkeypox infection despite tecovirimat in an immunocompromised adult.

We report a case of an immunocompromised man with monkeypox who experienced disease progression despite timely initiation of tecovirimat and ultimately required utilization of cidofovir and VIGIV for treatment. In immunocompromised patients, monkeypox might present with a more severe course of disease requiring consideration of alternative treatment strategies.

A case of herpes simplex 2 encephalitis with an unusual radiographic manifestation.

Herpes Simplex Virus (HSV) continues to be an important pathogen inflicting encephalitis in adults and children globally that entails high morbidity and mortality. Prompt diagnosis and treatment are the keys to minimize potential sequelae of the disease. Although HSV encephalitis-1(HSVE-1) is well recognized for its radiographic manifestation of temporal lobe involvement owing to its pathogenesis, radiographic features of HSVE-2 are less uniform. Lumbar puncture with HSV PCR testing is the gold standard for diagnosis. However, when lumbar puncture is not immediately obtainable, consideration of HSVE should be entertained in compatible clinical setting even in the absence of characteristic radiographic finding. We report a case of type 2 HSVE with atypical radiographic manifestation involving bilateral basal ganglia.

A Rare Cause of a Scrotal Abscess due to the Symbiotic Infection of Gardnerella vaginalis and Prevotella bivia in an Adult Male.

Gardnerella vaginalis (G. vaginalis) is the major bacteria detected in women with bacterial vaginosis (BV). Prevotella bivia (P. bivia) has been demonstrated to show a symbiotic relationship with G. vaginalis. Some men have been shown to be colonized with G. vaginalis in their urogenital or anorectal tracts, however genitourinary infections in males, including balanitis and urethritis, due to this organism appear to be much less common. In this report, we summarize previous cases of men with G. vaginalis infection, and we present a rare and unusual case of a unilateral scrotal abscess caused by G. vaginalis in co-infection with P. bivia.

Bidirectional shift of group III metabotropic glutamate receptor-mediated synaptic depression in the epileptic hippocampus.

A common function of group III metabotropic glutamate receptors (mGluRs) located at the presynaptic site of a glutamatergic synapse is synaptic depression. Here, we studied synaptic depression mediated by group III mGluR activation at Schaffer collateral-CA1 (SC-CA1) synapses and associational-commissural-CA3 (AC-CA3) synapses by recording field excitatory postsynaptic potentials in the in vitro brain slice preparation. In order to gauge the impact of synaptic depression in chronically epileptic tissue, we compared rats after pilocarpine-induced status epilepticus (post-SE) with control animals. We observed that synaptic transmission at control AC-CA3 synapses was sensitive to the group III mGluR agonist L-AP4 (10µM), while there was no effect of this compound at SC-CA1 synapses in the same tissue. In contrast, synaptic depression at AC-CA3 synapses by L-AP4 was lost in chronically epileptic tissue, and we found a significant synaptic depression at SC-CA1 synapses in post-SE tissue by L-AP4 and by the mGluR8-selective agonist DCPG. The depression by L-AP4 and DCPG in CA1 was also demonstrated in immature control tissue suggesting developmental down-regulation of mGluR8 at this synapse as well as re-appearance of this isoform under pathological conditions. Quantitative real-time RT-PCR was used to identify mGluR isoforms and to assess their transcriptional changes in post-SE tissue. These analyses revealed down-regulation of mGluR4 and mGluR6 at AC-CA3 and up-regulation of mGluR8 at SC-CA1 synapses. We conclude that group III mGluR-mediated synaptic depression is differentially altered in chronically epileptic tissue by a bidirectional shift of the transcriptional level.

Dopamine induces contraction in the proximal, but relaxation in the distal rat isolated small intestine.

In the gut, dopamine is released by enteric neurons and modulates motility of small intestine smooth muscle cells. Here, we systematically analyzed the dopamine-induced effects on the longitudinal smooth muscle of different sections of the rat isolated small intestine. We found that exogenous dopamine had biphasic effects and could lead to both an early contraction and a late relaxation, depending on the region of small intestine. Thus, dopamine-induced early contractions were commonly observed in the duodenum, but less frequently in the jejunum, and rarely in the ileum. The amplitudes of these early contractions showed a striking regional dependence (duodenum>jejunum>ileum) and were significantly blocked by SCH23390 and raclopride. Conversely, dopamine-induced late relaxations were regularly obtained in the ileum and in the jejunum, but less frequently in the duodenum. Interestingly, the amplitudes of these relaxations showed an inverse regional dependence (ileum>jejunum>duodenum), and were insensitive to dopamine receptor antagonists. Rather, they were significantly inhibited by propranolol and prazosin. We conclude that dopamine exerts differential effects on smooth muscle motility in different regions within the rat small intestine. In proximal parts, dopamine predominantly causes D(1) and D(2) dopamine receptor-dependent contraction, whereas it leads to alpha and beta adrenoceptor-dependent relaxation in more distal parts.