ABSTRACT
Fish tank granuloma has traditionally been associated with Mycobacterium marinum. We report the case of a 54 old-year woman that worked in a freshwater fish pet store and developed a skin ulcer in a hand finger with a suppurative granuloma secondary to Microbacterium paraoxydans. This is a bacterial fish pathogen, rarely observed in human infections. Identification was performed by colony morphology and MALDI-TOF. She evolved satisfactorily after receiving a sequential treatment with beta-lactams and linezolid. To our knowledge, it is the first known description of this type.
Subject(s)
Granuloma , Mycobacterium marinum , Humans , Female , Middle Aged , Granuloma/microbiology , Granuloma/pathology , Granuloma/drug therapy , Mycobacterium marinum/isolation & purification , Microbacterium , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium Infections, Nontuberculous/diagnosisABSTRACT
Gurltia paralysans is a rare metastrongylid nematode of domestic cats that is found mainly in the veins of the spinal cord subarachnoid space and parenchyma. Endemic regions for G. paralysans mainly include Chile and Argentina. The ante mortem diagnosis of gurltiosis is difficult and based primarily on neurological signs, epidemiological factors, and the exclusion of other causes of feline myelopathies. The purpose of this retrospective case series was to describe clinical, imaging, and pathologic characteristics in nine domestic cats naturally infected with G. paralysans. Imaging tests included radiography, myelography, computed tomographic myelography (myelo-CT), and magnetic resonance imaging (MRI). Neurological signs included paraparesis, paraplegia, pelvic limb ataxia and proprioceptive deficits, pelvic limb tremors, lumbosacral hyperesthesia, and tail trembling or atony. Complete blood count findings included a decrease in the mean corpuscular hemoglobin concentration value in eight cats. Eosinophilia in peripheral blood was observed in three cats, and thrombocytopenia was observed in three cats. Cerebrospinal fluid analysis revealed mononuclear pleocytosis in five cases. Myelo-CT showed diffuse enlargement of the spinal cord at the midthoracic, lumbar, and sacral regions in all cats. Magnetic resonance image findings in the thoracic and lumbar region demonstrated multiple small nodular areas of T2 hyperintensity in the periphery of the spinal cord parenchyma. Localized intraparenchymal areas of increased T2 intensity were also observed in the thoracolumbar spinal cord and lumbosacral conus medullaris. In conclusion, G. paralysans should be considered as a differential diagnosis for domestic cats in endemic regions that have this combination of clinical and imaging characteristics.