RESUMO
BACKGROUND: Cerebral syphilitic gumma is a relatively rare clinical disease. Its clinical manifestations are non-specific, and the imaging manifestations are similar to other intracranial occupying lesions, often misdiagnosed as tumors or abscesses. There are few reports on this disease in the relevant literature. To our knowledge, we have reported the first case of cerebral syphilitic gumma misdiagnosed as a brain abscess.We report this case and provide useful information for clinical doctors on neurosyphilis diseases. CASE SUMMARY: We report the case to explore the diagnostic essentials of cerebral syphilitic gumma and attempt to mitigate the rates of misdiagnosis and missed diagnosis by equipping physicians with knowledge of neurosyphilis characteristics. The clinical diagnosis and treatment of a patient with cerebral syphilitic gumma were reported. Clinical manifestations, classifications, and diagnostic points were retrospectively analyzed. The patient was admitted to the hospital with fever and limb weakness. Brain magnetic resonance imaging showed multiple space-occupying lesions and a positive serum Treponema pallidum gelatin agglutination test. The patient was misdiagnosed as having a brain abscess and underwent a craniotomy. A postoperative pathological diagnosis of syphilis gumma was made. The patient improved and was discharged after penicillin anti-syphilis treatment. Follow-up recovery was satisfactory. CONCLUSION: Cerebral syphilitic gumma is rare in clinical practice, and it is often misdiagnosed and missed. Clinical diagnosis should be considered in combination with multiple examinations.
RESUMO
BACKGROUND: Microbes play important roles in kanef-degumming. This study aims at identifying the key candidate microbes and proteins responsible for the degumming of kenaf bast (Hibiscus cannabinus). Kenaf bast was cut into pieces and immersed into microbia fermentation liquid collected from different sites. Fermentation liquid samples were collected at 0, 40, 110 and 150 h and then subjected to the 16S/18S rRNA sequencing analysis and isobaric tag for relative and absolute quantitation (iTRAQ) analysis. The microbial (bacterial and fungal) diversity and the differentially expressed proteins/peptides (DEPs) were identified. RESULTS: With the prolonged degumming time, the weight loss rate increased, the bacterial diversity was decreased. [Weeksellaceae], Enterobacteriaceae and Moraxellaceae were rapidly increased at 0~40 h, and then decreased and were gradually replaced by Bacteroidaceae from 40 h to 150 h. Similarly, Chryseobacterium and Dysgonomonas were gradually increased at 0~110 h and then decreased; Acinetobacter and Lactococcus were increased at 0~40 h, followed by decrease. Bacteroides was the dominant genus at 150 h. Sequencing 18S rRNA-seq showed the gradually decreased Wallemia hederae and increased Codosiga hollandica during degumming. iTRAQ data analysis showed Rds1, and pyruvate kinase I was decreased and increased in the kanef-degumming, respectively. Other DEPs of ferredoxin I, superoxide dismutase and aconitatehydratase were identified to be related to the Glyoxylate and dicarboxylate metabolism (ko00630). CONCLUSIONS: Bacteria including Chryseobacterium, Dysgonomonas, Acinetobacter, Lactococcus and Bacteroidesand fungi like Wallemia hederae and Codosiga hollandica are key candidate microbes for kanef degumming.