Evaluation of Intestinal Barrier Dysfunction with Serum Iohexol Concentration in Dogs with Acute Hemorrhagic Diarrhea Syndrome.

Histopathologic examination of intestinal biopsies from dogs with acute hemorrhagic diarrhea syndrome (AHDS) reveals necrotizing enteritis and epithelial integrity loss. Serum iohexol measurement has been utilized to assess intestinal permeability. Our hypothesis is that dogs with AHDS have increased intestinal permeability, which is associated with the severity of clinical signs. In this prospective case-control study, 53 client-owned dogs (28 AHDS, 25 healthy controls) were evaluated. Clinical severity was assessed using the AHDS index and systemic inflammatory response syndrome (SIRS) criteria. Simultaneously, dogs received oral iohexol, and serum iohexol concentrations (SICs) were measured two hours later. Results indicated significantly higher (p = 0.002) SIC in AHDS dogs (median: 51 µg/mL; min-max: 9-246) than in healthy controls (30 µg/mL; 11-57). There was a significant positive correlation between AHDS index and SIC (rS = 0.4; p = 0.03) and a significant negative between SIC and serum albumin concentrations (Pearson r = -0.55; p = 0.01). Dogs with severe AHDS (mean 106 µg/mL; range: 17-246) demonstrated significantly higher (p = 0.002) SIC than those with mild to moderate disease (29 µg/mL; 9-54). These findings underscore the association between intestinal permeability and clinical severity in dogs with AHDS assessed by iohexol.

Plant-Derived Xanthones against Clostridial Enteric Infections.

Intestinal bacterial infections are a major threat to human and animal health. In this study, we found plant-derived antibacterial xanthones, particularly α-mangostin (AMG) from the mangosteen peel, exhibiting extraordinary activities against Clostridium perfringens. Structure-activity relationship analysis showed that prenylation modulated the activity of xanthones. The efficacy of AMG (4, 8, 20 mg/kg body weight) was also demonstrated in the broiler chicken necrotic enteritis model infected with Clostridium perfringens. In the models (n = 6 per group), feed supplementation of AMG maintained the homeostasis of the gut microbiome by reducing the colonization of clostridia and promoting the integrity of intestinal barriers via the upregulation of mucin expression. These results suggest that plant-derived xanthones may be a potential alternative to antibiotics for treating clostridial enteric infections in the clinic.

Small Intestinal Perforation Secondary to Necrotizing Enteritis-An Under-Recognized Complication of Crohn's Disease.

Small bowel perforation is an uncommon but severe event in the natural history of Crohn's disease with fewer than 100 cases reported. We review Crohn's disease cases with necrotizing enteritis and share a case of a 26-year-old female who presented with a recurrent episode of small intestinal perforation. A PubMed literature review of case reports and series was conducted using keywords and combinations of "Crohn's disease," "small intestine perforation," "small bowel perforation," "free perforation," "regional enteritis," and "necrotizing enteritis." Data extracted included demographic data, pre- or postoperative steroid administration, medical or surgical management, and case fatality. Nineteen reports from 1935 to 2021 qualified for inclusion. There were 43 patients: 20 males and 23 females with a mean age of 36 ± 15 years old. 75 total perforations were described: 56 ileal (74.6%), 15 jejunal (20.0%), 2 cecal (2.7%), and 1 small intestine non-specified (2.7%). 38 of 43 patients were managed surgically by primary repair (11), ostomy creation (21), or an anastomosis (11). Of 11 case fatalities, medical management alone was associated with higher mortality (5/5; 100% mortality) compared to those treated surgically (6/38; 15.8% mortality; P < .001). Patient sex, disease history, acute abdomen, and pre- or postoperative steroid use did not significantly correlate with mortality. Jejunal perforation was significantly (P = .028) associated with event mortality while ileal was not (P = .45). Although uncommon, necrotizing enteritis should be considered in Crohn's patients who present with small intestinal perforation. These cases often require urgent surgical intervention and may progress to fulminant sepsis and fatality if not adequately treated.

Shanghai Fever: Not Only an Asian Disease.

Objectives: To describe a case of Shanghai fever disease and to analyze other published reports in non-Asiatic countries, defining clinical characteristics and highlighting that this is not only an Asian disease. Study design: A computerized search without language restriction was conducted using PubMed and Scopus; all references listed were hand-searched to identify any other relevant literature. An article was considered eligible for inclusion in the systematic review if it reported cases with Shanghai fever described in non-Asiatic countries. Our case was also included in the analysis. Results: Ten articles reporting 10 cases of Shanghai fever disease were considered. Fever, diarrhea and ecthyma gangrenosum were the most frequent symptoms observed. Blood was the most common site of isolation for Pseudomonas aeruginosa. Three patients underwent surgery due to necrotizing enteritis and intestinal perforation. Meningitis was documented in one case. None of the patients received antipseudomonal antibiotics within 24 h of admission. The outcome was good in nine cases; only one patient died due to multiple organ failure from Pseudomonas sepsis. No common primary immune deficiency was identified in these patients. Extremely young age (<1 year) was the only host factor predisposing to Shanghai fever. Conclusions: It is important to shed light on this disease in non-Asiatic countries and take into account that it can also affect healthy children. Pediatricians, therefore, should consider Shanghai fever among diagnoses in children with community-onset diarrhea, fever and skin lesions suggestive of ecthyma gangrenosum to start an appropriate treatment sooner and to reduce the mortality in these children.

Prevalence and multilocus sequence typing of Clostridium perfringens isolated from retail chicken products and diseased chickens in Tai'an region, China.

BACKGROUND: Clostridium perfringens is an important zoonotic microorganism, which can cause diseases in animals and humans under suitable conditions. Contamination of C. perfringens in chicken products has been reported worldwide, but the genetic diversity and relationship of isolates were seldom analyzed. OBJECTIVES: The current study was undertaken to investigate the prevalence of C. perfringens from retail chicken products and sick chickens with suspected necrotic enteritis (NE) in Tai'an area, China. METHODS: In total, 295 samples were collected from Tai'an large poultry retail market and veterinary hospital in 2018, then the isolates were tested for toxin genes, drug resistance and multilocus sequence typing (MLST). RESULTS: Overall, 138 (46.78%) samples were determined to be positive for C. perfringens, and 99.37% of the isolates were identified as C. perfringens type A, with the remaining isolates being type F; 18.99% of the isolates were positive for cpb2 gene. Antimicrobial susceptibility testing revealed that 52.27% of the isolates from poultry retail market and diseased chickens showed multiple antibiotic resistance. MLST results showed that 50 analyzed isolates can be divided into 39 sequences types (STs), clustered in three clonal complexes (CCs) and 23 singletons. Although most of the isolates belong to type A, considerable genetic diversity can be observed, with the Simpson's diversity index up to 0.9181. MLST results and phylogenetic analysis showed that a portion of the isolates from humans and chickens were assigned to the same clusters in the phylogenetic tree or found to be in the same CCs, indicating the chicken isolates and the human isolates are related in certain stratification. CONCLUSIONS: This study showed that the contamination rate of C. perfringens in the local retail chicken products was relatively high. Most of the isolates exhibit broad-spectrum antimicrobial resistance. The high antibiotic resistance of C. perfringens isolates and the relationship between isolates from human and chicken indicated potential public health risks.

Acute hemorrhagic necrotizing enteritis: a case report and review of the literature.

Acute hemorrhagic necrotizing enteritis (AHNE) is a potentially fatal infection, triggered by beta toxin produced by Clostridium perfringens type C and characterized by extensive hemorrhagic, inflammatory, or ischemic necrosis that mainly affects the small bowel, clinically presenting as diarrhea, hematochezia, abdominal pain and hypotensive shock. AHNE is rarely reported in humans nowadays, we present a case of AHNE in a 51-year-old man presenting as watery diarrhea, hematochezia and abdominal pain along with shortness of breath who unfortunately died of the disease despite active medical treatment and multiple surgical interventions. We aim to improve awareness of clinicians on this fulminant disease, associated with high mortality rates. This is the first case report that attempts to summarize the pathogenesis, clinical characteristics, diagnostic methods, treatment and prognosis of AHNE based on the current English literature. AHNE, which is exceedingly rare in clinical practice, has been associated with poorly specific clinical manifestations, high rates of misdiagnosis in its early stages and mortality rates in severe cases. In patients with a history of ingesting contaminated food and presenting with sudden progressively worsening abdominal pain, diarrhea, hematochezia, accompanied by hypotensive shock or ileus, AHNE should be highly suspected. In order to reduce the mortality of this disease, emphasis should be laid on early recognition and timely surgical intervention in AHNE. In severe cases, death cannot be avoided despite adopting active supportive treatment and timely surgical intervention.

Clostridium perfringens-Associated Necrotic Enteritis-Like Disease in Coconut Lorikeets (Trichoglossus haematodus).

Several outbreaks of necrotic enteritis-like disease in lorikeets, from which Clostridium perfringens was consistently isolated, are described. All lorikeets had acute, segmental, or multifocal fibrinonecrotizing inflammatory lesions in the small and/or the large intestine, with intralesional gram-positive rods. The gene encoding C. perfringens alpha toxin was detected by PCR (polymerase chain reaction) on formalin-fixed, paraffin-embedded (FFPE) tissues in 20 out of 24 affected lorikeets (83%), but it was not amplified from samples of any of 10 control lorikeets (P < .0001). The second most prevalent C. perfringens toxin gene detected was the beta toxin gene, which was found in FFPE from 7 out of 24 affected lorikeets (29%). The other toxin genes were detected inconsistently and in a relatively low number of samples. These cases seem to be associated with C. perfringens, although the specific type involved could not be determined.

NetF-producing Clostridium perfringens and its associated diseases in dogs and foals.

The role of type A Clostridium perfringens in canine acute hemorrhagic diarrhea syndrome and foal necrotizing enteritis is poorly characterized. However, a highly significant association between the presence of novel toxigenic C. perfringens and these specific enteric diseases has been described. These novel toxigenic strains produce 3 novel putative toxins, which have been designated NetE, NetF, and NetG. Although not conclusively demonstrated, current evidence suggests that NetF is likely the major virulence factor in strains responsible for canine acute hemorrhagic diarrhea syndrome and foal necrotizing enteritis. NetF is a beta-pore-forming toxin that belongs to the same toxin superfamily as CPB and NetB toxins produced by C. perfringens. The netF gene is encoded on a conjugative plasmid that, in the case of netF, also carries another putative toxin gene, netE. In addition, these strains consistently also carry a cpe tcp-conjugative plasmid, and a proportion also carry a separate netG tcp-conjugative plasmid. The netF and netG genes form part of a locus with all the features of the pathogenicity loci of tcp-conjugative plasmids. The netF-positive isolates are clonal in origin and fall into 2 clades. Disease in dogs or foals can be associated with either clade. Thus, these are strains with unique virulence-associated characteristics associated with serious and sometimes fatal cases of important enteric diseases in 2 animal species.

Fatal Photobacterium damselae-induced enteritis in a leatherback turtle Dermochelys coriacea.

Stranded leatherback turtle Dermochelys coriacea complete pathology reports are rare, and the cause of mortality is difficult to determine in many cases. We conducted a complete pathological study of a stranded leatherback turtle from the western Mediterranean. The main finding was a fibrino-necrotizing enteritis with associated bacteria which were identified as Photobacterium damselae subsp. damselae according to biochemical and phenotypical characteristics. This report provides evidence of the pathogenic effect of this bacterium in wild sea turtles.

Vaccination against Clostridium perfringens type C enteritis in pigs: a field study using an adapted vaccination scheme.

BACKGROUND: Clostridium perfringens type C induced necrotizing enteritis (NE) causes high mortality in newborn piglets. Immunization programs employing commercially available vaccines are used to prevent disease. Sows are vaccinated during every gestation period and piglets take up antibodies from the colostrum. Antibodies against the major clostridial toxin beta-toxin (CPB) are considered essential for protective immunity. Because the pathogen can persist for several years on farms, continuous vaccination is essential to protect pig herds from the re-occurrence of NE. RESULTS: In two field trials using commercially available vaccines we monitored neutralizing anti-CPB antibodies in pigs after vaccination. The first trial compared antibody titers in primiparous (gilts) and multiparous sows and their piglets after vaccination. A proportion of gilts and their piglets' showed no or low antibody titers. All multiparous sows developed significantly higher serum and colostrum antibody titers after a booster vaccination shortly before their next farrowing. These colostral antibody titer highly correlated with the serum antibody titer of their piglets after consumption of colostrum. In a second field trial, we adapted the vaccination schemes using 3 instead of 2 initial vaccinations before the first farrowing of gilts. This significantly increased serum and colostrum antibody titers in gilts and serum antibody titers in piglets. CONCLUSION: We demonstrate that despite following recommended vaccination protocols, a proportion of gilts might not sufficiently seroconvert to provide efficient passive immunity to their offsprings. A simple adaptation of the vaccination scheme can however improve passive protection of piglets from NE.

A NOVEL ORTHOREOVIRUS ASSOCIATED WITH EPIZOOTIC NECROTIZING ENTERITIS AND SPLENIC NECROSIS IN AMERICAN CROWS (CORVUS BRACHYRHYNCHOS).

Epizootic mortalities in American Crows (Corvus brachyrhynchos) during the winter months, referred to as winter mortality of crows, have been recorded in North America for almost two decades. The most common postmortem findings include necrotizing enteritis, colitis, and fibrinous splenic necrosis. These findings are proposed to be due to infection with a Reovirus sp. Our objectives were to characterize the pathology and seasonality of the epizootics in New York State (NYS), confirm the causative role of an Orthoreovirus sp., and determine its phylogeny. On the basis of our proposed case definition for reovirosis, we examined case data collected by the NYS Wildlife Health Program for 16 yr. A total of 558 cases of reovirosis were recorded between 2001 and 2017. Reovirosis had a clear seasonal presentation: cases occurred almost exclusively in winter months (71% in December-January). Detailed data from a 2-yr period (2016-17) demonstrated that reovirosis caused up to 70% of all recorded crow deaths during epizootic months. Crows with positive orthoreovirus isolation from the spleen or intestine were 32 times more likely to die with characteristic histologic lesions of enteritis or enterocolitis and splenic necrosis than crows with negative isolation results. An in situ hybridization probe specific to virus isolated from NYS crow reovirosis cases demonstrated a direct association between viral presence and characteristic histologic lesions. Sigma C (capsid protein) sequences of isolates from NYS crows showed high homology with Tvärminne avian virus, recently proposed as a novel Corvus orthoreovirus clade, and only distantly related to the avian orthoreovirus clade. Our study indicated that a novel orthoreovirus was the cause of winter mortality (or reovirosis) of American Crows and placed the NYS isolates in the newly proposed genus of Corvid orthoreovirus.

Application of an Endothelial Cell Culture Assay for the Detection of Neutralizing Anti-Clostridium Perfringens Beta-Toxin Antibodies in a Porcine Vaccination Trial.

BACKGROUND: Beta-toxin (CPB) is the major virulence factor of Clostridium perfringens type C, causing hemorrhagic enteritis in newborn pigs but also other animals and humans. Vaccines containing inactivated CPB are known to induce protective antibody titers in sow colostrum and neutralization of the CPB activity is thought to be essential for protective immunity in newborn piglets. However, no method is available to quantify the neutralizing effect of vaccine-induced antibody titers in pigs. (2) Methods: We developed a novel assay for the quantification of neutralizing anti-CPB antibodies. Sera and colostrum of sows immunized with a commercial C. perfringens type A and C vaccine was used to determine neutralizing effects on CPB induced cytotoxicity in endothelial cells. Antibody titers of sows and their piglets were determined and compared to results obtained by an ELISA. (3) Results: Vaccinated sows developed neutralizing antibodies against CPB in serum and colostrum. Multiparous sows developed higher serum and colostrum antibody titers after booster vaccinations than uniparous sows. The antibody titers of sows and those of their piglets correlated highly. Piglets from vaccinated sows were protected against intraperitoneal challenge with C. perfringens type C supernatant. (4) Conclusions: The test based on primary porcine endothelial cells quantifies neutralizing antibody activity in serum and colostrum of vaccinated sows and could be used to reduce and refine animal experimentation during vaccine development.

Necrotizing Enteritis in Nesting Adult Eastern Bluebirds (Sialia sialis) in New York State, USA.

Increased mortalities of adult Eastern Bluebirds, Sialia sialis, breeding in artificial nesting boxes were recorded in New York State, US. A total of 46 dead bluebirds were reported from 23 sites between early April and mid-August 2017. The maximum distance between sites was over 600 km. A total of 27 carcasses were available for postmortem examination. The most common cause of death was necrotizing enteritis, found in 56% (9/16) of birds that could be examined histopathologically. Lesions consisted of foci of hypereosinophilic debris and inflammation rich in Gram-negative bacteria. Aerobic and anaerobic culture of intestines from 4/8 birds with necrotizing enteritis yielded no growth. Plagiorhynchus cylindraceus acanthocephalids were often (6/9, 67%) but not invariably present in affected birds. Occasional incidental lesions included foreign-body microgranulomas in the wall of the ventriculus and intravascular nematodiasis at the base of the heart. The cause of sporadic outbreaks of necrotizing enteritis in breeding bluebirds remains undetermined and warrants further investigation.

Antimicrobial Susceptibility and Clonal Relationship of Tetracycline Resistance Genes in netF-Positive Clostridium perfringens.

NetF-producing type A Clostridium perfringens, a pathotype of C. perfringens, causes necrotizing enteritis in neonatal foals and necrotizing and hemorrhagic enteritis in dogs. Recent core genome multilocus sequence typing study revealed that netF+ C. perfringens strains belong to two distinct clonal populations (clonal complexes I and II). There are no reports on susceptibility to antimicrobial drugs of isolates from this pathotype. The susceptibility to 13 different antimicrobial drugs of 49 netF+ strains recovered from foals or dogs with necrotizing enteritis in Canada, the United States, and Switzerland was assessed using a commercial microdilution panel designed for anaerobic human pathogens. All isolates were highly susceptible to 12 antimicrobial agents, including all beta-lactams tested, such as penicillin G and ampicillin, as well as clindamycin, chloramphenicol, and metronidazole. The isolates consistently presented a reduced susceptibility or resistance to tetracycline, which was associated with previously described tetracycline resistance genes. Clonal complex I isolates (n = 41) possessed the tetA408(P) gene, whereas clonal complex II isolates (n = 8) possessed the tetA(P)-tetB(P) genes and were more likely to be fully resistant.

Circular RNA expression profile of spleen in a Clostridium perfringens type C-induced piglet model of necrotizing enteritis.

Clostridium perfringens type C is a pathogen that causes necrotizing enteritis (NE), which is an intestinal tract disease in piglets. The pathogenesis of C. perfringens type C-induced NE is still unclear, leading to a lack of effective therapies. Earlier studies have reported that circular RNAs (circRNAs) are involved in the pathogenic processes of various diseases. However, it is not known if circRNAs in spleen play a role in C. perfringens type C infection in NE. To address this question, we infected 7-day-old piglets with C. perfringens type C to induce NE. Hematoxylin and eosin staining of small intestine revealed inflammation, atrophy and shedding of intestinal villi, and intestinal mucosal necrosis. We observed increased expression of cytokine genes (such as IL-1ß and IL-6) and inflammation in the spleen. In addition, we used RNA-seq and bioinformatics analysis to examine changes in circRNA expression. A total of 103 circRNAs were found to be differentially expressed in NE, and Gene Ontology analysis revealed that the genes producing differentially expressed circRNAs were enriched in regulation of the cellular metabolic process protein binding. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that the genes producing differentially expressed circRNAs were involved in the tumor necrosis factor signaling pathway, T cell receptor signaling pathway and nuclear factor-κB signaling pathway. Finally, we found eight circRNAs (including circ_0002220 and circ_0000821) that are related to NE. Therefore, our study provides new insights into the mechanisms underlying C. perfringens type C infection in piglets.

[One case of severely burned patient complicated by acute hemorrhagic necrotizing enteritis and fungal infection].

One severely burned patient, caused by heat lead slag and combined with shock, was hospitalized in our burn unit on 2nd June, 2016. The patient received treatments including anti-shock, intensive care, anti-infection, and organ protection. On post injury day 16, the patient suffered outbreak of acute hemorrhagic necrotizing enteritis after eating dumplings. Plasma and albumin were given, octreotide was intravenously infused to inhibit the secretion of intestinal fluid, the broad-spectrum antibiotics were used for anti-infection, abdominal puncture and drainage were performed, sodium tanshinone ⅡA sulfonate was applied to improve the intestinal microcirculation, ulinastatin was applied to alleviate inflammatory reaction, somatostatin was given to reduce intestinal bleeding, and voriconazole was given for antifungal treatment. The patient gradually recovered and was finally cured and discharged. Among critically ill patients, gastrointestinal tract is not only the initiating organ of sepsis, but also one of the target organs which can be easily damaged during sepsis. This case reminds us the importance of gastrointestinal management in severely burned patients.

One case of severely burned patient complicated by acute hemorrhagic necrotizing enteritis and fungal infection / 中华烧伤杂志

One severely burned patient, caused by heat lead slag and combined with shock, was hospitalized in our burn unit on 2nd June, 2016. The patient received treatments including anti-shock, intensive care, anti-infection, and organ protection. On post injury day 16, the patient suffered outbreak of acute hemorrhagic necrotizing enteritis after eating dumplings. Plasma and albumin were given, octreotide was intravenously infused to inhibit the secretion of intestinal fluid, the broad-spectrum antibiotics were used for anti-infection, abdominal puncture and drainage were performed, sodium tanshinone ⅡA sulfonate was applied to improve the intestinal microcirculation, ulinastatin was applied to alleviate inflammatory reaction, somatostatin was given to reduce intestinal bleeding, and voriconazole was given for antifungal treatment. The patient gradually recovered and was finally cured and discharged. Among critically ill patients, gastrointestinal tract is not only the initiating organ of sepsis, but also one of the target organs which can be easily damaged during sepsis. This case reminds us the importance of gastrointestinal management in severely burned patients.

Intoxicação experimental por Simarouba versicolor (Simaroubaceae) em ovinos e indução de resistência ao consumo da planta / Experimental poisoning by Simarouba versicolor (Simaroubaceae) in sheep and induced resistance to consumption of the plant

Simarouba versicolor é uma árvore semidecídua pertencente à família Simaroubaceae. Um surto de intoxicação por S. versicolor em bovinos por brotos da planta presente no pasto em Mato Grosso do Sul e sua reprodução experimental foram descritos. Esse estudo teve por objetivos verificar experimentalmente se os ovinos podem ser utilizados como modelo clínico-patológico no estudo da intoxicação por Simarouba versicolor St. Hil. (fam. Simaroubaceae), determinar se há indução de resistência pela ingestão de pequenas e repetidas doses e, se a planta mantém sua toxicidade quando dessecada. Foram realizados dois experimentos, sendo o primeiro com folhas verdes ou folhas dessecadas e trituradas de S. versicolor em doses únicas de 5g/kg, 5g/kg e 3g/kg a três ovinos (Ovino 1, 2 e 3 respectivamente). O experimento 2, foi realizado com diferentes doses diárias de folhas dessecadas e trituradas de S. versicolor em quatro ovinos que receberam 1,5g/kg, 0,75g/kg, 0,6g/kg e 0,3g/kg e, com um ovino que recebeu 3g/kg como controle positivo (Ovino 4). A administração foi suspensa quando os ovinos apresentaram sinais clínicos da intoxicação. Após doze dias de recuperação, os animais sobreviventes foram desafiados com a mesma dose diária da planta ingerida anteriormente para avaliar o desenvolvimento de resistência. Os sinais clínicos observados nos dois experimentos caracterizaram-se por anorexia, mucosas oculares congestas, polidipsia, sialorreia, fezes pastosas que evoluíram para diarreia líquida fétida esverdeada, decúbito lateral e morte para os Ovinos 1 a 7. As principais lesões histológicas observadas foram necrose do tecido linfoide (linfonodos, baço, placas de Peyer) e enterite necrosante. Com os resultados obtidos, pode-se concluir que os ovinos podem ser utilizados como modelo experimental clínico-patológico na intoxicação por S. versicolor. Com o método utilizado, não houve resistência ao consumo diário de folhas da planta pelos ovinos e, as folhas mantiveram sua toxicidade quando dessecadas.(AU)

Simarouba versicolor St. Hil. is a semideciduous tree belonging to the Simaroubaceae family. An outbreak of poisoning in cattle by shoots of S. versicolor present in the pasture in Mato Grosso do Sul and experimental reproduction of the poisoning was described. This study aimed to verify experimentally whether sheep could be used as a clinical-pathological model in the study of the poisoning caused by S. versicolor, to determine if there develops resistance induced by ingestion of small and repeated doses of the leaves, and if the plant keeps its toxicity when dried. Two experiments were conducted: Experiment 1 with green leaves or dried and powdered leave of S. versicolor, given in single doses of 5g/kg, 5g/kg and 3g/kg to three sheep (Sheep 1, 2 and 3 respectively). Experiment 2 was made with different daily doses of dried and powdered leaves of S. versicolor; to four sheep was given 1.5g/kg, 0.75g/kg, 0.6g/kg and 0.3g/kg, and the positive control (Sheep 4) received 3g/kg. The administration was suspended when the animals showed clinical signs of poisoning. After twelve days of recovery, the surviving sheep were challenged with the same daily dose given previously, to assess the development of resistance. Clinical signs observed in both experiments were characterized by anorexia, congested ocular mucosa, polydipsia, drooling, loose stools which evolved into fetid greenish watery diarrhea, lateral decumbency and death of Sheep 1 to 7. The main histological lesions observed were necrosis of lymphoid tissue (lymph nodes, spleen, Peyer's patches) and necrotizing enteritis. With the results it can be concluded that sheep can be used as experimental model for the clinic-pathological aspects of poisoning by S. versicolor. The method used has not shown resistance to the daily consumption of the plant by the sheep, and the leaves kept their toxicity when dried.(AU)

"STOP, LOOK, and LISTEN." Hepatic Portal Venous Gas: Time for Clinical Assessment!

Pneumatosis intestinalis and portal venous gas are findings usually associated with intra-abdominal surgical catastrophes that frequently require emergent surgical intervention. Herein we present a case of a patient who presented in septic shock, with extensive portal vein gas, diffuse intestinal wall thickening, and atherosclerotic vascular insufficiency in the absence of pneumatosis intestinalis. Given his advanced age, multiple comorbidities, magnitude of the initial findings, and his dramatic clinical response to aggressive fluid resuscitation, a cognitive decision was made to continue with nonoperative management. The patient recovered uneventfully and was discharged home in a stable condition.

Endothelial binding of beta toxin to small intestinal mucosal endothelial cells in early stages of experimentally induced Clostridium perfringens type C enteritis in pigs.

Beta toxin (CPB) is known to be an essential virulence factor in the development of lesions of Clostridium perfringens type C enteritis in different animal species. Its target cells and exact mechanism of toxicity have not yet been clearly defined. Here, we evaluate the suitability of a neonatal piglet jejunal loop model to investigate early lesions of C. perfringens type C enteritis. Immunohistochemically, CPB was detected at microvascular endothelial cells in intestinal villi during early and advanced stages of lesions induced by C. perfringens type C. This was first associated with capillary dilatation and subsequently with widespread hemorrhage in affected intestinal segments. CPB was, however, not demonstrated on intestinal epithelial cells. This indicates a tropism of CPB toward endothelial cells and suggests that CPB-induced endothelial damage plays an important role in the early stages of C. perfringens type C enteritis in pigs.