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1.
Georgian Med News ; (304-305): 91-95, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965256

RESUMO

The aim of the study is to determine the clinical and laboratory characteristics of acute lymphadenitis in children.; The study was performed using retrograde analysis of diagnosis and treatment of 158 children with acute lymphadenides of nonspecific and specific etiology, different localization (submandibular, cervical, axillary, inguinal and other peripheral localization) who were treated at the inpatient department in the pediatric surgery of MHCF "Local oncologic dispensary of Kramatorsk" from 2015 to 2019. Among the inpatient children there were 86 (54.4%) boys and 72 (45.6%) girls. The age of the patients ranged from 2 months to 18 years. The average age of the patients was 5.8±0.61 years. The surgical procedures were performed in 131 patients (82.9%) while the non-specific nature of the inflammatory process was confirmed in 102 patients (77.9%) taking into account the clinical course of the disease and the results of microbiological analysis. A specific inflammatory process was found out in 29 patients (22.1%). It was clinically detected that 18 children (13.7%) had BCG-lymphadenitis (confirmed by histological examination) and 11 patients (8.4%) had benign lymphoreticulosis (felinosis) among them.; Due to the use of shear wave elastography 62.9% of the children were able to avoid any surgery, extra puncture and they were treated conservatively.


Assuntos
Doença da Arranhadura de Gato , Linfadenite/diagnóstico , Doença Aguda , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Pacientes Internados , Masculino , Pescoço/diagnóstico por imagem , Estudos Retrospectivos
2.
Am J Clin Pathol ; 154(2): 215-224, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32367142

RESUMO

OBJECTIVES: Kikuchi-Fujimoto disease (KFD) and systemic lupus erythematosus (SLE) are benign entities with histologic features that raise concern about malignancy and infection. We searched for a histology-independent KFD/SLE signature relying on only immunophenotype and basic clinical characteristics. METHODS: A histology-independent KFD/SLE signature was generated using 975 excised lymph nodes with flow immunophenotyping, including 16 cases of KFD/SLE. This signature was then evaluated in 1,198 fine-needle aspiration (FNA) specimens. RESULTS: The top flow cytometry discriminant for KFD/SLE was uniform CD38+ expression on CD19+ events. Immunohistochemistry demonstrated nodules of IgD+, IgM- B cells surrounding necrotizing and activated T-cell areas. A signature combining 6 flow cytometry criteria with age and sample site had a positive predictive value of 88% for KFD/SLE, which had a prevalence of 1.6%. All 4 signature-positive FNA cases with follow-up excision were KFD/SLE. At a second institution, 4 of 5 KFD/SLE cases passed the top discriminant. CONCLUSIONS: A flow cytometry signature combined with age and biopsy site identifies KFD/SLE independent of histology, suggesting a shared immune composition and independently confirming that KFD/SLE represents a distinct entity. Unexpectedly, an IgD+CD38+ small B-cell population is a distinctive feature of KFD/SLE, suggesting a possible pathologic role for anergic/autoreactive B cells.


Assuntos
Linfadenite Histiocítica Necrosante/diagnóstico , Lúpus Eritematoso Sistêmico/patologia , Linfonodos/patologia , Linfadenite/diagnóstico , Linfadenopatia/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Citometria de Fluxo , Linfadenite Histiocítica Necrosante/patologia , Humanos , Imunofenotipagem , Linfadenite/patologia , Linfadenopatia/patologia , Masculino
3.
J Pediatr Adolesc Gynecol ; 33(4): 429-431, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32224248

RESUMO

BACKGROUND: Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is a cyclic autoinflammatory disease generally diagnosed in childhood. There have been studies suggesting a relationship between menstruation and other autoinflammatory syndromes such as familial Mediterranean fever (FMF), but not PFAPA specifically. CASE: This case describes a patient with a diagnosis of PFAPA who experienced complete resolution with tonsillectomy only to have recurrence of symptoms with onset of menstruation. She experienced symptom control with initiation of oral contraceptives. SUMMARY AND CONCLUSION: Prior to this case report, there had been no evidence in the literature suggesting a relationship between PFAPA and menstruation despite the observed association in other autoinflammatory syndromes. Onset of menses may be a trigger in PFAPA.


Assuntos
Febre/complicações , Linfadenite/complicações , Menstruação/fisiologia , Faringite/complicações , Estomatite Aftosa/complicações , Criança , Feminino , Febre/diagnóstico , Humanos , Linfadenite/diagnóstico , Masculino , Faringite/diagnóstico , Recidiva , Estomatite Aftosa/diagnóstico , Síndrome
5.
Arerugi ; 69(1): 53-58, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32051370

RESUMO

We report an adult case of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, who had a tonsillectomy at 10 years old and relapsed later. An early 40's-year-old man had been suffering from recurrent fever attack once in 1-2 months during childhood. He was accompanied by fever which was persist for several days, aphthous stomatitis, tongued tonsillitis with moss, pharyngitis, and submandibular lymphadenitis with tenderness. He was not doing well during fare-up. At the time of admission, CRP level was 12.5mg/dl and the remarkably increased expression of CD64 on neutrophils was found. Bacterial infections and collagen diseases were excluded by the several examinations. We suspected PFAPA syndrome, and treated with cimetidine, but cimetidine was not effective. At the time of flare up, administration of prednisolone was remarkably effective. We diagnosed PFAPA syndrome on the basis of clinical courses. Genetic analysis of responsible gene of familial Mediterranean fever, MEFV showed E148Q heterozygous mutation in exon 2.Since an adult case of PFAPA syndrome is likely to be made misunderstanding for infectious recurrent pharyngitis, it is important to note that we should consider PFAPA syndrome as a differential diagnosis when we meet with the adult patient of recurrent fever.


Assuntos
Febre/diagnóstico , Linfadenite/diagnóstico , Faringite/diagnóstico , Pirina/genética , Estomatite Aftosa/diagnóstico , Adulto , Criança , Humanos , Masculino , Recidiva , Síndrome
6.
Reumatol. clín. (Barc.) ; 15(6): 355-359, nov.-dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-189653

RESUMO

INTRODUCCIÓN: El síndrome PFAPA es una enfermedad autoinflamatoria de diagnóstico clínico. Se han propuesto diversos tratamientos; entre ellos, la tonsilectomía podría ser un tratamiento efectivo. MATERIAL Y MÉTODOS: Estudio multicéntrico retrospectivo. Se incluyeron pacientes diagnosticados de síndrome PFAPA, según los criterios de Thomas, en 3 hospitales madrileños, entre 2009-2013. RESULTADOS: Se incluyeron 32 casos. Las medianas de edad de inicio del cuadro y al diagnóstico fueron 32 meses (RIQ 24-44) y 47,5 meses (RIQ 37-60), respectivamente. Se hallaron incrementos en las cifras de leucocitos (13.580/μl [RIQ 8.200-16.600] vs.8.300/μl [RIQ 7.130-9.650], p = 0,005), neutrófilos (9.340/μl [RIQ 5.900-11.620] vs.3.660/μl [RIQ 2.950-4.580], p = 0,002) y proteína C reactiva (11,0mg/dl [RIQ 6,6-12,7] vs.0,2mg/dl [RIQ 0,1-0,6], p = 0,003) durante los episodios febriles, respecto a los periodos libres de síntomas. El 80,8% refería remisión de los síntomas en 24h tras corticoterapia oral. Fueron tonsilectomizados 14 pacientes. En 11 cesaron los episodios febriles, mientras que en 3 se redujo su frecuencia; hubo 2 sangrados posquirúrgicos como complicación. El cuadro se había resuelto en el 56,3% de los pacientes, a una mediana de edad de 60 meses (RIQ 47-95), con una duración similar entre los pacientes que fueron tonsilectomizados y los que no. CONCLUSIONES: Se presenta una cohorte amplia de niños con síndrome de PFAPA en la que se confirma que, en nuestro medio, los niños con este síndrome presentan unas características clínicas y analíticas similares a las descritas en la literatura, con buena respuesta a corticoterapia y elevada resolución de la clínica tras la amigdalectomía


INTRODUCTION: PFAPA syndrome is an autoinflammatory disease whose diagnosis is mainly clinical. Several treatments have been proposed; among them, tonsillectomy could be an effective one. MATERIAL AND METHODS: Retrospective multicenter study. Patients included were diagnosed with PFAPA syndrome, according to the Thomas criteria, in 3 hospitals in Madrid between 2009-2013. RESULTS: Thirty-two cases were included. Median age at onset and at diagnosis were 32 months (IQR 24-44) and 47.5 months (IQR 37-60), respectively. There were increases in leukocytes (13,580/μL [IQR 8,200-16,600] vs.8,300/μL [IQR 7,130-9,650], P=.005), neutrophils (9,340/μL [IQR 5,900-11,620] vs.3,660/μL [IQR 2,950-4,580], P=.002) and C-reactive protein (11.0mg/dL [IQR 6.6-12.7] vs.0.2mg/dL [IQR 0.1-0.6], P=.003) during febrile episodes. In all, 80.8% of patients reported remission of symptoms within 24h after oral corticosteroid therapy. Fourteen patients were tonsillectomized. In 11, the febrile episodes stopped while, in 3, the frequency was reduced; there were 2 cases of postoperative bleeding. The disease was resolved in 56.3% of the patients, at a median age of 60 months (IQR 47-95), with similar duration in patients who were tonsillectomized and those who were not. CONCLUSIONS: We present a large cohort of children with PFAPA syndrome, with clinical and analytical features similar to those described in the literature, and a good response to corticosteroids and a high resolution rate of symptoms after tonsillectomy


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Febre/diagnóstico , Febre/epidemiologia , Linfadenite/diagnóstico , Linfadenite/epidemiologia , Faringite/diagnóstico , Faringite/epidemiologia , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/epidemiologia , Estudos de Coortes , Progressão da Doença , Estudos Retrospectivos , Espanha/epidemiologia , Síndrome , Saúde da População Urbana
7.
J Med Microbiol ; 68(12): 1759-1765, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31724936

RESUMO

Corynebacterium pseudotuberculosis is the causative agent of caseous lymphadenitis (CLA), a chronic disease of sheep and goats. Current methods for CLA diagnosis cannot identify all infected animals; therefore, the development of an improved diagnosis is essential. We evaluated recombinant phospholipase D (rPLD) protein individually or combined with rCP01850 or rCP09720 proteins for the detection of CLA in sheep. A total of 40 positive and 25 negative sera samples were analysed by ELISA using the recombinant proteins. ELISA using rPLD (E1), rPLD+rCP01850 (E2) and rPLD+rCP09720 (E3) showed 90, 92.5 and 97.5 % sensitivity and 92, 72 and 92 % specificity, respectively. The area under the receiver operating characteristic curves for E1, E2 and E3 was 0.925, 0.882 and 0.990, respectively. ELISA using rPLD +rCP09720 demonstrated the best sensitivity and specificity. Thus, the combination of these recombinant proteins in indirect ELISA has the potential for the diagnosis of CLA in sheep.


Assuntos
Ensaio de Imunoadsorção Enzimática/métodos , Linfadenite/veterinária , Fosfolipase D/imunologia , Proteínas Recombinantes/imunologia , Doenças dos Ovinos/diagnóstico , Animais , Corynebacterium pseudotuberculosis/genética , Linfadenite/diagnóstico , Ovinos
8.
J Korean Med Sci ; 34(46): e302, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31779059

RESUMO

BACKGROUND: Nontuberculous mycobacteria (NTM) lymphadenitis is an under-recognized entity, and data of the true burden in children are limited. Without a high index of suspicion, diagnosis may be delayed and microbiological detection is challenging. Here, we report a cluster of NTM lymphadenitis experienced in Korean children. METHODS: Subjects under 19 years of age diagnosed with NTM lymphadenitis during November 2016-April 2017 and April 2018 were included. Electronic medical records were reviewed for clinical, laboratory and pathological findings. Information regarding underlying health conditions and environmental exposure factors was obtained through interview and questionnaires. RESULTS: A total of ten subjects were diagnosed during 18 months. All subjects were 8-15 years of age, previously healthy, male and had unilateral, nontender, cervicofacial lymphadenitis for more than 3 weeks with no significant systemic symptoms and no response to empirical antibiotics. Lymph nodes involved were submandibular (n = 8), preauricular (n = 6) and submental (n = 1). Five patients had two infected nodes and violaceous discoloration was seen in seven subjects. Biopsy specimens revealed chronic granulomatous inflammation and acid-fast bacteria culture identified Mycobacterium haemophilum in two cases and NTM polymerase chain reaction was positive in two cases. Survey revealed various common exposure sources. CONCLUSION: NTM lymphadenitis is rare but increasing in detection and it may occur in children and adolescents. Diagnosis requires high index of suspicion and communication between clinicians and the laboratory is essential for identification of NTM.


Assuntos
Linfadenite/diagnóstico , Infecções por Mycobacterium não Tuberculosas/patologia , Adolescente , Antibacterianos/uso terapêutico , Criança , Humanos , Linfadenite/tratamento farmacológico , Linfadenite/etiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Mycobacterium haemophilum/genética , Mycobacterium haemophilum/isolamento & purificação , Micobactérias não Tuberculosas/genética , Micobactérias não Tuberculosas/isolamento & purificação , RNA Bacteriano/metabolismo
9.
Clin Exp Rheumatol ; 37 Suppl 121(6): 116-118, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31603071

RESUMO

OBJECTIVES: Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a multifactorial autoinflammatory disease (AID), which mainly affects children. There have been hardly any cases reported concerning the Chinese population. We aimed to describe the first cohort of adult PFAPA patients in China. METHODS: We evaluated all the adult patients suffering from PFAPA syndrome diagnosed in our centre from April 2015 through March 2018. The patients were diagnosed clinically, and whole exome sequencing was performed in each patient to rule out mono-genic AIDs. RESULTS: During the study period, a total of 9 adult patients (8 men, 1 woman) with PFAPA syndrome were diagnosed. They all had disease onset in adulthood, and the mean age at onset was 25.2±9.5 years. The mean duration of attacks was 4.1±1.0 days, and the mean interval between attacks was 6.2±2.7 weeks. Apart from periodic fever, which was present in all patients, pharyngitis, cervical adenitis and aphthous stomatitis were present in 89%, 67% and 44% patients, respectively. Other common symptoms included fatigue (100%), headache (56%), and myalgia (55%). Inflammatory markers, except ferritin, increased during attacks and returned to normal afterwards. Glucocorticoids given at onset of attacks were effective, while colchicine and tonsillectomy were of no effect. CONCLUSIONS: Our study is the first to suggest the presence of PFAPA syndrome in the Chinese adult population. Clinicians should take into account PFAPA syndrome when diagnosing patients suffering from recurrent fevers of unknown origin, especially those with pharyngitis, cervical adenopathy and aphthous stomatitis.


Assuntos
Linfadenite , Faringite , Estomatite Aftosa , Adulto , Idade de Início , China , Feminino , Febre , Humanos , Linfadenite/diagnóstico , Masculino , Faringite/diagnóstico , Estomatite Aftosa/diagnóstico
10.
Lakartidningen ; 1162019 Oct 29.
Artigo em Sueco | MEDLINE | ID: mdl-31661147

RESUMO

Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis (PFAPA) syndrome is the most common autoinflammatory disorder among children in many parts of the world and an important differential diagnosis in children presenting with recurrent fever episodes. Commonly, PFAPA has an onset under the age of 5 years. Fever episodes in PFAPA usually last 3-6 days and are associated with one or more of the cardinal symptoms aphthous stomatitis, pharyngitis and cervical adenitis. The fever episodes typically recur with an interval of 3-6 weeks, often with a striking regularity. During the episodes, the patient has elevated inflammatory variables such as CRP and serum amyloid A (SAA) and may sometimes have additional symptoms such as abdominal pain, nausea and leg pain. Between the fever episodes, the patient is typically free of symptoms with normalized inflammatory variables and grows normally. Awareness and recognition of PFAPA is key to providing the patient with adequate treatment and avoiding misdiagnosis.


Assuntos
Doenças Hereditárias Autoinflamatórias/diagnóstico , Biomarcadores/sangue , Pré-Escolar , Diagnóstico Diferencial , Feminino , Febre/diagnóstico , Febre/tratamento farmacológico , Febre/etiologia , Doenças Hereditárias Autoinflamatórias/classificação , Doenças Hereditárias Autoinflamatórias/complicações , Doenças Hereditárias Autoinflamatórias/tratamento farmacológico , Humanos , Inflamação/sangue , Linfadenite/diagnóstico , Linfadenite/tratamento farmacológico , Linfadenite/etiologia , Masculino , Faringite/diagnóstico , Faringite/tratamento farmacológico , Faringite/etiologia , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/tratamento farmacológico , Estomatite Aftosa/etiologia , Síndrome
12.
Mol Cell Probes ; 48: 101459, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31550519

RESUMO

BACKGROUND: Tubercular lymphadenitis (TBLA) is one of the most common extrapulmonary manifestations of tuberculosis in patients with HIV. With several other pathological conditions presenting as lymphadenitis and lack of consensus regarding a gold standard test, the diagnosis of TBLA remains a challenge for the clinician. OBJECTIVES: and design: In this study, we have assessed the potential of loop-mediated isothermal amplification (LAMP) test for the diagnosis of TBLA in HIV-infected patients. The study group included samples collected by fine needle aspiration (FNAC) of lymph nodes from 24 HIV-infected patients with TBLA. A composite reference standard was used to identify cases of TBLA based on clinical suspicion, results of cytology, AFB smear, MGIT culture, GeneXpert MTB/RIF, multiplex polymerase chain reaction (MPCR) and subsequently clinical response to antitubercular therapy. These tests were also carried out in 26 control samples of lymph node FNAC from HIV-infected patients with non-tubercular lymphadenitis. RESULTS: LAMP assay was positive in 19/24 TBLA cases and yielded a sensitivity of 79.17% with 100% specificity. Cytology was suggestive in 18/24 (75%) TBLA cases. GeneXpert MTB/RIF assay correctly identified 16/24 TBLA cases, but the test did show one false positive result reducing its specificity. MPCR had the highest sensitivity of 91.67% as it correctly identified 22/24 cases and showed no false positive result. CONCLUSION: The current study highlights the potential of LAMP test for the specific diagnosis of tubercular lymphadenitis in FNAC samples from HIV-infected patients, especially when cytology is either non-conclusive or non-available. Though MPCR had a higher sensitivity than LAMP assay, the added advantages of low cost, minimal technical expertise and simplicity of procedure make LAMP assay a suitable diagnostic test in resource-limited settings.


Assuntos
Infecções por HIV/microbiologia , Linfadenite/diagnóstico , Reação em Cadeia da Polimerase Multiplex/métodos , Mycobacterium tuberculosis/genética , Tuberculose/diagnóstico , Adulto , Técnicas Bacteriológicas/métodos , Bioensaio/métodos , Biópsia por Agulha Fina/métodos , Feminino , Humanos , Índia , Linfadenite/microbiologia , Masculino , Sensibilidade e Especificidade , Tuberculose/microbiologia
14.
Diagn Microbiol Infect Dis ; 95(3): 114858, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31358343

RESUMO

Seven weeks after being kicked in the face by a cow, a 34-year-old male patient developed a posttraumatic mycobacterial lymphadenitis. A rapidly growing mycobacterial isolate cultured from a surgically drained lymphadenitis pus specimen was identified as Mycobacterium smegmatis by matrix-assisted laser desorption/ionization mass spectrometry and a combination of ITS-, hsp65-, and 16S rRNA-DNA sequence analysis, but as Mycobacterium fortuitum complex using the commercial INNO-LiPA Mycobacteria v2 line probe assay. As it is unclear if the misidentification of this strain is an exception, more research is required.


Assuntos
Linfadenite/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium fortuitum/classificação , Mycobacterium fortuitum/genética , Mycobacterium smegmatis/classificação , Mycobacterium smegmatis/genética , Adulto , Animais , Bovinos , Erros de Diagnóstico , Humanos , Linfadenite/microbiologia , Linfadenite/patologia , Linfadenite/terapia , Masculino , Testes de Sensibilidade Microbiana , Técnicas de Diagnóstico Molecular/normas , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/patologia , Infecções por Mycobacterium não Tuberculosas/cirurgia , Mycobacterium fortuitum/química , Mycobacterium smegmatis/química , Kit de Reagentes para Diagnóstico , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Resultado do Tratamento
15.
Microb Pathog ; 135: 103628, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31325572

RESUMO

Caseous lymphadenitis is an infectious disease of almost all animals, particularly small ruminants that are caused by Corynebacterium pseudotuberculosis. The organism causes the formation of suppurative abscesses in superficial and visceral lymph nodes and in visceral organs. This current study was designed to elucidate the clinicopathological responses and PCR detection of the aetiological agent in the vital organs of goats challenged with C. pseudotuberculosis and its immunogenic mycolic acid extract. A total of twelve clinically healthy crossbred Boer female goats were divided into three groups: A, B, and C (four goats per group). Group A was inoculated intradermally with 2 ml of sterile phosphate buffered saline (PBS) pH 7 as a control group. Group B was inoculated intradermally with 2 ml of mycolic acid extract (1 g/ml), while group C was inoculated intradermally with 2 ml of 109 colony-forming unit (cfu) of live C. pseudotuberculosis. The experimental animals were observed for clinical responses for 90 days post-inoculation and the clinical signs were scored according to the severity. The clinical signs observed in this study were temperature, heart rate, respiratory rate, rumen motility, enlargement of lymph nodes, and body condition score. The experimental animals were euthanised and tissue samples from different anatomical regions of the vital organs were collected in 10% buffered formalin, processed, sectioned, and stained with H&E. Results of both C. pseudotuberculosis and mycolic acid treated groups indicated a significant difference (p < 0.05) in body temperature. Group C showed a significant increase in temperature (p < 0.05) at week 1 (39.59 ±â€¯0.29 °C), week 2 (39.67 ±â€¯0.27 °C) and week 3 (40.22 ±â€¯0.15 °C). Whereas group B showed a significant increase in temperature (p < 0.05) only at week 1 (39.36 ±â€¯0.14 °C). Heart rate in group C showed a significant increase between week 1 (93.35 ±â€¯0.42 bpm) and week 11 (86.52 ±â€¯1.32 bpm), and the mean heart rate of group B showed a significant increase (p < 0.05) between week 1 (89.90 ±â€¯0.60 bpm) and week 9 (86.90 ±â€¯0.99 bpm). Group C showed a significant increase of respiratory rate (p < 0.05) at week 1 (36.85 ±â€¯0.14 bpm), week 2 (36.90 ±â€¯0.62), week 3 (30.80 ±â€¯1.97 bpm), and week 4 (34.85 ±â€¯1.19 bpm). The mean of the respiratory rate of group B only increased at week 1 (32.98 ±â€¯1.30 bpm) and week 2 (31.87 ±â€¯0.48 bpm). Both groups C & B showed significant decreases in rumen motility and body condition score as compared to the control. The histopathological changes were significant in group C, this was shown by mild to severe haemorrhage, congestion, degeneration and necrosis, oedema, infiltration with inflammatory cells mainly lymphocytes and macrophages, while group B was less affected and showed mild to moderate haemorrhage, congestion, degeneration and necrosis, infiltration of inflammatory cells and oedema as compared to the control group. This study concluded that C. pseudotuberculosis caused typical CLA disease with a short incubation period in the experiment. While the mycolic acid extracted from C. pseudotuberculosis caused mild clinical signs, no abscess formation, and negative PCR result. Moreover, evidence of mild to moderate histopathological changes in vital organs was also observed.


Assuntos
Infecções por Corynebacterium/diagnóstico , Infecções por Corynebacterium/microbiologia , Corynebacterium pseudotuberculosis/isolamento & purificação , Corynebacterium pseudotuberculosis/metabolismo , Doenças das Cabras/diagnóstico , Doenças das Cabras/microbiologia , Ácidos Micólicos/imunologia , Ácidos Micólicos/metabolismo , Abscesso/microbiologia , Animais , Temperatura Corporal , Infecções por Corynebacterium/patologia , Infecções por Corynebacterium/fisiopatologia , Corynebacterium pseudotuberculosis/genética , Feminino , Doenças das Cabras/patologia , Doenças das Cabras/fisiopatologia , Cabras , Coração , Frequência Cardíaca , Rim/patologia , Contagem de Leucócitos , Fígado/patologia , Pulmão/patologia , Linfonodos/microbiologia , Linfadenite/diagnóstico , Linfadenite/imunologia , Linfadenite/microbiologia , Linfadenite/fisiopatologia , Reação em Cadeia da Polimerase/métodos , Taxa Respiratória , Baço/patologia
16.
Br J Radiol ; 92(1103): 20190517, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31322919

RESUMO

Intramammary lymph nodes (IMLN) are one of the most common benign findings at screening mammography. However, abnormal IMLN features, such as diminished or absent hilum, thickened cortex, not circumscribed margins, increased size or interval change, warrants additional follow-up or pathologic analysis to exclude malignancy. Some benign inflammatory conditions may be associated with imaging-detected suspected abnormal IMLN, such as reactive hyperplasia and silicone-induced lymphadenopathy. In patients with known breast cancer, IMLN are a potential site of locoregional spread, which can change the prognosis and management. In some cases, initial breast carcinomas can also mimic IMLN. Breast radiologists must also be aware of the typical and atypical characteristics of IMLN to suggest further investigation when it is necessary.


Assuntos
Linfadenite/diagnóstico , Imagem Multimodal/métodos , Neoplasias da Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Metástase Linfática , Imagem por Ressonância Magnética/métodos , Mamografia/métodos , Prognóstico
17.
Int J Rheum Dis ; 22(8): 1489-1497, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31131563

RESUMO

AIM: The syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) is a common inflammatory disease that presents with periodic fever. We aimed to establish more specific diagnostic criteria for PFAPA based on the clinical characteristics of PFAPA patients in our directory. METHOD: The clinical, laboratory, genetic, and family history details of 257 Japanese PFAPA patients treated at our and other affiliated hospitals between April 2000 and April 2018 were analyzed along with quantitative measurements of the number of CD64 molecules on neutrophils, and the levels of serum inflammatory cytokines. The sensitivity and specificity of the criteria were calculated for several diseases. RESULTS: Because recurrent fevers were crucial findings, they were defined as the required criterion. Tonsillitis/pharyngitis with white moss were important accompanying signs. Other symptoms associated with febrile episodes were cervical lymphadenitis with tenderness, aphthous stomatitis, sore throat, vomiting, and headache but not cough. A total of 159 (62%) patients had a family history of recurrent fevers, indicating autosomal dominant inheritance. C-reactive protein levels were extremely elevated during febrile attacks but normal in attack-free periods. Serum immunoglobulin D levels were high in 72 of the 199 tested patients. Oral glucocorticoid and cimetidine were extremely effective in all and 51.6% of the patients, respectively. We defined the above as supportive criteria. These criteria were sensitive and specific enough to distinguish PFAPA from other recurrent fever diseases. Raised serum interferon-γ levels and remarkable CD64 expression on neutrophils during flare-ups were recognized, indicating they contributed to diagnosis. CONCLUSION: Our new criteria are useful for diagnosing PFAPA.


Assuntos
Febre/diagnóstico , Doenças Hereditárias Autoinflamatórias/diagnóstico , Linfadenite/diagnóstico , Faringite/diagnóstico , Estomatite Aftosa/diagnóstico , Biomarcadores/sangue , Pré-Escolar , Citocinas/sangue , Feminino , Febre/sangue , Febre/imunologia , Febre/terapia , Glucocorticoides/uso terapêutico , Doenças Hereditárias Autoinflamatórias/sangue , Doenças Hereditárias Autoinflamatórias/imunologia , Doenças Hereditárias Autoinflamatórias/terapia , Hereditariedade , Antagonistas dos Receptores Histamínicos H2/uso terapêutico , Humanos , Lactente , Mediadores da Inflamação/sangue , Japão , Linfadenite/sangue , Linfadenite/imunologia , Linfadenite/terapia , Masculino , Proteína Cofatora de Membrana/sangue , Neutrófilos/imunologia , Linhagem , Faringite/sangue , Faringite/imunologia , Faringite/terapia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estomatite Aftosa/sangue , Estomatite Aftosa/imunologia , Estomatite Aftosa/terapia , Síndrome , Tonsilectomia , Resultado do Tratamento
18.
Int J Pediatr Otorhinolaryngol ; 123: 63-65, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31075708

RESUMO

We describe the case of a young boy with severe clinical symptoms which mimicked several findings consistent with a peritonsillar abscess (PTA). After the patient exhibited no improvement with medical management, imaging revealed an intramuscular medial pterygoid abscess secondary to parapharyngeal space lymphadenitis. This is the first reported case of a patient with a medial pterygoid abscess secondary to lymphadenitis. We also describe a minimally invasive surgical approach for incision and drainage of the abscess that has not previously been described in the literature.


Assuntos
Abscesso/diagnóstico por imagem , Abscesso/cirurgia , Linfadenite/diagnóstico , Músculos Pterigoides , Abscesso/etiologia , Criança , Drenagem , Humanos , Linfadenite/complicações , Masculino , Tomografia Computadorizada por Raios X
19.
Anaerobe ; 57: 115-116, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31002871

RESUMO

Eggerthia catenaformis is a Gram-positive anaerobic rod, which has been rarely reported in human diseases. We report the second case of bacteremia due to this microorganism in an elderly patient. A 73-year-old man, without underlying diseases presented with fever, odynophagia and swelling of the cervical lymph node for several days. Culture of drained cervical fluid resulted in the isolation of Raoultella ornithinolytica and Streptococcus anginosus. Anaerobic blood cultures yielded a rare anaerobic microorganism, identified as Eggerthia catenaformis. No resistance to tested antimicrobials was documented. Treatment with drainage and several antibiotic regimens was established, and the general condition of the patient improved, at two months of follow-up.


Assuntos
Abscesso/complicações , Bacteriemia/diagnóstico , Bacteriemia/patologia , Firmicutes/isolamento & purificação , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/patologia , Doenças Periodontais/complicações , Abscesso/diagnóstico , Idoso , Antibacterianos/uso terapêutico , Sangue/microbiologia , Drenagem , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/diagnóstico , Infecções por Enterobacteriaceae/microbiologia , Humanos , Linfadenite/complicações , Linfadenite/diagnóstico , Linfadenite/microbiologia , Linfadenite/terapia , Masculino , Doenças Periodontais/diagnóstico , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Streptococcus anginosus/isolamento & purificação
20.
Eur J Clin Microbiol Infect Dis ; 38(6): 1113-1122, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30834995

RESUMO

Nontuberculous mycobacteria are the most frequent cause of chronic cervical lymphadenitis in childhood. The aim of the study was to evaluate the performance of IL-2, IL-17, and INF-γ in-house enzyme-linked immunospot assays using a Mycobacterium avium lysate, in order to identify a noninvasive diagnostic method of nontuberculous mycobacteria infection. Children with subacute and chronic lymphadenopathies or with a previous diagnosis of nontuberculous mycobacteria lymphadenitis were prospectively enrolled in the study. Sixty children with lymphadenitis were included in our study: 16 with confirmed infection (group 1), 30 probable infected (group 2) and 14 uninfected (group 3). Significantly higher median cytokine values were found in group 1 vs group 2, in group 1 vs group 3, and in group 2 vs group 3 considering IL-2-based enzyme-linked immunospot assay (p = 0.015, p < 0.001, p = 0.004, respectively). INF-γ-based enzyme-linked immunospot assay results were significantly higher in group 2 vs group 3 (p = 0.010). Differences between infected and uninfected children were not significant considering IL-17 assays (p = 0.431). Mycobacterium avium lysate IL-2 and INF-γ-based enzyme-linked immunospot assays seem to be promising noninvasive diagnostic techniques for discriminating children with nontuberculous mycobacteria lymphadenitis and noninfected subjects.


Assuntos
Citocinas/sangue , ELISPOT/normas , Linfadenite/diagnóstico , Complexo Mycobacterium avium/imunologia , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Adolescente , Biomarcadores/sangue , Criança , Pré-Escolar , Testes Diagnósticos de Rotina , Feminino , Humanos , Lactente , Recém-Nascido , Interferon gama/sangue , Interleucina-17/sangue , Interleucina-2/sangue , Linfadenite/sangue , Masculino , Infecção por Mycobacterium avium-intracellulare/sangue , Estudos Prospectivos , Curva ROC
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