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PubMed1985

The pathogenesis of Yersinia enterocolitica infection in gnotobiotic piglets.

Yersinia enterocolitica is an important cause of enteritis and mesenteric adenitis in many countries. However the pathogenesis of the disease caused by this organism has not been fully elucidated. Most isolates from clinical material possess two independent properties associated with virulence whose relative contribution to the development of disease is not known. These are the ability to penetrate the intestinal wall, which is thought to be controlled by a plasmid gene, and the production of heat-stable enterotoxin, which is controlled by a chromosomal gene. In this study, we infected neonatal gnotobiotic piglets with strains of Y. enterocolitica expressing these two properties in various combinations. The suitability of the piglet model was shown in experiments in which piglets fed virulent Y. enterocolitica serogroup O3 developed a clinical illness related to the size of the inoculum, which was accompanied by intestinal lesions similar to those reported in naturally and experimentally infected people and animals. The results confirmed the key role of a 47 X 10(6)-mol. wt plasmid in the pathogenicity of Y. enterocolitica, but suggested that penetration of the intestinal wall may be governed by chromosomal rather than plasmid-borne genes. No role for enterotoxin in the pathogenesis of yersiniosis was shown, although there was evidence that enterotoxin may promote intra-intestinal proliferation of Y. enterocolitica, thus favouring increased shedding of bacteria and encouraging their spread between hosts.

Animals↗

PubMedDate not supplied

Cervicofacial lymphadenitis due to atypical mycobacteria: a surgical disease.

Despite the increasing prevalence of cervicofacial lymphadenitis due to atypical mycobacteria (AMB) in children, the true nature of AMB infection in clinical practice is poorly understood. The purpose of our study was to define the most common signs and symptoms, and to establish a workable scheme of diagnosis and treatment. Patients fulfilling the criteria of AMB infection (i.e., clinical signs, positive cultures or polymerase chain reaction, histologic features) were included in the study. All children underwent a standard surgical procedure, depending on pretreatment and the course of the disease. Sixteen infants presented with characteristic unilateral lymphadenopathy predominantly involving the submandibular area (13/16). Eight children had been initially treated at various institutions by fine-needle puncture or incision, and 7 of the 16 patients had received antituberculous multidrug treatment for a varying length of time. Complete excision of the affected lymph nodes was the definitive treatment in all patients. Three children had transient marginal mandibular nerve paralysis that resolved within a few months in all cases. Recognition of the characteristic features of AMB adenitis may permit early diagnosis and appropriate surgical treatment.

Child↗

PubMed1977

The liver in sarcoidosis.

Neddle biopsies of the liver were performed in 121 cases of sarcoidosis. Granulomas compatible with sarcoidosis were seen in 24 percent of the cases. Liver function tests (serum alkaline phosphatase, serum aspartate aminotransferase, serum alanine aminotransferase, and bromsulphthalein clearance test) were performed on 325 patients with sarcoidosis and on 132 with non-sarcoid erythema nodosum (EN). Pathological findings were seen especially in patients with extensive EN, without any correlation with the disease responsible for the eruption. Hepatic granulomas were found more often in patients with sarcoid changes in lung parenchyma than in those with bilateral hilar adenitis only. There were no other definite correlations between hepatic granulomas and other clinical and laboratory findings. The incidence of pathological results in this study was clearly lower than, e.g., in the USA, thus reflecting the good prognosis of sarcoidosis in the Scandinavian countries.

Acute Disease↗

PubMed2004

Swan-neck deformity and paresthesia following giant orf.

Orf is a zoonotic infection caused by a parapoxvirus that primarily infects sheep and goats. Human orf infection can take place when abraded skin comes into contact with infected animals. It occurs most commonly on the index finger. The characteristic lesion resembles a tumor and resolves spontaneously, usually without any complications. However, rare complications such as lymphangitis, adenitis, erythema multiforme, erysipelas, papulovesicular eruption, Pseudomonas aeruginosa infection, and bullous pemphigoid have been reported. Herein, we report a case of giant orf causing swan-neck deformity and paresthesia. These complications have not been previously reported in the literature.

Animals↗

PubMed2006

Tuberculosis complicating treatment of hepatitis C in an HIV-infected haemophilia A patient.

Pegylated interferon (pegIFN)/ribavirin has been established as the treatment of choice for chronic hepatitis C in HIV co-infected individuals [1-3]. We report the case of an individual who was well prior to treatment, but was diagnosed with tuberculous adenitis after receiving 12 weeks of pegIFN/ribavirin therapy. The association of pegIFN and ribavirin therapy with tuberculosis (TB) has not been described previously.

Adult↗

PubMed1989

Chronic infectious mononucleosis; a case report.

A 39-year-old woman had an adenitis colli followed by anaemia, splenomegaly, atypical lymphoid cells in blood with increased B-lymphocytes, reduced T-suppressor/cytotoxic cells, increased polyclonal IgM, high titres of EB VCA IgG, EB EA IgD&R +/- and EBNA IgG-. The disease progressed slowly for 2 years, splenectomy was followed by clinical improvement; spleen morphology was compatible with a benign disease of viral origin.

Adult↗

PubMed2005

Thymoma-associated exfoliative dermatitis in a rabbit.

A 5-year-old rabbit with generalized scaling is presented. Multiple skin scrapings and acetate tape impressions were negative for mites and Malassezia. Culture for dermatophytes was also negative. Skin biopsies showed similarities with sebaceous adenitis described in rabbits (absence of sebaceous glands, perifollicular lymphocytic infiltrate at the level of the absent sebaceous glands, lymphocytic mural folliculitis, interface dermatitis). The owners refused any treatment and 2 months later the rabbit was euthanized due to anorexia. At necropsy a mass was found in the anterior mediastinum. Histopathology confirmed a diagnosis of thymoma. A possible paraneoplastic skin disease was suspected, based on similarities with thymoma-associated exfoliative dermatitis in cats.

Animals↗

PubMed2006

Three cases of immune-mediated adnexal skin disease treated with cyclosporin.

Cyclosporin is currently considered a new and interesting drug in veterinary dermatology for the treatment of immune-mediated skin diseases, and a safe and effective alternative to immunosuppressive therapy with glucocorticoids. The authors report a case of granulomatous folliculitis and furunculosis and of sebaceous adenitis in two cats and a case of alopecia areata in a dog, successfully controlled with cyclosporin.

Alopecia↗

PubMed2006

An evaluation of the clinical, cytological, infectious and histopathological features of feline acne.

Clinical, cytological, microbial and histopathological features of feline acne were investigated in 22 cats referred or volunteered to a veterinary dermatology practice in the south-west region of the USA. For comparison, same parameters were evaluated in five unaffected pet cats. Additionally, all cats were evaluated by immunohistochemistry (IHC) for the presence of feline calicivirus (FCV) and feline herpes virus (FHV-1) in acne lesions. The age of onset of acne in affected cats ranged from 6 months to 14 years with a median of 4 years. The most common dermatologic lesions were comedones (73%), alopecia (68%), crusts (55%), papules (45%) and erythema (41%). Pruritus was reported in 35% of the affected cats. Cytological evidence of Malassezia pachydermatitis was present on 4/22 (18%) of affected cats. Microsporum canis was isolated from a single affected cat. Bacteria were isolated from 10 of the 22 (45%) affected cats; coagulase-positive staphylococci and alpha-haemolytic streptococci were most common. Histopathological features included lymphoplasmacytic periductal inflammation (86%), sebaceous gland duct dilatation (73%), follicular keratosis with plugging and dilatation (59%), epitrichial gland occlusion and dilatation (32%), folliculitis (27%), pyogranulomatous sebaceous adenitis (23%) and furunculosis (23%). In one affected cat from a household with five cats, simultaneously having feline acne, FCV antigen was detected in the biopsy of the chin by IHC. Chin tissue samples from all other affected cats, as well as the five healthy cats, were negative by IHC for FCV and FHV-1 antigens.

Acne Vulgaris↗

PubMed2005

Uveodermatologic (VKH-like) syndrome in American Akita dogs is associated with an increased frequency of DQA1*00201.

The Akita breed of dog is affected by a number of distinct immune-mediated diseases, including thyroiditis, sebaceous adenitis, pemphigus foliaceus, uveitis, polyarthritis, myasthenia gravis, and uveodermatologic (UV) syndrome. UV syndrome is manifested by progressive uveitis and depigmenting dermatitis that closely resembles the human Vogt - Koyanagi - Harada syndrome. This study examined the allelic diversity of the three DLA class II loci (DRB1, DQA1, and DQB1) in the American Akita dog, and the relationship of specific DLA class II alleles to the UV. Low allelic variation was demonstrated within genes of DLA class II. American Akita dogs possessed six of the reported 16 DQA1 alleles, but only eight of 61 reported alleles in DRB1 and nine of 47 reported alleles in DQB1. Almost one-half of American Akita dogs were homozygous for a single allele at DQA1 and up to a quarter at DRB1 and DQB1. DLA-DQA1*00201 was associated with a significantly higher relative risk (RR = 15.3) or odds ratio (OR = 15.99) for UV syndrome than other DLA class II alleles. No significant association was noted with haplotypes of DRB1, DQB1, and DQA1 alleles; DRB1*03201-DQA1*00201 trended toward significance. This study confirmed loss of DLA genetic diversity in the American Akita dog in common with other pure breeds of dog and suggested a role for certain DLA class II gene alleles in the pathogenesis of UV.

Alleles↗

PubMed1992

Glutamate mutase from Clostridium cochlearium. Purification, cobamide content and stereospecific inhibitors.

Both components, E and S, of the adenosylcobalamin-(coenzyme B12)-dependent glutamate mutase from Clostridium cochlearium were purified. Component S (16 kDa) must be added to component E to obtain activity, although the latter contains substoichiometric amounts of component S besides the major 50-kDa subunit. The enzyme proved to be very similar to that of C. tetanomorphum as described by Barker et al. [Barker, H. A., Rooze, V., Suzuki, F. & Iodice, A. A. (1964) J. Biol. Chem. 239, 3260-3266] but component E of C. cochlearium was more stable and led to the first pure preparation. The pink component E showed a cobamide-like absorbance spectrum with a characteristic maximum at 470 nm indicating the presence of a cob(II)amide, probably Co alpha-[alpha-(aden-9-yl)]-cob(II)amide. A typical cob(II)amide signal at g = 2.23 with hyperfine and superhyperfine splitting was observed by EPR spectroscopy. A cobamide content of about 0.43 mol/mol 50-kDa subunit was determined by cyanolysis. Substitution of the migrating hydrogen at C-4 of glutamate by fluorine yielded the potent competitive inhibitor (2S,4S)-4-fluoroglutamate (Ki = 70 microM). (2R,3RS)-3-Fluoroglutamate (Ki = 600 microM) was also inhibitory. The competitive inhibition by 2-methyleneglutarate (Ki = 400 microM) and (S)-3-methylitaconate (Ki = 100 microM) but not by (RS)-2-methylglutarate suggested the transient formation of an sp2 center during catalysis. However, the presence of an N-terminal pyruvoyl residue was excluded and no evidence for the participation of another electrophilic center in the reaction was obtained.

Amino Acid Isomerases↗

PubMed1993

Orf. Clinical and epidemiological study.

Twenty eight human cases of orf were studied from clinical and epidemiological points of view. Most of the patients were shepherds who were inoculated from infected animals during all seasons of the year. Typical lesions of different stages of orf were located on the hands, and were accompanied by local symptoms such as pain, pruritus, lymphangitis and adenitis, or less frequently by systemic symptoms such as fever or malaise. Two cases developed erythema multiforme, one developed erysipelas and another a papulovesicular eruption. Tzanck test may contribute to the diagnosis. The course of the disease can not be influenced by antibiotics, and only measures of local hygiene are recommended, except in complicated cases.

Adolescent↗

PubMed2006

Paediatric tuberculosis in a Pacific Islands community in New Zealand.

OBJECTIVES: To describe the demographic, clinical and management aspects of an outbreak of tuberculosis (TB) within a paediatric Pacific Island community in Auckland, New Zealand, in 2002-2003. METHODS: The index and source case are described along with details of the extensive contact tracing that was undertaken in this community. RESULTS: A total of 24 children were diagnosed with TB over an 11-month period. All cases were found to be epidemiologically linked to the one source case, mother of the index case. This total included 22 children with pulmonary disease, 1 case of miliary disease (index case) and 1 of cervical adenitis. Only 58% had symptoms at diagnosis and only 5 presented to medical attention with symptoms, the remainder had symptoms disclosed after contact tracing occurred. The Mycobacterium tuberculosis isolate was fully sensitive and all children (excluding the child with miliary disease) received short course directly observed therapy. One child developed hepatotoxicity requiring modification of his drug regimen. CONCLUSIONS: Children are at high risk of developing active disease after exposure to TB. The study describes the minimal symptoms manifested in many of the children with significant radiological changes consistent with pulmonary TB. This highlights the need to consider Mantoux testing and chest X-rays for children presenting with persistent respiratory symptoms in high-risk populations. Issues of contact tracing and adherence were also a problem in this population.

Adult↗

PubMed1993

Laparoscopic appendicectomy: a prospective analysis.

The potential advantages of laparoscopic surgery for a number of abdominal operations including appendicectomy have been heralded. In this study the aims were to assess prospectively the role of routine diagnostic laparoscopy in the diagnosis of acute appendicitis and determine the efficacy of laparoscopic appendicectomy. Patients with suspected acute appendicitis had diagnostic laparoscopy. When the diagnosis was confirmed laparoscopic appendicectomy was performed. Where an alternative diagnosis was made the appropriate treatment was instituted. If no diagnosis could be made the macroscopically normal appendix was removed by laparoscopic appendicectomy. Eighty-one patients (50 female, 31 male) had an initial diagnostic laparoscopy; 53 had appendicitis and proceeded to laparoscopic appendicectomy. A diagnosis could not be established at diagnostic laparoscopy in six patients and they also proceeded to laparoscopic appendicectomy. An alternative diagnosis was made in the remaining 22 patients (19 female and 3 male), with five proceeding to laparotomy and one patient with mesenteric adenitis having laparoscopic appendicectomy. Seven patients having laparoscopic appendicectomy required conversion to an open operation due to a retrocaecal or perforated appendix. The median operating time for successful laparoscopic appendicectomy was 55 min (range 30-95). Morbidity occurred in five of 53 patients having a successful laparoscopic appendicectomy. The median postoperative hospital stay was 2 days. The median time before return to normal activities was 8 days. Diagnostic laparoscopy is a useful diagnostic technique in women with suspected acute appendicitis, as it improves diagnostic accuracy, reduces the negative appendicectomy rate and avoids unnecessary laparotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

PubMed1998

Mycobacterial lymphadenitis in eastern Sydney.

BACKGROUND: There has been a resurgence of tuberculosis (TB) in the developed world, especially extrapulmonary manifestations, of which lymphadenitis is the most common. We reviewed all cases of mycobacterial lymphadenitis notified in the eastern suburbs of Sydney from 1989 to 1996. AIMS: To review all cases of mycobacterial adenitis in eastern Sydney. METHODS: This was a retrospective review of the medical records of 54 patients (aged 1.2 to 84 years), recruited from all notifications of TB presenting as lymphadenitis at Prince of Wales, Sydney Children's and St Vincent's Hospitals. RESULTS: There were two distinct groups: Group 1, patients with Mycobacterium tuberculosis (MTB), n = 37 (68.5%), Group 2, patients with atypical mycobacteria, n = 17 (31.5%). For Group 1, 83.3% were foreign born and 18.9% were positive for the human immunodeficiency virus (HIV). Disease involved single node groups in 73% (the cervical chain was involved in 70.1%). Complete resolution of lymphadenopathy at conclusion of treatment occurred in 73.1%. Outcome was not documented in 13.5%, of the rest; 83.8% completed treatment; 2.7% were lost to follow up before treatment concluded; 2.7% were still being seen at the time of writing and 10.8% died within six months of treatment starting (all were HIV positive). HIV positive patients had more diffuse disease. Group 2 were all Australian born. They comprised children less than six years who were all HIV negative and adults (aged 30-55 years) who were all HIV positive. The children were all treated surgically with 80% having complete resolution of their modes. Those adults with HIV had a mortality of 83.3% during treatment. CONCLUSIONS: In eastern Sydney lymphadenitis caused by MTB in the HIV negative population is mostly seen in those who are immigrants. Our large proportion of HIV positive patients tended to have diffuse disease and a high mortality. The reporting of outcomes was poor and in a greater than expected number of outcome and follow up were inadequately documented.

AIDS-Related Opportunistic Infections↗

PubMed1979

The leukocytic response in ligated rat submandibular glands.

Within 1 h after ligation of the main excretory duct of the rat submandibular salivary gland neutrophils begin to migrate into the parenchymal epithelium and by 18 h they accumulate, unchanged, within the lumina of acini and intralobular ducts. By 24 h, monocytes become the predominant intraepithelial migrating cell type. These selectively migrate into lumina of convoluted ducts where they phagocytize intraluminal material consisting of secretion products, egested cell debris and neutrophils. By 4 days monocytes laden with phagosomes begin to migrate into the stroma and by 17 days relatively few leukocytes remain within the parenchyma. Changes in ligated gland weight reflect the cytological changes. It is concluded that in experimental obstructive adenitis monocytes play a most important role while neutrophils are adventitious.

Animals↗

PubMed1986

Immunohistochemical localization of amylase in sialoadenitis and salivary gland tumors.

Immunohistochemical demonstration of alpha-amylase has been made in sialoadenitis-involved tissue and salivary gland tumors, as well as in normal salivary glands. Immunoreactive alpha-amylase with trypsin pretreatment was confined to irregularly staining serous acinar cells in the parotid and submandibular glands, and to demilunes in sublingual glands. In obstructive adenitis, staining was irregular from high to negative in acini in early or intermediate stages. Dilated ductal segments contained cells positive for alpha-amylase in the early stage following obstruction. Pleomorphic adenomas were usually negative for alpha-amylase but in rare cases tumor epithelia stained variably positive; i.e., staining occurred throughout the cytoplasm or at the periphery or apical part of the tumor cells. Luminal cavities of tubular and duct-like structures contained alpha-amylase-positive material. Epithelia in Warthin's tumor were also negative in general; however, scattered single or grouped tumor cells containing alpha-amylase were found. Mucoepidermoid tumors were also negative, though slightly positive cells were found intermingled among the negative squamous and mucous tumor cells. Cystic lesions in mucoepidermoid tumor were sometimes positive in the wall cells together with material secreted into the lumen.

Adenoma, Pleomorphic↗

PubMed1991

An investigation of parotid gland function and histopathology in autoimmune disease-prone mice of different age groups.

This work aimed to characterize parotid gland function in autoimmune disease-prone murine strains (MRL/n, MRL/l and NZB/W) in relation to increasing age and to relate the extent of functional impairment to the intensity of histopathologic changes observed at the different ages. Pilocarpine-stimulated parotid saliva was collected to assess salivary flow rate and composition. Parotid tissue was then removed for histopathologic assessment. Parotid flow rates were not significantly reduced in autoimmune strains compared to controls but were reduced with age in NZB/W mice and in males of the C57 (control) strain. Age-related salivary compositional changes were present in MRL/l mice and in male NZB/W mice. Focal lymphocytic adenitis increased with age in prevalence and intensity in both sexes. The functional and histopathologic changes were not closely correlated. These results suggest that the parotid gland of autoimmune disease-prone mice provides only a poor replication of the salivary changes in human Sjögren's syndrome. Nevertheless, both the functional and histopathological changes developing in these strains, even though of limited extent, are significantly influenced by age.

Aging↗