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Imaging of rickettsial, spirochetal, and parasitic infections.

This article reviews the clinical signs, symptoms, and neuroimaging findings of the commonly known rickettsial, spirochetal, and parasitic infections (cysticercosis is covered elsewhere in this issue). Differential diagnoses and significant imaging characteristics are reviewed to help narrow the diagnostic possibilities. Several of the infections in this disparate group are not seen as commonly as they once were because of advances in early diagnosis, treatment, improvements in sanitation, and prevention of epidemics. Many of the infections, however, are endemic to certain parts of the world and are seen with increasing frequency in immunocompromised individuals.

Brain↗

[Intestinal spirochetosis in homosexuals infected with HIV. 3 cases].

We report 3 cases of intestinal spirochetosis in homosexuals infected with the human immunodeficiency virus (2 group III and 1 group IV C1, according to the Centers for Disease Control classification) presenting with moderate, chronic diarrhea. The diagnosis was made based on the histological examination of colorectal biopsies showing a layer of spirochetes carpeting the epithelium. Electron microscopy evaluation and culturing of the microorganism provided information on the bacterium's morphology. Metronidazole effectively treated the diarrhea. Intestinal spirochetes, whose existence has been recognized for more than a century, constitute a heterogeneous group of bacteria whose pathogenic role in man remains controversial. The systemic search for these organisms in a large series of patients would help to situate their place among the various etiologies of infectious diarrhea in immunodepressed subjects.

Adult↗

Infectious diseases of travelers and immigrants.

Many tropical and other unusual infections can occur in travelers or among foreign-born persons who have emigrated to the United States. The approach to the differential diagnosis includes considering the patient's geographic history, dates of travel, and clinical presentation, along with the geographic distribution and possible incubation periods of suspected pathogens. Important considerations include malaria, typhoid fever, rickettsial disease, dengue, brucellosis, tuberculosis, and leptospirosis. Traveler's diarrhea and dysentery are also common.

Bacterial Infections↗

Hematological changes in infectious diseases. Hematological consequences of bacterial, protozoal and spirochetal infections (2).

A number of distinct hematological alterations take place in the presence of infectious diseases. This review seeks to provide a diagnostic guide and prognostic criteria for the clinician in the light of the concomitant hematological changes occurring in course of acute and chronic viral, bacterial, spirochetal and protozoal infections. The authors emphasize the fact that although certain broad principles may be applied to each type of infection, these principles may have to be interpreted with considerable latitude in any individual case, on account of the variable factors of virulence and resistance. The careful examination of blood films and bone marrow smears, supplemented when appropriate by cytochemical reactions, may be useful in the differential diagnosis of various infective states and in assessing both the severity of the pathological condition and the response of the patient.

Bacterial Infections↗

Comparative pathology of bacterial enteric diseases of swine.

Enteric bacterial infections are among the most common and economically significant diseases affecting swine production worldwide. Clinical signs of these infections include diarrhea, reduced growth rate, weight loss, and death of preweaned, weanling, grower-finisher, young and adult age breeding animals. The most common etiological agents include Escherichia coli, Clostridium perfringens, Lawsonia intracellularis, Salmonella enterica, and Brachyspira (Serpulina) spp. With the exception of Brachyspira (Serpulina) hyodysenteriae, the cause of swine dysentery, and Lawsonia intracellularis, the cause of proliferative enteropathy, the pathological changes seen with these agents closely resemble the diseases occurring in human beings. Histological changes in the intestines of swine with enteric bacterial infections include bacterial colonization without significant damage (e.g., certain enterotoxigenic E. coli and C. perfringens type A), attaching and effacing lesions with enteropathogenic E. coli and Brachyspira pilosicoli, the cause of colonic spirochetosis, inflammation with S. enterica, and necrotizing and hemorrhagic lesions with certain C. perfringens. Extraintestinal spread of bacteria and/or toxins occurs with some serotypes of E. coli and most serotypes of S. enterica. Enteric bacterial diseases of swine have been used as models to study the pathogenesis of similar diseases of human beings. Several of these pathogens are also important causes of food-borne disease in humans.

Animals↗

Diarrhea in growing-finishing swine.

Regardless of the etiology of an enteric disease in nursery age to finisher swine, making a prompt and accurate diagnosis is crucial. Eliciting a complete history, assessing clinical signs and pathology, and selecting and interpreting laboratory tests are essential components in achieving this. Early detection and diagnosis of enteric disease is particularly critical in the nursery through finisher phase because of economic impacts. Recurrent topics when discussing control and prevention of enteric diseases are reducing stress and improving pig comfort and reducing or eliminating exposure through sanitation and biosecurity. These are not new concepts; in fact, prior to the advent of antimicrobials, they were the mainstay of treatment of enteric diseases. With concern over the use of antimicrobials in food animal production increasing, exploiting disease ecology to control enteric diseases is increasing in importance. New vaccines and bacterins for postweaning swine enteric diseases are needed tools to exploit the pig's immune system. Recent advances in diagnostic capabilities allow an increase in understanding and exploitation of disease ecology.

Animals↗