Clinical analysis of patients with oral and maxillofacial infections in oral emergency / 北京大学学报(医学版)

OBJECTIVE@#To analyze the composition, incidence and clinical characteristics of oral and maxillofacial infections in oral emergency.@*METHODS@#A retrospective study on patients with oral and maxillofacial infections who visited the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2017 to December 2019 was conducted. General characteristics, such as disease composition, gender, age distribution and position of involved teeth were analyzed.@*RESULTS@#A total of 8 277 patients with oral and maxillofacial infections were finally collected, including 4 378 male patients (52.9%) and 3 899 female patients (47.1%), with gender ratio of 1.12:1. The common diseases were periodontal abscess (3 826 cases, 46.2%), alveolar abscess (3 537 cases, 42.7%), maxillofacial space infection (740 cases, 9.0%), sialadenitis (108 cases, 1.3%), furuncle & carbuncle (56 cases, 0.7%) and osteomyelitis (10 cases, 0.1%). Male patients were more easily affected by periodontal abscess, space infection and furuncle & carbuncle than female patients with the gender ratios 1.24:1, 1.26:1, 2.50:1 individually, while the incidence of alveolar abscess, sialadenitis, furuncle & carbuncle had no significant gender difference. Different diseases were prone to occur at different ages. The peak ages of alveolar abscess were 5-9 and 27-67 years, while the peak age of periodontal abscess was 30-64 years. Space infection tended to occur between 21-67 years. There were 7 363 patients with oral abscess (3 826 patients with periodontal abscess and 3 537 patients with alveolar abscess), accounting for 88.9% of all the patients with oral and maxillofacial infections, involving 7 999 teeth, including 717 deciduous teeth and 7 282 permanent teeth. Periodontal abscess usually occurred in permanent teeth, especially the molar teeth. Alveolar abscess may occur in both primary teeth and permanent teeth. In primary teeth, the most vulnerable sites were primary molar teeth and maxillary central incisors while in permanent teeth the most vulnerable sites were first molar teeth.@*CONCLUSION@#Understanding the incidence of oral and maxillofacial infection was conducive to the correct diagnosis and effective treatment of clinical diseases, as well as targeted education for patients of different ages and genders to prevent the occurrence of diseases.

Study on the explicitation of implicit knowledge and the construction of knowledge graph on moxibustion in medical case records of ZHOU Mei-sheng's Jiusheng / 中国针灸

To explore the methods of the explicitation of implicit knowledge and the construction of knowledge graph on moxibustion in medical case records of ZHOU Mei-sheng's Jiusheng. The medical case records data of Jiusheng was collected, the frequency statistic was analyzed based on Python3.8.6, complex network analysis was performed using Gephi9.2 software, community analysis was performed by the ancient and modern medical case cloud platform V2.3.5, and analysis and verification of correlation graph and weight graph were proceed by Neo4j3.5.25 image database. The disease systems with frequency≥10 % were surgery, ophthalmology and otorhinolaryngology, locomotor, digestive and respiratory systems. The diseases under the disease system were mainly carbuncle, arthritis, lumbar disc herniation and headache. The commonly used moxibustion methods were fumigating moxibustion, blowing moxibustion, direct moxibustion and warming acupuncture. The core prescription of points obtained by complex network analysis included Yatong point, Zhiyang(GV 9), Sanyinjiao(SP 6), Dazhui(GV 14), Zusanli(ST 36), Lingtai(GV 10), Xinshu(BL 15), Zhijian point and Hegu(LI 4), which were basically consistent with high-frequency points. A total of 6 communities were obtained by community analysis, corresponding to different diseases. Through the analysis of correlation graph, 13 pairs of strong association rule points were obtained. The correlation between Zhiyang(GV 9)-Dazhui(GV 14) and Yatong point-Lingtai(GV 10) was the strongest. The acupoints with high correlation with Yatong point were Zhiyang(GV 9), Lingtai(GV 10), Dazhui(GV 14), Zusanli(ST 36) and Sanyinjiao(SP 6). In the weight graph of the high-frequency disease system, the relationship of the first weight of the surgery system disease was fumigating moxibustion-carbuncle-Yatong point, and the relationship of the first weight of the ophthalmology and otorhinolaryngology system disease was blowing moxibustion-laryngitis-Hegu (LI 4). The results of correlation graph and weight graph are consistent with the results of data mining, which can be used as an effective way to study the knowledge base of moxibustion diagnosis and treatment in the future.

Seguridad ocupacional contra Bacillus anthracis en la industria de curtiembre peruana / Occupational safety against Bacillus anthracis in the Peruvian tannery industry

El carbunco es una zoonosis que afecta a animales herbívoros, causada por el microorganismo Bacillus anthracis; que se encuentra en su forma vegetativa en el organismo infectado, y una vez en contacto con el aire forma esporas que infectan al huésped, liberando toxinas que inducen edema, septicemia y necrosis tisular. En humanos, la transmisión se produce por cortes, pinchazos o contacto directo de piel lesionada con esporas o tejidos de animales infectados. En Perú, para la década de 1980, se reportaron 400 casos anuales en áreas rurales agrícolas, adquiridos por manipulación del ganado vacuno, muerto por ántrax. Es por ello, que la piel y el cuero procedente de animales infectados representa un riesgo de infección para los trabajadores de industrias curtiembres. Se realizó un estudio transversal para evaluar el riesgo biológico ocupacional y las medidas de bioseguridad relacionadas con el Bacillus anthracis en pequeñas, medianas y grandes empresas curtiembres peruanas. Se aplicó un instrumento a los trabajadores para cuantificar las variables, componentes de riesgo biológico y conocer las medidas higiénicas adoptadas. Posteriormente se calculó e interpretó el nivel de riesgo biológico. Se encontró que el nivel de riesgo supera el límite de exposición biológica para el Bacillus anthracis en todas las empresas evaluadas y los trabajadores de las pequeñas empresas tienen poco conocimiento acerca del riesgo biológico al que están expuestos, siendo necesaria la capacitación de los trabajadores acerca del Bacillus anthracis y adopción de medidas de bioseguridad en empresas curtiembres, que garanticen la salud de los trabajadores(AU)

Anthrax is a zoonosis that affects herbivorous animals, caused by the microorganism Bacillus anthracis; which is found in its vegetative form in the infected organism, and once in contact with the air it forms spores that infect the host, releasing toxins that induce edema, septicemia and tissue necrosis. In humans, transmission occurs through cuts, punctures, or direct contact of broken skin with spores or tissues of infected animals. In Peru, for the 1980s, 400 annual cases were reported in rural agricultural areas, acquired by handling cattle, which died of anthrax. For this reason, the skin and leather from infected animals represent a risk of infection for workers in tanneries. A cross-sectional study was carried out to evaluate the occupational biological risk and biosafety measures related to Bacillus anthracis in small, medium and large Peruvian tanneries. An instrument was applied to the workers to quantify the variables, components of biological risk and to know the hygienic measures adopted. Subsequently, the level of biological risk was calculated and interpreted. It was found that the level of risk exceeds the biological exposure limit for Bacillus anthracis in all the companies evaluated and the workers of the small companies have little knowledge about the biological risk to which they are exposed, being necessary the training of the workers about the Bacillus anthracis and adoption of biosafety measures in tanneries, which guarantee the health of workers(AU)

Clostridial diseases diagnosed in cattle from the South of Rio Grande do Sul, Brazil. A forty-year survey (1978-2018) and a brief review of the literature / Clostridioses diagnosticadas em bovinos no sul do Rio Grande do Sul. Uma pesquisa de quarenta anos (1978-2018) e breve revisão da literatura

Clostridial diseases are important causes of livestock losses in the southern Rio Grande do Sul. Since 1978 annual surveys conducted at the "Laboratório Regional de Diagnóstico" of the "Universidade Federal de Pelotas" (LRD-UFPel) have shown that clostridial diseases represent 10.40% of the bacterial diseases diagnosed in cattle and 1.65% of all diseases diagnosis in cattle over a 40-year period. The purpose of this study is to review the clinical, epidemiological and pathological aspects of the clostridial diseases diagnosed in cattle from January 1978 to December 2018 at the LRD-UFPel in the hopes that it will constitute a useful guide for field veterinary practitioners and interested farmers. We assessed and review the necropsy protocols of 6,736 cattle; these necropsies were performed either by LRD-UFPel faculty or by field veterinary practitioners; 111 outbreaks (1.65%) were diagnosed as clostridial disease, distributed as follows: 35 outbreaks of tetanus, 34 of blackleg, 23 of bacillary hemoglobinuria, 11 of malignant edema (gas gangrene), and eight of botulism. Approximately 904, from a total of 42,480 cattle at risk, died in these outbreaks.(AU)

Clostridioses são doenças produzidas por alguma das espécies do gênero Clostridium e são importantes causas de perdas pecuárias no sul do Rio Grande do Sul. Pesquisas anuais realizadas no Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas (LRD-UFPel) desde 1978 demonstraram que as clostridioses representaram 11,1% das doenças bacterianas diagnosticadas em bovinos e 1,65% de todos os diagnósticos de doenças em bovinos ao longo de 40 anos. O objetivo deste estudo é revisar os aspectos clínicos, epidemiológicos e patológicos das clostridioses diagnosticadas de janeiro de 1978 a dezembro de 2018, pelo LRD/UFPel com a intenção de que esse trabalho possa servir de guia útil para os veterinários de campo e fazendeiros interessados. Foram avaliados e revisados os protocolos de necropsia de 6.736 bovinos; essas necropsias foram realizadas pelo pessoal do LRD/UFPel ou por veterinários de campo. Cento e quatro (1,16%) casos foram diagnosticados como clostridioses, distribuídos da seguinte forma: 35 surtos de tétano, 34 de carbúnculo sintomático, 23 de hemoglobinúria bacilar, 11 de edema maligno (gangrena gasosa) e oito de botulismo. Aproximadamente 904, de um total de 42.480 bovinos sob-risco, morreram nesses surtos.(AU)

Blackleg in a free-range brown brocket deer (Mazama gouazoubira) / Carbúnculo sintomático em veado virá de vida livre (Mazama gouazoubira)

A case of blackleg in a brown brocket deer (Mazama gouazoubira) associated with trauma from being hit by a car in southern Rio Grande do Sul is reported. The clinical signs included fever, dehydration and lethargy that worsened progressively until 36 hours after the accident, when the animal died. In the fore right limb, there was a comminuted closed fracture of the radius and ulna but no skin wounds were observed. Grossly, the musculature of the pelvic limbs presented hemorrhage, edema and emphysema. Microscopically, the muscles of both rear legs had necrosis, edema, hemorrhage and mild inflammatory infiltration of neutrophils. Clostridium chauvoei was cultured from affected skeletal muscles, and it was also detected by immunohistochemistry, confirming a diagnosis of blackleg. The overlapping habitat of cattle and brown brocket deer is proposed as a predisposing factor in this case and alerts to spillover cases maybe happening in this region. In addition, blackleg should be included as differential diagnoses of deer with post-traumatic myositis.(AU)

Descreve-se um caso de carbúnculo sintomático em um veado-virá (Mazama gouazoubira), macho, jovem, resgatado após atropelamento em uma rodovia na região sul do Rio Grande do Sul. O cervídeo apresentou febre, desidratação e letargia, progredindo para a morte em 36 horas. No membro torácico direito foi observado fratura cominutiva fechada de rádio e ulna sem a presença de feridas perfurantes. Na necropsia foi observada hemorragia, edema e enfisema na musculatura dos membros pélvicos. Microscopicamente, os músculos dos membros pélvicos apresentaram necrose, edema, hemorragia e discreto infiltrado inflamatório neutrofílico. Houve o isolamento de Clostridium chauvoei e marcação positiva na técnica de IHQ com anticorpo monoclonal anti-C. chauvoei, confirmando o diagnóstico de carbúnculo sintomático. A sobreposição de habitat entre bovinos domésticos e cervídeos pode ser um fator de risco para esta doença e chama a atenção para casos de "spillover" que podem estar ocorrendo na região. Adicionalmente, sugere-se que o carbúnculo sintomático seja incluído nos diagnósticos diferenciais de cervídeos que apresentam miosite pós-traumática.(AU)

Blackleg in cattle in the state Mato Grosso do Sul, Brazil: 59 cases / Carbúnculo sintomático em bovinos em Mato Grosso do Sul: 59 casos

This study aimed to review cases of blackleg (Clostridium chauvoei infection) diagnosed in cattle from Midwestern Brazil from 1994 to 2014 considering epidemiological, clinical, necropsy and histopathological findings. Also the following laboratory tests were used for the diagnosis of some cases of blackleg: microbiological culture and identification of the agent, microbiological culture and identification of the agent by the polymerase chain reaction (PCR), and identification of the agent in formalin fixed paraffin embedded tissues (FFPE). Criteria for presumptive diagnosis of blackleg included necrohemorrhagic emphysematous myositis consisting of inflammatory infiltrate, coagulative necrosis of myofiber, interstitial edema, hemorrhage, and gas bubbles between myofibers. Fifty nine cases from 51 outbreaks of blackleg were found, which corresponded to 1.1% of 5,375 cattle deaths investigated. In five of those outbreaks, samples of affected muscles cultures for the identification of pathogenic clostridia were made. Another three samples of similar material were cultured for clostridia with subsequent identification of the isolate by PCR. Twelve samples of FFPE affected muscle fragments were submitted to PCR for identification of the etiological agent. Except for January, cases were observed in each month of the year, with higher numbers in July-October. Most affected cattle were in the age of 7-12 years, but calves younger than 6 month-old and older than 24 months were also observed. Vaccination histories were scarce. In 32 outbreaks some vaccination history was available, but only in two of those vaccination has been carried out properly. In 56 six cases the skeletal muscles were involved. Muscles of the hind limbs were the most affected. In ten cases muscles of the tongue, myocardium and diaphragm were also affected. In three of the cases the visceral form was observed. Deaths occurred after a clinical course of 6-24 hours, but in most cases cattle were found death. Sudden death was the outcome in visceral cases (cardiac) blackleg. Clostridium chauvoei was confirmed to be the cause by culturing in 5 cases, and by PCR and histopatology in 8 cases. Bacterial culture followed by PCR did not demonstrate C. chauvoei. Calculation of the economic impact indicates that blackleg is a frequent disease in the state of Mato Grosso do Sul (MS) that inflicts significant economic loss. The amount of these losses would be reduced through proper vaccination programs against the prevalent strains of C. chauvoei in the region.(AU)

Este estudo foi realizado com o objetivo de descrever casos de carbúnculo sintomático (infecção por Clostridium chauvoei) diagnosticados em bovinos do Centro-Oeste brasileiro de 1994-2014, avaliando a epidemiologia, os sinais clínicos, os achados de necropsia e a histopatologia; objetivou-se também avaliar os seguintes testes laboratoriais para o diagnóstico de carbúnculo sintomático: cultura microbiológica e identificação do agente, cultura microbiológica e identificação do agente por reação em cadeia de polimerase (PCR) e identificação do agente em material fixado em formol e incluído em parafina (FFIP). Os critérios para o diagnóstico presuntivo de carbúnculo sintomático incluíram miosite necro-hemorrágica enfisematosa, caracterizada por infiltrado inflamatório, necrose de coagulação de miofribras, edema intersticial, hemorragia e bolhas de gás em meio às miofribras. Cinquenta e nove casos oriundos de 51 surtos foram encontrados, o que corresponde a 1,1% das 5.375 mortes de bovinos investigadas. Em cinco desses casos, amostras do músculo afetado foram cultivadas para clostrídios patogênicos. Amostras semelhantes de outros três animais foram cultivadas para clostrídios e os isolamentos identificados subsequentes por PCR. Doze fragmentos de músculo afetado FFIP foram submetidos a PCR para identificação do agente etiológico. Com exceção de janeiro, os casos de carbúnculo sintomático foram observados em todos os meses do ano com uma maior incidência em junho-outubro. A faixa etária da maioria dos bovinos afetados era de 7-12 anos de idade, mas bovinos mais jovens que 6 meses e mais velhos que 24 meses foram também afetados. Os históricos de vacinação eram escassos nesses surtos. Em 32 surtos havia alguma informação sobre a vacinação, mas em apenas dois casos a vacinação tinha sido realizada adequadamente. Cinquenta e seis casos de carbúnculo sintomático deste estudo eram casos clássicos afetando os músculos esqueléticos. Os músculos mais afetados foram os dos membros pélvicos. Em dez casos os músculos da língua, miocárdio e diafragma estavam também afetados. Apenas três dos casos apresentaram a forma visceral (cardíaca). O curso clínico foi de 6-24 horas, mas na maioria dos casos os bovinos foram encontrados mortos. Em casos da forma visceral ocorria morte súbita. Clostridium chauvoei foi confirmado como o agente causal por cultura em cinco casos e por PCR em amostra FFIP em 8 casos. Cultura bacteriana seguida de PCR do isolado não demonstrou C. chauvoei. Carbúnculo sintomático é uma doença frequente em bovinos no Mato Grosso do Sul podendo provocar importantes prejuízos para os produtores rurais. Esses prejuízos podem ser reduzidos através de um programa de vacinação adequado usando-se vacinas eficazes contra cepas de C. chauvoei prevalentes na região.(AU)

Furunculose estreptocócica em equinos / Streptococcal Furunculosis in horses

Foram atendidos quatro casos de furunculose bacteriana, causados pelo agente Streptococcus spp., em equinos de um centro de equoterapia no município de Lavras MG. Micro-organismos do gênero Streptococcus não são agentes usuais deste tipo de afecção. As lesões se apresentavam circunscritas, alopécicas, nodulares, crostosas, dolorosas e não pruriginosas. O diagnóstico se baseou na apresentação clínica e na cultura de secreções coletadas das lesões cutâneas. Antibioticoterapia sistêmica e pomadas tópicas foram utilizados no tratamento, levando à resolução dos casos em vinte dias.

We report four cases of bacterial furunculosis caused by Streptococcus spp. in horses located in a therapeutic riding center in Lavras-MG. Microorganisms of the Streptococcus genus are not usual agents of this affection. The lesions were circumscribed, alopecic, nodular, some showed crosts, were painful and not itchy. The diagnosis was based on clinical presentation and culture of secretions collected from these lesions. Treatment consisted of systemic antibiotics and topical ointments, leading to resolution in twenty days.

Cura local con apiterapia en una paciente con ántrax / Local cure with apitherapy in a patient with anthrax

Se describe el caso clínico de una paciente de 67 años de edad, quien ingresa en el en Servicio de Dermatología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" con diagnóstico de ántrax en región posterosuperior del tórax. Se realiza necrectomía y radiografía simple de tórax que muestra un derrame pleural izquierdo de gran cuantía; por tanto, se traslada al Servicio de Neumología donde se le diagnostica neoplasia de pulmón. La infección de piel se trató con antimicrobianos de uso parenteral y curas locales con miel de abejas, así se logró la resolución total de la lesión.

The case report of a 67 years patient who was admitted in the Dermatology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital with diagnosis of anthrax in postero-superior region of the thorax is described. A necrectomy and simple x-ray of thorax are carried out that which show a significant left pleural effusion; therefore, he was transferred to the Pneumology Service where he is diagnosed with lung neoplasia. The skin infection was treated with antimicrobials of parenteral use and local cures with honey, thus, the total resolution of the lesion was achieved.

Cognitive-Enhancing Effect of Dianthus superbus var. Longicalycinus on Scopolamine-Induced Memory Impairment in Mice

Dianthus superbus (D. superbus) is a traditional crude drug used for the treatment of urethritis, carbuncles and carcinomas. The objective of this study was to confirm the cognitive enhancing effect of D. superbus in memory impairment induced mice and to elucidate the possible potential mechanism. Effect of D. superbus on scopolamine induced memory impairment on mice was evaluated using the Morris water maze and passive avoidance tests. We also investigated acetylcholinesterase (AChE) activity and brain-derived neurotropic factor (BDNF) expression in scopolamine-induced mice. HPLC-DAD analysis was performed to identify active compounds in D. superbus. The results revealed that D. superbus attenuated the learning and memory impairment induced by scopolamine. D. superbus also inhibited AChE levels in the hippocampi of the scopolamine-injected mice. Moreover, D. superbus increased BDNF expression in the hippocampus. Eight compounds were identified using HPLC-DAD analysis. The content of 4-hydroxyphenyl acetic acid was higher than contents of other compounds. These results indicated that D. superbus improved memory functioning accompanied by inhibition of AChE and upregulation of BDNF, suggesting that D. superbus may be a useful therapeutic agent for the prevention or treatment of Alzheimer's disease.

First Imported Case of Skin Infection Caused by PVL-positive ST30 Community-Associated Methicillin-Resistant Staphylococcus aureus Clone in a Returning Korean Traveler from the Philippines

Although pandemic community-associated (CA-) methicillin-resistant Staphylococcus aureus (MRSA) ST30 clone has successfully spread into many Asian countries, there has been no case in Korea. We report the first imported case of infection caused by this clone in a Korean traveler returning from the Philippines. A previously healthy 30-yr-old Korean woman developed a buttock carbuncle while traveling in the Philippines. After coming back to Korea, oral cephalosporin was given by a primary physician without any improvement. Abscess was drained and MRSA strain isolated from her carbuncle was molecularly characterized and it was confirmed as ST30-MRSA-IV. She was successfully treated with vancomycin and surgery. Frequent international travel and migration have increased the risk of international spread of CA-MRSA clones. The efforts to understand the changing epidemiology of CA-MRSA should be continued, and we should raise suspicion of CA-MRSA infection in travelers with skin infections returning from CA-MRSA-endemic countries.

El compromiso cardíaco en el ántrax por inhalación / Hearth involvement in inhalational anthrax

Ántrax es una zoonosis que puede ser usada como arma biológica. Existen estudios que analizan el compromiso en varios órganos, sin embargo no existen estudios que investiguen el compromiso a nivel cardíaco. Se analizó la literatura médica internacional y nacional en relación al posible compromiso cardíaco en ántrax por inhalación. El análisis se basó en las tres epidemias de ántrax por inhalación reportadas en la literatura mundial (Manchester, USA 1957; Sverdlock URSS (1979); USA (2001) y un caso de ántrax por inhalación reportado en Perú. El ántrax por inhalación no solo puede tener presentaciones cardíacas, sino que puede ser confundido con patologías cardíacas. La detección de estos síndromes cardiológicos puede servir de alerta epidemiológica por lo que el cardiólogo debe sospechar de esta patología, principalmente en grupos en riesgo epidemiológico de ser afectados por bioterrorismo.

Anthrax is a zoonosis, which could be used as a biological weapon in its inhalation form. There are several studies that analyze the involvement of various organs. However, there are no studies that assess the involvement at cardiac level. International and peruvian medical literature has been consulted in regard to the possible cardiac involvement in inhalation anthrax. The analysis was based in the three anthrax epidemics reported in world literature [Manchester, USA (1957); Sverdlock, URSS (1979); USA (2001)] and a case of inhalation anthrax reported in Peru. Inhalation anthrax not only may have cardiac involvement but it may also be mistaken for cardiac pathologies. Detection of these cardiologic syndromes may help as epidemiological alerts and the cardiologist should suspect this pathology, mainly in epidemiological groups at risk for bioterrorism threats.

Superficial Skin Infections and the Use of Topica and Systemic Antibiotics in General Practice

Superficial bacterial infections of the skin are very common. With the increasing burden of human immunodeficiency virus (HIV); this is likely to worsen. Examples of such infections include impetigo; erysipelas; cellulitis; ecthyma; furuncles; carbuncles and subcutaneous abscesses. Common causative organisms are staphylococci and streptococci. Generally; Staphylococcus aureus infections tend to spread locally; causing abscesses and carbuncles; while streptococci are apt to spread along tissue planes; and give rise to either cellulitis or erysipelas. However; this is not always the case. These infections cause a significant morbidity; and have to be diagnosed and treated promptly. Some result in serious complications

Mionecroses clostridiais bovinas / Bovine clostridial myonecrosis

As mionecroses são enfermidades altamente fatais, representadas pelo carbúnculo sintomático e edema maligno. Com o objetivo de determinar a ocorrência dos diferentes clostrídios envolvidos nas mionecroses em bovinos no Brasil, foi realizado um estudo retrospectivo a partir de 30 casos suspeitos de carbúnculo sintomático e edema maligno. Empregou-se a técnica de estreptavidina biotina peroxidase em tecidos de bovinos fixados em formol e incluídos em parafina de arquivos de patologia de diferentes estados do país. Foram detectados 21 Clostridium chauvoei (70%), cincoClostridium septicum(17%), seguidos de doisC. chauvoeiassociado aoC. septicum (7%), um C. chauvoei mais Clostridium sordellii (3%) e um C. chauvoei mais Clostridium novyi tipo A (3%). Este é o primeiro diagnóstico de C. novyi tipo A no Brasil, e o primeiro relato da ocorrência de C. chauvoei associado à lesão no miocárdio. Os achados da maior ocorrência de C. chauvoei e C. septicum corroboram com estudos anteriores no país. Estes dados sobre a ocorrência dos agentes responsáveis pelas mionecroses em diferentes estados do país são de extrema importância frente às decisões relativas ao controle dessas enfermidades.

Clostridial myonecroses are highly fatal diseases, characterized by black leg and malignant oedema. In order to determine the occurrence of the different agents involved in Brazilian clostridial myonecrosis, a retrospective study was conducted concerning 30 suspected cases of blackleg and gas gangrene using a streptavidin-biotin peroxidase technique in formalin-fixed, paraffin-embedded tissues of cattle from the archives of pathology of different states of Brazil. The clostridia predominantly detected wereClostridium chauvoei(70%), followed by Clostridium septicum (5 cases or 17%), C. chauvoei plus C. septicum (2 cases or 7%), C. chauvoei plus Clostridium sordellii (1 case or 3%), C. chauvoei plus Clostridium novyi type A (1 case or 3%). This is the first diagnosis of C. novyi type A in Brazil. The findings of the higher occurrence of C. chauvoei and C. septicum concur with previous works in Brazil. This article also includes the first report in Brazil of the occurrence of C. chauvoei associated with a lesion in the myocardium. Thus, this study supplies important data about the occurrence of the agents responsible for clostridial myonecrosis in different states of Brazil, these data being important for decisions relative to control of these diseases.

Tsutsugamushi Disease and the Importance of Performing a Thorough Medical History and Physical Examination / 대한피부과학회지

Tsutsugamushi disease is an acute febrile illness that is caused by infection with Orientia tsutsugamushi. The diagnosis is based on the patient's history of exposure, the characteristic clinical features and serologic testing. But the diagnosis can be difficult when an eschar is overlooked or it is absent. Making the differential diagnosis with drug eruption is especially difficult when a skin rash develops with a prior medication history for fever or myalgia. We report here on 3 cases of Tsutsugamushi disease. Two of the cases were misdiagnosed as drug eruption due to medication for carbuncle or back pain. For the other case, Tsutsugamushi disease was accompanied with allergic contact dermatitis due to Rhus (lacquer tree). All the patients had fever, myalgia and an atypical skin rash that differed from that of drug eruption and allergic contact dermatitis. The detection of eschar was possible by having a clinical suspicion of Tsutsugamushi disease. Thus, we report here on three cases of Tsutsugamushi disease and these cases show the importance of taking a complete medical history and performing a thorough physical examination.

Trends of the Bacterial Skin Infections of Dermatology Outpatients in 1996, 2001 and 2006 / 대한피부과학회지

BACKGROUND: Bacterial infections of the skin are treatable and reversible, so clinicians should be alert for the cutaneous signs of the skin infection. However, there have been only a few reports about the epidemiology of skin infections. OBJECTIVE: This study was done to evaluate the trend of the clinical features, the results of cultures and the prevalence of MRSA in the dermatology outpatients who had suspected bacterial skin infection in 1996, 2001 and 2006 and we wanted to compare the trends of bacterial skin infection over the last eleven years. METHODS: The survey was conducted via the medical records of 24 patients in 1996, 77 patients in 2001 and 88 patients in 2006 who visited the our dermatology department and who underwent Gram-stain and bacterial culture. RESULTS: Of the 347 samples, bacteria were cultured in 197 samples. Among them, 77 samples had coagulase negative Staphylococci, which were excluded as normal skin flora. Among 120 samples, the number of cases of secondary pyoderma, folliculitis, furuncle or carbuncle and cellulitis were 63, 17, 17 and 15, respectively. There was no change in the type of diagnosis during eleven years. The most common pathogen of skin infection was S. aureus (42.7%) and there was no trend to increase for ten years. However, the prevalence of methicillin resistant S. aureus (MRSA) increased for eleven years. CONCLUSION: The most common pathogen in pyogenic skin infections of the dermatology outpatients was S. aureus, which was sensitive to beta-lactamase resistant beta-lactam antibiotics, but there was an increase of the prevalence of MRSA for eleven years, and the first therapeutic choice for MRSA is vancomycin or teicoplanin.

Detection of several clostridia by a direct fluorescent antibody test in formalin-fixed, paraffin-embedded tissues

Descreve-se a aplicabilidade de uma técnica de imunofluorescência direta, para o diagnóstico de mionecroses causadas por clostrídios, a partir de tecidos fixados em formol e incluídos em parafina. Essa técnica pode auxiliar no diagnóstico do carbúnculo sintomático e da gangrena gasosa, contribuindo para determinar a real prevalência dessas doenças no país

Identification of Clostridium chauvoei in clinical samples cultures from blackleg cases by means of PCR

C. chauvoei presence was detected by means of polymerase chain reaction (PCR) from supernatant of culture in cooked meat medium of liver, muscle and metatarsian bone marrow samples of seven calves with blackleg symptoms. The isolation under anaerobic conditions of one muscle sample revealed Clostridium perfringens in pure culture.

Foi detectada presença de Clostridium chauvoei pela reação de PCR a partir de cultivo em cooked meat medium de amostras de fígado, músculo e medula óssea metatarsiana de sete bezerros acometidos de carbúnculo sintomático. O isolamento de uma amostra de músculo sob condições anaeróbias revelou Clostridium perfringens em cultura pura.

Zoonosis y enfermedades de transmisión vectorial / Zoonoses and vector-borne diseases

Las zoonosis y especialmente las zoonosis emergentes es un fenómeno mundial de gran impacto por sus dimensiones y sus consecuencias que pueden ser considerables. La interdependencia entre personas y animales propia de nuestro mundo y los variados factores que están modificando esas relaciones se combinan para crear un terreno propicio a la aparición de patógenos zoonóticos nuevos. En este artículo se presentan algunas zoonosis de importancia en Chile, con énfasis en la vigilancia según el decreto N° 158 sobre las enfermedades de notificación obligatoria. La identificación de casos en países no endémicos ha demostrado la necesidad de globalizar los esfuerzos para erradicar la Enfermedad de Chagas y, recientemente, la OMS creó una red mundial con el objetivo de erradicar la enfermedad el 2010, en la cual nuestro país participa activamente.

Amenaza bioterrorista en Argentina / Bioterrorist threatening in Argentina

This report describes present concepts related to biological terrorism with special reference to he factibility of bioterrorist' attack in Argenina