Microbiological and histopathological features of canine acral lick dermatitis.

The purpose of this study was to investigate microbiological and histopathological features of canine acral lick dermatitis (ALD). Microbial characteristics of ALD are poorly described in current literature. If infection is recognized, antimicrobial selection is usually empirical, based on appearance, cytology or surface culture, rather than deep tissue culture. It was hypothesized that cultures obtained from deep tissue would yield different results than predicted by surface culture and cytology, and that isolates from ALD have unpredictable susceptibility patterns showing resistance to antibiotics routinely administered for canine pyoderma. Biopsies were obtained from 31 lesions and submitted for aerobic, anaerobic and fungal culture, and histopathological evaluation. Surface aerobic culture and susceptibility and cytology were obtained for comparison in 22 dogs. Skin scrapings and dermatophyte culture were performed. Bacteria were isolated in 30 of 31 cases. Staphylococcus intermedius was isolated in 58% of deep cultures. Twenty per cent of deep isolates were methicillin-resistant Staphylococcus species. Forty-eight per cent of cases yielded organisms defined as multidrug resistant on deep culture. Only 57% and 55% of bacteria isolated from tissue culture were sensitive to amoxicillin-clavulanic acid and cefazolin, respectively. Cytology and superficial cultures did not correlate well with deep cultures. Surface culture predicted deep tissue isolates in eight of 22 cases. Microsporum gypseum was isolated from one dog. Histopathological features included acanthosis, follicular elongation, lymphoplasmacytic dermal inflammation, folliculitis, furunculosis, perihidradenitis, hidradenitis and vertical streaking fibrosis. Lesions associated with ALD warrant tissue bacterial cultures as the majority of cases yielded positive growth of bacteria differing from superficial culture and often resistant to empirical drugs.

Small noncleaved B cell Burkitt-like lymphoma with chromosome t(8;14) translocation and Epstein-Barr virus nuclear-associated antigen in a homosexual man with acquired immune deficiency syndrome.

This case report describes new manifestations of the acquired immune deficiency syndrome (AIDS) in a promiscuous homosexual man. Investigation of upper gastrointestinal bleeding in the patient lead to discovery of a high-grade, small, noncleaved cell (Burkitt-like) gastroduodenal lymphoma with visceral and extralymphatic extension. Specific phenotyping of the lymphoma revealed that it was a monoclonal B cell lymphoma of mu kappa isotype. An in vitro cell line was established that was Epstein-Barr virus nuclear-associated antigen-positive. The lymphoma cells displayed a t(8;14) translocation similar to endemic African Burkitt lymphoma. Epstein-Barr virus genomes were identified in the lymphoma and an axillary lymph node biopsy specimen by molecular hybridization. These data strongly suggest that Epstein-Barr virus actively infected this patient. However, he showed normal Epstein-Barr virus-specific serologic responses, indicating an immune defect against the virus.

The hemodynamic significance of massive pneumopericardium in preterm infants with respiratory distress syndrome. Clinical and experimental observations.

Radiographic and clinical data were evaluated in 12 preterm infants with pneumopericardium complicating ventilator therapy of respiratory distress syndrome. Eight infants had massive or tension pneumopericardium, reflected by bradycardia, hypotension, and cyanosis of abrupt onset; cardiac size decreased dramatically but returned to approximately the former size after aspiration of the pneumopericardium. In puppies, pneumopericardium large enought to reduce heart size by 32 +/- 3% caused decreased mean arterial pressure (-22 +/- 7%) and right ventricular peak systolic pressure (-11 +/- 2%) and increased right ventricular diastolic and intrapericardial pressures. These findings suggest that pneumopericardium per se causes severe hemodynamic compromise. When it is large enought to reduce heart size, drastic circulatory impairment is produced and pericardiocentesis should be performed immediately.