Subject(s)
Appendicitis , Colonoscopy , Acute Disease , Appendectomy , Appendicitis/diagnosis , Appendicitis/surgery , Colonoscopy/methods , Humans , Male , Mass Screening , Middle Aged , Suppuration/diagnosisABSTRACT
AIMS: This study was applied to evaluate the usefulness of a high-throughput sample preparation protocol prior to the application of quantitative real-time PCR (qPCR) for the early diagnosis of bloodstream and pyogenic infections in humans and animals compared to matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and classical culture. METHODS AND RESULTS: Saponin-mediated selective host cell lysis combined with DNase-1 was applied for processing of whole blood and pus clinical samples collected from suspected cases of septicaemia and pyogenic infections in humans and animals. The pre-PCR processing strategy enabled the recovery of microbial cells with no changes in their colony forming units immediately after the addition of saponin. DNase-1 was efficient for removing the DNAs from the host cells as well as dead cells with damaged cell membranes. The metagenomic qPCR and MALDI-TOF MS could identify the bacterial community of sepsis at species level with a concordance of 97·37% unlike the conventional culture. According to qPCR results, Staphylococcus aureus (24·24%) was predominated in animal pyogenic infections, whereas Klebsiella pneumonia (31·81%) was commonly detected in neonatal sepsis. CONCLUSIONS: Saponin combined with DNase-1 allowed the efficient recovery of microbial DNA from blood and pus samples in sepsis using qPCR assay. SIGNIFICANCE AND IMPACT OF THE STUDY: Metagenomic qPCR could identify a broad range of bacteria directly from blood and pus with more sensitivity, higher discriminatory power and shorter turnaround time than those using MALDI-TOF MS and conventional culture. This might allow a timely administration of a prompt treatment.
Subject(s)
Bacteria/isolation & purification , Real-Time Polymerase Chain Reaction/methods , Sepsis/diagnosis , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization/methods , Animals , Bacteria/chemistry , Bacteria/genetics , Deoxyribonuclease I , Humans , Saponins , Sepsis/microbiology , Specimen Handling , Suppuration/diagnosis , Suppuration/microbiologyABSTRACT
PURPOSE: Diagnosis of intraocular lymphoma (IOL) is usually achieved by histopathological analysis. However, it may lead to inconclusive results due to the scarcity of malignant cells obtained by biopsy, hence leading to delayed diagnosis. We report two cases of IOL with pseudo-hypopyon, a rare feature of IOL, as their initial ocular feature, diagnosed using a multidisciplinary diagnostic approach. Common clinical features of IOL with pseudo-hypopyon were also investigated. METHODS: Retrospective case series and literature review. RESULTS: Two cases of IOL, a 78-year-old female and a 59-year-old male, whom had been diagnosed with systemic B-cell lymphoma developed pseudo-hypopyon and visual impairment during the course of their chemotherapy. Diagnosis of IOL was achieved from anterior chamber aspiration samples with supplementary diagnostic tools including flow cytometric immunophenotyping, interleukin and IgH gene rearrangement analysis in addition to the conventional histopathological analysis. Generally, pseudo-hypopyon was more commonly seen in secondary IOL and may associate with hyphema and high intraocular pressure. CONCLUSION: Pseudo-hypopyon is a rare feature of IOL, more commonly seen in secondary IOL, which can be accompanied by hyphema and high intraocular pressure. Supplementary diagnostic tools such as flow cytometric immunophenotyping, interleukin analysis, and immunogloblin H gene rearrangement analysis are useful for supporting the diagnosis of IOL with pseudo-hypopyon.
Subject(s)
Intraocular Lymphoma/diagnosis , Lymphoma, B-Cell/diagnosis , Lymphoma, Large B-Cell, Diffuse/diagnosis , Aged , Antimetabolites, Antineoplastic/therapeutic use , Female , Flow Cytometry , Humans , Immunophenotyping , Intraocular Lymphoma/drug therapy , Intraocular Lymphoma/pathology , Lymphoma, B-Cell/drug therapy , Lymphoma, B-Cell/pathology , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/pathology , Magnetic Resonance Imaging , Male , Methotrexate/therapeutic use , Middle Aged , Patient Care Team , Retrospective Studies , Suppuration/diagnosis , Tomography, X-Ray ComputedABSTRACT
PURPOSE: Our purpose is to report a patient with primary unilateral ciliary body marginal zone lymphoma who initially presented with hemorrhagic hypopyon. METHODS: Retrospective review of the clinical, imaging, and immunohistopathological features of the case was performed. RESULTS: A 59-year-old man was referred with right anterior uveitis of unknown etiology which was unresponsive to systemic treatment. Slit-lamp biomicroscopy showed normotensive hemorrhagic hypopyon in that eye. Anterior segment ultrasound biomicroscopy revealed an iridociliary mass lesion. Because an anterior chamber paracentesis was noncontributory, a diagnostic cyclectomy was performed. Histopathological evaluation showed that the neoplastic cells were positive for CD20, lambda light chain, and BCL 2. BCL 6, CD10, CD5, SOX11, kappa, and Cyclin D1 stains were negative. The final diagnosis was extranodal marginal zone lymphoma of the ciliary body. CONCLUSIONS: Although rare, ciliary lymphoma may be a cause of intractable anterior uveitis. Repeat biopsies could be carried out when there is a high level of clinical suspicion.
Subject(s)
Ciliary Body/pathology , Hyphema/diagnosis , Lymphoma, B-Cell, Marginal Zone/diagnosis , Uveal Neoplasms/diagnosis , Biomarkers, Tumor/metabolism , Ciliary Body/metabolism , Humans , Hyphema/metabolism , Lymphoma, B-Cell, Marginal Zone/metabolism , Magnetic Resonance Imaging , Male , Microscopy, Acoustic , Middle Aged , Positron-Emission Tomography , Retrospective Studies , Suppuration/diagnosis , Suppuration/metabolism , Tomography, X-Ray Computed , Uveal Neoplasms/metabolism , Uveitis, Anterior/diagnosisSubject(s)
Eye Neoplasms/diagnosis , Eye Pain/diagnosis , Iris Diseases/diagnosis , Pigmentation Disorders/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Suppuration/diagnosis , Child, Preschool , Eye Neoplasms/drug therapy , Eye Pain/drug therapy , Female , Glucocorticoids/therapeutic use , Humans , Intraocular Pressure/physiology , Iris Diseases/drug therapy , Pigmentation Disorders/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Slit Lamp Microscopy , Suppuration/drug therapySubject(s)
Abdominal Abscess/diagnosis , Abdominal Pain/etiology , Chronic Pain/etiology , Suppuration/etiology , Urachus/abnormalities , Abdominal Abscess/etiology , Abdominal Abscess/therapy , Abdominal Pain/diagnosis , Abdominal Pain/therapy , Anti-Bacterial Agents/therapeutic use , Chronic Pain/diagnosis , Chronic Pain/therapy , Humans , Laparoscopy , Male , Suppuration/diagnosis , Suppuration/therapy , Tomography, X-Ray Computed , Ultrasonography , Umbilicus , Urachus/diagnostic imaging , Urachus/surgery , Young AdultSubject(s)
Adenocarcinoma of Lung/pathology , Eye Neoplasms/diagnosis , Eye Neoplasms/secondary , Iridocyclitis/diagnosis , Lung Neoplasms/pathology , Adenocarcinoma of Lung/diagnosis , Aged , Anterior Chamber/diagnostic imaging , Anterior Chamber/pathology , Diagnosis, Differential , Humans , Iridocyclitis/etiology , Lung Neoplasms/diagnosis , Male , Suppuration/diagnosis , Suppuration/etiology , Vitreous Body/diagnostic imaging , Vitreous Body/pathologyABSTRACT
The authors report the case of a 62-year-old man with a history of total left hip arthroplasty nine years previously presenting with a large infiltrated plaque on the posterior area of the left thigh with three months of evolution without systemic symptoms or elevated inflammatory markers. Computed tomography of the left lower limb revealed a 12-centimeter linear extension of the lesion to the posterior part of the left proximal femur. Prosthesis joint infection, although rare, is a surgical complication to be taken into account, even if the surgery was performed many years before.
Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Hip Prosthesis/adverse effects , Suppuration/diagnosis , Biopsy , Femur , Humans , Male , Middle Aged , Streptococcus agalactiae/isolation & purification , Suppuration/microbiology , Thigh , Tomography, X-Ray ComputedABSTRACT
AIM: to develop an additional criterion for objective diagnosis of purulent-destructive forms of acute pyelonephritis. MATERIALS AND METHODS: A total of 35 blood samples from patients with acute pyelonephritis aged from 19 to 85 years (mean age was 52 years) were studied. For the analysis, a classical bacteriological method of isolating blood culture and a modern molecular genetic method of fluorescent in situ hybridization (FISH) using DNA probes complementary to species-specific regions of the 16S rRNA gene of microorganisms were used. The obtained results were processed using the Statistica 6.0 program. RESULTS: The bacteriological study showed that only in one patient (2.9%) a blood culture was positive, whereas with FISH, polymicrobial infection consisting of two associates was observed in five patients (14.3%), and 207 specific luminescence from different DNA probes were detected in blood samples. The associations of members of the Enterobacteriaceae with S. aureus were 2.4 times more frequent than associations of the Enterobacteriaceae with S. epidermidis, indicating a development of the polymicrobial infection and, accordingly, the development of purulent stage of acute pyelonephritis. CONCLUSION: For the diagnosis of acute pyelonephritis, we suggest to use an additional criterion, which consists in applying of FISH method for the detection and simultaneous identification of bacteria that were adhered on the surface of erythrocytes and located intracellularly. This method may allow for the differential diagnosis of serous and purulent stages of acute pyelonephritis.
Subject(s)
Bacteria/isolation & purification , Coinfection/diagnosis , Pyelonephritis/diagnosis , Pyelonephritis/microbiology , Adult , Aged , Aged, 80 and over , Coinfection/microbiology , DNA Probes , Humans , In Situ Hybridization, Fluorescence , Middle Aged , Suppuration/diagnosis , Young AdultABSTRACT
An 8-year-old male neutered domestic shorthair cat was presented for evaluation of acute respiratory distress. Respiratory auscultation revealed a diffuse and symmetric increase in bronchovesicular sounds. Thoracic radiographs showed a diffuse unstructured interstitial pulmonary pattern with multifocal alveolar foci. Despite an aggressive treatment with supportive care, including oxygenotherapy and systemic antibiotics, progressive respiratory distress increased. Three days after the presentation, acute anterior uveitis was noticed on left eye. Ophthalmic examination and ocular ultrasonography revealed unilateral panuveitis with ocular hypertension. The right eye examination was unremarkable. Cytological examination of aqueous humor revealed a suppurative inflammation. Serratia marcescens was identified from aqueous humor culture. Primary pulmonary infection was suspected but was not confirmed as owners declined bronchoalveolar lavage. Active uveitis resolved and cat's pulmonary status improved after appropriate systemic antibacterial therapy. Vision loss was permanent due to secondary mature cataract. To the best of authors' knowledge, this is the first report of endogenous bacterial endophthalmitis secondary to S. marcescens infection in a cat.
Subject(s)
Cat Diseases/pathology , Endophthalmitis/veterinary , Eye Infections, Bacterial/veterinary , Serratia Infections/veterinary , Serratia marcescens/physiology , Animals , Anti-Bacterial Agents/therapeutic use , Cat Diseases/diagnosis , Cat Diseases/microbiology , Cats , Endophthalmitis/diagnosis , Endophthalmitis/microbiology , Endophthalmitis/pathology , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/microbiology , Eye Infections, Bacterial/pathology , Male , Panuveitis/diagnosis , Panuveitis/microbiology , Panuveitis/pathology , Panuveitis/veterinary , Serratia Infections/complications , Serratia Infections/microbiology , Serratia Infections/pathology , Suppuration/diagnosis , Suppuration/microbiology , Suppuration/pathology , Suppuration/veterinary , Treatment Outcome , Uveitis, Anterior/diagnosis , Uveitis, Anterior/microbiology , Uveitis, Anterior/pathology , Uveitis, Anterior/veterinaryABSTRACT
Abstract: The authors report the case of a 62-year-old man with a history of total left hip arthroplasty nine years previously presenting with a large infiltrated plaque on the posterior area of the left thigh with three months of evolution without systemic symptoms or elevated inflammatory markers. Computed tomography of the left lower limb revealed a 12-centimeter linear extension of the lesion to the posterior part of the left proximal femur. Prosthesis joint infection, although rare, is a surgical complication to be taken into account, even if the surgery was performed many years before.
Subject(s)
Humans , Male , Middle Aged , Suppuration/diagnosis , Arthroplasty, Replacement, Hip/adverse effects , Hip Prosthesis/adverse effects , Streptococcus agalactiae/isolation & purification , Suppuration/microbiology , Thigh , Biopsy , Tomography, X-Ray Computed , FemurABSTRACT
It was reviewed a history of diagnosis and treatment of suppurative mediastinitis from ancient times to our time depending on inflammation type, localization and clinical features. An important role of national surgical school in the development of surgical treatment was emphasized.
Subject(s)
Mediastinitis/history , Suppuration/history , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , History, Ancient , History, Medieval , Humans , Mediastinitis/diagnosis , Mediastinitis/therapy , Russia , Suppuration/diagnosis , Suppuration/therapyABSTRACT
Introducción: La incidencia de uretritis por Haemophilus está aumentando. Nuestro objetivo principal es describir las características clínico-microbiológicas de estos pacientes. Como objetivo secundario discutiremos el tratamiento más adecuado en función de las resistencias antibióticas testadas. Material y métodos: Seleccionamos los pacientes de la Unidad de Infecciones de Transmisión Sexual diagnosticados microbiológicamente de uretritis entre julio de 2015 y julio de 2018. De ellos, seleccionamos aquellos en los que se aisló un Haemophilus mediante cultivo agar chocolate. Las resistencias antibióticas se testaron mediante método de difusión disco-placa. De estos pacientes se recogieron los datos de forma transversal y prospectiva durante las visitas en consultas externas. Resultados: Se aisló un Haemophilus spp. en 33,6% de los pacientes diagnosticados de uretritis. De estos pacientes, la manifestación clínica más frecuente fue la supuración uretral (57,9%) y el 60% eran hombres que tienen sexo con hombres, siendo el aislamiento de este microorganismo más frecuente de forma estadísticamente significativa entre los hombres que tienen sexo con hombres que el aislamiento de Neisseria o Chlamydia. Haemophilus spp. se encontró de forma aislada en el 39,5% de los pacientes, siendo el más frecuente H. parainfluenzae en el 84,2%. El 34,2% de los casos de Haemophilus aislados fueron resistentes a azitromicina y el 26,3% eran resistentes tanto a azitromicina como a tetraciclinas. En los casos en los que no se perdió el seguimiento del paciente (n = 17; 44,7%), el tratamiento administrado de forma empírica consiguió una remisión clínica y microbiológica en 11 pacientes, mientras que en 6 fue necesario administrar una pauta de un nuevo antibiótico. Conclusiones: Haemophilus es un nuevo agente etiológico de uretritis no gonocócicas cuya incidencia está en aumento, especialmente entre hombres que tienen sexo con hombres que practican sexo oral sin protección. Estos pacientes pueden presentar una clínica similar a una uretritis gonocócica. Es necesario confirmar la erradicación debido al elevado número de resistencias antibióticas testadas en Haemophilus spp
Introduction: The incidence of urethritis due to Haemophilus species is increasing. The main aim of this study was to describe the clinical and microbiological characteristics of patients with this form of urethritis. A secondary aim was to discuss the adequacy of treatments in patients with different types of antibiotic resistance. Material and methods: We studied patients with a microbiologically confirmed diagnosis of urethritis seen at the Sexually Transmitted Infections Unit of our hospital between July 2015 and July 2018. We selected all patients in whom Haemophilus species were isolated on chocolate agar. Antibiotic resistance was tested using the disk-diffusion method. Cross-sectional data were collected prospectively during outpatient visits. Results: Haemophilus species were isolated in 33.6% of cases. The most common clinical manifestation was urethral discharge (57.6%); 60% of the patients were men who have sex with men and in this subgroup Haemophilus species were significantly more common than either Neisseria or Chlamydia species. Haemophilus species were found in isolation in 39.5% of patients and the most common one was Haemophilus parainfluenzae (isolated in 84.2% of cases). In total, 34.2% of patients were resistant to azithromycin and 26.3% were resistant to both azithromycin and tetracycline. Empirical treatment achieved clinical and microbiologic cure in 11 of the patients who were not lost to follow-up (n = 17; 44.7%). The remaining 6 patients required treatment with a new antibiotic. Conclusions: Haemophilus species are a new cause of nongonococcal urethritis, whose incidence is rising, particularly in men who have sex with men who engage in unprotected oral sex. The clinical manifestations are similar to those seen in gonococcal urethritis. Eradication of infection must be confirmed due to the high rate of antibiotic resistance associated with Haemophilus species
