Inadvertent inoculation of Apophysomyces following tetanus immunisation- a case report.

Mucormycosis is a rare, life-threatening fungal infection. While typically affecting immunosuppressed individuals, cases in the immunocompetent have been reported, particularly secondary to trauma, and the subspecies Apophysomyces. These fungi are typically difficult to isolate. This case report describes cutaneous Mucormycosis caused by Apophysomyces complex at a vaccination site, given following a motor vehicle accident. This life-threatening infection occurred in an immunocompetent 17-year old girl, resulting in multiple hospital admissions and finally, radical surgical debridement of her left upper limb. This case highlights the aggressive nature of this infection and the importance of early clinical recognition as effective treatment requires aggressive debridement typically prior to microbiological confirmation.

Hepatitis E virus infection as a direct cause of neuralgic amyotrophy.

INTRODUCTION: We describe a patient who developed neuralgic amyotrophy (NA) related to hepatitis E virus (HEV) infection. METHODS: The patient underwent neurological and electrodiagnostic examinations, high-resolution analysis of serological changes, and HEV load profile, and was treated with intravenous immunoglobulin. RESULTS: There was evidence of bilateral, asymmetric acute inflammatory cervical polyradiculopathy and possible brachial plexopathy. Positive serum anti-HEV IgM was followed by seroconversion to anti-HEV IgG positivity. A calculated anti-HEV antibody index was compatible with intrathecal synthesis, and HEV genotype 3 RNA was found in serum and cerebrospinal fluid (CSF). Liver function tests returned to normal within 6 weeks. CONCLUSIONS: Bilateral involvement of cervical nerve roots and/or plexus, elevated liver function tests, and abnormal CSF are typical features of HEV-associated NA. The pathogenesis involves possible immune-mediated mechanisms. However, our findings support the hypothesis that HEV-related NA is associated with direct infection. Muscle Nerve 54: 325-327, 2016.

[Gut microflora in liver and intestinal diseases: a revolution in the making]. / Le microbiote dans les maladies du foie et du tube digestif: la révolution annoncée.

After the era of classical bacteriology, the exploratory techniques of the gut microbiota have been revolutionized by the sequencing of microbial 16S rRNA. The data obtained are substantial and have led us to formulate novel hypotheses in multiple domains of medicine. This article briefly outlines these hypotheses with particular regard to the fields of steatohepatitis and inflammatory bowel diseases.