A rare case of Clostridium sordellii bacteremia in an immunocompromised patient.

Clostridium sordellii is a gram-positive, anaerobic sporeforming rod with peritrichous flagella that is rarely associated with disease in humans. In most cases, infections occur after trauma, childbirth and routine gynecological procedures or intravenous drug abuse. C. sordellii produce several exotoxins that lead to progressive edema and shock, and C. sordellii infections have high mortality rates of up to 70%. Since its first report in 1922, only a few cases of bacteremia have been reported. This report describes a case of C. sordellii bacteremia in a patient with rectum carcinoma and liver metastases.

[Invasive pulmonary aspergillosis. Occurrence in a non-neutropenic female patient with abdominal sepsis]. / Invasive pulmonale Aspergillose: Auftreten bei einer nichtneutropenischen Patientin mit abdomineller Sepsis.

Invasive pulmonary aspergillosis (IPA) is a life-threatening infection predominantly affecting immunocompromised patients, e.g. with acute leukemia. This case report demonstrates that IPA can also occur in non-neutropenic critically ill surgical patients. The case of a 63-year-old woman is reported, who developed IPA of the respiratory tract in the course of diffuse purulent peritonitis. First-line therapy with voriconazol failed to be effective. However, application of caspofungin, intensive kinetic therapy (including prone position) and airway management by interventional bronchoscopy enabled successful treatment of this severe complication.

Early and selective disappearance of telethonin protein from the sarcomere in neurogenic atrophy.

Mutations of the human telethonin gene have recently been shown to cause limb girdle muscular dystrophy type 2G in three Brazilian families. The mRNA has been shown to be dynamically regulated in animals, however, the fate of the protein in human muscle is unknown. In order to assess the expression of telethonin in more frequently encountered myopathological conditions we generated and characterized a rabbit antiserum raised against the C-terminal end of telethonin by immunoblotting and immunogold EM. Indirect immunofluorescence analysis of a wide variety of neuromuscular disorders including dystrophinopathies, metabolic myopathies, denervation disorders, congenital and inflammatory myopathies revealed that the characteristic Z-band staining of telethonin was preserved in all disease entities included in our study. However, a reduced telethonin immunoreactivity was observed in up to 10% of type II fibers in 10 cases of neurogenic atrophy. A decreased telethonin staining was more frequently observed in early stages of fiber atrophy than in type II fibers displaying normal or highly atrophic fiber diameters. Hence, not only the telethonin transcript is rapidly downregulated in denervated muscle but the protein itself undergoes dynamic changes while its known sarcomeric binding partner titin remains unaltered. Beyond its role as a static component of Z-bands, these findings indicate that telethonin protein levels seems to be at least in part regulated by neuronal activity and is thus linked to the dynamic control of myofibrillogenesis and muscle turnover in human skeletal muscle.