WU polyomavirus infection among children in South China

This study aimed at investigating the prevalence and clinical characteristics of children with respiratory infection by WU polyomavirus (WUPyV) in Southern China. Nasopharyngeal aspirate samples were collected from 771 children with acute respiratory tract infection admitted to hospital and 82 samples from healthy subjects for routine examination at the outpatient service at the Second Affiliated Hospital of Shantou University, Medical College from July 2008 to June 2009. WUPyV was detected by the polymerase chain reaction (PCR) and DNA sequencing. All WUPyV‐positive specimens were characterized further for nine viruses causing common respiratory infections, including in?uenza A and B, respiratory syncytial virus (RSV), parainfluenza virus (PIV) 1 and 3, human metapneumovirus, human bocavirus, adenovirus, and rhinovirus by PCR or real time (RT)‐PCR. Fifteen out of 771 specimens from patients with acute respiratory tract infection, but none from healthy subjects, were positive for WUPyV and the positivity rate was 2%. Patients with WUPyV infection were between 2 and 48 months of age, and nine of the patients were male while six female. Four out of 15 patients were co‐infected with RSV, one with adenovirus or rhinovirus, respectively. Patients with WUPyV infection displayed predominantly cough, moderate fever, and wheezing, and were diagnosed with pneumonia (n = 8), bronchiolitis (n = 4), upper respiratory tract infections (n = 2) and bronchitis (n = 1). One patient developed encephalitis. Therefore, WUPyV infection can cause acute respiratory tract infection with atypical symptoms, including severe complications, in children. J. Med. Virol. 83:1440–1445, 2011. © 2011 Wiley‐Liss, Inc.     

WU and KI polyomavirus infections in Filipino children with lower respiratory tract disease

BackgroundWU and KI are human polyomaviruses initially detected in the respiratory tract, whose clinical significance remains uncertain.ObjectivesTo determine the epidemiology, viral load and clinical characteristics of WU and KI polyomaviruses.Study designWe tested respiratory specimens collected during a randomized, placebo-controlled pneumococcal conjugate vaccine trial and related epidemiological study in the Philippines. We analyzed 1077 nasal washes from patients aged 6 weeks to 5 years who developed lower respiratory tract illness using quantitative real-time PCR for WU and KI. We collected data regarding presenting symptoms, signs, radiographic findings, laboratory data and coinfection.ResultsThe prevalence and co-infection rates for WU were 5.3% and 74% respectively and 4.2% and 84% respectively for KI. Higher KI viral loads were observed in patients with severe or very severe pneumonia, those presenting with chest indrawing, hypoxia without wheeze, convulsions, and with KI monoinfection compared with co-infection. There was no significant association between viral load and clinical presentation for WU.ConclusionsThese findings suggest a potential pathogenic role for KI, and that there is an association between KI viral load and illness severity.     

我国急性呼吸道感染患儿中检测到KI和WU多瘤病毒

目的 了解多瘤病毒WU和KI在我国儿童急性呼吸道疾病中的感染情况.方法 采用PCR扩增的方法对2006年11月至2007年10月收集的急性呼吸道感染患儿的318份鼻咽抽吸物(NPA)标本进行了多瘤病毒WU和KI基因检测.结果 318份标本共检测出14份病毒核酸阳性标本,其中WUV 7份(2.2%),KIPyV 7份(2.2%).该14例基因检测阳性患儿临床均有上呼吸道感染或下呼吸道感染症状.结论 WUV和KIPyV可能也是儿童急性呼吸道感染中较为重要的一个病原,且与儿童上呼吸道感染和下呼吸道感染存在相关性.     

Detection of polyomavirus SV40 in tonsils from immunocompetent children

BACKGROUND: BK virus (BKV), JC virus (JCV) and simian virus 40 (SV40) are nonenveloped DNA viruses, members of the family Polyomaviridae. BK and JC viruses establish persistent infections in humans, and evidence suggests that SV40 can infect humans, as well. Whether persistence occurs in the lymphoid system is unknown. METHODS: Paraffin-embedded tonsils from 220 immunocompetent children (mean age 9.3 years) were examined by polymerase chain reaction (PCR) to detect viral DNA of BKV, JCV, SV40, and Epstein-Barr virus (EBV). RESULTS: Polyomavirus-specific DNA sequences were detected in 8.3% (29/351) of specimens collected from 220 children. Twenty-one (9.5%) children had polyomavirus DNA present in at least one tonsil, with sequences identified as SV40 (n=20) and BKV (n=1). Polyomavirus JCV was not detected. Among patients positive for SV40, 8 of 14 (57%) contained viral DNA in both available tonsils. EBV DNA was detected in 99 (28.2%) samples from 67 (30.5%) patients. Eleven samples (3.1%) from 8 (3.6%) children were positive for both polyomavirus and EBV. SV40-positive children were significantly older than the SV40-negative subjects (P<0.001). T-antigen expression was detected in an SV40 DNA-positive tonsil by immunohistochemistry. CONCLUSIONS: These results suggest that SV40 can infect tonsils, that lymphoid tissue may represent a site for polyomavirus persistence, and that immunohistochemistry is not a useful detection assay when there are very few virus-infected cells in a tissue.     

Prevalence and patterns of polyomavirus urinary excretion in immunocompetent adults and children

BK and JC polyomavirus infections are acquired commonly during childhood, mainly asymptomatically. These viruses are thought to remain latent in renal tissue after the primary infection and to reactivate under certain conditions. This reactivation leads to urinary excretion of virus particles, which can be detected by a range of methods. However, while this reactivation has been studied in depth in immunocompromised patients, little information is available about healthy individuals. The present study used PCR-based methods to examine urine samples from healthy individuals (51 adults and 15 children), and found that 62.7% of adults and 13.2% of children excreted polyomaviruses in the urine, mostly JC virus (41.2%). JC virus excretion was continuous, while BK virus excretion was mostly occasional.     

Urinary tract infection due to Fusarium oxysporum in an immunocompetent patient with chronic kidney disease

Infections due to Fusarium species are collectively referred to as fusariosis. Fusarium oxysporum has been reported to cause keratitis, onychomycosis, skin infections, catheter associated fungemia and has not been described as a cause of urinary tract infection. Here, we present the first case of fusariosis with urinary tract involvement in a 67 year old male, with chronic kidney disease and type 2 diabetes mellitus. This case illustrates the ever increasing spectrum of rare but offending pathogenic fungi. Early diagnosis of infection with a specific pathogen may lead to changes in antifungal therapy and may be critical for an improved outcome.     

Human cytomegalovirus infection of the gastrointestinal tract in apparently immunocompetent patients

Human cytomegalovirus (HCMV) infection is usually reported in immunocompromised patients. This study reports 11 cases of HCMV infection of the gastrointestinal (GI) tract diagnosed in apparently immunocompetent hosts. The median age of the patients studied was 76 years, and the major presenting symptoms were diarrhea, epigastric pain, and abdominal discomfort. The large intestine was involved in 6 cases, the stomach in 4 cases, and the lower esophagus in 1 case. Endoscopy revealed ulcers or hypertrophic folds in the GI tract and single ulcers or erosions in the colon and rectum. Light microscopy showed chronic inflammatory infiltrate in the lamina propria in all cases. The diagnosis of HCMV infection was based on the histological and immunohistochemical identification of HCMV inclusion bodies in different cell types, including epithelial, endothelial, stromal, and smooth muscle cells. Both "classical" inclusions, characterized by an "owl's eye" appearance, and atypical inclusions were found. For all patients, no apparent causes of immunodeficiency were detected at the time of diagnosis of HCMV infection. At follow-up, however, 4 patients were found to harbor a malignant tumor (ie, pancreas, lung, Vater's papilla, and extrahepatic bile duct) at an interval of 2 to 5 months after the diagnosis of HCMV infection. Especially in elderly patients, HCMV infection of the GI tract might be an early clue to the presence of immunologic defects induced by an underlying neoplasia.     

Secondary acute myeloid leukemia in children treated for acute lymphoid leukemia

We studied the risk of the development of acute myeloid leukemia (AML) during initial remission in 733 consecutive children with acute lymphoid leukemia (ALL) who were treated with intensive chemotherapy. This complication was identified according to standard morphologic and cytochemical criteria in 13 patients 1.2 to 6 years (median, 3.0) after the diagnosis of ALL. At three years of follow-up, the cumulative risk of secondary AML during the first bone marrow remission was 1.6 percent (95 percent confidence limits, 0.7 and 3.5 percent); at six years, it was 4.7 percent (2 and 10 percent). The development of secondary AML was much more likely among patients with a T-cell than a non-T-cell immunophenotype (cumulative risk, 19.1 percent [6 and 47 percent] at six years). Sequential cytogenetic studies in 10 patients revealed entirely different karyotypes in 9, suggesting the induction of a second neoplasm. In eight of these patients, the blast cells had abnormalities of the 11q23 chromosomal region, which has been associated with malignant transformation of a pluripotential stem cell. There was no evidence of loss of DNA from chromosome 5 or 7, a karyotypic change commonly observed in cases of AML secondary to treatment with alkylating agents, irradiation, or both. We conclude that there is a substantial risk of AML in patients who receive intensive treatment for ALL, especially in those with a T-cell immunophenotype, and that 11q23 chromosomal abnormalities may be important in the pathogenesis of this complication.     

Distribution of lymphoid tissue in the caecal mucosa of chickens

In order to clarify the fundamental structure of the host defence mechanism in chicken caeca, a detailed analysis of the distribution of lymphoid nodules (LNs) was carried out on longitudinal sections of both the mesenteric (side of the ileocaecal ligament) and the antimesenteric mucosa. An overwhelming majority of solitary or aggregated LNs were located in the mesenteric mucosa, although a few were also found in the antimesenteric mucosa. Of the total LNs, 45.7% were detected at the proximal 7.8% section in the caecal tonsil. LNs (21.4%) were also concentrated in the distal 22.0% section corresponding to the apex. A moderate concentration of LNs (13.1%) was found at the transitional 20.0% region between the base and body. Approximately 80.2% of total LNs were found at the above 3 regions in the mesenteric mucosa. In many cases, the frequency of LNs in the caecal tonsils was opposite to that at the apices. Aggregated LNs were mainly found in the caecal tonsils, transitional region and apex. Almost all aggregated LNs consisted of fundamental nodular units possessing M cells in their follicle associated epithelia. The aggregated LNs in the above 3 regions therefore could provide immunological surveillance against caecal luminal contents. In particular, the cooperative function between LNs of the caecal tonsil and apex might be highly important in maintaining the caecal microenvironment.     

Peri-implant tissue is an important niche for Staphylococcus epidermidis in experimental biomaterial-associated infection in mice

Biomaterial-associated infections (BAI), which are predominantly caused by Staphylococcus epidermidis, are a significant problem in modern medicine. Biofilm formation is considered the pivotal element in the pathogenesis, but in previous mouse studies we retrieved S. epidermidis from peri-implant tissue. To assess the kinetics and generality of tissue colonization, we investigated BAI using two S. epidermidis strains, two biomaterials, and two mouse strains. With small inocula all implants were culture negative, whereas surrounding tissues were positive. When higher doses were used, tissues were culture positive more often than implants, with higher numbers of CFU. This was true for the different biomaterials tested, for both S. epidermidis strains, at different times, and for both mouse strains. S. epidermidis colocalized with host cells at a distance that was >10 cell layers from the biomaterial-tissue interface. We concluded that in mouse experimental BAI S. epidermidis peri-implant tissue colonization is more important than biofilm formation.     

Skin and soft tissue infection caused by Cysteiniphilum litorale in an immunocompetent patient: A case report

Cysteiniphilum litorale is a Gram-negative coccobacillus first isolated from the seawater of Wailingding Island near the estuary of Pearl River in southern China. This organism was previously not considered to cause disease in animals or humans. We report a case of a 19-year-old female patient infected with abscess caused by C. litorale in the middle digit of her right hand after minor trauma during the handling of estuarine shrimps at home. C. litorale was cultured from the wound exudate of the patient and identified by 16S rRNA gene sequencing. Whether C. litorale may be transmitted to humans via other channels requires further exploration.     

Polyomavirus infection of the urinary tract presenting as hemorrhagic cystitis in an immunocompetent five-year-old boy

Human polyomavirus infection, which can be detected morphologically on Pap-stained routine urine cytology specimens, is most commonly encountered in immunocompromised patients and is a well-described complication of renal transplantation. We present a case of an immunocompetent 5-year-old boy with a sudden onset of dysuria and hematuria due to a self-limited polyomavirus urinary tract infection detected on routine urine cytology and confirmed with real-time PCR. Although rare cases of nonhemorrhagic cystitis have been reported, to the best of our knowledge this is the first case of hemorrhagic cystitis occurring in this setting.     

Identification of the novel KI polyomavirus in the respiratory tract of an Italian patient

Recently, a new human polyomavirus, KIV, was detected in respiratory specimens of patients with acute respiratory tract infection. Whether this reflects a causal role of the virus in the respiratory tract is still debated. To investigate the presence of KIV in respiratory samples of Italian patients and to determine the degree of similarity with other known polyomaviruses, 222 respiratory specimens collected by general practitioners between 2006 and 2007 were screened. The entire VP1 gene region was amplified and sequenced. Maximum Likelihood tree was generated by PAUP* software. One out of 222 samples tested was positive for KIV. Phylogenetic analysis indicated that this isolate clustered with other KIV isolates, while the WUV isolates seem to belong to a different lineage. The phylogenetic tree also showed that all other known polyomaviruses are quite distant from this isolate. This is the first report describing the presence of KIV in the respiratory tract of a 5-year-old Italian child with acute respiratory symptoms. Further investigations are needed to establish an etiological link of KIV with acute respiratory illness.     

Disseminated Trichosporon asahii infection presenting as eosinophilia in an immunocompetent patient: A case report

Trichosporon are naturally found in external environments and are a part of the normal flora of the human skin, respiratory tract, and gastrointestinal tract. Disseminated Trichosporon infection occurs sporadically in patients with immunodeficiency, and is mainly manifested as blood, urine, catheter, and thorax/peritoneum infections, rarely as lymphatic, liver and spleen infections. Elevated blood eosinophil granulocyte from Trichosporon infection have rarely been reported. Here, we report a rare Case of eosinophilia associated with lymphatic and liver and spleen infections due to Trichosporon asahii in an immunocompetent patient. No reports of eosinophilia from Trichosporon infections other than lung, to our knowledge, have been published.     

Back muscle as a promising site for ovarian tissue transplantation, an animal model

BACKGROUND: The aim of this study was to evaluate the optimal transplantationsite for ovarian tissue fragments in murine hosts. We comparedthe transplantation to the back muscle (B) versus the kidneycapsule (K) in a mouse allograft model. METHODS: Hemi-ovaries from 12-day-old mice were allografted into B andK of bilaterally ovariectomized same strain recipients whichhad undergone gonadotrophin stimulation (n = 15). Graft survivalafter 27 days, angiogenesis and follicle development were scoredand compared to age-matched control ovaries (38-day old, n =5). The ability of oocytes to be fertilized was studied afterIVF, ICSI and embryos were transferred to recipient mothers.Anti-mouse CD 31+ antibody was used to evaluate neo-vascularizationin grafts. RESULTS: Primordial follicle survival was higher (P < 0.01) and vascularsupport was better (P < 0.01) in B- than in K-grafts. From34 oocytes retrieved from B-grafts (15 metaphase I, of which14 matured in vitro, and 19 collected at metaphase II), 18 morulaewere obtained. Transfer of 12 embryos obtained by ICSI led tothree live offspring, and transfer of six IVF embryos to anotherrecipient mother yielded four offspring, one of which was borndead and one showed placental anomalies. CONCLUSIONS: The back muscle is a promising site for ovarian allografts inmice. This is the first report of live offspring obtained afterback muscle grafting using both IVF and ICSI.