Cutaneous Infection Caused by a Novel Francisella sp.

A 69-year-old patient presented with a tender, thickly crusted skin lesion of 1 week''s duration. A bacterial culture swab taken from the underlying granular tissue yielded a pure isolate of a Gram-negative coccobacillus, presumptively identified as a novel Francisella species via 16S rRNA and multilocus gene sequence analysis.     

Ocular Infection by a Psychrophile: Pseudomonas fluorescens

Accurate identification of infectious pathogens is essential for appropriate management of ocular infections. Routine laboratory protocols typically support bacterial growth at 37°C. We report a case, wherein we serendipitously isolated Pseudomonas fluorescens – an organism that prefers lower temperatures for optimal growth (psychrophilic) in the environment – from eviscerated contents of an eye with total corneal melt. This case highlights the need for being vigilant for organisms with different temperature sensitivities in culture media than that found in routine protocols.     

Cat Scratch Disease Due to Bartonella henselae Infection Mimicking Parotid Malignancy

An unusual Bartonella henselae infection presenting clinically as a putative parotid cancer was diagnosed based on serological tests, histomorphology and amplification of a 16S-rDNA sequence of Bartonella henselae. The patient improved greatly upon antibiotic treatment and did not require surgery. Although uncommon, infection with Bartonella spp., particularly Bartonella henselae, should be included in the differential diagnosis of parotid tumors. Electronic Publication     

Infection and diarrhea caused by Cryptosporidium sp. among Guatemalan infants.

During July 1985 to June 1986, fecal excretion of Cryptosporidium oocysts was determined prospectively in a cohort of 130 infants, aged 0 to 11 months, living in a marginal urban area of Guatemala City, Guatemala. A total of 1,280 stool specimens were examined; 158 of them were collected during episodes of diarrhea, and 1,122 were collected during symptom-free periods, every 2 to 3 weeks, from every child. Of the children, 20 (15.4%) excreted Cryptosporidium oocysts during the observation period. Of the diarrheal episodes, 13 (8.3%) were associated with Cryptosporidium sp. Of the control specimens, seven (0.6%) were positive for oocysts. Most of the infections were documented during the months of February to May, at the end of the dry season. Cryptosporidium infections are very common among Guatemalan infants and are an important cause of diarrhea and weight loss. The introduction of liquid or solid foods in the diets of the children, the presence of domestic animals (dogs, cats, or poultry), and the absence of toilet facilities in the house seem to be important risk factors for infection; also, deficient nutritional status may predispose the infected child to Cryptosporidium-associated illness.     

Outer Ear Canal Infection with Rhabditis sp. Nematodes in a Human

Here we report the first human case of an outer ear canal infection with a free-living nematode of the genus Rhabditis. Otomicroscopy revealed viable worms in the outer ear canal of a patient suffering from chronic otorrhea and hearing loss. The nematode was identified by microscopy and internal transcribed spacer (ITS)-PCR.     

Ocular spherulocystosis.

Spherulocystosis (myospherulosis), a rare entity, is characterised by histopathological changes of sac-like refractile structures in soft tissue and presents clinically as an inflammatory lesion. It is caused by trauma or is induced iatrogenically by the topical application of fat based ointments. A case of myospherulosis confined to the region of the lacrimal caruncle, which developed soon after topical antibiotic application for suspected conjunctivitis, in a 49 year old woman is reported. Though this lesion is uncommon, this report illustrates the importance of recognising this condition to avoid confusion with and treatment for fungal infection.     

Infection naturelle a Cryptosporidium sp. chez le poulet de chair au Maroc

La prevalence de l'infection crytosporidienne a ete determinee dans 38 elevages de poulets de chair. Deux cent vingt cinq poulets ont fait l'objet d'examens clinique et lesionnel. Les analyses de decalques et de prelevements de tissus effectues a partir de l'intestin, la bourse de Fabricius et la trachee ont revele la presence de Cryptosporidium sp. dans 37% des elevages enquetes. La prevalence de la cryptosporidiose a l'interieur des elevages variait de 14 a 100%. Une frequence elevee de la presence de Cryptosporidium sp. a ete observee chez les poulets ages de 36 a 45 jours et le parasite n'a pas ete detecte chez les poulets ages de moins de 25 jours. La localisation la plus frequente de Cryptosporidium sp. etait la bourse de Fabricius (24%), suivie par l'intestin (15%) et la trachee (2%). Au niveau des bourses de Fabricius, les lesions d'hyperplasie epitheliale induite par Cryptosporidium etaient le plus souvent associees (94%) a l'atrophie et la depletion lymphoide.     

Ocular myasthenia gravis.

Ocular dysfunction accounts for nearly 70% of the initial manifestations of myasthenia gravis. Since the prevalence rate of myasthenia gravis is two to 10 cases per 100,000 population, it is important for clinicians to be cognizant of this disorder and its varied ocular presentations. The clinical manifestations, diagnosis, treatment, and prognosis of ocular myasthenia gravis are reviewed.     

Infection of Genital Tract and Transmission of Ocular Infection to Newborns by the Agent of Guinea Pig Inclusion Conjunctivitis

Female guinea pigs were inoculated intravaginally with the agent of guinea pig inclusion conjunctivitis (Gp-ic). Evidence for infection was obtained by demonstration of Gp-ic inclusions in epithelial cells of genital tract smears, histopathology, recovery of Gp-ic during infection, and antibody response. Infection of the genital tract was produced with low doses (20-200 median egg lethal doses) of the agent. The infection lasted about 3 weeks, and there was no marked clinical response. Ocular infection that could be detected as early as 3 days after birth in offspring of infected mothers was also demonstrated.     

Plasmid Copy Number and Disease Severity in Naturally Occurring Ocular Chlamydia trachomatis Infection

The Chlamydia trachomatis plasmid is a virulence factor. Plasmid copy number, C. trachomatis load and disease severity were assessed in a treatment-naive population where trachoma is hyperendemic. By using droplet digital PCR, plasmid copy number was found to be stable (median, 5.34 [range, 1 to 18]) and there were no associations with C. trachomatis load or disease severity.     

Disseminated BCG Infection Mimicking Metastatic Nasopharyngeal Carcinoma in an Immunodeficient Child with a Novel Hypomorphic NEMO Mutation

Background

Nuclear factor-??B essential modulator (NEMO) deficiency is a developmental and immunological disorder. The genetic and phenotypic correlation has been described.

Methods

We report a unique clinical presentation and the identification of a novel missense mutation in the NEMO gene in a 3-year-old boy with bacillus Calmette-Guerin (BCG) infection.

Results

The patient presented with fever, cervical lymphadenopathy, and abnormal anti-Epstein?CBarr virus (EBV) antibody titers, suggestive of EBV-related diseases including chronic active EBV infection, X-linked lymphoproliferative syndrome, or nasopharyngeal carcinoma. Although the biopsy specimen from a nasopharyngeal lesion was initially diagnosed as squamous cell carcinoma, this was changed to disseminated BCG infection involving the nasopharynx, multiple systemic lymph nodes, and brain. A novel mutation (designated D311E) in the NEMO gene, located in the NEMO ubiquitin-binding (NUB) domain, was identified as the underlying cause of the immunodeficiency. Impaired immune responses which are characteristic of patients with NEMO deficiency were demonstrated. The patient underwent successful unrelated bone marrow transplantation at 4.9 years of age.

Conclusion

This study suggests the importance of the NUB domain in host defense against mycobacteria. The unique presenting features in our patient indicate that a hypomorphic NEMO mutation can be associated with atypical pathological findings of the epithelial tissues in patients with BCG infection.     

Ocular allergy and immunology.

The eye may be the target of allergic inflammation in a large number of systemic immunologic conditions. Ocular signs and symptoms can often be the most striking and disabling aspects of such diseases. The eye is also affected by several local conditions in which immunologic mechanisms are thought to play a significant role. Certain anatomic and physiologic features appear to endow the eye with a unique immunologic reactivity which has made this organ of special interest to allergists and immunologists.     

Ocular immunopathology in murine lupus.

Immunoglobulin deposits and DNA were identified by use of immunofluorescence microscopy within the ciliary process and choroid of a majority of (NZB X W)F1 mice with murine lupus. The number of animals with such deposits increased from 57% at 36 weeks of age to 90% at one year of age. Ultrastructural examination showed electron-dense deposits between the basement laminae of the endothelium and pigmented epithelium of the ciliary process, accompanied by alterations in the epithelial basement membranes. Similar electron-dense deposits were also identified in the vicinity of the lamina choroidocapillaris. The titer of antibody to DNA did not correlate with the presence of ocular deposits, suggesting that time is an important factor in the development of ocular immunopathology in these animals.