1/23. Comparative pathology, and immunohistology associated with clinical illness after ehrlichia phagocytophila-group infections. The ehrlichia phagocytophila-group also includes E. equi and the human granulocytic ehrlichiosis (HGE) agent that are probably a single species. disease is mild to severe illness in ruminants, horses, and humans, but the comparative pathology and ehrlichial distribution in tissues is poorly described. We compared pathology and ehrlichial distribution in humans with HGE, horses with E. equi infection, and a sheep with E. phagocytophila infection. Frequent findings included splenic lymphoid depletion, small macrophage aggregates and apoptoses in liver, and paracortical hyperplasia in lymph nodes. bone marrow was normocellular or hypercellular. Only the spleen was frequently infected; other organs with infected cells included lung, liver, heart, and kidney, but lesions were present in lung and liver only. Most infected cells were neutrophils. ehrlichia phagocytophila-group infections are associated with moderate tissue damage. While the pathogenesis of granulocytic ehrlichiosis is not clear, pathologic studies suggest that the process is initiated by ehrlichia-infected cells but may result from host-mediated injury and immunosuppression. ( info) |
2/23. Chronic hyperbilirubinemia associated with hepatic uptake and storage impairment. A new syndrome resembling that of the mutant Southdown sheep. A 19-year-old female complained of moderate jaundice since early childhood, without any other clinical abnormality. Apart from the hyperbilirubinemia (which comprised around 50% of conjugated bilirubin), usual hepatic function tests were normal. Oral cholecystogram showed a delayed opacification of a normal gallbladder. liver histology and hepatic bilirubin UDP-glucuronyltransferase activity were normal. The plasma disappearance rates of bromosulfophthalein, dibromosulfopthalein, rose bengal, and indocyanine green were dramatically reduced. There was a marked impairment of the relative storage capacities of bromosulfophthalein and dibromosulfophthalein; this reduction was associated with, and thought to be the cause of, some decrease of the biliary transport maximum. This new form of chronic benign hyperbilirubinemia seems therefore primarily due to a defect of hepatic uptake and storage, and closely resembles the disease observed in the mutant Southdown sheep. Since it is not yet possible to quantify the Y- and Z-proteins from a needle biopsy of human liver, their role in the pathogenesis of the present disease remains speculative. ( info) |
3/23. A case report of sporadic ovine listerial menigoencephalitis in iowa with an overview of livestock and human cases. A case of ovine listeriosis was examined in a flock of sheep. The index case was a male lamb, which was part of a flock of 85 sheep located in central iowa. Because the sheep were raised on a premise where soybean sprouts were also cultivated for the organic foods market, the potential of a public health concern was addressed. To identify the source of contaminations, clinical and environmental samples were cultured for listeria monocytogenes. Isolates were serotyped and analyzed using pulsed-field gel electrophoresis (PFGE). listeria monocytogenes (serotype 1) was recovered from the brain of a male lamb with clinical signs of listerial encephalitis. Isolates of serotypes 1 and 4 were also cultured from feces of clinically healthy lambs, compost piles, and soybean cleanings. By PFGE, the clinical isolate was distinctly different from the other isolates. Environmental isolates were identified as L. monocytogenes serotypes 1 and 4. However, by PFGE, none matched the profile of the single clinical isolate. Thus, the ultimate source of contamination is unknown. ( info) |
4/23. Hepatic hydatid cysts with superinfection in a non-endemic area in taiwan. Hepatic hydatid cysts are extremely rare in taiwan. We report a case of complicated, multivesicular, hydatid cysts in the liver and a secondary infection with klebsiella pneumoniae. The cysts were detected in an early stage by ultrasonography and computed tomography and treated successfully with radical resection. ( info) |
5/23. Laboratory outbreak of q fever. An outbreak of q fever in a university department where sheep placentas were being used for research is described. Of six persons exposed to the sheep, four had positive titers with only one person developing an acute febrile illness and liver disease. This report illustrates the value of the family physician obtaining an occupational history and conducting an outbreak investigation. ( info) |
6/23. Ovine chlamydiosis in an abattoir worker. The strain of chlamydia psittaci causing enzootic abortion in ewes (the EAE strain) may cause serious infection in pregnant women, often resulting in hepatic and renal dysfunction, disseminated intravascular coagulation and fetal loss. The first case of such an infection in an abattoir worker is described and the possibility of human-to-human transmission considered. Direct handling of sheep or their products of conception can usually be established but this is not always so. There is much still to be learned about this uncommon but severe zoonosis. ( info) |
7/23. Three rare cases of anthrax arising from the same source. anthrax is an acute bacterial infection caused by bacillus anthracis. humans become infected under natural conditions by contact with infected animals or contaminated animal products. About 95% of human anthrax is cutaneous and 5% respiratory. Gastrointestinal anthrax is very rare, and has been reported in less than 1% of all cases. anthrax meningitis is a rare complication of any of the other three forms of disease. We report three rare cases of anthrax (gastrointestinal, oropharyngeal and meningitis) arising from the same source. The three patients were from a single family and were admitted with different clinical pictures after the ingestion of half-cooked meat from a sick sheep. These cases emphasize the need for awareness of anthrax in the differential diagnosis in areas where the disease remains endemic. ( info) |
8/23. sepsis due to gestational psittacosis: A multidisciplinary approach within a perinatological center--review of reported cases. chlamydia psittaci is associated with significant morbidity and mortality during pregnancy, and its rarity can delay early diagnosis and treatment. A farmer's wife presented at 31 weeks with febrile illness and developed signs of septic shock, indicating immediate delivery. The child developed uneventfully. The mother survived after symptomatic mechanical ventilation, including extracorporeal lung assistance, for 11 days due to multi-organ failure. Only two weeks after admission antibody titres against chlamydia were rising. The placenta demonstrated acute intervillositis and destruction of throphoblastic cells. Retrospectively, the infection was presumed to derive from infected pregnant sheep. pregnant women should be advised to avoid contact with sheep and their gestational products. Proper history, early recognition and appropriate management is mandatory for survival of both mother and child. ( info) |
9/23. Human orf. A diagnostic consideration? We saw four unrelated cases of human orf infection over a 3-month period. Each patient had a clear-cut history of contact with sheep and developed a characteristic painful pustular lesion on the hand. There were no significant systemic symptoms. Examination of an aspirate by electron microscopy confirmed the diagnosis. The lesions resolved spontaneously within 6 weeks. Human orf infection occurs in north america, and although seldom reported, it should be considered in the diagnosis of cutaneous lesions in patients who have exposure to animals associated with it. ( info) |
10/23. Illness caused by a Kokobera-like virus in south-eastern australia. Three patients who lived in south-eastern australia and who suffered acute polyarticular illnesses in the summer months of 1983-1984 and 1984-1985 are described. Two patients lived in the southwestern plains of new south wales and one in Bairnsdale in eastern victoria. Serological studies implicated Kokobera virus, a flavivirus, as the likely causative agent. This would appear to be the first report to indicate the pathogenicity of Kokobera virus. ( info) |