1/8. Atypical avian influenza (H5N1). We report the first case of avian influenza in a patient with fever and diarrhea but no respiratory symptoms. Avian influenza should be included in the differential diagnosis for patients with predominantly gastrointestinal symptoms, particularly if they have a history of exposure to poultry. ( info) |
2/8. Ornithonyssus (acari: Macronyssidae) mite dermatitis in poultry field-workers in Almarg, Qalyobiya governorate. Cutaneous manifestations of bird and rat mite infestation in man are not easily recognized by physicians or patients. Clinical signs and symptoms are developed secondary to bites of mites that have infested rats, domestic poultry or birds nesting in or near human habitation and comes into contact with man. This study details 4 cases of pruritic dermatitis developed in four field workers in poultry farms in Al-Marg district, Qalyobia governorate, egypt. The zoonotic species of Ornithoyssus sp., (family Macronyssidae) was isolated from all samples collected from patients' habitat and the role played by Ornithonyssus mites in causing dermatitis in man was discussed. ( info) |
3/8. Isolation of erysipelothrix rhusiopathiae from a 55 year old man and a positive tracing of the infection to chicken-raising premise. erysipelothrix rhusiopathiae was isolated from the swollen finger of a 55 year old man. The swelling was due to a peck by an infected chicken. Tracing the infection to the chicken-raising premises has proven that the bacterium was present in some of the chicken and manure samples. ( info) |
| Thirteen cases of disseminated infection with mycobacterium avium-intracellulare (MAI) seen at the National Jewish Hospital and research Center and 24 cases from the literature were analyzed to define clinical and therapeutic features of the disease. Disseminated MAI infection was a disease of immunocompromised and apparently normal hosts. It was acquired from the environment by unknown mechanisms, usually entering the body through the lungs and spreading to include the reticuloendothelial system, bones, and less commonly, the skin. Diagnosis was often delayed and required culture of tissue or secretions. Medical personnel must maintain a high index of suspicion for MAI disease, especially in immunocompromised hosts. These patients should be monitored carefully for evidence of MAI with frequent cultures of blood and bone marrow. blood culture systems able to recover MAI promptly and reliably should be employed (52, 64). New diagnostic aids, such as the standardized preparation of PPD-B currently being prepared or tests for antibody to MAI, will help in differentiating MAI from other processes. If MAI is recovered, broad-spectrum therapy should be instituted. Response to combination antimicrobial chemotherapy in the patients surveyed in this report was gratifying. Over two-thirds of treated patients responded to therapy. New antimycobacterial agents such as ansamycin and thienamycin have been shown to have activity against MAI in vitro (40, 81, 92) and may further improve therapeutic efficacy. Studies of in vitro synergy, currently in progress in our laboratory, will also help define the optimal therapeutic regimen for each individual patient. While the patients presented in this report had a reassuring response to therapy, those who had many bacilli in the tissues had a poorer outcome. patients with AIDS often have this lepromatous histology (37) and thus may respond more poorly than the patients in this report even when optimal therapy is employed. Careful monitoring of AIDS patients for MAI infection may permit earlier institution of therapy and improve the chances for control of the infection. Studies to assess the relationship of in vitro sensitivity to therapeutic response in these patients are currently underway in our laboratory. It is hoped that early institution of therapy and optimization of regimens according to in vitro sensitivity data will lead to decreased morbidity and mortality in all patients with MAI infection. ( info) |
| Two uncommon neoplastic lesions--a neurofibrosarcoma and a leiomyosarcoma--were found in 7-week-old slaughterhouse chickens. Grossly, the neoplasms both appeared as locally extensive, nodular lesions that displaced the mesentery and abdominal viscera. Histologically, these tumors were anaplastic and invasive into the surrounding tissues. ( info) |
6/8. erysipelas in caged laying chickens and suspected erysipeloid in animal caretakers. erysipelas was diagnosed in 2 succeeding caged layer flocks housed in the same building and was characterized clinically by sudden death. At necropsy, lesions comprised generalized congestion, hemorrhages in the skeletal muscles and visceral organs, and swelling of liver, spleen, and kidney with or without large irregular zones of necrosis. Focal to massive hepatic necrosis was seen histologically with minimal or no inflammatory reaction. erysipelothrix rhusiopathiae was cultured from internal organs of affected birds in both outbreaks. Medication with penicillin in the feed controlled the mortality, but relapse occurred after cessation of medication. Two attendants who handled the dead birds in this building developed a painful localized infection of the fingers that later spread to the regional lymph node. The infection responded when antibiotic therapy for erysipeloid was initiated. ( info) |
7/8. Chicken fancier's spleen. Splenic epidermoid cysts are rare congenital lesions which usually present insidiously with non-specific symptoms such as dull left upper quadrant pain, or as incidental findings on clinical examination. We present a chicken breeder who presented as an emergency with a tender left upper quadrant mass and septicaemia secondary to zoonotic infection of a primary splenic cyst with salmonella enteritidis. The cystic nature of the swelling was confirmed by ultrasound and the anatomy assessed with computed tomography. She was aggressively resuscitated and underwent laparotomy and splenectomy, after which she made an uncomplicated recovery. The importance of early diagnosis and surgical treatment is discussed, together with the measures required as prophylaxis against overwhelming post-splenectomy sepsis. ( info) |
8/8. Occupational asthma by anisakis simplex. BACKGROUND: No cases of occupational asthma caused by the inhalation of antigens from anisakis simplex have been published. OBJECTIVE: The purpose of this study was to evaluate the possibility that A simplex can play a role in the asthma experienced by 2 workers when handling fish and fish flour. methods: skin prick and bronchial challenge tests with A simplex were performed. We also carried out measurements of specific IgE to A simplex and immunoblotting. RESULTS: Both patients had strong positive skin test responses, challenge test responses, and specific IgE to A simplex. immunoblotting showed that both patients also had IgE against several bands in the fish flour extract, suggesting contamination by anisakis allergens. CONCLUSION: These 2 patients provide evidence for occupational asthma caused by A simplex, based on in vivo and in vitro tests for anisakis-specific IgE. ( info) |