PubMed · 9117670
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T Kondo, T Iwasaki. 1996. [Perivalvular abscess].. https://pubmed.ncbi.nlm.nih.gov/9117670/
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Wild-caught box turtles (Terapene carolina carolina) with aural abscesses were observed over a period of several years. Histopathologic evaluation of epithelial tissues (conjunctiva, pharynx, trachea, auditory tube) revealed mucosal hyperplasia and squamous metaplasia, and accumulated keratin-like material in the middle ear cavity. These manifestations suggested the possibility of vitamin A deficiency. A nonsignificant trend toward reduced serum and hepatic vitamin A levels was observed in turtles with abscesses (mean serum and hepatic vitamin A levels 71 and 49% of respective levels in turtles without abscesses). Three organochlorine (OC) compounds (alpha-benzene hexachloride, heptachlor epoxide, and oxychlordane) and total (microg/g) OC compounds were significantly higher in turtles with abscesses compared with turtles without abscesses. No OC compounds were higher in turtles without abscesses compared with turtles with abscesses. These data suggest a possible effect of environmental chemicals on metabolism or utilization of vitamin A in wild box turtles, resulting in hypovitaminosis A.
The performance of the Amplified Mycobacterium Tuberculosis Direct Test (MTD; Gen-Probe, Inc., San Diego, Calif.) for rapid diagnosis of extrapulmonary tuberculosis was evaluated by testing 178 nonrespiratory specimens from 158 patients. Criteria for specimen inclusion were (i) a positive smear for acid-fast bacilli (n = 54) and (ii) the source if the smear was negative (tissue biopsies and aspirates and abscess material were tested; n = 124). Results were compared to those of mycobacterial culture; clinical history was reviewed when MTD and culture results disagreed. Forty-eight specimens (27.0%) were positive for mycobacteria, including 23 Mycobacterium tuberculosis complex specimens; of which 21 were smear positive. Twenty-five specimens were MTD positive; 20 of these grew M. tuberculosis complex. All of the five MTD-positive, M. tuberculosis complex culture-negative specimens were considered truly positive, based on review of the medical record. Of the three MTD-negative, M. tuberculosis complex culture-positive specimens, two contained inhibitory substances; one of the two was smear positive. Excluding the latter specimen from analysis, after chart review, the sensitivity, specificity, and positive and negative predictive values of the MTD were 92.6, 100, 100, and 98.7%, respectively, by specimen and 89.5, 100, 100, and 98.6% by patient. Given the few smear-negative samples from patients with extrapulmonary tuberculosis in our study, additional similar studies that include more smear-negative, M. tuberculosis complex culture-positive specimens to confirm our data are desirable.
A case of an unusual complication after percutaneous nephrolithotomy. After removal of an infectious staghorn calculus followed by SWL, the patient developed a double infundibular stricture leaving the kidney divided into three separate compartments. In spite of the absence of clinical symptoms of infection, this was further complicated by abscess formation and finally, function loss of the upper part of the kidney. Combined retro- and anterograde endoscopic surgery failed to re-establish the complete continuity of the uretero-caliceal system and the patient had to undergo partial nephrectomy. Possible etiologies, contributing factors and means of prevention for this rare complication are discussed.