[Uncommon casuistics of the oral cavity; case of pseudobotryomycoma of the palate].
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A case of actinomycosis mimicking abdominal neoplasm in a 56-year old woman is presented. Actinomyces israelii is a common saprophyte found in the mouth and gastrointestinal tract. It is an anaerobic, Gram-positive, branching filamentous fungus related in many respects to the bacteria. Damage to the mucosa by trauma, disease or surgery is an essential prerequisite to infection with this organism. In 20% of the cases the abdomen is involved, but an abdominal mass is a rare presentation. In such cases diagnosis prior to exploratory laparotomy is difficult.
A dimorphic fungus Penicillium marneffei is a causative agent of penicilliosis, a life-threatening disseminated disease in immunocompromised hosts predominantly found in southeast Asia and southern China. P. marneffei is the only known Penicillium that possesses a dimorphic characteristic. Since it is difficult to produce large amount of P. marneffei yeasts in vivo for experimentation purpose, yeast cells were produced in different in vitro conditions as alternatives. We interested in investigating the immunologic properties of yeast cells from different culture preparations. It was found that yeast cells obtained from brain heart infusion broth and Sabouraud dextrose broth did not resemble those resided in clinical specimens. A solution of 1% peptone, on the other hand, could induce a direct conidial transition into fission yeasts. Ability of yeast cells in each preparation to activate macrophages was determined by analyzing surface expression of CD40 and CD86 co-stimulatory molecules after two days of co-cultivation. Every P. marneffei yeast cell preparation demonstrated such ability. However, the ones from Sabouraud dextrose broth seemed to induce less phagocytosis. Additionally, although distinct antigenic profiles and lack of conformity in antigenic expression were observed among yeast cells from different culture conditions, most major immunogenic bands were present when Western analysis was performed using polyclonal antisera from penicilliosis patients. The results of the study raise attention on immunological and biochemical characteristics of P. marneffei yeasts if such preparations are to be used in future laboratory investigations.
Malassezia, a yeast-like fungus found in normal skin flora is known to be associated with various skin diseases and systemic infections. There is yet no standardized in vitro susceptibility testing method and minimum inhibitory concentration (MIC) breakpoints for Malassezia species. In this study, we investigated the in vitro activity of ketoconazole, itraconazole and terbinafine against 30 Malassezia strains (22 Malassezia furfur/dermatis, 8 M. japonica) isolated from cheek and/or scalp swabs and/or cephalic pustules of 21 neonates. The isolates were identified to species level on the basis of growth on Sabouraud dextrose agar, assimilation of Tween compounds and catalase reaction. The antifungal susceptibility tests were performed by agar dilution method using modified Dixon agar (MDA) and the agar dilution plates were incubated at 32 degrees C. For the isolates which exhibited sufficient growth, MICs were read at 48 hours, for the remaining slow-growing isolates, MIC readings were done on 7th day. For all drugs tested, the lowest concentration that provided complete inhibition of growth visually was interpreted as the MIC (microg/ml) value. Itraconazole was the most active drug in vitro against Malassezia species, followed by ketoconazole and terbinafine in rank order. In vitro activity of terbinafine was poor for half of the Malassezia strains tested. Variations in activity against individual Malassezia strains were detected for ketoconazole and terbinafine, while in vitro activity of itraconazole was similar for all strains tested. In order to validate the clinical significance of these results, further in vitro and in vivo correlation studies are needed.
An outbreak of a disease characterised by jaundice, rapidly developing ascites and portal hypertension associated with 20 p. 100 mortality rate was investigated in 1974. Analysis of food samples revealed that the disease outbreak was due to the consumption of maize (corn) heavily infested with the fungus Aspergillus flavus. Unseasonal rains prior to harvest, chronic drought conditions, poor storage facilities and ignorance of dangers of consuming fungal contaminated food seem to have caused the outbreak. The level of aflatoxin in food samples consumed during the outbreak was ranging between 2.5 and 15.6 microgram/g. Anywhere between 2 and 6 mg of aflatoxin seems to have been consumed daily by the affected people for many weeks. In contrast, during 1975, analysis of corn samples from the same areas revealed very low levels of aflatoxin, viz., less than 0.1 microgram/g. This was in line with the absence of major outbreak in 1975.
Groups of neotropical bats (Artibeus lituratus) were inoculated by the intraperitoneal or intranasal routes with varying doses of yeast phase Paracoccidioides brasiliensis. Bats infected with 10(6) viable yeast cells intraperitoneally developed fatal, disseminated disease, with delayed hypersensitivity appearing within 2 weeks. No precipitating antibodies were detected up to 7 weeks post-exposure. After intranasal instillation of 10(5) viable P. brasiliensis, the disease spread from the lung to the spleen by 3 weeks and to the liver by 9 weeks. As few as 10 viable cells were capable of causing pulmonary disease. Antibodies were detected at 5 weeks and persisted for several weeks thereafter. No viable P. brasiliensis was recovered from the intestines or fecal contents of any bats. Artibeus lituratus appears to be very susceptible to paracoccidioidomycosis by the respiratory route. The resulting immune response is characterized by delay appearance of precipitating antibodies and a moderate degree of delayed hypersensitivity. The pathogenesis of the resulting disease is similar to that observed in humans. The absence of intestinal involvement, even in chronic systemic disease, suggests that bats do not play a direct role in dissemination of this fungus in nature.
Beauveria bassiana is one of the most promising agents for use as a bioacaricide to control the cattle tick Boophilus microplus, responsible for economic losses and transmission of infectious diseases. With the aim of optimizing the efficacy of chemical products, as well as the use of entomopathogens, the objective of the present study was to evaluate the compatibility and the synergism between this fungus and the drug deltamethrin on a strain of B. microplus that is resistant to this product.
This report describes a series of 553 flexible upper gastrointestinal (GI) endoscopies performed on 382 children in two surgical centers between 1975 and 1987. Indications included abdominal pain (180), reassessment of known disease (149), upper GI bleeding (99), foreign body ingestion (77), vomiting (14), dysphagia (10), and miscellaneous (24). Findings were chronic peptic ulcer (47), gastritis/duodenitis (63), healing disease (92), nonhealing disease (22), recurrent disease (32), foreign body impaction (22), stricture (9), esophagitis (7), varices (7), mass (6 [3 polyp, 1 lymphoma, 1 fungus ball, 1 inflammation]), normal (209), and miscellaneous (37). Endoscopic diagnosis was uniformly correct except on two occasions, when the presence of recurrent tracheoesophageal fistula in small infants was missed due to use of an inadequate instrument. A pathologic lesion is likely to be identifiable in GI bleeding (84.8%). Endoscopic surveillance for progress of known disease was found to be valuable, particularly in peptic ulcer management, as both incomplete healing after standard therapy as well as recurrence are frequent. The recent practice of routine antral biopsy in children with severe "nonspecific abdominable pain" enabled four cases of Campylobacter pylori colonization in the stomach to be diagnosed, thus allowing appropriate treatment. Endoscopy was therapeutic on 61 occasions: injection sclerotherapy (32), foreign body removal (20), polypectomy (3), and stricture dilatation (6). Endoscopy-guided bougienage, in particular, represents a recent major advance. There was no morbidity or mortality in the entire series. It is concluded that pediatric upper GI endoscopy performed by experienced surgeons is safe and effective. As a result of better understanding and technological advances, a changing trend of wider and more rational applications of the procedure is now evident.
A detailed clinical and mycological study of horse infections with Histoplasma farciminosum was conducted for the first time in the Middle East. The disease seems to prevail in endemic form in the region. In all of the cases studied the infection involved only the cutaneous lymphatics and skin tissue with extension to the regional draining lymph glands. The disease seems to impose serious economic impact in the infected areas. Full description and thorough characterization of both the mycelial form and the yeast phase of the causative fungus were made.
The present study was conducted in the 1993 grazing season with yearling calves exposed to a pasture with a natural mixed trichostrongyle larval infection. It was shown that daily feeding with the microfungus Duddingtonia flagrans during the first 2 months of the season led to a lowered herbage infectivity and a reduced acquisition of Ostertagia sp. and Cooperia sp. later in the season. In addition, the procedure delayed the onset of clinical disease. This was due to the nematode-destroying effects of the fungi in the dung excreted by the fungus-treated calves, as evidenced by results from a parallel in vitro assay on faecal larval cultures. The paper discusses future research needs before practical biological control can be implemented.
The processes which give rise to emerging infectious diseases of wildlife can be categorised as follows: ecosystem alterations of anthropogenic or natural origin; movement of pathogens or vectors, via human or natural agency; and changes in microbes or in the recognition of emerging pathogens due to advances in the techniques of epidemiology. These are simplistic divisions because factors influencing the emergence of diseases of wild animals generally fall into more than one category. Mycoplasmosis among passerines is related to habitat changes and artificial feeding resulting in increased bird densities and subsequent disease transmission. The origin of this strain of Mycoplasma gallisepticum is not known. Hantavirus infections in rodents have emerged due to human-induced landscape alterations and/or climatic changes influencing population dynamics of hantavirus reservoir hosts, with disease consequences for humans. Movement of pathogens or vectors is a very important process by which diseases of wildlife expand geographic range. Although the origin of caliciviruses of rabbits and hares is somewhat obscure, their movement by humans, either deliberately or accidentally, has greatly expanded the distribution of these viruses. Rabies is an ancient disease, but geographic expansion has occurred by both natural and anthropogenic movements of wild animals. Human movement of amphibians may explain the distribution of the highly pathogenic chytrid fungus around the world. Newly recognised paramyxoviruses may reflect both changes in these pathogens and the development of techniques of identification and classification. Many more such examples of emerging diseases will arise in the future, given the extensive alterations in landscapes world-wide and movements of animals, vectors and pathogens. Those who study and diagnose diseases of wildlife must be alert for emerging diseases so that the impact of such diseases on wild animals, domestic animals and humans can be minimised.
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