Science.gov

Sample records for immunocompetent child caused

  1. Chromoblastomycosis Associated with Bone and Central Nervous Involvement System in an Immunocompetent Child Caused by Exophiala Spinifera.

    PubMed

    Srinivas, Sahana M; Gowda, Vykuntaraju K; Mahantesh, S; Mannapur, Rajeshwari; Shivappa, Sanjay K

    2016-01-01

    Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera. Child showed good improvement with voriconazole and itraconazole after 1 year of treatment. Skin lesions healed with minimal scarring and his power improved. PMID:27293256

  2. Chromoblastomycosis Associated with Bone and Central Nervous Involvement System in an Immunocompetent Child Caused by Exophiala Spinifera

    PubMed Central

    Srinivas, Sahana M; Gowda, Vykuntaraju K; Mahantesh, S; Mannapur, Rajeshwari; Shivappa, Sanjay K

    2016-01-01

    Chromoblastomycosis is a chronic granulomatous infection of the skin and subcutaneous tissue caused by specific group of dematiaceous fungi. The infection results from traumatic injury and is seen more commonly on feet and lower legs. It is rarely seen in children and metastatic spread to other systems is exceptionally rare. We report a 12-year-old immunocompetent male child diagnosed with chromoblastomycosis on the lower leg, who in a span of few months developed osteomyelitis and left hemiparesis. Fungal culture showed growth of Exophiala spinifera. Child showed good improvement with voriconazole and itraconazole after 1 year of treatment. Skin lesions healed with minimal scarring and his power improved. PMID:27293256

  3. Cerebellar mutism caused by primary varicella infection in an immunocompetent child.

    PubMed

    Erol, Ilknur; Özkale, Yasemin; Saygi, Semra; Alehan, Füsun

    2014-06-01

    Varicella (chickenpox) is a common childhood infection caused by the varicella-zoster virus, which is often self-limiting and usually benign. Although uncommon, neurologic complications of varicella have been documented that include postinfectious cerebellar ataxia, meningoencephalitis, Reye syndrome, myelitis, optic neuritis, stroke, Guillain-Barré syndrome, seventh cranial nerve palsy, and Ramsay-Hunt syndrome. In this case study, the authors describe a 7-year-old girl who presented with varicella skin rash with unsteady gait and anarthria on day 2, and her condition was attributed to cerebellar mutism. To date, this complication has never been reported in a child with primary varicella infection. Therefore, this case study documents a rare but serious complication of childhood chickenpox.

  4. Abdominal Lymphonodular Cryptococcosis in an Immunocompetent Child

    PubMed Central

    Zaidi, Mehjabeen; Qureshi, Sonia; Shakoor, Sadia; Fatima, Saira; Mir, Fatima

    2015-01-01

    We describe our experience with an apparently immunocompetent child presenting with pyrexia of unknown origin without focal signs. Investigations revealed lymphadenopathy at lung hila, mesentery, and porta hepatis. The child had received at least two months of empiric antituberculous therapy (ATT) before she came to us. A CT-guided biopsy revealed granulomatous inflammation. PAS stain showed yeasts which stained blue with Alcian blue, suggesting C. neoformans. PMID:26649217

  5. Recurrent respiratory infection caused by Bordetella bronchiseptica in an immunocompetent infant.

    PubMed

    de la Torre, María José Lozano; de la Fuente, Celia García; de Alegría, Carlos Ruiz; Del Molino, Concepción Pérez; Agüero, Jesús; Martínez-Martínez, Luis

    2012-09-01

    Bordetella bronchiseptica rarely infects immunocompetent humans. We report an unusual case of recurrent pertussis-like syndrome caused by B. bronchiseptica in a 7-month-old immunocompetent boy. Molecular analysis demonstrated that the isolates from the child and mother were identical.

  6. Klebsiella pneumoniae liver abscess in an immunocompetent child.

    PubMed

    Kwon, Jang-Mi; Jung, Hye Lim; Shim, Jae Won; Kim, Deok Soo; Shim, Jung Yeon; Park, Moon Soo

    2013-09-01

    Klebsiella pneumoniae has emerged as a leading pathogen that causes pyogenic liver abscesses (PLAs) in Korea. K. pneumoniae liver abscess (KLA) is potentially life threatening, and the diagnosis is difficult. In developed countries, PLA is rarely observed in children and is frequently associated with disorders of granulocyte function and previous abdominal infection. We observed a case of KLA in a healthy 12-year-old boy. To our knowledge, this is the first reported case of KLA in an immunocompetent child without an underlying disease in Korea. The patient was treated with percutaneous catheter drainage and antibiotics. The catheter was placed in the intrahepatic abscess for 3 weeks and parenteral antibiotics (ceftriaxone and amikacin) were administered for 4 weeks, followed by oral antibiotics (cefixime) for 2 weeks. We reported this case to raise awareness of KLA in immunocompetent children among physicians, and to review the diagnosis, risk factors, potential complications, and appropriate treatment of KLA.

  7. Pulmonary nodules in an immunocompetent child with cat scratch disease.

    PubMed

    Bandyopadhyay, Anuja; Burrage, Lindsay C; Gonzalez, Blanca E

    2013-12-01

    We describe an immunocompetent child with cat scratch disease and pulmonary nodules as part of her initial presentation. Although pulmonary manifestations have been reported with cat scratch disease, nodules are rare in the normal host.

  8. Tuberculous liver abscess in an immunocompetent child with pulmonary tuberculosis as a cause of fever of unknown origin.

    PubMed

    Çalışkan, Bahar; Somer, Ayper; Hatipoğlu, Nevin; Keser, Melike; Yekeler, Ensar; Gün, Feryal; Güllüoğlu, Mine; Salman, Tansu; Salman, Nuran

    2015-01-01

    Infectious diseases are the leading cause of FUO. A case of prolonged fever with hepatic and pulmonary tuberculosis as a final diagnosis is herein presented. A 4-year-old, otherwise healthy boy presented with an axillary temperature of up to 39.5ºC for the previous 3 weeks. His medical history revealed an occasional increase in body temperature up to 38.5ºC for the last 6 months. Physical examination revealed coarse breath sounds on the basal lung area. Chest X-ray showed mediastinal lymphadenomegaly and computed tomography revealed paratracheal conglomerated lymph nodes and a groundglass appearance on the right lung. There were multiple contrast-enhanced, hypoechoic nodules with central necrosis in the liver parenchyma on abdominal magnetic resonance imaging. Open liver biopsy yielded chronic granulomatous inflammation compatible with pathological findings of tuberculosis infection. The culture specimen was positive for Mycobacterium tuberculosis. The patient improved rapidly after antituberculous therapy was initiated. Tuberculosis, especially in its disseminated form, poses a distinct diagnostic challenge in cases of prolonged fever with unproven etiology, and thus persistence should be exercised in disclosing the cause of such fevers. PMID:26613227

  9. Bacillary angiomatosis in an immunocompetent child: the first reported case.

    PubMed

    Paul, M A; Fleischer, A B; Wieselthier, J S; White, W L

    1994-12-01

    Bacillary angiomatosis, an infectious process associated with Rochalima spp., was thought until recently to be restricted to HIV-infected or otherwise immunosuppressed patients. In 1993, bacillary angiomatosis was reported in several immunocompetent adults. An extensive literature review failed to find references to bacillary angiomatosis in immunocompetent children. We describe a 6-year-old female who presented with a single, rapidly growing, friable, erythematous papule on her neck. Histologic examination of a biopsy specimen confirmed the diagnosis of bacillary angiomatosis. The patient was otherwise healthy, and her physical examination was normal. Laboratory studies, including HIV serology, were normal. The patient was treated with six weeks of oral erythromycin without evidence of recurrence. We present and discuss the implications of the first case of bacillary angiomatosis in an immunocompetent child.

  10. Unexpected postmortem diagnosis of acanthamoeba meningoencephalitis in an immunocompetent child

    PubMed Central

    Binesh, Fariba; Karimi, Mehran; Navabii, Hossein

    2011-01-01

    Meningoencephalitis caused by Acanthamoeba spp. is a rare opportunistic infection, difficult to diagnose and treat, which causes death in almost all cases. Here, the authors report a 5-year-old Iranian immunocompetent girl who died of fulminant acanthamoeba meningoencephalitis. To the authors’ knowledge, this is the first case of acanthamoeba meningoencephalitis in Iran. PMID:22679147

  11. Bacillary angiomatosis in an immunocompetent child: a case report and review of the literature.

    PubMed

    Zarraga, Matthew; Rosen, Les; Herschthal, David

    2011-07-01

    Bacillary angiomatosis is an infectious disease caused by 2 gram-negative bacilli, Bartonella henselae and Bartonella quintana. This disease is characterized by vascular proliferations in the skin and/or visceral organs, and typically manifests in immunocompromised patients. However, we report a case of a 10-year-old immunocompetent female child with a questionable history of being scratched by a cat. Although initially diagnosed as a pyogenic granuloma, a diagnosis of bacillary angiomatosis was made based on histologic examination of the excised lesion demonstrating interstitial bacillary deposition on Warthin-Starry silver stain. The patient was successfully treated with 2 weeks of azithromycin after which all symptoms resolved.

  12. Cytomegalovirus-associated colitis causing diarrhea in an immunocompetent patient

    PubMed Central

    Carter, Dan; Olchovsky, David; Pokroy, Russell; Ezra, David

    2006-01-01

    Cytomegalovirus (CMV) colitis rarely occurs in immunocompetent patients. We report a case of disabling and life threatening diarrhea in an immunocompetent elderly woman due to CMV colitis. The diagnosis of CMV was based on histological examination of tissues biopsied at colonoscopy, positive CMV antigen and high CMV-IgM titer in peripheral blood samples and a good response to systemic gancyclovir treatment. We conclude that CMV should be considered in the differential diagnosis of colitis in elderly immunocompetent patients. PMID:17106945

  13. [Sepsis caused by Raoultella ornithinolytica in an immunocompetent patient].

    PubMed

    Sueifan, M; Moog, V; Rau, E; Eichenauer, T

    2016-02-01

    Raoultella ornithinolytica is a species of gram-negative encapsulated and aerobic bacteria belonging to the family Enterobacteriaceae and is mainly found in fish. The most distinctive feature of this bacterium is the ability to convert histidine to histamine; therefore, the consumption of decomposing fish infected by R. ornithinolytica causes rashes, diarrhea, flushing, sweating and vomiting. This food poisoning is also called histamine fish poisoning; however, human infections with R. ornithinolytica are extremely rare and have so far only affected patients with diseases suppressing the immune system. The current case report describes for the first time sepsis with evidence of bloodstream infection by R. ornithinolytica in an immunocompetent male patient and the successful antibiotic treatment.

  14. Bone involvement by Sporothrix schenckii in an immunocompetent child.

    PubMed

    Ribeiro, Bruno Niemeyer de Freitas; Ribeiro, Renato Niemeyer de Freitas; Penna, Claudia Renata Rezende; Frota, Ana C

    2015-08-01

    Sporotrichosis in children is rare, and its osteoarticular form is very unusual. Disseminated forms are described mostly in immunocompromised patients. We report a case of a 5-year-old immunocompetent boy with multiple suppurated cutaneous lesions that progressed to polyarthritis of the hands and feet. Radiographic imaging demonstrated multifocal lytic lesions. Sporotrichosis was diagnosed through biopsy and culture. This article describes the radiographic appearance of a rare manifestation of this disease. In areas of high prevalence, the diagnosis of sporotrichosis should be taken into account, even in immunocompetent patients, when dactylitis with lytic lesions is present.

  15. [The subcutaneous mucormycosis due to Lichtheimia corymbifera: A case report in an immunocompetent child].

    PubMed

    Razouk, S; Sebbani, S; Agoumi, A; Benouchen, T; Malihi, A; Nacir, A; Abouhafsse, A; Al Hamany, Z; Tligui, H

    2012-06-01

    Mucormycosis due to Lichtheimia (ex Absidia) corymbifera is a rare fungal infection, occurring most often in an environment of immune deficiency, rarely in an immunocompetent patient. It comes in different clinical forms, frequently misleading, hence the interest of a pathological and mycological examination that allows the diagnosis of certainty. The management of this condition should be introduced early because it affects the functional prognosis of the patient. In this study, the authors report a case of mucormycosis in a 10-year-old child, and with clinical immunocompetent less severe than the cases reported in the literature.

  16. Endocarditis by Kocuria rosea in an immunocompetent child.

    PubMed

    Moreira, Jorge Salomão; Riccetto, Adriana Gut Lopes; Silva, Marcos Tadeu Nolasco da; Vilela, Maria Marluce dos Santos

    2015-01-01

    Kocuria rosea belongs to genus Kocuria (Micrococcaceae family, suborder Micrococcineae, order Actinomycetales) that includes about 11 species of bacteria. Usually, Kocuria sp are commensal organisms that colonize oropharynx, skin and mucous membrane; Kocuria sp infections have been described in the last decade commonly affecting immunocompromised patients, using intravenous catheter or peritoneal dialysis. These patients had mainly bacteremia/recurrent sepsis. We hereby describe the case of a 10-year-old girl, immunocompetent, who had endocarditis/sepsis by K. rosea which was identified in five different blood cultures by Vitek 2 ID-GPC card (BioMérieux, France). Negative HIV serology, blood count within normal range of leukocytes/neutrophils and lymphocytes, normal fractions of the complement, normal level of immunoglobulins for the age; lymphocyte immunophenotyping was also within the expected values. Thymus image was normal at chest MRI. No catheters were required. Identification of K. rosea was essential to this case, allowing the differentiation of coagulase-negative staphylococci and use of an effective antibiotic treatment. Careful laboratory analysis of Gram-positive blood-born infections may reveal more cases of Kocuria sp infections in immunocompetent patients, which may collaborate for a better understanding, prevention and early treatment of these infections in pediatrics.

  17. Endobronchial avium mycobacteria infection in an immunocompetent child.

    PubMed

    Perisson, Caroline; Nathan, Nadia; Thierry, Briac; Corvol, Harriet

    2013-01-01

    A 12-month-old boy, with no medical history, was admitted for dyspnoea with no cough or fever. Chest auscultation revealed an expiratory wheezing with decreased right-sided breath sounds. Chest imaging revealed subcarinal adenopathy and a nodule in the right principal bronchus (RB). Bronchoscopy showed a major obstruction of the RB by a granuloma, and a smaller granuloma in the left principal bronchus. The granulation tissue was removed by laser section. Histological examination revealed a necrotising granulomatous inflammation, culture showed a Mycobacterium avium complex (MAC). Tests to rule out tuberculosis and immunodeficiency were negative. The diagnosis of an MAC endobronchial granuloma was ascertained and a multidrug therapy associating clarithromycin, rifampin and ethambutol was started. The clinical outcome was good after 3 months of treatment and the bronchoscopy normalised after 1 year. Although rare, the frequency of MAC respiratory infections in immunocompetent children can increase. Reporting these cases should help to optimise diagnosis and treatment. PMID:24252838

  18. Osteomyelitis caused by Sporothrix schenckii in an immunocompetent patient.

    PubMed

    Ferreira, Laura Cunha; Barroso, Paulo Feijo; Tonomura, Elise; Akiti, Tiyomi; Rodrigues, Káris Maria de Pinho

    2016-01-01

    Sporotrichosis is the most common subcutaneous mycosis in South America and its association with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil. The disease most commonly presents as subacute or chronic cutaneous lesions, although dissemination to various organs and systems occurs in rare cases, mainly in immunosuppressed individuals. This report describes a case of sporotrichosis with severe bone and subcutaneous damage in an immunocompetent patient who did not exhibit the characteristic skin lesions of sporotrichosis, including ulcers, nodules, and lymphangitis.

  19. Osteomyelitis caused by Sporothrix schenckii in an immunocompetent patient.

    PubMed

    Ferreira, Laura Cunha; Barroso, Paulo Feijo; Tonomura, Elise; Akiti, Tiyomi; Rodrigues, Káris Maria de Pinho

    2016-01-01

    Sporotrichosis is the most common subcutaneous mycosis in South America and its association with zoonotic transmission remains a relevant public health problem in Rio de Janeiro, Brazil. The disease most commonly presents as subacute or chronic cutaneous lesions, although dissemination to various organs and systems occurs in rare cases, mainly in immunosuppressed individuals. This report describes a case of sporotrichosis with severe bone and subcutaneous damage in an immunocompetent patient who did not exhibit the characteristic skin lesions of sporotrichosis, including ulcers, nodules, and lymphangitis. PMID:27598646

  20. Kingella kingae Causing Septic Arthritis of the Knee in an Immunocompetent Adult.

    PubMed

    Ricketts, J; Rehmatullah, N N T; Sutton, P

    2015-01-01

    The bacterium Kingella kingae is a species of Gram-negative coccobacillus usually found in the oropharynx. This is an emerging pathogen reported to cause bacteraemia, endocarditis, and osteoarticular infections in children and endocarditis in the immunocompromised adult. However, there are few cases of isolated joint infections reported in the immunocompetent adult. Due to specific isolation techniques required, delay in diagnosis can compromise patient outcome. We report a rare case of septic arthritis of the knee in an immunocompetent adult caused by K. kingae.

  1. Cerebral macroabscess caused by Candida albicans in an immunocompetent patient: A diagnostic challenge

    PubMed Central

    Figueiredo, Sônia M.; Campolina, Sabrina; Rosa, Carlos A.; Gontijo, Marcus; Tirone, Thelma; Assunção, Claudia B.; Freire, Tarcísio F.A.; Christo, Paulo P.; Caligiorne, Rachel B.

    2014-01-01

    We describe the history of a 24-year-old immunocompetent man with an expansive lesion in the brainstem that, after many misdiagnoses, was found to be caused by a Candida albicans abscess. One year after surgery and 3 months of fluconazole treatment, the patient was asymptomatic and all image and laboratory tests were normal. PMID:24567895

  2. [Primary cutaneous Nocardia brasiliensis cellulitis in immunocompetent child].

    PubMed

    Shachor-Meyouhas, Yael; Ravid, Sarit; Suhair, Hanna; Kassis, Imad

    2012-08-01

    Primary cutaneous nocardiosis is an infrequent infection among children, generally affecting immunocompromised hosts. It is caused by Gram positive bacteria, partially alcohol and acid resistant which are saprophytes of the soil, water and organic matter. In most cases the causal agent enters through inhalation, and hematogenous dissemination may occur mainly among the immune compromised patients. Direct cutaneous inoculation is less frequent, especially among children. We report an 8-year old female who lives in an urban house with a small garden, who presented with an ulcer on her right shin accompanied by surrounding cellulitis, pain, swelling and fever. The patient's medical history was unremarkable, with no exposure to animals or travelling, except for rafting on the Jordan River the previous week. Culture from the ulcer grew Nocardia brasiliensis, and she recovered after 8 weeks of therapy with trimethoprim-sulphamethoxazole. PMID:23350294

  3. Infectious diseases causing diffuse alveolar hemorrhage in immunocompetent patients: a state-of-the-art review.

    PubMed

    von Ranke, Felipe Mussi; Zanetti, Gláucia; Hochhegger, Bruno; Marchiori, Edson

    2013-02-01

    Diffuse alveolar hemorrhage (DAH) represents a syndrome that can complicate many clinical conditions and may be life-threatening, requiring prompt treatment. It is recognized by the signs of acute- or subacute-onset cough, hemoptysis, diffuse radiographic pulmonary infiltrates, anemia, and hypoxemic respiratory distress. DAH is characterized by the accumulation of intra-alveolar red blood cells originating most frequently from the alveolar capillaries. It must be distinguished from localized pulmonary hemorrhage, which is most commonly due to chronic bronchitis, bronchiectasis, tumor, or localized infection. Hemoptysis, the major sign of DAH, may develop suddenly or over a period of days to weeks; this sign may also be initially absent, in which case diagnostic suspicion is established after sequential bronchoalveolar lavage reveals worsening red blood cell counts. The causes of DAH can be divided into infectious and noninfectious, the latter of which may affect immunocompetent or immunodeficient patients. Pulmonary infections are rarely reported in association with DAH, but they should be considered in the diagnostic workup because of the obvious therapeutic implications. In immunocompromised patients, the main infectious diseases that cause DAH are cytomegalovirus, adenovirus, invasive aspergillosis, Mycoplasma, Legionella, and Strongyloides. In immunocompetent patients, the infectious diseases that most frequently cause DAH are influenza A (H1N1), dengue, leptospirosis, malaria, and Staphylococcus aureus infection. Based on a search of the PubMed and Scopus databases, we review the infectious diseases that may cause DAH in immunocompetent patients.

  4. A novel cause of community-acquired pneumonia in a young immunocompetent host.

    PubMed

    James, Nicholas; Gilman, Matthew; Duncan, Robert; Gray, Anthony

    2016-09-01

    Diffuse pulmonary infiltrates represent a common problem encountered by pulmonologists. The differential diagnosis is extensive and includes infectious, inflammatory, environmental and malignant conditions. Appropriate evaluation, aside from a thorough history and physical examination, includes serologic, radiographic and procedural elements. We describe a case of a healthy male with diffuse pulmonary infiltrates. Work up revealed a novel infectious etiology. Although this particular microorganism has been described to cause native valve endocarditis, recurrent breast abscesses, osteomyelitis and bacteremia, it has to date not been described as a cause for community acquired pneumonia in immunocompetent hosts.

  5. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male

    PubMed Central

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-01-01

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere’s disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere’s, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses’ have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

  6. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male.

    PubMed

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-03-28

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere's disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere's, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses' have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy. PMID:25834342

  7. Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male.

    PubMed

    Ahmed, Zohair; Bansal, Saurabh K; Dhillon, Sonu

    2015-03-28

    A 21-year-old male with no significant past medical history, presented with right upper quadrant (RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was immunocompetent. Computed tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere's disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere's, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses' have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy.

  8. Severe meningoencephalitis due to late reactivation of Varicella-Zoster virus in an immunocompetent child.

    PubMed

    Spiegel, Ronen; Miron, Dan; Lumelsky, Dmitry; Horovitz, Yoseph

    2010-01-01

    Recurrent reactivation of latent Varicella-Zoster virus may cause various neurological complications including encephalitis, myelitis, stroke episodes, and meningitis. It occurs mainly in elderly or immunocompromised patients and is very rare in children. We report a 14-year girl who presented with meningoencephalitis due to reactivation of Varicella-Zoster virus 10 years after she had chickenpox and 4 years after she had zoster. Characteristic skin lesions of varicella were absent. Varicella-Zoster virus DNA was detected in cerebrospinal fluid and magnetic resonance imaging (MRI) findings were consistent with small vessel cerebral vasculitis. Treatment with acyclovir and high dose methylprednisolone resulted in near-complete neurological recovery. Although rare, Varicella-Zoster virus may reactivate to cause significant central nervous system disease even in immunocompetent children. Diagnosis depends on a high degree of suspicion because the typical rash may not associate the disease. Characteristic lesions on MRI and the presence of Varicella-Zoster virus DNA in cerebrospinal fluid are key findings for the correct diagnosis.

  9. Herpes zoster as a cause of viral meningitis in immunocompetent patients.

    PubMed

    Kangath, Raghesh Varot; Lindeman, Tracey Einem; Brust, Karen

    2013-01-09

    A 30-year-old Caucasian woman, without significant medical history or immunosuppression, presented with a 7-day history of severe headache and neck pain. The patient was presumed to have tension headache versus migraine, but was admitted because her symptoms did not resolve. A lumbar puncture was performed showing lymphocytic pleocytosis suggestive of aseptic meningitis and the patient was started on broad-spectrum antibiotics and acyclovir. After admission, a rash was discovered on her left lumbar region with vesicles on top of an erythematous base. Varicella PCR was conducted on the patient's cerebrospinal fluid which was positive. Upon further history, patient was found to have previous varicella infection as a child, but no prior episodes of dermatomal zoster. Therefore, this patient was found to have aseptic meningitis and cutaneous manifestation of disseminated varicella-zoster despite immunocompetence. Antibacterial treatment was discontinued and she was continued on acyclovir for 7 days with transition to valacyclovir for 2 additional weeks with good treatment response and symptom resolution.

  10. Herpes zoster and meningitis due to reactivation of varicella vaccine virus in an immunocompetent child.

    PubMed

    Han, Jin-Young; Hanson, David C; Way, Sing Sing

    2011-03-01

    Neurologic complications from varicella zoster virus (VZV) reactivation are rare. In this article, we describe a previously immunized child who developed herpes zoster with meningitis. Vaccine strain of VZV was recovered from a skin swab and the cerebrospinal fluid. Reactivation of the vaccine strain of VZV should be recognized as a potential cause of meningitis in children.

  11. Bacillary angiomatosis in an immunocompetent child with a grafted traumatic wound.

    PubMed

    Turgut, Mehmet; Alabaz, Derya; Karakaş, Mehmet; Kavak, Meric; Aksaray, Necmi; Alhan, Emre; Cevlik, Filiz; Tuncer, Ilhan

    2004-10-01

    Bacillary angiomatosis is an infectious disease which usually develops in immunocompromised patients. Contact with cats is implicated in its pathogenesis. We report a seven-year-old immunocompetent boy with bacillary angiomatosis without a history of direct contact with cats. The clinical diagnosis of bacillary angiomatosis was made following histopathological examination of a biopsy sample from the infected facial wound, in the vicinity of which angiomatous lesions had developed. Surprisingly, similar lesions also appeared at the donor site of the skin graft which was grafted on the facial wound. This case demonstrates that bacillary angiomatosis may also be seen in immunocompetent patients and that it may contaminate wounds without the intermediary of cats.

  12. A rare case report of subcutaneous phaeohyphomycotic cyst caused by Exophiala oligosperma in an immunocompetent host with literature review.

    PubMed

    Venkateshwar, Sithara; Ambroise, M Moses; Asir, G Johny; Mudhigeti, Nagaraja; Ramdas, Anita; Authy, K; Shivaprakash, M R; Kanungo, Reba

    2014-08-01

    We report a rare case of phaeohyphomycotic cyst in an immunocompetent patient caused by Exophiala oligosperma. This fungus is earlier known to cause infections in the immunocompromised. Identification of black fungi at species level is more challenging by conventional methods, and hence final identification of the fungi was based on sequencing of rDNA. The patient was managed with surgical excision. To the best of our knowledge, this is the first case report of E. oligosperma human infection from India. PMID:24902578

  13. [Listeria monocytogenes meningitis in immunocompetent children: unpasteurized cheese likely cause of infection].

    PubMed

    Valdivia-Tapia, María Del C; Pinelo-Chumbe, Elizabeth; Carreazo, Nilton Y

    2015-08-01

    Listeria meningoencephalitis is a rare condition, occurring mainly in immunocompromised patients. We present two cases of Listeria monocytogenes meningoencephalitis in immunocompetent children, with successful treatment with betalactam/aminoglycoside combination. Unpasteurized cheese was postulated as the source of infection.

  14. Infectious Spondylitis with Bacteremia Caused by Roseomonas mucosa in an Immunocompetent Patient

    PubMed Central

    Kim, Kyong-Young; Hur, Jaehyung; Jo, Wonyong; Hong, Jeongmin; Cho, Oh-Hyun; Kang, Dong Ho; Kim, Sunjoo

    2015-01-01

    Roseomonas are a gram-negative bacteria species that have been isolated from environmental sources. Human Roseomonas infections typically occur in immunocompromised patients, most commonly as catheter-related bloodstream infections. However, Roseomonas infections are rarely reported in immunocompetent hosts. We report what we believe to be the first case in Korea of infectious spondylitis with bacteremia due to Roseomonas mucosa in an immunocompetent patient who had undergone vertebroplasty for compression fractures of his thoracic and lumbar spine. PMID:26483995

  15. Endobronchial leiomyoma in an immunocompetent four-year-old female child.

    PubMed

    Gupta, Pallav; Aggarwal, Riti; Rijal, Prashant; Chugh, Krishan

    2014-03-01

    Pulmonary leiomyoma are uncommonly encountered benign mesenchymal neoplasms in children, usually found in immunosuppressed individuals in association with human immunodeficiency virus or Ebstein-Barr virus infection. We describe an interesting case of a 4-year-old immunocompetent girl who presented with pleural effusion and lung collapse secondary to endobronchial leiomyoma. She underwent a left thoracotomy and a left pneumonectomy for excision of the bronchial mass.

  16. [Pyomyositis, sacroiliitis and spondylodiscitis caused by Staphylococcus hominis in a immunocompetent woman].

    PubMed

    Gómez Rodríguez, N; Durán Muñoz, O

    2006-12-01

    In absence of risk factors, osteoarticular infections by coagulase-negative staphylococci are very infrequent. We described the case of a immunocompetent 73-year-old-woman that suffered pyomyositis, left sacroiliitis and spondylodiscitis involving the first and second thoracic vertebrae by Staphylococcus hominis. This multifocal infection occurred five-weeks after intramuscular administration of NSAI for treatment of low back pain associated with a herniated disc L4-L5. This is the first know case of a multifocal muscle skeletal infection by Staphylococcus hominis in a patient immunocompetent.

  17. Herpes zoster caused by vaccine-strain varicella zoster virus in an immunocompetent recipient of zoster vaccine.

    PubMed

    Tseng, Hung Fu; Schmid, D Scott; Harpaz, Rafael; LaRussa, Philip; Jensen, Nancy J; Rivailler, Pierre; Radford, Kay; Folster, Jennifer; Jacobsen, Steven J

    2014-04-01

    We report the first laboratory-documented case of herpes zoster caused by the attenuated varicella zoster virus (VZV) contained in Zostavax in a 68-year-old immunocompetent adult with strong evidence of prior wild-type VZV infection. The complete genome sequence of the isolate revealed that the strain carried 15 of 42 (36%) recognized varicella vaccine-associated single-nucleotide polymorphisms, including all 5 of the fixed vaccine markers present in nearly all of the strains in the vaccine. The case of herpes zoster was relatively mild and resolved without complications.

  18. Superficial Phaeohyphomycosis Caused by Aureobasidium melanogenum Mimicking Tinea Nigra in an Immunocompetent Patient and Review of Published Reports.

    PubMed

    Chen, Wan-Ting; Tu, Mei-Eng; Sun, Pei-Lun

    2016-08-01

    Aureobasidium pullulans is a ubiquitous black yeast-like fungus belonging to order Dothideales. It was regarded as a contaminant, but is now considered a pathogen causing a wide range of human infections. We report a case of superficial phaeohyphomycosis in an immunocompetent patient with clinical presentations mimicking tinea nigra. On microscopic examination of lesion scales, multiple thick-walled, pigmented oval spores with septa were noted. A fungus with black mucoid colonies was repeatedly isolated from the lesions during the treatment course. This fungus was identified as A. melanogenum on the basis of morphological characteristics and subsequently confirmed by sequencing internal transcribed spacers of ribosomal DNA. The clinical presentations and microscopic findings of lesion scales were considerably similar to those of tinea nigra. However, fungal culturing proved that the causative pathogen was A. melanogenum rather than Hortaea werneckii. The patient might have acquired this infection during gardening activities. We also reviewed reported cases of cutaneous A. pullulans infection. PMID:26883514

  19. Severe disseminated phaeohyphomycosis in an immunocompetent patient caused by Veronaea botryosa.

    PubMed

    Bonifaz, Alexandro; Davoudi, Mehrnaz Mohammad; de Hoog, G S; Padilla-Desgarennes, Carmen; Vázquez-González, Denisse; Navarrete, Gisela; Meis, Jacques F; Badali, Hamid

    2013-06-01

    We present a severe case of disseminated phaeohyphomycosis due to Veronaea botryosa. A 32-year-old female, native from Cuautla, Morelos, Mexico, presented a chronic dermatosis which started 10 years earlier with multiple exophytic, multilobulated, soft, and pedunculated or sessile neoformations of diverse sizes from 2 to 10 cm in diameter, which became verrucose and increased in size. The patient was immunocompetent, and no hereditary or familiar precedents of importance were known. No treatment was given, and the dermatosis remained relatively stable until the patient became pregnant in 2001 and 2003. The infection then exacerbated and worsened, leading to dissemination to the extremities, trunk, and face. The initial diagnosis was chromoblastomycosis which was treated with terbinafine and itraconazole but without visible improvement. Histopathology revealed pigmented, irregular, unbranched, and septate hyphae. Veronaea botryosa was isolated (CBS 127264 = JX566723), and its identity was confirmed by sequencing the internal transcribed spacer (ITS) rDNA. Therapy with posaconazole (800 mg/day) was started showing a gradual improvement of lesions with a reduction in size and flattening of the eruptions.

  20. Chronic invasive fungal sinusitis causing a pathologic Le Fort I fracture in an immunocompetent patient.

    PubMed

    Richter, Amy L; Gallagher, K Kelly

    2016-09-01

    We describe the case of a 77-year-old immunocompetent woman with a history of chronic rhinosinusitis who presented with a pathologic Le Fort I fracture after a forceful sneeze. Imaging revealed diffuse sinus opacification and a Le Fort type I complex fracture involving the maxilla, pterygoid plates, clivus, and right nasal bridge. The patient underwent endoscopic debridement of her sinuses, which revealed mucosal dehiscence and otherwise normal healthy bleeding tissue. Anatomic pathology identified necrotic bone with invasive fungal hyphae. Cultures demonstrated Burkholderia cepacia, diphtheroid organisms, and Enterococcus and Serratia spp. The patient was administered an intravenous antibiotic and antifungal for several months, but interval imaging found no significant improvement in bone healing although the stability of her palate had improved on clinical examination. Chronic rhinosinusitis has been found to be a complication of soft-tissue, orbital, and intracranial infections but, to the best of our knowledge, a pathologic facial fracture secondary to chronic invasive fungal and bacterial rhinosinusitis has not been previously reported in the literature. PMID:27657320

  1. Primary cellulitis and cutaneous abscess caused by Yersinia enterocolitica in an immunocompetent host: A case report and literature review.

    PubMed

    Kato, Hirofumi; Sasaki, Shugo; Sekiya, Noritaka

    2016-06-01

    Primary extraintestinal complications caused by Yersinia enterocolitica are extremely rare, especially in the form of skin and soft-tissue manifestations, and little is known about their clinical characteristics and treatments. We presented our case and reviewed past cases of primary skin and soft-tissue infections caused by Y enterocolitica. We report a case of primary cellulitis and cutaneous abscess caused by Y enterocolitica in an immunocompetent 70-year-old woman with keratodermia tylodes palmaris progressiva. She presented to an outpatient clinic with redness, swelling, and pain of the left ring finger and left upper arm without fever or gastrointestinal symptoms 3 days before admission. One day later, ulceration of the skin with exposed bone of the proximal interphalangeal joint of the left ring finger developed, and cefditoren pivoxil was described. However, she was admitted to our hospital due to deterioration of symptoms involving the left finger and upper arm. Cefazolin was initiated on admission, then changed to sulbactam/ampicillin and vancomycin with debridement of the left ring finger and drainage of the left upper arm abscess. Wound culture grew Y enterocolitica serotype O:8 and methicillin-sensitive Staphylococcus aureus. Blood cultures were negative and osteomyelitis was ruled out. Vancomycin was switched to ciprofloxacin, then skin and soft-tissue manifestations showed clear improvement within a few days. The patient received 14 days of ciprofloxacin and oral amoxicillin/clavulanate and has since shown no recurrence. We reviewed 12 cases of primary skin and soft-tissue infections caused by Y enterocolitica from the literature. In several past cases, portal entry involved failure of the skin barrier on distal body parts. Thereafter, infection might have spread to the regional lymph nodes from the ruptured skin. Y enterocolitica is typically resistant to aminopenicillins and narrow-spectrum cephalosporins. In most cases, these inefficient

  2. Solitary Pyomyositis of the Left Rhomboideus Muscle Caused by Streptococcus anginosus and Streptococcus intermedius in an Immunocompetent Person.

    PubMed

    Tanaka, Yasuhiro; Takaya, Kenichi; Yamamoto, Go; Shinzato, Isaku; Takafuta, Toshiro

    2015-01-01

    Primary pyomyositis is a bacterial infection of the skeletal muscle commonly affecting children with Staphylococcus aureus most often isolated as a pathogen. However, pyomyositis caused by anaerobic bacteria is rare in adults. Here, we report a case of solitary Pyomyositis of the left rhomboideus muscle in an immunocompetent person. A 70-year-old Japanese male presented with high fever and left shoulder pain. His muscle below the lower edge of the left scapula was tender and swollen. His laboratory examinations revealed severe inflammation. Computed tomography showed a solitary low-density area around a contrast enhancement in the left rhomboideus muscle. He was diagnosed as having solitary pyomyositis. Although his symptoms did not improve despite empiric intravenous administration of antibiotics, an incision was performed. Streptococcus anginosus and Streptococcus intermedius were isolated from the culture of drainage fluid. His symptoms gradually disappeared after the incisional drainage and continuous administration of antibiotics. Pyomyositis did not recur after his discharge. To the best of our knowledge, this is the first report on anaerobic pyomyositis of the shoulder muscle.

  3. Isolated sinusitis sphenoidalis caused by Trichoderma longibrachiatum in an immunocompetent patient with headache.

    PubMed

    Molnár-Gábor, Etelka; Dóczi, Ilona; Hatvani, Lóránt; Vágvölgyi, Csaba; Kredics, László

    2013-08-01

    We present a case of isolated sinusitis sphenoidalis caused by Trichoderma longibrachiatum, an emerging causal agent of fungal infections with an often fatal outcome. A Trichoderma strain was isolated from secretion obtained from the sinus sphenoidalis of a rhinosinusitis patient and identified by sequence analysis of two loci as Trichoderma longibrachiatum from the Longibrachiatum Clade of the genus Trichoderma. T. longibrachiatum can trigger a fatal pathomechanism in immunodeficient patients, but only rarely causes disease in healthy people. The case presented is unique because the patient was not immunocompromised.

  4. Severe Acute Infection Due to Serratia marcescens Causing Respiratory Distress in An Immunocompetent Adult.

    PubMed

    Ruiz-Sada, Pablo; Escalante, Mikel; Lizarralde, Eva

    2016-01-01

    The role of Serratia marcescens changed from a harmless saprophytic microorganism to an important opportunistic human pathogen. It often causes nosocomial device-associated outbreaks and rarely serious invasive community acquired infections. We present a case of a community-acquired Serratia marcescens bacteremia leading to Respiratory Distress Syndrome in a previously healthy 51-year-old man without identifiable risk factors. Full recovery was achieved with solely medical treatment and observation in ICU during three days. To our knowledge it is an extremely uncommon presentation and just few cases have been previously reported in the literature.

  5. Atypical manifestation of cat-scratch disease: isolated epigastric pain in an immunocompetent, 12-year-old child

    PubMed Central

    Kayemba-Kay’s, Simon; Kovács, Tamas; Rakotoharinandrasana, Iarolalao; Benosman, Sidi Mohamed

    2015-01-01

    Key Clinical Message We present a 12-year-old immunocompetent girl with hepato splenic cat-scratch disease (CSD). Her sole inaugural complaint was isolated epigastric pain. She fully recovered, with normalized abdominal CT scan following 2 weeks course of Azythromycin®. CSD should be included in differential diagnosis in children with epigastric pain, especially in those with domestic pets. PMID:26273467

  6. A Case of Septic Shock caused by Achromobacter xylosoxidans in an Immunocompetent Female Patient after Extracorporeal Shock Wave Lithotripsy for a Ureteral Stone

    PubMed Central

    Lee, So Yon; Park, In Young; Park, So Yeon; Lee, Jin Seo; Kang, Goeun; Kim, Jae Seok

    2016-01-01

    Achromobacter xylosoxidans can cause various types of infections, but its infection in humans is rare. A. xylosoxidans has been reported as a rare etiological agent of infections including primary bacteremia, catheter-related bloodstream infection, endocarditis, otitis, and pneumonia, particularly in immunocompromised hosts. We encountered a case of septic shock caused by A. xylosoxidans in a 52-year-old, immunocompetent woman with no underlying disease, who received extracorporeal shock wave lithotripsy to remove a left upper ureteral stone. She was treated with antibiotics to which the organism was susceptible but died as a result of septic shock. PMID:27104016

  7. Aggressive cutaneous zygomycosis caused by Apophysomyces variabilis in an immunocompetent child.

    PubMed

    Al-Zaydani, Ibrahim A; Al-Hakami, Ahmed M; Joseph, Martin R P; Kassem, Walid M; Almaghrabi, Mohamed K; Nageeb, Abdalla; Hamid, Mohamed E

    2015-12-01

    A zygomycetous fungus was observed in a biopsy of a 9-year-old male. The patient was presented with severe cutaneous lesions subsequent to a traumatic car accident. Following fungal detection, antifungal treatment was prescribed but condition deteriorated rapidly and above knee amputation was done as lifesaving and to control fungal infection. Analysis of the 28 S rRNA gene (accession KT149770) aligned the isolate with members of the genus Apophysomyces and the pathogen was identified as Apophysomces variabilis. PMID:26858932

  8. Fungal laryngitis in immunocompetent patients.

    PubMed

    Ravikumar, A; Prasanna Kumar, S; Somu, L; Sudhir, B

    2014-01-01

    The diagnosis of fungal laryngitis is often overlooked in immunocompetent patients because it is commonly considered a disease of the immunocompromised. Further confusion is caused by clinical and histological similarity to more common conditions like Leukoplakia. Demonstration of hyperkeratosis particularly if associated with intraepithelial neutrophils on biopsy should trigger a search for fungus using specialized stains. These patients usually present with hoarseness of voice. Pain is present inconsistently along with dysphagia and odynophagia. We present three cases of fungal laryngitis in immunocompetent patients out of which one underwent microlaryngeal surgery with excision biopsy. All these patients responded well with oral antifungal therapy.

  9. Coxsackievirus A6 and Hand, Foot and Mouth Disease: Three Case Reports of Familial Child-to-Immunocompetent Adult Transmission and a Literature Review.

    PubMed

    Kaminska, Karolina; Martinetti, Gladys; Lucchini, Renzo; Kaya, Gürkan; Mainetti, Carlo

    2013-01-01

    Hand, foot and mouth disease (HFMD) is a highly contagious viral infection characterized by typical maculopapular or vesicular eruptions on the hands and feet and in the oral cavity. It affects predominantly children and/or immunocompromised adults. It usually follows a benign and self-limiting course. However, HFMD cases with severe or lethal complications such as encephalitis, meningitis, pulmonary edema and myocarditis have also been reported, mostly in children, but also in adults. High infectivity of HFMD has contributed to several large outbreaks of this disease in recent decades in East and Southeast Asia, the United States and Finland. The most common pathogens were Coxsackievirus A16, Enterovirus 71 and, recently, also Coxsackieviruses A6 and A10. Differences in the course of HFMD have been observed, depending on the virus type. Recently, many cases of atypical HFMD have been described in the literature with unusual morphology and/or localization of skin lesions. Atypical HFMD manifestations including vesiculobullous exanthema, often on the trunk or extremities, and perioral zone involvement were often caused by Coxsackievirus A6 infections. We present 3 cases of familial transmission of HFMD caused by Coxsackievirus A6 with some atypical features, benign course and complete recovery among immunocompetent adults. PMID:24019771

  10. Primary central nervous system lymphoma with lymphomatosis cerebri in an immunocompetent child: MRI and 18F-FDG PET-CT findings.

    PubMed

    Jain, Tarun K; Sharma, Punit; Suman, Sudhir K C; Faizi, Nauroze A; Bal, Chandrasekhar; Kumar, Rakesh

    2013-01-01

    Primary central nervous system lymphoma (PCNSL) is extremely rare in immunocompetent children. We present the magnetic resonance imaging (MRI) and (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography-computed tomography (PET-CT) findings of such a case in a 14-year old immunocompetent boy. In this patient, PCNSL was associated with lymphomatosis cerebri. Familiarity with the findings of this rare condition will improve the diagnostic confidence of the nuclear radiologist and avoid misdiagnosis.

  11. Polyarticular Septic Arthritis Caused by Haemophilus influenzae Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature

    PubMed Central

    Ali, Raheel Ahmed; Kaplan, Sheldon L.; Rosenfeld, Scott B.

    2015-01-01

    Background. The standard use of vaccinations against pathogens has resulted in a decreased incidence of musculoskeletal infections caused by these previously common bacterial pathogens. Consequently, the incidence of infections caused by atypical bacteria is rising. This report presents a case of septic arthritis caused by non-type b H. influenzae in a pediatric patient. Methods. We report a case of an infant with polyarticular septic arthritis caused by H. influenzae serotype f. A literature review was conducted with the inclusion criteria of case reports and studies published between 2004 and 2013 addressing musculoskeletal H. influenzae infections. Results. An 8-month-old female presented with pain and swelling in her right ankle and left elbow. The patient was diagnosed with septic arthritis and underwent incision and drainage. Wound and blood cultures were positive for Haemophilus influenzae serotype f. In addition to treatment with IV antibiotics, the patient underwent immunocompetency studies, which were normal. Subsequent follow-up revealed eradication of the infection. Conclusions. Haemophilus influenzae non-type b may cause serious invasive infections such as sepsis or septic arthritis in children with or without predisposing factors such as immunodeficiency or asplenia. Optimal treatment includes surgical management, culture driven IV antibiotics, and an immunologic workup. PMID:26064739

  12. Polyarticular Septic Arthritis Caused by Haemophilus influenzae Serotype f in an 8-Month-Old Immunocompetent Infant: A Case Report and Review of the Literature.

    PubMed

    Ali, Raheel Ahmed; Kaplan, Sheldon L; Rosenfeld, Scott B

    2015-01-01

    Background. The standard use of vaccinations against pathogens has resulted in a decreased incidence of musculoskeletal infections caused by these previously common bacterial pathogens. Consequently, the incidence of infections caused by atypical bacteria is rising. This report presents a case of septic arthritis caused by non-type b H. influenzae in a pediatric patient. Methods. We report a case of an infant with polyarticular septic arthritis caused by H. influenzae serotype f. A literature review was conducted with the inclusion criteria of case reports and studies published between 2004 and 2013 addressing musculoskeletal H. influenzae infections. Results. An 8-month-old female presented with pain and swelling in her right ankle and left elbow. The patient was diagnosed with septic arthritis and underwent incision and drainage. Wound and blood cultures were positive for Haemophilus influenzae serotype f. In addition to treatment with IV antibiotics, the patient underwent immunocompetency studies, which were normal. Subsequent follow-up revealed eradication of the infection. Conclusions. Haemophilus influenzae non-type b may cause serious invasive infections such as sepsis or septic arthritis in children with or without predisposing factors such as immunodeficiency or asplenia. Optimal treatment includes surgical management, culture driven IV antibiotics, and an immunologic workup.

  13. Tuberculous dactylitis (spina ventosa) with concomitant ipsilateral axillary scrofuloderma in an immunocompetent child: A rare presentation of skeletal tuberculosis

    PubMed Central

    Bhaskar; Khonglah, Tashi; Bareh, Jerryson

    2013-01-01

    Tuberculous dactylitis is a distinctly uncommon, yet well recognized form of tuberculosis involving the small bones of the hand or foot. It occurs in young children in endemic areas under 5 years of age. Tuberculosis of the short tubular bones like phalanges, metacarpals or metatarsals is quite uncommon beyond 6 years of age, once the epiphyseal centers are well established. The radiographic features of cystic expansion have led to the name “Spina Ventosa” for tuberculous dactylitis of the short bones. Scrofuloderma is a mycobacterial infection affecting children and young adults, representing direct extension of tuberculosis into the skin from underlying structures e.g. lymph nodes. An 8-year-old malnourished girl had multiple axillary ulcers with lymphadenopathy. Tuberculous dactylitis with ipsilateral axillary scrofuloderma was suspected on clinical and radiological grounds. The suspicion was confirmed by histology and bacteriology. The patient responded to antitubercular drugs with progressive healing of the lesions without surgery. Concomitant presence of these dual lesions suggesting active disseminated tuberculosis in immune-competent child over 6 years is very rare and hardly reported. PMID:23977657

  14. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis

    PubMed Central

    Akkoc, Gulsen; Kadayifci, Eda Kepenekli; Karaaslan, Ayse; Atici, Serkan; Yakut, Nurhayat; Ocal Demir, Sevliya; Soysal, Ahmet; Bakir, Mustafa

    2016-01-01

    Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae. PMID:27213062

  15. Epstein-Barr Virus Encephalitis in an Immunocompetent Child: A Case Report and Management of Epstein-Barr Virus Encephalitis.

    PubMed

    Akkoc, Gulsen; Kadayifci, Eda Kepenekli; Karaaslan, Ayse; Atici, Serkan; Yakut, Nurhayat; Ocal Demir, Sevliya; Soysal, Ahmet; Bakir, Mustafa

    2016-01-01

    Epstein-Barr virus (EBV) usually causes mild, asymptomatic, and self-limited infections in children and adults; however, it may occasionally lead to severe conditions such as neurological diseases, malignant diseases, hepatic failure, and myocarditis. Epstein-Barr virus-related neurological disorders include meningitis, encephalitis, and cranial or peripheral neuritis, which are mostly seen in immunocompromised patients. The therapeutic modalities for EBV-related severe organ damage including central nervous system manifestations are still uncertain. Herein, we describe a seven-year-old boy with EBV encephalitis who presented with prolonged fever, exudative pharyngitis, reduced consciousness, and neck stiffness. Cranial magnetic resonance imaging showed contrast enhancement in the bilateral insular cortex and the right hypothalamus. The diagnosis was made by EBV-DNA amplification in both the blood and cerebrospinal fluid samples. He was discharged with acyclovir therapy without any sequelae. PMID:27213062

  16. Thoracic Spondylodiscitis Caused by Methicillin-resistant Staphylococcus aureus as a Superinfection of Pulmonary Tuberculous Granuloma in an Immunocompetent Patient: A Case Report

    PubMed Central

    Donnarumma, Pasquale; Tarantino, Roberto; Palmarini, Valeria; De Giacomo, Tiziano; Delfini, Roberto

    2014-01-01

    Study Design Case report. Objective To describe a very rare case of an immunocompetent man who underwent surgery for thoracic spondylodiscitis caused by methicillin-resistant Staphylococcus aureus (MRSA) that developed as a superinfection of a pulmonary tuberculous granuloma. Methods Posterior decompression and pedicle screw vertebral fixation were followed by T5–T6 anterior somatotomy with implant of an expandable mesh and lateral plating as symptoms worsened. During the anterior approach, an atypical resection of the left lower lobe was also performed. Results A tuberculous granuloma was detected on histology. Ziehl-Neelsen stain confirmed the diagnosis. Culture also detected MRSA. Conclusions Early medical management is the first choice for spondylodiscitis to eradicate the infection and alleviate pain. Immobilization of the affected spine segments can protect the patient from vertebral collapse and from the appearance of neurologic deficits. Surgery is suggested if there are compressive effects on the spinal cord, spinal epidural abscess, vertebral collapse, and deformity. We decided to remove the abscess and to restore the anterior column using an anterior approach. Moreover, in this case, an anterior approach allowed us to identify the etiology of the lesion and to determine the best chemotherapy regimen. PMID:25844289

  17. Thoracic Spondylodiscitis Caused by Methicillin-resistant Staphylococcus aureus as a Superinfection of Pulmonary Tuberculous Granuloma in an Immunocompetent Patient: A Case Report.

    PubMed

    Donnarumma, Pasquale; Tarantino, Roberto; Palmarini, Valeria; De Giacomo, Tiziano; Delfini, Roberto

    2015-04-01

    Study Design Case report. Objective To describe a very rare case of an immunocompetent man who underwent surgery for thoracic spondylodiscitis caused by methicillin-resistant Staphylococcus aureus (MRSA) that developed as a superinfection of a pulmonary tuberculous granuloma. Methods Posterior decompression and pedicle screw vertebral fixation were followed by T5-T6 anterior somatotomy with implant of an expandable mesh and lateral plating as symptoms worsened. During the anterior approach, an atypical resection of the left lower lobe was also performed. Results A tuberculous granuloma was detected on histology. Ziehl-Neelsen stain confirmed the diagnosis. Culture also detected MRSA. Conclusions Early medical management is the first choice for spondylodiscitis to eradicate the infection and alleviate pain. Immobilization of the affected spine segments can protect the patient from vertebral collapse and from the appearance of neurologic deficits. Surgery is suggested if there are compressive effects on the spinal cord, spinal epidural abscess, vertebral collapse, and deformity. We decided to remove the abscess and to restore the anterior column using an anterior approach. Moreover, in this case, an anterior approach allowed us to identify the etiology of the lesion and to determine the best chemotherapy regimen.

  18. Does clutch size evolve in response to parasites and immunocompetence?

    USGS Publications Warehouse

    Martin, T.E.; Moller, A.P.; Merino, S.; Clobert, J.

    2001-01-01

    Parasites have been argued to influence clutch size evolution, but past work and theory has largely focused on within-species optimization solutions rather than clearly addressing among-species variation. The effects of parasites on clutch size variation among species can be complex, however, because different parasites can induce age-specific differences in mortality that can cause clutch size to evolve in different directions. We provide a conceptual argument that differences in immunocompetence among species should integrate differences in overall levels of parasite-induced mortality to which a species is exposed. We test this assumption and show that mortality caused by parasites is positively correlated with immunocompetence measured by cell-mediated measures. Under life history theory, clutch size should increase with increased adult mortality and decrease with increased juvenile mortality. Using immunocompetence as a general assay of parasite-induced mortality, we tested these predictions by using data for 25 species. We found that clutch size increased strongly with adult immunocompetence. In contrast, clutch size decreased weakly with increased juvenile immunocompetence. But, immunocompetence of juveniles may be constrained by selection on adults, and, when we controlled for adult immunocompetence, clutch size decreased with juvenile immunocompetence. Thus, immunocompetence seems to reflect evolutionary differences in parasite virulence experienced by species, and differences in age-specific parasite virulence appears to exert opposite selection on clutch size evolution.

  19. Child deaths of unknown cause: review of 7 years' experience.

    PubMed

    Bowen, Kathryn A; Marshall, William N

    2004-01-01

    Using data from the Pima County (Arizona) Child Fatality Review Team, we sought to describe the nature of unknown cause pediatric deaths. Of 1,150 total deaths (1995-2001), 22 were unknown cause and 3 had only a mode of death on the death certificate. There were 15 infants <6 months, 4 children 1-4 years, 2 children 5-9 years, 1 preteen (10-14 years), and 3 aged 15-17 years. Four patterns were seen: those resembling SIDS but with confounding history, autopsy, or scene investigation; sleeping toddlers with respiratory symptoms; children with underlying conditions not expected to cause death; and deaths without complete investigation. PMID:15583775

  20. Disseminated Nocardia farcinica in an immunocompetent patient.

    PubMed

    Boamah, H; Puranam, P; Sandre, R M

    2016-01-01

    Nocardia farcinica is a gram-positive, partially acid-fast, methenamine silver-positive aerobic actinomycete that is infrequently associated with nocardiosis. The relative frequency of Nocardia farcinica isolates in nocardiosis is unknown but thought to be under diagnosis. It is increasingly been recognized in immunocompetent patients. We report a case of disseminated Nocardia farcinica causing brain abscess in 55 year old immunocompetent man who was successfully treated with long term antibiotics. The present report illustrates that early detection and treatment of disseminated Nocardia farcinica can lead to a good outcome. PMID:27617207

  1. Crusted demodicosis in an immunocompetent pediatric patient.

    PubMed

    Guerrero-González, Guillermo Antonio; Herz-Ruelas, Maira Elizabeth; Gómez-Flores, Minerva; Ocampo-Candiani, Jorge

    2014-01-01

    Demodicosis refers to the infestation by Demodex spp., a saprophytic mite of the pilosebaceous unit. Demodex proliferation can result in a number of cutaneous disorders including pustular folliculitis, pityriasis folliculorum, papulopustular, and granulomatous rosacea, among others. We report the case of a 7-year-old female presenting with pruritic grayish crusted lesions over her nose and cheeks, along with facial erythema, papules, and pustules. The father referred chronic use of topical steroids. A potassium hydroxide mount of a pustule scraping revealed several D. folliculorum mites. Oral ivermectin (200 μg/kg, single dose) plus topical permethrin 5% lotion applied for 3 consecutive nights were administered. Oral ivermectin was repeated every week and oral erythromycin plus topical metronidazole cream was added. The facial lesions greatly improved within the following 3 months. While infestation of the pilosebaceous unit by Demodex folliculorum mites is common, only few individuals present symptoms. Demodicosis can present as pruritic papules, pustules, plaques, and granulomatous facial lesions. To our knowledge, this is the first reported case of facial crusted demodicosis in an immunocompetent child. The development of symptoms in this patient could be secondary to local immunosuppression caused by the chronic use of topical steroids. PMID:25371830

  2. Crusted demodicosis in an immunocompetent pediatric patient.

    PubMed

    Guerrero-González, Guillermo Antonio; Herz-Ruelas, Maira Elizabeth; Gómez-Flores, Minerva; Ocampo-Candiani, Jorge

    2014-01-01

    Demodicosis refers to the infestation by Demodex spp., a saprophytic mite of the pilosebaceous unit. Demodex proliferation can result in a number of cutaneous disorders including pustular folliculitis, pityriasis folliculorum, papulopustular, and granulomatous rosacea, among others. We report the case of a 7-year-old female presenting with pruritic grayish crusted lesions over her nose and cheeks, along with facial erythema, papules, and pustules. The father referred chronic use of topical steroids. A potassium hydroxide mount of a pustule scraping revealed several D. folliculorum mites. Oral ivermectin (200 μg/kg, single dose) plus topical permethrin 5% lotion applied for 3 consecutive nights were administered. Oral ivermectin was repeated every week and oral erythromycin plus topical metronidazole cream was added. The facial lesions greatly improved within the following 3 months. While infestation of the pilosebaceous unit by Demodex folliculorum mites is common, only few individuals present symptoms. Demodicosis can present as pruritic papules, pustules, plaques, and granulomatous facial lesions. To our knowledge, this is the first reported case of facial crusted demodicosis in an immunocompetent child. The development of symptoms in this patient could be secondary to local immunosuppression caused by the chronic use of topical steroids.

  3. Crusted Demodicosis in an Immunocompetent Pediatric Patient

    PubMed Central

    Gómez-Flores, Minerva; Ocampo-Candiani, Jorge

    2014-01-01

    Demodicosis refers to the infestation by Demodex spp., a saprophytic mite of the pilosebaceous unit. Demodex proliferation can result in a number of cutaneous disorders including pustular folliculitis, pityriasis folliculorum, papulopustular, and granulomatous rosacea, among others. We report the case of a 7-year-old female presenting with pruritic grayish crusted lesions over her nose and cheeks, along with facial erythema, papules, and pustules. The father referred chronic use of topical steroids. A potassium hydroxide mount of a pustule scraping revealed several D. folliculorum mites. Oral ivermectin (200 μg/kg, single dose) plus topical permethrin 5% lotion applied for 3 consecutive nights were administered. Oral ivermectin was repeated every week and oral erythromycin plus topical metronidazole cream was added. The facial lesions greatly improved within the following 3 months. While infestation of the pilosebaceous unit by Demodex folliculorum mites is common, only few individuals present symptoms. Demodicosis can present as pruritic papules, pustules, plaques, and granulomatous facial lesions. To our knowledge, this is the first reported case of facial crusted demodicosis in an immunocompetent child. The development of symptoms in this patient could be secondary to local immunosuppression caused by the chronic use of topical steroids. PMID:25371830

  4. Decreased milk drinking causing flecainide toxicity in an older child

    PubMed Central

    Thompson, Ben; Mangat, Jasveer; Barton, Chris; Hawcutt, Daniel B

    2012-01-01

    Flecainide is a class IC antiarrhythmic agent, used frequently in all age groups for the treatment of tachyarrhythmias. Flecainide blocks the voltage-gated sodium channel in the myocardium, leading to prolongation of depolarisation resulting in slowed conduction velocity. Within a paediatric population, flecainide is indicated primarily for supraventricular tachycardia resulting from atrioventricular nodal re-entry and accessory pathway mediated re-entry. It can be considered for use in patients with atrial tachycardia, fascicular ventricular tachycardia, benign right ventricular outflow tract tachycardia and paroxysmal atrial fibrillation. It is well documented to cause paradoxical proarryhthmia in children, with evidence that milk can reduce absorption in infants. The authors present the case of an older child whose flecainide levels were persistently subtherapeutic until he reduced his milk intake. At this time he developed symptoms of severe flecainide toxicity associated with increased levels. PMID:22729333

  5. Invasive pulmonary aspergillosis presenting as thoracic mass causing obstruction of the superior and inferior vena cava in an immunocompetent patient: a diagnostic dilemma.

    PubMed

    Bunkar, Moti lal; Takhar, Rajendra Prasad; Arya, Savita

    2015-01-01

    Invasive pulmonary aspergillosis (IPA) is a disease of immunocompromised patients, but its prevalence is increasing in immunocompetent persons. Patients usually present with non-specific symptoms, sometimes consistent with bronchopneumonia. We discuss the case of a 19-year-old boy who presented with constitutional respiratory symptoms along with signs of obstruction of the superior and inferior vena cava. A chest radiograph was suggestive of a thoracic mass raising suspicion of bronchogenic carcinoma/ benign mass, sarcoidosis and tuberculosis, but a diagnosis of invasive aspergillosis was established. The patient showed excellent clinico-radiological improvement with administration of voriconazole. Invasive pulmonary aspergillosis may also present with atypical findings and should be considered in differentials when investigating a case even if the patient does not have a risk factor. PMID:26506978

  6. Disseminated Histoplasmosis with Haemophagocytic Lymphohistiocytosis in an Immunocompetent Host

    PubMed Central

    Sonawane, Pratibha Balasaheb; Chandak, Sachet Vijay; Rathi, Pravin M

    2016-01-01

    Haemophagocytic lymphohistiocytosis (HLH) is a devastating syndrome due to uninhibited immune activation. Disseminated histoplasmosis is a rare cause of HLH. There have been few case reports and series demonstrating a relation between the two disease entities in immunosuppressed hosts. HLH secondary to disseminated histoplasmosis is even rarer in an immunocompetant host. We report a rare case of HLH triggered by disseminated histoplasmosis in an immunocompetant patient. PMID:27134914

  7. [Burns in children: child abuse or another cause?].

    PubMed

    van Ewijk, Roelof; op de Coul, Moniek E; Teeuw, A H Rian; Wolf, Bart H M

    2012-01-01

    Burns are common in children but it is not always clear whether the burn is accidental or not. Child abuse should always be considered. We present two children in which the diagnosis only became clear after admission and further investigation. Patient A, a 15-month-old boy, had a burn on his left shoulder. The burn was assumed suspect in view of the unclear history given by the parents and a possible delay in their seeking help. The patient was ultimately diagnosed with impetigo bullosa and successfully treated with antibiotics. Patient B, a 24-month-old girl, had burns on both feet and her right hand, which were infected as a result of the delay in seeking help. The burns were identified as abuse-related. The child was removed from her mother's care and sent to a foster home. A well-defined work-up should be followed in case of burns in children. PMID:23171561

  8. 'Stranger' child-murder: issues relating to causes and controls.

    PubMed

    Wilson, P R

    1988-02-01

    Most industrialised countries are concerned with a perceived increase in the killing of children and adolescents by strangers. Though reliable statistics are lacking, the growth of serial murder suggests that more young persons may be at risk than ever before. Explanations, either of a psychological or sociological kind, of child murder by strangers are inadequately developed. Despite the tendency to see such killers as psychiatrically ill a number of studies suggest that the majority of offenders do not differ significantly, at least in psychological traits, from non-offenders. Subcultural and other sociological perspectives stressing "social disadvantage" have low levels of exploratory power and do not assist greatly in understanding child killings. Despite sketchy and contradictory evidence on the effects of the media on sexual and violent crime case study material supports the view that pornography, including popular music, may increase the propensity of individuals to commit atrocities. Counter-measures to control stranger child killing lie in more sophisticated law enforcement (profiling and computer links between police forces) long periods of incarceration of the offender and more sophisticated analyses of the crimes.

  9. Dietary antioxidants enhance immunocompetence in larval amphibians.

    PubMed

    Szuroczki, Dorina; Koprivnikar, Janet; Baker, Robert L

    2016-11-01

    Dietary antioxidants have been shown to confer a variety of benefits through their ability to counter oxidative stress, including increased immunocompetence and reduced susceptibility to both infectious and non-infectious diseases. However, little is known about the effects of dietary antioxidants on immune function in larval amphibians, a group experiencing worldwide declines driven by factors that likely involve altered immunocompetence. We investigated the effects of dietary antioxidants (quercetin, vitamin E, and β-carotene) on two components of the immune system, as well as development and growth. Lithobates pipiens tadpoles fed diets with supplemental β-carotene or vitamin E exhibited an enhanced swelling response as measured with a phytohemagglutinin assay (PHA), but there was no induced antibody response. Effects were often dose-dependent, with higher antioxidant levels generally conferring stronger swelling that possibly corresponds to the innate immune response. Our results indicate that the antioxidant content of the larval amphibian diets not only had a detectable effect on their immune response capability, but also promoted tadpole growth (mass gain), although developmental stage was not affected. Given that many environmental perturbations may cause oxidative stress or reduce immunocompetence, it is critical to understand how nutrition may counter these effects. PMID:27475300

  10. Preseptal cellulitis in a child caused by Megacopta centrosignatum.

    PubMed

    Wong, Albert Chak Ming; Mak, Shiu Ting

    2012-12-01

    Preseptal cellulitis in children can be caused by a reaction to embedded insects, their body parts, or secretions. We report the case of a 2-year-old girl who presented with preseptal cellulitis caused by an insect identified as Megacopta centrosignatum in her superior fornix.

  11. Recurrent varicella in an immunocompetent woman.

    PubMed

    Dyer, Joseph; Greenfield, Melinda

    2016-01-01

    Varicella-zoster virus (VZV) infection causes 2 distinct disease processes. Primary VZV infection results in varicella (chickenpox), a common generalized eruption, and subsequent reactivation of VZV classically results in herpes zoster (shingles), which presents as a unilateral, dermatomal eruption. Although a single VZV infection typically confers protection against its reactivation, recurrent varicella rarely is reported, particularly in immunocompetent patients. We present the case of a 52-year-old black woman with an intact immune system who demonstrated 3 VZV infections. PMID:26919358

  12. Causes and Alleviation of Occupational Stress in Child Care Work

    ERIC Educational Resources Information Center

    Dillenburger, Karola

    2004-01-01

    Occupational stress in not a new phenomenon in the working population. However, in the helping professions it has only recently attracted attention. The survey reported here was carried out in order to assess the extent of occupational stress, identify its causes, and suggest ways in which occupational stress can be alleviated. Field social…

  13. Pustular irritant contact dermatitis caused by dexpanthenol in a child.

    PubMed

    Gulec, Ali Ihsan; Albayrak, Hulya; Uslu, Esma; Başkan, Elife; Aliagaoglu, Cihangir

    2015-03-01

    Pustular irritant contact dermatitis is rare and unusual clinic form of contact dermatitis. Dexpanthenol is the stable alcoholic analogue of pantothenic acid. It is widely used in cosmetics and topical medical products for several purposes. We present the case of 8-year-old girl with pustules over erythematous and eczematous areas on the face and neck. To the best of our knowledge, this is the first case reported that is diagnosed as pustular irritant contact dermatitis caused by dexpanthenol. PMID:24506320

  14. Do pheromones reveal male immunocompetence?

    PubMed Central

    Rantala, Markus J; Jokinen, Ilmari; Kortet, Raine; Vainikka, Anssi; Suhonen, Jukka

    2002-01-01

    Pheromones function not only as mate attractors, but they may also relay important information to prospective mates. It has been shown that vertebrates can distinguish, via olfactory mechanisms, major histocompatibility complex types in their prospective mates. However, whether pheromones can transmit information about immunocompetence is unknown. Here, we show that female mealworm beetles (Tenebrio molitor) prefer pheromones from males with better immunocompetence, indicated by a faster encapsulation rate against a novel antigen, and higher levels of phenoloxidase in haemolymph. Thus, the present study indicates that pheromones could transmit information about males' parasite resistance ability and may work as a reliable sexual ornament for female choice. PMID:12204128

  15. Histoplasmosis Presenting as a Laryngeal Ulcer in an Immunocompetent Host.

    PubMed

    John, Mary; Koshy, Jency Maria; Mohan, Sangeetha; Paul, Preethi

    2015-06-01

    Histoplasmosis is a granulomatous disease of worldwide distribution caused by a dimorphic fungus Histoplasma capsulatum. Majority of primary infections in immunocompetent hosts are asymptomatic or may present with flu-like illness. Histoplasmosis may occur in three forms: (i) Primary acute pulmonary form, (ii) chronic pulmonary and (iii) disseminated form. The manifestations of disseminated form of histoplasmosis are fever, weakness, weight loss, hepatosplenomegaly, and mucocutaneous lesions. The mucosal involvement could be oropharyngeal or laryngeal involvement. We report an unusual case of histoplasmosis presenting as a laryngeal ulcer in an immunocompetent host.

  16. Bacillary Angiomatosis in Immunocompetent Patient with Atypical Manifestations.

    PubMed

    Iraji, Fariba; Pourazizi, Mohsen; Abtahi-Naeini, Bahareh; Meidani, Mohsen; Rajabi, Parvin

    2015-01-01

    Bacillary angiomatosis is an infectious disease caused by two Gram-negative bacilli; this disease usually affects immunosuppressed hosts with a history of cat scratch. We report a rare case of bacillary angiomatosis in an immunocompetent 26-year-old woman with no history of exposure to cats, and with atypical clinical features (very pruritic vascular papules and nodules with ulceration and hemorrhage on the right arm and fingers). She was successfully treated with clarithromycin for 3 months. Bacillary angiomatosis must be kept in mind in the differential diagnosis of any papules and nodules in cases of unknown etiology and also in immunocompetent patients and HIV-negative individual.

  17. Bacillary Angiomatosis in Immunocompetent Patient with Atypical Manifestations

    PubMed Central

    Iraji, Fariba; Pourazizi, Mohsen; Abtahi-Naeini, Bahareh; Meidani, Mohsen; Rajabi, Parvin

    2015-01-01

    Bacillary angiomatosis is an infectious disease caused by two Gram-negative bacilli; this disease usually affects immunosuppressed hosts with a history of cat scratch. We report a rare case of bacillary angiomatosis in an immunocompetent 26-year-old woman with no history of exposure to cats, and with atypical clinical features (very pruritic vascular papules and nodules with ulceration and hemorrhage on the right arm and fingers). She was successfully treated with clarithromycin for 3 months. Bacillary angiomatosis must be kept in mind in the differential diagnosis of any papules and nodules in cases of unknown etiology and also in immunocompetent patients and HIV-negative individual. PMID:26538736

  18. Meningoencephalitis caused by a zygomycete fungus (Basidiobolus) associated with septic shock in an immunocompetent patient: 1-year follow-up after treatment.

    PubMed

    Auxiliadora-Martins, M; Alkmim-Teixeira, G C; Machado-Viana, J; Nicolini, E A; Martins-Filho, O A; Bellissimo-Rodrigues, F; Carlotti, C G; Basile-Filho, A

    2010-08-01

    Zygomycosis is an infection caused by opportunistic fungi of the Zygomycetes class, specifically those from the Mucorales and Entomophthorales orders. It is an uncommon disease, mainly restricted to immunocompromised patients. We report a case of a 73-year-old male patient with a history of fever (39 degrees C) lasting for 1 day, accompanied by shivering, trembling, and intense asthenia. The patient was admitted to the intensive care unit with complex partial seizures, and submitted to orotracheal intubation and mechanical ventilation under sedation with midazolam. The electroencephalogram showed evidence of non-convulsive status epilepticus. There is no fast specific laboratory test that permits confirmation of invasive fungal disease. Unless the physician suspects this condition, the disease may progress rapidly while the patient is treated with broad-spectrum antibiotics. Differential diagnosis between fungal and bacterial infection is often difficult. The clinical presentation is sometimes atypical, and etiological investigation is not always successful. In the present case, the histopathological examination of the biopsy obtained from the right temporal lobe indicated the presence of irregular, round, thick-walled fungi forming papillae and elongated structures of irregular diameter, with no septa, indicative of zygomycete (Basidiobolus). Treatment with liposomal amphotericin B and fluconazole was initiated after diagnosis of meningoencephalitis by zygomycete, with a successful outcome.

  19. Causes and consequences of increase in child survival rates: ethnoepidemiology among the Hmong of Thailand.

    PubMed

    Kunstadter, P; Kunstadter, S L; Leepreecha, P; Podhisita, C; Laoyang, M; Thao, C S; Thao, R S; Yang, W S

    1992-12-01

    The Hmong "hill tribe" minority in Thailand has much higher exposure to factors usually associated with risk of child mortality (high fertility, low status of women, low education, less use of modern medical care for births, exposure to warfare, economic and physical disruption, and poor hygienic conditions) than the rural ethnic Thai population. Nonetheless, infant mortality has declined from over 120 per 1000 to under 50 per 1000 live births among both these populations in the past 30 years. The reason for the rapid increase in child survival among the Hmong appears to be better access to and more use of modern curative and preventive medical care associated with road construction rather than major changes in social or hygienic conditions. Conventional wisdom suggests that high fertility is both a cause and a consequence of high infant and child mortality and that parents will not reduce fertility until they see that mortality has declined. Most Hmong parents recognize the decline in child mortality and attribute it to better access to modern medical care. Most Hmong parents also say that, if they were starting to have children now, they would want to have fewer children. Fear of child death is infrequently mentioned as a motive for having more children, and the perceived decline in child mortality is rarely mentioned as a reason for reduced fertility. Most Hmong parents explain their desired family size in terms of economic conditions rather than perceived risk of child mortality. Results of this study suggest that fertility and child mortality can vary independently of one another and that major reductions in child mortality can be accomplished without waiting for major social changes (e.g., improved education or status of women) or major reductions in fertility.

  20. Causes and consequences of increase in child survival rates: ethnoepidemiology among the Hmong of Thailand.

    PubMed

    Kunstadter, P; Kunstadter, S L; Leepreecha, P; Podhisita, C; Laoyang, M; Thao, C S; Thao, R S; Yang, W S

    1992-12-01

    The Hmong "hill tribe" minority in Thailand has much higher exposure to factors usually associated with risk of child mortality (high fertility, low status of women, low education, less use of modern medical care for births, exposure to warfare, economic and physical disruption, and poor hygienic conditions) than the rural ethnic Thai population. Nonetheless, infant mortality has declined from over 120 per 1000 to under 50 per 1000 live births among both these populations in the past 30 years. The reason for the rapid increase in child survival among the Hmong appears to be better access to and more use of modern curative and preventive medical care associated with road construction rather than major changes in social or hygienic conditions. Conventional wisdom suggests that high fertility is both a cause and a consequence of high infant and child mortality and that parents will not reduce fertility until they see that mortality has declined. Most Hmong parents recognize the decline in child mortality and attribute it to better access to modern medical care. Most Hmong parents also say that, if they were starting to have children now, they would want to have fewer children. Fear of child death is infrequently mentioned as a motive for having more children, and the perceived decline in child mortality is rarely mentioned as a reason for reduced fertility. Most Hmong parents explain their desired family size in terms of economic conditions rather than perceived risk of child mortality. Results of this study suggest that fertility and child mortality can vary independently of one another and that major reductions in child mortality can be accomplished without waiting for major social changes (e.g., improved education or status of women) or major reductions in fertility. PMID:1427741

  1. Intestinal histoplasmosis in immunocompetent adults

    PubMed Central

    Zhu, Lin-Lin; Wang, Jin; Wang, Zi-Jing; Wang, Yi-Ping; Yang, Jin-Lin

    2016-01-01

    AIM: To present a retrospective analysis of clinical and endoscopic features of 4 cases of immunocompetent hosts with intestinal histoplasmosis (IH). METHODS: Four immunocompetent adults were diagnosed with IH between October 2005 and March 2015 at West China Hospital of Sichuan University. Clinical and endoscopic characteristics were summarized and analyzed retrospectively. GMS (Gomori methenamine silver), PAS (periodic acid-Schiff) and Giemsa staining technique were used to confirm Histoplasma capsulatum(H. capsulatum). The symptoms, signs, endoscopic presentations, radiographic imaging, pathological stain results and follow-up are presented as tables and illustrations. RESULTS: The cases were male patients, ranging from 33 to 61 years old, and primarily presented with non-specific symptoms such as irregular fever, weight loss, abdominal pain and distention. Hepatosplenomegaly and lymphadenopathy were the most common signs. Endoscopic manifestations were localized or diffuse congestion, edema, ulcers, and polypoid nodules with central erosion involving the terminal ileum, ascending colon, transverse colon, descending colon, sigmoid colon and rectum, similar to intestinal tuberculosis, tumor, and inflammatory bowel disease. Numerous yeast-like pathogens testing positive for PAS and GMS stains but negative for Giemsa were detected in the cytoplasm of the histiocytes, which were highly suggestive of H. capsulatum. CONCLUSION: Immunocompetent individuals suffering from histoplasmosis are rarely reported. It is necessary that gastroenterologists and endoscopists consider histoplasmosis as a differential diagnosis, even in immunocompetent patients. PMID:27099446

  2. Babesiosis in Immunocompetent Patients, Europe

    PubMed Central

    Zadeh, Mahsa Mohseni; Hansmann, Yves; Grawey, Isabelle; Christmann, Daniel; Aguillon, Sarah; Jouglin, Maggy; Chauvin, Alain; De Briel, Dominique

    2011-01-01

    We report 2 cases of babesiosis in immunocompetent patients in France. A severe influenza-like disease developed in both patients 2 weeks after they had been bitten by ticks. Diagnosis was obtained from blood smears, and Babesia divergens was identified by PCR in 1 case. Babesiosis in Europe occurs in healthy patients, not only in splenectomized patients. PMID:21192869

  3. The Cause of Child Abuse and Neglect and Their Effects on the Development of Children in Samaru Zaria, Nigeria.

    ERIC Educational Resources Information Center

    Amdi, Veronica

    1990-01-01

    Initial discussion of the definition, types, causes, and effects of child abuse and neglect is followed by a description of a study of child abuse in Samaru Village of Nigeria and the effects of such abuse on the development of the child. (BG)

  4. Burn injuries caused by a hair-dryer--an unusual case of child abuse.

    PubMed

    Darok, M; Reischle, S

    2001-01-01

    About 1.4-26% burn injuries in children appear to be abusive in origin. A 2.5-year-old girl was referred to our institute because of suspected child abuse. Clinical examination and later interrogation of the mother revealed non-recent deep second degree burn injuries on both gluteal regions, caused by the partner of the mother by pressing a hand-held hair-dryer against the skin. The authors present the findings of this unusual method of child abuse.

  5. Rothia mucilaginosa pneumonia in an immunocompetent patient.

    PubMed

    Baeza Martínez, Carlos; Zamora Molina, Lucia; García Sevila, Raquel; Gil Carbonell, Joan; Ramos Rincon, José Manuel; Martín Serrano, Concepción

    2014-11-01

    Rothia mucilaginosa is a gram-postive coccus that occurs as part of the normal flora of the oropharynx and upper respiratory tract. Lower respiratory tract infections caused by this organism are rare and usually occur in immunocompromised patients. This is the case of an immunocompetent 47-year-old woman with right upper lobe pneumonia in which R.mucilaginosa was isolated in sputum and bronchial aspirate. Infections caused by this agent in the last four years in our hospital were reviewed. The most common predisposing factor was COPD with bronchiectasis. R.mucilaginosa was identified as the causative agent for pneumonia in only two cases, of which one was our case and the other was a patient with lung cancer.

  6. Rothia mucilaginosa pneumonia in an immunocompetent patient.

    PubMed

    Baeza Martínez, Carlos; Zamora Molina, Lucia; García Sevila, Raquel; Gil Carbonell, Joan; Ramos Rincon, José Manuel; Martín Serrano, Concepción

    2014-11-01

    Rothia mucilaginosa is a gram-postive coccus that occurs as part of the normal flora of the oropharynx and upper respiratory tract. Lower respiratory tract infections caused by this organism are rare and usually occur in immunocompromised patients. This is the case of an immunocompetent 47-year-old woman with right upper lobe pneumonia in which R.mucilaginosa was isolated in sputum and bronchial aspirate. Infections caused by this agent in the last four years in our hospital were reviewed. The most common predisposing factor was COPD with bronchiectasis. R.mucilaginosa was identified as the causative agent for pneumonia in only two cases, of which one was our case and the other was a patient with lung cancer. PMID:24568756

  7. [Chronic Salmonella typhimurium diarrhea in an immunocompetent patient].

    PubMed

    Mellado-Ferreiro, M; Jarne-Betrán, V; Arteaga-Mazuelas, M; Abínzano-Guillén, M L

    2016-01-01

    Chronic diarrhea caused by infection in immunocompetent patients is an infrequent condition in developed countries, although certain pathogens,generally parasites (Giardia lamblia, Isospora belli,Cryptosporidium, Cyclospora, Strongyloides, Ameba,Trichuris and Schistosoma) and some bacteria (Aeromonas,Plesiomonas, Campylobacter, Clostridium difficile, Salmonella or Mycobacterium tuberculosis)can cause persistent diarrhea.We present the case of a patient who showed Salmonella typhimurium in his stool culture and recovered following treatment with levofloxacin for 7 days. PMID:27125610

  8. Adenovirus Infections in Immunocompetent and Immunocompromised Patients

    PubMed Central

    2014-01-01

    SUMMARY Human adenoviruses (HAdVs) are an important cause of infections in both immunocompetent and immunocompromised individuals, and they continue to provide clinical challenges pertaining to diagnostics and treatment. The growing number of HAdV types identified by genomic analysis, as well as the improved understanding of the sites of viral persistence and reactivation, requires continuous adaptions of diagnostic approaches to facilitate timely detection and monitoring of HAdV infections. In view of the clinical relevance of life-threatening HAdV diseases in the immunocompromised setting, there is an urgent need for highly effective treatment modalities lacking major side effects. The present review summarizes the recent progress in the understanding and management of HAdV infections. PMID:24982316

  9. Treatment of Granulomatous Amoebic Encephalitis with Voriconazole and Miltefosine in an Immunocompetent Soldier

    PubMed Central

    Webster, Duncan; Umar, Imram; Kolyvas, George; Bilbao, Juan; Guiot, Marie-Christine; Duplisea, Kevin; Qvarnstrom, Yvonne; Visvesvara, Govinda S.

    2012-01-01

    A 38-year-old male immunocompetent soldier developed generalized seizures. He underwent surgical debulking and a progressive demyelinating pseudotumor was identified. Serology and molecular testing confirmed a diagnosis of granulomatous amoebic encephalitis caused by Acanthamoeba sp. in this immunocompetent male. The patient was treated with oral voriconazole and miltefosine with Acanthamoeba titers returning to control levels and serial imaging demonstrating resolution of the residual lesion. PMID:22869634

  10. Disseminated Aspergillosis in the Immunocompetent Host: A Case Report and Literature Review.

    PubMed

    Cheon, Shinhye; Yang, Min Kyu; Kim, Chung-Jong; Kim, Taek Soo; Song, Kyoung-Ho; Woo, Se Joon; Kim, Eu Suk; Park, Kyoung Un; Kim, Hong Bin

    2015-10-01

    Disseminated aspergillosis is very rare in immunocompetent hosts and is typically associated with a poor prognosis. We describe the case of a 66-year-old, immunocompetent man who developed pneumonia, endophthalmitis and probable spondylitis caused by Aspergillus species. The patient was successfully treated with antifungal drugs. We reviewed the English-language literature between 1980 and 2012 for disseminated aspergillosis cases in immunocompetent hosts, using the keywords "dissemin*" and "aspergillo*." Disseminated aspergillosis in immunocompetent hosts is very rare in the literature. However, awareness of possible dissemination of Aspergillus spp. is necessary in patients who have a probable lung lesion and in cases with unusual presentation of a disseminated infection, even if the patient has no risk factors. PMID:26016845

  11. Enterococcus gallinarum meningitis in an immunocompetent host: a case report.

    PubMed

    Antonello, Vicente Sperb; Zenkner, Francis de Moura; França, Josiane; Santos, Breno Riegel

    2010-01-01

    We describe a rare case of a 53-year-old man with a long history of alcohol abuse, with Enterococcus gallinarum meningitis, an organism that rarely causes human infection and is primarily found in the gastrointestinal tract of poultry. The patient improved with high-dose ampicillin and gentamicin therapy. To our knowledge, this is the first Brazilian reported case of E. gallinarum meningitis and probably the first case described in an immunocompetent host. PMID:20464133

  12. Pleural Nocardiosis in an Immunocompetent Patient: A Case Report

    PubMed Central

    Mantur, Prakash

    2016-01-01

    Nocardiosis is a rare infection that has attracted attention with its increased rate of occurrence in the recent years. In India there is a rare documentation of the pleural involvement in nocardiosis. We report here a case of pleural nocardiosis caused by Nocardia brasiliensis in an immunocompetent patient. This case highlights the importance of considering nocardiosis as a differential diagnosis in patients with pleural lesions. PMID:26894067

  13. Pleiotropic effects of juvenile hormone in ant queens and the escape from the reproduction-immunocompetence trade-off.

    PubMed

    Pamminger, Tobias; Treanor, David; Hughes, William O H

    2016-01-13

    The ubiquitous trade-off between survival and costly reproduction is one of the most fundamental constraints governing life-history evolution. In numerous animals, gonadotropic hormones antagonistically suppressing immunocompetence cause this trade-off. The queens of many social insects defy the reproduction-survival trade-off, achieving both an extraordinarily long life and high reproductive output, but how they achieve this is unknown. Here we show experimentally, by integrating quantification of gene expression, physiology and behaviour, that the long-lived queens of the ant Lasius niger have escaped the reproduction-immunocompetence trade-off by decoupling the effects of a key endocrine regulator of fertility and immunocompetence in solitary insects, juvenile hormone (JH). This modification of the regulatory architecture enables queens to sustain a high reproductive output without elevated JH titres and suppressed immunocompetence, providing an escape from the reproduction-immunocompetence trade-off that may contribute to the extraordinary lifespan of many social insect queens.

  14. Methemoglobinemia due to quinine causing severe acute kidney injury in a child

    PubMed Central

    Kudale, S.; Sethi, S. K.; Dhaliwal, M.; Kher, V.

    2014-01-01

    Congenital methemoglobinemia is a rare condition resulting from a deficiency of nicotinamide adenine dinucleotide-cytochrome b5 reductase. Acquired methemoglobinemia may result due to certain drugs, chemicals and food items. Information on epidemiological determinants from India is sparse. This report describes methemoglobinemia in a 4-year-old child after parenteral administration of quinine causing acute kidney injury. This case emphasizes the need of awareness of potential adverse events of antimalarial drugs. Prompt management of methemoglobinemia is essential to avoid potential life-threatening complications. PMID:25484537

  15. [Fever and lymphadenopathy: acute toxoplasmosis in an immunocompetent patient].

    PubMed

    Kaparos, Nikolaos; Favrat, Bernard; D'Acremont, Valérie

    2014-11-26

    Toxoplasmosis is an infectious disease caused by the intracellular parasite Toxoplasma gondii. In Switzerland about a third of the population has antibodies against this pathogen and has thus already been in contact with the parasite or has contracted the disease. Immunocompetent patients are usually asymptomatic (80-90%) during primary infection. The most common symptom is neck or occipital lymphadenopathy. Serology is the diagnostic gold standard in immunocompetent individuals. The presence of IgM antibodies is however not sufficient to make a definite diagnosis of acute toxoplasmosis. Distinction between acute and chronic toxoplasmosis requires additional serological tests (IgG avidity test). If required, the most used and probably most effective treatment is the combination of pyrimethamine and sulfadiazine, with folinic acid.

  16. Diet effects on honeybee immunocompetence.

    PubMed

    Alaux, Cédric; Ducloz, François; Crauser, Didier; Le Conte, Yves

    2010-08-23

    The maintenance of the immune system can be costly, and a lack of dietary protein can increase the susceptibility of organisms to disease. However, few studies have investigated the relationship between protein nutrition and immunity in insects. Here, we tested in honeybees (Apis mellifera) whether dietary protein quantity (monofloral pollen) and diet diversity (polyfloral pollen) can shape baseline immunocompetence (IC) by measuring parameters of individual immunity (haemocyte concentration, fat body content and phenoloxidase activity) and glucose oxidase (GOX) activity, which enables bees to sterilize colony and brood food, as a parameter of social immunity. Protein feeding modified both individual and social IC but increases in dietary protein quantity did not enhance IC. However, diet diversity increased IC levels. In particular, polyfloral diets induced higher GOX activity compared with monofloral diets, including protein-richer diets. These results suggest a link between protein nutrition and immunity in honeybees and underscore the critical role of resource availability on pollinator health.

  17. Causes and determinants of inequity in maternal and child health in Vietnam

    PubMed Central

    2012-01-01

    Background Inequities in health are a major challenge for health care planners and policymakers globally. In Vietnam, rapid societal development presents a considerable risk for disadvantaged populations to be left behind. The aim of this review is to map the known causes and determinants of inequity in maternal and child health in Vietnam in order to promote policy action. Methods A review was performed through systematic searches of Pubmed and Proquest and manual searches of “grey literature.” A thematic content analysis guided by the conceptual framework suggested by the Commission on Social Determinants of Health was performed. Results More than thirty different causes and determinants of inequity in maternal and child health were identified. Some determinants worth highlighting were the influence of informal fees and the many testimonies of discrimination and negative attitudes from health staff towards women in general and ethnic minorities in particular. Research gaps were identified, such as a lack of studies investigating the influence of education on health care utilization, informal costs of care, and how psychosocial factors mediate inequity. Conclusions The evidence of corruption and discrimination as mediators of health inequity in Vietnam calls for attention and indicates a need for more structural interventions such as better governance and anti-discriminatory laws. More research is needed in order to fully understand the pathways of inequities in health in Vietnam and suggest areas for intervention for policy action to reach disadvantaged populations. PMID:22883138

  18. 'It was caused by the carelessness of the parents': cultural models of child malnutrition in southern Malawi.

    PubMed

    Flax, Valerie L

    2015-01-01

    Parents' conceptions of child growth, health and malnutrition are culturally bound, making information about local understandings of malnutrition and its causes necessary for designing effective nutrition programmes. This study used ethnographic methods to elucidate cultural models of child care and malnutrition among the Yao of southern Malawi. Data were collected in six rural villages from 28 key informant interviews with village chiefs and traditional healers among others and 18 focus group discussions with parents and grandmothers of young children. For the Yao, lack of parental care is a key cause of poor child health and can lead to thinness (kunyililika) or swelling (kuimbangana). Parents are said to be careless if they are not attentive to the child's needs, are unable to provide adequate quality or quantity of food, or fail to follow sexual abstinence rules. Maintaining abstinence protects the family and failure to do so causes the transfer of 'heat' from a sexually active parent to a 'cold' child and results in child health problems, including signs and symptoms of malnutrition. These findings indicate that the Yao understanding of care is much broader than the concept of care during feeding described in the nutrition literature. In addition, the Yao note the importance of several key feeding practices supported by international agencies and understand the influence of illness on child nutritional status. These congruencies with the public health frame should be used together with information about the cultural context to design more socially and emotionally relevant care and nutrition programmes among the Yao. PMID:23941316

  19. 'It was caused by the carelessness of the parents': cultural models of child malnutrition in southern Malawi.

    PubMed

    Flax, Valerie L

    2015-01-01

    Parents' conceptions of child growth, health and malnutrition are culturally bound, making information about local understandings of malnutrition and its causes necessary for designing effective nutrition programmes. This study used ethnographic methods to elucidate cultural models of child care and malnutrition among the Yao of southern Malawi. Data were collected in six rural villages from 28 key informant interviews with village chiefs and traditional healers among others and 18 focus group discussions with parents and grandmothers of young children. For the Yao, lack of parental care is a key cause of poor child health and can lead to thinness (kunyililika) or swelling (kuimbangana). Parents are said to be careless if they are not attentive to the child's needs, are unable to provide adequate quality or quantity of food, or fail to follow sexual abstinence rules. Maintaining abstinence protects the family and failure to do so causes the transfer of 'heat' from a sexually active parent to a 'cold' child and results in child health problems, including signs and symptoms of malnutrition. These findings indicate that the Yao understanding of care is much broader than the concept of care during feeding described in the nutrition literature. In addition, the Yao note the importance of several key feeding practices supported by international agencies and understand the influence of illness on child nutritional status. These congruencies with the public health frame should be used together with information about the cultural context to design more socially and emotionally relevant care and nutrition programmes among the Yao.

  20. Intra-cranial Toxoplasmosis in an Immunocompetent Female.

    PubMed

    Hoti, Yaser Ud Din; Aziz, Amir; Ishaque, Khurram; Abbas, Sadia; Ud Din, Tariq Salah

    2016-06-01

    Intra-cranial toxoplasmosis is a rare entity occurring mostly in immunosuppressed individuals. It is extremely rare in an immune competent patient. Toxoplasmosis is the third leading cause of food borne illness. Depending upon the site, degree of inflammation and local damage, toxoplasmosis encephalitis and cranial abscess can cause long lasting neurologic sequel. With modern imaging techniques, toxoplasmosis antibody titers, slit lamp examination and brain biopsy, there is improvement in diagnosis along with reduction in the mortality rate. We present a case illustrating the radiological manifestations, complications, potential pitfalls in diagnosis and treatment of intra-cranial toxoplasmosis in immunocompetent patient. PMID:27376217

  1. Sewing needle: a rare cause of intra-cardiac foreign body in a 3-year-old child.

    PubMed

    Choudhary, Sandeep; Pujar Venkateshacharya, Suresh; Reddy, Chinnaswamy

    2016-10-01

    Sewing needles are rare causes of penetrating cardiac injury. Suicidal attempt, accidental penetration, domestic violence, and child abuse are likely causes for such injury. 1 Owing to their sharp nature, needles can rapidly migrate through the tissues. Fatalities are due to cardiac tamponade, infection, peripheral embolism, and valve dysfunction. PMID:27321856

  2. Isolated injury of the superior mesenteric artery caused by a lap belt in a child.

    PubMed

    La Greca, Gaetano; Castello, Giorgio; Barbagallo, Francesco; Grasso, Emanuele; Latteri, Saverio; Scala, Vincenzo; Russello, Domenico

    2006-10-01

    Isolated vascular injuries are rare in cases of blunt abdominal trauma, and superior mesenteric artery injury is extremely rare but potentially lethal. The incidence of this kind of life-threatening injury has increased in recent years. The diagnosis of these isolated injuries is difficult, and its delay is associated with a higher morbidity and mortality. The authors report on the case of a child with an isolated injury of the superior mesenteric artery caused by a lap belt, during a motor-vehicle crash which was successfully managed. Correct use of all types of restraints is to be recommended. The diagnosis of this rare intraabdominal vascular injury is possible especially when the major signs are evident, but an awareness of this rare possibility is essential for the outcome.

  3. Sepsis Caused by Achromobacter Xylosoxidans in a Child with Cystic Fibrosis and Severe Lung Disease

    PubMed Central

    Stobbelaar, Kim; Van Hoorenbeeck, Kim; Lequesne, Monique; De Dooy, Jozef; Ho, Erwin; Vlieghe, Erika; Ieven, Margaretha; Verhulst, Stijn

    2016-01-01

    Patient: Female, 10 Final Diagnosis: Sepsis Symptoms: Fever • hypotension • not tollerating enteral feeds • respiratory deterioration Medication: — Clinical Procedure: IV antibiotics • lungtransplantion Specialty: Pediatrics and Neonatology Objective: Unusual clinical course Background: Achromobacter xylosoxidans is an aerobic, motile, Gram-negative, opportunistic pathogen that can be responsible for various severe nosocomial and community-acquired infections. It has been found in immunocompromised patients and patients with several other underlying conditions, but the clinical role of this microorganism in cystic fibrosis is unclear. Case Report: We describe a case of septic shock caused by A. xylosoxidans in a 10-year-old child with cystic fibrosis and severe lung disease. Conclusions: As the prevalence of A. xylosoxidans in cystic fibrosis patients is rising and patient-to-patient transmission is highly probable, further studies are warranted to determine its role and to document the appropriate treatment strategy for eradication and long-term treatment of this organism. PMID:27498677

  4. Sepsis Caused by Achromobacter Xylosoxidans in a Child with Cystic Fibrosis and Severe Lung Disease.

    PubMed

    Stobbelaar, Kim; Van Hoorenbeeck, Kim; Lequesne, Monique; De Dooy, Jozef; Ho, Erwin; Vlieghe, Erika; Ieven, Margaretha; Verhulst, Stijn

    2016-01-01

    BACKGROUND Achromobacter xylosoxidans is an aerobic, motile, Gram-negative, opportunistic pathogen that can be responsible for various severe nosocomial and community-acquired infections. It has been found in immunocompromised patients and patients with several other underlying conditions, but the clinical role of this microorganism in cystic fibrosis is unclear. CASE REPORT We describe a case of septic shock caused by A. xylosoxidans in a 10-year-old child with cystic fibrosis and severe lung disease. CONCLUSIONS As the prevalence of A. xylosoxidans in cystic fibrosis patients is rising and patient-to-patient transmission is highly probable, further studies are warranted to determine its role and to document the appropriate treatment strategy for eradication and long-term treatment of this organism. PMID:27498677

  5. [Multifocal tuberculosis in immunocompetent patients].

    PubMed

    Rezgui, Amel; Fredj, Fatma Ben; Mzabi, Anis; Karmani, Monia; Laouani, Chadia

    2016-01-01

    Multifocal tuberculosis is defined as the presence of lesions affecting at least two extrapulmonary sites, with or without pulmonary involvement. This retrospective study of 10 cases aims to investigate the clinical and evolutionary characteristics of multifocal tuberculosis. It included 41 cases with tuberculosis collected between 1999 and 2013. Ten patients had multifocal tuberculosis (24%): 9 women and 1 man, the average age was 50 years (30-68 years). Our patients were correctly BCG vaccinated. The evaluation of immunodepression was negative in all patients. 7 cases had lymph node tuberculosis, 3 cases digestive tuberculosis, 2 cases pericardial tuberculosis, 2 cases osteoarticular tuberculosis, 1 case brain tuberculosis, 2 cases urinary tuberculosis, 4 cases urogenital tuberculosis, 1 case adrenal tuberculosis, 1 case cutaneous and 1 case muscle tuberculosis. All patients received anti-tuberculosis treatment for a mean duration of 10 months, with good evolution. Multifocal tuberculosis is difficult to diagnose. It can affect immunocompetent patients but often has good prognosis. Anti-tuberculosis therapy must be initiated as soon as possible to avoid sequelae. PMID:27583077

  6. [Aspergillus fumigatus mediastinitis in an immunocompetent pediatric patient after heart surgery].

    PubMed

    Acuña, Mirta; Farfán, Felipe; Cofré, Fernanda; Benadof, Dona

    2016-02-01

    Postsurgical aspergillosis occurs primarily in immunocompetent patients whose main predisposing factor is the loss of skin and mucosal integrity during surgery. Local infection tends to be destructive and refractory to treatment and relapses are common. It is important to consider aspergillosis in the differential diagnosis of slowly progressive and destructive surgical site infections with negative bacterial cultures. We present the case of a child who developed Aspergillus fumigatus mediastinitis months after heart surgery.

  7. Research opportunities on immunocompetence in space

    NASA Technical Reports Server (NTRS)

    Beisel, W. R. (Editor); Talbot, J. M. (Editor)

    1985-01-01

    The most significant of the available data on the effects of space flight on immunocompetences and the potential operational and clinical significance of reported changes are as follows: (1) reduced postflight blastogenic response of peripheral lymphocytes from space crew members; (2) postflight neutrophilia persisting up to 7 days; (3) gingival inflammation of the Skylab astronauts; (4) postflight lymphocytopenia, eosinopenia, and monocytopenia; (5) modifications and shifts in the microflora of space crews and spacecraft; and (6) microbial contamination of cabin air and drinking water. These responses and data disclose numerous gaps in the knowledge that is essential for an adequate understanding of space-related changes in immunocompetence.

  8. Tackling Teacher Turnover in Child Care: Understanding Causes and Consequences, Identifying Solutions

    ERIC Educational Resources Information Center

    Hale-Jinks, Claudia; Knopf, Herman; Kemple, Kristen

    2006-01-01

    "Teacher turnover," the number of teachers who leave a program during a year has numerous detrimental effects that can lower the quality of care received by children and families. High rates of teacher turnover, high child-to-adult ratios, and poorly trained staff characterize poor-quality child care in the United States. In fact, high rates of…

  9. Understanding the Use of Psychotropic Medications in the Child Welfare System: Causes, Consequences, and Proposed Solutions

    ERIC Educational Resources Information Center

    Alavi, Zakia; Calleja, Nancy G.

    2012-01-01

    Recent studies have highlighted the progressively increasing number of children prescribed psychotropic medication, while findings have illustrated significantly greater usage among child welfare-involved children. These findings have raised serious concerns among mental health and child welfare professionals as well as the general public. To…

  10. Little Evidence That Time in Child Care Causes Externalizing Problems during Early Childhood in Norway

    ERIC Educational Resources Information Center

    Zachrisson, Henrik D.; Dearing, Eric; Lekhal, Ratib; Toppelberg, Claudio O.

    2013-01-01

    Associations between maternal reports of hours in child care and children's externalizing problems at 18 and 36 months of age were examined in a population-based Norwegian sample ("n" = 75,271). Within a sociopolitical context of homogenously high-quality child care, there was little evidence that high quantity of care causes…

  11. Nodular tertiary syphilis in an immunocompetent patient*

    PubMed Central

    Bittencourt, Maraya de Jesus Semblano; de Brito, Arival Cardoso; Nascimento, Bianca Angelina Macêdodo; Carvalho, Alessandra Haber; Drago, Marion Guimarães

    2016-01-01

    Acquired syphilis can be divided into primary, secondary, latent, and tertiary stages. About 25% of patients with untreated primary syphilis will develop late signs that generally occur after three to five years, with involvement of several organs. The authors present an immunocompetent female who developed a tertiary stage syphilis presenting with long-standing nodular plaques. PMID:27579755

  12. Nodular tertiary syphilis in an immunocompetent patient.

    PubMed

    Bittencourt, Maraya de Jesus Semblano; Brito, Arival Cardoso de; Nascimento, Bianca Angelina Macêdodo; Carvalho, Alessandra Haber; Drago, Marion Guimarães

    2016-01-01

    Acquired syphilis can be divided into primary, secondary, latent, and tertiary stages. About 25% of patients with untreated primary syphilis will develop late signs that generally occur after three to five years, with involvement of several organs. The authors present an immunocompetent female who developed a tertiary stage syphilis presenting with long-standing nodular plaques. PMID:27579755

  13. Anesthesia management in a child with laryngeal papilloma causing near complete airway obstruction.

    PubMed

    Harshad, Parate Leena; Pujari, Vinayak; Channappa, Nagaraj Mungasuvalli; Anandaswamy, Tejesh Channasandra

    2015-01-01

    Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease of viral etiology affecting most commonly larynx. A 5-year-old child with stridor was posted for microlaryngoscopic excision of laryngeal papilloma. We discuss the perioperative management of case with the various ventilation strategies. In child with stridor intubation remains the safest option. It is suggested to maintain spontaneous ventilation until intubation as mask ventilation could be difficult. PMID:25558205

  14. Anesthesia management in a child with laryngeal papilloma causing near complete airway obstruction

    PubMed Central

    Harshad, Parate Leena; Pujari, Vinayak; Channappa, Nagaraj Mungasuvalli; Anandaswamy, Tejesh Channasandra

    2015-01-01

    Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease of viral etiology affecting most commonly larynx. A 5-year-old child with stridor was posted for microlaryngoscopic excision of laryngeal papilloma. We discuss the perioperative management of case with the various ventilation strategies. In child with stridor intubation remains the safest option. It is suggested to maintain spontaneous ventilation until intubation as mask ventilation could be difficult. PMID:25558205

  15. Hepatosplenic Cat Scratch Disease in Immunocompetent Adults

    PubMed Central

    García, Juan C.; Núñez, Manuel J.; Castro, Begoña; Fernández, Jesús M.; Portillo, Aránzazu; Oteo, José A.

    2014-01-01

    Abstract Cat-scratch disease (CSD) is the most frequent presentation of Bartonella henselae infection. It has a worldwide distribution and is associated with a previous history of scratch or bite from a cat or dog. CSD affects children and teenagers more often (80%) than adults, and it usually has a self-limiting clinical course. Atypical clinical course or systemic symptoms are described in 5%–20% of patients. Among them, hepatosplenic (HS) forms (abscess) have been described. The majority of published cases have affected children or immunosuppressed patients. Few cases of HS forms of CSD in immunocompetent adult hosts have been reported, and data about the management of this condition are scarce. Herein, we present 3 new cases of HS forms of CSD in immunocompetent adults and review 33 other cases retrieved from the literature. We propose an approach to clinical diagnosis and treatment with oral azithromycin. PMID:25398062

  16. Malignant syphilis in an immunocompetent female patient*

    PubMed Central

    Requena, Camila Bueno; Orasmo, Cínthia Rosane; Ocanha, Juliana Polizel; Barraviera, Silvia Regina Catharino Sartore; Marques, Mariangela Esther Alencar; Marques, Silvio Alencar

    2014-01-01

    Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient. PMID:25387504

  17. Bartonella henselae endocarditis in an immunocompetent adult.

    PubMed

    Holmes, A H; Greenough, T C; Balady, G J; Regnery, R L; Anderson, B E; O'Keane, J C; Fonger, J D; McCrone, E L

    1995-10-01

    We describe a case of aggressive Bartonella henselae endocarditis in an immunocompetent man who owned a cat. Aortic valve replacement was required, and his infection was diagnosed by histology, serology, and polymerase chain reaction analysis. The manifestations of his disease included mediastinal lymphadenopathy, glomerulonephritis, myocarditis, and a petechial rash; the unusual finding of a positive titer of c-antineutrophil cytoplasmic antibodies was noted. Serological titers were markedly elevated for > 1 year despite clinical improvement. PMID:8645787

  18. Maxillary sinus fusariosis in immunocompetent hosts.

    PubMed

    Kurien, M; Anandi, V; Raman, R; Brahmadathan, K N

    1992-08-01

    We report the first known cases of Fusariosis of maxillary sinus with granuloma and oro-antral fistula in two immunocompetent hosts. Fusarium solani was demonstrated in the direct microscopic examination and isolated in heavy growth from the biopsy materials. Both these patients were successfully treated with oral ketoconazole (200 mg daily) for three weeks followed by a Caldwell-Luc operation. Ketoconazole was continued for two months post-operatively. PMID:1402369

  19. Malignant syphilis in an immunocompetent female patient.

    PubMed

    Requena, Camila Bueno; Orasmo, Cínthia Rosane; Ocanha, Juliana Polizel; Barraviera, Silvia Regina Catharino Sartore; Marques, Mariangela Esther Alencar; Marques, Silvio Alencar

    2014-01-01

    Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient. PMID:25387504

  20. Cutaneous Infection Caused by Macrophomina phaseolina in a Child with Acute Myeloid Leukemia▿

    PubMed Central

    Srinivasan, Ashok; Wickes, Brian L.; Romanelli, Anna M.; Debelenko, Larisa; Rubnitz, Jeffrey E.; Sutton, Deanna A.; Thompson, Elizabeth H.; Fothergill, Annette W.; Rinaldi, Michael G.; Hayden, Randall T.; Shenep, Jerry L.

    2009-01-01

    We report a case of Macrophomina phaseolina skin infection in an immunocompromised child with acute myeloid leukemia, which was treated successfully with posaconazole without recurrence after a hematopoietic stem cell transplant. The fungus was identified by DNA sequencing using both the internal transcribed spacer and D1/D2 region of the 28S ribosomal DNA gene. PMID:19386841

  1. Child-Centered Pedagogies, Curriculum Reforms and Neoliberalism. Many Causes for Concern, Some Reasons for Hope

    ERIC Educational Resources Information Center

    Rodríguez, Encarna

    2013-01-01

    This article maps some of the ways in which neoliberalism, pedagogy, and curriculum are closely interconnected. Looking at the Spanish curriculum reform during the first Socialist administration in the late 1980s and early 1990s, it explicitly identifies child-centered pedagogies as an important tool in articulating the neoliberal agenda in…

  2. What Happened to My Child? Unknown Causes of Developmental Disability and Research in Genetics

    ERIC Educational Resources Information Center

    Pevsner, Jonathan; Silverman, Wayne

    2007-01-01

    At one time or the other, virtually every parent has gone to the doctor concerned about his or her child. Thanks to the advances of modern medicine, the doctor can diagnose the problem most of the time and treat it successfully. Many potential problems, some life-threatening like diphtheria and neural tube defects, can even be prevented altogether…

  3. Determination of Knowledge, Attitudes and Behaviors Regarding Factors Causing Home Accidents and Prevention in Mothers with a Child Aged 0-5 Years

    ERIC Educational Resources Information Center

    Akturk, Ümmühan; Erci, Behice

    2016-01-01

    Objective: In this study, it was aimed to determine knowledge, "attitudes" and "behaviors" in mothers with a child aged 0-5 years regarding factors causing "home accidents" and prevention. Method: The target population of the study consisted of mothers with a child aged 0-5 years who were admitted to pediatrics ward…

  4. First Case of Lung Abscess due to Salmonella enterica Serovar Abony in an Immunocompetent Adult Patient

    PubMed Central

    Dendrinos, John; Nikitiadis, Emanuel; Vrioni, Georgia; Tsakris, Athanassios

    2016-01-01

    In healthy individuals, nontyphoidal Salmonella species predominantly cause a self-limited form of gastroenteritis, while they infrequently invade or cause fatal disease. Extraintestinal manifestations of nontyphoidal Salmonella infections are not common and mainly occur among individuals with specific risk factors; among them, focal lung infection is a rare complication caused by nontyphoidal Salmonella strains typically occurring in immunocompromised patients with prior lung disease. We describe the first case of a localized lung abscess formation in an immunocompetent healthy female adult due to Salmonella enterica serovar Abony. The patient underwent lobectomy and was discharged after full clinical recovery. This case report highlights nontyphoidal Salmonellae infections as a potential causative agent of pleuropulmonary infections even in immunocompetent healthy adults. PMID:27429814

  5. First Case of Lung Abscess due to Salmonella enterica Serovar Abony in an Immunocompetent Adult Patient.

    PubMed

    Pitiriga, Vassiliki; Dendrinos, John; Nikitiadis, Emanuel; Vrioni, Georgia; Tsakris, Athanassios

    2016-01-01

    In healthy individuals, nontyphoidal Salmonella species predominantly cause a self-limited form of gastroenteritis, while they infrequently invade or cause fatal disease. Extraintestinal manifestations of nontyphoidal Salmonella infections are not common and mainly occur among individuals with specific risk factors; among them, focal lung infection is a rare complication caused by nontyphoidal Salmonella strains typically occurring in immunocompromised patients with prior lung disease. We describe the first case of a localized lung abscess formation in an immunocompetent healthy female adult due to Salmonella enterica serovar Abony. The patient underwent lobectomy and was discharged after full clinical recovery. This case report highlights nontyphoidal Salmonellae infections as a potential causative agent of pleuropulmonary infections even in immunocompetent healthy adults. PMID:27429814

  6. Isolated retroperitoneal hydatid cyst in a child: a rare cause of acute scrotal swelling?

    PubMed

    Khan, Rizwan Ahmad; Wahab, Shagufta; Chana, Rajendra Singh; Fareed, Rehan

    2010-08-01

    Hydatidosis affects almost every region of the body. Although adults are mostly affected, children also suffer from the disease especially in endemic areas. The usual affected location is the liver, lung, spleen, brain, and kidney. We report a hydatid cyst located in a retroperitoneal location presenting with a sudden scrotal extension in a 7-year-old child. The finding presented a diagnostic dilemma vis-à-vis obstructed inguinal hernia.

  7. Verrucous tumor mimicking squamous cell carcinoma in immunocompetent patient.

    PubMed

    Ruiz-Villaverde, Ricardo; Sanchez-Cano, Daniel; Martinez-Peinado, Carmen M; Galan-Gutierrez, Manuel

    2016-01-01

    Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals. An increase in non-tuberculous mycobacterial (NTM) infections targeting skin has been described. Many hypotheses have been developed in order to explain it: the increasing burden of immunocompromised individuals, immigration from endemic countries, improved laboratory identification techniques, and changes inhuman behavior that expose individuals to this NTM. Mycobacterium mucogenicum group comprises M. mucogenicum, Mycobacterium aubagnense, and Mycobacterium phocaicum. This group of organisms was first named Mycobacterium chelonae-like organism in 1982. Most clinically significant cases of those organisms involved catheter-related infections. Nevertheless, we report an interesting patient with a cutaneous infection produced by M. mucogenicum mimicking a squamous cell carcinoma; an excellent response to combined therapy with rifampicin and clarythromicin was observed. PMID:27267196

  8. Chronic cholecystitis with Cystoisospora belli in an immunocompetent patient.

    PubMed

    Takahashi, Hideo; Falk, Gavin A; Cruise, Michael; Morris-Stiff, Gareth

    2015-01-01

    A 47-year-old woman presented with a history of vague abdominal pain for several years, which worsened over the past 2 months, with pain more prominent in the right upper quadrant. She also had a history of peptic ulcer disease. The ultrasound scan of right upper quadrant revealed normal gallbladder and oesophagogastroduodenoscopy was unremarkable. A (99m)technetium labelled hepato iminodiacetic acid (HIDA) scan with cholecystokinin provocation demonstrated a decreased gallbladder ejection fraction (EF) of 32%. On this basis, the patient was diagnosed with biliary dyskinesia and underwent an elective laparoscopic cholecystectomy. Histopathological analysis revealed chronic cholecystitis with Cystoisospora belli identified in the gallbladder wall. Cystoisospora has been identified to cause an opportunistic acalculous cholecystitis among immunocompromised hosts, especially those with AIDS. This is the first case report of chronic cholecystitis due to C. belli in an immunocompetent patient. PMID:26065551

  9. Intra-familial child homicide in Finland 1970-1994: incidence, causes of death and demographic characteristics.

    PubMed

    Vanamo, T; Kauppi, A; Karkola, K; Merikanto, J; Räsänen, E

    2001-04-01

    The purpose of this study was to investigate all child homicides for the 25-year period, 1970-1994 in Finland and to analyse the specific characteristics of the filicide cases. A total of 292 child homicides occurred during this period. In 201 (69%) cases the offender was a parent or a stepparent of the child. Altogether, 173 (59%) of the victims were boys and 119 (41%) were girls. For the closer examination of the filicide cases we excluded the neonaticide and homicide-suicide cases. Consequently, we report on 70 filicide victims. Of these victims, 42 (60%) were boys and 28 (40%) were girls. Twenty six (37%) of the children were killed before the age of 1 year and 53 (79%) before the age of 5 years. The offender was the mother in 43 (61%) cases and the father or the stepfather in 26 (37%) cases. The victims of the mothers were younger than those of the fathers. The most frequent causes of death were head injuries, drowning and suffocation. The most common means of assault were battering, drowning and strangulation. One in two of the fatally battered children had a documented history of previous abuse. PMID:11248450

  10. Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes

    PubMed Central

    Banakou, Domna; Groten, Raphaela; Slater, Mel

    2013-01-01

    An illusory sensation of ownership over a surrogate limb or whole body can be induced through specific forms of multisensory stimulation, such as synchronous visuotactile tapping on the hidden real and visible rubber hand in the rubber hand illusion. Such methods have been used to induce ownership over a manikin and a virtual body that substitute the real body, as seen from first-person perspective, through a head-mounted display. However, the perceptual and behavioral consequences of such transformed body ownership have hardly been explored. In Exp. 1, immersive virtual reality was used to embody 30 adults as a 4-y-old child (condition C), and as an adult body scaled to the same height as the child (condition A), experienced from the first-person perspective, and with virtual and real body movements synchronized. The result was a strong body-ownership illusion equally for C and A. Moreover there was an overestimation of the sizes of objects compared with a nonembodied baseline, which was significantly greater for C compared with A. An implicit association test showed that C resulted in significantly faster reaction times for the classification of self with child-like compared with adult-like attributes. Exp. 2 with an additional 16 participants extinguished the ownership illusion by using visuomotor asynchrony, with all else equal. The size-estimation and implicit association test differences between C and A were also extinguished. We conclude that there are perceptual and probably behavioral correlates of body-ownership illusions that occur as a function of the type of body in which embodiment occurs. PMID:23858436

  11. [Fractured tracheostomy tube: a rare cause of respiratory distress in the tracheotomized child. Case report].

    PubMed

    Cuestas, Giselle; Martínez, Juan C; Pena, Roberto; Razetti, Juan

    2015-12-01

    Fracture and migration of the tracheotomy tube in the tracheobronchial tree is an uncommon complication of tracheotomy. Early diagnosis and proper treatment are essential because of the potential risk of fatal respiratory obstruction. Diagnosis should be suspected in all tracheotomized children undergoing breathing difficulties. It is confirmed by chest x-ray and endoscopic examination. The recommended treatment includes the endoscopic removal of the aspirated cannula through the tracheal stoma. We describe the clinical presentation and the management of a broken tracheotomy tube which was presented as a foreign body in the airway of a 18-month-old child. Recommendations for tracheostomy care are listed.

  12. [Fractured tracheostomy tube: a rare cause of respiratory distress in the tracheotomized child. Case report].

    PubMed

    Cuestas, Giselle; Martínez, Juan C; Pena, Roberto; Razetti, Juan

    2015-12-01

    Fracture and migration of the tracheotomy tube in the tracheobronchial tree is an uncommon complication of tracheotomy. Early diagnosis and proper treatment are essential because of the potential risk of fatal respiratory obstruction. Diagnosis should be suspected in all tracheotomized children undergoing breathing difficulties. It is confirmed by chest x-ray and endoscopic examination. The recommended treatment includes the endoscopic removal of the aspirated cannula through the tracheal stoma. We describe the clinical presentation and the management of a broken tracheotomy tube which was presented as a foreign body in the airway of a 18-month-old child. Recommendations for tracheostomy care are listed. PMID:26593816

  13. Listerial Rhombencephalitis in an Immunocompetent Woman

    PubMed Central

    Zajkowska, Agata; Garkowski, Adam; Pancewicz, Sławomir; Guziejko, Katarzyna; Moniuszko, Anna; Zajkowska, Joanna

    2014-01-01

    Listeriosis usually affects immunocompromised patients including elderly people and pregnant women, but it may also affect otherwise healthy individuals. In our report, we present a case of a rare and very severe form of listeriosis-rhombencephalitis in a 61-year-old female with no history of immunosuppression, who, because of history, clinical picture, and laboratory results as well as negative cultures, was at first diagnosed with viral encephalitis. This paper underlines that Listeria monocytogenes infection should be taken into consideration in case of lymphocytic encephalitis even in immunocompetent patients. Typical MRI picture may be crucial in establishing a proper diagnosis as the lab results may be misleading. PMID:25126431

  14. Isolated pulmonary mucormycosis presenting as cavitary lesion in an immunocompetent adult: A rare case report.

    PubMed

    Acharya, Sourya; Shukla, Samarth; Noman, Obaid; Dawande, Pratibha

    2016-01-01

    Cavitary lung lesions have a specific array of differential diagnosis. Among rare causes is mucormycosis that should not be overlooked. A high index of suspicion is necessary for a correct diagnosis and aggressive management. It usually occurs in immunosupressed patients. It is a life-threatening, rapidly progressive, and angioinvasive fungal infection. We present a case of pulmonary mucormycosis presenting as a cavity in an immunocompetent middle aged male. PMID:26958531

  15. Sphingomonas paucimobilis osteomyelitis in an immunocompetent patient. A rare case report and literature review.

    PubMed

    Pascale, Renato; Russo, Enrico; Esposito, Isabella; Leone, Sebastiano; Esposito, Silvano

    2013-10-01

    Sphingomonas paucimobilis occurs widely both in natural and nosocomial environments, including hospital water systems, respiratory therapy equipment, and laboratory instruments. It is an opportunistic pathogen that rarely causes infections in humans. Among S. paucimobilis nosocomial infections, osteomyelitis is particularly rare. Almost all infections occur in patients with comorbidities such as malignancy, immunosuppressant therapy, diabetes mellitus and acquired immunodeficiency syndrome. We present the first case of Sphingomonas paucimobilis osteomyelitis in an immunocompetent patient and include updated literature concerning infections by this microorganism.

  16. Pyelonephritis caused by Actinobaculum schaalii in a child with pyeloureteral junction obstruction.

    PubMed

    Pajkrt, D; Simoons-Smit, A M; Savelkoul, P H M; van den Hoek, J; Hack, W W M; van Furth, A M

    2003-07-01

    Reported here is the case of a 5-year old boy with a pyeloureteral junction (PUJ) obstruction and pyelonephritis caused by Actinobaculum schaalii, an Actinomyces-like organism. Pyelonephritis or any other urinary tract infection caused by Actinobaculum schaalii has not been described in children before. The patient responded well to pyeloplasty in combination with antibiotic treatment.

  17. Disseminated Cryptococcal infection in an immunocompetent host mimicking plasma cell disorder: a case report and literature review

    PubMed Central

    Abid, Muhammad Bilal; De Mel, Sanjay; Limei, Michelle Poon

    2015-01-01

    Key Clinical Message Cryptococcosis is a potentially fatal fungal infection caused mainly by Cryptocococcus neoformans (CN) species and it rarely infects immunocompetent hosts. The outcomes are better only if the condition is suspected and diagnosed early and treatment is instituted. PMID:25984313

  18. Severe metapneumovirus infections among immunocompetent and immunocompromised patients admitted to hospital with respiratory infection.

    PubMed

    Souza, Juliana Sinohara; Watanabe, Aripuana; Carraro, Emerson; Granato, Celso; Bellei, Nancy

    2013-03-01

    Human metapneumovirus (hMPV) is considered an important cause of acute respiratory infections. hMPV can cause morbidity in hematopoietic stem cell transplant recipients and recent research has demonstrated that it is an important virus in patients admitted to hospital with respiratory infections and suspected of having pandemic 2009 influenza A (H1N1pdm09) virus. The purpose of this study was to investigate infections caused by hMPV in two groups of patients admitted to hospital: Immunocompromized patients with a potential risk of severe outcomes and immunocompetent patients with severe acute respiratory syndrome. A total of 288 samples were tested: 165 samples were collected from patients with suspected influenza A (H1N1) pdm09 infection during the first pandemic wave in 2009; and 123 samples were collected from patients of a hematopoietic stem cell transplantation program in 2008-2009. Amplification of the hMPV genes was performed by polymerase chain reaction. This was followed by sequencing and phylogenetic analysis. hMPV was detected in 14.2% (41/288) of all samples: 17% (28/165) of immunocompetent patients with suspected H1N1 infection and 10.6% (13/123) among hematopoietic stem cell transplant recipients. hMPV accounted for 12.1% (8/66) of immunocompetent adults patients with severe respiratory infections (median age, 55.9 years). Two hMPV subtypes were identified, A2 (26.9%; 7/26) and B2 (73.1%; 19/26) but no difference was observed between the patient groups in terms of age or immunosuppression level. This study highlights the significance of hMPV in immunocompetent adult patients with severe infections and further investigations are recommended for understanding the impact of this virus.

  19. Why Bother with Beliefs? Examining Relationships between Race/Ethnicity, Parental Beliefs about Causes of Child Problems, and Mental Health Service Use

    ERIC Educational Resources Information Center

    Yeh, May; McCabe, Kristen; Hough, Richard L.; Lau, Anna; Fakhry, Fatme; Garland, Ann

    2005-01-01

    In this study, the authors examined the role of parental beliefs about the causes of child problems in predicting later mental health service use in a large, diverse population of at-risk youths. Study hypotheses were that parental beliefs consistent with biopsychosocial causes would be associated with later mental health service use;…

  20. Childhood scurvy: an unusual cause of refusal to walk in a child.

    PubMed

    Alqanatish, J T; Alqahtani, F; Alsewairi, W M; Al-kenaizan, S

    2015-01-01

    Scurvy, or vitamin C deficiency, is rarely presented to a rheumatology clinic. It can mimic several rheumatologic disorders. Although uncommon, it may present as pseudovasculitis or chronic arthritis. Scurvy still exists today within certain populations, particularly in patients with neurodevelopmental disabilities, psychiatric illness or unusual dietary habits.Scurvy presentation to the rheumatologist varies from aches and mild pains to excruciating bone pain or arthritis. Musculoskeletal and mucocutaneous features of scurvy are often what prompts referrals to pediatric rheumatology clinics. Unless health care providers inquire about nutritional habits and keep in mind the risk of nutritional deficiency, it will be easy to miss the diagnosis of scurvy. Rarity of occurrence as compared to other nutritional deficiencies, combined with a lack of understanding about modern-day risk factors for nutritional deficiency, frequently leads to delayed recognition of vitamin C deficiency. We report a case of scurvy in a mentally handicapped Saudi child, who presented with new onset inability to walk with diffuse swelling and pain in the left leg. Skin examination revealed extensive ecchymoses, hyperkeratosis and follicular purpura with corkscrew hairs, in addition to gingival swelling with bleeding. Clinical diagnosis of scurvy was rendered and confirmed by low serum vitamin C level. The patient did extremely well with proper nutritional support and vitamin C supplementation. It has been noticed lately that there is increased awareness about scurvy in rheumatology literature. A high index of suspicion, together with taking a thorough history and physical examination, is required for diagnosis of scurvy in patient who presents with musculoskeletal symptoms. Nutritional deficiency should also be considered by the rheumatologist formulating differential diagnosis for musculoskeletal or mucocutaneous complaints in children, particularly those at risk. PMID:26063195

  1. Childhood scurvy: an unusual cause of refusal to walk in a child.

    PubMed

    Alqanatish, J T; Alqahtani, F; Alsewairi, W M; Al-kenaizan, S

    2015-06-11

    Scurvy, or vitamin C deficiency, is rarely presented to a rheumatology clinic. It can mimic several rheumatologic disorders. Although uncommon, it may present as pseudovasculitis or chronic arthritis. Scurvy still exists today within certain populations, particularly in patients with neurodevelopmental disabilities, psychiatric illness or unusual dietary habits.Scurvy presentation to the rheumatologist varies from aches and mild pains to excruciating bone pain or arthritis. Musculoskeletal and mucocutaneous features of scurvy are often what prompts referrals to pediatric rheumatology clinics. Unless health care providers inquire about nutritional habits and keep in mind the risk of nutritional deficiency, it will be easy to miss the diagnosis of scurvy. Rarity of occurrence as compared to other nutritional deficiencies, combined with a lack of understanding about modern-day risk factors for nutritional deficiency, frequently leads to delayed recognition of vitamin C deficiency. We report a case of scurvy in a mentally handicapped Saudi child, who presented with new onset inability to walk with diffuse swelling and pain in the left leg. Skin examination revealed extensive ecchymoses, hyperkeratosis and follicular purpura with corkscrew hairs, in addition to gingival swelling with bleeding. Clinical diagnosis of scurvy was rendered and confirmed by low serum vitamin C level. The patient did extremely well with proper nutritional support and vitamin C supplementation. It has been noticed lately that there is increased awareness about scurvy in rheumatology literature. A high index of suspicion, together with taking a thorough history and physical examination, is required for diagnosis of scurvy in patient who presents with musculoskeletal symptoms. Nutritional deficiency should also be considered by the rheumatologist formulating differential diagnosis for musculoskeletal or mucocutaneous complaints in children, particularly those at risk.

  2. Peritoneal band containing talc: rare cause of small bowel obstruction in a previously unoperated child.

    PubMed

    Kyzer, S; Gelber, E; Koren, R; Chaimoff, C

    1994-12-01

    The authors report on a 10-year-old boy who was operated on for small bowel obstruction. The obstruction was caused by a peritoneal band that was found to contain talc of an unknown source. The possible explanation for this rare pathology is discussed. PMID:7877051

  3. Cause of Death and the Quest for Meaning after the Loss of a Child

    ERIC Educational Resources Information Center

    Lichtenthal, Wendy G.; Neimeyer, Robert A.; Currier, Joseph M.; Roberts, Kailey; Jordan, Nancy

    2013-01-01

    This study examined patterns of making meaning among 155 parents whose children died from a variety of violent and non-violent causes. Findings indicated 53% of violent loss survivors could not make sense of their loss, as compared to 32% of non-violent loss survivors. Overall, there was overlap in sense-making strategies across different causes…

  4. Parental Beliefs about the Causes of Child Problems: Exploring Racial/ethnic Patterns.

    ERIC Educational Resources Information Center

    Yeh, May; Hough, Richard L.; McCabe, Kristen; Lau, Anna; Garland, Ann

    2004-01-01

    Objective: To examine racial/ethnic patterns of parental beliefs about etiological explanations for youth problems. Method: The parents of 1,338 youths with identified mental health problems were asked about their beliefs about the causes for their children's problems from a questionnaire with 11 etiological categories. Results: Parents of African…

  5. A rare case of phaeohyphomycosis caused by Fonsecaea pedrosoi in a child with nephrotic syndrome

    PubMed Central

    Nayyar, C.; Gulati, N.; Sherwal, B. L.

    2016-01-01

    Dematiaceous fungi are the etiological agents of phaeohyphomycosis and are now increasingly being recognized for causing disease in humans. A high level of suspicion and routine fungal cultures are required to identify these cases. There is no consensus regarding their management. Here, an unusual presentation of phaeohyphomycosis (secondary to Fonsecaea pedrosoi) presenting as a disseminated infection in a case of nephrotic syndrome is described. PMID:27194840

  6. Asian-Indian Parents' Attributions about the Causes of Child Behavior: A Replication and Extension with Parents from Chennai, India

    ERIC Educational Resources Information Center

    Montemayor, Raymond; Ranganathan, Chitra

    2012-01-01

    Using hypothetical vignettes, 152 parents of children 10-17 years old living in Chennai, India, made attributions about whether the origins of 2 positive and 2 negative behaviors performed by their own child or another child were due to the child's personality or the situation, or to parenting or nonparenting influences based on the frequency,…

  7. Periostitis of the metatarsal caused by a date palm thorn in a child: a case report.

    PubMed

    Suresh, S S

    2011-01-01

    Date palm thorn injuries are common in Middle Eastern countries, where there are many date palm plantations. If detected, these injuries can be treated without subsequent complications. In children, however, the diagnosis can very easily be missed. An untreated embedded thorn may cause late complications, including periostitis or osteomyelitis. In this article, the author presents a case of date palm thorn-induced periostitis of the fourth metatarsal. The lesion was successfully treated in this 10-year-old male by curettage of the lesion and removal of the thorn embedded in the periosteum of the metatarsal. The presence of the date palm thorn was confirmed with ultrasound scan and computerized tomography.

  8. Bacillary angiomatosis in a child undergoing chemotherapy.

    PubMed

    Myers, S A; Prose, N S; Garcia, J A; Wilson, K H; Dunsmore, K P; Kamino, H

    1992-10-01

    Bacillary angiomatosis is an infectious disease of the skin and viscera characterized by vascular lesions, originally described in patients with human immunodeficiency virus infection. There are also case reports of bacillary angiomatosis occurring in immunocompetent patients and in noninfected patients with suppressed immune function. We report a case of bacillary angiomatosis in a child undergoing chemotherapy for acute leukemia.

  9. Eye lesion caused by adult Brugia malayi: a first case reported in a child from Malaysia.

    PubMed

    Rohela, M; Jamaiah, I; Yaw, C C

    2006-07-01

    We are reporting a case of an eye lesion caused by an adult Brugia malayi. The patient was a 3-year-old Chinese boy from Kemaman District, Terengganu, Peninsular Malaysia. He presented with a one week history of redness and palpebral swelling of his right eye. He claimed that he could see a worm in his right eye beneath the conjunctiva. He had no history of traveling overseas and the family kept dogs at home. He was referred from Kemaman Hospital to the eye clinic of Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia. On examination by the ophthalmologist, he was found to have a subconjunctival worm in his right eye. Full blood count revealed eosinophilia (10%). Four worm fragments, each about 1 cm long were removed from his right eye under general anesthesia. A thick blood smear stained with Giemsa was positive for microfilariae of Brugia malayi. A Brugia Rapid test done was positive. He was treated with diethylcarbamazine.

  10. Macro creatine kinase type 1: a cause of spuriously elevated serum creatine kinase associated with leukoencephalopathy in a child.

    PubMed

    Bodensteiner, John B

    2014-07-01

    Macro creatine kinase type 1 is a complex formed by the creatine kinase isoenzyme BB and monoclonal IgG and occurs in about 1% of patients studied. First identified as a cause of spurious elevation of the total serum creatine kinase in patients suspected of myocardial infarction, the test has been largely replaced by the measurement of troponin levels. We present a child with delayed milestones and persistently elevated total serum creatine kinase measurements (∼ 1000-4000 IU) normal electromyogram and brisk myotatic reflexes. Creatine kinase isoenzymes and brain imaging showed the presence of macro creatine kinase type 1 and extensive signal abnormality of the cerebral white matter. Macro creatine kinase type 1 has been associated with several conditions though it has not been described in association with leukoencephalopathy or in patients this young. Macro creatine kinase type 1 can be a cause of elevated total creatine kinase in patients without primary muscle disease. The significance of the relationship of the macro creatine kinase to the leukoencephalopathy in this patient is unknown.

  11. Massive Trichuris trichiura infection as a cause of chronic bloody diarrhea in a child.

    PubMed

    Diniz-Santos, Daniel R; Jambeiro, Jamile; Mascarenhas, Ramiro R; Silva, Luciana R

    2006-02-01

    The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by Trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive Trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that Trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations.

  12. Time to focus child survival programmes on the newborn: assessment of levels and causes of infant mortality in rural Pakistan.

    PubMed Central

    Fikree, Fariyal F.; Azam, Syed Iqbal; Berendes, Heinz W.

    2002-01-01

    OBJECTIVE: Population-based surveys were conducted in selected clusters of Pakistan's least developed provinces, Balochistan and North-West Frontier Province (NWFP), including the Federally Administered Tribal Areas (FATA), to assess levels and causes of neonatal and postneonatal mortality. METHODS: Interviews were conducted in a total of 54 834 households: Balochistan, 20 486; NWFP, 26 175; and FATA, 8173. Trained interviewers administered questionnaires after obtaining verbal informed consent from the respondents. Verbal autopsy interviews were conducted for infant deaths reported for the previous year. FINDINGS: The infant mortality rate based on combined data from the different sites was 99.7 per 1000 live births (range 129.0-70.1). The contribution of neonatal deaths to all infant deaths was much higher for NWFP (67.2%), where the overall rate was lowest, than for Balochistan (50.8%) and FATA (56.8%). Around 70% of all neonatal deaths occurred in the early neonatal period. The three main clinical causes of infant deaths were diarrhoea syndrome (21.6%), tetanus (11.7%) and acute respiratory infections (11.6%). In the neonatal period, however, tetanus (18.3%), small size for gestational age or low birth weight (15.3%), and birth injury (12.0%) accounted for nearly half (45.6%) of all deaths, while the contributions of diarrhoea syndrome (5.1%) and acute respiratory infections (6.0%) were less significant (11.1%). Tetanus was the cause of death for 21.7% and 17.1% of all infant deaths in FATA and NWFP respectively. CONCLUSION: The results suggest that there should be a shift in child survival programmes to give greater emphasis to maternal and neonatal health, in particular to maternal tetanus immunization, safe delivery and cord care. PMID:12075362

  13. A case of Kaposi sarcoma in an immunocompetent, heterosexual Irish man: a discussion of etiology and viral transmission.

    PubMed

    Florek, Aleksandra G; Eilers, David; Armstrong, April W

    2015-10-01

    Four types of Kaposi sarcoma (KS) have been described, all of which are caused by human herpesvirus-8 (HHV-8).  The incidence of KS in the United States is highest among HIV-positive homosexual men and elderly men of Eastern European, Jewish, or Mediterranean descent. However, few reports describe KS in HIV-negative, immunocompetent heterosexual men in the United States. HHV-8 is transmitted largely via saliva and close sexual contact, whereas there are only a handful of reports of transmission via blood and blood products. We report a case of an HIV-negative, immunocompetent heterosexual man who acquired KS via blood transfusion. A 77-year-old immunocompetent, monogamously heterosexual, HIV-negative Irish man presented with a biopsy-proven KS lesion on the right thigh. Past surgical history included a coronary artery bypass graft, during which he received a blood transfusion from an unknown donor source.  His ecchymotic KS lesions progressed while on doxycycline, intralesional vinblastine, and topical anti-angiogenic medications.  The patient eventually achieved stabilization of KS lesions with acitretin. Our case report emphasizes the need to characterize the phenotype and transmission route of HHV-8 in heterosexual, immunocompetent patients in geographic regions with low HHV-8 seroprevalence. PMID:26632797

  14. Chronic Invasive Nongranulomatous Fungal Rhinosinusitis in Immunocompetent Individuals

    PubMed Central

    Turhan, Ozge; Ozbudak, Irem Hicran; Turhan, Murat

    2016-01-01

    Chronic invasive nongranulomatous fungal rhinosinusitis is a well-described but uncommon type of fungal rhinosinusitis (FRS). While the prevalence of chronic FRS is 0.11% in healthy individuals, only 1.3% of them are in nongranulomatous invasive nature. The majority of the cases in the literature have been reported from developing countries mostly located in the tropical regions, as typically occurring in the background of diabetes mellitus or corticosteroid treatment. The current paper reports four consecutive cases, who were diagnosed within a short period of six months at a single center of a country located outside the tropical climate zone. None of the patients had a comorbid disease that may cause immune suppression or a history of drug use. The only risk factor that may have a role in development of chronic invasive nongranulomatous FRS was that all of our patients were people working in greenhouse farming. Three cases underwent endoscopic sinus surgery, and one case underwent surgery with both endoscopic and external approaches. Systemic antifungal therapy was initiated in all cases in the postoperative period with voriconazole 200 mg orally twice a day. All patients achieved a complete clinical remission. Chronic invasive nongranulomatous FRS should be kept in mind in the presence of long-standing nonspecific sinonasal symptoms in immunocompetent individuals, particularly with a history of working in greenhouse farming. PMID:27703827

  15. Listeria meningoencephalitis in an immunocompetent person.

    PubMed

    Drnda, Alija; Koluder, Nada; Hadzic, Amir; Bajramovic, Nermina; Baljic, Rusmir; Mulabdic, Velida

    2009-01-01

    Listeria monocytogenes is a small, aerobic or facultative anaerobic, non-sporulating gram positive bacillus that can be isolated from soil, vegetation or animal reservoirs. There are six species of Listeria, and only L. monocytogenes is pathogenic for humans. Human disease occurs mainly in immunocompromised people, neonates and in pregnancy, while the cases in immunocompetent people are rare. CNS manifestations of the disease can be in form of meningitis, encephalitis, and also cerebritis and abscess since L. monocytogenes shows tropism for brain and brain stem as well for the meninges. In this case we presented 55 year old male patient with etiologically confirmed listerial meningoencephalitis, transferred from regional hospital tothe Clinic for Infectious Diseases with diagnosis of acute meningoencephalitis. Disease started 4 days before the admission. Prior to this the patient was completely healthy. In his history he denied any preexisting disease. At admittance he was febrile, with altered consciousness, disoriented, showing ocular deviation, dystaxia, and with completely positive meningeal signs. Neurologist diagnosis was rhombencephalitis. CSF analysis showed mildly opalescent liquor with pleocytosis 546/mm3 and polymorphonuclear cell predominance >70%. CSF culture showed positive isolate of L. monocytogenes. Initial therapy was: Penicillin G and Chloramphenicol, together with all other supportive and symptomatic therapy. After initial therapy and based on antibiogram, ampicillin was administered for4 weeks, followed by imipenemum for 10 days. Control CSF analysis showed pleocytosis and increased protein level and the patient was discharged as recovered with diagnosis of acute meningoencephalitis PMID:19537672

  16. Thalassemia Intermedia Caused by 16p13.3 Sectional Duplication in a β-Thalassemia Heterozygous Child.

    PubMed

    Liu, Sha; Jiang, Hua; Wu, Man-Yu; Zhang, Yong-Ling; Li, Dong-Zhi

    2015-01-01

    Thalassemia intermedia is an inherited hemoglobin disorder characterized by a significant genetic and clinical heterogeneity. A wide spectrum of different genotypes-homozygous, heterozygous, and compound heterozygous-have been found to be responsible for it. The authors describe a Chinese child of β-thalassemia heterozygote with the mutation IVS2-654 (C→T) (HBB:c.316-197C→T) presenting with severe thalassemia intermedia. Multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization (CGH) analyses of the α gene cluster revealed an approximate 146-kb duplication at 16p13.3 including the complete α gene cluster. The duplicated allele and the normal allele in trans result in a total of 6 active α genes. The severe clinical phenotype seemed to be related to the considerable excess of the α-globin and the β-globin deficit caused by the presence of the β-thalassemia. The α gene duplication should be considered in patients heterozygous for β-thalassemia who show a more severe phenotype than β-thalassemia trait.

  17. The effect of interferon treatment in rabies prophylaxis in immunocompetent, immunosuppressed, and immunodeficient mice.

    PubMed

    Marcovistz, R; Germano, P M; Rivière, Y; Tsiang, H; Hovanessian, A G

    1987-02-01

    The development of rabies is modulated by many interacting factors, most of which are dependent on the host immune response. For this reason, we studied the action of interferon (IFN) treatment on street rabies virus infection in mice, immunocompetent or immunosuppressed with cyclophosphamide. In immunocompetent mice, paralysis of hind limbs is the first symptom characteristic of rabies disease before weight loss and general prostration leading to death. Paralysis does not occur in immunosuppressed mice, which develop a shaggy hair and eventually lose weight and die. Administration of interferon (10(5) units, intraperitoneally) 1 h after virus inoculation and every 24 h led to a delay in the onset of first disease signs, but in general did not rescue immunocompetent or immunosuppressed mice from death. In both types of mice, rabies virus production in the brain was reduced by 1 log in response to IFN treatment. In immunocompetent mice treated with IFN, there was a significant increase of antibody synthesis against rabies virus. As expected, antibody synthesis in immunosuppressed mice was almost negligible. However, in mice treated with IFN and cyclophosphamide there was still significant antibody synthesis specific for rabies virus. IFN administered intravenously, subcutaneously, or intraperitoneally crosses the blood-brain barrier to cause enhanced levels of the two double-stranded RNA-dependent enzymes, the protein kinase and 2',5'-oligoadenylate (2-5A) synthetase in the brain. However in spite of this effect, IFN treatment seems to be unable to prevent the evolution of rabies disease in immunocompetent and immunosuppressed mice. Since the suppressing effect of cyclophosphamide is nonselective on both the cellular and humoral immune responses of mice, we investigated the action of IFN in rabies virus-infected athymic nude mice, which lack T cells. Athymic nude mice infected with street rabies virus become cachectic and die without any apparent symptom of

  18. Investigating the Relationship between Effective Communication of Spouse and Father-Child Relationship (Test Pattern Causes to Education Parents)

    ERIC Educational Resources Information Center

    Ataeifar, Robabeh; Amiri, Sholeh; Ali Nadi, Mohammad

    2016-01-01

    This research is targeted with the plan of father-child model or effective relationship mediating of spouses or investigating attachment style, personality traits, communication skills, and spouses' sexual satisfaction. Based on this, 260 people (father and child) were selected through random sampling method based on share. Participants were…

  19. The Causes and Consequences of Child Poverty in the United States. Innocenti Occasional Papers, Number 10. Special Subseries: Child Poverty in Industrialized Countries.

    ERIC Educational Resources Information Center

    Danziger, Sheldon; Stern, Jonathan

    This report addresses the sources and remedies for child poverty in the United States through a review of the effects of trends, policies, and changes in social relationships; and an analysis of data concerning poverty and children. An introduction sketches the present condition of children in poverty and the policies and attitudes of the past 30…

  20. Atypical Cutaneous Sporotrichosis in an Immunocompetent Adult: Response to Potassium Iodide

    PubMed Central

    Gandhi, Nikita; Chander, Ram; Jain, Arpita; Sanke, Sarita; Garg, Taru

    2016-01-01

    Cutaneous sporotrichosis, also known as “Rose Gardener's disease,” caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide. PMID:27057047

  1. Atypical Cutaneous Sporotrichosis in an Immunocompetent Adult: Response to Potassium Iodide.

    PubMed

    Gandhi, Nikita; Chander, Ram; Jain, Arpita; Sanke, Sarita; Garg, Taru

    2016-01-01

    Cutaneous sporotrichosis, also known as "Rose Gardener's disease," caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide. PMID:27057047

  2. Atypical Cutaneous Sporotrichosis in an Immunocompetent Adult: Response to Potassium Iodide.

    PubMed

    Gandhi, Nikita; Chander, Ram; Jain, Arpita; Sanke, Sarita; Garg, Taru

    2016-01-01

    Cutaneous sporotrichosis, also known as "Rose Gardener's disease," caused by dimorphic fungus Sporothrix schenkii, is usually characterized by indolent nodular or nodulo-ulcerative lesions arranged in a linear pattern. We report bizarre nonlinear presentation of Sporotrichosis, in an immunocompetent adult occurring after a visit to Amazon rain forest, speculating infection with more virulent species of Sporothrix. The diagnosis was reached with the help of periodic acid-Schiff positive yeast cells and cigar shaped bodies seen in skin biopsy along with the therapeutic response to potassium iodide.

  3. Adrenal and hepatic aspergillosis in an immunocompetent patient.

    PubMed

    Chen, Liyu; Liu, Yanbin; Wang, Weiya; Liu, Kai

    2015-06-01

    Invasive aspergillosis, an infection most frequently induced by Aspergillus fumigatus and Aspergillus flavus, typically occurs in immunocompromised patients and is usually transmitted through inhalation of Aspergillus spores. As the lungs are by far the most common site involved in invasive aspergillosis and invasive aspergillosis in immunocompetent hosts is very rare, there have been a few case reports of extra-pulmonary, disseminated invasive aspergillosis in immunocompetent persons. Herein, we report a case of an adult, male, immunocompetent patient with disseminated invasive aspergillosis that successively spread from the right adrenal gland to the left hepatic lobe. The patient was successfully treated through surgical excisions of his adrenal and hepatic masses followed by voriconazole therapy. To our knowledge, this is the first case report of invasive aspergillosis affecting the adrenal glands.

  4. Asian-Indian parents' attributions about the causes of child behavior: a replication and extension with parents from Chennai, India.

    PubMed

    Montemayor, Raymond; Ranganathan, Chitra

    2012-01-01

    Using hypothetical vignettes, 152 parents of children 10-17 years old living in Chennai, India, made attributions about whether the origins of 2 positive and 2 negative behaviors performed by their own child or another child were due to the child's personality or the situation, or to parenting or nonparenting influences based on the frequency, intensity, and cross-situational consistency of the behavior. Parents attributed the positive behaviors of all children to the personality of the child and to parenting. Parents attributed negative behavior of their own children to situational influences and nonparenting effects, but attributed the negative behavior of other children to their personality and to parenting, a pattern that enhances and reinforces parent self-esteem. Results were discussed in terms of the self-serving bias and the actor-observer bias, cognitive distortions that protect and enhance parents' views of themselves and their children.

  5. Asian-Indian parents' attributions about the causes of child behavior: a replication and extension with parents from Chennai, India.

    PubMed

    Montemayor, Raymond; Ranganathan, Chitra

    2012-01-01

    Using hypothetical vignettes, 152 parents of children 10-17 years old living in Chennai, India, made attributions about whether the origins of 2 positive and 2 negative behaviors performed by their own child or another child were due to the child's personality or the situation, or to parenting or nonparenting influences based on the frequency, intensity, and cross-situational consistency of the behavior. Parents attributed the positive behaviors of all children to the personality of the child and to parenting. Parents attributed negative behavior of their own children to situational influences and nonparenting effects, but attributed the negative behavior of other children to their personality and to parenting, a pattern that enhances and reinforces parent self-esteem. Results were discussed in terms of the self-serving bias and the actor-observer bias, cognitive distortions that protect and enhance parents' views of themselves and their children. PMID:23264991

  6. Delftia acidovorans: A rare pathogen in immunocompetent and immunocompromised patients.

    PubMed

    Bilgin, Huseyin; Sarmis, Abdurrahman; Tigen, Elif; Soyletir, Guner; Mulazimoglu, Lutfiye

    2015-01-01

    Delftia acidovorans is an aerobic, nonfermenting Gram-negative bacillus. It is usually a nonpathogenic environmental organism and is rarely clinically significant. Although D acidovorans infection most commonly occurs in hospitalized or immunocompromised patients, there are also several reports documenting the infection in immunocompetent patients. The present article describes a B cell lymphoblastic leukemia patient with D acidovorans pneumonia who was successfully treated with antibiotic therapy. The present report indicates that unusual pathogens may be clinically significant in both immunocompromised and immunocompetent patients. D acidovorans is often resistant to aminoglycosides; therefore, rapid detection of this microorganism is important. PMID:26600818

  7. Illustration of the Difficulty of Identifying Streptococcus equi Strains at the Subspecies Level through a Case of Endocarditis in an Immunocompetent Man

    PubMed Central

    Daubié, Anne Sophie; Defrance, Carine; Renvoisé, Aurélie; Barreda, Eleodoro; D'Alessandro, Cosimo; Brossier, Florence; Jarlier, Vincent

    2014-01-01

    We report a case of endocarditis caused by Streptococcus equi in an immunocompetent patient who was subsequently cured after appropriate antibiotherapy and cardiac surgery. However, it was challenging to identify the strain to the subspecies level, which highlights the necessity of developing reliable molecular tools to discriminate between the subspecies. PMID:24478515

  8. Deriving causes of child mortality by re–analyzing national verbal autopsy data applying a standardized computer algorithm in Uganda, Rwanda and Ghana

    PubMed Central

    Liu, Li; Li, Mengying; Cummings, Stirling; Black, Robert E.

    2015-01-01

    Background To accelerate progress toward the Millennium Development Goal 4, reliable information on causes of child mortality is critical. With more national verbal autopsy (VA) studies becoming available, how to improve consistency of national VA derived child causes of death should be considered for the purpose of global comparison. We aimed to adapt a standardized computer algorithm to re–analyze national child VA studies conducted in Uganda, Rwanda and Ghana recently, and compare our results with those derived from physician review to explore issues surrounding the application of the standardized algorithm in place of physician review. Methods and Findings We adapted the standardized computer algorithm considering the disease profile in Uganda, Rwanda and Ghana. We then derived cause–specific mortality fractions applying the adapted algorithm and compared the results with those ascertained by physician review by examining the individual– and population–level agreement. Our results showed that the leading causes of child mortality in Uganda, Rwanda and Ghana were pneumonia (16.5–21.1%) and malaria (16.8–25.6%) among children below five years and intrapartum–related complications (6.4–10.7%) and preterm birth complications (4.5–6.3%) among neonates. The individual level agreement was poor to substantial across causes (kappa statistics: –0.03 to 0.83), with moderate to substantial agreement observed for injury, congenital malformation, preterm birth complications, malaria and measles. At the population level, despite fairly different cause–specific mortality fractions, the ranking of the leading causes was largely similar. Conclusions The standardized computer algorithm produced internally consistent distribution of causes of child mortality. The results were also qualitatively comparable to those based on physician review from the perspective of public health policy. The standardized computer algorithm has the advantage of requiring minimal

  9. Ofuji's disease in an immunocompetent patient successfully treated with dapsone

    PubMed Central

    Anjaneyan, Gopikrishnan; Manne, Sindhura; Panicker, Vinitha Varghese; Eapen, Malini

    2016-01-01

    Eosinophilic pustular folliculitis or Ofuji's disease is a non-infectious eosinophilic infiltration of hair follicles, which usually presents with itchy papules and pustules in a circinate configuration. We report this case of an immunocompetent patient with erythematous papules and plaques without macropustules diagnosed as eosinophilic pustular folliculitis—a rarely reported entity outside Japan. He was successfully treated with oral dapsone. PMID:27730038

  10. Do men’s faces really signal heritable immunocompetence?

    PubMed Central

    2013-01-01

    In the literature on human mate choice, masculine facial morphology is often proposed to be an intersexual signal of heritable immunocompetence, and hence an important component of men’s attractiveness. This hypothesis has received considerable research attention, and is increasingly treated as plausible and well supported. In this article, we propose that the strength of the evidence for the immunocompetence hypothesis is somewhat overstated, and that a number of difficulties have been under-acknowledged. Such difficulties include (1) the tentative nature of the evidence regarding masculinity and disease in humans, (2) the complex and uncertain picture emerging from the animal literature on sexual ornaments and immunity, (3) the absence of consistent, cross-cultural support for the predictions of the immunocompetence hypothesis regarding preferences for masculinized stimuli, and (4) evidence that facial masculinity contributes very little, if anything, to overall attractiveness in real men. Furthermore, alternative explanations for patterns of preferences, in particular the proposal that masculinity is primarily an intrasexual signal, have been neglected. We suggest that immunocompetence perspectives on masculinity, whilst appealing in many ways, should still be regarded as speculative, and that other perspectives–and other traits–should be the subject of greater attention for researchers studying human mate preferences. PMID:23555177

  11. Acute appendicitis due to Cytomegalovirus in an apparently immunocompetent patient: a case report

    PubMed Central

    2014-01-01

    Introduction In healthy subjects, Cytomegalovirus infection can be asymptomatic or manifest as mononucleosis syndrome, but organ disease has also been reported. However, in immunocompromised patients this infection can lead to its most significant and severe disease and even mortality. When Cytomegalovirus causes a gastrointestinal tract infection, it more commonly manifests with luminal tract disease and is usually characterized by ulcerative lesions. Appendicitis is a rare manifestation, and has been reported mainly in human immunodeficiency virus-infected patients or patients with other causes of immunocompromise. Case presentation The authors report on a case of acute primary Cytomegalovirus infection complicated with acute appendicitis due to Cytomegalovirus in an apparently immunocompetent 24-year-old Caucasian man also suffering from primary sclerosing cholangitis and ulcerative colitis. Diagnosis was based on clinical manifestations, serology results, as well as microbiological and histological findings. Treatment consisted of surgery and anti-Cytomegalovirus therapy. Conclusions Cytomegalovirus should be included among the etiologic agents of acute appendicitis in patients with primary sclerosing cholangitis and ulcerative colitis. Currently, there are no definitive data regarding the frequency of Cytomegalovirus appendicitis and the role of anti-Cytomegalovirus treatment in human immunodeficiency virus-negative and apparently immunocompetent subjects. PMID:24612821

  12. Meningitis with polymerase chain reaction for varicella zoster positivity in cerebrospinal flid of a young immunocompetent adult

    PubMed Central

    Gupta, Pooja; Ranjan, Rajeev; Agrawal, C. S.; Muralikrishnan, K; Dave, Nikhil; Rana, Davinder Singh

    2016-01-01

    Meningitis caused by varicella zoster virus (VZV) is quite rare among young immunocompetent adults though immunocompromised patients are often seen to be affected by reactivation of VZV presenting with primary clinical features of dermatomal rashes and neurological sequelae. Here, we report the clinical scenario of a young, healthy male who had presented with fever, headache, and onset of dermatomal rashes later than the fever and was eventually diagnosed to be a case of VZV meningitis. We would like to highlight the fact that even young immunocompetent patients though rarely, might contract VZV meningitis and clinicians should have a high index of suspicion and keen eyes to catch the more obvious features of VZV infection on complete physical examination and must not harbor any reservations in ordering polymerase chain reaction for VZV DNA or initiating aggressive antiviral therapy.

  13. Meningitis with polymerase chain reaction for varicella zoster positivity in cerebrospinal flid of a young immunocompetent adult

    PubMed Central

    Gupta, Pooja; Ranjan, Rajeev; Agrawal, C. S.; Muralikrishnan, K; Dave, Nikhil; Rana, Davinder Singh

    2016-01-01

    Meningitis caused by varicella zoster virus (VZV) is quite rare among young immunocompetent adults though immunocompromised patients are often seen to be affected by reactivation of VZV presenting with primary clinical features of dermatomal rashes and neurological sequelae. Here, we report the clinical scenario of a young, healthy male who had presented with fever, headache, and onset of dermatomal rashes later than the fever and was eventually diagnosed to be a case of VZV meningitis. We would like to highlight the fact that even young immunocompetent patients though rarely, might contract VZV meningitis and clinicians should have a high index of suspicion and keen eyes to catch the more obvious features of VZV infection on complete physical examination and must not harbor any reservations in ordering polymerase chain reaction for VZV DNA or initiating aggressive antiviral therapy. PMID:27695246

  14. Epstein-Barr Virus-Associated Acute Liver Failure Present in a 67-Year-Old Immunocompetent Female

    PubMed Central

    Zhang, Wei; Chen, Betty; Chen, Yongxin; Chamberland, Robin; Fider-Whyte, Alexa; Craig, Julia; Varma, Chintalapati; Befeler, Alex S.; Bisceglie, Adrian M. Di; Horton, Peter; Lai, Jin-Ping

    2016-01-01

    Acute liver failure (ALF) is a rare illness with a high mortality rate. The only favorable management is emergent liver transplantation. About 13% of ALF cases have no clear etiology. Epstein-Barr virus (EBV)-associated ALF accounts for less than 1% of all ALF cases, and is seen mostly in adults younger than 40 years. There are only a few cases of EBV-associated ALF in elderly immunocompromised adults. We report a case of ALF in an immunocompetent 67-year-old woman caused by EBV infection that was treated by orthotopic liver transplantation (OLT). The diagnosis of EBV-associated ALF was established by EBV-DNA polymerase chain reaction (PCR) and EBV-encoded RNA (EBER-RNA) in situ hybridization (EBER-RISH). The patient is currently doing well 6 months after transplantation without any evidence of clinical EBV infection. This case illustrates the importance of early recognition and diagnosis of EBV-associated ALF by detection of EBV from liver biopsy, especially when patients are immunocompetent and other causes are excluded. To the best of our knowledge, this is the first case of EBV-associated ALF present in an immunocompetent elderly female. PMID:27785330

  15. Prototheca wickerhamii as a cause of neuroinfection in a child with congenital hydrocephalus. First case of human protothecosis in Poland.

    PubMed

    Zak, Iwona; Jagielski, Tomasz; Kwiatkowski, Stanisław; Bielecki, Jacek

    2012-10-01

    This report describes a rare case of neuroinfection due to Prototheca wickerhamii in a child with severe, congenital hydrocephalus. The infection resolved completely after the patient was treated with oral ketoconazole, followed by intravenous fluconazole and amphotericin B. A probable source of infection was contamination during ventriculoperitoneal drain care procedures. PMID:22858361

  16. "The environment as a cause of disease in children": Josef Friedjung's transnational influence on modern child welfare theory.

    PubMed

    Danto, Elizabeth Ann

    2013-01-01

    Josef K. Friedjung's Advanced Pediatrics--A Companion to Traditional Textbooks (Erlebte Kinderheilkunde--eine Ergänzung er gebräuchlichen Lehrbucher), published in 1919 in Vienna, has cast a long but nearly-vanished shadow over modern child welfare theory. The originality of his focus on "the whole child" was in some ways a commentary on Sigmund Freud, but its overtly progressive political character gave Friedjung's argument visible applicability within the field of urban social welfare. As a pediatrician and an ardent cosmopolitan, Friedjung was willing to consider conflicting values between traditional family systems and the state. Had the Nazis not forced him into exile in Palestine, where he died in 1946, Friedjung's pioneering oeuvre would have joined our child welfare narrative long ago. Fortunately today archival evidence on which this study draws, fragmented as it is in both German and English, does confirm that the first and second generation psychoanalysts, Friedjung among them, built a mental health movement around a social justice core closely allied to the cultural context of central Europe from 1918 to 1933. In many ways, child welfare as we know it emerged as a practical implementation of that ideology.

  17. Conundrum of Autism: A Review of Its Causes and Significant Impact on the Education of a School Age Child

    ERIC Educational Resources Information Center

    Nwokeafor, Cosmas U.

    2009-01-01

    Autism is a brain development disorder that is characterized by impaired social interaction, communication, restricted and repetitive behavior which starts before a child is three years old. As a result of the outcome of set of signs such as restricted and repetitive behaviors, autism distinguishes itself from milder Autism Spectrum Disorders…

  18. A case of unusual Gram-negative bacilli septic arthritis in an immunocompetent patient.

    PubMed

    Chiu, Li Qi; Wang, Wilson

    2013-08-01

    The Gram-negative bacilli Acinetobacter baumannii, Burkholderia cepacia, Ochrobactrum anthropi, Pseudomonas mendocina, Ralstonia spp., Serratia marcescens and Stenotrophomonas maltophilia are ubiquitous environmental organisms of low virulence, and do not usually cause illness in immunocompetent hosts. We report a case of multiple concurrent opportunistic Gram-negative bacilli causing septic arthritis in a healthy patient following trauma to the knee. Repeated operations, including arthroscopy, arthrotomy and debridement, were required before tissue cultures became negative. The patient also required an extended duration of intravenous and oral antibiotic treatment before he was discharged. Gram-negative bacillary septic arthritis is an uncommon but significant condition that requires repeated debridement and washouts in order to achieve bacterial eradication. This case report highlights the importance of an awareness of the external environment at the time of injury, as it impacts the type of organisms causing the infection, and consequently, the choice of empiric antibiotics required for successful treatment.

  19. Cause-specific mortality among children and young adults with epilepsy: Results from the U.S. National Child Death Review Case Reporting System.

    PubMed

    Tian, Niu; Shaw, Esther C; Zack, Matthew; Kobau, Rosemarie; Dykstra, Heather; Covington, Theresa M

    2015-04-01

    We investigated causes of death in children and young adults with epilepsy by using data from the U.S. National Child Death Review Case Reporting System (NCDR-CRS), a passive surveillance system composed of comprehensive information related to deaths reviewed by local child death review teams. Information on a total of 48,697 deaths in children and young adults 28days to 24years of age, including 551 deaths with epilepsy and 48,146 deaths without epilepsy, was collected from 2004 through 2012 in 32 states. In a proportionate mortality analysis by official manner of death, decedents with epilepsy had a significantly higher percentage of natural deaths but significantly lower percentages of deaths due to accidents, homicide, and undetermined causes compared with persons without epilepsy. With respect to underlying causes of death, decedents with epilepsy had significantly higher percentages of deaths due to drowning and most medical conditions including pneumonia and congenital anomalies but lower percentages of deaths due to asphyxia, weapon use, and unknown causes compared with decedents without epilepsy. The increased percentages of deaths due to pneumonia and drowning in children and young adults with epilepsy suggest preventive interventions including immunization and better instruction and monitoring before or during swimming. State-specific and national population-based mortality studies of children and young adults with epilepsy are recommended.

  20. Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient

    PubMed Central

    Abdel-Rahman, Nader; Izhakain, Shimon; Wasser, Walter G.; Fruchter, Oren; Kramer, Mordechai R.

    2015-01-01

    Nocardiosis is an opportunistic infection caused by the Gram-positive weakly acid-fast, filamentous aerobic Actinomycetes. The lungs are the primary site of infection mainly affecting immunocompromised patients. In rare circumstances even immunocompetent hosts may also develop infection. Diagnosis of pulmonary nocardiosis is usually delayed due to nonspecific clinical and radiological presentations which mimic fungal, tuberculous, or neoplastic processes. The present report describes a rare bronchoscopic presentation of an endobronchial nocardial mass in a 55-year-old immunocompetent woman without underlying lung disease. The patient exhibited signs and symptoms of unresolving community-acquired pneumonia with a computed tomography (CT) scan that showed a space-occupying lesion and enlarged paratracheal lymph node. This patient represents the unusual presentation of pulmonary Nocardia beijingensis as an endobronchial mass. Pathology obtained during bronchoscopy demonstrated polymerase chain reaction (PCR) confirmation of nocardiosis. Symptoms and clinical findings improved with antibiotic treatment. This patient emphasizes the challenge in making the diagnosis of pulmonary nocardiosis, especially in a low risk host. A literature review presents the difficulties and pitfalls in the clinical assessment of such an individual. PMID:26819795

  1. Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient.

    PubMed

    Abdel-Rahman, Nader; Izhakian, Shimon; Wasser, Walter G; Fruchter, Oren; Kramer, Mordechai R

    2015-01-01

    Nocardiosis is an opportunistic infection caused by the Gram-positive weakly acid-fast, filamentous aerobic Actinomycetes. The lungs are the primary site of infection mainly affecting immunocompromised patients. In rare circumstances even immunocompetent hosts may also develop infection. Diagnosis of pulmonary nocardiosis is usually delayed due to nonspecific clinical and radiological presentations which mimic fungal, tuberculous, or neoplastic processes. The present report describes a rare bronchoscopic presentation of an endobronchial nocardial mass in a 55-year-old immunocompetent woman without underlying lung disease. The patient exhibited signs and symptoms of unresolving community-acquired pneumonia with a computed tomography (CT) scan that showed a space-occupying lesion and enlarged paratracheal lymph node. This patient represents the unusual presentation of pulmonary Nocardia beijingensis as an endobronchial mass. Pathology obtained during bronchoscopy demonstrated polymerase chain reaction (PCR) confirmation of nocardiosis. Symptoms and clinical findings improved with antibiotic treatment. This patient emphasizes the challenge in making the diagnosis of pulmonary nocardiosis, especially in a low risk host. A literature review presents the difficulties and pitfalls in the clinical assessment of such an individual.

  2. Susceptibility to disease varies with ontogeny and immunocompetence in a threatened amphibian.

    PubMed

    Abu Bakar, Amalina; Bower, Deborah S; Stockwell, Michelle P; Clulow, Simon; Clulow, John; Mahony, Michael J

    2016-08-01

    Ontogenetic changes in disease susceptibility have been demonstrated in many vertebrate taxa, as immature immune systems and limited prior exposure to pathogens can place less developed juveniles at a greater disease risk. By causing the disease chytridiomycosis, Batrachochytrium dendrobatidis (Bd) infection has led to the decline of many amphibian species. Despite increasing knowledge on how Bd varies in its effects among species, little is known on the interaction between susceptibility and development within host species. We compared the ontogenetic susceptibility of post-metamorphic green and golden bell frogs Litoria aurea to chytridiomycosis by simultaneously measuring three host-pathogen responses as indicators of the development of the fungus-infection load, survival rate, and host immunocompetence-following Bd exposure in three life stages (recently metamorphosed juveniles, subadults, adults) over 95 days. Frogs exposed to Bd as recently metamorphosed juveniles acquired higher infection loads and experienced lower immune function and lower survivorship than subadults and adults, indicating an ontogenetic decline in chytridiomycosis susceptibility. By corresponding with an intrinsic developmental maturation in immunocompetence seen in uninfected frogs, we suggest these developmental changes in host susceptibility in L. aurea may be immune mediated. Consequently, the physiological relationship between ontogeny and immunity may affect host population structure and demography through variation in life stage survival, and understanding this can shape management targets for effective amphibian conservation. PMID:27021312

  3. Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient.

    PubMed

    Abdel-Rahman, Nader; Izhakian, Shimon; Wasser, Walter G; Fruchter, Oren; Kramer, Mordechai R

    2015-01-01

    Nocardiosis is an opportunistic infection caused by the Gram-positive weakly acid-fast, filamentous aerobic Actinomycetes. The lungs are the primary site of infection mainly affecting immunocompromised patients. In rare circumstances even immunocompetent hosts may also develop infection. Diagnosis of pulmonary nocardiosis is usually delayed due to nonspecific clinical and radiological presentations which mimic fungal, tuberculous, or neoplastic processes. The present report describes a rare bronchoscopic presentation of an endobronchial nocardial mass in a 55-year-old immunocompetent woman without underlying lung disease. The patient exhibited signs and symptoms of unresolving community-acquired pneumonia with a computed tomography (CT) scan that showed a space-occupying lesion and enlarged paratracheal lymph node. This patient represents the unusual presentation of pulmonary Nocardia beijingensis as an endobronchial mass. Pathology obtained during bronchoscopy demonstrated polymerase chain reaction (PCR) confirmation of nocardiosis. Symptoms and clinical findings improved with antibiotic treatment. This patient emphasizes the challenge in making the diagnosis of pulmonary nocardiosis, especially in a low risk host. A literature review presents the difficulties and pitfalls in the clinical assessment of such an individual. PMID:26819795

  4. Pneumocystis Infection in an Immunocompetent Host Can Promote Collateral Sensitization to Respiratory Antigens ▿

    PubMed Central

    Swain, Steve D.; Meissner, Nicole; Han, Soo; Harmsen, Allen

    2011-01-01

    Infection with the opportunistic fungal pathogen Pneumocystis is assumed to pass without persistent pathology in immunocompetent hosts. However, when immunocompetent BALB/c mice were inoculated with Pneumocystis, a vigorous Th2-like pulmonary inflammation ensued and peaked at 14 days postinfection. This coincided with a 10-fold increase in the number of antigen-presenting cells (APCs) in the lung, and these cells were capable of presenting antigen in vitro, as well as greater uptake of antigen in vivo. When mice were presented with exogenous antigen at the 14-day time point of the infection, they developed respiratory sensitization to that antigen, in the form of increased airway hyperresponsiveness upon a later challenge, whereas mice not infected but presented with antigen did not. Like other forms of collateral sensitization, this response was dependent on interleukin-4 receptor signaling. This ability to facilitate sensitization to exogenous antigen has been previously reported for other infectious disease agents; however, Pneumocystis appears to be uniquely capable in this respect, as a single intranasal dose without added adjuvant, when it was administered at the appropriate time, was sufficient to initiate sensitization. Pneumocystis infection probably occurs in most humans during the first few years of life, and in the vast majority of cases, it fails to cause any overt direct pathology. However, as we show here, Pneumocystis can be an agent of comorbidity at this time by facilitating respiratory sensitization that may relate to the later development or exacerbation of obstructive airway disease. PMID:21343358

  5. Visceral myopathy causing chronic intestinal pseudoobstruction and intestinal failure in a child with Sanjad-Sakati syndrome.

    PubMed

    Pal, Kamalesh; Moammar, Hissa; Mitra, Dilip K

    2010-02-01

    Sanjad-Sakati syndrome is a rare autosomal recessive disorder mainly occurring in the Arab Peninsula. This condition is associated with metabolic and septic complications starting in the neonatal period. Chronic intestinal pseudoobstruction owing to visceral myopathy is a rare disabling condition. We report a rare concurrence of Sanjad-Sakati syndrome and chronic intestinal pseudoobstruction in a Saudi child complicated by intestinal failure, sepsis, and early mortality. PMID:20152369

  6. Saccharomyces cerevisiae osteomyelitis in an immunocompetent baker.

    PubMed

    Seng, Piseth; Cerlier, Alexandre; Cassagne, Carole; Coulange, Mathieu; Legré, Regis; Stein, Andreas

    2016-01-01

    Invasive infection caused by Saccharomyces cerevisiae is rare. We report the first case of osteomyelitis caused by S. cerevisiae (baker's yeast) in a post-traumatic patient. The clinical outcome was favorable after surgical debridement, prolonged antifungal treatment and hyperbaric oxygen therapy. PMID:27347482

  7. Simultaneous Chronic Invasive Fungal Infection and Tracheal Fungus Ball Mimicking Cancer in an Immunocompetent Patient.

    PubMed

    Çetinkaya, Erdoğan; Çörtük, Mustafa; Gül, Şule; Mert, Ali; Boyacı, Hilal; Çam, Ertan; Dincer, H Erhan

    2016-01-01

    Fungal infections of the lung are uncommon and mainly affect people with immune deficiency. There are crucial problems in the diagnosis and treatment of this condition. Invasive pulmonary aspergillosis and candidiasis are the most common opportunistic fungal infections. Aspergillus species (spp.) are saprophytes molds that exist in nature as spores and rarely cause disease in immunocompetent individuals. In patients with immune deficiency or chronic lung disease, such as cavitary lung disease or bronchiectasis, Aspergillus may cause a variety of aspergillosis infections. Here we present a case of a 57-year-old patient without immunodeficiency or chronic lung disease who was diagnosed with endotracheal fungus ball and chronic fungal infection, possibly due to Aspergillus. Bronchoscopic examination showed a paralyzed right vocal cord and vegetating mass that was yellow in color, at the posterior wall of tracheal lumen. After 3 months, both the parenchymal and tracheal lesions were completely resolved. PMID:27418930

  8. Simultaneous Chronic Invasive Fungal Infection and Tracheal Fungus Ball Mimicking Cancer in an Immunocompetent Patient

    PubMed Central

    Çetinkaya, Erdoğan; Gül, Şule; Mert, Ali; Boyacı, Hilal; Çam, Ertan; Dincer, H. Erhan

    2016-01-01

    Fungal infections of the lung are uncommon and mainly affect people with immune deficiency. There are crucial problems in the diagnosis and treatment of this condition. Invasive pulmonary aspergillosis and candidiasis are the most common opportunistic fungal infections. Aspergillus species (spp.) are saprophytes molds that exist in nature as spores and rarely cause disease in immunocompetent individuals. In patients with immune deficiency or chronic lung disease, such as cavitary lung disease or bronchiectasis, Aspergillus may cause a variety of aspergillosis infections. Here we present a case of a 57-year-old patient without immunodeficiency or chronic lung disease who was diagnosed with endotracheal fungus ball and chronic fungal infection, possibly due to Aspergillus. Bronchoscopic examination showed a paralyzed right vocal cord and vegetating mass that was yellow in color, at the posterior wall of tracheal lumen. After 3 months, both the parenchymal and tracheal lesions were completely resolved. PMID:27418930

  9. Simultaneous Chronic Invasive Fungal Infection and Tracheal Fungus Ball Mimicking Cancer in an Immunocompetent Patient.

    PubMed

    Çetinkaya, Erdoğan; Çörtük, Mustafa; Gül, Şule; Mert, Ali; Boyacı, Hilal; Çam, Ertan; Dincer, H Erhan

    2016-01-01

    Fungal infections of the lung are uncommon and mainly affect people with immune deficiency. There are crucial problems in the diagnosis and treatment of this condition. Invasive pulmonary aspergillosis and candidiasis are the most common opportunistic fungal infections. Aspergillus species (spp.) are saprophytes molds that exist in nature as spores and rarely cause disease in immunocompetent individuals. In patients with immune deficiency or chronic lung disease, such as cavitary lung disease or bronchiectasis, Aspergillus may cause a variety of aspergillosis infections. Here we present a case of a 57-year-old patient without immunodeficiency or chronic lung disease who was diagnosed with endotracheal fungus ball and chronic fungal infection, possibly due to Aspergillus. Bronchoscopic examination showed a paralyzed right vocal cord and vegetating mass that was yellow in color, at the posterior wall of tracheal lumen. After 3 months, both the parenchymal and tracheal lesions were completely resolved.

  10. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    PubMed

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-01-01

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. PMID:27511757

  11. Subcutaneous infection by Ochroconis mirabilis in an immunocompetent patient.

    PubMed

    Shi, Dongmei; Lu, Guixia; Mei, Huan; de Hoog, G Sybren; Samerpitak, Kittipan; Deng, Shuwen; Shen, Yongnian; Liu, Weida

    2016-03-01

    Recently, the taxonomy of Ochroconis (Ascomycota, Pezizomycotina, Venturiales, Sympoventuriaceae) has been revised with the recognition of an additional genus, Verruconis. Ochroconis comprises mesophilic saprobes that occasionally infect vertebrates which mostly are cold-blooded, while Verruconis contains thermophilic species which is a neurotrope in humans and birds. On the basis of molecular data it is noted that only a single Ochroconis species regularly infects immunocompetent human hosts. Here we report a subcutaneous infection due to Ochroconis mirabilis in a 50-year-old immunocompetent female patient. In vitro antifungal susceptibility tests revealed that terbinafine was the most effective drug. The patient was successfully cured with oral administration of terbinafine 250 mg daily in combination with 3 times of topical ALA-photodynamic therapy for 9 months. PMID:27182484

  12. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    PubMed

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-08-10

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids.

  13. Neurologic Disorders in Immunocompetent Patients with Autochthonous Acute Hepatitis E

    PubMed Central

    Perrin, H. Blasco; Cintas, P.; Abravanel, F.; Gérolami, R.; d'Alteroche, L.; Raynal, J.-N.; Alric, L.; Dupuis, E.; Prudhomme, L.; Vaucher, E.; Couzigou, P.; Liversain, J.-M.; Bureau, C.; Vinel, J.-P.; Kamar, N.; Izopet, J.

    2015-01-01

    Neurologic disorders, mainly Guillain-Barré syndrome and Parsonage–Turner syndrome (PTS), have been described in patients with hepatitis E virus (HEV) infection in industrialized and developing countries. We report a wider range of neurologic disorders in nonimmunocompromised patients with acute HEV infection. Data from 15 French immunocompetent patients with acute HEV infection and neurologic disorders were retrospectively recorded from January 2006 through June 2013. The disorders could be divided into 4 main entities: mononeuritis multiplex, PTS, meningoradiculitis, and acute demyelinating neuropathy. HEV infection was treated with ribavirin in 3 patients (for PTS or mononeuritis multiplex). One patient was treated with corticosteroids (for mononeuropathy multiplex), and 5 others received intravenous immunoglobulin (for PTS, meningoradiculitis, Guillain-Barré syndrome, or Miller Fisher syndrome). We conclude that pleiotropic neurologic disorders are seen in HEV-infected immunocompetent patients. Patients with acute neurologic manifestations and aminotransferase abnormalities should be screened for HEV infection. PMID:26490255

  14. A rare cause of cerebral venous thrombosis: cryptococcal meningoencephalitis.

    PubMed

    Senadim, Songul; Alpaydin Baslo, Sezin; Tekin Güveli, Betül; Dedei Daryan, Metin; Kantaroglu, Elif; Ozturk, Oya; Atakli, Dilek

    2016-07-01

    Cryptococcal meningoencephalitis (CM) is a serious central nervous system infection caused by Cryptococcus neoformans, seen mostly in immunocompromised hosts and less in immunocompetent patients. The vast majority of cryptococcosis cases are seen as human immunodeficiency virus infections with advanced immunosuppression. Meningitis and meningoencephalitis are the most common clinical manifestations. Nevertheless, immunocompetent patients with CM are rarely reported. Cerebral venous sinus thrombosis is a rare complication of CM. Here, we report an immunocompetent patient with CM from a non-endemic area, who presented with an acute onset and atypical symptoms associated with cerebral venous thrombosis. PMID:27025504

  15. Asymptomatic “Candidatus Neoehrlichia mikurensis” Infections in Immunocompetent Humans

    PubMed Central

    Siński, Edward; Kowalec, Maciej; Zajkowska, Joanna; Pancewicz, Sławomir A.

    2014-01-01

    In Europe, human infections with “Candidatus Neoehrlichia mikurensis” have mainly been restricted to immunocompromised patients. We report here the first cases of asymptomatic “Ca. Neoehrlichia mikurensis” infection in immunocompetent humans (5/316 [1.6%] were infected). Due to the potential threats of infections with “Ca. Neoehrlichia mikurensis” in healthy persons to the safety of the blood supply, further study of this phenomenon is required. PMID:24899023

  16. Asymptomatic "Candidatus Neoehrlichia mikurensis" infections in immunocompetent humans.

    PubMed

    Welc-Falęciak, Renata; Siński, Edward; Kowalec, Maciej; Zajkowska, Joanna; Pancewicz, Sławomir A

    2014-08-01

    In Europe, human infections with "Candidatus Neoehrlichia mikurensis" have mainly been restricted to immunocompromised patients. We report here the first cases of asymptomatic "Ca. Neoehrlichia mikurensis" infection in immunocompetent humans (5/316 [1.6%] were infected). Due to the potential threats of infections with "Ca. Neoehrlichia mikurensis" in healthy persons to the safety of the blood supply, further study of this phenomenon is required. PMID:24899023

  17. Septic arthritis in immunocompetent and immunosuppressed hosts.

    PubMed

    Wang, Dingyuan Alvin; Tambyah, Paul Anantharajah

    2015-04-01

    Septic arthritis has long been considered an orthopedic emergency. Historically, Neisseria gonorrhoeae and Staphylococcus aureus have been the most common causes of septic arthritis worldwide but in the modern era of biological therapy and extensive use of prosthetic joint replacements, the spectrum of microbiological causes of septic arthritis has widened considerably. There are also new approaches to diagnosis but therapy remains a challenge, with a need for careful consideration of a combined medical and surgical approach in most cases.

  18. Vaccination and all-cause child mortality from 1985 to 2011: global evidence from the Demographic and Health Surveys.

    PubMed

    McGovern, Mark E; Canning, David

    2015-11-01

    Based on models with calibrated parameters for infection, case fatality rates, and vaccine efficacy, basic childhood vaccinations have been estimated to be highly cost effective. We estimated the association of vaccination with mortality directly from survey data. Using 149 cross-sectional Demographic and Health Surveys, we determined the relationship between vaccination coverage and the probability of dying between birth and 5 years of age at the survey cluster level. Our data included approximately 1 million children in 68,490 clusters from 62 countries. We considered the childhood measles, bacillus Calmette-Guérin, diphtheria-pertussis-tetanus, polio, and maternal tetanus vaccinations. Using modified Poisson regression to estimate the relative risk of child mortality in each cluster, we also adjusted for selection bias that resulted from the vaccination status of dead children not being reported. Childhood vaccination, and in particular measles and tetanus vaccination, is associated with substantial reductions in childhood mortality. We estimated that children in clusters with complete vaccination coverage have a relative risk of mortality that is 0.73 (95% confidence interval: 0.68, 0.77) times that of children in a cluster with no vaccinations. Although widely used, basic vaccines still have coverage rates well below 100% in many countries, and our results emphasize the effectiveness of increasing coverage rates in order to reduce child mortality.

  19. Non-healing genital herpes mimicking donovanosis in an immunocompetent man.

    PubMed

    Gupta, Vishal; Khute, Prakash; Patel, Anjali; Gupta, Somesh

    2016-01-01

    Although atypical presentations of herpetic infection in immunocompetent individuals are common, they very rarely have the extensive, chronic and verrucous appearances seen in the immunocompromised host. We report a case of genital herpes manifesting as painless chronic non-healing genital ulcers with exuberant granulation tissue in an immunocompetent man. Owing to this morphology, the ulcers were initially mistaken for donovanosis. To the best of our knowledge, such a presentation of genital herpes in an immunocompetent individual has not been described previously.

  20. Recurrent abscesses due to Finegoldia magna, Dermabacter hominis and Staphylococcus aureus in an immunocompetent patient.

    PubMed

    Martin, J; Bemer, P; Touchais, S; Asseray, N; Corvec, S

    2009-10-01

    A case of recurrent abscesses in an immunocompetent patient is reported, involving the opportunistic human pathogen Dermabacter hominis, the virulent anaerobic pathogen Finegoldia magna and Staphylococcus aureus.

  1. In kittiwakes food availability partially explains the seasonal decline in humoral immunocompetence

    USGS Publications Warehouse

    Gasparini, J.; Roulin, A.; Gill, V.A.; Hatch, Shyla A.; Boulinier, T.

    2006-01-01

    1. The immune system plays an important role in fitness, and interindividual variation in immunocompetence is due to several factors including food supply. 2. Seasonal variation in food resources may therefore explain why immunocompetence in bird nestlings usually declines throughout the breeding season, with chicks born early in the season receiving more food than chicks born later, and thereby possibly developing a more potent immune system. Although there are studies supporting this hypothesis, none has been experimental. 3. We performed an experiment in the kittiwake Rissa tridactyla by manipulating the food supply of pairs that were left to produce a first brood, and of pairs that were induced to produce a late replacement brood. 4. If food supply mediates, at least partially, seasonal variations in chick immunocompetence, non-food-supplemented chicks would show a stronger seasonal decline in immunocompetence than food-supplemented chicks. 5. Food supplementation improved humoral immunocompetence (the production of immunoglobulins Y), but not T-cell immunocompetence (phytohaemagglutinin, PHA response). T-cell immunocompetence of food-supplemented and non-food- supplemented chicks decreased through the season but to a similar extent, whereas the humoral immunocompetence of non-food-supplemented chicks decreased more strongly than that of food-supplemented chicks. 6. Our results suggest that the seasonal decline in humoral immunocompetence can be explained, at least partly, by variations in food supply throughout the breeding season. ?? 2006 British Ecological Society.

  2. Fibrolipomatous hamartoma of the median nerve: A cause of acute bilateral carpal tunnel syndrome in a three-year-old child: A case report and comprehensive literature review

    PubMed Central

    Senger, Jenna-Lynn; Classen, Dale; Bruce, Garth; Kanthan, Rani

    2014-01-01

    A three-year-old boy was investigated for inexplicable incessant crying. On examination, his left wrist was mildly swollen (three to four months) and sensitive. Exploration and carpal tunnel decompression of the left wrist with incisional biopsy was performed for the presence of a fusiform swelling intimately associated with the median nerve. Histopathology revealed the presence of enlarged nerve bundles admixed with mature fat cells and diffuse fibroblastic proliferation. Three months later, he underwent urgent contralateral carpal tunnel decompression for a similar presentation. The final diagnosis was bilateral fibrolipomatous hamartoma (FLH) of the median nerves causing acute bilateral compression neuropathy. FLH of the median nerve is an extremely unusual cause of acute bilateral carpal tunnel syndrome in a young child presenting with ‘incessant crying’. A comprehensive review of FLH including epidemiology, etiology, clinical presentation, differential diagnosis, imaging, pathology, treatment and prognosis is discussed. PMID:25332651

  3. Strongyloidiasis in the immunocompetent: an overlooked infection

    PubMed Central

    Tachamo, Niranjan; Nazir, Salik; Lohani, Saroj; Karmacharya, Paras

    2016-01-01

    Strongyloidiasis is a parasitic infestation caused by Strongyloides stercoralis. Most cases are asymptomatic; however, symptomatic patients may present with a wide range of non-specific cutaneous, pulmonary, or gastrointestinal symptoms posing a diagnostic dilemma and delay in diagnosis. We report a case of a 58-year-old female who presented with months of generalized pruritus and abdominal discomfort along with persistent eosinophilia due to strongyloidiasis, which completely resolved with treatment. PMID:27609726

  4. Strongyloidiasis in the immunocompetent: an overlooked infection.

    PubMed

    Tachamo, Niranjan; Nazir, Salik; Lohani, Saroj; Karmacharya, Paras

    2016-01-01

    Strongyloidiasis is a parasitic infestation caused by Strongyloides stercoralis. Most cases are asymptomatic; however, symptomatic patients may present with a wide range of non-specific cutaneous, pulmonary, or gastrointestinal symptoms posing a diagnostic dilemma and delay in diagnosis. We report a case of a 58-year-old female who presented with months of generalized pruritus and abdominal discomfort along with persistent eosinophilia due to strongyloidiasis, which completely resolved with treatment. PMID:27609726

  5. DISSEMINATED REFRACTARY TUBERCULOSIS WITH BICEPS TENDON INVOLVEMENT IN AN IMMUNOCOMPETENT PATIENT

    PubMed Central

    dos Reis Oliveira, Marcelo; Schiefer, Márcio; da Silva, Marcos Britto; Fontenelle, César; Júnior, Yonder Archanjo Ching-San; Franco, José Sérgio

    2015-01-01

    Objective: The authors report a rare case of disseminated tuberculosis which had compromised the long head of biceps tendon and shoulder joint, during standard drug therapy. Methods: On a first sight, the accurate diagnosis wasn't accomplished and the patient had been treated with physiotherapy for rotator cuff tear. However, the patient presented with a fast growing mass in anterior region of the proximal third of the arm, complaining of pain increase. Aspirative punction of the mass revealed a yellow fluid and the laboratorial analysis confirmed infection by M. Tuberculosis. The patient was treated with surgical debridement and his drug therapy was changed. Results: Resolution of infectious status and complete shoulder function restoration was succeeded. Conclusion: Due to its high prevalence in Brazil, tuberculosis must always be considered as a possible cause of inflammatory joint disease, even in immunocompetent patients. PMID:27004180

  6. Polymorphisms in cytomegalovirus genotype in immunocompetent patients with corneal endotheliitis or iridocyclitis.

    PubMed

    Oka, Naoko; Suzuki, Takashi; Inoue, Tomoyuki; Kobayashi, Takeshi; Ohashi, Yuichi

    2015-08-01

    Cytomegalovirus (CMV) that caused corneal endotheliitis and iridocyclitis in immunocompetent patients was genotyped. The gB type1 was detected in seven endotheliitis samples (77.8%) and five iridocyclitis samples (100%), and the gB type 3 was detected in two endotheliitis samples (22.2%). The UL144 type 1 was found in five endotheliitis samples (45.5%) and five iridocyclitis samples (83.3%). The UL144 type 2 was found in two endotheliitis samples (18.2%) and one iridocyclitis sample (16.7%). The gB type 1 was predominant in endotheliitis and iridocyclitis, and the CMV genotypes in eyes with endotheliitis and iridocyclitis were similar.

  7. Propionibacterium Acnes Brain Abscess in an Immunocompetent Man in the Absence of Prior Neurosurgery.

    PubMed

    Odunukan, Olufunso W; Masannat, Fares; Baka, J Jeff

    2016-02-01

    Propionibacterium acnes is a rare, but established, cause of intracranial abscesses. We describe a case of P. acnes brain abscess in an immunocompetent man without prior neurosurgery. A 49-year old man with mild psoriasis presented with a two-week history of gait changes, generalized weakness and a two-day history of headaches, aphasia and confusion. Imaging revealed a left thalamic mass and surgical biopsy suggested a pyogenic abscess. Cultures of biopsy samples of the abscess grew P. acnes alone. MRI and serial neurological exam showed marked clinical improvement with intravenous antibiotics. The significant reduction in the abscess was sustained on MRI obtained at six weeks after completion of antibiotic therapy. In conclusion, P. acnes must be considered as a differential diagnosis in individuals presenting with features suggestive of a brain abscess even in the absence of immunosuppression or previous neurosurgery. PMID:26999913

  8. Genetic characterization of a novel G3P[14] rotavirus strain causing gastroenteritis in 12 year old Australian child.

    PubMed

    Donato, Celeste M; Manuelpillai, Nicholas M; Cowley, Daniel; Roczo-Farkas, Susie; Buttery, Jim P; Crawford, Nigel W; Kirkwood, Carl D

    2014-07-01

    A genotype G3P[14] rotavirus strain was identified in a 12year old child presenting to the Emergency Department of the Royal Children's Hospital, Melbourne, with gastroenteritis. G3P[14] strains have been previously identified in rabbits in Japan, China, the USA and Italy and a single lapine-like strain from a child in Belgium. Full genome sequence analysis of RVA/Human-wt/AUS/RCH272/2012/G3P[14] (RCH272) revealed that the strain contained the novel genome constellation G3-P[14]-I2-R3-C3-M3-A9-N2-T6-E2-H3. The genome was genetically divergent to previously characterized lapine viruses and the genes were distantly related to a range of human bovine-like strains and animal strains of bovine, bat and canine/feline characteristics. The VP4, VP6, NSP2, NSP3, NSP4 and NSP5 genes of RCH272 clustered within bovine lineages in the phylogenetic analysis and shared moderate genetic similarity with an Australian bovine-like human strain RVA/Human-tc/AUS/MG6/1993/G6P[14]. Bayesian coalescent analysis suggested these genes of RCH272 and RVA/Human-tc/AUS/MG6/1993/G6P[14] were derived from a population of relatively homogenous bovine-like ancestral strains circulating between 1943 and 1989. The VP7, VP1, VP2 and NSP1 genes shared moderate genetic similarity with the Chinese strain RVA/Bat-tc/CHN/MSLH14/2011/G3P[3] and the VP3 gene clustered within a lineage comprised of canine and feline strains. This strain may represent the direct transmission from an unknown host species or be derived via multiple reassortment events between strains originating from various species. The patient lived in a household containing domesticated cats and dogs and in close proximity to a colony of Gray-headed Flying-foxes. However, without screening numerous animal populations it is not possible to determine the origins of this strain. PMID:24780429

  9. Cytodiagnosis of disseminated histoplasmosis in an immunocompetent individual with molluscum contagiosum-like skin lesions and lymphadenopathy

    PubMed Central

    Gupta, Prajwala; Bhardwaj, Minakshi

    2016-01-01

    Disseminated histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum (H. capsulatum). The early clinical manifestations are nonspecific, often lead to diagnostic difficulty, and is misdiagnosed as tuberculosis and seen usually in immunosuppressed states. Fine needle aspiration cytology (FNAC) is a simple, safe, and quick technique to establish the initial diagnosis of H. capsulatum, thereby prompting early treatment. The skin involvement is rare in disseminated disease and we describe a case of disseminated histoplasmosis in an immunocompetent patient with unusual molluscum contagiosum like umbilicated skin lesions and FNAC of the cervical lymph node was the only tool for rapid and early confirmatory diagnosis.

  10. Pancreatic Candidiasis That Mimics a Malignant Pancreatic Cystic Tumor on Magnetic Resonance Imaging: A Case Report in an Immunocompetent Patient.

    PubMed

    Seong, Minjung; Kang, Tae Wook; Ha, Sang Yun

    2015-01-01

    Candida is a commensal organism that is frequently found in the human gastrointestinal tract. It is the most common organism that causes pancreatic fungal infections. However, magnetic resonance imaging findings of Candida infection in the pancreas have not been described. We report imaging findings of pancreatic candidiasis in a patient in immunocompetent condition. It presented as a multi-septated cystic mass with a peripheral solid component in the background of pancreatitis and restricted diffusion on diffusion-weighted image that mimicked a malignant pancreatic cystic tumor.

  11. Treatment of experimental pneumonia due to penicillin-resistant Streptococcus pneumoniae in immunocompetent rats.

    PubMed Central

    Gavaldà, J; Capdevila, J A; Almirante, B; Otero, J; Ruiz, I; Laguarda, M; Allende, H; Crespo, E; Pigrau, C; Pahissa, A

    1997-01-01

    A model of pneumonia due to Streptococcus pneumoniae resistant to penicillin was developed in immunocompetent Wistar rats and was used to evaluate the efficacies of different doses of penicillin, cefotaxime, cefpirome, and vancomycin. Adult Wistar rats were challenged by intratracheal inoculation with 3 x 10(9) CFU of one strain of S. pneumoniae resistant to penicillin (MICs of penicillin, cefotaxime, cefpirome, and vancomycin, 2, 1, 0.5, and 0.5 microg/ml, respectively) suspended in brain heart broth supplemented with 0.7% agar. The rats experienced a fatal pneumonia, dying within 5 days and with peak mortality (70 to 80%) occurring 48 to 72 h after infection, and the bacterial counts in the lungs persisted from 8.87 +/- 0.3 log10 CFU/g of lung at 24 h of the infection to 9.1 +/- 0.3 log10 CFU/g at 72 h. Four hours after infection the animals were randomized into the following treatment groups: (i) control without treatment, (ii) penicillin G at 100,000 IU/kg of body weight every 2 h, (iii) penicillin G at 250,000 IU/kg every 2 h, (iv) cefotaxime at 100 mg/kg every 2 h, (v) cefpirome at 200 mg/kg every 2 h, and (vi) vancomycin at 50 mg/kg every 8 h. Two different protocols were used for the therapeutic efficacy studies: four doses of beta-lactams and one dose of vancomycin or eight doses of beta-lactams and two doses of vancomycin. Results of the therapy for experimental pneumonia caused by penicillin-resistant S. pneumoniae showed that initially, all the antimicrobial agents tested had similar efficacies, but when we prolonged the treatment, higher doses of penicillin, cefotaxime, and cefpirome were more effective than penicillin at lower doses in decreasing the residual bacterial titers in the lungs. Also, when we extended the treatment, vancomycin was more efficacious than penicillin at lower doses but was less efficacious than higher doses of penicillin or cefpirome. The model that we have developed is simple and amenable for inducing pneumonia in

  12. Cutaneous tuberculosis revealing multifocal tuberculosis in immunocompetent patients.

    PubMed

    Amraoui, N; Krich, S; Meziane, M; Gallouj, S; Abid, H; Elmrini, A; Moumna, K; Harmouch, T; Mernissi, F

    2015-09-01

    Multifocal tuberculosis (TB) is rare. It occurs especially in immunocompromised patients. Association with skin involvement is rarer, and few cases are reported in the literature. The present study reports 7 cases of multifocal TB with cutaneous localization in immunocompetent patients. Cutaneous forms of TB included in this series are: gummas, scrofuloderma, vasculitis TB and lupus TB. The patients had at least two extra skin locations, namely: osteoarticular, lung, pleural, scrotal, muscular, digestive, laryngeal, nodal and splenic locations. These patients had no context of immunosuppression which is uncommon, but should be kept in mind, especially in endemic countries. PMID:27649875

  13. Immunologic studies in Holstein-Friesian cattle: an immunocompetence profile.

    PubMed

    Kateley, J R; Bazzell, S J

    1978-10-01

    An immunocompetence profile has been developed for Holstein-Friesian cattle. In vitro and in vivo immunoassays were used to determine (1) the percentage of peripheral blood lymphocyte (PBL) subpopulations bearing surface-membrane receptors for sheep erythrocytes, complement, or surface immunoglobulin; (2) the PBL blastogenic response to leukoagglutinin, concanavalin A, or pokeweed mitogen, (3) the serum immunoglobulin concentrations of IgG, IgM, and IgA, (4) the humoral antibody response to keyhole limpet hemocyanin, and (5) the in vitro blastogenic response and in vivo delayed hypersensitivity skin reaction to purified protein derivative in cattle immunized with BCG. PMID:362996

  14. Risk Factors for Sporadic Cryptosporidiosis among Immunocompetent Persons in the United States from 1999 to 2001

    PubMed Central

    Roy, Sharon L.; DeLong, Stephanie M.; Stenzel, Sara A.; Shiferaw, Beletshachew; Roberts, Jacquelin M.; Khalakdina, Asheena; Marcus, Ruthanne; Segler, Suzanne D.; Shah, Dipti D.; Thomas, Stephanie; Vugia, Duc J.; Zansky, Shelley M.; Dietz, Vance; Beach, Michael J.

    2004-01-01

    Many studies have evaluated the role of Cryptosporidium spp. in outbreaks of enteric illness, but few studies have evaluated sporadic cryptosporidiosis in the United States. To assess the risk factors for sporadic cryptosporidiosis among immunocompetent persons, a matched case-control study was conducted in seven sites of the Foodborne Diseases Active Surveillance Network (FoodNet) involving 282 persons with laboratory-identified cryptosporidiosis and 490 age-matched and geographically matched controls. Risk factors included international travel (odds ratio [OR] = 7.7; 95% confidence interval [95% CI] = 2.7 to 22.0), contact with cattle (OR = 3.5; 95% CI = 1.8 to 6.8), contact with persons >2 to 11 years of age with diarrhea (OR = 3.0; 95% CI = 1.5 to 6.2), and freshwater swimming (OR = 1.9; 95% CI = 1.049 to 3.5). Eating raw vegetables was protective (OR = 0.5; 95% CI = 0.3 to 0.7). This study underscores the need for ongoing public health education to prevent cryptosporidiosis, particularly among travelers, animal handlers, child caregivers, and swimmers, and the need for further assessment of the role of raw vegetables in cryptosporidiosis. PMID:15243043

  15. Direct Invasion of the Optic Nerves, Chiasm, and Tracts by Cryptococcus neoformans in an Immunocompetent Host

    PubMed Central

    Gaines, Nathan; Baradaran, Hediyeh; Schuetz, Audrey N.; Lavi, Ehud; Simpson, Sara A.; Dinkin, Marc J.

    2015-01-01

    Cryptococcus spp is a common fungal infection and frequent cause of meningitis in immunocompromised patients; however, immunocompetent patients are also at risk of infection. Visual loss often occurs via elevated intracranial hypertension but can rarely occur through direct optic nerve, chiasm, or tract invasion. We report a case of a 38-year-old woman who presented with decreased acuity in both eyes. She had generalized visual field constriction in the right eye and temporal hemianopsia in the left eye. Magnetic resonance imaging of the brain and orbits showed multiple areas of ill-defined enhancement in the optic chiasm and tracts as well as in the diaphragmatic sella, prepontine and interpeduncular cisterns, and along cranial nerves VI, VII, and VIII bilaterally. Initial cerebrospinal fluid (CSF) showed 34 white blood cells, hypoglycorrhachia, and negative cryptococcal antigen and bacterial and fungal cultures. A transphenoidal biopsy of the dura and pituitary gland was unremarkable. Empiric steroids resulted in marked improvement in visual acuity in both eyes, but while tapering steroids, she developed rapid visual loss bilaterally. Repeat CSF performed 6 weeks later demonstrated a cryptococcal antigen titer of 1:512. Retroactive staining of the pituitary biopsy was positive for mucicarmine, a component of the polysaccharide capsule of Cryptococcus spp. After induction therapy with amphotericin B and flucytosine and 1 year of fluconazole, her visual acuity was 20/20 in both eyes. In summary, Cryptococcus can affect immunocompetent patients and often presents with insidious, chronic meningitis. Visual loss is common in cryptococcal meningitis but usually results from fulminant papilledema related to elevated intracranial pressure. In rare cases, direct nerve or chiasm infiltration by the fungus results in vision loss. PMID:26425249

  16. Calling rate, corticosterone plasma levels and immunocompetence of Hypsiboas albopunctatus.

    PubMed

    Titon, Stefanny Christie Monteiro; de Assis, Vania Regina; Titon, Braz; Barsotti, Adriana Maria Giorgi; Flanagan, Sarah Perry; Gomes, Fernando Ribeiro

    2016-11-01

    During the breeding season, male anuran amphibians produce advertisement calls. Androgens play a permissive role in the activation of calling activity, which is often positively correlated to androgen plasma levels and testes mass. Additionally, calling effort is also correlated to corticosterone plasma levels (hereinafter referred to as CORT), which is associated with the mobilization of energy substrates to sustain the high energy flux associated with this activity. However, high CORT also has many immunosuppressive effects and might interfere with reproduction. Consequently, CORT might mediate a compromise between reproductive effort and immunocompetence in anurans. In the present study, we investigated the relationship between calling rate, immunocompetence, and CORT in Hypsiboas albopunctatus, a midsize anuran occurring in South America. To understand these relationships, we conducted focal observations of calling behavior, followed by blood collection for CORT measurements and evaluation of some immune parameters. Our results showed that individuals with larger testes had higher calling rates, and those with higher calling rates showed lower cell-mediated immune response (swelling response to phytohaemagglutinin), although these relationships were not mediated by CORT. Furthermore, males calling early in the evening showed high CORT, and individuals with lower body condition index had higher CORT. We conclude that calling activity shows a cost in terms of cellular immune response in H. albopunctatus, but this compromise does not appear to be mediated by glucocorticoid plasma levels. PMID:27364933

  17. Song predicts immunocompetence in male European starlings (Sturnus vulgaris).

    PubMed Central

    Duffy, Deborah L; Ball, Gregory F

    2002-01-01

    According to the immunocompetence handicap hypothesis, sexually selected characteristics predict immune function and this relationship is mediated by testosterone. In the present study, we investigated whether bird song could predict immunity in European starlings (Sturnus vulgaris). We recorded the singing and reproductive behaviours of 16 adult male starlings in an outdoor aviary and then assessed their cell-mediated and humoral immunity in vivo. The males were observed in groups of four for 2 h each day over a 4-day period. For each male, the number of songs produced was recorded and the average song-bout length was computed. Next, cell-mediated and humoral immunity were assessed via cutaneous swelling responses to the T-cell mitogen phytohaemagglutinin and antibody responses to a novel antigen, keyhole limpet haemocyanin. Song rate and song-bout length were positively correlated with cell-mediated and humoral immunity, respectively. Additionally, a negative relationship between plasma testosterone concentration and antibody response was observed. These data demonstrate that male starling song can be used as a predictor of immunocompetence, with more robust singers exhibiting enhanced immunity. Whether this relationship is mediated directly by testosterone requires further investigation. PMID:11958717

  18. Severe Acquired Toxoplasmosis in Immunocompetent Adult Patients in French Guiana

    PubMed Central

    Carme, B.; Bissuel, F.; Ajzenberg, D.; Bouyne, R.; Aznar, C.; Demar, M.; Bichat, S.; Louvel, D.; Bourbigot, A. M.; Peneau, C.; Neron, P.; Dardé, M. L.

    2002-01-01

    The most common presentation of symptomatic postnatally acquired toxoplasmosis in immunocompetent patients is painless cervical adenopathy. Acute visceral manifestations are associated in rare cases. We report 16 cases of severe primary toxoplasmosis diagnosed in French Guiana during a 6.5-year period. All of the subjects were immunocompetent adults hospitalized with clinical presentations consisting of a marked, nonspecific infectious syndrome accompanied by an altered general status with at least one visceral localization, mainly pulmonary involvement (14 cases). Acute toxoplasmosis was diagnosed according to the results of serological tests suggestive of recent primary infection and the absence of an alternative etiology. Recovery was rapid following specific antitoxoplasmosis treatment. Thirteen of the 16 patients had consumed game in the 2 weeks before the onset of the symptoms, and in eight cases the game was considered to have been undercooked. Toxoplasma strains, which were virulent in mice, were isolated from three patients. Microsatellite analysis showed that all of these isolates exhibited an atypical multilocus genotype, with one allele found only for isolates of this region. PMID:12409371

  19. Pulpal regeneration after cavity preparation, with special reference to close spatio-relationships between odontoblasts and immunocompetent cells.

    PubMed

    Ohshima, Hayato; Nakakura-Ohshima, Kuniko; Takeuchi, Kiichi; Hoshino, Masaaki; Takano, Yoshiro; Maeda, Takeyasu

    2003-04-01

    The regeneration process of the odontoblast cell layer incident to tooth injury, especially its relationship with immunocompetent cells in pulp healing, has not been fully understood. The purpose of the present study was to clarify this relationship between odontoblasts and immunocompetent cells in the process of pulp regeneration following cavity preparation in rat molars by immunocytochemistry for heat shock protein (Hsp) 25 as well as class II major histocompatibility complex (MHC) molecules. In untreated control teeth, intense Hsp 25-immunoreactivity was found in the cell bodies of odontoblasts and their processes within the predentin, whereas class II MHC-positive cells were predominantly located beneath the odontoblast cell layer. Cavity preparation caused the destruction of the odontoblast layer to form an edematous lesion and the shift of class II MHC-positive cells with the injured odontoblasts toward the pulp core at the affected site. Some damaged odontoblasts without apparent cytoplasmic processes, round in profile, retained the immunoreactivity for Hsp25, suggesting the survival of a part of the odontoblasts against artificial external stimuli. Twelve hours after cavity preparation, numerous class II MHC-positive cells appeared along the pulp-dentin border and extended their processes deep into the exposed dentinal tubules. By postoperative 72 hours, newly differentiated odontoblasts with Hsp 25-immunoreactivity were arranged at the pulp-dentin border, but the class II MHC-positive cells moved from the pulp-dentin border to the subodontoblastic layer. These findings indicate that the time course of changes in the expression of Hsp 25-immunoreactivity reflects the regeneration process of odontoblasts. The functional roles of Hsp 25-positive odontoblasts and immunocompetent cells such as class II MHC-positive cells in the process of pulp regeneration after cavity preparation are discussed in conjunction with our previous experimental data.

  20. Multiple skin ulcers due to Serratia marcescens in a immunocompetent patient.

    PubMed

    Carlesimo, M; Pennica, A; Muscianese, M; Bottoni, U; Abruzzese, C; Giubettini, M; Pranteda, G; Pranteda, G

    2014-06-01

    Serratia marcescens is a species of gram negative bacillus, classified as a member of the Enterobacteriaceae, mainly involved in opportunistic infections, particulary in the hospital environment. Cutaneous infections have rarely reported in literature and are predominantly observed in elderly or in immunocompromised patients. The clinical manifestations of skin infections include granulomatous lesions, necrotizing fasciitis, nodules, cellulitis, ulcers, dermal abscesses. Infections caused by S. marcescens may be difficult to treat because of resistance to a variety of antibiotics, including ampicillin and first and second generation cephalosporins. Aminoglycosides have good activity against S. marcescens, but resistant strains have also been described. We report a very intriguing case of S. marcescens infection, in an immunocompetent 18-year-old man, causing multiple rounded ulcers of varying sizes, along with few pustular lesions that both clinically and histopathologically mimic a pyoderma gangrenosum (PG). This is a non infectious neutrophilic skin disorder, characterized by painful and rapidly progressing skin ulceration. According to our experience, we would strongly recommend to perform cultures of multiple skin ulcers resembling PG, even in young healthy patients, to ensure correct diagnosis and treatment, since resistant to conventional antibiotics bacteria such as S. marcescens may be the cause of these lesions, like in the case here reported.

  1. Ocular toxoplasmosis: a very rare presentation in an immunocompetent patient

    PubMed Central

    Matias, Margarida; Gomes, Antonia; Marques, Tiago; Fonseca, Ana Claudia

    2014-01-01

    A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye. The ophthalmological examination revealed hypertensive non-granulomatous panuveitis, retinal vasculitis with focus of retinochoroiditis with pigmented central area suggestive of ocular toxoplasmosis in the active phase. He started treatment with azithromycin, pyrimethamine, topical steroids and measures for control of intraocular pressure. Serology for Toxoplasma gondii was positive and for HIV, negative. For headache and vomiting, he was hospitalised in order to exclude cerebral toxoplasma. The cerebral CT scan, MRI and lumbar puncture were negative and treatment was changed to pyrimethamine, sulfadiazine and prednisolone. For persistence of vomiting he started clindamycin with clinical and ophthalmological improvement. The patient is currently under prophylaxis with co-trimoxazol for 1 year, and maintains clinical improvement. This case illustrates the rarity of presentation of ocular toxoplasmosis, without cerebral in an immunocompetent patient. PMID:25270156

  2. Acute, Severe Cryptosporidiosis in an Immunocompetent Pediatric Patient

    PubMed Central

    Tallant, Caitlin; Huddleston, Patrick; Alshanberi, Asim

    2016-01-01

    Severe diarrheal illness in children can be attributed to a number of different microbiological agents. Without appropriate microbiological testing of stool samples, patients who present with multiple days of severe diarrhea might have a delay in proper diagnosis and treatment. Here, we report a case of an immunocompetent pediatric patient presenting with acute cryptosporidiosis. Humans and bovine species are known hosts of cryptosporidium and several studies have evaluated the zoonotic transmission of cryptosporidium from cattle to humans. Adding diagnostic tests for cryptosporidium like Ziehl-Neelsen staining of stool or fecal rapid antigen detection techniques should be considered in the workup of patients presenting with undifferentiated, severe diarrheal illness, especially in those who have close contact with livestock. PMID:27478580

  3. Serratia marcescens endogenous endophthalmitis in an immunocompetent host.

    PubMed

    Memon, Muhammad; Raman, Vasant

    2016-01-01

    A systemically well 66-year-old white Caucasian man presented to the urgent care department with a short history of progressive pain and blurring of vision in his left eye. He denied a history of trauma, intraocular surgery or use of illicit drugs. He was diagnosed with endogenous endophthalmitis. Vitreous biopsy grew Serratia marcescens, a Gram negative bacteria. In spite of extensive investigation, there was no obvious source of infection. He had an indwelling urine catheter for prostate hypertrophy, but urine culture was negative. There was no evidence of immunocompromise. He was treated with systemic as well as intravitreal antibiotics. In spite of appropriate treatment, the patient lost vision. S. marcescens endophthalmitis, seen even in immunocompetent people, carries a poor visual prognosis. PMID:26791115

  4. Bacillary angiomatosis with atypical clinical presentation in an immunocompetent patient.

    PubMed

    Bernabeu-Wittel, J; Luque, R; Corbi, R; Mantrana-Bermejo, M; Navarrete, M; Vallejo, A; Bernabeu-Wittel, M

    2010-01-01

    Bacillary angiomatosis is a recently described infectious disease that usually affects immunosupressed hosts with a previous history of contact with cats. We report a rare case of bacillary angiomatosis in an immunocompetent 59-year-old woman with no history of previous exposure to cats, and atypical clinical features (fever and subcutaneous nodules with ulceration on the left ankle). Histopathology of the lesion showed extensive ulceration and reactive tumor-like vascular proliferation of the blood vessels with swollen endothelial cells and an inflammatory infiltrate including neutrophils and lymphocytes in the dermis and subcutis. Staining with the Warthin-Starry method demonstrated the presence of clustered bacilli located in the extracellular matrix adjacent to the proliferating endothelial cells. Diagnosis was confirmed with the detection of Bartonella spp. DNA in the affected skin and in bone marrow using polymerase chain reaction.

  5. Visceral leishmaniasis with endobronchial involvement in an immunocompetent adult.

    PubMed

    Kotsifas, Konstantinos; Metaxas, Eugenios; Koutsouvelis, Ioannis; Skoutelis, Athanassios; Kara, Panayiota; Tatsis, George

    2011-01-01

    Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement. PMID:21577261

  6. Invasive Pulmonary Aspergillosis with Disseminated Infection in Immunocompetent Patient

    PubMed Central

    Moreno-González, Gabriel; Ricart de Mesones, Antoni; Tazi-Mezalek, Rachid; Marron-Moya, Maria Teresa; Rosell, Antoni; Mañez, Rafael

    2016-01-01

    Invasive pulmonary aspergillosis (IPA) is a rare pathology with increasing incidence mainly in critical care settings and recently in immunocompetent patients. The mortality of the disease is very high, regardless of an early diagnosis and aggressive treatment. Here, we report a case of a 56 yr old previously healthy woman who was found unconscious at home and admitted to the emergency room with mild respiratory insufficiency. In the first 24 hours she developed an acute respiratory failure with new radiographic infiltrates requiring Intensive Care Unit admission. A severe obstructive pattern with impossibility of ventilation because of bilateral atelectasis was observed, requiring emergent venovenous extracorporeal membrane oxygenator device insertion. Bronchoscopy revealed occlusion of main bronchi, demonstrating by biopsy an invasive infection by Aspergillus fumigatus and A. flavus. Despite an aggressive treatment and vital support the patient had a fatal outcome. The forensic study confirms the diagnosis of IPA but also revealed the presence of disseminated aspergillosis. PMID:27445566

  7. Central nervous system histoplasmosis in an immunocompetent pediatric patient.

    PubMed

    Esteban, Ignacio; Minces, Pablo; De Cristofano, Analía M; Negroni, Ricardo

    2016-06-01

    Neurohistoplasmosis is a rare disease, most prevalent in immunosuppressed patients, secondary to disseminated disease with a high mortality rate when diagnosis and treatment are delayed. We report a previously healthy 12 year old girl, from a bat infested region of Tucuman Province, Argentine Republic, who developed meningoencephalitis due to Histoplasma capsulatum. Eighteen months prior to admission the patient started with headaches and intermittent fever. The images of the central nervous system showed meningoencephalitis suggestive of tuberculosis. She received antibiotics and tuberculostatic medications without improvement. Liposomal amphotericin B was administered for six weeks. The patient's clinical status improved remarkably. Finally the culture of cerebral spinal fluid was positive for micelial form of Histoplasma capsulatum. The difficulties surrounding the diagnosis and treatment of neurohistoplasmosis in immunocompetent patients are discussed in this manuscript, as it also intends to alert to the presence of a strain of Histoplasma capsulatum with affinity for the central nervous system.

  8. Serratia marcescens endogenous endophthalmitis in an immunocompetent host.

    PubMed

    Memon, Muhammad; Raman, Vasant

    2016-01-20

    A systemically well 66-year-old white Caucasian man presented to the urgent care department with a short history of progressive pain and blurring of vision in his left eye. He denied a history of trauma, intraocular surgery or use of illicit drugs. He was diagnosed with endogenous endophthalmitis. Vitreous biopsy grew Serratia marcescens, a Gram negative bacteria. In spite of extensive investigation, there was no obvious source of infection. He had an indwelling urine catheter for prostate hypertrophy, but urine culture was negative. There was no evidence of immunocompromise. He was treated with systemic as well as intravitreal antibiotics. In spite of appropriate treatment, the patient lost vision. S. marcescens endophthalmitis, seen even in immunocompetent people, carries a poor visual prognosis.

  9. Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

    PubMed Central

    Kotsifas, Konstantinos; Metaxas, Eugenios; Koutsouvelis, Ioannis; Skoutelis, Athanassios; Kara, Panayiota; Tatsis, George

    2011-01-01

    Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement. PMID:21577261

  10. Take Care of Your Child's Teeth

    MedlinePlus

    ... Baby teeth hold space for adult teeth. Take care of your child’s teeth to protect your child from tooth decay (cavities). Tooth decay can: Cause your child pain Make it hard for your child to chew ...

  11. Fostering the Battered and Abused Child.

    ERIC Educational Resources Information Center

    McFadden, Emily Jean

    1980-01-01

    This article describes a 20-hour, eight-week course for experienced foster parents. Goals include understanding the causes of child abuse, understanding the consequences of child abuse, and understanding the interaction patterns which provoke child abuse. (Author/DB)

  12. Death of an Adult Child

    MedlinePlus

    ... iGive.com Purchase Through AmazonSmile Contact Us Donate Death of an Adult Child The death of any child, regardless of cause or age, ... the situations that may have caused their child’s death. Judgmental statements from others indicating that the child ...

  13. Ferrets as a Novel Animal Model for Studying Human Respiratory Syncytial Virus Infections in Immunocompetent and Immunocompromised Hosts

    PubMed Central

    Stittelaar, Koert J.; de Waal, Leon; van Amerongen, Geert; Veldhuis Kroeze, Edwin J.B.; Fraaij, Pieter L.A.; van Baalen, Carel A.; van Kampen, Jeroen J.A.; van der Vries, Erhard; Osterhaus, Albert D.M.E.; de Swart, Rik L.

    2016-01-01

    Human respiratory syncytial virus (HRSV) is an important cause of severe respiratory tract disease in immunocompromised patients. Animal models are indispensable for evaluating novel intervention strategies in this complex patient population. To complement existing models in rodents and non-human primates, we have evaluated the potential benefits of an HRSV infection model in ferrets (Mustela putorius furo). Nine- to 12-month-old HRSV-seronegative immunocompetent or immunocompromised ferrets were infected with a low-passage wild-type strain of HRSV subgroup A (105 TCID50) administered by intra-tracheal or intra-nasal inoculation. Immune suppression was achieved by bi-daily oral administration of tacrolimus, mycophenolate mofetil, and prednisolone. Throat and nose swabs were collected daily and animals were euthanized four, seven, or 21 days post-infection (DPI). Virus loads were determined by quantitative virus culture and qPCR. We observed efficient HRSV replication in both the upper and lower respiratory tract. In immunocompromised ferrets, virus loads reached higher levels and showed delayed clearance as compared to those in immunocompetent animals. Histopathological evaluation of animals euthanized 4 DPI demonstrated that the virus replicated in the respiratory epithelial cells of the trachea, bronchi, and bronchioles. These animal models can contribute to an assessment of the efficacy and safety of novel HRSV intervention strategies. PMID:27314379

  14. Recurrent abscesses due to Finegoldia magna, Dermabacter hominis and Staphylococcus aureus in an immunocompetent patient.

    PubMed

    Martin, J; Bemer, P; Touchais, S; Asseray, N; Corvec, S

    2009-10-01

    A case of recurrent abscesses in an immunocompetent patient is reported, involving the opportunistic human pathogen Dermabacter hominis, the virulent anaerobic pathogen Finegoldia magna and Staphylococcus aureus. PMID:19332143

  15. The United Nations Declaration of the Rights of the Child (1959): Genesis, Transformation and Dissemination of a Treaty (Re)Constituting a Transnational Cause

    ERIC Educational Resources Information Center

    Moody, Zoe

    2015-01-01

    Over the course of the 20th century, the social and legal status of the child evolved considerably. One remarkable illustration of this process can be seen by tracing the evolution of specific international treaties on the rights of the child. Although developments in national legislation inspired the authors of these treaties, it was through…

  16. Fatal measles presenting as acute respiratory distress syndrome in an immunocompetent adult

    PubMed Central

    Karanth, Suman S; Marupudi, Krishna Chaitanya; Gupta, Anurag; Rau, Nileshwar Radhakrishna

    2014-01-01

    Fatal measles is known to occur among immunocompromised adults. We report a rare case of an immunocompetent non-pregnant young lady who suffered from fatal acute respiratory distress syndrome due to measles. Physicians must be vigilant to this deadly presentation of measles even in immunocompetent individuals. We emphasise the inadequacies of vaccination programmes in India reflected not only by the existing high measles-related childhood mortalities, but also an emerging rise in deaths among adults. PMID:25139919

  17. Isolated Pancreatic Histoplasmosis: An Unusual Suspect of Pancreatic Head Mass in an Immunocompetent Host.

    PubMed

    Aggarwal, Avin; Garg, Shashank

    2015-01-01

    Histoplasmosis is endemic to the Mississippi and Ohio River valley regions in the US. It usually affects patients with underlying immunodeficiency but can also be seen in immunocompetent hosts. Although gastrointestinal involvement is common in the setting of disseminated histoplasmosis, isolated gastrointestinal involvement is uncommon. We report a case of isolated pancreatic histoplasmosis in an immunocompetent patient, presenting as painless jaundice and pancreatic head mass. PMID:26828075

  18. Fatal measles presenting as acute respiratory distress syndrome in an immunocompetent adult.

    PubMed

    Karanth, Suman S; Marupudi, Krishna Chaitanya; Gupta, Anurag; Rau, Nileshwar Radhakrishna

    2014-08-19

    Fatal measles is known to occur among immunocompromised adults. We report a rare case of an immunocompetent non-pregnant young lady who suffered from fatal acute respiratory distress syndrome due to measles. Physicians must be vigilant to this deadly presentation of measles even in immunocompetent individuals. We emphasise the inadequacies of vaccination programmes in India reflected not only by the existing high measles-related childhood mortalities, but also an emerging rise in deaths among adults.

  19. [Herpes zoster in immunocompetent pregnant women and their perinatal outcome].

    PubMed

    Casanova Román, Gerardo; Reyna Figueroa, Jesús; Figueroa Damián, Ricardo; Ortiz Ibarra, Javier

    2004-02-01

    A prospective and descriptive study was done in pregnant women diagnosed with herpes zoster, to know the demographic characteristics and clinical manifestations as well as maternal and/or neonatal complications to cause by this viral infection during pregnancy. The study included all pregnant women diagnosed with herpes zoster at the Department of Infectious Diseases of the Instituto Nacional de Perinatologia México, between 1994 and 2002. A total of 17 women were included in the study. All were given clinical and ultrasound follow-up to discard any maternal or fetal complications also at the moment of birth. A review in the newborn was made to establish the demographic, anthropometric and clinical characteristics; also the data collected included mother's age, gestational age at the moment of diagnosis with herpes zoster, anatomical lesion site, treatments administered, ultrasound characteristics, newborn's gestational age, weight, height, Apgar at birth and type of delivery. The most frequent site (58.8%) for herpes zoster lesions on the mother was the intercostal area, followed by the scapular region, the lumbar region and the limbs. None of the patients experienced complications during pregnancy, including post-herpetic pain. Sixteen of the newborns had no complications and one was a stillborn due to 60% of placental separation. These findings suggest a benign evolution of herpes zoster during pregnancy, supporting similar findings in the literature. No complications during pregnancy are suggested, and no phenotypical alterations occurred in the child at the moment of birth.

  20. Concomitant Mycobacterium avium infection and Hodgkin's disease in a lymph node from an HIV-negative child.

    PubMed

    de Armas, Yaxsier; Capó, Virginia; González, Ida; Mederos, Lilian; Díaz, Raúl; de Waard, Jacobus H; Rodríguez, Alberto; García, Yarmila; Cabanas, Ricardo

    2011-03-01

    We report a case of an immunocompetent child with simultaneously an infection with Mycobacterium avium and Hodgkin's disease in a cervical lymph node. A positive PCR result for M. avium on a biopsy of the lymph node directed the definitive diagnosis for both etiologies and avoided a possible dissemination of this infection after chemotherapy was started.

  1. Diagnostic Challenges of Cryptococcus neoformans in an Immunocompetent Individual Masquerading as Chronic Hydrocephalus.

    PubMed

    Mahajan, Kedar R; Roberts, Amity L; Curtis, Mark T; Fortuna, Danielle; Dharia, Robin; Sheehan, Lori

    2016-01-01

    Cryptococcus neoformans can cause disseminated meningoencephalitis and evade immunosurveillance with expression of a major virulence factor, the polysaccharide capsule. Direct diagnostic assays often rely on the presence of the cryptococcal glucuronoxylomannan capsular antigen (CrAg) or visualization of the capsule. Strain specific phenotypic traits and environmental conditions influence differences in expression that can thereby compromise detection and timely diagnosis. Immunocompetent hosts may manifest clinical signs and symptoms indolently, often expanding the differential and delaying appropriate treatment and diagnosis. We describe a 63-year-old man who presented with a progressive four-year history of ambulatory dysfunction, headache, and communicating hydrocephalus. Serial lumbar punctures (LPs) revealed elevated protein (153-300 mg/dL), hypoglycorrhachia (19-47 mg/dL), lymphocytic pleocytosis (89-95% lymphocyte, WBC 67-303 mg/dL, and RBC 34-108 mg/dL), and normal opening pressure (13-16 cm H2O). Two different cerebrospinal fluid (CSF) CrAg assays were negative. A large volume CSF fungal culture grew unencapsulated C. neoformans. He was initiated on induction therapy with amphotericin B plus flucytosine and consolidation/maintenance therapy with flucytosine, but he died following discharge due to complications. Elevated levels of CSF Th1 cytokines and decreased IL6 may have affected the virulence and detection of the pathogen. PMID:27525140

  2. Tuberculous Empyema Necessitatis in a 40-Year-Old Immunocompetent Male.

    PubMed

    Babamahmoodi, Farhang; Davoodi, Lotfollah; Sheikholeslami, Roya; Ahangarkani, Fatemeh

    2016-01-01

    Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient's condition and health care setting. This problem can be seen in endemic area in which controlling of TB is hard. Report of the disease in local health care center for desirable treatment and health maintenance is necessary. We explained a rare case of pulmonary TB in a patient that was healthy in other fields and just showed the minimum systemic symptoms. The patient came with a mass in lower part of back of chest cage, with a mild pain. The imaging survey showed EN. Smear and Ziehl-Neelsen stains from subcutaneous aspiration were positive for TB. This case showed importance of clinical view and awareness of this silent but serious disease in endemic area especially for TB. PMID:27555974

  3. Tuberculous Empyema Necessitatis in a 40-Year-Old Immunocompetent Male

    PubMed Central

    Babamahmoodi, Farhang; Sheikholeslami, Roya; Ahangarkani, Fatemeh

    2016-01-01

    Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient's condition and health care setting. This problem can be seen in endemic area in which controlling of TB is hard. Report of the disease in local health care center for desirable treatment and health maintenance is necessary. We explained a rare case of pulmonary TB in a patient that was healthy in other fields and just showed the minimum systemic symptoms. The patient came with a mass in lower part of back of chest cage, with a mild pain. The imaging survey showed EN. Smear and Ziehl-Neelsen stains from subcutaneous aspiration were positive for TB. This case showed importance of clinical view and awareness of this silent but serious disease in endemic area especially for TB. PMID:27555974

  4. Feed intake, body weight, body condition score, musculation, and immunocompetence in aged mares given equine somatotropin.

    PubMed

    Malinowski, K; Christensen, R A; Konopka, A; Scanes, C G; Hafs, H D

    1997-03-01

    Sixteen 20- to 26-yr-old mares were given 0, 6.25, or 12.5 mg/d equine somatotropin (eST) to determine whether aged mares respond to ST with changes in feed intake, body weight, body condition score (based mostly on fat cover), or immunocompetence. Neither dry matter intake, body weight, nor body condition scores were altered during the 6 wk of eST injection. However, based on photographs taken to evaluate musculation before and after treatment (scores 0 to 4), mares given eST developed greater (P < .07) muscle definition (1.8 +/- .6 and 2.5 +/- .6 for 6.25 and 12.5 mg eST/d, respectively) than control mares (.7 +/- .4). Total circulating leukocytes increased (P < .05) in both of the eST-treated groups during the 6-wk injection period, caused by an increase (P < .05) in granulocytes. Lymphocyte numbers were not altered. Granulocyte oxidative burst activity was not altered by eST treatment. Although lymphocyte proliferative responses to phytohemagglutinin, pokeweed mitogen, or lipopolysaccharide were not altered during the treatment period, lymphocyte proliferation in response to phytohemagglutinin and pokeweed mitogen increased twofold in eST-treated horses at 2 wk after eST treatment. In overview, the increased musculation and the increase in granulocyte numbers in mares given eST suggest that eST supplementation may improve the health and well-being of aged mares. PMID:9078493

  5. Treatment Response and Outcomes in Post-transplantation Lymphoproliferative Disease vs Lymphoma in Immunocompetent Patients.

    PubMed

    Trusson, R; Serre, J E; Szwarc, I; Brunot, V; Garrigue, V; Delmas, S; Kanouni, T; Cartron, G; Mourad, G

    2016-01-01

    Posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation may carry a poorer prognosis than lymphoma in immunocompetent individuals, but comparative data are lacking. In a retrospective, single-center, case-control study, 21 cases of PTLD were identified in patients undergoing kidney transplantation since 2000, and compared to 42 nontransplanted controls cared for in the same institution and matched for age, prognostic index, and cerebral localization. Two-year and 5-year overall survival was 57% and 44%, respectively, in PTLD patients and 71% and 58% in controls (log-rank test P = .20). On multivariable analysis, overall survival was similar for PTLD and control patients (hazard ratio 1.71, 95% confidence interval 0.81 to 3.61, P = .16). Response rate to first-line chemotherapy was similar between the 2 groups. Death was due to progression of the disease in 46% vs 94% of PTLD and control patients, respectively (P < .01), or sepsis in 31% vs 0% (P = .03). Treatment-related mortality was significantly higher in PTLD (19%) than in controls (0%, P = .03). In conclusion, response to first-line chemotherapy and overall survival are similar in PTLD and control patients, whereas causes of death were significantly different. Better prevention and management of infectious complications could improve the results in PTLD patients. PMID:27569924

  6. Primary orbital chronic granulomatous reaction to deep staphylococcal infection due to trauma in immunocompetent.

    PubMed

    Rao, Lavanya G; Gonsalves, Sarita R J; Pathan, Atiya; Sinha, Akansha

    2013-01-01

    A 53-year-old man presented with a slow-growing mass in the right orbit and temporal area of 1 year duration following a road traffic accident. Examination revealed a nodular fungating mass involving the orbit, right temporal area with multiple discharging sinuses causing proptosis and restricted ocular motility. The patient denied light perception in the right eye. There was exposure keratopathy and optic atrophy. Imaging showed mass lesion of the orbit extending intracranially. Tissue biopsy and culture revealed a chronic granulomatous reaction due to deep infection with coagulase-positive staphylococci. The patient showed remarkable improvement to systemic antibiotics and anticonvulsants. Mortality is high in such cases due to intracranial extension if there is a delay in treatment. This case report summarises a rare aetiology and successful treatment of a case of chronic granulomatous reaction due to deep bacterial infection following trauma and is deemed rare as cases of primary orbital infection in immunocompetent have not been reported so far. PMID:23904427

  7. Diagnostic Challenges of Cryptococcus neoformans in an Immunocompetent Individual Masquerading as Chronic Hydrocephalus

    PubMed Central

    Fortuna, Danielle; Dharia, Robin

    2016-01-01

    Cryptococcus neoformans can cause disseminated meningoencephalitis and evade immunosurveillance with expression of a major virulence factor, the polysaccharide capsule. Direct diagnostic assays often rely on the presence of the cryptococcal glucuronoxylomannan capsular antigen (CrAg) or visualization of the capsule. Strain specific phenotypic traits and environmental conditions influence differences in expression that can thereby compromise detection and timely diagnosis. Immunocompetent hosts may manifest clinical signs and symptoms indolently, often expanding the differential and delaying appropriate treatment and diagnosis. We describe a 63-year-old man who presented with a progressive four-year history of ambulatory dysfunction, headache, and communicating hydrocephalus. Serial lumbar punctures (LPs) revealed elevated protein (153–300 mg/dL), hypoglycorrhachia (19–47 mg/dL), lymphocytic pleocytosis (89–95% lymphocyte, WBC 67–303 mg/dL, and RBC 34–108 mg/dL), and normal opening pressure (13–16 cm H2O). Two different cerebrospinal fluid (CSF) CrAg assays were negative. A large volume CSF fungal culture grew unencapsulated C. neoformans. He was initiated on induction therapy with amphotericin B plus flucytosine and consolidation/maintenance therapy with flucytosine, but he died following discharge due to complications. Elevated levels of CSF Th1 cytokines and decreased IL6 may have affected the virulence and detection of the pathogen. PMID:27525140

  8. Midgut microbiota and host immunocompetence underlie Bacillus thuringiensis killing mechanism.

    PubMed

    Caccia, Silvia; Di Lelio, Ilaria; La Storia, Antonietta; Marinelli, Adriana; Varricchio, Paola; Franzetti, Eleonora; Banyuls, Núria; Tettamanti, Gianluca; Casartelli, Morena; Giordana, Barbara; Ferré, Juan; Gigliotti, Silvia; Ercolini, Danilo; Pennacchio, Francesco

    2016-08-23

    Bacillus thuringiensis is a widely used bacterial entomopathogen producing insecticidal toxins, some of which are expressed in insect-resistant transgenic crops. Surprisingly, the killing mechanism of B. thuringiensis remains controversial. In particular, the importance of the septicemia induced by the host midgut microbiota is still debated as a result of the lack of experimental evidence obtained without drastic manipulation of the midgut and its content. Here this key issue is addressed by RNAi-mediated silencing of an immune gene in a lepidopteran host Spodoptera littoralis, leaving the midgut microbiota unaltered. The resulting cellular immunosuppression was characterized by a reduced nodulation response, which was associated with a significant enhancement of host larvae mortality triggered by B. thuringiensis and a Cry toxin. This was determined by an uncontrolled proliferation of midgut bacteria, after entering the body cavity through toxin-induced epithelial lesions. Consequently, the hemolymphatic microbiota dramatically changed upon treatment with Cry1Ca toxin, showing a remarkable predominance of Serratia and Clostridium species, which switched from asymptomatic gut symbionts to hemocoelic pathogens. These experimental results demonstrate the important contribution of host enteric flora in B. thuringiensis-killing activity and provide a sound foundation for developing new insect control strategies aimed at enhancing the impact of biocontrol agents by reducing the immunocompetence of the host. PMID:27506800

  9. Progressive Multifocal Leukoencephalopathy in a HIV Negative, Immunocompetent Patient

    PubMed Central

    2016-01-01

    Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease most common in immunodeficient patients. It occurs due to reactivation of the John Cunningham Virus (JCV) and carries a poor prognosis, with a median life expectancy of 6 months. We report a case of a 66-year-old man with a history of HCV related cirrhosis (HCV) and hepatocellular carcinoma (HCC) who was found to have PML in the setting of a negative viral load in the CSF and a CD4+ >200. He initially presented with two weeks of mild confusion and word-finding difficulty concerning for hepatic encephalopathy. An MRI was notable for extensive T2/FLAIR hyperintensity signal in the left temporal lobe. Brain biopsy was positive for JCV. PML is rare in immunocompetent individuals, especially in the setting of a negative viral load. It is possible, however, that transient states of immunosuppression may have been responsible in this case. Although viral load was reported as negative, virus may still have been detected but was below the quantifiable threshold. It is important for clinicians to note that a negative result does not necessarily exclude the possibility of PML, and care should be taken to review lab values on viral load in closer detail. PMID:27529042

  10. Immunocompetent murine models for the study of glioblastoma immunotherapy

    PubMed Central

    2014-01-01

    Glioblastoma remains a lethal diagnosis with a 5-year survival rate of less than 10%. (NEJM 352:987-96, 2005) Although immunotherapy-based approaches are capable of inducing detectable immune responses against tumor-specific antigens, improvements in clinical outcomes are modest, in no small part due to tumor-induced immunosuppressive mechanisms that promote immune escape and immuno-resistance. Immunotherapeutic strategies aimed at bolstering the immune response while neutralizing immunosuppression will play a critical role in improving treatment outcomes for glioblastoma patients. In vivo murine models of glioma provide an invaluable resource to achieving that end, and their use is an essential part of the preclinical workup for novel therapeutics that need to be tested in animal models prior to testing experimental therapies in patients. In this article, we review five contemporary immunocompetent mouse models, GL261 (C57BL/6), GL26 (C57BL/6) CT-2A (C57BL/6), SMA-560 (VM/Dk), and 4C8 (B6D2F1), each of which offer a suitable platform for testing novel immunotherapeutic approaches. PMID:24779345

  11. Antiviral Prevention of Sepsis Induced Cytomegalovirus Reactivation in Immunocompetent Mice

    PubMed Central

    Forster, Meghan R.; Trgovcich, Joanne; Zimmerman, Peter; Chang, Alexander; Miller, Cortland; Klenerman, Paul; Cook, Charles H.

    2009-01-01

    Introduction Immunocompetent patients can reactivate latent cytomegalovirus (CMV) during critical illness and reactivation is associated with significantly worse outcomes. Prior to clinical trials in humans to prove causality, we sought to determine an optimal antiviral treatment strategy. Methods Mice latently infected with murine CMV (MCMV) received a septic reactivation trigger and were randomized to receive one of four ganciclovir regimens or saline. Lungs were evaluated for viral transcriptional reactivation and fibrosis after each regimen. Influences of ganciclovir on early sepsis induced pulmonary inflammation and T-cell activation were studied after sepsis induction. Results All ganciclovir regimens reduced measurable MCMV transcriptional reactivation, and 10mg/day for 7 or 21 days was most effective. Lower dose (5mg/kg/day) or delayed therapy were associated with significant breakthrough reactivation. Higher doses of ganciclovir given early were associated with the lowest incidence of pulmonary fibrosis, and delay of therapy for 1 week was associated with significantly worse pulmonary fibrosis. Although bacterial sepsis induced activation of MCMV-specific pulmonary T-cells, this activation was not influenced by ganciclovir. Conclusion These results suggest that antiviral treatment trials in humans should use 10mg/kg/day ganciclovir administered as early as possible in at-risk patients to minimize reactivation events and associated pulmonary injury PMID:20004216

  12. Immunocompetent molecules and their response network in horseshoe crabs.

    PubMed

    Kawabata, Shun-ichiro

    2010-01-01

    Horseshoe crab hemocyte selectively responds to bacterial lipopolysaccharides (LPS), which depends critically on the proteolytic activity of the LPS-responsive serine protease zymogen factor C. In response to stimulation by LPS, the hemocyte secretes several kinds of immunocompetent proteins. The coagulation cascade triggered by LPS or beta-1,3-D-glucans (BDG) results in the formation of coagulin fibrils that are subsequently stabilized by transglutaminase (TGase)-dependent cross-linking. Invading pathogens are recognized and agglutinated by lectins and then killed by antimicrobial peptides. Moreover, LPS-triggered hemocyte exocytosis is enhanced by a feedback mechanism in which the antimicrobial peptides serve as endogenous mediators. Factor C also acts as an LPS-sensitive complement C3 convertase. In addition, a sub-cuticular epidermis-derived protein forms a TGase-stabilized mesh at sites of injury. Horseshoe crabs have a sophisticated innate immune response network that coordinately effects pathogen recognition and killing, prophenoloxidase activation, complement activation and TGase-dependent wound healing.

  13. Immunopathological assessments of human Blastocystis spp. in experimentally infected immunocompetent and immunosuppresed mice.

    PubMed

    Abdel-Hafeez, Ekhlas H; Ahmad, Azza K; Abdelgelil, Noha H; Abdellatif, Manal Z M; Kamal, Amany M; Hassanin, Kamel M A; Abdel-Razik, Abdel-Razik H; Abdel-Raheem, Ehab M

    2016-05-01

    Blastocystis spp., one of the most common parasites colonizing the human intestine, is an extracellular, luminal protozoan with controversial pathogenesis. The host's immune response against Blastocystis spp. infection has also not been defined yet. Therefore, this research aimed to assess the potential pathogenicity of this parasite and its ability to modulate the immune response in experimental infected immunocompetent and immunosuppresed mice. These results demonstrated that the infected immunosuppressed mice were more affected than infected immunocompetent mice. Histopathological examination of the small intestine in the infected immunosuppressed mice showed that Blastocystis spp. infiltrated all the layers. Moreover, the epithelia showed exfoliation and inflammatory cell infiltration in submucosa compared to that of the infected immunocompetent mice. As well, examination of the large intestine of the infected immunosuppressed group showed severe goblet cell hyperplasia. Blastocystis spp. infiltrated all the large intestine layers compared to that of the infected immunocompetent group. Furthermore, there was a significant upregulation of the expression of proinflammatory cytokines: interleukin 12 (IL-12) and tumor necrosis factor alpha (TNF-α) in the infected immunosuppressed mice compared to that of the infected immunocompetent ones (p ≤ 0.004 and p ≤ 0.002, respectively). However, the expression of anti-inflammatory cytokines (IL-4 and IL-10) was significantly downregulated in the infected immunosuppressed group compared to that of the infected immunocompetent group one at 10 days postinfection (p ≤ 0.002 and p ≤ 0.001, respectively). The results of this study revealed that Blastocystis spp. affected the production of pro- and anti-inflammatory cytokines in both groups of mice compared to healthy normal (naive) group. Additionally, these data showed that there was a significant upregulation (p ≤ 0.005) of the locally

  14. Child Care Subsidy Use and Child Development: Potential Causal Mechanisms

    ERIC Educational Resources Information Center

    Hawkinson, Laura E.

    2011-01-01

    Research using an experimental design is needed to provide firm causal evidence on the impacts of child care subsidy use on child development, and on underlying causal mechanisms since subsidies can affect child development only indirectly via changes they cause in children's early experiences. However, before costly experimental research is…

  15. Cat-scratch disease presenting as a solitary splenic abscess in an immunocompetent adult: case report and literature review.

    PubMed

    Anyfantakis, Dimitrios; Kastanakis, Miltiades; Papadomichelakis, Alexandros; Petrakis, Georgios; Bobolakis, Emmanouil

    2013-06-01

    Cat-scratch disease is a common zoonotic infectious disease caused by Bartonella henselae. It is generally characterized by regional lymphadenopathy following exposure to an infected cat. Organ systemic manifestations occur rarely in atypical forms of the disease. Abscess of the spleen represents a rare, life-threatening clinical entity. Here we report an unusual case of cat scratch disease presenting as an isolated splenic abscess in an immunocompetent adult. Comprehensive social history revealed retrospectively close contact with cats. Diagnosis of B. henselae infection was confirmed on the basis of positive serology, skin lesion and imaging findings. Initial efforts at spleen preserving management failed to improve clinical symptoms and classical splenectomy was finally performed. Splenic bartonellosis may become potentially fatal if not recognized. Since diagnosis is challenging, a high index of clinical suspicion is required.

  16. Prostatic and central nervous system histoplasmosis in an immunocompetent host: case report and review of the prostatic histoplasmosis literature.

    PubMed

    Mawhorter, S D; Curley, G V; Kursh, E D; Farver, C E

    2000-03-01

    Histoplasmosis is a common cause of systemic mycosis in areas of the United States where it is endemic. Central nervous system and genitourinary histoplasmosis is rare, especially in immunocompetent hosts. We describe a case of disseminated histoplasmosis in a normal host that was associated with cerebral and prostatic histoplasmosis presenting as fever of undetermined origin, weight loss, and severe debilitating altered mental status. The patient subsequently developed acute renal failure that manifested as obstructive uropathy during antifungal therapy with amphotericin B. Transurethral resection of the prostate resulted in improved renal function during continuation of amphotericin B therapy. Pathological analysis of the prostate revealed necrotizing granulomas with intralesional fungal organisms. Blood and urine cultures were positive for Histoplasma capsulatum. Diagnostic issues and management are discussed. Treatment resulted in return of normal cognitive and motor function. This case is compared with the 8 previously reported cases of H. capsulatum prostatitis. PMID:10722452

  17. Child Development

    MedlinePlus

    ... content Start of Search Controls Search Form Controls Child Development Cancel Submit Search The CDC CDC A-Z ... Z # Start of Search Controls Search Form Controls Child Development Cancel Submit Search The CDC Child Development Note: ...

  18. Computed Tomography Features of Pulmonary Nocardiosis in Immunocompromised and Immunocompetent Patients

    PubMed Central

    Mehrian, Payam; Esfandiari, Ehsan; Karimi, Mohammad Ali; Memari, Behzad

    2015-01-01

    Summary Background Nocardiosis primarily occurs in the setting of immunocompromising conditions. However, it may also occur in immunocompetent patients. We described computed tomography features of pulmonary nocardiosis and compared immunocompetent and immunocompromised patients. Material/Methods CT images of 25 patients (Mean age of 39.5 years; 76% male) with pulmonary nocardiosis proved by bronchoalveolar lavage or biopsy were reviewed by two experienced pulmonary radiologists and detailed findings were reported on. Fourteen patients (56%) were immunocompetent, while 44% had an underlying immunocompromising condition, including chronic granulomatous disease (CGD) (n=4), diabetes mellitus (DM) (n=2), malignancy (n=2), HIV (n=1), concomitant CGD and DM (n=1), and steroid therapy for nephrotic syndrome (n=1). Results Most patients had bilateral involvement with no zonal predominance. Multiple pulmonary nodules (96%) were the most common CT findings, followed by consolidation (76%) and cavity (52%). Other findings included bronchiectasis (48%), pleural thickening (40%), ground glass opacity (32%), mass-like consolidation (20%), intrathoracic lymphadenopathy (16%), pleural effusion (12%), reticular infiltration (4%), and pericardial effusion (4%). There was no statistically significant difference in the CT findings of immunocompromised and immunocompetent groups. Conclusions Pulmonary nocardiosis presents mainly as multiple pulmonary nodules, consolidations, and cavity in both immunocompromised and immunocompetent patients. However, these features are more suggestive of nocardiosis in the setting of an underling immunocompromised condition. PMID:25584096

  19. Asthma - child - discharge

    MedlinePlus

    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

  20. Adaptation and immunogenicity of Cryptosporidium parvum to immunocompetent mice.

    PubMed

    Matsuo, Tomohide; Tsuge, Yasuko; Umemiya-Shirafuji, Rika; Fujino, Takashi; Matsui, Toshihiro

    2014-03-01

    The adaptation and immunogenisity of Cryptosporidium parvum isolated from Siberian chipmunks (SC1 strain) in immunocompetent (ICR) mice were examined. The oocysts were received to the severe combined immunodeficiency (SCID) mice by repeated passage. The oocysts collected from the 18th SCID mice were inoculated to 5 ICR mice. The mice began to shed oocysts from 6 days after inoculation, the patency was 5 days, and the maximum oocysts per gram of feces (OPG) value was 10(4). The maximum of OPG value was gradually increased by successive passage, and finally that in the 22nd mice reached 10(6) (patency: 11 days). It is considered that these results indicate completion of their adaptation to ICR mice. To examine the immunogenicity of C. parvum to ICR mice, 8 groups of 5 mice each were inoculated with 1.3 × 10(6) oocysts of SC1 strain, which were collected after adaptation to SCID mice. All groups shed oocysts from 6th day, and their patency was from 8 to 12 days. On the 21st day after the primary infection, these mice were challenged with 1.3 × 10(6) oocysts. No oocysts shed from any groups, although 2 control groups shed oocysts from the 6th day, and their OPG values were more than 10(6). These results suggest that this strain has strong immunogenicity against ICR mice. Therefore, the immunological healthy mice were considered a useful experimental model to investigate immunological and drug treatments in the strain of C. parvum.

  1. Opioid modulation of immunocompetence: Receptor characterization and second messenger involvement

    SciTech Connect

    Hemmick, L.M.

    1989-01-01

    The purpose of this thesis was to examine the effects of opioids on several indices of immunocompetence, determined the receptor specificity of these effects, and ascertain whether the actions of opioids on lymphocytes could be correlated with activation of second messenger systems. By measuring {sup 45}Ca{sup 2+} uptake into lymphocytes, it was demonstrated that {beta}-endorphin 1-31 ({beta}-END 1-31) enhanced rat thymocyte Ca{sup 2+} uptake in response to concanavalin A (Con A) but not phytohemagglutinin (PHA). Related opioid peptides and alkaloids were unable to mimic the effect, and naloxone did not block it, suggesting that {beta}-END 1-31 acted by binding to specific, non-opioid receptors on the thymocytes. Rat splenocyte Con A-stimulated Ca{sup 2+} uptake was not affected by {beta}-END 1-31. {beta}-END 1-31 did not affect basal Ca{sup 2+} uptake by either cell type. Using ({sup 3}H)thymidine uptake as an index of lymphocyte proliferation, {beta}-END 1-31 and several related opioid peptides reversed prostaglandin E{sub 1} (PGE{sub 1}) suppression of rat lymph node cell Con A- and PHA-stimulated proliferation. Naloxone did not block the reversal. {beta}-END 1-31 was unable to reverse forskolin and cholera toxin suppression of proliferation, indicating that the lowering of cyclic AMP levels was not the mechanism involved. Verapamil inhibition of proliferation was also not reversed by {beta}-END 1-31, suggesting that promotion of Ca{sup 2+} influx was not a major mechanism involved.

  2. Cryptococcal meningitis initially presenting with eye symptoms in an immunocompetent patient: A case report

    PubMed Central

    Li, Jun; Wang, Peipei; Ye, Ling; Wang, Yanfang; Zhang, Xiuzhen; Yu, Songping

    2016-01-01

    Although cryptococcal meningitis (CM) typically occurs in immunocompromised hosts, immunocompetent humans are susceptible to CM. In humans with an intact immune system, CM presents with signs and symptoms typical of meningitis, including fever, headache and neck stiffness. The present study reported the case of a female immunocompetent patient who presented visual blurring in both eyes and bilateral papilledema for ~1 month. Following hospital admission, the patient was diagnosed with optic nerve inflammation and was treated with intravenous methylprednisolone and oral prednisone. However, the initial symptoms failed to improve and the patient developed a headache. The microscopic examination and India ink test performed using the cerebrospinal fluid of the patient showed the presence of Cryptococcus neoformans. Following combined treatment with amphotericin B and fluconazole, the patient made a full recovery with total resolution of the initial symptoms. This case demonstrates that CM in immunocompetent patients may initially include eye symptoms, which may result in a delayed diagnosis of CM. PMID:27446330

  3. Genetic, molecular and physiological basis of variation in Drosophila gut immunocompetence

    PubMed Central

    Bou Sleiman, Maroun S.; Osman, Dani; Massouras, Andreas; Hoffmann, Ary A.; Lemaitre, Bruno; Deplancke, Bart

    2015-01-01

    Gut immunocompetence involves immune, stress and regenerative processes. To investigate the determinants underlying inter-individual variation in gut immunocompetence, we perform enteric infection of 140 Drosophila lines with the entomopathogenic bacterium Pseudomonas entomophila and observe extensive variation in survival. Using genome-wide association analysis, we identify several novel immune modulators. Transcriptional profiling further shows that the intestinal molecular state differs between resistant and susceptible lines, already before infection, with one transcriptional module involving genes linked to reactive oxygen species (ROS) metabolism contributing to this difference. This genetic and molecular variation is physiologically manifested in lower ROS activity, lower susceptibility to ROS-inducing agent, faster pathogen clearance and higher stem cell activity in resistant versus susceptible lines. This study provides novel insights into the determinants underlying population-level variability in gut immunocompetence, revealing how relatively minor, but systematic genetic and transcriptional variation can mediate overt physiological differences that determine enteric infection susceptibility. PMID:26213329

  4. Cytomegalovirus enteritis in immunocompetent subjects: a case report and review of the literature.

    PubMed

    Karigane, Daiki; Takaya, Saho; Seki, Yuki; Mastumoto, Yuka; Onose, Akira; Kosakai, Arifumi; Sugaya, Norio; Mori, Takehiko

    2014-05-01

    Cytomegalovirus (CMV) enteritis (or colitis) is generally diagnosed in immunocompromised patients in association with human immunodeficiency virus infection as well as in recipients of solid organ or hematopoietic stem cell transplant. CMV enteritis has been reported only sporadically in immunocompetent individuals. We encountered a 76-year-old woman who developed CMV enteritis without any previously identified immunocompromised states. An extensive literature review of 33 cases of CMV enteritis or colitis diagnosed in immunocompetent individuals, including the present case, revealed that the median age of the patients was 68, the accompanying symptoms were diarrhea (76%), abdominal pain (52%), and hematochezia or melena (27%), and that the outcome was generally favorable, including resolution without any treatment in 24% of the patients. CMV enteritis should be recognized more widely as a disease entity not only in immunocompromised patients but also in immunocompetent individuals, especially in elderly populations.

  5. Learner Pregnancy--Perceptions on Its Prevalence and the Child Support Grant (CSG) Being the Possible Cause in South African Secondary Schools

    ERIC Educational Resources Information Center

    Naong, Matsidiso Nehemia

    2011-01-01

    Learner pregnancy has recently become a thorn in the flesh for most schools in South Africa, and documentary evidence shows that its prevalence is greater amongst Black public schools than White schools. Within its discourse, more often than not, the Child Support Grant (CSG) has featured prominently in the perceived increase in the pregnancy rate…

  6. Attributions of Stability, Control and Responsibility: How Parents of Children with Intellectual Disabilities View Their Child's Problematic Behaviour and Its Causes

    ERIC Educational Resources Information Center

    Jacobs, Myrthe; Woolfson, Lisa Marks; Hunter, Simon C.

    2016-01-01

    Background: Children with intellectual disabilities have high rates of behaviour problems. This study explored parents' causal beliefs and attributions for general problematic child behaviour in children with different aetiologies of intellectual disabilities. Materials and Methods: Ten parents of children with intellectual disabilities…

  7. Cryptococcus neoformans as a cause of bronchiolitis obliterans organizing pneumonia.

    PubMed

    Kessler, Alexander T; Al Kharrat, Tamim; Kourtis, Athena P

    2010-06-01

    The most frequent manifestations of Cryptococcus neoformans (CN) disease are systemic infections in immunocompromised patients and localized pulmonary disease in immunocompetent individuals. Such pulmonary cryptococcosis can range from asymptomatic infection to frank pneumonia that can be severe. Bronchiolitis obliterans organizing pneumonia (BOOP) is a rare severe form of pneumonitis caused by a variety of infectious and toxic agents or connective tissue diseases. BOOP due to Cryptococcus neoformans has very rarely been reported; there have been only five such case reports, mostly in immunocompromised patients. We report herein on a case of CN-associated BOOP in an immunocompetent individual and discuss the diagnosis and treatment of this entity. PMID:20169387

  8. Bacillary angiomatosis on a region of burned skin in a immunocompetent patient.

    PubMed

    Karakaş, M; Baba, M; Aksungur, V L; Homan, S; Memisoğlu, H R; Uğuz, A

    2000-09-01

    Bacillary angiomatosis usually develops in immunodeficient patients with a history of contact with cats. We report a 21-year-old immunocompetent woman with facial angiomatous lesions following a second-degree burn and without a history of direct contact with cats. The diagnosis of bacillary angiomatosis was based on the demonstration of bacilli in histological sections stained by the Warthin-Starry method. The lesions resolved 2 months after treatment with oral erythromycin for 8 weeks. This case emphasizes that bacillary angiomatosis may be seen in immunocompetent individuals and may be transmitted in other ways than cat scratches, e.g. by arthropods.

  9. Otomycosis in immunocompetent and immunocompromised patients: comparative study and literature review.

    PubMed

    Viswanatha, Borlingegowda; Sumatha, Dadarao; Vijayashree, Maliyappanahalli Siddappa

    2012-03-01

    A comparative clinical study was carried out that included 50 cases of otomycosis in immunocompetent patients and 50 cases of otomycosis in immunocompromised patients. Clinical presentation, predisposing factors, mycologic profile, and treatment outcomes were compared. Aspergillus spp were the most commonly isolated fungi in the immunocompetent group, and Candida albicans in the immunocompromised group. Bilateral involvement was more common in the immunocompromised group. All the patients were treated with topical clotrimazole ear drops. Four patients in the immunocompromised group did not respond to treatment with clotrimazole but were treated successfully with fluconazole ear drops. Three patients had a small tympanic membrane perforation due to otomycosis.

  10. Primary Cardiac Lymphoma in an Immunocompetent 71-Year-Old Man

    PubMed Central

    Montanaro, Claudia; Loiacono, Ferdinando; De Cobelli, Francesco; Foppoli, Marco; Margonato, Alberto

    2015-01-01

    Isolated cardiac lymphomas are very rare, especially in immunocompetent patients. As a consequence, little is known about the best therapeutic management and about patients' outcomes in these cases. Diffuse large B-cell lymphoma is the most frequent subtype; anthracycline-based chemotherapy has been the most successful treatment. We describe the case of a primary cardiac lymphoma in an immunocompetent 71-year-old man. As of December 2015, the patient had been in clinical remission for 2 years. The most relevant literature on primary cardiac lymphoma is reported and discussed. PMID:26664312

  11. Primary Cardiac Lymphoma in an Immunocompetent 71-Year-Old Man.

    PubMed

    Montanaro, Claudia; Loiacono, Ferdinando; Fragasso, Gabriele; De Cobelli, Francesco; Foppoli, Marco; Margonato, Alberto

    2015-12-01

    Isolated cardiac lymphomas are very rare, especially in immunocompetent patients. As a consequence, little is known about the best therapeutic management and about patients' outcomes in these cases. Diffuse large B-cell lymphoma is the most frequent subtype; anthracycline-based chemotherapy has been the most successful treatment. We describe the case of a primary cardiac lymphoma in an immunocompetent 71-year-old man. As of December 2015, the patient had been in clinical remission for 2 years. The most relevant literature on primary cardiac lymphoma is reported and discussed. PMID:26664312

  12. The newly nonsporulated characterization of an Aspergillus fumigatus isolate from an immunocompetent patient and its clinic indication.

    PubMed

    Zhang, Caiyun; Kong, Qingtao; Cai, Zhendong; Liu, Fang; Chen, Peiying; Song, Jinxing; Lu, Ling; Sang, Hong

    2015-08-01

    Aspergillus fumigatus (A. fumigatus) commonly produces abundant and heavily melanized infectious conidia, which are the primary agents that cause invasive aspergillosis (IA) in immunocompromised patients. We isolated a white nonsporulating A. fumigatus strain (A1j) from an immunocompetent patient. It was identified by histopathological examination and morphological observation, and subsequently confirmed by DNA sequencing of internal transcribed spacer (ITS) regions and partial β-tubulin genes. Neither a long waiting time nor passage on various medium types could stimulate the formation of spores and pigment. No significant relative difference was found in sensitivity to antifungal agents or cell wall destabilizing reagents, as compared to wild-type A. fumigatus Af293. Nevertheless, A1j was hypovirulent in the immunosuppressed mice model, consistent with the good result in our patient. RNA deep-sequencing analysis (RNA-seq) revealed that hundreds of transcripts were significantly dysregulated, including those related to pigmentation and sporulation. qRT-PCR confirmed the anergic state of key regulator brlA for sporulation under the induction of conidiation conditions, but without mutation. To the best of our knowledge, this is the first report of a white, nonsporulating A. fumigatus strain infection in an immunocompetent patient. In our opinion, A1j may represent a mutant of typical A. fumigatus, providing a new clue for identification of clinical A. fumigatus isolates. Furthermore, the good prognosis of our patient and the reduced virulence in the mice model infected with A1j highlight the potential of sporulation inhibitors as a new generation of antifungal agents.

  13. Quantitative Analysis of α-L-Iduronidase Expression in Immunocompetent Mice Treated with the Sleeping Beauty Transposon System

    PubMed Central

    Aronovich, Elena L.; Hall, Bryan C.; Bell, Jason B.; McIvor, R. Scott; Hackett, Perry B.

    2013-01-01

    The Sleeping Beauty transposon system, a non-viral, integrating vector that can deliver the alpha-L-iduronidase-encoding gene, is efficient in correcting mucopolysaccharidosis type I in NOD/SCID mice. However, in previous studies we failed to attain reliable long-term alpha-L-iduronidase expression in immunocompetent mice. Here, we focused on achieving sustained high-level expression in immunocompetent C57BL/6 mice. In our standard liver-directed treatment we hydrodynamically infuse mice with plasmids containing a SB transposon-encoding human alpha-L-iduronidase, along with a source of SB transposase. We sought to 1) minimize expression of the therapeutic enzyme in antigen-presenting cells, while avoiding promoter shutdown and gender bias, 2) increase transposition efficiency and 3) improve immunosuppression. By using a liver-specific promoter to drive IDUA expression, the SB100X hyperactive transposase and transient cyclophosphamide immunosuppression we achieved therapeutic-level (>100 wild-type) stabilized expression for 1 year in 50% of C57BL/6 mice. To gain insights into the causes of variability in transgene expression, we quantified the rates of alpha-L-iduronidase activity decay vis-a-vis transposition and transgene maintenance using the data obtained in this and previous studies. Our analyses showed that immune responses are the most important variable to control in order to prevent loss of transgene expression. Cumulatively, our results allow transition to pre-clinical studies of SB-mediated alpha-L-iduronidase expression and correction of mucopolysaccharidosis type I in animal models. PMID:24205141

  14. Melioidosis as a Cause of Acute Abdomen in Immuno-Competent Male from Eastern India

    PubMed Central

    Karuna, Tadepalli; Khadanga, Sagar; Dugar, Dharmendra; Sau, Biyanka; Bhoi, Priyadarshini

    2015-01-01

    Though melioidosis is rare in India, it has gained importance as one of the most potent emerging infections. In India, the cases have been under-reported because of the lack of awareness. The majority of cases present with multifocal pyogenic infections with septicemia. We present an unusual case of melioidosis presenting as acute intestinal perforation. The organism was ceftazidime resistant, and we successfully treated the case with imipenem and doxycyclin. This case highlights ruling out the possibility of melioidosis in acute abdomen and existence of ceftazidime resistant cases in India. PMID:25949062

  15. Melioidosis as a cause of acute abdomen in immuno-competent male from eastern India.

    PubMed

    Karuna, Tadepalli; Khadanga, Sagar; Dugar, Dharmendra; Sau, Biyanka; Bhoi, Priyadarshini

    2015-01-01

    Though melioidosis is rare in India, it has gained importance as one of the most potent emerging infections. In India, the cases have been under-reported because of the lack of awareness. The majority of cases present with multifocal pyogenic infections with septicemia. We present an unusual case of melioidosis presenting as acute intestinal perforation. The organism was ceftazidime resistant, and we successfully treated the case with imipenem and doxycyclin. This case highlights ruling out the possibility of melioidosis in acute abdomen and existence of ceftazidime resistant cases in India. PMID:25949062

  16. Investigation of Spa Pools Associated with Lung Disorders Caused by Mycobacterium avium Complex in Immunocompetent Adults

    PubMed Central

    Lumb, Richard; Stapledon, Richard; Scroop, Andrew; Bond, Peter; Cunliffe, David; Goodwin, Allan; Doyle, Robyn; Bastian, Ivan

    2004-01-01

    Three cases of Mycobacterium avium complex-related lung disorders were associated with two poorly maintained spa pools by genotypic investigations. Inadequate disinfection of the two spas had reduced the load of environmental bacteria to less than 1 CFU/ml but allowed levels of M. avium complex of 4.3 × 104 and 4.5 × 103 CFU/ml. Persistence of the disease-associated genotype was demonstrated in one spa pool for over 5 months until repeated treatments with greater than 10 mg of chlorine per liter for 1-h intervals eliminated M. avium complex from the spa pool. A fourth case of Mycobacterium avium complex-related lung disease was associated epidemiologically but not genotypically with another spa pool that had had no maintenance undertaken. This spa pool contained low numbers of mycobacteria by smear and was culture positive for M. avium complex, and the nonmycobacterial organism count was 5.2 × 106 CFU/ml. Public awareness about the proper maintenance of private (residential) spa pools must be promoted by health departments in partnership with spa pool retailers. PMID:15294830

  17. Child Abuse

    MedlinePlus

    ... or become violent. An older child may use drugs or alcohol, try to run away or abuse others. Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.

  18. [The first case of persistent vaginitis due to Aspergillus protuberus in an immunocompetent patient].

    PubMed

    Borsa, Barış Ata; Özgün, Gonca; Houbraken, Jos; Ökmen, Fırat

    2015-01-01

    The vast majority of vaginal fungal infections are caused by Candida species. However, vaginitis cases caused by molds are extremely rare. Aspergillus protuberus is previously known as a member of Aspergillus section Versicolores which can cause opportunistic infections in immunocompromised patients, however it has recently been described as a seperate species. Although the members of Aspergillus section Versicolores have been isolated rarely in cases of pulmonary infections, eye infections, otomycosis, osteomyelitis and onycomycoses, to the best of our knowledge, there is no published case of human infection caused by A.protuberus. In this report, the first case of persistent vaginitis due to A.protuberus in an immunocompetent patient was presented. A 42-year-old female patient was admitted to our hospital with the complaints of pelvic pain, vaginal itching and discharge during one month. Her symptoms had been persistant despite of the miconazole nitrate and clotrimazole therapies for probable candidal vaginitis. Fungal structures such as branched, septate hyphae together with the conidial forms were seen in microscopic examination as in the cervical smear. Thereafter, a vaginal discharge sample was taken for microbiological evaluation and similar characteristics of fungal structures were observed in the microscopic examination as of cervical smear. Then, preliminary result was reported as Aspergillus spp. At the same time, the sample was plated on Sabouraud dextrose agar (SDA) in duplicate and incubated at room temperature and at 37°C. After 5 days, white, powdery and pure-looking fungal colonies were observed in SDA which was incubated at room temperature, while the other medium remained sterile. The culture was submitted to the CBS-KNAW Fungal Biodiversity Center for further characterization. Phenotypic identification showed that the isolated strain belonged to the Aspergillus section Versicolores. The strain was grown for 7 days on malt extract agar and then

  19. Onycholysis and Chromonychia: A Case Caused by Trichosporon inkin

    PubMed Central

    Ortega-Springall, María Fernanda; Arroyo-Escalante, Sara; Arenas, Roberto

    2016-01-01

    Yeasts cause only 5-10% of onychomycosis; the most common yeast is Candida albicans, and rarely Trichosporon spp. is found. Recently, it has become an important cause of fungemia with a high mortality rate in immunocompromised patients. Superficial infections caused by Trichosporon spp., including piedra and onychomycosis, occur in immunocompetent patients. Herein, we report a case of a fungal nail infection characterized by onycholysis and chromonychia caused by Trichosporon inkin. PMID:27171745

  20. Catheter-associated fungemia due to Exophiala oligosperma in a leukemic child and review of fungemia cases caused by Exophiala species.

    PubMed

    Al-Obaid, I; Ahmad, S; Khan, Z U; Dinesh, B; Hejab, H M

    2006-11-01

    A case of catheter-associated fungemia due to Exophiala oligosperma in a 3-year-old leukemic child is presented. The etiologic agent was isolated from blood specimens and the catheter tip. The isolate was identified by its morphological characteristics and DNA sequencing of the internal transcribed spacer region of rDNA. Despite initial amphotericin B and itraconazole therapy, the child's fever subsided only after removal of the catheter. A review of the medical literature revealed 29 cases of infection due to Exophiala species. Twenty-three of these 29 patients had a CVC in place when they developed fever or other manifestations of fungemia. Withdrawal of the CVC together with amphotericin B and/or itraconazole therapy generally resulted in a good prognosis. PMID:17033790

  1. Case report: Infrapatellar bursitis caused by Prototheca wickerhamii.

    PubMed

    Van den Bossche, Dorien; de Haan, Roel; Van der Werff Ten Bosch, Jutte; Van Hecke, Wim; Symoens, Françoise; Van den Borre, Ina; Allard, Sabine; De Bel, Annelies

    2012-01-01

    A 54-year-old immunocompetent man presented with an infrapatellar bursitis caused by Prototheca wickerhamii. Because of clinical and microbiological relapse two weeks after bursectomy, six weekly injections of 5 mg of conventional amphotericin B were chosen for intrabursal treatment. Four months after completion of the treatment, the patient remains cured. PMID:24371726

  2. First Report of Babesia microti-Caused Babesiosis in Spain

    PubMed Central

    Arsuaga, Marta; Gonzalez, Luis M.; Lobo, Cheryl A.; de la Calle, Fernando; Bautista, Jose M.; Azcárate, Isabel G.; Puente, Sabino

    2016-01-01

    Abstract Babesiosis is an emerging zoonosis now found in several areas of the world. Using PCR and indirect immunofluorescence assay, we have diagnosed the first case of human babesiosis caused by Babesia microti in Spain. Diagnosis was delayed because of the nonspecific clinical symptoms that occurred in an immunocompetent patient. PMID:27560451

  3. First Report of Babesia microti-Caused Babesiosis in Spain.

    PubMed

    Arsuaga, Marta; Gonzalez, Luis M; Lobo, Cheryl A; de la Calle, Fernando; Bautista, Jose M; Azcárate, Isabel G; Puente, Sabino; Montero, Estrella

    2016-10-01

    Babesiosis is an emerging zoonosis now found in several areas of the world. Using PCR and indirect immunofluorescence assay, we have diagnosed the first case of human babesiosis caused by Babesia microti in Spain. Diagnosis was delayed because of the nonspecific clinical symptoms that occurred in an immunocompetent patient.

  4. Borrelia persica Infection in Immunocompetent Mice - A New Tool to Study the Infection Kinetics In Vivo

    PubMed Central

    Schwarzer, Sandra; Overzier, Evelyn; Hermanns, Walter; Baneth, Gad; Straubinger, Reinhard K.

    2016-01-01

    Borrelia persica, a bacterium transmitted by the soft tick Ornithodoros tholozani, causes tick-borne relapsing fever in humans in the Middle East, Central Asia and the Indian peninsula. Immunocompetent C3H/HeOuJ mice were infected intradermally with B. persica at varying doses: 1 x 106, 1 x 104, 1 x 102 and 4 x 100 spirochetes/mouse. Subsequently, blood samples were collected and screened for the presence of B. persica DNA. Spirochetes were detected in all mice infected with 1 x 106, 1 x 104 and 1 x 102 borrelia by real-time PCR targeting the flaB gene of the bacterium. Spirochetemia developed with a one- to two-day delay when 1 x 104 and 1 x 102 borrelia were inoculated. Mice injected with only four organisms were negative in all tests. No clinical signs were observed when infected mice were compared to negative control animals. Organs (heart, spleen, urinary bladder, tarsal joint, skin and brain) were tested for B. persica-specific DNA and cultured for the detection of viable spirochetes. Compiled data show that the target organs of B. persica infections are the brain and the skin. A newly developed serological two-tiered test system (ELISA and western blot) for the detection of murine IgM, IgG and IgA antibody titers against B. persica showed a vigorous antibody response of the mice during infection. In conclusion, the infection model described here for B. persica is a platform for in vivo studies to decipher the so far unexplored survival strategies of this Borrelia species. PMID:26890814

  5. Reduced Immunocompetent B Cells and Increased Secondary Infection in Elderly Patients With Severe Sepsis.

    PubMed

    Suzuki, Kodai; Inoue, Shigeaki; Kametani, Yoshie; Komori, Yukako; Chiba, Sayuri; Sato, Takehito; Inokuchi, Sadaki; Ogura, Shinji

    2016-09-01

    Lymphocyte exhaustion was recently recognized as a mechanism of immunosuppression in sepsis. While B cells are known to play pivotal roles in bacterial infection and sepsis, changes in B-cell-mediated humoral immunity have not been evaluated in critically ill septic patients. We aimed to investigate changes in humoral immunity caused by defective B-cell function during severe sepsis. Thirty-three severe sepsis patients and 44 healthy subjects were prospectively enrolled. Blood was collected from patients within 72 h of and 8 to 11 h after sepsis onset to measure B-cell subtypes, serum immunoglobulin M concentration, and CpG-B oligodeoxynucleotide-induced immunoglobulin M (IgM) production ex vivo. Participants were divided into two age groups: adults (18-64 years) and elderly (≥65 years). The fraction of CD21 exhausted B cells in acute sepsis patients (3.18%) was higher than that observed in healthy donors (0.77%, respectively, P <0.01). Significantly, serum IgM in elderly septic patients (≥65 years) was negatively correlated with acute physiology and chronic health evaluation II score (r = -0.57, P <0.05). Consistently, in B cells stimulated ex vivo, both aging and sepsis induced significant reductions in supernatant IgM (P <0.01). This finding was clinically relevant, as elderly patients with decreased IgM production might be more susceptible to infection by Gram-negative bacteria and fungi. Reduced immunocompetent B cells may be related to increased secondary infection after sepsis, especially in the elderly. Finally, impaired humoral immunity with increased CD21 exhausted B cells and insufficient immunoglobulin M production may be a critical immunological change in sepsis. PMID:27172158

  6. Cell phenotypic change due to Cryptosporidium parvum infection in immunocompetent mice.

    PubMed

    Codices, Vera; Martins, Catarina; Novo, Carlos; Pinho, Mário; de Sousa, Bruno; Lopes, Angela; Borrego, Miguel; Matos, Olga

    2013-03-01

    Cryptosporidium parvum is an intracellular parasite causing enteritis which can become life-threatening in immunocompromised host. Immunoregulatory T cells play a central role in the regulatory network of the host. Here, we proposed to characterize the populations of immune cells during infection and reinfection with C. parvum. Four-week-old BALB/C mice were inoculated with oocysts of C. parvum at days 0 and 22. Fecal and blood samples, spleens, and small intestines were collected for analysis. Peripheral blood and spleen cell populations were characterized by flow cytometry. After infection (days 0 to 21), mice presented higher values of neutrophils, eosinophils, NK cells and CD4(+)CD25(high) T cells in peripheral blood. After reinfection, this upward trend continued in the following days for all four populations in infected mice. At day 35, infected mice presented similar values to the control group, except for CD4(+)CD25(high) T cells, which remained higher in infected mice. A possible correlation between alterations in blood and spleen cell populations was also studied, but no consistent association could be established. Small intestine sections were screened for intracellular stages of the parasite but no evidence of pathology was observed. Here, we report information which may be important for the understanding of the specific cell-mediated response in immunocompetent mice to C. parvum infection. Although some questions remain unanswered and complementary studies are needed, our results are expected to contribute to a better understanding of innate and Treg cells role in the clearance process of this parasite.

  7. Acyclovir-resistant varicella-zoster virus keratitis in an immunocompetent patient.

    PubMed

    Gueudry, J; Boutolleau, D; Gueudin, M; Burrel, S; Miri, A; Bodaghi, B; Muraine, M

    2013-09-01

    Varicella-zoster virus (VZV) resistance to acyclovir (ACV) has only been reported in rare cases of immunocompromised patients. We report the first case of an immunocompetent patient with ACV-resistant VZV keratitis associated with a nucleotide deletion in the VZV thymidine kinase gene, leading to production of a truncated protein.

  8. Pyogenic Liver Abscess Due to Rhodococcus equi in an Immunocompetent Host

    PubMed Central

    Napoleão, Fátima; Vieira Damasco, Paulo; Ferreira Camello, Thereza Cristina; Damasceno do Vale, Márcio; Braga de Andrade, Arnaldo Feitosa; Hirata, Raphael; de Mattos-Guaraldi, Ana Luíza

    2005-01-01

    A case of pyogenic liver abscess (PLA) due to Rhodococcus equi in an immunocompetent individual was successfully treated by combining surgery and antibiotics. The R. equi-targeted antimicrobial agents erythromycin and rifampin were used only after surgical resection of the lesion and identification of the infective organism. PMID:15695730

  9. Successful treatment of larynx-tracheobronchial-pulmonary aspergillosis in an immunocompetent host.

    PubMed

    Qu, W X; Feng, X W; Zhao, L

    2014-02-14

    Immunocompromised individuals are susceptible to pulmonary Aspergillus infections, whereas invasive Aspergillus infection is extremely rare in the presence of normal immunity. A case of larynx-tracheobronchial-pulmonary aspergillosis in an immunocompetent 57-year-old female host who was successfully treated with amphotericin-B and voriconazole is reported here.

  10. Clinical Presentation of Herpes Zoster in Immunocompetent and Immunocompromised Hospitalized Children Treated With Acyclovir.

    PubMed

    Kuchar, Ernest; Szenborn, Leszek; Lis, Izabela; Jaroszewska, Anna; Czeladzka, Justyna

    2016-07-01

    Herpes zoster, defined as the reactivation of a latent varicella-zoster virus (VZV) infection, used to be a serious disease in immunocompromised children until recently. The aim of this study was to describe the clinical presentation of herpes zoster in hospitalized immunocompromised children compared with hospitalized immunocompetent counterparts. We reviewed the hospital charts of 72 children aged 6 months to 18 years diagnosed with herpes zoster and treated with acyclovir in our department covering a 19-year period. Forty-six of the children were immunocompromised which was mainly due to hematologic diseases. There were no differences in the age at which herpes zoster occurred, length of hospitalization, and the location or extent of the skin eruption. General symptoms were observed more frequently in the hospitalized immunocompetent patients compared with the hospitalized immunocompromised children (80% vs. 56%). The average age at which primary VZV infection occurred was higher among the immunocompromised children than the immunocompetent children with the latter group suffering from significantly more primary VZV infections during infancy. The presentation of herpes zoster in immunocompromised children is similar to that of herpes zoster in hospitalized immunocompetent children. PMID:27347778

  11. Aspergillus pseudomembranous tracheobronchitis in an immunocompetent individual: A diagnostic conundrum with therapeutic challenge

    PubMed Central

    Gaspar, Balan Louis; Agarwal, Ritesh; Gupta, Kirti; Shivaprakash, M R

    2016-01-01

    Aspergillus tracheobronchitis is an extremely uncommon manifestation of Aspergillus infection. Most of the cases described in the literature are in the immunosuppressed individuals and is almost uniformly fatal. Immunocompetent individuals do manifest the disease, but the disease if diagnosed early can be appropriately treated and thus can be life-saving. Here, we describe a similar case which was diagnosed only at autopsy.

  12. Intracranial Fusarium Fungal Abscess in an Immunocompetent Patient: Case Report and Review of the Literature

    PubMed Central

    Peterson, Asa; Pham, Martin H.; Lee, Brian; Commins, Deborah; Cadden, Joseph; Giannotta, Steven L.; Zada, Gabriel

    2014-01-01

    Introduction Fusarium spp is an omnipresent fungal species that may lead to fatal infections in immunocompromised populations. Spontaneous intracranial infection by Fusarium spp in immunocompetent individuals is exceedingly rare. Case Report An immunocompetent 33-year-old Hispanic woman presented with persistent headaches and was found to have a contrast-enhancing mass in the left petrous apex and prepontine cistern. She underwent a subsequent craniotomy for biopsy and partial resection that revealed a Fusarium abscess. She had a left transient partial oculomotor palsy following the operation that resolved over the next few weeks. She was treated with long-term intravenous antifungal therapy and remained at her neurologic baseline 18 months following the intervention. Discussion To our knowledge, this is the first reported case of Fusarium spp brain abscess in an immunocompetent patient. Treatment options include surgical intervention and various antifungal medications. Conclusion This case demonstrates the rare potential of intracranial Fusarium infection in the immunocompetent host, as well as its successful treatment with surgical aspiration and antifungal therapy. PMID:25485222

  13. Plasmablastic lymphoma exclusively involving bones mimicking osteosarcoma in an immunocompetent patient

    PubMed Central

    Sarker, Azmal Kabir; Im, Hyung-Jun; Paeng, Jin Chul; Cheon, Gi Jeong; Kang, Keon Wook; Chung, June-Key; Lee, Dong Soo

    2016-01-01

    Abstract Background: It has been known that plasmablastic lymphoma (PBL) is a neoplasm of immunocompromised patients occurring in soft tissue of oral cavity or in the vicinity whereas bone is an unlikely site to harbor PBL. However, its occurrence is increasingly being reported in immunocompetent individuals in either osseous or extra-oral sites. To our best knowledge, F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient have not been reported, yet . Case summary: We report a case of PBL involving multiple bones in an immunocompetent patient. Features of different imaging modalities including F-18 Fluoro-deoxy glucose (FDG) positron emission tomography/computed tomography (PET/CT) were correlated well as findings of osteosarcoma in mandible with metastatic lesions. However, the histopathology and immunohistochemistry (IHC) of bone tissues from 2 separate biopsy sites revealed features of PBL. Conclusion: awareness to F-18 FDG PET/CT findings of PBL involving bones in an immunocompetent patient may prevent misdiagnosis. PMID:27428232

  14. Immunocompetence of breeding females is sensitive to cortisol levels but not to communal rearing in the degu (Octodon degus).

    PubMed

    Ebensperger, Luis A; León, Cecilia; Ramírez-Estrada, Juan; Abades, Sebastian; Hayes, Loren D; Nova, Esteban; Salazar, Fabián; Bhattacharjee, Joydeep; Becker, María Inés

    2015-03-01

    One hypothesis largely examined in social insects is that cooperation in the context of breeding benefits individuals through decreasing the burden of immunocompetence and provide passive immunity through social contact. Similarly, communal rearing in social mammals may benefit adult female members of social groups by reducing the cost of immunocompetence, and through the transfer of immunological compounds during allonursing. Yet, these benefits may come at a cost to breeders in terms of a need to increase investment in individual immunocompetence. We examined how these potential immunocompetence costs and benefits relate to reproductive success and survival in a natural population of the communally rearing rodent, Octodon degus. We related immunocompetence (based on ratios of white blood cell counts, total and specific immunoglobulins of G isotype titers) and fecal glucocorticoid metabolite (FGC) levels of adults immunized with hemocyanin from the mollusk Concholepas concholepas to measures of sociality (group size) and communal rearing (number of breeding females). Offspring immunocompetence was quantified based on circulating levels of the same immune parameters. Neither female nor offspring immunocompetence was influenced by communal rearing or sociality. These findings did not support that communal rearing and sociality enhance the ability of females to respond to immunological challenges during lactation, or contribute to enhance offspring condition (based on immunocompetence) or early survival (i.e., to 3months of age). Instead, levels of humoral and cellular components of immunocompetence were associated with variation in glucorcorticoid levels of females. We hypothesize that this covariation is driven by physiological (life-history) adjustments needed to sustain breeding. PMID:25497887

  15. The PHA Test Reflects Acquired T-Cell Mediated Immunocompetence in Birds

    PubMed Central

    Tella, José L.; Lemus, Jesús A.; Carrete, Martina; Blanco, Guillermo

    2008-01-01

    Background cological immunology requires techniques to reliably measure immunocompetence in wild vertebrates. The PHA-skin test, involving subcutaneous injection of a mitogen (phytohemagglutinin, PHA) and measurement of subsequent swelling as a surrogate of T-cell mediated immunocompetence, has been the test of choice due to its practicality and ease of use in the field. However, mechanisms involved in local immunological and inflammatory processes provoked by PHA are poorly known, and its use and interpretation as an acquired immune response is currently debated. Methodology Here, we present experimental work using a variety of parrot species, to ascertain whether PHA exposure produces larger secondary than primary responses as expected if the test reflects acquired immunocompetence. Moreover, we simultaneously quantified T-lymphocyte subsets (CD4+, CD5+ and CD8+) and plasma proteins circulating in the bloodstream, potentially involved in the immunological and inflammatory processes, through flow cytometry and electrophoresis. Principal Findings Our results showed stronger responses after a second PHA injection, independent of species, time elapsed and changes in body mass of birds between first and second injections, thus supporting the adaptive nature of this immune response. Furthermore, the concomitant changes in the plasma concentrations of T-lymphocyte subsets and globulins indicate a causal link between the activation of the T-cell mediated immune system and local tissue swelling. Conclusions/Significance These findings justify the widespread use of the PHA-skin test as a reliable evaluator of acquired T-cell mediated immunocompetence in diverse biological disciplines. Further experimental research should be aimed at evaluating the relative role of innate immunocompetence in wild conditions, where the access to dietary proteins varies more than in captivity, and to ascertain how PHA responses relate to particular host-parasite interactions. PMID:18820730

  16. The metabolic evaluation of the child with an intellectual developmental disorder: diagnostic algorithm for identification of treatable causes and new digital resource.

    PubMed

    van Karnebeek, Clara D M; Shevell, Michael; Zschocke, Johannes; Moeschler, John B; Stockler, Sylvia

    2014-04-01

    Intellectual developmental disorders (IDD), characterized by significant impairment of cognitive functions, with limitations of learning, adaptive behavior and skills, are frequent (2.5% of the population affected) and present with significant co-morbidity. The burden of IDD, in terms of emotional suffering and associated health care costs, is significant; prevention and treatment therefore are important. A systematic literature review, updated in 2013, identified 89 inborn errors of metabolism (IEMs), which present with IDD as prominent feature and are amenable to causal therapy. Therapeutic effects include improvement and/or stabilization of psychomotor/cognitive development, behavior/psychiatric disturbances, seizures, neurologic and systemic manifestations. The levels of available evidence for the various treatments range from Level 1b, c (n=5); Level 2a, b, c (n=14); Level 4 (n=53), and Levels 4-5 (n=27). For a target audience comprising clinical and biochemical geneticists, child neurologists and developmental pediatricians, five experts translated....this data into a 2-tiered diagnostic algorithm: The first tier comprises metabolic "screening" tests in urine and blood, which are relatively accessible, affordable, less invasive, and have the potential to identify 60% of all treatable IEMs. The second tier investigations for the remaining disorders are ordered based on individual clinical signs and symptoms. This algorithm is supported by an App www.treatable-id.org, which comprises up-to-date information on all 89 IEMs, relevant diagnostic tests, therapies and a search function based on signs and symptoms. These recommendations support the clinician in early identification of treatable IEMs in the child with IDD, allowing for timely initiation of therapy with the potential to improve neurodevelopmental outcomes. The need for future studies to determine yield and usefulness of these recommendations, with subsequent updates and improvements to developments in

  17. Cytomegalovirus infection-associated fulminant hepatitis in an immunocompetent adult requiring emergency living-donor liver transplantation: report of a case.

    PubMed

    Yu, Young-Dong; Park, Gil-Chun; Park, Pyoung-Jae; Choi, Young-Il; Hwang, Shin; Song, Gi-Won; Jung, Dong-Hwan; Ahn, Chul-Soo; Kim, Ki-Hun; Moon, Deog-Bok; Ha, Tae-Yong; Lee, Sung-Gyu

    2013-04-01

    Human cytomegalovirus (CMV) infection is usually self-limiting in healthy adults, but it can lead to significant complications. This report presents the case of an immunocompetent adult with fulminant hepatitis caused by a CMV infection requiring emergency living-donor liver transplantation. A 39-year-old female with persistent fever for 6 weeks was referred for fulminant hepatitis, but the underlying etiology was not identified. Rapid deterioration of consciousness led to an emergency living-donor liver transplant using a modified right lobe graft. She showed increasing CMV antigenemia after surgery and the explant liver pathology showed massive hepatic necrosis with positive staining for CMV protein. Treatment with ganciclovir improved the graft liver function and her general condition recovered. This report presents a rare case of CMV-associated fulminant hepatitis which led to emergency liver transplantation. Although CMV is rare, it should be included in the differential diagnosis of patients with severe hepatitis, even immunocompetent patients, after other more common etiologies have been excluded.

  18. [Herpes simplex virus hepatitis; rare in immunocompetent patients].

    PubMed

    Ozokcu, Leyla; de Bruijckere, Leo M; Jansen, Jan; van den Berge, Marcel

    2009-01-01

    A 42-year-old woman was referred with fever and abdominal pain with peritoneal irritation. A diagnostic laparoscopy showed hepatic lesions. Histopathological investigation of the liver biopsy showed hepatitis caused by herpes simplex virus (HSV). The patient was treated with acyclovir and recovered well. HSV is a rare cause of viral hepatitis and has a high mortality rate.

  19. Adiposity, compared with masculinity, serves as a more valid cue to immunocompetence in human mate choice.

    PubMed

    Rantala, Markus J; Coetzee, Vinet; Moore, Fhionna R; Skrinda, Ilona; Kecko, Sanita; Krama, Tatjana; Kivleniece, Inese; Krams, Indrikis

    2013-01-22

    According to the 'good genes' hypothesis, females choose males based on traits that indicate the male's genetic quality in terms of disease resistance. The 'immunocompetence handicap hypothesis' proposed that secondary sexual traits serve as indicators of male genetic quality, because they indicate that males can contend with the immunosuppressive effects of testosterone. Masculinity is commonly assumed to serve as such a secondary sexual trait. Yet, women do not consistently prefer masculine looking men, nor is masculinity consistently related to health across studies. Here, we show that adiposity, but not masculinity, significantly mediates the relationship between a direct measure of immune response (hepatitis B antibody response) and attractiveness for both body and facial measurements. In addition, we show that circulating testosterone is more closely associated with adiposity than masculinity. These findings indicate that adiposity, compared with masculinity, serves as a more important cue to immunocompetence in female mate choice.

  20. Mycobacterium avium complex (MAC) osteomyelitis and septic arthritis in an immunocompetent host.

    PubMed

    Jones, A R; Bartlett, J; McCormack, J G

    1995-01-01

    We describe a case of Mycobacterium avium complex (MAC) osteomyelitis and septic arthritis in an immunocompetent man. Infection was derived from a chainsaw injury sustained on the lateral aspect of the ankle 13 years earlier, and had spread through the bone, joint and soft tissue emerging at the medial aspect. This was successfully treated with surgical debridement, drainage, arthrodesis and 18 months of chemotherapy consisting of clarithromycin, rifampicin, ethambutol, and ciprofloxacin with an initial 2 weeks of amikacin. Infections with this organisms are generally associated with immunocompromised states, particularly advanced AIDS. However, our patient illustrates that atypical mycobacterial infections must also be considered in immunocompetent patients who have a prolonged clinical course and an appropriate potential source of infection.

  1. Hepatosplenic cat scratch disease in immunocompetent adults: report of 3 cases and review of the literature.

    PubMed

    García, Juan C; Núñez, Manuel J; Castro, Begoña; Fernández, Jesús M; López, Asunción; Portillo, Aránzazu; Oteo, José A

    2014-10-01

    Cat-scratch disease (CSD) is the most frequent presentation of Bartonella henselae infection. It has a worldwide distribution and is associated with a previous history of scratch or bite from a cat or dog. CSD affects children and teenagers more often (80%) than adults, and it usually has a self-limiting clinical course. Atypical clinical course or systemic symptoms are described in 5%-20% of patients. Among them, hepatosplenic (HS) forms (abscess) have been described. The majority of published cases have affected children or immunosuppressed patients. Few cases of HS forms of CSD in immunocompetent adult hosts have been reported, and data about the management of this condition are scarce. Herein, we present 3 new cases of HS forms of CSD in immunocompetent adults and review 33 other cases retrieved from the literature. We propose an approach to clinical diagnosis and treatment with oral azithromycin.

  2. HHV-6 encephalitis presenting as status epilepticus in an immunocompetent patient

    PubMed Central

    Shahani, Lokesh

    2014-01-01

    Human herpes virus 6 (HHV-6) infections are frequently detected in patients with immunosuppressed transplant; however, reactivation in an immunocompetent patient is rarely reported. The author reports the case of a 65-year-old woman presenting with status epilepticus with foci in the temporal and occipital lobe and MRI suggestive of encephalitis in the parietal, occipital and temporal regions. The cerebrospinal fluid (CSF) analysis showed normal cell counts, protein and glucose levels and hence viral aetiologies were considered. The patient's workup returned positive for HHV-6 in serum as well as CSF. The patient responded well to a 21-day course of antivirals with complete resolution of her symptoms. This case highlights the importance of considering HHV-6 encephalitis even among immunocompetent patients presenting with encephalitis and having signs of temporal lobe involvement. PMID:25239996

  3. Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient*

    PubMed Central

    Medeiros, Karina Bittencourt; Landeiro, Luana Gomes; Diniz, Lucia Martins; Falqueto, Aloísio

    2016-01-01

    A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy. PMID:27579758

  4. Disseminated cryptococcosis presenting as mediastinal and hilar lymphadenopathy in an immunocompetent patient

    PubMed Central

    Oki, Masahide; Saka, Hideo; Kajikawa, Shigehisa; Murakami, Ayuka; Ishida, Akane

    2016-01-01

    Abstract We herein report a rare case of disseminated cryptococcosis presenting as mediastinal and hilar lymphadenopathy in a young immunocompetent man. A previously healthy 26‐year‐old man presented with persistent headache and nonproductive cough. Chest computed tomography indicated mediastinal and hilar lymphadenopathy. Cryptococcal lymphadenitis and meningitis was confirmed by endobronchial ultrasound‐guided transbronchial needle aspiration and central spinal fluid examination, respectively. He received liposomal amphotericin B and flucytosine followed by fluconazole and finally improved. PMID:27512567

  5. Disseminated cutaneous sporotrichosis associated with ocular lesion in an immunocompetent patient.

    PubMed

    Medeiros, Karina Bittencourt; Landeiro, Luana Gomes; Diniz, Lucia Martins; Falqueto, Aloísio

    2016-01-01

    A 59-year-old female patient, previously healthy, immunocompetent, presented left bulbar conjunctiva lesions and nodular-ulcerated lesions on the arms and cervical region, besides left cervical and retroauricular lymphadenopathy. She had previous contact with domestic cats that excoriated her face. The diagnosis was conclusive of disseminated sporotrichosis through clinical and epidemiological history and cultures of skin and ocular secretions. It evolved with good response to oral antifungal therapy. PMID:27579758

  6. Aspergillus pseudomembranous tracheobronchitis in an immunocompetent individual: A diagnostic conundrum with therapeutic challenge.

    PubMed

    Gaspar, Balan Louis; Agarwal, Ritesh; Gupta, Kirti; Shivaprakash, M R

    2016-01-01

    Aspergillus tracheobronchitis is an extremely uncommon manifestation of Aspergillus infection. Most of the cases described in the literature are in the immunosuppressed individuals and is almost uniformly fatal. Immunocompetent individuals do manifest the disease, but the disease if diagnosed early can be appropriately treated and thus can be life-saving. Here, we describe a similar case which was diagnosed only at autopsy. PMID:27625454

  7. Severe adenovirus community-acquired pneumonia in immunocompetent adults: chest radiographic and CT findings

    PubMed Central

    Tan, Dingyu; Fu, Yangyang; Wang, Zhiwei; Cao, Jian; Walline, Joseph; Zhu, Huadong

    2016-01-01

    Background Severe adenovirus pneumonia and its associated imaging features are well-described in immunocompromised patients but are rare and poorly understood in immunocompetent adults. We sought to describe the radiographic and CT findings of severe adenovirus community-acquired pneumonia (CAP) in eight immunocompetent adults. Methods We reviewed systematically chest imaging manifestations of laboratory-confirmed severe adenovirus pneumonia in eight immunocompetent adults from April 2012 to April 2014. Results All patients showed abnormal results on initial chest radiograph and CT, with the exception of one normal initial chest radiograph. The abnormalities of the initial chest radiographs were unilateral (n=4) or bilateral (n=3), including consolidation (n=4), dense patchy opacity (n=3), ground glass opacity (GGO) (n=1), and pleural effusion (n=1). The initial CT findings consisted of unilateral (n=5) and bilateral (n=3) abnormalities, including consolidation (n=8), GGO (n=2), pleural effusion (n=3) and small nodules (n=1). Focal consolidation was the predominant finding in six patients whose initial CT scans were examined within one week after illness onset. Follow-up radiologic findings showed rapid development of bilateral consolidation within ten days after illness onset, usually accompanied by adjacent ground-glass opacity and pleural effusion. The parenchymal abnormalities began to absorb around two weeks after illness onset, with no appearances of fibrosis. Conclusions Severe adenovirus CAP in immunocompetent adults mainly appears as focal consolidation followed by rapid progression to bilateral consolidation, usually accompanied by adjacent GGO and pleural effusion, which may resemble bacterial pneumonia. Adenovirus should be considered in severe pneumonia cases with negative cultures and failure to respond to antibiotics. PMID:27162658

  8. Aspergillus pseudomembranous tracheobronchitis in an immunocompetent individual: A diagnostic conundrum with therapeutic challenge

    PubMed Central

    Gaspar, Balan Louis; Agarwal, Ritesh; Gupta, Kirti; Shivaprakash, M R

    2016-01-01

    Aspergillus tracheobronchitis is an extremely uncommon manifestation of Aspergillus infection. Most of the cases described in the literature are in the immunosuppressed individuals and is almost uniformly fatal. Immunocompetent individuals do manifest the disease, but the disease if diagnosed early can be appropriately treated and thus can be life-saving. Here, we describe a similar case which was diagnosed only at autopsy. PMID:27625454

  9. Fatal Cryptococcus gattii genotype AFLP5 infection in an immunocompetent Cuban patient

    PubMed Central

    Illnait-Zaragozí, María T.; Ortega-Gonzalez, Lilia M.; Hagen, Ferry; Martínez-Machin, Gerardo F.; Meis, Jacques F.

    2013-01-01

    We describe the first clinical case of cryptococcosis due C. gattii in a Cuban immunocompetent patient who had a traveling history two years before to Central America. Molecular characterization of the isolate showed it to be genotype AFLP5 of which MLST sequences clustered with clinical and environmental strains from Colombia. The patient died one year after the diagnosis despite a prolonged treatment with (liposomal) amphotericin B, fluconazole, voriconazole and gamma interferon. PMID:24432215

  10. Treatment of a solid tumor using engineered drug-resistant immunocompetent cells and cytotoxic chemotherapy.

    PubMed

    Dasgupta, Anindya; Shields, Jordan E; Spencer, H Trent

    2012-07-01

    Multimodal therapy approaches, such as combining chemotherapy agents with cellular immunotherapy, suffers from potential drug-mediated toxicity to immune effector cells. Overcoming such toxic effects of anticancer cellular products is a potential critical barrier to the development of combined therapeutic approaches. We are evaluating an anticancer strategy that focuses on overcoming such a barrier by genetically engineering drug-resistant variants of immunocompetent cells, thereby allowing for the coadministration of cellular therapy with cytotoxic chemotherapy, a method we refer to as drug-resistant immunotherapy (DRI). The strategy relies on the use of cDNA sequences that confer drug resistance and recombinant lentiviral vectors to transfer nucleic acid sequences into immunocompetent cells. In the present study, we evaluated a DRI-based strategy that incorporates the immunocompetent cell line NK-92, which has intrinsic antitumor properties, genetically engineered to be resistant to both temozolomide and trimetrexate. These immune effector cells efficiently lysed neuroblastoma cell lines, which we show are also sensitive to both chemotherapy agents. The antitumor efficacy of the DRI strategy was demonstrated in vivo, whereby neuroblastoma-bearing NOD/SCID/γ-chain knockout (NSG) mice treated with dual drug-resistant NK-92 cell therapy followed by dual cytotoxic chemotherapy showed tumor regression and significantly enhanced survival compared with animals receiving either nonengineered cell-based therapy and chemotherapy, immunotherapy alone, or chemotherapy alone. These data show there is a benefit to using drug-resistant cellular therapy when combined with cytotoxic chemotherapy approaches.

  11. Subclinical VZV reactivation in immunocompetent children hospitalized in the ICU associated with prolonged fever duration.

    PubMed

    Papaevangelou, V; Quinlivan, M; Lockwood, J; Papaloukas, O; Sideri, G; Critselis, E; Papassotiriou, I; Papadatos, J; Breuer, J

    2013-05-01

    A prospective observational study was conducted to examine whether asymptomatic VZV reactivation occurs in immunocompetent children hospitalized in an ICU and its impact on clinical outcome. A secondary aim was to test the hypothesis that vaccinated children have a lower risk of reactivation than naturally infected children. Forty immunocompetent paediatric ICU patients and healthy controls were enrolled. Patients were prospectively followed for 28 days. Clinical data were collected and varicella exposure was recorded. Admission serum levels of TNF-a, cortisol and VZV-IgG were measured. Blood and saliva samples were collected for VZV-DNA detection via real-time PCR. As a comparison, the detection of HSV-DNA was also examined. Healthy children matched for age and varicella exposure type (infection or vaccination) were also included. VZV reactivation was observed in 17% (7/39) of children. Children with VZV reactivation had extended duration of fever (OR = 1.17; 95% CI, 1.02-1.34). None of the varicella-vaccinated children or healthy controls had detectable VZV-DNA in any blood or saliva samples examined. HSV-DNA was detected in saliva from 33% of ICU children and 2.6% of healthy controls. Among children with viral reactivation, typing revealed wild-type VZV and HSV-1. In conclusion, VZV reactivation occurs in immunocompetent children under severe stress and is associated with prolonged duration of fever.

  12. Rfp-Y region polymorphism and Marek's disease resistance in multitrait immunocompetence-selected chicken lines.

    PubMed

    Lakshmanan, N; Lamont, S J

    1998-04-01

    Although the influence of the chicken classical MHC in resistance to many diseases is well established, the role of the recently identified, genetically independent, MHC-like region known as Rfp-Y is unclear. The objectives of this study were to analyze the frequencies of DNA polymorphisms of the Rfp-Y region in White Leghorn lines, which were divergently selected in replicate for multitrait immunocompetence, and to determine the association of these polymorphisms with Marek's disease (MD) resistance. Chicks, either with or without herpes virus of turkey (HVT) vaccination, were challenged with 500 ffu of a very virulent Marek's disease virus (Md5) at 2 d of age. The MD-related data were collected for 10 wk. PvuII-digested genomic DNA was hybridized with an Rfp-Y region-specific probe, 18.1. Three Rfp-Y polymorphisms were observed. The frequency of one Rfp-Y polymorphism was significantly different between divergently selected multitrait immunocompetence lines in one replicate only; therefore, the impact of multitrait immunocompetence selection on Rfp-Y polymorphisms is inconclusive. The PvuII defined Rfp-Y region polymorphisms had no association with either innate or vaccine-induced MD resistance to Md5 virus challenge.

  13. Treatment of a Solid Tumor Using Engineered Drug-Resistant Immunocompetent Cells and Cytotoxic Chemotherapy

    PubMed Central

    Dasgupta, Anindya; Shields, Jordan E.

    2012-01-01

    Abstract Multimodal therapy approaches, such as combining chemotherapy agents with cellular immunotherapy, suffers from potential drug-mediated toxicity to immune effector cells. Overcoming such toxic effects of anticancer cellular products is a potential critical barrier to the development of combined therapeutic approaches. We are evaluating an anticancer strategy that focuses on overcoming such a barrier by genetically engineering drug-resistant variants of immunocompetent cells, thereby allowing for the coadministration of cellular therapy with cytotoxic chemotherapy, a method we refer to as drug-resistant immunotherapy (DRI). The strategy relies on the use of cDNA sequences that confer drug resistance and recombinant lentiviral vectors to transfer nucleic acid sequences into immunocompetent cells. In the present study, we evaluated a DRI-based strategy that incorporates the immunocompetent cell line NK-92, which has intrinsic antitumor properties, genetically engineered to be resistant to both temozolomide and trimetrexate. These immune effector cells efficiently lysed neuroblastoma cell lines, which we show are also sensitive to both chemotherapy agents. The antitumor efficacy of the DRI strategy was demonstrated in vivo, whereby neuroblastoma-bearing NOD/SCID/γ-chain knockout (NSG) mice treated with dual drug-resistant NK-92 cell therapy followed by dual cytotoxic chemotherapy showed tumor regression and significantly enhanced survival compared with animals receiving either nonengineered cell-based therapy and chemotherapy, immunotherapy alone, or chemotherapy alone. These data show there is a benefit to using drug-resistant cellular therapy when combined with cytotoxic chemotherapy approaches. PMID:22397715

  14. The relation between child death and child maltreatment

    PubMed Central

    Jenny, C; Isaac, R

    2006-01-01

    The death of a child is a sentinel event in a community, and a defining marker of a society's policies of safety and health. Child death as a result of abuse and neglect is a tragic outcome that occurs in all nations of the world. The true incidence of fatal child abuse and neglect is unknown. The most accurate incidence data of such deaths have been obtained from countries where multi‐agency death review teams analyse the causes of child fatalities, as is done in the United States and Australia. PMID:16492892

  15. A Letter to the Parent(s) of a Child with Developmental Apraxia of Speech. Part II: The Nature and Causes of DAS.

    ERIC Educational Resources Information Center

    Hall, Penelope K.

    2000-01-01

    One of a series of letters to parents of children with developmental apraxia of speech (DAS), this letter discusses issues and current thinking about the nature and causes of the disorder. These include the idea that DAS is a disorder of overall language development or that DAS is a problem of the "motor-programming" system for speech. An…

  16. Child Development

    MedlinePlus

    As children grow older, they develop in several different ways. Child development includes physical, intellectual, social, and emotional changes. Children grow and mature at very different rates. It's ...

  17. Chronic bilateral hearing loss in an immunocompetent patient

    PubMed Central

    Akyol, Asli G.; Nazliel, Bijen; Oner, Yusuf; Erdem, Ozlem

    2014-01-01

    Congenital, infectious, toxic, and demyelinating disorders are common etiological causes of deafness. Tuberculous meningitis, as one of the infectious causes, should be considered in the differential diagnosis since tuberculosis represents an endemic public health problem in developing countries. Multiple cranial nerve palsies can be expected due to basal meningitis; however, presentation with bilateral hearing loss is quite rare. Early diagnosis and treatment are crucial to prevent mortality and residual neurologic deficits. The focus of this discussion is a 42-year-old female presenting with bilateral hearing loss and nonspecific complaints who was finally diagnosed with chronic tuberculous meningitis. We also demonstrate the characteristic radiological and histopathological findings. PMID:25274594

  18. Sustained Viremia and High Viral Load in Respiratory Tract Secretions Are Predictors for Death in Immunocompetent Adults with Adenovirus Pneumonia

    PubMed Central

    Sun, Bing; Yu, Xiaomin; Li, Hui; Cao, Bin

    2016-01-01

    The predictors for fatal adenovirus (AdV) pneumonia among immunocompetent adults are unclear. Laboratory-confirmed, hospitalized AdV pneumonia adults were prospectively enrolled in Beijing Chao-Yang hospital from March to June 2013. Clinical data and serial whole blood and respiratory tract secretions from such patients were collected. Quantitative real-time polymerase chain reaction was performed to quantify the viral load. A total of 14 AdV pneumonia cases were consecutively enrolled, and four of them were fatal. Ten cases were caused by AdV-55, three by AdV-7 and one by AdV-3. There were no differences in age, gender or underlying diseases between the patients in the fatal cases and surviving cases. At admission (on day 5–7 after illness onset), the patients in fatal cases presented higher initial viral loads in respiratory tract secretions (8.578 ± 2.115 vs 6.263 ± 1.225 Log10 copies/ml, p = 0.023). All patients in fatal cases presented with viremia on day 12–14 (100% vs 66.7%, p = 0.017). A higher initial viral load in the respiratory tract and sustained viremia (more than 2 weeks) may be predictors for fatal clinical outcomes. PMID:27532864

  19. The Child, The Family and Responsible Parenthood.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    This booklet presents evidence which links the effects of unplanned pregnancies on the health of the mother and child. The first section identifies the causes of high mortality and morbidity rates among children. Teenage child-bearing, child-bearing past the age of 35, family size and birth intervals are discussed. The second section presents…

  20. Child Abuse and Neglect in Indian Families.

    ERIC Educational Resources Information Center

    Sharan, M. B.

    Conditions in India that contribute to child abuse and neglect are discussed. Sections focus on child rearing practices, discipline of children at home and in school, the nation's six million abandoned children, child sexual abuse, causes of abuse, poverty, lack of education, characteristics of abused children and their abusers, situational…

  1. Child Labor and School Attendance in Kenya

    ERIC Educational Resources Information Center

    Moyi, Peter

    2011-01-01

    Sub-Saharan Africa has the highest incidence of child labor in the world and estimates show that it continues to grow. This paper examines the causes and magnitude of child labor in Kenya. Unlike previous studies that examined child labor as only an economic activity, this paper includes household chores. Including household chores is important…

  2. The Hyperactive Child.

    ERIC Educational Resources Information Center

    Murphy, Linda; Della Corte, Suzanne

    1987-01-01

    The newsletter's main article focuses on hyperactivity and attention deficit disorder. The causes of hyperactivity, which affects 3-5 percent of all children, are elusive but may include neurological immaturity, inherent genetic problems, or fetal exposure to harmful substances. Patterns of behavior that typify a hyperactive child include a short…

  3. Child Maltreatment

    PubMed Central

    Al-Saadoon, Muna; Al-Sharbati, Marwan; Nour, Ibtisam El; Al-Said, Basma

    2012-01-01

    Child maltreatment (CM) is common worldwide, and can take many forms. It may even endanger the child’s life, especially when younger children are the victims. CM affects the child’s quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital (SQUH), Oman. The aim of this case series is to increase the level of awareness of CM among Oman’s medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman’s health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families. PMID:22375265

  4. Staphylococcus saprophyticus bacteremia after ESWL in an immunocompetent woman.

    PubMed

    Hofmans, M; Boel, A; Van Vaerenbergh, K; De Beenhouwer, H

    2015-06-01

    Staphylococcus saprophyticus is a well-known cause of uncomplicated urinary tract infections, especially in young and sexually active women. Presence in blood cultures is rare and often attributed to contamination. When bacteremia is significant, it occurs mostly in patients with hematologic malignancies and is predominantly catheter-related. However, we describe a case of significant bacteremia with S. saprophyticus associated with urinary tract infection after extracorporeal shock wave lithotripsy of an ureterolithiasis in an otherwise healthy patient.

  5. Staphylococcus saprophyticus bacteremia after ESWL in an immunocompetent woman.

    PubMed

    Hofmans, M; Boel, A; Van Vaerenbergh, K; De Beenhouwer, H

    2015-06-01

    Staphylococcus saprophyticus is a well-known cause of uncomplicated urinary tract infections, especially in young and sexually active women. Presence in blood cultures is rare and often attributed to contamination. When bacteremia is significant, it occurs mostly in patients with hematologic malignancies and is predominantly catheter-related. However, we describe a case of significant bacteremia with S. saprophyticus associated with urinary tract infection after extracorporeal shock wave lithotripsy of an ureterolithiasis in an otherwise healthy patient. PMID:25523318

  6. Myristoylation negative msbB-mutants of probiotic E. coli Nissle 1917 retain tumor specific colonization properties but show less side effects in immunocompetent mice

    PubMed Central

    Stritzker, Jochen; Hill, Philip J; Gentschev, Ivaylo

    2010-01-01

    Specific colonization of solid tumors by bacteria opens the way to novel approaches in both tumor diagnosis and therapy. However, even non-pathogenic bacteria induce responses by the immune system, which could be devastating for a tumor bearing patient. As such effects are caused e.g., by the lipid A moiety of the lipopolysaccharide, a msbB-mutant of the probiotic E. coli Nissle 1917 strain was investigated. Bacteria of the mutant strain did not show any growth defects in culture media when compared to wild-type E. coli Nissle 1917 but were unable to myristoylate lipid A, had less toxic effects on immunocompetent BALB/c mice, and were still able to specifically colonize tumors. Therefore, the modification of lipid A could result in bacterial strains that might be better suited for diagnosis and therapy of tumors than the corresponding wild-type strains, even if those are not considered pathogenic or are of probiotic background. PMID:21326939

  7. Child Care and Child Nutrition

    ERIC Educational Resources Information Center

    Karolak, Eric

    2009-01-01

    The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…

  8. Colonic Spirochetosis in a 60-Year-Old Immunocompetent Patient

    PubMed Central

    Ngwa, Taiwo; Peng, Jennifer L.; Choi, Euna; Tayarachakul, Sucharat; Liangpunsakul, Suthat

    2016-01-01

    Spirochetes, a genetically and morphologically distinct group of bacteria, are thin, spiral-shaped, and highly motile. They are known causes of several human diseases such as syphilis, Lyme disease, relapsing fever, and leptospirosis. We report a case of colonic spirochetosis in a healthy patient presenting for surveillance colonoscopy. The diagnosis of intestinal spirochetosis was made accidentally during the histological examination of colonic polyps, which were removed during colonoscopy. We also performed an extensive review on intestinal spirochetosis with a focus on clinical presentation and outcomes of reported cases from the past two decades. PMID:27570780

  9. [Immunocompetence and reproductive characteristics of male Campbell dwarf hamsters selected for low and high humoral immune response to SRBC: testing the immunocompetence handicap hypothesis].

    PubMed

    Rogovin, K A; Khrushcheva, A M; Shekarova, O N; Bushuev, A V; Sokolova, O V; Vasil'eva, N Iu

    2014-01-01

    We selected Campbell dwarf hamsters (Phodopus campbelli Thomas, 1905) for low and high humoral immune response to the sheep red blood cells (SRBC) challenge in three generations (P, F1, F2). Non-specific innate immunity and acquired T-cell immunity, resting metabolic rate, testosterone, and cortisole hormone levels, reproductive characteristics, including maturation related morphological traits, and aggressive behavior were studied within sets of males:with low (LI) and high (HI) immune response to SRBC. We found no difference between LI and HI males in cutaneous response to injection of phytohemagglutinin, (DTH test for T-cell immunity), in activity of Peroxidase - Endogenous Hydrogen Peroxide System of Neutrophils , in the white blood count, in resting metabolic rate, in body mass and ano-genital distance at the age of two months, in the blood level of testosterone before and after recurrent immunization by SRBC and in the blood level of cortisole in response to the social stressor (10 min encounter in the neutral arena). At that, LI males had significantly higher basal level of blood cortisole, were less aggressive in response to stranger male and had smaller testosterone-dependent mid-ventral specific skin gland at the age of two months. Males of two groups did not differ in the initial mating success with intact young females (time since pair formation until first litter born), although females of LI males born fewer number of pups. In fact, our results do not support the Handicap Immunocompetence Hypothesis (Folstad, Karter, 1999) which is based on the assumption of trade-off between immunocompetence and reproductive effort. PMID:25782275

  10. Severe Community-Acquired Pneumonia with Bacteremia Caused by Herbaspirillum aquaticum or Herbaspirillum huttiense in an Immune-Competent Adult

    PubMed Central

    Kimball, Joanna; Smith, L. Patrick; Salzer, William

    2015-01-01

    Herbaspirillum spp. are Gram-negative bacteria that inhabit soil and water. Infections caused by these organisms have been reported in immunocompromised hosts. We describe severe community-acquired pneumonia and bacteremia caused by Herbaspirillum aquaticum or H. huttiense in an immunocompetent adult male. PMID:26179298

  11. Paecilomyces lilacinus septic olecranon bursitis in an immunocompetent host.

    PubMed

    Schweitzer, Karl M; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2012-05-01

    Paecilomyces lilacinus is a filamentous fungus that is a rare cause of infection in immunocompromised human hosts. We present a case of lilacinus septic olecranon bursitis in an otherwise healthy 78-year-old male. This patient's case was complicated by wound breakdown after bursectomy and appropriate anti-fungal treatment, requiring a local soft tissue rearrangement. This case demonstrates the need for appropriate and timely medical and surgical treatment in infections involving lilacinus, which are not isolated solely to systemically immunocompromised and medically-ill patient populations. In cases where the patient is systemically immumocompromised or has been rendered locally immunocompromised, it is essential to obtain a full culture work-up, including fungi. PMID:22715445

  12. Gastrointestinal granuloma due to Candida albicans in an immunocompetent cat

    PubMed Central

    Duchaussoy, Anne-Claire; Rose, Annie; Talbot, Jessica J.; Barrs, Vanessa R.

    2015-01-01

    A 3.5 year-old cat was admitted to the University of Melbourne Veterinary Teaching Hospital for chronic vomiting. Abdominal ultrasonography revealed a focal, circumferential thickening of the wall of the duodenum extending from the pylorus aborally for 3 cm, and an enlarged gastric lymph node. Cytology of fine-needle aspirates of the intestinal mass and lymph node revealed an eosinophilic inflammatory infiltrate and numerous extracellular septate acute angle branching fungal-type hyphae. Occasional hyphae had globose terminal ends, as well as round to oval blastospores and germ tubes. Candida albicans was cultured from a surgical biopsy of the duodenal mass. No underlying host immunodeficiencies were identified. Passage of an abrasive intestinal foreign body was suspected to have caused intestinal mucosal damage resulting in focal intestinal candidiasis. The cat was treated with a short course of oral itraconazole and all clinical signs resolved. PMID:26862475

  13. A complicated case of an immunocompetent patient with disseminated nocardiosis.

    PubMed

    Cooper, Chad J; Said, Sarmad; Popp, Maryna; Alkhateeb, Haider; Rodriguez, Carlos; Porres Aguilar, Mateo; Alozie, Ogechika

    2014-02-18

    Nocardia species are aerobic, gram positive filamentous branching bacteria that have the potential to cause localized or disseminated infection. Nocardiosis is a rare disease that usually affects immunocompromised patients and presents as either pulmonary, cutaneous or disseminated nocardiosis. Forty-two year-old hispanic male presented to our care with bilateral lower extremity weakness, frontal headache, subjective fever, nausea, and vomiting. Brain computed tomography (CT) revealed multiple hyperdense lesions with vasogenic edema in the frontal, parietal and left temporal lobes. Chest CT demonstrated bilateral cavitary nodules in the lung and right hilar lymphadenopathy. Brain magnetic resonance imaging revealed multiple bilateral supratentorial and infratentorial rim enhancing lesions involving the subcortical gray-white matter interface with vasogenic edema. Patient was started on empiric therapy for unknown infectious etiology with no response. He eventually expired and autopsy findings revealed a right hilar lung abscess and multiple brain abscesses. Microscopic and culture findings from tissue sample during autopsy revealed nocardia wallacei species with multidrug resistance. The cause of death was stated as systemic nocadiosis (nocardia pneumonitis and encephalitis). The presence of simultaneous lung and brain abscesses is a reliable indication of an underlying Nocardia infection. An increased awareness of the various presentations of nocardiosis and a high index of clinical suspicion can help in a rapid diagnosis and improve survival in an otherwise fatal disease. This case highlights the importance of obtaining a tissue biopsy for definitive diagnosis on the initial presentation when an infectious process is considered in the differential diagnosis and early treatment can be initiated. PMID:24757510

  14. Insidious manifestation of pyogenic liver abscess caused by Streptococcus intermedius and Micrococcus luteus: a case report.

    PubMed

    Ioannou, Antreas; Xenophontos, Eleni; Karatsi, Alexandra; Petrides, Christos; Kleridou, Maro; Zintilis, Chrysostomos

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora.

  15. Disseminated tuberculosis causing isolated splenic vein thrombosis and multiple splenic abscesses.

    PubMed

    Jain, Deepak; Verma, Kamal; Jain, Promil

    2014-09-01

    Tuberculosis is a common infectious cause of splenic enlargement in developing countries, but tubercular splenic abscesses are a rare presentation, found predominantly in immunocompromised populations. We report a case of tubercular splenic abscesses with isolated splenic vein thrombosis in an immunocompetent person.

  16. First case of a dog bite wound infection caused by Streptococcus minor in human.

    PubMed

    Tré-Hardy, M; Saussez, T; Yombi, J C; Rodriguez-Villalobos, H

    2016-11-01

    We report the first case of human infection caused by Streptococcus minor in a 51-year-old immunocompetent woman admitted for dog bite injuries. At present, the role of Streptococcus minor in bite wound infections is unknown. Further studies on virulence factors are needed to elucidate its pathogenicity mechanisms. PMID:27688883

  17. Chronic Invasive Fungal Granuloma–A Diagnostic Dilemma in an Immunocompetent Host

    PubMed Central

    S. Chavan, Shrinivas; Bhople, K.S.; Deshmukh, Sunil D; V. Jain, Prateek; Sonavani, Mangala

    2016-01-01

    Introduction: Invasive fungal sinusitis, though considered to be rare entity, is nowadays frequently encountered, not only in immunocompromised patients but also in immunocompetent patients. The changing prevalence towards immunocompetent hosts is due to the indiscriminate usage of broad spectrum antibiotics, steroids, and immunosuppressive drugs. Diagnosing invasive fungal sinusitis should not pose any difficulty to both the clinician [a whitish colour secretion in elderly Diabetics, and CT Scan PNS showing concretion in the sinus along with destruction of the surrounding bone] and to the pathologist; however, when the invasive fungal sinus infection presents in a form of a granuloma then its diagnosis imposes a challenge to medical professionals. Case Report We are presenting a case study,which consists of 3 cases of chronic invasive fungal sinus infection.Two patients were treated for tuberculoma and had completed a course of Anti Koch’s Treatment and one patient was given a trial of broad spectrum antibiotics and steroids.Eventually all cases were diagnosed as a chronic invasive form of fungal granuloma (CIFG). Conclusion: CIFG of the paranasal sinuses is seen in immunocompetent hosts, especially those that are in the 2nd and 3rd decades of their lives. Gradually progressive proptosis is the primary presenting symptom. MRI scanning is a better imaging modality compared to CT scanning. Routine H&E staining may prove inadequate and special stains such as the GMS stain should be employed in the slightest doubt of a fungal aetiology. A team approach towards patients is paramount for early diagnosis and timely medical and surgical intervention. PMID:26878009

  18. Stuttering and the Bilingual Child--New Ways to Help

    ERIC Educational Resources Information Center

    Childhood Education, 2004

    2004-01-01

    What should parents of a child who stutters do if their child speaks more than one language? Research shows that a child's language skills can affect his or her fluency, according to the nonprofit Stuttering Foundation of America. However, it has not been proven that speaking two languages in the home since birth causes stuttering. If the child is…

  19. Child Labor.

    ERIC Educational Resources Information Center

    Bonnet, Michel; And Others

    1994-01-01

    Includes "Uprooted Children Threatened by Exploitation" (Bonnet); "Child of the Wind" (Roess); "At the Fishing School with the Sampaneers" (Bertrand); and "The Street Kids of Nairobi: Surviving in the City" (Goodson). (SK)

  20. Child Care

    MedlinePlus

    Children's healthy development depends on safe and positive experiences when they are very young. If you work or go to school, you want to know that your child is in good hands while you are away. You may ...

  1. Disobedient Child

    MedlinePlus

    ... friendless, or even suicidal If your family has developed a pattern of responding to disagreements with physical or emotional abuse If you or your spouse or child use alcohol or other drugs to feel better ...

  2. [The use of melamine-formaldehyde latex in the automated analysis of immunocompetent cells].

    PubMed

    Ovcharova, E N; Denisov, L A; Sukhomudrenko, A G

    1991-01-01

    The optimization of the loading of monodispersed melamine-formaldehyde latex with fluorochrome has permitted its use as indicator material, equally suitable both for the visual evaluation of the reaction of phagocytosis and for the automated evaluation of this reaction by means of a scanning fluorescent microscope. The study has shown the possibility of using fluorescent melamine formaldehyde latex for the evaluation of the phagocytosis of mouse peritoneal macrophages and human blood cells, as well as the analysis of the surface receptors of immunocompetent cells.

  3. TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT.

    PubMed

    Chen, Xiao-Hua; Gao, Yun-Chao; Zhang, Yi; Tang, Zheng-Hao; Yu, Yong-Sheng; Zang, Guo-Qing

    2015-01-01

    Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient. PMID:26200971

  4. Mycobacterium avium lung disease combined with a bronchogenic cyst in an immunocompetent young adult.

    PubMed

    Kwon, Yong Soo; Han, Joungho; Jung, Ki Hwan; Kim, Je Hyeong; Koh, Won-Jung

    2013-01-01

    We report a very rare case of a bronchogenic cyst combined with nontuberculous mycobacterial pulmonary disease in an immunocompetent patient. A 21-year-old male was referred to our institution because of a cough, fever, and worsening of abnormalities on his chest radiograph, despite anti-tuberculosis treatment. Computed tomography of the chest showed a large multi-cystic mass over the right-upper lobe. Pathological examination of the excised lobe showed a bronchogenic cyst combined with a destructive cavitary lesion with granulomatous inflammation. Microbiological culture of sputum and lung tissue yielded Mycobacterium avium. The patient was administered anti-mycobacterial treatment that included clarithromycin. PMID:23346002

  5. Immunocompromised and immunocompetent mouse models for head and neck squamous cell carcinoma

    PubMed Central

    Lei, Zhen-ge; Ren, Xiao-hua; Wang, Sha-sha; Liang, Xin-hua; Tang, Ya-ling

    2016-01-01

    Mouse models can closely mimic human oral squamous epithelial carcinogenesis, greatly expand the in vivo research possibilities, and play a critical role in the development of diagnosis, monitoring, and treatment of head and neck squamous cell carcinoma. With the development of the recent research on the contribution of immunity/inflammation to cancer initiation and progression, mouse models have been divided into two categories, namely, immunocompromised and immunocompetent mouse models. And thus, this paper will review these two kinds of models applied in head and neck squamous cell carcinoma to provide a platform to understand the complicated histological, molecular, and genetic changes of oral squamous epithelial tumorigenesis. PMID:26869799

  6. Disseminated Coccidioidomycosis with Clinically Evident Splenomegaly in an Immunocompetent Host, First Case Reported in the literature

    PubMed Central

    Bird, Garrett R.; Libke, Robert D.; Billelo, John F.; Parks, Nancy A.; Pollard, John S.

    2009-01-01

    Coccidioidomycosis is a dimorphic fungus endemic to the southwestern United States, Central and South America. We report a case of a previously healthy person who presented with respiratory failure and disseminated Coccidioidomycosis who eventually had a fatal outcome. Coccidioidomycosis, or “Valley Fever” has been called the “great imitator” (1) as it can have a wide variety of clinical presentations. This case is unique as it represents the first described case of an immunocompetent host with rapidly progressing, disseminated coccidioidomycosis with clinically apparent splenomegaly and hepatomegaly. PMID:21264046

  7. [HPV infection might play a role in the development of non-melanoma skin cancer in immunocompetent individuals].

    PubMed

    Birch-Johansen, Fatima; Norrild, Bodil; Olesen, Anne Braae; Jensen, Allan; Kjær, Susanne Krüger

    2012-02-13

    Human papillomavirus (HPV) is necessary for the development of cervical cancer and is also involved in vulvar, anus, penis and head and neck cancer. Little is known about the role of HPV infection in non-melanoma skin cancer (NMSC). Through a systematic review of the literature, we studied the HPV prevalence in immunocompetent individuals in relation to NMSC. We found that HPV, including multiple HPV types, tended to be more prevalent in NMSC, especially in squamous cell carcinoma (SCC) compared to basal cell carcinoma and healthy skin, indicating a potential link between HPV and SCC in immunocompetent individuals.

  8. Is drinking water a risk factor for endemic cryptosporidiosis? A case-control study in the immunocompetent general population of the San Francisco Bay Area

    PubMed Central

    Khalakdina, Asheena; Vugia, Duc J; Nadle, Joelle; Rothrock, Gretchen A; Colford, John M

    2003-01-01

    Background Cryptosporidiosis, caused by Cryptosporidium, is an enteric illness that has received much attention as an infection of immunocompromised persons as well as in community outbreaks (frequently waterborne). There are, however, no studies of the risk factors for sporadic community-acquired cryptosporidiosis in the immunocompetent US population. We undertook a case-control study in the San Francisco Bay Area as part of a national study sponsored by the Centers for Disease Control and Prevention to ascertain the major routes of transmission for endemic cryptosporidiosis, with an emphasis on evaluating risk from drinking water. Methods Cases were recruited from a population-based, active surveillance system and age-matched controls were recruited using sequential random-digit dialing. Cases (n = 26) and controls (n = 62) were interviewed by telephone using a standardized questionnaire that included information about the following exposures: drinking water, recreational water, food items, travel, animal contact, and person-to-person fecal contact, and (for adults) sexual practices. Results In multivariate conditional logistic regression analyses no significant association with drinking water was detected. The major risk factor for cryptosporidiosis in the San Francisco Bay Area was travel to another country (matched odds ratio [95% confidence interval]: 24.1 [2.6, 220]). Conclusion The results of this study do not support the hypothesis that drinking water is an independent risk factor for cryptosporidiosis among the immunocompetent population. These findings should be used to design larger studies of endemic cryptosporidiosis to elucidate the precise mechanisms of transmission, whether waterborne or other. PMID:12689343

  9. Protective Vaccination against Papillomavirus-Induced Skin Tumors under Immunocompetent and Immunosuppressive Conditions: A Preclinical Study Using a Natural Outbred Animal Model

    PubMed Central

    Vinzón, Sabrina E.; Braspenning-Wesch, Ilona; Müller, Martin; Geissler, Edward K.; Nindl, Ingo; Gröne, Hermann-Josef

    2014-01-01

    Certain cutaneous human papillomaviruses (HPVs), which are ubiquitous and acquired early during childhood, can cause a variety of skin tumors and are likely involved in the development of non-melanoma skin cancer, especially in immunosuppressed patients. Hence, the burden of these clinical manifestations demands for a prophylactic approach. To evaluate whether protective efficacy of a vaccine is potentially translatable to patients, we used the rodent Mastomys coucha that is naturally infected with Mastomys natalensis papillomavirus (MnPV). This skin type papillomavirus induces not only benign skin tumours, such as papillomas and keratoacanthomas, but also squamous cell carcinomas, thereby allowing a straightforward read-out for successful vaccination in a small immunocompetent laboratory animal. Here, we examined the efficacy of a virus-like particle (VLP)-based vaccine on either previously or newly established infections. VLPs raise a strong and long-lasting neutralizing antibody response that confers protection even under systemic long-term cyclosporine A treatment. Remarkably, the vaccine completely prevents the appearance of benign as well as malignant skin tumors. Protection involves the maintenance of a low viral load in the skin by an antibody-dependent prevention of virus spread. Our results provide first evidence that VLPs elicit an effective immune response in the skin under immunocompetent and immunosuppressed conditions in an outbred animal model, irrespective of the infection status at the time of vaccination. These findings provide the basis for the clinical development of potent vaccination strategies against cutaneous HPV infections and HPV-induced tumors, especially in patients awaiting organ transplantation. PMID:24586150

  10. [Fatal fulminating hepatitis due to Herpes simplex virus type 2 in a young immunocompetent female].

    PubMed

    Chauveau, E; Martin, J; Saliba, F; Nicolas, X; Richecoeur, M; Klotz, F

    1999-01-01

    Fulminant herpes simplex viral hepatitis is uncommon in immunocompetent subjects. A 24-year-old woman presenting hepatomegaly with fever was hospitalized after returning from a trip to southern Africa. The patient was neither pregnant nor immunocompromised. Because of recent tropical travel, differential diagnosis included alphabetic hepatotropic virus infection, yellow fever, African hemorrhagic fever, and arbovirus infection. After ruling out other common viral etiologies, a definitive diagnosis of herpes simplex viral infection was made on the basis of clinical and laboratory findings showing high fever, leukopenia, and thrombopenia; of histological examination of the native liver after transplantation showing non-inflammatory confluent focal hemorrhagic necrosis; and on serologic tests demonstrating seroconversion for herpes simplex virus type 2. Outcome after transplantation was rapidly fatal but the death was not directly related to infection. The most likely etiology of fulminant hepatitis in a young woman returning from travel in a tropical area is hepatitis virus B or hepatitis virus E in cases involving pregnancy. However herpes simplex virus should be included in differential diagnosis even in immunocompetent subjects.

  11. The neonicotinoids thiacloprid, imidacloprid, and clothianidin affect the immunocompetence of honey bees (Apis mellifera L.).

    PubMed

    Brandt, Annely; Gorenflo, Anna; Siede, Reinhold; Meixner, Marina; Büchler, Ralph

    2016-03-01

    A strong immune defense is vital for honey bee health and colony survival. This defense can be weakened by environmental factors that may render honey bees more vulnerable to parasites and pathogens. Honey bees are frequently exposed to neonicotinoid pesticides, which are being discussed as one of the stress factors that may lead to colony failure. We investigated the sublethal effects of the neonicotinoids thiacloprid, imidacloprid, and clothianidin on individual immunity, by studying three major aspects of immunocompetence in worker bees: total hemocyte number, encapsulation response, and antimicrobial activity of the hemolymph. In laboratory experiments, we found a strong impact of all three neonicotinoids. Thiacloprid (24h oral exposure, 200 μg/l or 2000 μg/l) and imidacloprid (1 μg/l or 10 μg/l) reduced hemocyte density, encapsulation response, and antimicrobial activity even at field realistic concentrations. Clothianidin had an effect on these immune parameters only at higher than field realistic concentrations (50-200 μg/l). These results suggest that neonicotinoids affect the individual immunocompetence of honey bees, possibly leading to an impaired disease resistance capacity.

  12. Osteomyelitis and pyoarthritis resulting from local paracoccidioidomycosis in an immunocompetent patient: a case report

    PubMed Central

    2012-01-01

    Introduction Paracoccidioidomycosis is a type of mycosis that is endemic to Brazil and is triggered by the fungus Paracoccidioides brasiliensis. Isolated bone involvement in this disease is very rare, especially in children. To the best of our knowledge this report documents the first case of an immunocompetent pediatric patient in which paracoccidioidomycosis of the hip articulation was the sole manifestation of the disease (that is, there were no pulmonary or skin lesions). Case presentation An 11-year-old Brazilian Caucasian boy from a rural area was examined in the orthopedic ward of our emergency department. Our patient reported a three-month history of pain in the right hip with intermittent claudication and also complained of recurring episodes of intense pain and an inability to walk, which he had been experiencing for the previous five days. He additionally presented with a fever that had persisted for two days. Our patient’s medical history did not include any clinical respiratory manifestations, skin lesions, history of trauma or immunosuppression risk factors. Conclusions This is one of the very few reported cases of isolated articular involvement in osteomyelitis in a pediatric immunocompetent patient. Paracoccidioidomycosis should be considered among the differential diagnoses in such cases, especially in cases of patients who reside in rural areas where the condition is considered to be endemic, in order to administer the proper course of treatment in a timely fashion and improve the chances of a favorable prognosis. PMID:23043817

  13. The Risk of Serious Bacterial Infection in Neutropenic Immunocompetent Febrile Children.

    PubMed

    Barg, Assaf A; Kozer, Eran; Mordish, Yair; Lazarovitch, Tsilia; Kventsel, Iris; Goldman, Michael

    2015-08-01

    Only few reports have looked into the risk of invasive bacterial infection in children with neutropenia that is not malignancy related. The objective of the current study was to determine the clinical significance of neutropenia as a predictor of serious bacterial infection (SBI) in immunocompetent children. We conducted a retrospective case-control study including children 3 months to 18 years of age with fever ≥ 38°C hospitalized or presenting to the emergency department. Patients who had neutropenia ≤ 1000 ANC/μL and had a blood culture taken were matched for age with the consecutive febrile patients for whom a blood culture was taken. The main outcome was the rate of SBI. SBIs were more prevalent among the control group than in the group of children with neutropenia, 19/71 and 6/71, respectively (P = 0.0005). More children were treated with antibiotics among the control group than in the group of children with neutropenia, 39/71 and 20/71, respectively (P < 0.0001). Acute-phase reactants including CRP and platelets were higher in the control group. We concluded that immunocompetent patients with fever and moderate neutropenia do not carry a higher risk for SBIs compared with patients with fever who do not have neutropenia.

  14. Report of Two Fatal Cases of Mycobacterium mucogenicum Central Nervous System Infection in Immunocompetent Patients

    PubMed Central

    Adékambi, Toïdi; Foucault, Cedric; La Scola, Bernard; Drancourt, Michel

    2006-01-01

    Neurological infections due to rapidly growing mycobacteria (RGM) have rarely been reported. We recently investigated two unrelated immunocompetent patients, one with community-acquired lymphocytic meningitis and the other with cerebral thrombophlebitis. Mycobacterium mucogenicum was isolated in pure culture and detected by PCR sequencing of cerebrospinal fluid samples. Both patients eventually died. The two isolates exhibited an overlapping antimicrobial susceptibility pattern. They were susceptible in vitro to tetracyclines, macrolides, quinolones, amikacin, imipenem, cefoxitin, and trimethoprim-sulfamethoxazole and resistant to ceftriaxone. They shared 100% 16S rRNA gene sequence similarity with M. mucogenicum ATCC 49650T over 1,482 bp. Their partial rpoB sequences shared 97.8% and 98.1% similarity with M. mucogenicum ATCC 49650T, suggesting that the two isolates were representative of two sequevars of M. mucogenicum species. This case report should make clinicians aware that M. mucogenicum, an RGM frequently isolated from tap water or from respiratory specimens and mostly without clinical significance, can even be encountered in the central nervous system of immunocompetent patients. PMID:16517863

  15. Immunocompetence and high metabolic rates enhance overwinter survival in the root vole, Microtus oeconomus.

    PubMed

    Książek, Aneta; Zub, Karol; Szafrańska, Paulina A; Wieczorek, Monika; Konarzewski, Marek

    2014-12-01

    Despite its presumed significance, the association between immune defence, energy expenditures and overwinter survival is rarely studied. We analysed individual variation in immunocompetence quantified as neutrophil-to-lymphocyte ratio (N/L), total white blood cells (WBC) and natural antibody levels, along with resting (RMR) and peak metabolic rates (PMR) and mortality during three consecutive winter seasons in a natural population of the root vole, Microtus oeconomus. In early winter, WBC count was negatively correlated with RMR, whereas N/L ratio was negatively correlated with swim-elicited PMR. We suggest that while the first correlation reflected the trade-off between energy allocation in immunocompetence and other metabolically demanding processes, the latter correlation stemmed from stress-induced immunosuppression elicited by the necessity to cope with swimming in frequently flooded habitat. In addition, the analysis carried out during the first year of study characterized by a high population density and prevalence of infestation with a blood parasite--Babesia spp., showed that its intensity was inversely correlated with the N/L ratio. In summary, our results suggest that elevated N/L ratio increases the winter survival of free-ranging rodents by increasing their ability to cope with parasitic infections.

  16. Survival and maturation of microencapsulated porcine neonatal pancreatic cell clusters transplanted into immunocompetent diabetic mice.

    PubMed

    Omer, Abdulkadir; Duvivier-Kali, Valérie F; Trivedi, Nitin; Wilmot, Karen; Bonner-Weir, Susan; Weir, Gordon C

    2003-01-01

    Differentiation and maturation of porcine neonatal pancreatic cell clusters (NPCCs) microencapsulated in barium alginate were assessed after transplantation into immunocompetent mice. Microencapsulated NPCCs were transplanted into the peritoneal cavity of streptozocin-induced diabetic B6AF1 mice (n = 32). The microcapsules were removed at 2, 6, and 20 weeks and examined for cellular overgrowth, insulin content, and insulin secretory responses to glucose and glucose with theophylline. The differentiation, maturation, and proliferation of the beta-cells in the NPCCs were assessed by immunohistochemistry. Blood glucose levels were normalized in 81% of the animals that received a transplant and remained normal until termination of the experiments at 20 weeks. Hyperglycemic blood glucose levels after explantation of the capsules confirmed the function of the encapsulated NPCCs. Insulin content of the encapsulated NPCCs was increased 10-fold at 20 weeks after transplantation compared with pretransplantation levels. A 3.2-fold increase of the ratio of the beta-cell area to the total cellular area was observed at 20 weeks, demonstrating the maturation of NPCCs into beta-cells. In conclusion, NPCCs encapsulated with simple barium alginate can differentiate into beta-cells and reverse high blood glucose levels in immunocompetent mice without immunosuppression for >20 weeks.

  17. Polyarticular Septic Arthritis in an Immunocompetent Adult: A Case Report and Review of the Literature.

    PubMed

    Miller, Annelise; Abduljabbar, Fahad; Jarzem, Peter

    2015-01-01

    Septic arthritis is a clinical emergency requiring prompt diagnosis and treatment to avoid significant morbidity and mortality. Polyarticular septic arthritis (PASA) accounts for 15% of all infectious arthritides and rarely occurs in immunocompetent adults. Staphylococcus aureus is the most commonly isolated organism, with infection primarily affecting knees, shoulders, elbows, and hips. The morbidity associated with PASA is very high, and mortality in treated cases of PASA may be as high as 50% of cases. We report a case of PASA with associated epidural abscess in a healthy adult male, who presented with complaints of arthralgia and limited range of motion of his left shoulder, wrist, and ankle. He also presented with low back pain and motor weakness associated with an epidural abscess spanning L2-S1, with multilevel vertebral osteomyelitis. Surgical washout of the affected joints as well as decompressive laminectomies was performed, and he received a standard course of intravenous antibiotics. Staphylococcus aureus was isolated from joint aspirations and from blood cultures. The patient had a full neurological and functional recovery postoperatively with no sequelae. To the best of our knowledge this is the only case report of Staphylococcus aureus PASA with concomitant epidural abscess in an immunocompetent adult.

  18. The neonicotinoids thiacloprid, imidacloprid, and clothianidin affect the immunocompetence of honey bees (Apis mellifera L.).

    PubMed

    Brandt, Annely; Gorenflo, Anna; Siede, Reinhold; Meixner, Marina; Büchler, Ralph

    2016-03-01

    A strong immune defense is vital for honey bee health and colony survival. This defense can be weakened by environmental factors that may render honey bees more vulnerable to parasites and pathogens. Honey bees are frequently exposed to neonicotinoid pesticides, which are being discussed as one of the stress factors that may lead to colony failure. We investigated the sublethal effects of the neonicotinoids thiacloprid, imidacloprid, and clothianidin on individual immunity, by studying three major aspects of immunocompetence in worker bees: total hemocyte number, encapsulation response, and antimicrobial activity of the hemolymph. In laboratory experiments, we found a strong impact of all three neonicotinoids. Thiacloprid (24h oral exposure, 200 μg/l or 2000 μg/l) and imidacloprid (1 μg/l or 10 μg/l) reduced hemocyte density, encapsulation response, and antimicrobial activity even at field realistic concentrations. Clothianidin had an effect on these immune parameters only at higher than field realistic concentrations (50-200 μg/l). These results suggest that neonicotinoids affect the individual immunocompetence of honey bees, possibly leading to an impaired disease resistance capacity. PMID:26776096

  19. Combination therapy for chronic invasive rhinocerebral aspergillosis in a clinically immunocompetent patient

    PubMed Central

    Lujber, László; Gerlinger, Imre; Kuncz, Ádám; Pytel, József

    2003-01-01

    Background: Adequate therapy for chronic invasive rhinocerebral aspergillosis in immunocompetent patients is controversial. The incidence of the disease is high in the Sudan and the Middle East. Misinterpretation of diagnostic criteria, failure to verify tissue invasion of fungi, and a lack of understanding of the pathophysiology of various forms of fungal rhinosinusitis lead to controversies in nomenclature, diagnosis, and therapy. Objective: The aim of this report was to detail the clinical presentation and the endoscopic and imaging study findings of a patient with invasive Aspergillus rhinosinusitis with endocranial and orbital extension. This patient was treated with surgical débridement and a combination of antifungal drugs and immunomodulatory therapy. Methods: Endoscopic débridement and high-dose liposomal amphotericin B, in combination with flucytosine and immunomodulators, were used to treat this patient. Results: After treatment, the patient experienced 3 years of disease-free follow-up. Conclusion: Surgical débridement and high-dose systemic combined antifungal therapy with immunomodulatory drugs produced an excellent long-term result for this apparently immunocompetent patient with extensive invasive fungal rhinosinusitis with cerebral and orbital involvement. PMID:24944397

  20. Pulmonary Cryptococcosis in the Immunocompetent Patient—Many Questions, Some Answers

    PubMed Central

    Fisher, John F.; Valencia-Rey, Paula A.; Davis, William B.

    2016-01-01

    Background. There are no prospective data regarding the management of pulmonary cryptococcosis in the immunocompetent patient. Clinical guidelines recommend oral fluconazole for patients with mild to moderate symptoms and amphotericin B plus flucytosine followed by fluconazole for severe disease. It is unclear whether patients who have histological evidence of Cryptococcus neoformans but negative cultures will even respond to drug treatment. We evaluated and managed a patient whose presentation and course raised important questions regarding the significance of negative cultures, antifungal choices, duration of therapy, and resolution of clinical, serologic, and radiographic findings. Methods. In addition to our experience, to answer these questions we reviewed available case reports and case series regarding immunocompetent patients with pulmonary cryptococcosis for the last 55 years using the following definitions: Definite - Clinical and/or radiographic findings of pulmonary infection and respiratory tract isolation of C. neoformans without other suspected etiologies; Probable - Clinical and radiographic findings of pulmonary infection, histopathologic evidence of C. neoformans, and negative fungal cultures with or without a positive cryptococcal polysaccharide antigen. Results. Pulmonary cryptococcosis resolves in most patients with or without specific antifungal therapy. Clinical, radiographic, and serologic resolution is slow and may take years. Conclusions. Persistently positive antigen titers are most common in untreated patients and may remain strongly positive despite complete or partial resolution of disease. Respiratory fungal cultures are often negative and may indicate nonviable organisms. PMID:27704021

  1. Necrotizing fasciitis caused by Aeromonas caviae.

    PubMed

    Kumar, Simit; Mukhopadhyay, Prabir; Chatterjee, Mitali; Bandyopadhyay, Manas K; Bandyopadhyay, Maitreyi; Ghosh, Tapashi; Samaddar, Debopriyo

    2012-10-01

    Aeromonads are rarely associated with human intestinal and extra-intestinal diseases and syndromes, ranging from relatively mild illnesses such as acute gastroenteritis to life-threatening conditions, including septicemia, necrotizing fasciitis, and myonecrosis. Among the aeromonas species known to cause human infection, Aeromonas caviae has been associated with septicemia and only one reported case of human soft tissue infection. Most of the infections due to aeromonas occur in immunocompromised patients. Herein we describe a successfully treated case of post-traumatic skin and soft-tissue infections due to A. caviae in an otherwise immunocompetent individual.

  2. Borrelia persica Infection in Immunocompetent Mice--A New Tool to Study the Infection Kinetics In Vivo.

    PubMed

    Schwarzer, Sandra; Overzier, Evelyn; Hermanns, Walter; Baneth, Gad; Straubinger, Reinhard K

    2016-02-01

    Borrelia persica, a bacterium transmitted by the soft tick Ornithodoros tholozani, causes tick-borne relapsing fever in humans in the Middle East, Central Asia and the Indian peninsula. Immunocompetent C3H/HeOuJ mice were infected intradermally with B. persica at varying doses: 1 x 10(6), 1 x 10(4), 1 x 10(2) and 4 x 10(0) spirochetes/mouse. Subsequently, blood samples were collected and screened for the presence of B. persica DNA. Spirochetes were detected in all mice infected with 1 x 10(6), 1 x 10(4) and 1 x 10(2) borrelia by real-time PCR targeting the flaB gene of the bacterium. Spirochetemia developed with a one- to two-day delay when 1 x 10(4) and 1 x 10(2) borrelia were inoculated. Mice injected with only four organisms were negative in all tests. No clinical signs were observed when infected mice were compared to negative control animals. Organs (heart, spleen, urinary bladder, tarsal joint, skin and brain) were tested for B. persica-specific DNA and cultured for the detection of viable spirochetes. Compiled data show that the target organs of B. persica infections are the brain and the skin. A newly developed serological two-tiered test system (ELISA and western blot) for the detection of murine IgM, IgG and IgA antibody titers against B. persica showed a vigorous antibody response of the mice during infection. In conclusion, the infection model described here for B. persica is a platform for in vivo studies to decipher the so far unexplored survival strategies of this Borrelia species.

  3. Dynamics of circulating gamma delta T cell activity in an immunocompetent mouse model of high-grade glioma

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Human gamma delta T cells are potent effectors against glioma cell lines in vitro and in human/mouse xenograft models of glioblastoma, however, this effect has not been investigated in an immunocompetent mouse model. In this report, we established GL261 intracranial gliomas in syngeneic WT C57BL/6 m...

  4. Cytomegalovirus Colitis and Subsequent New Diagnosis of Inflammatory Bowel Disease in an Immunocompetent Host: A Case Study and Literature Review

    PubMed Central

    Khan, Tipu V.; Toms, Carla

    2016-01-01

    Patient: Male, 40 Final Diagnosis: CMV colitis Symptoms: Abdominal pain • diarrhea • jaundice Medication: — Clinical Procedure: Flexible sigmoidoscopy • colonoscopy Specialty: Family Medicine Objective: Rare co-existance of disease or pathology Background: Infection with gastrointestinal cytomegalovirus in an immunocompetent host is a rather rare occurrence in the literature. There are a few reports of gastrointestinal infection in the immunocompetent who are then subsequently given a new diagnosis of inflammatory bowel disease. It is speculated that the initial cytomegalovirus colitis infection triggers the onset of inflammatory bowel disease. Case Report: Herein we report a case of cytomegalovirus colitis and new diagnosis of inflammatory bowel disease identified in a 40-year-old immunocompetent adult man who presented with gastrointestinal symptoms and disseminated cytomegalovirus infection requiring anti-viral therapy, which successfully treated the episode of cytomegalovirus infection. He then went on to have persistent symptomatic inflammatory bowel disease confirmed by pathology. Conclusions: In this paper we will review the literature and explore the rare case of cytomegalovirus colitis in the immunocompetent host and discuss the pathology, physiology, diagnosis, and treatment of cytomegalovirus colitis. PMID:27460032

  5. [An unusual cause of acute respiratory distress: obstructive bronchial aspergillosis].

    PubMed

    Margery, J; Perez, J-P; Vaylet, F; Bordier, E; Dot, J-M; Saint-Blancard, P; Bonnichon, A; Guigay, J; Pats, B; L'Her, P

    2004-06-01

    We report the case of a 77-Year-old immunocompetent woman who required intensive care for acute dyspnea revealing complete atelectasia of the left lung related to an aspergillus mycelium plug blocking the principal bronchus. The clinical course was favorable after deobstruction by thermocoagulation and oral itraconazole given for six Months. The patient was free of parenchymatous or endobronchial sequelae. Adjuvant oral corticoid therapy was given temporarily during the second Month of treatment when signs of transition towards allergic aspergillosis developed. Four Months after discontinuing the antifungal treatment, the patient developed a new episode of acute dyspnea caused by atelectasia limited to the right lower lobe. Treatment by itraconazole was resumed and continued as long-term therapy. No recurrence has been observed for eighteen Months. The diagnostic and therapeutic problems raised by Aspergillus fumigatus are well known in the immunocompromised subject, but can also be encountered in the immunocompetent subject. PMID:15292826

  6. Child Labor in Pakistan: A Study of the Lahore Area.

    ERIC Educational Resources Information Center

    Ahmed, Mian Aftab

    1991-01-01

    Child labor is exceptionally extensive in Pakistan. An interview survey in the Lahore area documented the magnitude, causes, and effects of child labor. Steps for fighting this problem are recommended. (BC)

  7. Child's Play

    ERIC Educational Resources Information Center

    Woolsey, Kristina; Woolsey, Matthew

    2008-01-01

    Emerging digital technologies enable teachers and students to access and manipulate sights and sounds in their school environments. The challenge is to systematically include these new media in academic environments, and to include adults who are ill prepared in technical issues as primary guides in this effort. This article suggests that child's…

  8. Child Nutrition

    MedlinePlus

    ... them Limit fast food and junk food Offer water or milk instead of sugary fruit drinks and sodas Learn about your children's nutrient requirements. Some of them, such as the requirements for iron and calcium, change as your child ages. NIH: ...

  9. Child CPR

    MedlinePlus

    ... Home FIRST AID, CPR and AED LIFEGUARDING Refresher Child - CPR (1:11) QUICK LINKS Home RedCross.org Purchase Course Materials Shop Our Store Contact Us Privacy Policy Terms and Conditions All rights reserved. 2011 American National Red Cross.

  10. Effects of egg storage on hatchability, chick quality, performance and immunocompetence parameters of broiler chickens.

    PubMed

    Goliomytis, Michael; Tsipouzian, Theofania; Hager-Theodorides, Ariadne L

    2015-09-01

    Pre-incubation egg storage is a necessity for the poultry industry. This study evaluated the effects of pre-incubation storage length of broiler eggs on hatchability, 1-day-old chick quality, subsequent performance, and immunocompetence. To this end, a total of 360 hatching eggs were stored for 4, 12, or 16 d prior to incubation. Hatchability and chick quality were assessed at hatch, and growth performance and immunocompetence parameters were assessed during a 35 d rearing period. Hatchability of set and fertile eggs, and embryonic mortality, were not affected by egg storage. On the contrary, 1-day-old chick BW and length were linearly negatively correlated with egg storage length (P-linear<0.05). Nevertheless, BW corrected for egg weight prior to setting was unaffected, and corrected chick length was positively affected by storage length. One-day-old chick Tona score, navel quality, and post-hatch growth performance (BW at 7 and 35 d, cumulative feed intake, and feed conversion ratio at 35 d) were unaffected by egg storage (P, P-linear>0.05). Lymphoid organ weights at 2 and 35 d, the titre of maternal anti-NDV antibodies, most of the thymocyte subpopulations defined by CD3, CD4, and CD8 cell surface expression in the thymus of 2-d-old chicks, cellular responses to the PHA skin test, humoral responses to primary SRBC, and NDV immunizations were also not influenced by length of storage (P, P-linear>0.05). On the contrary, the length of egg storage was found to negatively influence the abundance of CD3+CD4-CD8- thymocytes that represent the majority of γδ-T cells in the thymus of 2-day-old chicks, as well as the humoral response to booster NDV immunization of the birds. In brief, pre-incubation storage of broiler hatching eggs for up to 16 d did not affect most developmental and growth parameters investigated, except for BW and length at hatch. Egg storage was found to suppress some aspects of the immunocompetence of the birds, particularly aspects of acquired

  11. Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: A case report and literature review

    PubMed Central

    2012-01-01

    Background Fusobacterium species are uncommon causes of osteomyelitis. These organisms are normal flora of the oral cavity. Therefore, they mostly cause osteomyelitis of the head and neck. Hematogenous osteomyelitis at distant sites other than the head and neck has rarely been reported in pediatric or immunocompromised patients. Here, we report the first case of osteomyelitis of a long bone combined with a muscle abscess due to Fusobacterium nucleatum in an otherwise healthy adult. Case presentation A 59-year-old Korean man was admitted for pain and swelling of the right lower leg, which had been persistent for two weeks. Magnetic resonance imaging showed osteomyelitis of the right fibula with a surrounding muscle abscess of the right lower leg. Incision and drainage was performed, and repetitive tissue cultures grew F. nucleatum. In this patient, it was presumed that recurrent periodontitis caused hematogenous seeding of F. nucleatum to a distant site leading to osteomyelitis with a muscle abscess. The patient was successfully treated with intravenous ampicillin-sulbactam for three weeks and oral amoxicillin-clavulanate for eight weeks. He also underwent repeated surgical drainage. He has no evidence of recurrence after seven months of follow-up. Conclusions Clinicians should be aware that F. nucleatum could be the etiologic agent of hematogenous osteomyelitis of a long bone in an immunocompetent patient. PMID:22817336

  12. Chronically recurrent and widespread tinea corporis due to Trichophyton rubrum in an immunocompetent patient.

    PubMed

    Kong, Q T; Du, X; Yang, R; Huang, S Y; Sang, H; Liu, W D

    2015-04-01

    A 31-year-old immunocompetent male who presented with a 4-year history of extensive erythematous and scaly plaques involving the abdomen, gluteal and inguen regions with concomitant tinea pedis and onychomycosis is described. Diagnosis was based on positive mycological examination and positive histopathologic examination. Species identification was performed by growth on Sabouraud dextrose agar and by sequencing of the internal transcribed spacer regions of the rDNA region. The pathogen identified was Trichophyton rubrum. The same fungal species was cultured from his abdominal, gluteal, foot and toenail. A combination therapy with systemic terbinafine and topically applied terbinafine cream was successful. A 1-year follow-up did not show any recurrence of infection.

  13. Disseminated Varicella-Zoster Virus After Vaccination in an Immunocompetent Patient.

    PubMed

    Scotch, Allison H; Hoss, Elika; Orenstein, Robert; Budavari, Adriane I

    2016-06-01

    Severe adverse events associated with varicella-zoster virus (VZV) vaccination are rare. The authors describe a 53-year-old woman with no known immunodeficiency who presented with diffuse pruritic rash 17 days after receiving the varicella virus vaccine live. She had a low level of white blood cells and received a diagnosis of thrombocytopenia with elevated aminotransferase levels. Punch biopsy demonstrated positive VZV immunostaining and viral culture positive for VZV. After treatment with acyclovir, her rash improved and her white blood cell and platelet counts returned to normal. Mild reactions to vaccines including localized rash are well recognized. Disseminated infections have been reported in patients with congenital and acquired immunodeficiency, but systemic postvaccination infections are rare in immunocompetent adults. This case highlights the importance of recognizing adverse events associated with vaccination. PMID:27214778

  14. Reduced plant nutrition under elevated CO2 depresses the immunocompetence of cotton bollworm against its endoparasite

    NASA Astrophysics Data System (ADS)

    Yin, Jin; Sun, Yucheng; Ge, Feng

    2014-04-01

    Estimating the immunocompetence of herbivore insects under elevated CO2 is an important step in understanding the effects of elevated CO2 on crop-herbivore-natural enemy interactions. Current study determined the effect of elevated CO2 on the immune response of Helicoverpa armigera against its parasitoid Microplitis mediator. H. armigera were reared in growth chambers with ambient or elevated CO2, and fed wheat grown in the concentration of CO2 corresponding to their treatment levels. Our results showed that elevated CO2 decreases the nutritional quality of wheat, and reduces the total hemocyte counts and impairs the capacity of hemocyte spreading of hemolymph of cotton bollworm larvae, fed wheat grown in the elevated CO2, against its parasitoid; however, this effect was insufficient to change the development and parasitism traits of M. mediator. Our results suggested that lower plant nutritional quality under elevated CO2 could decrease the immune response of herbivorous insects against their parasitoid natural enemies.

  15. Case-based discussion: Lymphocytic interstitial pneumonia a rare presentation in an immunocompetent adult male

    PubMed Central

    Chitnis, Ajay; Vyas, Pradeep Kumar; Chaudhary, Priyanka; Ghatavat, Gaurav

    2015-01-01

    Lymphocytic interstitial pneumonia (LIP) is a rare form of interstitial lung disease usually associated with other systemic diseases; however, idiopathic cases are being reported. As per recent ATS/ERS 2013 guidelines, diagnostic criteria of clinical, radiological and histopathological for LIP is same as 2002 except some cystic changes on HRCT chest. Many cases diagnosed in the past as LIP now turn out to be NSIP; therefore as per new ATS/ERS classification whenever anybody report a case of LIP, NSIP should always be kept in mind as differential diagnosis. Here we present a case of LIP in an immunocompetent adult male presented with history of persistent dry cough and breathlessness on exertion, confirmed on HRCT chest and histopathologically, treated successfully with steroids. PMID:26628770

  16. [Cryptosporidium parvum infection in a pregnant immunocompetent woman with occupational risk].

    PubMed

    Neira, Patricia; Muñoz, Nelson; Rosales, José

    2010-08-01

    Cryptosporidioses is a parasitic zoonoses generated by diverse Cryptosporidium species. This coccidiosis affects multiple vertebrate species, including human beings. In Chile, as it happens in other countries, cryptosporidioses is a low frequency infection in immunocompetent individuals, acquiring a big relevance in immunocompromised ones. We present the following case: a recently graduated student from Veterinary medical school, with a 20 week pregnancy, living in "Laguna Verde" area in the Region of Valparaiso and who was infected with Cryptosporidium sp. Etiologic diagnosis was made by Ziehl Neelsen, and nested PCR followed by PCR product sequencing. During the same period, the infection was detected in her cats which were asymptomatic. In all of them, her and the cats, the species identified was Cryptosporidium parvum. Her husband and her other pets were all asymptomatic and non infected. This is the first report of a possible cryptosporidioses transmission between humans and cat. PMID:21046721

  17. Hepatosplenic T Cell Lymphoma in an Immunocompetent Female Diagnosed using Flow Cytometry: A Rare Clinical Entity.

    PubMed

    Dorwal, Pranav; Sachdev, Ritesh; Pande, Amit; Jain, Dharmendra; Jha, Bhawna; Raina, Vimarsh

    2016-08-01

    Hepatosplenic T-cell lymphoma is a rare haematopoietic malignancy that comprises less than 1% of Non-Hodgkin lymphomas. We are reporting a case of a 26-year-old female, who presented with pallor, weight loss, jaundice, pancytopenia and hepatosplenomegaly. The bone marrow examination showed infiltration by lymphoid cells. These cells on flow cytometric evaluation showed the phenotype of hepatosplenic T cell lymphoma. The cells were positive for CD3, CD8, CD56 and TCR γδ and negative for CD5, CD4, CD8, CD16, CD57, TCRαβ along with B cell markers. This case is reported for being a rare clinical entity and its presence in an immunocompetent female making it rarer. PMID:27656456

  18. Latent acyclovir-resistant herpes simplex virus type 1 in trigeminal ganglia of immunocompetent individuals.

    PubMed

    van Velzen, Monique; van Loenen, Freek B; Meesters, Roland J W; de Graaf, Miranda; Remeijer, Lies; Luider, Theo M; Osterhaus, Albert D M E; Verjans, Georges M G M

    2012-05-15

    Specific mutations within the hypervariable herpes simplex virus (HSV) gene thymidine kinase (TK) gene lead to acyclovir (ACV) resistance. To uncover the existence of latent ACV-resistant (ACV(R)) HSV-1, we determined the genetic and functional variability of the HSV-1 TK gene pool in paired trigeminal ganglia (TG) of 5 immunocompetent individuals. The latent virus pool consisted of a donor-specific HSV-1 quasispecies, including one major ACV-sensitive (ACV(S)) and multiple phylogenetic-related minor ACV(S) and ACV(R) TK variants. Contrary to minor variants, major TK variants were shared between paired TG. The data demonstrate the coexistence of phylogenetic-related ACV(S) and ACV(R) latent HSV-1 in human TG.

  19. Hematopoietic stem cell transplantation in immunocompetent hosts without radiation or chemotherapy.

    PubMed

    Chhabra, Akanksha; Ring, Aaron M; Weiskopf, Kipp; Schnorr, Peter John; Gordon, Sydney; Le, Alan C; Kwon, Hye-Sook; Ring, Nan Guo; Volkmer, Jens; Ho, Po Yi; Tseng, Serena; Weissman, Irving L; Shizuru, Judith A

    2016-08-10

    Hematopoietic stem cell (HSC) transplantation can cure diverse diseases of the blood system, including hematologic malignancies, anemias, and autoimmune disorders. However, patients must undergo toxic conditioning regimens that use chemotherapy and/or radiation to eliminate host HSCs and enable donor HSC engraftment. Previous studies have shown that anti-c-Kit monoclonal antibodies deplete HSCs from bone marrow niches, allowing donor HSC engraftment in immunodeficient mice. We show that host HSC clearance is dependent on Fc-mediated antibody effector functions, and enhancing effector activity through blockade of CD47, a myeloid-specific immune checkpoint, extends anti-c-Kit conditioning to fully immunocompetent mice. The combined treatment leads to elimination of >99% of host HSCs and robust multilineage blood reconstitution after HSC transplantation. This targeted conditioning regimen that uses only biologic agents has the potential to transform the practice of HSC transplantation and enable its use in a wider spectrum of patients. PMID:27510901

  20. Permanent phenotypic correction of hemophilia B in immunocompetent mice by prenatal gene therapy.

    PubMed

    Waddington, Simon N; Nivsarkar, Megha S; Mistry, Ajay R; Buckley, Suzanne M K; Kemball-Cook, Geoffrey; Mosley, Karen L; Mitrophanous, Kyriacos; Radcliffe, Pippa; Holder, Maxine V; Brittan, Mairi; Georgiadis, Anastasios; Al-Allaf, Faisal; Bigger, Brian W; Gregory, Lisa G; Cook, H Terence; Ali, Robin R; Thrasher, Adrian; Tuddenham, Edward G D; Themis, Mike; Coutelle, Charles

    2004-11-01

    Hemophilia B, also known as Christmas disease, arises from mutations in the factor IX (F9) gene. Its treatment in humans, by recombinant protein substitution, is expensive, thus limiting its application to intermittent treatment in bleeding episodes and prophylaxis during surgery; development of inhibitory antibodies is an associated hazard. This study demonstrates permanent therapeutic correction of his disease without development of immune reactions by introduction of an HIV-based lentiviral vector encoding the human factor IX protein into the fetal circulation of immunocompetent hemophiliac and normal outbred mice. Plasma factor IX antigen remained at around 9%, 13%, and 16% of normal in the 3 hemophilia B mice, respectively, until the last measurement at 14 months. Substantial improvement in blood coagulability as measured by coagulation assay was seen in all 3 mice and they rapidly stopped bleeding after venipuncture. No humoral or cellular immunity against the protein, elevation of serum liver enzymes, or vector spread to the germline or maternal circulation were detected.

  1. Improved local and systemic anti-tumor efficacy for irreversible electroporation in immunocompetent versus immunodeficient mice.

    PubMed

    Neal, Robert E; Rossmeisl, John H; Robertson, John L; Arena, Christopher B; Davis, Erica M; Singh, Ravi N; Stallings, Jonathan; Davalos, Rafael V

    2013-01-01

    Irreversible electroporation (IRE) is a non-thermal focal ablation technique that uses a series of brief but intense electric pulses delivered into a targeted region of tissue, killing the cells by irrecoverably disrupting cellular membrane integrity. This study investigates if there is an improved local anti-tumor response in immunocompetent (IC) BALB/c versus immunodeficient (ID) nude mice, including the potential for a systemic protective effect against rechallenge. Subcutaneous murine renal carcinoma tumors were treated with an IRE pulsing protocol that used 60% of the predicted voltage required to invoke complete regressions in the ID mice. Tumors were followed for 34 days following treatment for 11 treated mice from each strain, and 7 controls from each strain. Mouse survival based on tumor burden and the progression-free disease period was substantially longer in the treated IC mice relative to the treated ID mice and sham controls for both strains. Treated IC mice were rechallenged with the same cell line 18 days after treatment, where growth of the second tumors was shown to be significantly reduced or prevented entirely. There was robust CD3+ cell infiltration in some treated BALB/C mice, with immunocytes focused at the transition between viable and dead tumor. There was no difference in the low immunocyte presence for untreated tumors, nude mice, and matrigel-only injections in both strains. These findings suggest IRE therapy may have greater therapeutic efficacy in immunocompetent patients than what has been suggested by immunodeficient models, and that IRE may invoke a systemic response beyond the targeted ablation region. PMID:23717630

  2. Valaciclovir compared with acyclovir for improved therapy for herpes zoster in immunocompetent adults.

    PubMed Central

    Beutner, K R; Friedman, D J; Forszpaniak, C; Andersen, P L; Wood, M J

    1995-01-01

    Acyclovir treatment of acute herpes zoster speeds rash healing and decreases pain and ocular complications. The limited oral bioavailability of acyclovir necessitates frequent dosing. Valaciclovir, the l-valyl ester of acyclovir, is rapidly and almost completely converted to acyclovir in vivo and gives three- to fivefold increases in acyclovir bioavailability. In a randomized, double-blind, multicenter study, the safety and efficacy of oral valaciclovir given at a dosage of 1,000 mg three times daily for 7 or 14 days and oral acyclovir given at a dosage of 800 mg five times daily for 7 days were compared in immunocompetent adults aged > or = 50 years with herpes zoster. Patients were evaluated for 6 months. The intent-to-treat analysis (1,141 patients) showed that valaciclovir for 7 or 14 days significantly accelerated the resolution of herpes zoster-associated pain (P = 0.001 and P = 0.03, respectively) compared with acyclovir; median pain durations were 38 and 44 days, respectively, versus 51 days for acyclovir. Treatment with valaciclovir also significantly reduced the duration of postherpetic neuralgia and decreased the proportion of patients with pain persisting for 6 months (19.3 versus 25.7%). However, there were no differences between treatments in pain intensity or quality-of-life measures. Cutaneous manifestations resolved at similar rates in all groups. Adverse events were similar in nature and prevalence among groups, and no clinically important changes occurred in hematology or clinical chemistry parameters. Thus, in the management of immunocompetent patients > or = 50 years of age with localized herpes zoster, valaciclovir given at 1,000 mg three times daily for 7 days accelerates the resolution of pain and offers simpler dosing, while it maintains the favorable safety profile of acyclovir. PMID:7492102

  3. Comparative Effects of Ibandronate and Paclitaxel on Immunocompetent Bone Metastasis Model

    PubMed Central

    Chung, Yoon-Sok; Kang, Ho Chul

    2015-01-01

    Purpose Bone metastasis invariably increases morbidity and mortality. This study compares the effects of ibandronate and paclitaxel on bone structure and its mechanical properties and biochemical turnover in resorption markers using an immunocompetent Walker 256-Sprague-Dawley model, which was subjected to tumor-induced osteolysis. Materials and Methods Seventy rats were divided equally into 4 groups: 1) sham group (SHAM), 2) tumor group (CANC), 3) ibandronate treated group (IBAN), and 4) paclitaxel treated group (PAC). Morphological indices [bone volume fraction (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp)] and mechanical properties (failure load, stiffness) were evaluated after thirty days of treatment period. Bone resorption rate was analysed using serum deoxypyridinoline (Dpd) concentrations. Results Morphological indices showed that ibandronate (anti-resorptive drug) had a better effect in treating tumor-induced architectural changes in bone than paclitaxel (chemotherapeutic drug). The deterioration in bone architecture was reflected in the biomechanical properties of bone as studied with decreased failure load (Fx) and stiffness (S) of the bone on the 30th day post-surgery. Dpd concentrations were significantly lower in the IBAN group, indicating successful inhibition of bone resorption and destruction. Conclusion Ibandronate was found to be as effective as higher doses of paclitaxel in maintaining stiffness of bone. Paclitaxel treatment did not appear to inhibit osteoclast resorption, which is contrary to earlier in-vitro literature. Emphasis should be placed on the use of immunocompetent models for examining drug efficacy since it adequately reflects bone metastasis in clinical scenarios. PMID:26446649

  4. Allogeneic adipose-derived stem cells promote survival of fat grafts in immunocompetent diabetic rats.

    PubMed

    Zhang, Jun; Bai, Xiaozhi; Zhao, Bin; Wang, Yunchuan; Su, Linlin; Chang, Peng; Wang, Xujie; Han, Shichao; Gao, Jianxin; Hu, Xiaolong; Hu, Dahai; Liu, Xiaoyan

    2016-05-01

    Autologous adipose-derived stem cells (ADSCs) can protect fat grafts in cell-assisted lipotransfer (CAL). However, diabetes alters the intrinsic properties of ADSCs and impairs their function so that they lack these protective effects. We investigate whether allogeneic ADSCs from healthy donors could protect fat grafts in immunocompetent diabetic rats. Syngeniec adipose tissues and ADSCs were derived from diabetic Lewis (LEW) rats, whereas allogeneic ADSCs were from healthy brown-Norway rats. A grafted mixture containing 0.7 ml granule fat and 0.3 ml 6 × 10(6) allogeneic/syngeneic ADSCs was injected subcutaneously on the skulls of diabetic LEW rats. Fat samples were harvested to evaluate the levels of injury and vascularization as shown by perilipin A, CD34 and VEGF at 14 days. The immune response was evaluated with a lymphocytotoxicity test and the CD4/CD8 ratio in peripheral blood at 14 days. The volume retention of fat grafts was measured at 3 months. Healthy allogeneic ADSCs increased the expression levels of perilipin A, CD34 and VEGF at 14 days. The volume retention of fat grafts was improved by allogeneic ADSCs at 3 months. ADSCs were demonstrated to have low immunogenicity by the lymphocyte proliferation test and immunophenotype including MHC and co-stimulatory markers. The lymphocytotoxicity test and CD4/CD8 ratio indicated no obvious immune response elicited by allogeneic ADSCs. Thus, healthy allogeneic ADSCs can promote the survival of fat grafts in this immunocompetent diabetic rat model, with little or no obvious immune rejection.

  5. Improved Local and Systemic Anti-Tumor Efficacy for Irreversible Electroporation in Immunocompetent versus Immunodeficient Mice

    PubMed Central

    Neal, Robert E.; Rossmeisl, John H.; Robertson, John L.; Arena, Christopher B.; Davis, Erica M.; Singh, Ravi N.; Stallings, Jonathan; Davalos, Rafael V.

    2013-01-01

    Irreversible electroporation (IRE) is a non-thermal focal ablation technique that uses a series of brief but intense electric pulses delivered into a targeted region of tissue, killing the cells by irrecoverably disrupting cellular membrane integrity. This study investigates if there is an improved local anti-tumor response in immunocompetent (IC) BALB/c versus immunodeficient (ID) nude mice, including the potential for a systemic protective effect against rechallenge. Subcutaneous murine renal carcinoma tumors were treated with an IRE pulsing protocol that used 60% of the predicted voltage required to invoke complete regressions in the ID mice. Tumors were followed for 34 days following treatment for 11 treated mice from each strain, and 7 controls from each strain. Mouse survival based on tumor burden and the progression-free disease period was substantially longer in the treated IC mice relative to the treated ID mice and sham controls for both strains. Treated IC mice were rechallenged with the same cell line 18 days after treatment, where growth of the second tumors was shown to be significantly reduced or prevented entirely. There was robust CD3+ cell infiltration in some treated BALB/C mice, with immunocytes focused at the transition between viable and dead tumor. There was no difference in the low immunocyte presence for untreated tumors, nude mice, and matrigel-only injections in both strains. These findings suggest IRE therapy may have greater therapeutic efficacy in immunocompetent patients than what has been suggested by immunodeficient models, and that IRE may invoke a systemic response beyond the targeted ablation region. PMID:23717630

  6. [Pneumocystis jiroveci infection in immunocompetent patients with pulmonary disorders, in Portugal].

    PubMed

    Matos, Olga; Costa, Marina Célia; Correia, Isabel; Monteiro, Paula; Vieira, Jorge Roldão; Soares, Jorge; Bonnet, Marina; Esteves, Francisco; Antunes, Francisco

    2006-01-01

    The use of molecular tools with a great capacity to detect and differentiate strains of Pneumocystis has resulted: in the identification of low numbers of P. jiroveci organisms in clinically silent, colonized, immunocompromised patients and in immunocompetent persons. Considering this information, the aim of this study was to determine the prevalence of P. jiroveci carriers (subclinical infections) in Portuguese patients with pulmonary disorders and in healthy individuals. A total of 45 pulmonary specimens were collected from 45 immunocompetent adults with pulmonary disorders, and 37 oral washings from 37 healthy adults, between March 2001 and February 2004. All samples were analysed by indirect immunofluorescence with monoclonal antibodies and by amplification of the LSU mtrRNA by nested PCR. The results obtained in this study indicate that: 1) P. jiroveci is frequently detected (24.4%) in patients with pulmonary disorders in Portugal; 2) this population might play a role in circulation and transmission of P. jiroveci organisms in the community; 3) patients receiving corticosteroids are more likely to have detectable P. jiroveci in lungs (18%) than patients who are not receiving this immunosuppressor (12%); 4) P. jiroveci is infrequently detected in healthy adults. This may be due to very low numbers of latent organisms present in the lungs of healthy adults, difficulty in detecting few organisms, or due to the type of samples used. Screening of these individuals and notification of the results to their physician might be important: for further follow-up and whether or not prophylaxis or treatment should be prescribed; and for the clarification of the epidemiology of P. jiroveci asymptomatic infections.

  7. Evidence for the stress-linked immunocompetence handicap hypothesis in human male faces

    PubMed Central

    Moore, F. R.; Cornwell, R. E.; Law Smith, M. J.; Al Dujaili, E. A. S.; Sharp, M.; Perrett, D. I.

    2011-01-01

    The stress-linked immunocompetence handicap hypothesis (SL-ICHH) of sexual selection incorporates a role of the stress hormone corticosterone (C; cortisol in humans) in relationships between testosterone (T), immunity and secondary sexual trait expression. In support of this, C has been shown to mediate and moderate relationships between T and immune response and to be inversely related to attractiveness in some avian species. We predicted that female preferences for cues to T in human male faces would be contingent upon co-occurring cortisol levels. In study 1, we tested relationships between T and cortisol and attractiveness, masculinity and health ratings of raw male faces. We found cortisol to be inversely related to attractiveness. In study 2, we tested female preferences for male faces that were parametrically manipulated on the basis of cues to naturally co-occurring levels of T and cortisol across the menstrual cycle. Women preferred cues to low cortisol in general and in the fertile phase of the cycle, and there was an interaction between T and cortisol in general and in the non-fertile phase. Results were consistent with the SL-ICHH but not the original immunocompetence handicap model: females expressed preferences for cues to cortisol but not for cues to T, except in interaction with the stress hormone. Results inform the SL-ICHH by demonstrating female preferences for low cortisol and the nature of its interaction with T in humans, as well as indicating the traits that may be signalled by different combinations of the hormones including immune response, current health and resource acquisition characteristics. PMID:20843854

  8. Unusual cause of chest pain: empyema necessitans and tubercular osteomyelitis of the rib in an immunocompetent man.

    PubMed

    Dunphy, Louise; Shetty, Prashanth; Kavidasan, Ajitkumar; Rice, Alexandra

    2016-01-04

    A 33-year-old man, born in India but resident in the UK for 5 years, presented to the emergency department with a 4-week history of a dry cough and right-sided pleuritic chest pain. He reported systemic features, including fever and unintentional weight loss. His medical history included vitamin D deficiency. He had travelled to India 10 months previously and denied any exposure to tuberculosis (TB). He was an ex-smoker with a 20 pack history. Respiratory examination confirmed decreased air entry of the right lower lobe and stony dullness on percussion. His C reactive protein was 178 mg/L. A chest radiograph identified a moderate-sized right-sided pleural effusion and destruction of the lateral aspect of the right fifth rib, strongly suggestive of underlying malignancy. Further investigation with a CT of the thorax identified a focal lytic lesion in the right fifth rib, at its lateral aspect, with expansion of the rib observed. Ultrasound-guided pleural aspiration confirmed an exudative pleural effusion. Gram stain revealed no organisms or polymorphs. Four days post admission, the patient was transferred to the regional thoracic surgery unit and underwent video-assisted thoracic surgery, bronchoscopy and drainage of his empyema. His Mantoux tuberculin skin test and his TB Elispot were negative, suggesting that TB infection was unlikely. Culture confirmed no growth after 48 h incubation. Histology of his pleural biopsy identified multiple non-confluent necrotising granulomatous inflammation with very occasional acid-alcohol-fast bacilli-like organisms, highly suspicious for mycobacterial infection. The isolate, Mycobacterium tuberculosis, was identified by Accuprobe and HAIN tests, respectively. MPT64 erythrocyte sedimentation rate (ESR) results from the fifth rib were positive for M. tuberculosis. This case report discusses the aetiology, clinical presentation and pathophysiology of both empyema necessitans and tubercular osteomyelitis of the rib.

  9. Child Abuse: The Crying Baby at Risk.

    ERIC Educational Resources Information Center

    Kirkland, John

    The author considers the relationship between uncontrollable infant crying and child abuse. An integrative scheme is offered from evidence of child abuse literature, experimentally induced infant crying effects, attribution theory, and learned helplessness. It is suggested that infant crying often has causes beyond caregiver control, such as birth…

  10. The Principal's Role in Reporting Child Abuse.

    ERIC Educational Resources Information Center

    Payne, Beth

    1991-01-01

    The role of the principal in identifying and reporting child abuse and neglect is discussed in this bulletin. Although all 50 states and the District of Columbia have laws that require educators to report cases in which they have knowledge or reasonable cause to suspect child abuse, passage of legislation does not always lead to compliance.…

  11. Child Care in Mexico.

    ERIC Educational Resources Information Center

    Hernandez, Clotilde Juarez

    2003-01-01

    Discusses the following issues pertaining to Mexican child care: history of child care in Mexico; prevalence of child care in the national system; other agencies providing child care and the nature of their services; extent to which working families use child care; circumstances requiring day care; licensing, accreditation, and quality standards;…

  12. The Nature, Extent and Causes of Abuse of Children with Disabilities in Schools in Botswana

    ERIC Educational Resources Information Center

    Shumba, Almon; Abosi, Okey C.

    2011-01-01

    Studies show that the exact number of children with disabilities in Botswana is unknown. A study on child abuse sought to determine: the forms of child abuse perpetrated on children with disabilities; the extent of child abuse; and the causes of child abuse of children with disabilities. A questionnaire on child abuse was adapted and used to…

  13. [The presence of mycobacteria in bronchoalveolar lavage fluid from an immunocompetent patient does not necessarily imply tuberculosis].

    PubMed

    Vandenbos, Frédéric; Marcq, Laurent; Novellas, Sébastien; Chyderiotis, Georges; Haudebourg, Juliette; Benchetrit, Maxime; Burel-Vandenbos, Fanny

    2009-12-01

    Mycobacterium tuberculosis is the most frequently identified mycobacterium in the bronchoalveolar lavage fluid (BALF) of immunocompetent patients. Lung infections due to non-tuberculous mycobacteria (NTM) are rare in such patients and then often occur in the context of pre-existing chronic lung disease. We report the case of an immunocompetent 85-year-old woman without pre-existing lung disease in whom M. abscessus was recovered from BALF. Cytological examination of the BALF revealed an increased number of neutrophils and some acid-fast bacilli, all located within neutrophil cytoplasm. This case report contributes a cytological description of BALF in the context of M. abscessus infection, which is poorly detailed in the literature. PMID:20005441

  14. Visceral cat scratch disease with endocarditis in an immunocompetent adult: a case report and review of the literature.

    PubMed

    Shasha, David; Gilon, Dan; Vernea, Fiona; Moses, Allon E; Strahilevitz, Jacob

    2014-03-01

    Infective endocarditis and hepatosplenic abscesses are rare manifestations of cat scratch disease (CSD), especially among immunocompetent adults. An otherwise healthy woman who presented with fever and abdominal pain was diagnosed with multiple abscesses in the spleen and the liver, as well as a mitral valve vegetation. PCR on spleen tissue was positive for Bartonella henselae. Prolonged treatment with doxycycline and gentamicin led to complete recovery. Review of the literature revealed 18 cases of hepatosplenic CSD in immunocompetent adults; the majority presented with fever of unknown origin and abdominal pain. In most cases the causative organism was B. henselae and the pathological findings were necrotizing granulomas, similar to the pathological features in classic CSD. Concomitant endocarditis was diagnosed in one case. Because Bartonella is one of the leading pathogens of culture-negative endocarditis, we raise the question of whether a comprehensive evaluation for endocarditis is needed in cases of systemic CSD.

  15. Ileostomy and your child

    MedlinePlus

    ... embarrassment. You may see some changes in your child's behavior at first. Sometimes teenagers have a harder time ... You being open and natural will help your child's behavior stay positive. Help your child learn how to ...

  16. Child Care Aware

    MedlinePlus

    ... Connected With Enews Subscribe Child Care Aware® of America Overview Vision & Mission Audience Partners Child Care Providers ... Public Policy Agenda 2016-2017 Child Care in America: 2016 State Fact Sheets We Can Do Better – ...

  17. The Individual Child. Caring for Children No. 7.

    ERIC Educational Resources Information Center

    Murphy, Lois B.; Leeper, Ethel M.

    Discussed are ways to meet the needs of the individual preschool child within the child care center. Ways in which each child is unique are given to include type of personality rate of development, attitude toward the world, and coping method. Discussed are causes of individual differences including heredity and environment, prenatal and postnatal…

  18. Innocent Victims: NCJW Manual on Child Abuse and Neglect Programs.

    ERIC Educational Resources Information Center

    National Council of Jewish Women, New York, NY.

    The manual was written by the National Council of Jewish Women to provide guidelines for volunteer legislative action and community service for individuals in the area of child abuse and neglect. After an overview which details some of the causes of child abuse, information on child abuse and neglect legislation in each state is presented.…

  19. Evaluation of Diagnostic Value and Epidemiological Implications of PCR for Pneumocystis carinii in Different Immunosuppressed and Immunocompetent Patient Groups

    PubMed Central

    Sing, Andreas; Trebesius, Karlheinz; Roggenkamp, Andreas; Rüssmann, Holger; Tybus, Karin; Pfaff, Friederike; Bogner, Johannes R.; Emminger, Christoph; Heesemann, Jürgen

    2000-01-01

    To evaluate the value of single and nested PCRs for diagnosis of Pneumocystis carinii pneumonia (PCP) in a variety of respiratorily distressed patient groups, 574 respiratory samples from 334 patients (89 human immunodeficiency virus [HIV]-positive patients, 61 transplant recipients, 66 malignancy patients, 34 otherwise immunosuppressed patients, and 84 immunocompetent patients) were prospectively examined by microscopy and single and nested PCRs. The resulting data were correlated with clinical evidence of PCP. Microscopy and single PCR of bronchoalveolar lavage (BAL) specimens from HIV patients were 100% sensitive and specific in detecting PCP, whereas nested PCR, although being 100% sensitive, reached a specificity of only 97.5%. In the three non-HIV immunosuppressed patient groups, both single and nested PCR invariably produced lower positive predictive values than microscopy. Among immunocompetent patients, the positive predictive values of both PCRs were 0%. Therefore, the diagnostic values of the PCR methods tested do not seem to offer any additional advantage compared to that of conventional microscopy for these patient groups. However, nested PCR identified a significant percentage of clinically silent P. carinii colonizations in about 17 to 20% of immunocompetent and immunosuppressed non-HIV patients. PMID:10747126

  20. Antifungal Treatment is Not Required for Immunocompetent Individuals With Asymptomatic Esophageal Candidiasis.

    PubMed

    Min, Yang Won; Kim, Eun; Son, Hee Jung; Kim, Jae J; Rhee, Poong-Lyul

    2015-11-01

    Although esophageal candidiasis (EC) is an opportunistic infection, asymptomatic EC (AEC) is occasionally encountered in otherwise healthy individuals. This study evaluates the impact of antifungal treatment in immunocompetent individuals with AEC and investigates risk factors for persistent or recurrent EC. The authors identified patients with biopsy-proven AEC from the database of individuals receiving screening endoscopy (n = 99,255). After excluding patients receiving immunosuppressive therapy, being positive for human immunodeficiency virus, receiving no follow-up endoscopy, or having no antifungal treatment data, a total of 142 patients were divided into remission and nonremission groups. Remission was defined when EC was not detectable on follow-up endoscopy. On baseline comparison, nonremission group was older (57.5 ± 10.3 versus 52.5 ± 10.5 years, P = 0.017) and more likely to have cardiovascular disease (12.9% versus 1.8%, P = 0.021) and history of pulmonary tuberculosis (PTB) (22.6% versus 4.5%, P = 0.004) and exhibited a lower triglyceride level (101.4 ± 37.4 versus 122.6 ± 79.6 mg/dL, P = 0.039) than remission group, whereas grade of EC and concomitant endoscopic findings did not differ between 2 groups. Antifungal treatment was also similarly performed between 2 groups. Multivariate analysis revealed that history of PTB is independently associated with nonremission (odds ratio 4.495, 95% confidence interval 1.023-19.762, P = 0.047). No patients demonstrated EC-related complications during a mean follow-up of 28.0 ± 12.0 months. In conclusion, our results suggested that antifungal treatment is not required for immunocompetent individuals with AEC and past history of PTB is an independent predictor for persistent or recurrent EC.

  1. Leucyl-leucine methyl ester treatment of donor cells permits establishment of immunocompetent parent----F1 chimeras that are selectively tolerant of host alloantigens

    SciTech Connect

    Thiele, D.L.; Calomeni, J.A.; Lipsky, P.E.

    1987-10-01

    Treatment of murine lymphocytes with L-leucyl-L-leucine methyl ester (Leu-Leu-OMe) selectively removes natural killer cells, cytotoxic T lymphocyte precursors, and the capacity to cause lethal graft-vs-host disease, whereas bone marrow stem cell function and alloantigen-induced L3T4+ T helper function remains intact. The present studies assess the immunocompetence of allogeneic bone marrow chimeras established by reconstituting irradiated (C57BL/6 X DBA/2)F1 (B6D2F1) mice with Leu-Leu-OMe-treated C57BL/6 (B6) bone marrow and spleen cells. Spleen cells from such chimeras were found to have normal B and T cell mitogenic responses. Furthermore, levels of natural-killer cell function were comparable to those observed in B6----B6 syngeneic radiation chimeras established without Leu-Leu-OMe treatment of donor cells. Spleen cells from B6----B6D2F1 mice were identical with B6----B6 or B6 mice in allostimulatory capacity and thus contained no discernible cells of non-H-2b phenotype. Whereas B6----B6D2F1 spleen cells demonstrated alloproliferative and allocytotoxic responses toward H-2k bearing spleen cells, no H-2d specific proliferative or cytotoxic responses could be elicited. B6----B6D2F1 spleen cells did not suppress the generation of anti-H-2d or anti-H-2k proliferative or cytotoxic responses from control B6 spleen cells. Furthermore, addition of rat concanavalin A supernatants did not reconstitute anti-H-2d responses of B6----B6D2F1 chimeric spleen cells. Thus, Leu-Leu-OMe treatment of B6 donor cells not only prevents lethal graft-vs-host disease, but also permits establishment of long-lived parent----F1 chimeras that are selectively tolerant of host H-2 disparate alloantigens, but fully immunocompetent with respect to natural killer cell function, B and T cell mitogenesis, and anti-third party alloresponsiveness.

  2. Self-Medication and the Only Child

    ERIC Educational Resources Information Center

    Linder, Ronald L.; Lerner, Steven E.

    1972-01-01

    Study results reveal certain personal conflicts predisposing the use of tranquilizers, related to the family structure unique to the only child. Further research is required to substantiate these findings and related causes. (Author)

  3. Helping Your Child through Early Adolescence -- Helping Your Child Series

    MedlinePlus

    ... CHILD'S ACADEMIC SUCCESS Helping Your Child Through Early Adolescence -- Helping Your Child Series PDF (1 MB) For ... Acknowledgements Tips to Help Your Child through Early Adolescence No Child Left Behind < Previous page | ^ Top ^ | Next ...

  4. Use of whole blood lymphocyte stimulation test for immunocompetency studies in bald eagles, red-tailed hawks, and great horned owls.

    PubMed

    Redig, P T; Dunnette, J L; Sivanandan, V

    1984-11-01

    Mitogen-induced whole blood lymphocyte stimulation tests for immunocompetency studies in bald eagles (Haliaeetus leucocephalus), red-tailed hawks (Buteo jamaicensis), and great horned owls (Bubo virginianus) were developed. Combinations of incubation times, blood dilutions, concentrations of [3H]thymidine and [125I]2-deoxyuridine, antibiotics, phytohemagglutinin-P, and concanavalin A were tested for their effects on the stimulation index (SI). An antibiotic combination of gentamicin plus amphotericin B yielded low SI with lymphocytes from bald eagles, but not with lymphocytes from great horned owls or red-tailed hawks. Penicillin plus streptomycin caused no such depression of SI. Lymphocytes from all 3 species yielded maximum responses with a 48-hour prelabel and 12- to- 16 hour postlabel incubation period at 41 C and 1:20 blood dilution. Optimal mitogen concentrations for lymphocytes from bald eagles, red-tailed hawks, and great horned owls were 25 micrograms, 10 micrograms, and 10 micrograms of phytohemagglutinin-P/well, respectively, and 2.5 micrograms, 10 micrograms, and 10 micrograms of concanavalin A/well, respectively. Differences in SI were not seen between the 2 radioactive labels. The optimal concentration of the [3H]thymidine label ranged from 0.06 to 0.125 microCi/well. PMID:6524727

  5. Clinical dilemmas in evaluating the short child.

    PubMed

    Garganta, Melissa D; Bremer, Andrew A

    2014-08-01

    Concerns about a child's growth are one of the most common topics parents voice during general pediatric office visits and are a leading cause for referral to a pediatric endocrinologist. There are a variety of conditions that lead to short stature in children; however, in the absence of true pathology, idiopathic short stature and constitutional delay are the most frequent causes. This article reviews the general approach to evaluating the short child and clinical signs that should prompt further evaluation and referral. We also address the unique psychological issues that these children face and approaches to counseling families with a child with idiopathic short stature.

  6. Pyogenic liver abscess caused by Gemella morbillorum.

    PubMed

    Borro, Paolo; Sumberaz, Alessandro; Testino, Gianni

    2014-01-01

    Even though Gemella morbillorum infection (GMI) is rare in humans, it may nevertheless, cause endocarditis, meningitis, brain abscess, pleural empyema, nephritis, mediastinitis, and--occasionally--liver abscess. We are describing the case of a 64-years-old Caucasian male admitted with fever and abdominal pain. Laboratory parameters revealed inflammation signs, and instrumental examinations showed the presence of diverticula in the ascending colon. Abdominal ultrasound (US) and computer tomography (CT) showed two focal lesions in the right liver lobe. One had the characteristics of a simple cyst; the second was hypoechoic with a low density area, possibly containing necrotic material. US-guided needle biopsy was found negative for neoplastic cells, showing purulent infiltrate. Pus culture was found positive for GMI. Systemic antibiotic therapy coupled with repeated US-guided needle aspiration, induced the resolution of the hepatic abscess. Few cases have been reported of hepatic abscess caused by GMI in immunocompetent non-cirrhotic subjects.

  7. Rapid loss of behavioral plasticity and immunocompetence under intense sexual selection.

    PubMed

    van Lieshout, Emile; McNamara, Kathryn B; Simmons, Leigh W

    2014-09-01

    Phenotypic plasticity allows animals to maximize fitness by conditionally expressing the phenotype best adapted to their environment. Although evidence for such adjustment in reproductive tactics is common, little is known about how phenotypic plasticity evolves in response to sexual selection. We examined the effect of sexual selection intensity on phenotypic plasticity in mating behavior using the beetle Callosobruchus maculatus. Male genital spines harm females during mating and females exhibit copulatory kicking, an apparent resistance trait aimed to dislodge mating males. After exposing individuals from male- and female-biased experimental evolution lines to male- and female-biased sociosexual environments, we examined behavioral plasticity in matings with standard partners. While females from female-biased lines kicked sooner after exposure to male-biased sociosexual contexts, in male-biased lines this plasticity was lost. Ejaculate size did not diverge in response to selection history, but males from both treatments exhibited plasticity consistent with sperm competition intensity models, reducing size as the number of competitors increased. Analysis of immunocompetence revealed reduced immunity in both sexes in male-biased lines, pointing to increased reproductive costs under high sexual selection. These results highlight how male and female reproductive strategies are shaped by interactions between phenotypically plastic and genetic mechanisms of sexual trait expression.

  8. Clinical data analysis of 19 cases of community-acquired adenovirus pneumonia in immunocompetent adults

    PubMed Central

    Yu, Hong-Xia; Zhao, Mao-Mao; Pu, Zeng-Hui; Wang, Yun-Qiang; Liu, Yan

    2015-01-01

    The aim of this study was to investigate the characteristics of clinical manifestations, laboratory tests and imaging changes of community-acquired adenovirus pneumonia in immunocompetent adults. A retrospective study was performed on 19 adult community-acquired adenovirus pneumonia cases in Yantai, whereby the clinical data were collected and analyzed. Of 19 cases, 14 (73.68%) had fever and 17 (89.47%) had cough symptoms. Moreover, 14 cases (73.68%) had normal white blood cell counts, while 11 cases (57.89%) exhibited a reduction in lymphocyte proportion. Among the 19 cases, 17 cases exhibited lesions in a single lung, while 2 cases involved bilateral lungs. The lesions predominantly exhibited ground glass-like changes. The clinical manifestations of adult community-acquired adenovirus pneumonia patients with normal immune functions were mild, with such presenting symptoms as fever, cough, and sputum; most patients did not exhibit high levels of white blood cells or low lymphocyte counts, and the imaging features (ground glass-like effusion) were indicative of single-lung involvement. PMID:26770532

  9. Reduced immunocompetence of nestlings in replacement clutches of the European magpie (Pica pica)

    PubMed Central

    Sorci, G.; Soler, J. J.; Møller, A. P.

    1997-01-01

    Laying date is one of the most important determinants of reproductive success and recruitment probability in birds. Late breeders usually fledge fewer chicks than individuals with earlier breeding dates, and fledglings produced late in the season have high mortality rates. Food availability and nestling mass have been evoked as the principal mechanistic links between laying date and offspring survival. Here we suggest that another factor may actually account for the difference in survival rate between early and late offspring: immunocompetence. We predicted that nestlings produced later in the season or in replacement clutches should have lower immune responses when challenged with an antigen, than early nestlings or nestlings produced in first clutches. This hypothesis was tested in a population of magpies (Pica pica), in which we experimentally induced breeding failure in a group of nests and compared the immune response of nestlings in replacement clutches with the immune response of first clutch nestlings. Cellular immune response, as measured by wing web swelling (a correlate of T-lymphocyte production after injection of phytohaemagglutinin-P), significantly decreased with hatching date and was significantly lower in nestlings of replacement clutches. Furthermore, coefficients of intraclutch variation in immune response were higher in nestlings of replacement clutches. This experiment demonstrates an inverse relationship between immune responsiveness and breeding date, and reduced recruitment probability of late nestlings may be a direct consequence of their inability to cope with parasites.

  10. Primary Isolated Lymphoma of the Fourth Ventricle in an Immunocompetent Patient

    PubMed Central

    Bokhari, Rakan; Ghanem, Ahmad; Alahwal, Mahmoud

    2013-01-01

    Primary central nervous lymphoma (PCNSL) is a rare variant of extranodal non-Hodgkin's lymphoma with a especially poor prognosis. The diagnosis is usually encountered in immunodeficient patients but is also encountered, albeit uncommonly, in the immunocompetent. We present a 50-year-old male who developed signs and symptoms of increased intracranial pressure. Imaging revealed the presence of a fourth ventricle mass with obstructive hydrocephalus. First, the patient underwent emergency endoscopic third ventriculostomy followed, few days later, by complete tumor resection via a posterior fossa craniotomy. Postoperative histopathology revealed the lesion to be a PCNSL. He received adjuvant chemotherapy and radiation and remained with no recurrence on regular imaging studies for 18-month followup. We report herein the fourth case of isolated PCNSL lesion to the fourth ventricle in the literature and provide the rationale for our belief that craniotomy and tumor resection, if feasible, should be the initial line of management in similar cases to relieve hydrocephalus and achieve the diagnosis. PMID:23607015

  11. A Case of Nocardia farcinica Pneumonia and Mediastinitis in an Immunocompetent Patient

    PubMed Central

    Kim, Jinyoung; Kang, Minkyu; Kim, Juri; Jung, Sohee; Park, Junhung; Lee, Dongkyu

    2016-01-01

    Nocardia species are aerobic, gram-positive pathogens found worldwide in soil. Nocardia is considered an opportunistic pathogen, and its infection mostly occurs in immunocompromised patients. We report a case of Nocardia farcinica induced mediastinitis and pneumonia that occurred in a 64-year-old male patient who had no significant medical history except for hypertension. He visited another hospital with a complaint of dyspnea and left chest wall pain. The symptoms arose 7 days ago without any trauma and they worsened. A mediastinal mass was found on computed tomography scan. After being transferred to our hospital for further evaluation, he was diagnosed with mediastinitis and pneumonia. As N. farcinica was found to be the causative organism by 16S rRNA sequencing, proper antibiotic therapy including trimethoprim/sulfamethoxazole was initiated immediately. After this, the patient improved and he was discharged. If an infection has a disseminating course, nocardiosis cannot be excluded even in immunocompetent patients. Once the diagnosis is established, prompt antibiotic therapy should be performed based on the severity. PMID:27066088

  12. Hepatosplenic Abscesses and Osteomyelitis of the Spine in an Immunocompetent Adult with Cat Scratch Disease

    PubMed Central

    Knafl, D.; Lötsch, F.; Burgmann, H.; Goliasch, G.; Poeppl, W.; Ramharter, M.; Thalhammer, F.; Schuster, C.

    2015-01-01

    We present an 18-year-old, immunocompetent Austrian military conscript with cervical lymphadenopathy, fever, back-pain, and persistent inflammation markers despite two weeks of antimicrobial therapy with ampicillin/sulbactam. All specific laboratory investigations for identification of a specific etiology, including blood cultures and autoantibodies, were inconspicuous. Abdominal computed tomography showed multiple hypodense hepatosplenic lesions and osteomyelitis of the thoracic and lumbar spine with base plate fracture. Based on the patient's history, clinical presentation, and radiological findings, serology for cat scratch disease (CSD) was performed and high B. henselae specific IgM and IgG antibodies were detected. Due to its variety of clinical presentations, diagnosis of CSD is challenging, especially in the absence of a history of specific exposure. This case report shall remind the physician that cat scratch disease is a common disease, mainly presenting with fever and lymphadenopathy in young patients. Nevertheless CSD has many different and rare forms of presentations, including hepatosplenic lesions and bone involvement as shown in this case. PMID:26576306

  13. EBV+ diffuse large B-cell lymphoma arising within atrial myxoma in Chinese immunocompetent patient

    PubMed Central

    Liu, Xiaoyan; Liu, Pu; Li, Jun

    2015-01-01

    The incidence rate of Primary cardiac lymphoma is very low. Primary cardiac lymphoma within myxoma is extremely rare disease. So far, these cases have been reported only eight in the world, which has not reported in Chinese so far. Hence, we reported the unique Chinese case of 52-year-old immunocompetent male with primary Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma, and had no evidence of systemic lymphoma. The patient presented right sided body numbness, arm weakness no incentive and mouth twitch. A transthoracic echocardiogram revealed a large intraatrial mass, attached to the left atrial wall. The mass was removed by open thoracic surgery and subsequently diagnosed as malignant diffuse large B-cell lymphoma with myxoma by histopathology. This was the fourth case of discovered Epstein-Barr virus positive diffuse large B-cell lymphoma in a cardiac myxoma reported so far. The patient has been well by followed up for 5 months without chemotherapy. Now we discuss the importance of histodiagnosis and the proper treatment. Epstein-Barr virus positive diffuse large B-cell lymphoma arising within atrial myxoma is an extraordinary lymphoma for better prognosis, avoiding excessive treatment. PMID:25973119

  14. Clinical data analysis of 19 cases of community-acquired adenovirus pneumonia in immunocompetent adults.

    PubMed

    Yu, Hong-Xia; Zhao, Mao-Mao; Pu, Zeng-Hui; Wang, Yun-Qiang; Liu, Yan

    2015-01-01

    The aim of this study was to investigate the characteristics of clinical manifestations, laboratory tests and imaging changes of community-acquired adenovirus pneumonia in immunocompetent adults. A retrospective study was performed on 19 adult community-acquired adenovirus pneumonia cases in Yantai, whereby the clinical data were collected and analyzed. Of 19 cases, 14 (73.68%) had fever and 17 (89.47%) had cough symptoms. Moreover, 14 cases (73.68%) had normal white blood cell counts, while 11 cases (57.89%) exhibited a reduction in lymphocyte proportion. Among the 19 cases, 17 cases exhibited lesions in a single lung, while 2 cases involved bilateral lungs. The lesions predominantly exhibited ground glass-like changes. The clinical manifestations of adult community-acquired adenovirus pneumonia patients with normal immune functions were mild, with such presenting symptoms as fever, cough, and sputum; most patients did not exhibit high levels of white blood cells or low lymphocyte counts, and the imaging features (ground glass-like effusion) were indicative of single-lung involvement.

  15. Clinical deterioration in community acquired infections associated with lymphocyte upsurge in immunocompetent hosts.

    PubMed

    Cheng, Vincent C C; Wu, Alan K L; Hung, Ivan F N; Tang, Bone S F; Lee, Rodney A; Lau, Susanna K P; Woo, Patrick C Y; Yuen, Kwok-Yung

    2004-01-01

    Clinical deterioration during the course of community-acquired infections can occur as a result of an exaggerated immune response of the host towards the inciting pathogens, leading to immune-mediated tissue damage. Whether a surge in the peripheral lymphocyte count can be used as a surrogate marker indicating the onset of immunopathological tissue damage is not known. In this study, we report the clinical presentations and outcomes of a cohort of immunocompetent patients with non-tuberculous community acquired infections who experienced clinical deterioration during hospital stay (n=85). 12 (14.1%) patients had a surge in lymphocyte count preceding their clinical deteriorations, and their diagnoses included viral pneumonitis , viral encephalitis , scrub typhus , leptospirosis , brucellosis , and dengue haemorrhagic fever . The clinical manifestations during deterioration ranged from interstitial pneumonitis , airway obstruction , CNS disturbances , and systemic capillary leak syndrome , all of which were thought to represent immunopathological tissue damages. When compared with patients without lymphocyte surge, these patients were more likely to be infected with fastidious/viral pathogens (0 vs 12; p<0.05), in addition to having lower mean baseline lymphocyte counts (403+/-181 vs 1143+/-686 cells/microl; p<0.05). We postulate that the peripheral lymphocyte count may be a useful surrogate marker indicating the presence of immunopathological damage during clinical deterioration in certain infectious diseases.

  16. Child Care Handbook.

    ERIC Educational Resources Information Center

    American Home Economics Association, Washington, DC.

    This book discusses various aspects of child care programs. Chapter titles include: Child Care Needs and Issues; Present Influences on Early Childhood Programs; Licensing and Standards; The Program; Stories and Music; Art and Science; The Physical Environment Staffing the Child Care Center; Working with Parents; Guidance of the Young Child; Health…

  17. Child Support Report, 1998.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    1998-01-01

    This document is comprised of the 12 monthly issues of the 1998 "Child Support Report," which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Editorials and information on events and conferences of interest and…

  18. Child Support Report, 2000.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    2000-01-01

    This document comprises the 12 issues for 2000 of the "Child Support Report," which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Featured regularly are editorials and information on events of interest and…

  19. Toilet Training Your Child

    MedlinePlus

    ... to be present when you go to the bathroom and make your child feel comfortable in the bathroom. Allow your child to see urine and bowel ... begin teaching your child to go to the bathroom. Keep your child in loose, easily removable pants. ...

  20. THE DIFFICULT CHILD.

    ERIC Educational Resources Information Center

    ROUCEK, JOSEPH S.

    THIS BOOK CONSISTS OF 16 ESSAYS BY SPECIALISTS ON PROBLEMS WHICH MAY MAKE A CHILD DIFFICULT. EACH AUTHOR DISCUSSES ETIOLOGICAL FACTORS, CHARACTERISTICS, AND HOW DIFFICULTIES MAY BE REDUCED. THE FOLLOWING TOPICS ARE CONSIDERED--(1) "THE CREATIVE CHILD" BY E.P. TORRANCE, (2) "THE INATTENTIVE CHILD" BY I.W. SCHERER, (3) "THE CHILD WITH LANGUAGE…

  1. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

    The purpose of this paper was to elaborate on the definitions of child abuse in order to improve the understanding of child abuse. The definitions given by the U.S. House Joint Committee on Child Abuse in the Child Abuse Prevention and Treatment Act, and in research by Holden (1984), are cited. These definitions refer to the nature of abusive acts…

  2. Child Support Report, 1999.

    ERIC Educational Resources Information Center

    Sharman, Phil, Ed.

    1999-01-01

    This document comprises the 12 issues for 1999 of the "Child Support Report," which explores problems related to child support enforcement, reports on federal and state government child support enforcement initiatives, and summarizes research related to child support. Editorials and information on events and conferences of interest and funding…

  3. Insidious manifestation of pyogenic liver abscess caused by Streptococcus intermedius and Micrococcus luteus: a case report

    PubMed Central

    Ioannou, Antreas; Xenophontos, Eleni; Karatsi, Alexandra; Petrides, Christos; Kleridou, Maro; Zintilis, Chrysostomos

    2016-01-01

    Pyogenic liver abscesses are caused by various microorganisms and usually present with fever, abdominal pain, leukocytosis and liver enzyme abnormalities. This case presents the insidious manifestation of a pyogenic liver abscess in a 34-year-old immunocompetent male, where classical manifestations of a liver abscess were absent. The microorganisms cultured from the abscess belonged to oral cavity's and gastrointestinal tract's normal flora. PMID:26770811

  4. Ureaplasma urealyticum Causes Hyperammonemia in an Experimental Immunocompromised Murine Model

    PubMed Central

    Wang, Xiaohui; Karau, Melissa J.; Greenwood-Quaintance, Kerryl E.; Block, Darci R.; Mandrekar, Jayawant N.; Cunningham, Scott A.

    2016-01-01

    Hyperammonemia syndrome is an often fatal complication of lung transplantation which has been recently associated with Ureaplasma infection. It has not been definitely established that Ureaplasma species can cause hyperammonemia. We established a novel immunocompromised murine model of Ureaplasma urealyticum infection and used it to confirm that U. urealyticum can cause hyperammonemia. Male C3H mice were pharmacologically immunosuppressed with mycophenolate mofetil, tacrolimus and oral prednisone for seven days, and then challenged intratracheally (IT) and/or intraperitoneally (IP) with 107 CFU U. urealyticum over six days, while continuing immunosuppression. Spent U. urealyticum-free U9 broth was used as a negative control, with uninfected immunocompetent mice, uninfected immunosuppressed mice, and infected immunocompetent mice serving as additional controls. Plasma ammonia concentrations were compared using Wilcoxon ranks sum tests. Plasma ammonia concentrations of immunosuppressed mice challenged IT/IP with spent U9 broth (n = 14) (range 155–330 μmol/L) were similar to those of normal mice (n = 5), uninfected immunosuppressed mice (n = 5), and U. urealyticum IT/IP challenged immunocompetent mice (n = 5) [range 99–340 μmol/L, p = 0.60]. However, immunosuppressed mice challenged with U. urealyticum IT/IP (n = 20) or IP (n = 15) had higher plasma ammonia concentrations (range 225–945 μmol/L and 276–687 μmol/L, respectively) than those challenged IT/IP with spent U9 broth (p<0.001). U. urealyticum administered IT/IP or IP causes hyperammonemia in mice pharmacologically immunosuppressed with a regimen similar to that administered to lung transplant recipients. PMID:27537683

  5. Ureaplasma urealyticum Causes Hyperammonemia in an Experimental Immunocompromised Murine Model.

    PubMed

    Wang, Xiaohui; Karau, Melissa J; Greenwood-Quaintance, Kerryl E; Block, Darci R; Mandrekar, Jayawant N; Cunningham, Scott A; Patel, Robin

    2016-01-01

    Hyperammonemia syndrome is an often fatal complication of lung transplantation which has been recently associated with Ureaplasma infection. It has not been definitely established that Ureaplasma species can cause hyperammonemia. We established a novel immunocompromised murine model of Ureaplasma urealyticum infection and used it to confirm that U. urealyticum can cause hyperammonemia. Male C3H mice were pharmacologically immunosuppressed with mycophenolate mofetil, tacrolimus and oral prednisone for seven days, and then challenged intratracheally (IT) and/or intraperitoneally (IP) with 107 CFU U. urealyticum over six days, while continuing immunosuppression. Spent U. urealyticum-free U9 broth was used as a negative control, with uninfected immunocompetent mice, uninfected immunosuppressed mice, and infected immunocompetent mice serving as additional controls. Plasma ammonia concentrations were compared using Wilcoxon ranks sum tests. Plasma ammonia concentrations of immunosuppressed mice challenged IT/IP with spent U9 broth (n = 14) (range 155-330 μmol/L) were similar to those of normal mice (n = 5), uninfected immunosuppressed mice (n = 5), and U. urealyticum IT/IP challenged immunocompetent mice (n = 5) [range 99-340 μmol/L, p = 0.60]. However, immunosuppressed mice challenged with U. urealyticum IT/IP (n = 20) or IP (n = 15) had higher plasma ammonia concentrations (range 225-945 μmol/L and 276-687 μmol/L, respectively) than those challenged IT/IP with spent U9 broth (p<0.001). U. urealyticum administered IT/IP or IP causes hyperammonemia in mice pharmacologically immunosuppressed with a regimen similar to that administered to lung transplant recipients. PMID:27537683

  6. Immune responses during the larval stages of Mytilus galloprovincialis: metamorphosis alters immunocompetence, body shape and behavior.

    PubMed

    Balseiro, Pablo; Moreira, Rebeca; Chamorro, Rubén; Figueras, Antonio; Novoa, Beatriz

    2013-08-01

    We investigated the development of the immune system during the larval stages of the mussel Mytilus galloprovincialis. The ability of trochophore and veliger larvae to phagocytose foreign particles (Escherichia coli and zymosan) was measured. Phagocytosis was detected as early as 24 h post-fertilization (hpf) using flow cytometry and fluorescence microscopy. However, although there was a high basal production of reactive oxygen and nitrogen species (ROS and NRS), the phagocytosis of zymosan did not trigger an associated increase in radical production. In addition, a panel of immune-related mussel genes (Myticin B, Myticin C, Mytilin B, Mytimycin precursor 1, Macrophage migration inhibition factor, lysozyme, C1q, membrane attack complex protein and fibrinogen-related protein) was selected for expression profile analysis throughout the different developmental stages (trochophore, veliger, metamorphosis, post-settlement and spat). The expression of these genes increased during the transition from trochophore to spat, and the level of expression was higher in oocytes than in trochophores, suggesting that gene expression during the first larval stages might be maternal in origin. Metamorphosis was identified as a crucial stage when larvae increased the expression of immune-related genes and responded to environmental signals. Whole-mount in situ hybridization studies showed the mantle edge as an important area in the development of immunocompetence in bivalve larvae. Larvae responded to both live and heat-inactivated bacteria by modulating expression of immune-related genes. Altogether, our results support that during the early stages of M. galloprovincialis development, immune mechanisms emerge to aid larvae in managing infections.

  7. Chickenpox-related pulmonary granulomas in immunocompetent adults: clinicopathologic and molecular features of an underrated occurrence.

    PubMed

    Rossi, Giulio; Cavazza, Alberto; Gennari, William; Marchioni, Alessandro; Graziano, Paolo; Caminati, Antonella; Mengoli, Maria Cecilia; Magnani, Rita; Colby, Thomas V

    2012-10-01

    Pulmonary granulomas represent a common inflammatory reaction to several lung infective or noninfective diseases. However, little is known about the histology and clinical presentation of chickenpox-related granulomas in immunocompetent subjects. We collected a series of 8 adult patients (mean age, 40 y; range, 33 to 53 y) with several bilateral pulmonary granulomas incidentally discovered after imaging studies. All patients were asymptomatic and had experienced a varicella-zoster virus (VZV) infection as adults but were clinically suspected to have a metastatic neoplasm of unknown origin. Chest computed tomography scan revealed numerous, tiny (few millimeters to 1 cm in size) nodules randomly dispersed through the lungs. Positron emission tomography scan performed in 4 patients was negative. All patients underwent video-assisted thoracoscopic surgical resection and were still alive and well. At histology, granulomas consisted of well-defined, rounded, small nodules centered by a deeply eosinophilic, acellular necrosis rimmed by lamellar dense collagen and a chronic inflammatory infiltrate with or without multinucleated giant cells. Chickenpox-related granulomas were included in the differential diagnosis along with several other granulomatous diseases. Polymerase chain reaction-based molecular analysis for VZV performed on paraffin sections detected VZV DNA in all 8 cases. By contrast, 85 cases of pulmonary granulomas of different etiologies were simultaneously studied by molecular analysis with negative results. Pathologists should be familiar with the peculiar morphologic appearance of chickenpox-related granulomas. A careful search for a history of VZV infection in adulthood and molecular studies may be very helpful in confirming the diagnosis.

  8. Genome-Wide Association Study in Immunocompetent Patients with Delayed Hypersensitivity to Sulfonamide Antimicrobials

    PubMed Central

    Motsinger-Reif, Alison; Dickey, Allison; Yale, Steven; Trepanier, Lauren A.

    2016-01-01

    Background Hypersensitivity (HS) reactions to sulfonamide antibiotics occur uncommonly, but with potentially severe clinical manifestations. A familial predisposition to sulfonamide HS is suspected, but robust predictive genetic risk factors have yet to be identified. Strongly linked genetic polymorphisms have been used clinically as screening tests for other HS reactions prior to administration of high-risk drugs. Objective The purpose of this study was to evaluate for genetic risk of sulfonamide HS in the immunocompetent population using genome-wide association. Methods Ninety-one patients with symptoms after trimethoprim-sulfamethoxazole (TMP-SMX) attributable to “probable” drug HS based on medical record review and the Naranjo Adverse Drug Reaction Probability Scale, and 184 age- and sex-matched patients who tolerated a therapeutic course of TMP-SMX, were included in a genome-wide association study using both common and rare variant techniques. Additionally, two subgroups of HS patients with a more refined clinical phenotype (fever and rash; or fever, rash and eosinophilia) were evaluated separately. Results For the full dataset, no single nucleotide polymorphisms were suggestive of or reached genome-wide significance in the common variant analysis, nor was any genetic locus significant in the rare variant analysis. A single, possible gene locus association (COL12A1) was identified in the rare variant analysis for patients with both fever and rash, but the sample size was very small in this subgroup (n = 16), and this may be a false positive finding. No other significant associations were found for the subgroups. Conclusions No convincing genetic risk factors for sulfonamide HS were identified in this population. These negative findings may be due to challenges in accurately confirming the phenotype in exanthematous drug eruptions, or to unidentified gene-environment interactions influencing sulfonamide HS. PMID:27272151

  9. Defining New Therapeutics Using a More Immunocompetent Mouse Model of Antibody-Enhanced Dengue Virus Infection

    PubMed Central

    Pinto, Amelia K.; Brien, James D.; Lam, Chia-Ying Kao; Johnson, Syd; Chiang, Cindy; Hiscott, John; Sarathy, Vanessa V.; Barrett, Alan D.; Shresta, Sujan

    2015-01-01

    ABSTRACT With over 3.5 billion people at risk and approximately 390 million human infections per year, dengue virus (DENV) disease strains health care resources worldwide. Previously, we and others established models for DENV pathogenesis in mice that completely lack subunits of the receptors (Ifnar and Ifngr) for type I and type II interferon (IFN) signaling; however, the utility of these models is limited by the pleotropic effect of these cytokines on innate and adaptive immune system development and function. Here, we demonstrate that the specific deletion of Ifnar expression on subsets of murine myeloid cells (LysM Cre+ Ifnarflox/flox [denoted as Ifnarf/f herein]) resulted in enhanced DENV replication in vivo. The administration of subneutralizing amounts of cross-reactive anti-DENV monoclonal antibodies to LysM Cre+ Ifnarf/f mice prior to infection with DENV serotype 2 or 3 resulted in antibody-dependent enhancement (ADE) of infection with many of the characteristics associated with severe DENV disease in humans, including plasma leakage, hypercytokinemia, liver injury, hemoconcentration, and thrombocytopenia. Notably, the pathogenesis of severe DENV-2 or DENV-3 infection in LysM Cre+ Ifnarf/f mice was blocked by pre- or postexposure administration of a bispecific dual-affinity retargeting molecule (DART) or an optimized RIG-I receptor agonist that stimulates innate immune responses. Our findings establish a more immunocompetent animal model of ADE of infection with multiple DENV serotypes in which disease is inhibited by treatment with broad-spectrum antibody derivatives or innate immune stimulatory agents. PMID:26374123

  10. Disease Resistance in the Drywood Termite, Incisitermes schwarzi: Does Nesting Ecology Affect Immunocompetence?

    PubMed Central

    Calleri, Daniel V.; Rosengaus, Rebeca B.; Traniello, James F.A.

    2010-01-01

    Termites live in nests that can differ in microbial load and thus vary in degree of disease risk. It was hypothesized that termite investment in immune response would differ in species living in nest environments that vary in the richness and abundance of microbes. Using the drywood termite, Incisitermes schwarzi Banks (Isoptera: Kalotermitidae), as a model for species having low nest and cuticular microbial loads, the susceptibility of individuals and groups to conidia of the entomopathogenic fungus, Metarhizium anisopliae Sorokin (Hypocreales: Clavicipitaceae), was examined. The survivorship of I. schwarzi was compared to that of the dampwood termite, Zootermopsis angusticollis Hagen (Termopsidae), a species with comparatively high microbial loads. The results indicated that I. schwarzi derives similar benefits from group living as Z. angusticollis: isolated termites had 5.5 times the hazard ratio of death relative to termites nesting in groups of 25 while termites in groups of 10 did not differ significantly from the groups of 25. The results also indicated, after controlling for the influence of group size and conidia exposure on survivorship, that Z. angusticollis was significantly more susceptible to fungal infection than I. schwarzi, the former having 1.6 times the hazard ratio of death relative to drywood termites. Thus, disease susceptibility and individual investment in immunocompetence may not be dependent on interspecific variation in microbial pressures. The data validate prior studies indicating that sociality has benefits in infection control and suggest that social mechanisms of disease resistance, rather than individual physiological and immunological adaptations, may have been the principle target of selection related to variation in infection risk from microbes in the nest environment of different termite species. PMID:20572790

  11. Child deaths in South Africa: Lessons from the child death review pilot.

    PubMed

    Mathews, Shanaaz; Martin, Lorna J; Coetzee, David; Scott, Chris; Brijmohun, Yasheen

    2016-08-08

    South Africa (SA) has not met the child mortality target for the Millennium Development Goals, despite having invested substantially in programmes and policies to achieve these targets. The scale-up of the prevention of mother-to-child transmission programmes reduced HIV transmission from mother to child, but this has not been sustained owing to limitations in community-based child health services. Child mortality has declined, but has now plateaued. Children continue to die from preventable and treatable causes of death. Current data sources are incomplete, and do not provide information on deaths occurring out of health facilities. The child death review (CDR) pilot explores the pattern of child deaths and informs prevention strategies to improve child survival in SA. In this editorial we draw on the conclusions of the CDR pilot, where multiagency teams were established to investigate non-natural and unexpected deaths referred to two mortuary sites in order to strengthen child health and protection response systems and to prevent child deaths.

  12. Child deaths in South Africa: Lessons from the child death review pilot.

    PubMed

    Mathews, Shanaaz; Martin, Lorna J; Coetzee, David; Scott, Chris; Brijmohun, Yasheen

    2016-09-01

    South Africa (SA) has not met the child mortality target for the Millennium Development Goals, despite having invested substantially in programmes and policies to achieve these targets. The scale-up of the prevention of mother-to-child transmission programmes reduced HIV transmission from mother to child, but this has not been sustained owing to limitations in community-based child health services. Child mortality has declined, but has now plateaued. Children continue to die from preventable and treatable causes of death. Current data sources are incomplete, and do not provide information on deaths occurring out of health facilities. The child death review (CDR) pilot explores the pattern of child deaths and informs prevention strategies to improve child survival in SA. In this editorial we draw on the conclusions of the CDR pilot, where multiagency teams were established to investigate non-natural and unexpected deaths referred to two mortuary sites in order to strengthen child health and protection response systems and to prevent child deaths. PMID:27601103

  13. Ear-Shaped Stable Auricular Cartilage Engineered from Extensively Expanded Chondrocytes in an Immunocompetent Experimental Animal Model.

    PubMed

    Pomerantseva, Irina; Bichara, David A; Tseng, Alan; Cronce, Michael J; Cervantes, Thomas M; Kimura, Anya M; Neville, Craig M; Roscioli, Nick; Vacanti, Joseph P; Randolph, Mark A; Sundback, Cathryn A

    2016-02-01

    Advancement of engineered ear in clinical practice is limited by several challenges. The complex, largely unsupported, three-dimensional auricular neocartilage structure is difficult to maintain. Neocartilage formation is challenging in an immunocompetent host due to active inflammatory and immunological responses. The large number of autologous chondrogenic cells required for engineering an adult human-sized ear presents an additional challenge because primary chondrocytes rapidly dedifferentiate during in vitro culture. The objective of this study was to engineer a stable, human ear-shaped cartilage in an immunocompetent animal model using expanded chondrocytes. The impact of basic fibroblast growth factor (bFGF) supplementation on achieving clinically relevant expansion of primary sheep chondrocytes by in vitro culture was determined. Chondrocytes expanded in standard medium were either combined with cryopreserved, primary passage 0 chondrocytes at the time of scaffold seeding or used alone as control. Disk and human ear-shaped scaffolds were made from porous collagen; ear scaffolds had an embedded, supporting titanium wire framework. Autologous chondrocyte-seeded scaffolds were implanted subcutaneously in sheep after 2 weeks of in vitro incubation. The quality of the resulting neocartilage and its stability and retention of the original ear size and shape were evaluated at 6, 12, and 20 weeks postimplantation. Neocartilage produced from chondrocytes that were expanded in the presence of bFGF was superior, and its quality improved with increased implantation time. In addition to characteristic morphological cartilage features, its glycosaminoglycan content was high and marked elastin fiber formation was present. The overall shape of engineered ears was preserved at 20 weeks postimplantation, and the dimensional changes did not exceed 10%. The wire frame within the engineered ear was able to withstand mechanical forces during wound healing and neocartilage

  14. Child abuse by drowning.

    PubMed

    Griest, K J; Zumwalt, R E

    1989-01-01

    Drowning as a form of subtle fatal child abuse is difficult to distinguish from accidental immersion or from sudden unexpected natural death when the circumstances of immersion are concealed. Homicidal drownings are unwitnessed, usually occurring in the home, and the victims are young, either infants or toddlers. Accidental drownings are more likely to involve toddlers or older children in public areas such as swimming pools, drainage ditches, lakes, and rivers. This is especially true in rural areas. In cities, bathtubs remain a major site of accidental childhood drownings. Perpetrators of deliberate drownings often fit the sociopathologic profile of a child abuser. Because there is often a survival interval between immersion and death, pathologic findings consistent with postimmersion syndrome suggest the cause of death. Foreign material in the lungs, if immersion was other than in clear tap water, and injuries of the face are other positive correlating factors. A thorough investigation of the circumstances and cooperation between the investigating agency and the pathologist are essential to determine the correct manner of death in these cases. PMID:2909975

  15. Child abuse by drowning.

    PubMed

    Griest, K J; Zumwalt, R E

    1989-01-01

    Drowning as a form of subtle fatal child abuse is difficult to distinguish from accidental immersion or from sudden unexpected natural death when the circumstances of immersion are concealed. Homicidal drownings are unwitnessed, usually occurring in the home, and the victims are young, either infants or toddlers. Accidental drownings are more likely to involve toddlers or older children in public areas such as swimming pools, drainage ditches, lakes, and rivers. This is especially true in rural areas. In cities, bathtubs remain a major site of accidental childhood drownings. Perpetrators of deliberate drownings often fit the sociopathologic profile of a child abuser. Because there is often a survival interval between immersion and death, pathologic findings consistent with postimmersion syndrome suggest the cause of death. Foreign material in the lungs, if immersion was other than in clear tap water, and injuries of the face are other positive correlating factors. A thorough investigation of the circumstances and cooperation between the investigating agency and the pathologist are essential to determine the correct manner of death in these cases.

  16. First Report of Acute Postoperative Endophthalmitis Caused by Rothia Mucilaginosa after Phacoemulsification

    PubMed Central

    Álvarez-Ramos, Pablo; Del Moral-Ariza, Amparo; Alonso-Maroto, José M.; Marín-Casanova, Pilar; Calandria-Amigueti, José M.; Rodríguez-Iglesias, Manuel

    2016-01-01

    We aimed at reporting the first case of rapidly progressive acute postoperative endophthalmitis after phacoemulsification cataract surgery in an immunocompetent patient caused by Rothia mucilaginosa. An immunocompetent patient manifested endophthalmitis signs 48 hours after an uncomplicated cataract surgery by phacoemulsification. A bacteria of the family Micrococcaceae was cultured in the vitreous biopsy, namely R. mucilaginosa. The patient did not show a favorable clinical response after vitrectomy and systemic, intravitreal, and topical fortified antibiotics. The patient’s eye was very painful, and consequently, it deemed necessary to perform an evisceration. R. mucilaginosa may be an aggressive etiologic agent for postoperative endophthalmitis. Although the isolated R. mucilaginosa was susceptible to empirical treatment, it was impossible to control the infection with standard treatment, probably due to its ability to create a biofilm around the intraocular lens. PMID:27103973

  17. Chylothorax associated with child abuse.

    PubMed

    Ichikawa, Yasuhiro; Sato, Atsuo; Sato, Kodai; Nakamura, Kaori; Kitagawa, Norihiko; Tanoue, Koji; Shiro, Hiroyuki

    2015-12-01

    We report a case of right chylothorax associated with physical abuse in a 10-month-old boy who presented with respiratory decompensation. Chylothorax was improved by thoracic drainage and nutrition management, such as fasting followed by medium-chain triglyceride milk. Chest computed tomography on admission showed bilateral old rib fractures. Accordingly, physical abuse was suspected. Chylothorax of unknown cause in infancy, especially in those with coexisting rib fractures, must be scrutinized for child abuse. PMID:26388541

  18. Child abuse - physical

    MedlinePlus

    ... to a child of any race, religion, or economic status. HELP AN ABUSED CHILD Learn about the ... as cigarette burns Choke marks around the neck Circular marks around the wrists or ankles from twisting ...

  19. FPG Child Development Institute

    MedlinePlus

    ... Development, Teaching, and Learning The Frank Porter Graham Child Development Institute will partner with Zero to Three to ... Education October 4, 2016 More Frank Porter Graham Child Development Institute The University of North Carolina at Chapel ...

  20. Concussion - child - discharge

    MedlinePlus

    ... discharge; Mild traumatic brain injury - child - discharge; Closed head injury - child - discharge ... mild brain injury that can result when the head hits an object or a moving object strikes ...

  1. Estimating Local Child Abuse.

    ERIC Educational Resources Information Center

    Ards, Sheila

    1989-01-01

    Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)

  2. Normal Child Behavior

    MedlinePlus

    ... age. Development can be uneven, too, with a child's social development lagging behind his intellectual growth, or vice versa. ... members, and others. They may interfere with the child's intellectual development. They may be forbidden by law, ethics, religion, ...

  3. Toilet Teaching Your Child

    MedlinePlus

    ... KidsHealth in the Classroom What Other Parents Are Reading Upsetting News Reports? What to Say Vaccines: Which ... child small rewards, such as stickers or time reading with Mommy, every time your child goes in ...

  4. Surviving Your Child's Hospitalization.

    ERIC Educational Resources Information Center

    Cohen, David A.

    1988-01-01

    The parent of a young child who required major open heart surgery shares his suggestions for coping with a young child's hospitalization including parent visitation, relating to the hospital staff, getting answers to questions, and utilizing available services. (DB)

  5. Child Dental Health

    MedlinePlus

    Healthy teeth are important to your child's overall health. From the time your child is born, there are things you can do to promote healthy teeth and prevent cavities. For babies, you should clean ...

  6. What makes a child a 'competent' child?

    PubMed

    van Rooyen, Amanda; Water, Tineke; Rasmussen, Shayne; Diesfeld, Kate

    2015-12-01

    Competence is a vital component of the informed consent process. The perceived level of a child's competence may influence their degree of participation in health decisions that affect them. It is the responsibility of the health professional to gauge a child's level of competence. Child competence, however, is not a static attribute that is linked to age. Rather, it is dynamic, changing in nature and dependent on a child's previous experiences, personal attributes, network of relationships around them and cultural and environmental context. Consequently, there is no single verified assessment tool to assist in the recognition of competence for New Zealand children. Adding to this complexity are the unclear interpretations of New Zealand health legislation and policy regarding whether or not a child can legally consent or refuse healthcare advice and treatment without the consent of a legal guardian. Under the Care of Children Act 2004 and the Code of Health and Disability Services Consumers' Rights 1996, the Health and Disability Commissioner states "a child may consent themselves [to health treatment] if and when the child achieves sufficient understanding and maturity to understand fully what is proposed". This paper poses the question: What is 'competency' and how is this decided? For the purpose of this article, 'child' pertains to those under the age of 16 years. PMID:26913912

  7. Child-to-Child programme in Malaysia.

    PubMed

    Kasim, M S; Abraham, S

    1982-09-01

    Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.

  8. Child Care Subsidies and Child Development

    ERIC Educational Resources Information Center

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  9. Holocaust Child Survivors and Child Sexual Abuse

    ERIC Educational Resources Information Center

    Lev-Wiesel, Rachel; Amir, Marianne

    2005-01-01

    This study utilized a qualitative analysis of child survivors of the Holocaust who were sexually abused during World War II. The research study aimed to give this specific group of survivors a voice and to explore the impact of multiple extreme traumas, the Holocaust and childhood sexual abuse, on the survivors. Twenty-two child survivors of the…

  10. Treatment paradox in musculo-skeletal tuberculosis in an immunocompetent adult male; a case report from a tertiary care hospital.

    PubMed

    Chaskar, Priyanka; Rana, Geetika; Anuradha; Duggal, Nandini; Arora, Jyoti

    2015-04-01

    Paradoxical reactions like immune reconstitution inflammatory syndrome (IRIS) as seen with patients on retroviral treatment in HIV infection, have also been identified in HIV sero-negative patients with extra pulmonary tuberculosis especially lymph-node tuberculosis. Musculo-skeletal tuberculosis presenting as a cold abscess of the anterior chest wall is a rare entity which poses diagnostic and therapeutic challenge. A 35-year-old immunocompetent male came with complains of painless lump on right side of his chest over 9th and 10th intercostal space which gradually increased and extended upto 11th rib area. Clinically, diagnosis of cold abscess was made and anti-tubercular therapy (ATT) was started. Despite of being on ATT for 3 weeks, patient developed pain and signs of inflammation. Fluid was aspirated and sent for biochemical and microbiological investigations. The aspirated fluid was positive for acid fast bacilli by ZN stain and grew Mycobacterium tuberculosis in culture, sensitive to first line ATT. Pyogenic and fungal culture was negative. This case presented as an anterior chest wall cold abscess which deteriorated on initiation of first line ATT, thus creating a suspicion of resistance to ATT which was cleared on ATT susceptibility testing. Hence, this case underlines the possibility of treatment paradoxes seen in immunocompetent musculo-skeletal tuberculosis. PMID:26046019

  11. “Glowing Head” Mice: A Genetic Tool Enabling Reliable Preclinical Image-Based Evaluation of Cancers in Immunocompetent Allografts

    PubMed Central

    Day, Chi-Ping; Carter, John; Ohler, Zoe Weaver; Bonomi, Carrie; El Meskini, Rajaa; Martin, Philip; Graff-Cherry, Cari; Feigenbaum, Lionel; Tüting, Thomas; Van Dyke, Terry; Hollingshead, Melinda; Merlino, Glenn

    2014-01-01

    Preclinical therapeutic assessment currently relies on the growth response of established human cell lines xenografted into immunocompromised mice, a strategy that is generally not predictive of clinical outcomes. Immunocompetent genetically engineered mouse (GEM)-derived tumor allograft models offer highly tractable preclinical alternatives and facilitate analysis of clinically promising immunomodulatory agents. Imageable reporters are essential for accurately tracking tumor growth and response, particularly for metastases. Unfortunately, reporters such as luciferase and GFP are foreign antigens in immunocompetent mice, potentially hindering tumor growth and confounding therapeutic responses. Here we assessed the value of reporter-tolerized GEMs as allograft recipients by targeting minimal expression of a luciferase-GFP fusion reporter to the anterior pituitary gland (dubbed the “Glowing Head” or GH mouse). The luciferase-GFP reporter expressed in tumor cells induced adverse immune responses in wildtype mouse, but not in GH mouse, as transplantation hosts. The antigenicity of optical reporters resulted in a decrease in both the growth and metastatic potential of the labeled tumor in wildtype mice as compared to the GH mice. Moreover, reporter expression can also alter the tumor response to chemotherapy or targeted therapy in a context-dependent manner. Thus the GH mice and experimental approaches vetted herein provide concept validation and a strategy for effective, reproducible preclinical evaluation of growth and response kinetics for traceable tumors. PMID:25369133

  12. Salmonella typhimurium A1-R tumor targeting in immunocompetent mice is enhanced by a traditional Chinese medicine herbal mixture.

    PubMed

    Zhang, Yong; Zhang, Nan; Su, Shibing; Hoffman, Robert M; Zhao, Ming

    2013-05-01

    We have developed a bacterial cancer therapy strategy using the genetically-engineered strain Salmonella typhimurium A1-R (A1-R). A1-R is auxotrophic for leu and arg which attenuates bacterial growth in normal tissue but allows high tumor virulence. A1-R is effective against metastatic human and murine cancer cell lines in clinically-relevant nude-mouse models. However, A1-R treatment of tumors in immunocompetent mouse models with high doses is limited by toxicity. The current study evaluated a traditional Chinese medicine (TCM) herbal mixture in combination with A1-R therapy in a syngeneic metastatic immunocompetent mouse model of highly aggressive lung cancer. In a model of Lewis lung carcinoma, the combination of a TCM herbal mixture and S. typhimurium A1-R enabled bacteria to be safely administered at the large dose of 2 × 10(7) colony forming units once a week i.v. with increased treatment efficacy and reduced toxicity compared to monotherapy with A1-R. The herbal mixture prevented body weight loss, spleen weight gain and liver infection by A1-R, as well as hemorrhagic lesions on the skin, liver, and spleen, all observed with A1-R monotherapy. The results of the present study suggest that the combination of A1-R and TCM has important potential for therapy of highly aggressive types of cancer, including those which are resistant to standard therapy.

  13. Suicide among American Indian Adolescents. Some Facts about the Rising Rate of Suicide among American Indian Adolescents; Information on Causes and Warning Signs; and Examples of Effective Efforts and Prevention Resources. Linkages for Indian Child Welfare Programs.

    ERIC Educational Resources Information Center

    Berlin, Irving N.

    Suicide among American Indian adolescents has increased by almost 1000% over the past 20 years to become, as in Anglo society, the second most frequent cause of death in the 10 to 20 year old age group. The two major causes of adolescent suicide are acute stress and chronic depression. Environmental factors contributing to American Indian suicides…

  14. Caregiver-fabricated illness in a child: a manifestation of child maltreatment.

    PubMed

    Flaherty, Emalee G; Macmillan, Harriet L

    2013-09-01

    Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child's illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. This condition can result in significant morbidity and mortality. Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse. Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child. This report updates the previous clinical report "Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in the Medical Setting" The authors discuss the need to agree on appropriate terminology, provide an update on published reports of new manifestations of fabricated medical conditions, and discuss approaches to assessment, diagnosis, and management, including how best to protect the child from further harm. PMID:23979088

  15. Child Care Curriculum.

    ERIC Educational Resources Information Center

    Alaska State Dept. of Education, Juneau. Div. of Adult and Vocational Education.

    This competency-based curriculum is designed to be a handbook for the development of child care programs. It details the competencies, developed through a survey of child care provider-employers in Alaska, that students will require in a vocational child care program. The handbook is organized in seven sections. Section I introduces the concept of…

  16. Child Care Bulletin, 1998.

    ERIC Educational Resources Information Center

    Child Care Bulletin, 1998

    1998-01-01

    These two issues address topics related to state and federal public policy concerning child care. Issue 19 focuses on how various federal agencies work with the Child Care Bureau to strengthen and support child care services across the country. The issue includes articles describing initiatives of the Departments of Transportation, Labor,…

  17. Child Nutrition. Beginnings Workshop.

    ERIC Educational Resources Information Center

    Hayden, Jacqueline; Eastman, Wayne; Aird, Laura Dutil; McCrea, Nadine L.

    2002-01-01

    Four workshops focus on nutrition for infants and children in child care settings. Articles are: (1) "Nutrition and Child Development: Global Perspectives" (Jacqueline Hayden); (2) "Working with Families around Nutritional Issues" (Wayne Eastman); (3) "Breastfeeding Promotion in Child Care" (Laura Dutil Aird); and (4) "Food as Shared…

  18. Managing the Difficult Child.

    ERIC Educational Resources Information Center

    Murphy, Linda; Della Corte, Suzanne

    1990-01-01

    This newsletter issue focuses on ways parents can manage the difficult child with special needs. Characteristics of the difficult child are listed including poor listening skills, irritableness, impulsivity, and tendency to have tantrums. Typical reactions to the difficult child by parents, siblings, other relatives, neighbors, the school, and…

  19. [Autism and child protection].

    PubMed

    Coron, Guillaume

    2014-01-01

    The fostering of an autistic child deemed to be a child at risk leads one to question one's professional practices. In a children's home, an approach guided by psychoanalysis can recognise the benefits of behavioural or cognitive approaches. The aim of the professional's particular educational position is therefore to construct a relationship with each child.

  20. Child Care Bulletin, 1997.

    ERIC Educational Resources Information Center

    McGhee, Marilyn, Ed.

    1997-01-01

    This document is comprised of six issues of the Child Care Bulletin, a bimonthly publication of the National Child Care Information Center. The January-February issue focuses on involving communities in child care planning. Topics discussed in this issue include: community mobilization strategies, assessing needs and establishing goals, and…

  1. Child Care Update: 1987.

    ERIC Educational Resources Information Center

    Levy, Vic; And Others

    This paper provides information on child care needs, existing services, and special topics related to child care in Dane County, Wisconsin. Section I describes and compares needs and services; indicates locations of current full-day services; and offers specific recommendations for expanding child care. Section II concerns cost and affordability…

  2. Child Care Design Guide.

    ERIC Educational Resources Information Center

    Olds, Anita Rui

    This book provides architects, interior designers, developers, and child-care professionals with detailed information on the planning and design of child care centers. Part 1 examines the current state of child care in the United States and offers an overall philosophical concert--the spirit of place--as the framework for all center design. Part 2…

  3. Mother-Child Bonding.

    ERIC Educational Resources Information Center

    Pearce, Joseph Chilton

    1994-01-01

    Examines the nature of mother-child bonding from the prenatal stage through early infancy, discussing how the mother's actions, even before birth, stimulate her child's senses. Explains the crucial role that physical contact, breastfeeding, and visual stimuli have on mother-child bonding in human and animal newborns. (MDM)

  4. Metabolic, Immune, Epigenetic, Endocrine and Phenotypic Abnormalities Found in Individuals with Autism Spectrum Disorders, Down Syndrome and Alzheimer Disease May Be Caused by Congenital and/or Acquired Chronic Cerebral Toxoplasmosis

    ERIC Educational Resources Information Center

    Prandota, Joseph

    2011-01-01

    "Toxoplasma gondii" is a protozoan parasite that infects about a third of human population. It is generally believed that in immunocompetent hosts, the parasite infection takes usually asymptomatic course and induces self-limiting disease, but in immunocompromised individuals may cause significant morbidity and mortality. "T. gondii" uses sulfated…

  5. Molecular identification of adenovirus sequences: a rapid scheme for early typing of human adenoviruses in diagnostic samples of immunocompetent and immunodeficient patients.

    PubMed

    Madisch, Ijad; Wölfel, Roman; Harste, Gabi; Pommer, Heidi; Heim, Albert

    2006-09-01

    Precise typing of human adenoviruses (HAdV) is fundamental for epidemiology and the detection of infection chains. As only few of the 51 adenovirus types are associated with life- threatening disseminated diseases in immunodeficient patients, detection of one of these types may have prognostic value and lead to immediate therapeutic intervention. A recently published molecular typing scheme consisting of two steps (sequencing of a generic PCR product closely adjacent to loop 1 of the main neutralization determinant epsilon, and for species HAdV-B, -C, and -D the sequencing of loop 2 [Madisch et al., 2005]) was applied to 119 clinical samples. HAdV DNA was typed unequivocally even in cases of culture negative samples, for example in immunodeficient patients before HAdV causes high virus loads and disseminated disease. Direct typing results demonstrated the predominance of HAdV-1, -2, -5, and -31 in immunodeficient patients suggesting the significance of the persistence of these viruses for the pathogenesis of disseminated disease. In contrast, HAdV-3 predominated in immunocompetent patients and cocirculation of four subtypes was demonstrated. Typing of samples from a conjunctivitis outbreak in multiple military barracks demonstrated various HAdV types (2, 4, 8, 19) and not the suspected unique adenovirus etiology. This suggests that our molecular typing scheme will be also useful for epidemiological investigations. In conclusion, our two-step molecular typing system will permit the precise and rapid typing of clinical HAdV isolates and even of HAdV DNA in clinical samples without the need of time-consuming virus isolation prior to typing.

  6. Research priorities on ending child marriage and supporting married girls.

    PubMed

    Svanemyr, Joar; Chandra-Mouli, Venkatraman; Raj, Anita; Travers, Ellen; Sundaram, Lakshmi

    2015-09-03

    Over the past few years the issue of child marriage has received growing political and programmatic attention. In spite of some progress in a number of countries, global rates have not declined over the past decade. Knowledge gaps remain in understanding trends, drivers and approaches to ending child marriage, especially to understand what is needed to achieve results on a large scale. This commentary summarizes the outcomes of an Expert Group Meeting organized by World Health Organization to discuss research priorities on Ending Child Marriage and Supporting Married Girls. It presents research gaps and recommends priorities for research in five key areas; (i) prevalence and trends of child marriage; (ii) causes of child marriage (iii) consequences of child marriage; (iv) efforts to prevent child marriage; (v) efforts to support married girls.

  7. From child to child: children as communicators.

    PubMed

    Phinney, R; Evans, J

    1993-01-01

    Older children commonly care for their younger siblings while parents work to provide for the household. Through play, dance, and talk, children tend to interact with each other more intensely than do adults. In so doing, messages and awareness are exchanged more effectively. Child-to-Child is an active, child-centered learning approach which aims to capitalize on this phenomenon by training older siblings to be effective communicators. This approach has been formally practiced in over 70 countries since 1979. Child-to-Child encourages children to learn the meaning and importance of health messages on their own. Children will then be most likely to retain and communicate information throughout the family, to neighbors, and to the general community. No blueprint exists, however, on which program planners may base the design of new programs. Programs should instead be adapted by those living within the community and culture to fit local needs and circumstances. Nonetheless, the Aga Khan Foundation supported the study of 7 highly different Child-to-Child projects over 3 years in India to obtain some sense of which program elements are successful and potentially useful in other settings. The study revealed that all of the programs helped increase the health knowledge of children and teachers. Little information was obtained on the extent to which information was diffused by children within the community. Overall, the study produced the following results: planners should consider using Child-to-Child projects in schools; teacher training should be made a priority; administrative support should be provided; entire staffs should be made to feel involved in the decision making process; obstacles to changing teaching methods should not be underestimated; teaching materials should be locally made; projects should be integrated into official curricula; program topics should be relevant to local realities; respected authorities should be called upon to reinforce the validity

  8. Listening to the Voices of Children in Foster Care: Youths Speak out about Child Welfare Workforce Turnover and Selection

    ERIC Educational Resources Information Center

    Strolin-Goltzman, Jessica; Kollar, Sharon; Trinkle, Joanne

    2010-01-01

    Child welfare workforce turnover rates across private and public child welfare agencies are concerning. Although research about the causes of child welfare workforce turnover has been plentiful, empirical studies on the effects of turnover on child outcomes are sparse. Furthermore, the voices and experiences of youths within the system have been…

  9. Mother-child planning and child compliance.

    PubMed

    Gauvain, Mary; Perez, Susan M

    2008-01-01

    This study investigated child compliance and maternal instruction during planning. Based on the Child Behavior Checklist and free-play observations, 40 mothers and their 4- to 5-year-old children were assigned to a group with children who behaved within the normal range of compliance (n = 20) or a group with children with high rates of noncompliance for this age (n = 20). Mothers in the noncompliant group provided more low-level, directive, and negative instruction; requested more compliance; and shared less task responsibility with children. Mothers in both groups responded to child compliance by increasing or maintaining the level of instruction. Results are discussed in relation to the role of child compliance in regulating opportunities for cognitive development in social context. PMID:18489426

  10. Child protection. Accident prevention: a community approach.

    PubMed

    Roberts, H

    1991-07-01

    Child accidents are the main cause of death and a considerable cause of morbidity in children, as well as anxiety to adults. Attempts to tackle this major health problem have tended to rely on campaigns of education and exhortation; public health strategies remain underdeveloped. Health visitors are well placed to pursue child safety strategies which build on parents' own knowledge and experience. Helen Roberts describes an initiative based not on the question, why did that accident happen? but the more intriguing question of how is it that most parents manage to keep their children safe most of the time and what can we learn from them?

  11. Teacher-Child Relationships: Contribution of Teacher and Child Characteristics

    ERIC Educational Resources Information Center

    Choi, Ji Young; Dobbs-Oates, Jennifer

    2016-01-01

    This study investigates potential predictors of teacher-child relationships (i.e., closeness and conflict) focusing on child gender, teacher-child ethnicity match, and teacher education. Additionally, the study explores the possible moderation effect of teacher education on the associations between teacher-child relationships and child gender or…

  12. Interferon γ and interleukin 10 responses in immunocompetent and immunosuppressed New Zealand White rabbits naturally infected with Encephalitozoon cuniculi.

    PubMed

    Rodríguez-Tovar, Luis E; Castillo-Velázquez, Uziel; Arce-Mendoza, Alma Y; Nevárez-Garza, Alicia M; Zarate-Ramos, Juan J; Hernández-Vidal, Gustavo; Rodríguez-Ramírez, Heidi G; Trejo-Chávez, Armando

    2016-09-01

    Levels of interferon (IFN)-γ and interleukin (IL)-10 were measured in the serum of immunocompetent and immunosuppressed New Zealand White rabbits naturally infected with Encephalitozoon cuniculi. IFN-γ levels were elevated in infected rabbits, and a synergic effect was observed in animals treated with the immunosuppressive agent dexamethasone (Dex). The role of IL-10 in infected rabbits remains unclear, as IL-10 levels were similar to those of negative controls. Dex appeared to exhibit a proinflammatory effect, as IFN-γ levels were elevated in infected immunosuppressed rabbits. Similarly, Dex exhibited a synergic effect in infected immunosuppressed rabbits, as evidenced by the elevation in IFN-γ production. These data indicate that the immune response to this glucocorticoid should be considered in the design of future animal model studies of immunosuppression.

  13. Comprehensive models of human primary and metastatic colorectal tumors in immunodeficient and immunocompetent mice by chemokine targeting.

    PubMed

    Chen, Huanhuan Joyce; Sun, Jian; Huang, Zhiliang; Hou, Harry; Arcilla, Myra; Rakhilin, Nikolai; Joe, Daniel J; Choi, Jiahn; Gadamsetty, Poornima; Milsom, Jeff; Nandakumar, Govind; Longman, Randy; Zhou, Xi Kathy; Edwards, Robert; Chen, Jonlin; Chen, Kai Yuan; Bu, Pengcheng; Wang, Lihua; Xu, Yitian; Munroe, Robert; Abratte, Christian; Miller, Andrew D; Gümüş, Zeynep H; Shuler, Michael; Nishimura, Nozomi; Edelmann, Winfried; Shen, Xiling; Lipkin, Steven M

    2015-06-01

    Current orthotopic xenograft models of human colorectal cancer (CRC) require surgery and do not robustly form metastases in the liver, the most common site clinically. CCR9 traffics lymphocytes to intestine and colorectum. We engineered use of the chemokine receptor CCR9 in CRC cell lines and patient-derived cells to create primary gastrointestinal (GI) tumors in immunodeficient mice by tail-vein injection rather than surgery. The tumors metastasize inducibly and robustly to the liver. Metastases have higher DKK4 and NOTCH signaling levels and are more chemoresistant than paired subcutaneous xenografts. Using this approach, we generated 17 chemokine-targeted mouse models (CTMMs) that recapitulate the majority of common human somatic CRC mutations. We also show that primary tumors can be modeled in immunocompetent mice by microinjecting CCR9-expressing cancer cell lines into early-stage mouse blastocysts, which induces central immune tolerance. We expect that CTMMs will facilitate investigation of the biology of CRC metastasis and drug screening.

  14. New topical treatment of vulvodynia based on the pathogenetic role of cross talk between nociceptors, immunocompetent cells, and epithelial cells

    PubMed Central

    Keppel Hesselink, J M; Kopsky, D J; Sajben, N

    2016-01-01

    Topical treatments of localized neuropathic pain syndromes in general are mostly neglected, mainly due to the fact that most pain physicians expect that a topical formulation needs to result in a transdermal delivery of the active compounds. On the basis of the practical experience, this study brings forth a new, somewhat neglected element of the vulvodynia pathogenesis: the cross talk between the nerve endings of nociceptors, the adjacent immunocompetent cells, and vaginal epithelial cells. Insight into this cross talk during a pathogenic condition supports the treatment of vulvodynia with topical (compounded) creams. Vulvodynia was successfully treated with an analgesic cream consisting of baclofen 5% together with the autacoid palmitoylethanolamide 1%, an endogenous anti-inflammatory compound. In this review, data is presented to substantiate the rationale behind developing and prescribing topical products for localized pain states such as vulvodynia. Most chronic inflammatory disorders are based on a network pathogenesis, and monotherapeutic inroads into the treatment of such disorders are obsolete. PMID:27757050

  15. Specific effect of the HLDF differentiation factor on the cytokine production potential of immunocompetent blood cells in stomach adenocarcinoma.

    PubMed

    Autenshlyus, A I; Kunts, T A; Mikhaylova, E S; Varaksin, N A; Bogachuk, A P; Lipkin, V M

    2016-07-01

    The cytokine production potential of immunocompetent cells from the blood of stomach adenocarcinoma patients was analyzed after the pretreatment of cells with the HLDF differentiation factor with subsequent exposure to polyclonal activators (HLDF+PA). IL-1β, IL-1Ra, TNFα, IL-2, IL-6, IL-8, IL-10, IL-17, IL-18, IL-18BPa, IFNγ, G-CSF, and GM-CSF were quantified in the supernatants after precipitation of the cells. Specific effects of HLDF+PA were manifested as an increase in the production of IL-8, IL-17, and GM-CSF due to suppression of Th1-dependent immune reactions in a Th17-mediated mechanism that is a part of a broader functional antagonism of Th1 and Th17 lymphocyte subpopulations. PMID:27595831

  16. Progressive lymphadenopathy and intractable pain in an immunocompetent African-American adult with cat-scratch disease.

    PubMed

    Bonza, Sarah; McDougle, Leon; McConaghy, John R

    2008-10-01

    Persistent, painful cervical lymphadenopathy associated with malaise that does not respond to oral antibiotics may be cat-scratch disease. This condition is challenging to treat and may require surgical intervention. We present a case report of an immunocompetent 47-year-old African-American woman who was diagnosed with cat-scratch disease and hospitalized after multiple outpatient evaluations for progressive, painful lymphadenopathy. This case report outlines the patient's treatment in the author's urban outpatient clinic followed by an inpatient hospital stay with surgical intervention. Although the reported incidence of cat-scratch disease is higher in whites, primary care physicians should include cat-scratch disease in their differential diagnosis for African-American patients with regional lymphadenopathy, which is a hallmark of the disease. In addition, primary care physicians should be familiar with the atypical presentations of cat-scratch disease and the broad differential diagnosis for regional lymphadenopathy, including sarcoidosis, which is more common in African Americans.

  17. Primary cardiac diffuse large B-cell lymphoma in immunocompetent patients: clinical, histologic, immunophenotypic, and genotypic features of 3 cases.

    PubMed

    Soon, Gwyneth; Ow, Guan Wei; Chan, Hian Li; Ng, Siok Bian; Wang, Shi

    2016-10-01

    Primary cardiac lymphoma (PCL) is a rare extranodal lymphoma that involves only the heart and/or pericardium. Primary cardiac lymphoma is much less common in immunocompetent patients compared with those who are immunosuppressed. Patients with PCL have variable clinical manifestations that may lead to misdiagnosis and delay in treatment. Modern radiologic imaging now allows for earlier detection of these tumors. This study describes the clinical, histologic/cytologic, immunophenotypic, and molecular genetic findings for 3 immunocompetent patients with primary cardiac diffuse large B-cell lymphoma. All 3 patients had different initial clinical presentations. The neoplastic cells in all 3 cases were large in size, morphologically resembling diffuse large B-cell lymphoma. Neoplastic cells in 2 cases had non-germinal center (GC)-like (non-GC-like) and 1 case had GC-like immunophenotype. Neoplastic cells in all 3 cases showed C-MYC and BCL2 immunohistochemical protein coexpression. Neoplastic cells in 1 case showed double-hit MYC and BCL2 gene rearrangements, whereas another 1 case showed MYC gene rearrangement without BCL2 gene rearrangement. Epstein-Barr virus-encoded RNA was negative in the neoplastic cells in all 3 cases. All 3 patients received rituximab-based chemotherapy. Two patients subsequently had disease relapse at other extranodal sites at 10 and 24 months, respectively, whereas 1 patient was alive without disease at 9 months after diagnosis. If there is sufficient diagnostic tissue in these rare tumors, molecular studies should ideally be performed for prognostication and further patient management. PMID:27649953

  18. Tumor Vascular Permeability Pattern Is Associated With Complete Response in Immunocompetent Patients With Newly Diagnosed Primary Central Nervous System Lymphoma

    PubMed Central

    Chung, Sae Rom; Choi, Young Jun; Kim, Ho Sung; Park, Ji Eun; Shim, Woo Hyun; Kim, Sang Joon

    2016-01-01

    Abstract A dynamic contrast-enhanced MR imaging (DCE-MRI) could provide the information about tumor drug delivery efficacy. We investigated the potential utility of the permeability pattern of DCE-MRI for predicting tumor response to high dose-methotrexate treatment and progression-free survival (PFS) in patients with primary CNS lymphoma (PCNSL). Clinical and conventional imaging parameters were assessed as potential predictors of tumor response in 48 immunocompetent PCNSL patients in a preliminary study. Fifty additional immunocompetent patients (27 men and 23 women; mean age, 60.6 years) with PCNSL underwent DCE-MRI before starting first-line treatment with high dose-methotrexate. The DCE-MRI pattern was categorized as diffuse or nondiffuse. After 4 courses of high dose methotrexate, patients underwent follow-up brain MR imaging to identify their complete response (CR). Predictors of CR and PFS were analyzed using clinical parameters, conventional MRI, and DCE-MRI. CR was noted in 20 (74.1%) of 27 patients with diffuse DCE-MRI pattern and in 4 (17.4%) of 23 patients with nondiffuse DCE-MRI pattern. The diffuse DCE-MRI pattern showed a significantly higher association with CR than the nondiffuse pattern (P < 0.001). Multivariate Cox proportional hazards model revealed that the DCE-MRI pattern (hazard ratio = 0.70; P = 0.045), age (hazard ratio = 1.47; P = 0.041), and adjuvant autologous stem-cell transplantation (hazard ratio = 6.97; P = 0.003) tended to be associated with a PFS. The pretreatment diffuse DCE-MRI pattern can be used as a potential imaging biomarker for predicting CR and a longer PFS in patients with newly diagnosed PCNSLs. PMID:26871782

  19. Alternative male reproductive tactics and the immunocompetence handicap in the Azorean rock-pool blenny, Parablennius parvicornis

    PubMed Central

    Ros, Albert F.H; Bouton, Niels; Santos, Ricardo S; Oliveira, Rui F

    2006-01-01

    In the Azorean rock-pool blenny (Parablennius parvicornis) reproductively active males display alternative morphotypes, which differ in the expression of secondary sexual characters (SSC). Males expressing SSC, the M+ morphotype, have high androgen levels and compete for crevices that will be visited by females to spawn. M+ males holding nests court females and care for the eggs. Males with low expression of SSC, the M− morphotype, have low levels of androgens and reproduce by stealing fertilizations from the M+ males. Based on the hypothesis that androgens are immunosuppressive, we expected these morphotypes to differ in immunocompetence. To test this hypothesis, we conducted a field study in which we collected repeated blood samples to monitor leukocyte populations (blood smears), and to measure the primary antibody response of males that were experimentally challenged with a foreign non-pathogenic antigen (sheep red blood cells). Circulating levels of 11-ketotestosterone and testosterone were higher in M+ males than in M− males. Neither granulocyte nor thrombocyte counts did covariate with androgens or male tactic. In contrast, lymphocyte counts and humoral antibody response were negatively correlated with body size, and as expected, both were lower in M+ than in M− males. Interestingly, in M+ males androgen levels decreased after immunization, and this was less in nest-holder males than in M+ males that were floating around in the pools. Within each morphotype we found no relationship between androgens and immunocompetence. The latter result is not supportive for androgen regulated immunosuppression in M+ males. A possible alternative is enhancement of immunity in M− males. These males had relatively high levels of injuries in comparison with M+ males. High immunity might be a consequence of high infection rate because of such injuries. PMID:16627274

  20. High-risk human papillomavirus in non-melanoma skin lesions from renal allograft recipients and immunocompetent patients

    PubMed Central

    Reuschenbach, M; Tran, T; Faulstich, F; Hartschuh, W; Vinokurova, S; Kloor, M; Krautkrämer, E; Zeier, M; von Knebel Doeberitz, M; Sommerer, C

    2011-01-01

    Background: High-risk human papillomaviruses (HR-HPVs) can be detected in a proportion of non-melanoma skin cancers. Data on prevalence are inconclusive, but are essential to estimate the relevance of HR-HPV, particularly with regard to prophylactic HPV vaccines for skin cancer prevention. Methods: High-risk human papillomavirus DNA was investigated in 140 non-melanoma skin lesions from 54 immunocompetent patients and 33 immunosuppressed renal allograft recipients. Expression of p16INK4a, a marker for HR-HPV oncogene expression in the uterine cervix, and of p53 and pRB was evaluated immunohistochemically. Results: The highest prevalence of HR-HPV was found in squamous cell cancer (SCC) (46.2% (6 out of 13) in immunosuppressed and 23.5% (4 out of 17) in immunocompetent patients). High-risk human papillomavirus positivity was accompanied by diffuse p16INK4a expression in most SCC (P<0.001) and basal cell cancers (P=0.02), while almost all SCC in situ were p16INK4a positive irrespective of HR-HPV presence (P=0.66). Diffuse p16INK4a expression was associated with lack of pRB expression (P=0.001). p53 was strongly expressed in 40.0% (56 out of 140) of the lesions irrespective of HR-HPV presence. Conclusion: High-risk human papillomavirus can be detected in lesions of keratinised squamous epithelia. The association of HR-HPV with diffuse p16INK4a expression might indicate HR-HPV oncogene expression in a proportion of lesions. Overexpression of p53 suggests p53 pathway alterations in HR-HPV-positive and -negative lesions. PMID:21427726

  1. [A child with neonatal allo-immune neutropenia].

    PubMed

    Markhorst, D G; Hack, W W; de Waal, F C; Kuypers, R

    1990-10-01

    A newborn child with neonatal neutropenia as a result of the presence of maternal IgG isoantibodies against neutrophil granulocyte blood group antigens is reported. Mechanism, diagnostics and therapy of the disease are discussed. The diagnosis not only has consequences for the child, but also for the mother and following pregnancies. A review of the most important causes of neonatal neutropenia is given.

  2. Doing Harm While Doing Good: The Child Protection Paradox

    ERIC Educational Resources Information Center

    Ainsworth, Frank; Hansen, Patricia

    2012-01-01

    Every Australian citizen expects state and territory governments to protect children from child abuse and neglect. Protecting children from harm is seen as good. This however is not a simple matter. The ultimate act in protecting children is to remove them from parental care. This causes trauma for the child and pain and distress for parents no…

  3. Child-to-Parent Violence: Emotional and Behavioral Predictors

    ERIC Educational Resources Information Center

    Calvete, Esther; Orue, Izaskun; Gamez-Guadix, Manuel

    2013-01-01

    Child-to-parent violence (CPV) includes acts committed by a child to intentionally cause physical, psychological, or financial pain to a parent. Available data indicate increasing rates of CPV in Spain, which have been attributed to a tendency toward more permissive parenting styles and changes in the power cycles within the families. The primary…

  4. Child Abuse and Neglect: The Responsibilities of Educators.

    ERIC Educational Resources Information Center

    Manchak, Rosann K.

    This annotated bibliography of resources about child abuse and neglect begins with an introduction to the problem and causes of child abuse, legal definitions of abuse and neglect, and statistics illustrating the incidence of abuse. Designed to serve as an informational resource for educators, these resources are classified by categories…

  5. How to Be a Good Parent: Have a Good Child.

    ERIC Educational Resources Information Center

    Mohar, Carol J.

    It is a common article of belief that each child is unique. Action based on this belief, though, is rare. Researchers have largely neglected the question of the causes of children's individual uniqueness. But, when difficulties and serious problems arise in the course of child rearing, causality is located in the dynamics of family functioning.…

  6. Child Poverty: A Deficit that Goes beyond Dollars.

    ERIC Educational Resources Information Center

    Jones, Judith E.

    This report examines child poverty in the United States, discusses its cause and persistence, and makes recommendations for solutions. Areas examined involve the historical roots of social-welfare policy in the United States; the facts behind the mythologies and misperceptions concerning child and family poverty; the children and families to be…

  7. Early Mother-Child Interaction.

    ERIC Educational Resources Information Center

    d'Agostino, Micheline

    1986-01-01

    This journal issue presents an overview of mother-child interaction during the first year of the child's life. Contents of the first section, which concern the development of the mother-child relationship, focus on the concept of the maternal instinct, mother and child during intrauterine life, birth of the child, the postnatal period (including…

  8. FAQ: Child Sexual Exploitation

    MedlinePlus

    ... permanent memorialization of the crimes committed against them. Studies indicate that child victims endure depression, withdrawal, anger, and other psychological disorders. Victims also experience feelings ...

  9. Child maltreatment: international perspectives.

    PubMed

    D'Antonio, I J; Darwish, A M; McLean, M

    1993-01-01

    The purpose of this literature review was to explore definitions, incidence, and management of child maltreatment across cultures. Articles written in the English language published from 1962 to 1991 were reviewed to answer the following questions: (1) What role does cross-cultural variability play in defining child maltreatment? (2) What is the incidence of maltreatment in developed and developing countries across continents? (3) What measures have been instituted by countries to prevent and manage child maltreatment? Cross-cultural information was found to be limited. Child rearing attitudes had an impact on the identification, prevention, and management of maltreatment across nations.

  10. Parent & Child Perceptions of Child Health after Sibling Death

    PubMed Central

    Roche, Rosa M.; Brooten, Dorothy; Youngblut, JoAnne M.

    2016-01-01

    Background Understanding children’s health after a sibling’s death and what factors may affect it is important for treatment and clinical care. This study compared children’s and their parents’ perceptions of children’s health and identified relationships of children’s age, gender, race/ethnicity, anxiety, and depression and sibling’s cause of death to these perceptions at 2 and 4 months after sibling death. Methods 64 children and 48 parents rated the child’s health “now” and “now vs before” the sibling’s death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology. Children completed the Child Depression Inventory and Spence Children’s Anxiety Scale. Sibling cause of death was collected from hospital records. Results At 2 and 4 months, 45% to 54% of mothers’ and 53% to 84% of fathers’ ratings of their child’s health “now” were higher than their children’s ratings. Child health ratings were lower for: children with greater depression; fathers whose children reported greater anxiety; mothers whose child died of a chronic condition. Children’s ratings of their health “now vs before” their sibling’s death did not differ significantly from mothers’ or fathers’ ratings at 2 or 4 months. Black fathers were more likely to rate the child’s health better “now vs before” the death; there were no significant differences by child gender and cause of death in child’s health “now vs before” the death. Conclusions Children’s responses to a sibling’s death may not be visually apparent or become known by asking parents. Parents often perceive their children as healthier than children perceive themselves at 2 and 4 months after sibling death, so talking with children separately is important. Children’s perceptions of their health may be influenced by depression, fathers’ perceptions by children’s anxiety, and mother’s perceptions by the cause of sibling death.

  11. Parent & Child Perceptions of Child Health after Sibling Death

    PubMed Central

    Roche, Rosa M.; Brooten, Dorothy; Youngblut, JoAnne M.

    2016-01-01

    Background Understanding children’s health after a sibling’s death and what factors may affect it is important for treatment and clinical care. This study compared children’s and their parents’ perceptions of children’s health and identified relationships of children’s age, gender, race/ethnicity, anxiety, and depression and sibling’s cause of death to these perceptions at 2 and 4 months after sibling death. Methods 64 children and 48 parents rated the child’s health “now” and “now vs before” the sibling’s death in an ICU or ER or at home shortly after withdrawal of life-prolonging technology. Children completed the Child Depression Inventory and Spence Children’s Anxiety Scale. Sibling cause of death was collected from hospital records. Results At 2 and 4 months, 45% to 54% of mothers’ and 53% to 84% of fathers’ ratings of their child’s health “now” were higher than their children’s ratings. Child health ratings were lower for: children with greater depression; fathers whose children reported greater anxiety; mothers whose child died of a chronic condition. Children’s ratings of their health “now vs before” their sibling’s death did not differ significantly from mothers’ or fathers’ ratings at 2 or 4 months. Black fathers were more likely to rate the child’s health better “now vs before” the death; there were no significant differences by child gender and cause of death in child’s health “now vs before” the death. Conclusions Children’s responses to a sibling’s death may not be visually apparent or become known by asking parents. Parents often perceive their children as healthier than children perceive themselves at 2 and 4 months after sibling death, so talking with children separately is important. Children’s perceptions of their health may be influenced by depression, fathers’ perceptions by children’s anxiety, and mother’s perceptions by the cause of sibling death. PMID:27683673

  12. Child neglect and emotional abuse

    MedlinePlus

    ... or adults. Threatening the child with violence or abandonment. Constantly criticizing or blaming the child for problems. ... alone for a long time. This is called abandonment. These are signs that a child that may ...

  13. Loss of a child - resources

    MedlinePlus

    Child death - resources; Resources - loss of a child ... The following organizations are good resources for information on the loss of a child: The Compassionate Friends -- www.compassionatefriends.org Bereaved Parents of the USA -- www.bereavedparentsusa. ...

  14. The Effects of Sample Selection Bias on Racial Differences in Child Abuse Reporting.

    ERIC Educational Resources Information Center

    Ards, Sheila; Chung, Chanjin; Myers, Samuel L., Jr.

    1998-01-01

    Data from the National Incidence Study (NIS) of Child Abuse and Neglect suggest no racial difference in child maltreatment, although there are more black children within the child welfare population. This study found selection bias in the NIS design caused by the exclusion of family, friends, and neighbors that resulted in differences in NIS cases…

  15. Common skin and bleeding disorders that can potentially masquerade as child abuse.

    PubMed

    Patel, Bhavita; Butterfield, Rebecca

    2015-12-01

    Child abuse and neglect remains a major cause of morbidity and mortality among children worldwide. Over the last few decades, there has been growing research in the field of Child Abuse Pediatrics with greater recognition and research into potential diagnostic mimics of inflicted injury. This paper reviews some common skin findings and bleeding disorders that have features in common with child abuse.

  16. The Child Abuse Reporting Law. Protecting Children Becomes a Broader Community Responsibility. 2d Edition.

    ERIC Educational Resources Information Center

    Thomas, Mason P., Jr.

    North Carolina's Child Abuse Reporting Law makes all citizens legally responsible for reporting incidents of child abuse and neglect. Professionals, such as doctors and teachers, must also give their professional opinions as to the nature, extent, and causes of the damaged child's condition. The basic purpose of the law is to identify children at…

  17. Measuring child work and residence adjustments to parents' long-term care needs.

    PubMed

    Stern, S

    1996-02-01

    This article estimates the effects of various parent and child characteristics on the choice of care arrangement of the parent, taking into account the potential endogeneity of some of the child characteristics. Three equations are estimated: a care choice equation, a child location equation, and a child work equation. Results suggest a hierarchy of family decision making; child locations affect the care decision, which affects child work decisions. The results also question previous research attempting to explain causes of secular trends in long-term care.

  18. Measuring child work and residence adjustments to parents' long-term care needs.

    PubMed

    Stern, S

    1996-02-01

    This article estimates the effects of various parent and child characteristics on the choice of care arrangement of the parent, taking into account the potential endogeneity of some of the child characteristics. Three equations are estimated: a care choice equation, a child location equation, and a child work equation. Results suggest a hierarchy of family decision making; child locations affect the care decision, which affects child work decisions. The results also question previous research attempting to explain causes of secular trends in long-term care. PMID:8932413

  19. The Abusive Environment and the Child's Adaptation.

    ERIC Educational Resources Information Center

    Martin, Harold P.

    The biologic and developmental problems of abused children are usually thought of etiologically in relation to the physical trauma which has been suffered. Indeed, physical trauma can cause death, brain damage, developmental delays and deviations in personality development. The environment in which the abused child grows and develops is a most…

  20. A Child Survival and Development Revolution?

    ERIC Educational Resources Information Center

    Halpern, Robert

    1986-01-01

    Addresses the problems of child survival and development in developing countries by discussing the biomedical causes and the concomitant social determinants of high infant mortality rates. Describes four intervention strategies recommended by UNICEF: growth monitoring, oral rehydration therapy, breast feeding, and immunization. (HOD)