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Veterinary Radiology & Ultrasound : the... May 2024A 14-year-old intact female diabetic dog presented with seizures and hyperglycemic hyperosmolar syndrome. Radiographs revealed gas-filled tubular structures in the right...
A 14-year-old intact female diabetic dog presented with seizures and hyperglycemic hyperosmolar syndrome. Radiographs revealed gas-filled tubular structures in the right and left caudal abdomen, raising concerns of emphysematous pyometra or small intestinal ileus. Ultrasonography played a pivotal role in confirming emphysematous pyometra, a technique previously documented only once in veterinary practice. This report also presents the first documented case of emphysematous pyometra in a diabetic dog attributed to Klebsiella pneumoniae and complicated by emphysematous hepatitis.
Topics: Animals; Dogs; Klebsiella Infections; Female; Dog Diseases; Klebsiella pneumoniae; Pyometra; Emphysema; Ultrasonography; Hepatitis, Animal; Diabetes Complications; Anti-Bacterial Agents
PubMed: 38357787
DOI: 10.1111/vru.13340 -
Journal of Equine Veterinary Science Sep 2023Congential amastia, a medical condition in which mammary tissue fails to develop, was detected in a 3-year-old Quarter Horse mare. The dam of the mare was also afflicted...
Congential amastia, a medical condition in which mammary tissue fails to develop, was detected in a 3-year-old Quarter Horse mare. The dam of the mare was also afflicted with amastia, suggesting that the condition was due to an inherited genetic mutation as noted in other species. In addition, on presentation the mare had a purulent vaginal discharge secondary to a pyometra.
Topics: Female; Horses; Animals; Breast Diseases; Horse Diseases
PubMed: 37419397
DOI: 10.1016/j.jevs.2023.104874 -
Cureus Jan 2024We report a fatal case of early postoperative peritoneal dissemination in a patient who was diagnosed with cervical squamous cell carcinoma after laparoscopic...
We report a fatal case of early postoperative peritoneal dissemination in a patient who was diagnosed with cervical squamous cell carcinoma after laparoscopic hysterectomy for hematometra. A 73-year-old multiparous woman with pyometra and lower abdominal pain was referred to our hospital. Her medical history was remarkable for four open surgeries and conization at the age of 40 years. The cytology obtained from the mucosa of the palpated cervix was negative. The cytology and bacterial culture of the mucus collected from the uterine cavity were negative. Increasing fluid accumulation in the uterine cavity started to cause severe abdominal pain. A laparoscopy was performed. The small intestine showed extensive adhesions to the abdominal wall, which were dissected. A total hysterectomy was performed, and the uterus was placed in a collection bag, cut inside the bag, and retrieved transvaginally. Histopathological examination revealed nests of squamous cell carcinoma that replaced the entire uterine myometrium, and the tumor cells showed diffuse positivity for p16 on immunostaining. The patient was diagnosed with squamous cell carcinoma of the uterine cervix with invasion of the uterine myometrium. Three months later, the patient suffered from small bowel obstruction. A laparotomy was performed, and it revealed numerous disseminated lesions in the pelvic peritoneum and mesentery of the small intestine. Bypass surgery was performed. A biopsy of a disseminated lesion near the vaginal cuff revealed squamous cell carcinoma. The patient died within three weeks of bypass surgery.
PubMed: 38357085
DOI: 10.7759/cureus.52271 -
Asian Journal of Surgery Jul 2023
Topics: Female; Humans; Pyometra; Endometrium; Uterus
PubMed: 36907738
DOI: 10.1016/j.asjsur.2023.01.107 -
BMC Infectious Diseases Jan 2024Infection by Dialister micraerophilus, an obligate anaerobic gram-negative bacillus, has rarely been described, and its clinical characteristics remain unclear.
BACKGROUND
Infection by Dialister micraerophilus, an obligate anaerobic gram-negative bacillus, has rarely been described, and its clinical characteristics remain unclear.
CASE PRESENTATION
We report a case of bacteremia caused by D. micraerophilus, Enterocloster clostridioformis, and Eggerthella lenta in a 47-year-old woman, associated with pyometra. D. micraerophilus was identified using 16S rRNA gene sequencing and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. D. micraerophilus was detected by polymerase chain reaction using D. micraerophilus-specific primers and E. clostridioformis and E. lenta was isolated from the drainage pus sample obtained from the pyometra uterus. The patient achieved a cure after abscess drainage and 2-week antibiotic treatment.
CONCLUSIONS
To the best of our knowledge, this is the first report of D. micraerophilus bacteremia. D. micraerophilus may be associated with gynecological infections. Clinicians should consider both oral and gynecological sites when searching to identify the focus of D. micraerophilus infection.
Topics: Female; Humans; Middle Aged; Pyometra; RNA, Ribosomal, 16S; Bacteroides; Clostridium; Bacteremia; Clostridiales; Actinobacteria; Veillonellaceae
PubMed: 38267864
DOI: 10.1186/s12879-024-08999-6 -
Journal of the American Veterinary... Jul 2023
Topics: Female; Dogs; Animals; Lethargy; Appetite; Abdomen; Gastric Dilatation; Stomach Volvulus; Dog Diseases
PubMed: 37179050
DOI: 10.2460/javma.23.04.0191 -
Cureus Jan 2024Uterine rupture in the setting of pyometra is a rare occasion, with an incidence of less than 0.5%. The clinical manifestation of a perforated pyometra is non-specific;...
Uterine rupture in the setting of pyometra is a rare occasion, with an incidence of less than 0.5%. The clinical manifestation of a perforated pyometra is non-specific; therefore, it can mimic many other causes of acute abdomen, such as perforated viscus, acute appendicitis, or diverticulitis, which poses unique challenges to diagnosis solely based on clinical information. We reviewed a case of an elderly postmenopausal lady who presented with a sudden onset of generalized abdominal pain, preceded by fever and vomiting. Physical examination revealed a distended abdomen with clinical signs of peritonism. She was initially diagnosed with possible obstructed gastrointestinal carcinoma by clinical examination, with the differential diagnosis of diverticular abscess. Eventually, further abdominal and pelvic contrast-enhanced computed tomography (CECT) study revealed a pyometra with uterine rupture, complicated with pneumoretroperitoneum and pneumoperitoneum. This case emphasizes the value of a CT scan in establishing an accurate diagnosis and early detection of life-threatening complications, such as uterine rupture, as in this case.
PubMed: 38420051
DOI: 10.7759/cureus.53154 -
Journal of the American Veterinary... Mar 2024To compare results for surgery time, perioperative pain, need for rescue analgesia, variables, serum C-reactive protein concentration, and postoperative complications...
OBJECTIVE
To compare results for surgery time, perioperative pain, need for rescue analgesia, variables, serum C-reactive protein concentration, and postoperative complications for dogs with pyometra treated with laparoscopic-assisted ovariohysterectomy (LaOVH) versus open-surgery (OS) ovariohysterectomy.
ANIMALS
12 client-owned dogs with pyometra between June 1, 2016, and December 31, 2019.
METHODS
Dogs enrolled in this prospective single-center randomized clinical trial had pyometra confirmed by history, physical examination, ultrasonography, and blood work and were randomly assigned to treatment group LaOVH or OS. Differences in results for variables of interest were compared between groups using the Mann-Whitney U test, except the number of dogs requiring rescue analgesia was analyzed using the Fisher exact test. Values of P ≤ .05 were considered significant.
RESULTS
6 dogs were recruited in each group; results for 1 dog in the LaOVH group were excluded from further analysis due to free abdominal fluid detected during surgery. Median surgery time was significantly shorter and median total incision length was longer for the OS group (23 minutes; 106 mm), compared to the LaOVH group (37 minutes; 38 mm). No other results differed significantly between groups.
CLINICAL RELEVANCE
Although fewer patients in the LaOVH group required rescue analgesia, this was not statistically significant. Therefore, our results could not prove previously suggested advantages of LaOVH (eg, less perioperative pain or faster recovery) in dogs with pyometra. Additionally, for the LaOVH group, the median surgical time was approximately 50% longer, an assistant was needed, and specialized equipment was required.
Topics: Female; Dogs; Animals; Ovariectomy; Pyometra; Prospective Studies; Laparoscopy; Hysterectomy; Pain; Dog Diseases
PubMed: 37944246
DOI: 10.2460/javma.23.08.0467 -
The American Journal of Medicine Jul 2023
Topics: Female; Humans; Aged; Pyometra; Peritonitis; Fever
PubMed: 37001716
DOI: 10.1016/j.amjmed.2023.03.011 -
Journal of Infection and Chemotherapy :... Feb 2024Carbapenemase-producing Enterobacterales (CPE) are a serious concern in human clinical settings. Companion animal-origin CPE have been only rarely identified in several...
Carbapenemase-producing Enterobacterales (CPE) are a serious concern in human clinical settings. Companion animal-origin CPE have been only rarely identified in several countries, but they have not yet been identified in Japan. In this study, we present the first case of a canine infected with CPE in Japan. The patient was hospitalized due to pyometra. The pus discharged from the patient's uterus was subjected to bacteriological analysis. As a result, E. coli was identified in the pus and exhibited resistance to piperacillin, amoxicillin-clavulanic acid, cefazolin, ceftazidime, cefepime, meropenem, amikacin, and sulfamethoxazole-trimethoprim and susceptibility to aztreonam, minocycline, and levofloxacin. Results of the sodium mercaptoacetic acid double-disk synergy test showed that the E. coli isolate was positive for metallo-β-lactamases. Next-generation sequencing identified the bla gene, which was located in the IncFII-type plasmid together with bla, rmtB, aadA2, bleMBL, sul1, qacE, and dfrA12. The case was treated successfully with doxycycline and orbifloxacin. Our finding emphasizes that close attention should be paid to the significance of CPE harboring multidrug-resistance plasmid in companion animals, based on the perspective of One Health approach in Japan as well as in other countries.
PubMed: 38369122
DOI: 10.1016/j.jiac.2024.02.013