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Journal of Comparative Pathology Feb 2020A 1-year and 7-months-old neutered male toy poodle was presented with persistent respiratory distress, gradual weight loss and melaena. Thoracic radiography showed an...
A 1-year and 7-months-old neutered male toy poodle was presented with persistent respiratory distress, gradual weight loss and melaena. Thoracic radiography showed an unstructured interstitial lung pattern. Histopathological examination of tissues collected at necropsy examination revealed disseminated infection by Pneumocystis carinii. The organisms were detected in the lungs, lymph nodes, liver, heart, kidneys, spleen, gastrointestinal tract and pancreas. In the lungs, the organisms were present in the alveolar space and interstitial tissue, and calcified foci containing P. carinii were observed. The presence of the organism in non-thoracic lymph nodes provided evidence of lymphogenous spread. A definitive diagnosis of disseminated pneumocystosis was achieved through the use of Grocott methenamine silver staining, immunohistochemistry (IHC) and polymerase chain reaction for P. carinii. Depletion of cells expressing immunoglobulin (Ig)A and IgG was confirmed by IHC of lymphoid tissue, suggesting possible underlying immunodeficiency.
Topics: Animals; Dog Diseases; Dogs; Male; Pneumocystis Infections; Pneumocystis carinii
PubMed: 32138848
DOI: 10.1016/j.jcpa.2019.12.009 -
National Journal of Maxillofacial... 2023Mucormycosis is a fatal fungal infection, which is rare but commonly affects immunocompromised patients. Coronavirus disease 2019 (COVID-19) patients who were...
INTRODUCTION
Mucormycosis is a fatal fungal infection, which is rare but commonly affects immunocompromised patients. Coronavirus disease 2019 (COVID-19) patients who were immunocompromised, due to comorbid conditions, such as hematological malignancy and diabetes mellitus (DM), and patients on immunosuppressive therapy such as steroid therapy were the important host for mucormycosis infection.
AIM
This study aimed to study the clinicopathological correlation of mucormycosis in post-COVID-19 patients.
MATERIAL AND METHODS
The study was a retrospective study conducted in the Department of Pathology, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India, over four months from April 2021 to July 2021, and clinically diagnosed mucormycosis cases were included in this study. Clinical details, histology slides, and blocks were reviewed, and the data were analyzed. Three- to four-micrometer sections were taken from the blocks and stained with hematoxylin and eosin, and two more slides were made for each case for periodic acid-Schiff (PAS) and Grocott methenamine silver (GMS) staining.
RESULT
In this study, the maximum cases were above the fifth decade of life. Males were more commonly affected than females with a male-to-female ratio of 2.09:1. Of the total of 65 cases, 46 (70.77%) cases were positive for mucormycosis and 19 (29.23%) cases were negative on histopathological examination and special stain PAS and GMS. A significant correlation was found between mucormycosis-positive cases on steroid therapy and oxygen supply during the treatment for COVID-19 with P- values of 0.001 and 0.027, respectively.
CONCLUSION
For COVID-19 patients with altered glycemic control, receiving steroid therapy and oxygen supply poses a significant threat to the development of mucormycosis.
PubMed: 37661969
DOI: 10.4103/njms.njms_482_21 -
Journal of Cutaneous Pathology Nov 2020The American Society of Dermatopathology has established an Appropriate Use Criteria (AUC) Committee with the intention of establishing evidence-based recommendations... (Review)
Review
The American Society of Dermatopathology has established an Appropriate Use Criteria (AUC) Committee with the intention of establishing evidence-based recommendations regarding the appropriateness of various ancillary tests commonly utilized by dermatopathologists. Periodic acid Schiff (PAS) and Grocott (or Gomori) methenamine silver (GMS) stains represent some of the most commonly employed ancillary tests in dermatopathology. The utility of these tests was targeted for evaluation by the AUC. This literature review represents a comprehensive evaluation of available evidence for the utility of PAS and/or GMS staining of skin and nail biopsies. In concert with expert opinion, these data will be incorporated into future recommendations by the AUC for PAS and GMS staining in routine dermatopathology practice.
Topics: Dermatology; Humans; Methenamine; Pathology; Periodic Acid-Schiff Reaction; Skin Diseases; Staining and Labeling
PubMed: 32515092
DOI: 10.1111/cup.13769 -
Indian Journal of Otolaryngology and... Jun 2023Mucormycosis is an emerging angioinvasive fungal infection caused by ubiquitous saprophytic filamentous fungus that belongs to the class Zygomycosis. Mucormycosis or...
Mucormycosis is an emerging angioinvasive fungal infection caused by ubiquitous saprophytic filamentous fungus that belongs to the class Zygomycosis. Mucormycosis or black fungus infections in patients with recent COVID-19 infections has given rise to a new epidemic during the second wave of this current COVID-19 pandemic in India. Steroid misuse, poor glycemic control, use of industrial grade oxygen, improper humidification and specific variants strains have resulted in profound immunosuppression and are attributed for the high incidence of COVID associated Mucormycosis (CAM) in India. The aims of the present study were to assess the age and gender specific incidence of CAM, the utility of special stains (PAS and GMS) for diagnosing mucormycosis (false negatives and sensitivity). In the present study emphasis was laid on identifying if there exists a correlation between host response, angioinvasion and bone invasion with mortality. The Present study is a retrospective, cross sectional analytical study taken up in the Department of Pathology, Guntur Medical College for a period of 2 months between 1st of May 2021 to 30th of June 2021. Results were tabulated in Microsoft excel 2016 and SPSS software version 14 was used for calculation of odds ratio and for performing multivariate analysis. All samples were routinely fixed using 10% buffered formalin, processed and sectioned. All the sections were stained with Haematoxylin and Eosin and also special stains for fungus like periodic acid Schiff (PAS) and Gomori Methenamine silver (GMS) were used wherever required. CAM is a serious complication after recovery from COVID-19 infection due to its high morbidity and mortality (13.7% in this series). CAM epidemiology and presentation is mostly similar to non-COVID mucormycosis seen in pre-COVID era.
PubMed: 36571098
DOI: 10.1007/s12070-022-03305-9 -
The Turkish Journal of Pediatrics 2023Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of... (Review)
Review
BACKGROUND
Actinomycosis (ACM) is a rare infectious granulomatous disease caused by Actinomyces, a Grampositive, filamentous, saprophytic bacteria. There are several types of pediatric ACM, such as orocervicofacial (55%) and other less common forms: abdominopelvic and thoracic. We report a case of a 16-year-old who presented with abdominal ACM in the setting of acute appendicitis. After the case report, we provide a short literature review of pediatric appendicular ACM cases published.
CASE
A 16-year-old boy presented with nausea, vomiting, pain in the upper part of the abdomen and fever (37.5°C) lasting for 24 hours. On physical examination, the patient`s epigastrium and lower right abdominal quadrant were tender. White cell count and C-reactive protein (CRP) were elevated at 16,300/μL and 48.6mg/L respectively. Ultrasonography (US) showed appendicolith and edema of the appendiceal wall, focally with stratification as well as periappendiceal inflammation. The patient underwent a classic appendectomy, and the postoperative course was without complications. Histopathological analysis showed diffuse transmural neutrophilic infiltration of the appendix, focally with areas of necrosis and abscesses. There were numerous brightly eosinophilic colonies made of filamentous bacteria, located predominantly in submucosa. Special stains Grocott-Gomori`s Methenamine Silver and Gram were positive and a diagnosis of ACM was made.
CONCLUSIONS
Although appendicitis is very common in the general population, appendicitis associated with ACM is very rare, accounting for 0.02% - 0.06%, especially in the pediatric population. Diagnosis can be very challenging because they usually present with non-specific symptoms, and can form masses that mimic malignancies. Although rare, clinicians and pathologists should be aware of this entity. Satisfactory results and complete cure are achieved with adequate antibiotic therapy and surgery. In most cases, if there are no associated diseases, early and accurate diagnosis ensure an excellent prognosis.
Topics: Male; Humans; Child; Adolescent; Appendix; Appendicitis; Actinomycosis; Abscess; C-Reactive Protein
PubMed: 37661685
DOI: 10.24953/turkjped.2023.33 -
Frontiers in Medicine 2022The incidence of non-HIV-infected Pneumocystis Jirovecii Pneumonia (PJP) is increasing. The prognosis for non-HIV PJP is poor and diagnostic tests are of lower...
The incidence of non-HIV-infected Pneumocystis Jirovecii Pneumonia (PJP) is increasing. The prognosis for non-HIV PJP is poor and diagnostic tests are of lower sensitivity in non-HIV patients. Metagenomic next-generation sequencing (mNGS) was compared with routine detection assays, including Gomori methenamine silver (GMS) stain and polymerase chain reaction (PCR) technique. Specimens of 4 bronchoalveolar lavages (BAL) and 1 lung tissue samples were obtained from 4 non-HIV patients from our hospitals. Although both GMS and mNGS were positive for with PCR as positive control, the testing time of mNGS was obviously shorter than GMS. Compared with the traditional GMS method, mNGS has absolute advantages. However, the issue with PJP presentations having atypical symptoms and ambiguous imaging features persists. Hence, the disease can easily be ignored. Secondly, PJP progresses rapidly in non-HIV-infected patients and can cause severe respiratory failure with unfavorable prognosis. This study affirms that mNGS can be used to quickly and accurately diagnose PJP, but a combination of clinical judgement of symptoms, laboratory testing, and imaging examination is required to make a comprehensive judgment along with mNGS test results.
PubMed: 35372422
DOI: 10.3389/fmed.2022.812005 -
BMJ (Clinical Research Ed.) Jan 2023The studyHarding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open... (Randomized Controlled Trial)
Randomized Controlled Trial
The studyHarding C, Mossop H, Homer T, et al. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. 2022;376:e068229.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/methenamine-as-good-as-antibiotics-preventing-urinary-tract-infections/.
Topics: Female; Humans; Anti-Bacterial Agents; Methenamine; Urinary Tract Infections
PubMed: 36649970
DOI: 10.1136/bmj.p72 -
The American Journal of Surgical... Dec 2022Patients can be seen where "fungal debris," "mycetoma," or "mass-like obstruction" of the sinonasal tract is suspected clinically but lack fungus and instead have...
Patients can be seen where "fungal debris," "mycetoma," or "mass-like obstruction" of the sinonasal tract is suspected clinically but lack fungus and instead have granular, eosinophilic debris and bacterial colonies. We report and characterize 15 such cases, tentatively termed "bacteromas," compared with randomly selected cases of mycetoma and allergic fungal sinusitis (AFS). Pathology reports from 2016 to 2021 were searched. All candidate cases were examined microscopically and included if they had granular, amorphous debris with negative Grocott methenamine silver staining and lacked diagnostic features of other entities. The 7 males and 8 females ranged from 21 to 78 years old. Imaging frequently revealed opacification of the paranasal sinuses. Operative reports showed all to have paranasal sinus involvement. Most were unilateral (13/15, 87%). The maxillary sinus was involved in 11/15 (73%) cases, sphenoid sinus in 2/15 (13%), and frontal and ethmoid sinuses in 1/15 (7%), each. Bacteroma patients frequently had a history of allergic rhinitis (8/15, 53%), more than mycetomas (1/15, 7%) and AFS (5/15, 33%) ( P =0.0142). Facial pain was a common presenting symptom (13/15, 87%) in bacteromas compared with mycetomas (5/15, 33%) or AFS (1/15, 7%). Morphologically, cases consisted of large aggregates of paucicellular to acellular debris with a characteristic densely eosinophilic granular appearance, commonly associated with bacteria. Four of the 10 cultured patients grew Pseudomonas aeruginosa . Course posttreatment ranged from symptom resolution 1 week postoperatively to recurrent infections and symptoms 23 months from the initial operation. In summary, "bacteroma" is a heretofore undescribed pathologic entity of the sinuses that appears to be related to chronic bacterial infection and is distinct from mycetoma, AFS, and rhinolithiasis.
Topics: Male; Female; Humans; Young Adult; Adult; Middle Aged; Aged; Mycetoma; Paranasal Sinuses; Sinusitis; Diagnosis, Differential; Bacteria
PubMed: 36084622
DOI: 10.1097/PAS.0000000000001969 -
International Journal of Pharmaceutical... 2023Onychomycosis is the most common fungal nail infection accounting for 50% of nail disorders. This infection is most common in the toenails than in the nails of the...
Onychomycosis is the most common fungal nail infection accounting for 50% of nail disorders. This infection is most common in the toenails than in the nails of the fingers. It is caused by various fungal species like Trichophyton rubrum, Trichophyton mentagrophytes, Scopulariopsis brevicaulis, Aspergillus spp, Fusarium spp, Acremonium spp, Alternaria spp, and Neoscytalidium. Among them, dermatophyte fungus is involved in 70% to 80% of infections. Clinically, there are five types of onychomycosis classified based on causative organism and location of infection origin. Diagnosis of this infection uses a mycological study of nail samples using multiple staining techniques like periodic acid-Schiff, calcofluor, Grocott methenamine silver, fluorescence, and microscopy. The major risk factors of this infection include diabetes mellitus, psoriasis, peripheral vascular diseases, obesity, metabolic syndrome, nail trauma, human immunodeficiency virus and/or acquired immunodeficiency syndrome, immune-compromised individuals, chronic kidney failure, athletic activity, smoking, and hyperlipidemia. The treatment options for onychomycosis include topical and systemic antifungal agents, nanoparticles, laser therapy, photodynamic therapy, and nail avulsion. This article describes several types of onychomycosis, symptoms, diagnosis, currently available therapy and its drawback, current research to rectify the issues, and future medicinal approaches to improve patient health.
Topics: Humans; Onychomycosis
PubMed: 38100667
DOI: No ID Found -
Cureus Oct 2023Emphysematous gastritis is a rare entity that has not much literature available. It is known to manifest as a diffused wall inflammation and air within the wall of the...
Emphysematous gastritis is a rare entity that has not much literature available. It is known to manifest as a diffused wall inflammation and air within the wall of the stomach and has been associated with gas-forming organisms. We present a complex case of a middle-aged woman with a previous history of fulminant complicated with colectomy and diverting colostomy. She was admitted due to diabetic ketoacidosis, later complicated with worsening abdominal pain, and a CT scan of the abdomen and pelvis without contrast revealed findings consistent with ischemic bowel, severe pneumatosis intestinalis, and extensive portal venous gas. A stomach biopsy revealed hemorrhagic necrosis; a Gomori methenamine silver stain was compatible with fungal organisms, , correlating with Candida emphysematous gastritis. This case highlights the importance of early diagnosis of this syndrome in order to provide appropriate management, and early identification, to improve survival.
PubMed: 38022357
DOI: 10.7759/cureus.47870