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More frequent among adults, phenocopies may be caused by somatic mutations or anti-cytokine autoantibodies, mimicking the phenotypes of primary immunodeficiencies. A fourteen-year-old girl was referred for a two-year history of weight loss and multiple recurrent abscesses, complicated recurrent pneumonia, pyelonephritis, osteomyelitis, and septic shock, without fever. She had started with nausea, hyporexia, and weight loss, then with abscesses in her hands, knee, ankle, and spleen. She also developed a rib fracture and left thoracic herpes zoster. The patient was cachectic, with normal vital signs, bilateral crackles on chest auscultation, tumefaction of the knee joint, and poorly healed wounds in hands and chest, oozing a yellowish fluid. Chest computed tomography revealed multiple bilateral bronchiectases. Laboratory workup reported chronic anemia, leukocytosis, neutrophilia, mild lymphopenia, thrombocytosis, pan-hypergammaglobulinemia, and elevated acute serum reactants. Lymphocyte subsets were low but present. Mycobacterium tuberculosis was detected via polymerase chain reaction in a bone biopsy specimen from ankle osteomyelitis. Whole-exome sequencing failed to identify a monogenic defect. Interleukin-12 was found markedly elevated in the serum of the patient. Phosphorylation of STAT4, induced by increasing doses of IL-12, was neutralized by patient serum, confirming the presence of anti-IL12 autoantibodies. IL-12 and IL-23 are crucial cytokines in the defense against intracellular microorganisms, the induction of interferon-gamma production by lymphocytes, and other inflammatory functions. Patients who develop neutralizing serum autoantibodies against IL12 manifest late in life with weight loss, multiple recurrent abscesses, poor wound healing, and fistulae. Treatment with anti-CD20 monoclonal antibodies was effective.

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Introduction: Blood culture-negative infective endocarditis is the condition in which a causative organism cannot be identified after inoculation of at least three samples using standard blood-culture systems for 7 days. It has a low reported incidence of about 2.5-31%. Causes may be infectious or non-infectious; use of prior antibiotic therapy is usually the leading factor. Case presentation: The authors present a case of true culture-negative endocarditis involving the mitral valve, with multiple foci of spread including brain, spleen, liver, and Intervertebral disc, which remained persistent despite treatment with intravenous broad-spectrum antibiotics on an inpatient and outpatient basis but eventually improved after upgrading alternative broad-spectrum antibiotic for an extended duration. The patient had complications in the form of a flail mitral valve with persistent mitral regurgitation, requiring mitra-clip placement. Discussion: Positive blood culture is one of the major diagnostic criteria to establish infective endocarditis. Patients may have persistent negative cultures due to previous antibiotic use, the presence of fastidious organisms, or the use of inappropriate techniques or media. Involvement of a multidisciplinary team, use of multimodal investigations, and appropriate antibiotic stewardship are crucial. Extended duration of treatment and upgrading antibiotics can be helpful next steps in highly suspicious cases. With multifocal spread as in our case, it further becomes challenging to control and treat the infection as it is frequently connected with higher morbidity and mortality. Conclusion: Blood culture-negative endocarditis is an entity that can present with early complications. It is diagnostically and therapeutically challenging to treat such patients. Multimodal approaches for early diagnosis and appropriate treatment are crucial owing to its high morbidity and mortality.

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Hemoptysis associated with respiratory disorders are some findings of caudal vena cava thrombosis (CVCT) in cattle. Nevertheless, CVCT may be accompanied by a broad spectrum of clinical signs and gross lesions. This study reported the frequency of CVCT in cattle necropsied in Southern Brazil and described its clinical signs, as well as pathological findings. From a total of 1,976 postmortem examination reports in cattle in Southern Brazil, there were 30 cases (1.5%) of CVCT. In the clinical evaluation, the main clinical course was chronic (13/30), followed by peracute (7/30), acute (4/30), and subacute (5/30). Hemoptysis (17/30), dyspnea (8/30), and anorexia or hyporexia (7/30) were the most reported clinical signs. Septic thrombophlebitis of the caudal vena cava (24/30), hepatic abscesses (24/30), pulmonary hemorrhage (23/30), and embolic pneumonia (19/30) were the main lesions observed at the necropsy. We concluded that CVCT is a relevant cause of death in bovines from Santa Catarina state, mainly in adult dairy cows. The disease is characterized by a wide range of clinical signs and lesions, requiring attention from veterinarians for the correct diagnosis. Furthermore, the association between the clinical history, clinical signs, and lesions is essential for the diagnosis of CVCT in cattle.

Hemoptise associada a sinais respiratórios são achados típicos de tromboembolismo da veia cava caudal (TVCC) em bovinos. Todavia, o TVCC pode estar acompanhado de um amplo espectro de sinais clínicos e lesões macroscópicas. Esse estudo tem por objetivo relatar a frequência do diagnóstico de TVCC em bovinos necropsiados no sul do Brasil e descrever os sinais clínicos, assim como achados patológicos dessa condição. De um total de 1.976 exames post-mortem realizados em bovinos no Sul do Brasil, 30 casos de TVCC foram diagnosticados (1,5%). No exame clínico, o principal curso clínico observado foi crônico (13/30), seguido do hiperagudo (7/30), agudo (4/30) e subagudo (5/30), em um caso o histórico clínico não foi fornecido. Hemoptise (17/30), dispneia (8/30) e anorexia ou hiporexia (7/30) foram os sinais clínicos mais comumente relatados. Tromboflebite séptica da veia cava caudal (24/30), abscessos hepáticos (24/30), hemorragia pulmonar (23/30) e pneumonia embólica (19/30) foram as principais lesões observadas na necropsia. Com esse trabalho conclui-se que TVCC é uma causa relevante de morte em bovinos no estado de Santa Catarina, principalmente em vacas leiteiras adultas. A doença é caracterizada por uma variedade de sinais clínicos e lesões, necessitando de atenção dos veterinários para o correto diagnóstico. Ainda, a associação entre o histórico clínico, sinais clínicos e lesões de necropsia é essencial para o diagnóstico de TVCC em bovinos.

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Introducción: en todo paciente hospitalizado con absceso odontogénico cervicofacial se busca resolución pronta del absceso, pero es necesario conocer cuáles son los factores que favorecen la resolución en hospitalizaciones cortas (1-3 días). Objetivo: determinar factores clínico-epidemiológicos de pacientes con abscesos odontogénicos para identificar factores que correlacionan con hospitalización corta. Material y métodos: estudio transversal, retrospectivo, observacional y analítico de 100 pacientes con abscesos odontogénicos en un Hospital General de Zona del Instituto Mexicano del Seguro Social de los años 2012-2013. Variables de estudio: días de hospitalización, sexo, edad, comorbilidades, conteo leucocitario, trismus, diente causal, región afectada y tratamientos realizados. Tamaño de muestra obtenido con fórmula para estudios observaciones con manejo de prevalencias para poblaciones infinitas, se empleó χ2 para identificar factores que correlacionan con hospitalización corta. Resultados: mujeres 56%, rango de edad 12-89 años y de hospitalización de 1-23 días; con comorbilidades 56%, leucocitosis 39% y trismus 21%. La caries causó 64% de abscesos, molares inferiores 70% y región submandibular afectada 73%. Variables estadísticamente significativas; conteo leucocitario, diente causal y región afectada. Conclusión: factores correlacionados con hospitalización corta: conteo leucocitario menor a 10,500 leucocitos, que el molar inferior no sea el diente causal y que la región submandibular no esté afectada (AU)

Introduction: prompt resolution of the abscess is sought in all patients hospitalized with cervicofacial odontogenic abscess, but which factors favor this resolution in short hospitalizations (1-3 days). Objective: determine clinical-epidemiological factors of patients with odontogenic abscesses to identify factors that correlate with short hospitalization. Material and methods: crosssectional, retrospective, observational and analytical study of 100 patients with odontogenic abscesses in a General Hospital of the Zone of the Mexican Social Security Institute from 2012-2013. Study variables; days of hospitalization, sex, age, comorbidities, leukocyte count, trismus, causative tooth, affected region and treatments performed. Sample size obtained with the formula for observational studies with prevalence management for infinite populations, χ2 was used to identify factors that correlate with short hospitalization. Results: women 56%, age range 12-89 years and hospitalization of 1-23 days, with comorbidities 56%, leukocytosis 39% and trismus 21%. Caries caused 64% of abscesses, lower molars 70% and affected submandibular region 73%. Statistically significant variables; leukocyte count, causative tooth and affected region. Conclusion: factors correlated with short hospitalization; leukocyte count less than 10,500 leukocytes, that the lower molar is not the causal tooth and that the submandibular region is not affected.

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Background: Citrobacter koseri, a Gram-negative organism, rarely causes an epidural spinal abscess. Case Description: A 50-year-old male presented with mild paraparesis attributed to an magnetic resonance (MR)-documented spinal epidural abscess (SEA) at the T10-level. Following surgical debridement, cultures grew C. koseri, a rare Gram-negative organism. The abscess was subsequently managed with a prolonged course of antibiotics resulting in complete symptom and MR-documented radiological resolution. Conclusion: A 50-year-old male presented with a T10 SEA attributed to a rare Gram-negative organism, C. koseri. The abscess was appropriately managed with surgical decompression/debridement, followed by prolonged antibiotic therapy.

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The epidemiological behaviour of the main extraintestinal complication due to E. histolytica (amoebic liver abscess, ALA) has been little explored in developing countries. Since Mexico meets the characteristics to be considered as endemic, the aim of this work was to analyze the national surveillance data (seven years) of ALA issued by the General Directorate of Epidemiology. An analysis of cases and incidence of ALA (2014-2020) was performed in the annual reports issued by the GDE in Mexico. Cases and incidence of ALA were classified by year, incidence, age group, sex and seasons. Geographical distribution map for the whole country of ALA was constructed. The cases and mean incidence of ALA did not shown significant variation during the study period. Of the total cases accumulated, Sonora, Sinaloa, Nayarit, Colima and Zacatecas states showed the most incidence by ALA. Male sex of 24-44 years old showed higher ALA cases. No temporal behaviour was identified between the ALA cases. In Mexico, the incidence of ALA remains unchanged, however, it should not be underestimated since the monitoring programs for the search for new cases have not yet been implemented mainly in endemic states. These results summarize the priority in the national ALA report.

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ABSTRACT The treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CR-Kp) strains is difficult due to the limited antimicrobial options and high mortality. There are many reports on intracranial infections caused by CR-Kp, but only a few on brain abscesses caused by CR-Kp. Here, we present a case of brain abscess caused by CR-Kp successfully treated with combined antibiotics. A 26-year-old male patient was admitted to our hospital due to high fever and headache. His past medical history includes a surgical intervention due to an acute subdural hematoma, performed at an external healthcare center. After the current diagnosis of cerebral abscess, he underwent two surgeries. During the procedure, multiple cerebral abscesses were drained and capsulotomies were performed under ultrasound guidance. The combination of meropenem and vancomycin was started. The contents of the abscesses were sent to the microbiology and pathology laboratory. On the 3 rd day of treatment, the medical team was informed that CR-Kp grew in an abscess culture. The patient's treatment was changed to meropenem + colistin + tigecycline. The patient developed electrolyte disturbances during the follow-up and this was considered an adverse effect of colistin. On the 41 st day of treatment, colistin was discontinued, fosfomycin was added, and meropenem and tigecycline were maintained. Treatment was discontinued on the 68 th day, when the patient was discharged. The general condition of the patient, who has been followed up for two years, is satisfactory. The treatment of CR-Kp infections should be individualized, and the pharmacokinetics and pharmacodynamics of antibiotics should be considered in each case.

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La listeriosis es una enfermedad infecto contagiosa, transmitida por los alimentos, prevenible, y potencialmente grave. Las formas clínicas de presentación pueden ser muy variadas, desde una gastroenterocolitis hasta sepsis grave y compromiso multisistémico. Se discute el caso de una mujer joven que se presenta con manifestaciones neuropsiquiátricas y sistémicas subagudas, en contexto febril en la que a través de hemocultivos se llega al diagnóstico de Listeriosis invasiva. Se destaca el compromiso profundo parenquimatoso a forma de abscesos múltiples, como presentación menos frecuente. Se realiza tratamiento médico, antibioticoterapia prolongada, con franca mejoría clínica imagenológica. El diagnóstico de esta enfermedad requiere un alto índice de sospecha, optimizar las herramientas diagnósticas para un correcto relevo bacteriológico y así poder instaurar precozmente la antibioticoterapia.

Listeriosis is an infectious, contagious, foodborne, preventable, and potentially serious disease. The clinical forms of presentation can be very varied, from gastroenterocolitis to severe sepsis and multisystem involvement. We discuss the case of a young woman with subacute neuropsychiatric and systemic manifestations, in a febrile context in which the diagnosis of invasive Listeriosis is reached through blood cultures. Deep parenchymal involvement in the form of multiple abscesses stands out as a less frequent presentation. Medical treatment, prolonged antibiotic therapy, with clear clinical imaging improvement is performed. The diagnosis of this disease requires a high index of suspicion, optimization of diagnostic tools for a correct bacteriological relief and thus early initiation of antibiotic therapy.

A listeriose é uma doença infecciosa, contagiosa, transmitida por alimentos, evitável e potencialmente grave. As formas clínicas de apresentação podem ser muito variadas, desde gastroenterocolite até sepse grave e envolvimento multissistêmico. Discutimos o caso de uma jovem que apresenta manifestações neuropsiquiátricas e sistêmicas subagudas, em um contexto febril em que o diagnóstico de Listeriose invasiva é alcançado por meio de hemoculturas. O envolvimento do parênquima profundo na forma de múltiplos abscessos destaca-se como uma apresentação menos frequente. Realiza-se tratamento médico, antibioticoterapia prolongada, com nítida melhora da imagem clínica. O diagnóstico desta doença requer um alto índice de suspeição, otimização das ferramentas diagnósticas para um correto alívio bacteriológico e, assim, início precoce da antibioticoterapia.

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Necrotizing fasciitis is a serious infectious condition that may compromise the patient's life. In the present case study, a 42-year-old male patient was reported. The condition manifested as the presence of subjective fever, general malaise, myalgia, non-productive cough, dysphagia and neck pain ~1 week prior to hospital admission. Vascular dissection was considered as the initial diagnostic suspicion, and thus, angiotomography of neck vessels was performed, ruling out aortic and neck vessel dissection. Radiology indicated negativity for aortic syndrome and cervical vascular disease, but the presence of cervical-mediastinal edema, lamellar fluid between muscular and fatty planes and posterior pulmonary atelectasis, absence of pleural fluid or consolidations, and tonsillar hypertrophy without abscesses. Due to the rapid evolution of the condition, the presence of dyspnea with the need for supplemental oxygen, and the disproportion between the intensity of the pain described by the patient and the external findings observed, the presence of necrotizing fasciitis was considered. Point-of-care ultrasonography was performed, indicating a cobblestone pattern of the subcutaneous cellular tissue, with diffuse thickening of the anterior cervical fascia and increased echogenicity with soft tissue edema posterior to the fascia. Magnetic resonance imaging confirmed the inflammatory findings in the fascia and other cervical soft tissues, without exhibiting any signs of necrosis, but with the presence of abscesses in the visceral and carotid space.

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Central nervous system infections and cavernous sinus thrombosis are associated with high mortality rates and may be a consequence of oral infection propagation. A 24-year-old woman has attended a private dental office with a pain complaint in the upper right central incisor and had the endodontic treatment completed. However, the patient returned to the dental office reporting pain in the same tooth and the presence of swelling. Then, the root canal was retreated. After one week, the patient presented to a Basic Health Unit with a history of vomiting and convulsion crisis followed by loss of consciousness. A computed tomography exam showed cavernous sinus thrombosis and brain ischaemic areas. The present report describes a rare case of cavernous sinus thrombosis followed by brain ischaemia in a type-1 diabetic patient, associated with persistent endodontic infection, with subsequent patient's death.

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RESUMEN Antecedentes: El drenaje percutáneo es una alternativa a la cirugía en el manejo de los abscesos pélvi cos. El objetivo de este estudio es evaluar la seguridad y la eficacia del enfoque transglúteo. Material y métodos: Los drenajes fueron realizados por 3 cirujanos, bajo guía tomográfica. Se utilizó la técnica de Seldinger, con anestesia local; se utilizaron catéteres de 8 y 10 Fr. El drenaje fue exitoso si la colección desapareció y no había recurrido. Resultados: El promedio de edad de los pacientes fue de 49,2 años. El germen más común fue Esche richia coli. En la mitad de los casos, la causa fue posoperatoria. La duración media del drenaje fue de 9,2 días. El drenaje tuvo éxito en todos los casos, sin complicaciones mayores. Conclusión: El drenaje transglúteo guiado por tomografía computarizada (TC) es seguro y bien tolera do para el tratamiento de abscesos pélvicos profundos.

ABSTRACT Background: Percutaneous drainage is an alternative to surgery in the management of pelvic abscesses. The aim of this study is to evaluate the safety and efficacy of the transgluteal approach. Material and methods: Transgluteal percutaneous drainages were performed by 3 surgeons using computed tomography guidance. The Seldinger technique was used with 8 Fr and 10 Fr catheters under local anesthesia. Drainage was considered successful if the abscess regressed and did not recur. Results: Mean age was 49.2 years. Escherichia coli was the most common microorganism identified. In 50% of the cases, the abscesses occurred postoperatively. Mean duration of drainage was 9.2 days. Drainage was successful in all the cases and there were no major complications. Conclusion: Transgluteal computed tomography-guided approach is safe and well-tolerated for the treatment of deep pelvic abscesses.

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En la actualidad, las infecciones de piel y partes blandas forman parte de un alto porcentaje de las consultas en salud. Estas van desde infecciones leves, donde el manejo se realiza con tratamiento tópico, hasta aquellas con severo compromiso sistémico, requiriendo terapia antibiótica sistémica e incluso el desbridaje quirúrgico. En general, son producto de un desbalance entre los mecanismos de defensa de la barrera cutánea y los factores de virulencia y patogenicidad de los microorganismos que la afectan. Se pueden clasificar según distintos criterios, como por ejemplo, profundidad, gravedad, microorganismos involucrados y si estas son purulentas o no. El reconocer estas entidades clínicas es de suma importancia para llevar a cabo un adecuado tratamiento en los pacientes que presentan estas afecciones, ya que los diagnósticos erróneos llevan a las múltiples consultas con el consiguiente aumento de costos asociados en atención en salud.

Currently, skin and soft tissue infections are part of a high percentage of health consultations. These range from mild infections, where management is performed with topical treatment, to those with severe systemic compromise requiring systemic antibiotic therapy and even surgical debridement. In general, they are the product of an imbalance between the defense mechanisms of the skin barrier and the virulence and pathogenicity factors of the microorganisms that affect it, which can vary from bacterial, viral, fungal and parasites agents. Skin and soft tissue infections can be classified according to different criteria, such as depth, severity, microorganisms involved and whether they are purulent or not. Recognizing these clinical entities is of utmost importance to carry out adequate treatment in patients with these conditions, since erroneous diagnoses lead to multiple consultations with the consequent increase in costs associated with health care

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Resumen Corynebacterium kroppenstedtii es un bacilo gram positivo corineforme lipofílico, poco frecuente en la clínica humana. Forma parte de la microbiota cutánea de los seres humanos y, por esta razón, su interpretación clínica es compleja. La mastitis granulomatosa es una enfermedad inflamatoria de origen incierto con baja incidencia. Se presentan dos casos clínicos en los que se describe la asociación de C. kroppenstedtii con mastitis granulomatosa. El tejido mamario es rico en lípidos. El carácter lipofílico de este microorganismo podría explicar su presencia en dicho tejido.

Abstract Corynebacterium kroppenstedtii is a rare lipophilic coryneform gram-positive bacillus. It is part of the human skin microbiota and, for this reason, its clinical interpretation is complex. Granulomatous mastitis is an inflammatory disease of uncertain origin with a low incidence. The association of C. kroppenstedtii with granulomatous mastitis was described in two clinical case reports. The lipophilic characteristics of this microorganism explains why it can be found in lipid-rich breast tissue.

Resumo Corynebacterium kroppenstedtii é um bacilo gram-positivo corineforme lipofílico poco frecuente. Faz parte da microbiota do seres humanos, por isso sua interpretação clínica é complexa. A mastite granulomatosa é uma doença inflamatória de origem incerta com baixa incidência. Foram apresentados dois casos clínicos nos quais é descrita a associação de C. kroppenstedtii com mastite granulomatosa. O tecido mamário é rico em lipídios. O caráter lipofílico desse microrganismo pode explicar sua presença em tal tecido.

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Resumen Introducción: Los abscesos cerebrales son una urgencia neurológica grave con alto riesgo de déficit neurológico permanente. Son patologías raras en la edad pediátrica, con una incidencia anual de 0.5 por 100,000 niños. Se han realizado pocos estudios de abscesos cerebrales de origen odontogénico y la mayoría de los pacientes son adultos con patología dental de base. Eikenella corrodens es un cocobacilo gramnegativo anaerobio facultativo de crecimiento fastidioso, que forma parte de la biota de la cavidad oral, pero es un patógeno frecuente en infecciones de cabeza y cuello, así como en infecciones dentales. Caso clínico: Paciente de sexo masculino de 16 años, previamente sano, que presentó cefalea de 2 meses de evolución acompañada de náuseas y vómitos. Antecedente de extracción del cuarto molar superior derecho 4 meses antes, sin uso de profilaxis antibiótica. La resonancia magnética de cráneo mostró una lesión compatible con absceso cerebral. Se realizó drenaje por punción guiada por estereotaxia, del que se aisló E. corrodens. El paciente completó un tratamiento con ceftriaxona y metronidazol por vía intravenosa durante 4 semanas y ampicilina-sulbactam por vía oral por 2 semanas más. Conclusiones: Los abscesos cerebrales de origen odontogénico causados por E. corrodens en la edad pediátrica son muy raros. Actualmente, el uso de antibióticos profilácticos en procedimientos dentales es controversial, ya que se ha documentado el aumento de la resistencia microbiana por su uso indiscriminado. La optimización de los estudios diagnósticos y el tratamiento multidisciplinario han mejorado el pronóstico de los pacientes con absceso cerebral.

Abstract Background: Brain abscesses are a serious neurological emergency with a high risk of permanent neurological deficit. The pathology is a rare in the pediatric age: the annual incidence is 0.5 per 100,000 children. There are a few studies of brain abscesses of oral origin mostly in adult patients with an underlying dental pathology. Eikenella corrodens, a slow-growing, Gram negative, facultatively anaerobic rod-bacillus, is part of the oral cavity biota, and common as a pathogen in head, neck, and dental infections. Case report: A previously healthy 16-year-old male presented a headache of 2 months of evolution accompanied by nausea and vomiting. Four months earlier, the fourth upper right molar was extracted, with no antibiotic prophylactic treatment. Magnetic resonance imaging of the skull showed a lesion compatible with brain abscess. Stereotaxy-guided puncture drainage was performed, isolating E. corrodens. The treatment was with ceftriaxone and metronidazole intravenously for four weeks and ampicillin sulbactam orally for two more weeks. Conclusions: Brain abscesses of odontogenic origin by E. corrodens in the pediatric age are very rare. Currently, the use of prophylactic antibiotics in dental procedures is controversial because the indiscriminate use increases antimicrobial resistance. The optimization of diagnostic studies and multidisciplinary treatment has improved the prognosis of patients with brain abscesses.

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Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be anopportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganismmay present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reportsof infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agentsinvolved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amarals boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspectin the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination,and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of theisolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolatedand showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaningof the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine.Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole...(AU)

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Background: Pseudomonas aeruginosa is a bacterium that belongs to the microbiota of snakes, but it may also be anopportunistic pathogen and contaminate humans through fecal contact, bites, and injuries. In snakes, this microorganismmay present high pathogenicity at certain conditions and have been associated with high morbidity and mortality. Reportsof infection of Boa constrictor by this pathogen are rare. Thus, this study aimed to describe the P. aeruginosa oral infection in a snake specimen (Boa constrictor amarali), approaching the isolation and identification of the infectious agentsinvolved, the antimicrobial sensitivity and resistance, and the therapeutic protocol adopted.Case: A free-living adult female specimen of Boa constrictor amarali (Amaral’s boa), with no described previous history was rescued in an urban area by the Environmental Police. Clinical evaluations showed structures of caseous aspectin the oral cavity, with hyperemia spots in the mucosa. Samples of these lesions were sent for mycological examination,and fungal forms were not found. Samples were collected for isolation and culture. The antimicrobial susceptibility of theisolated microorganisms was determined by the modified Kirby-Bauer disk diffusion method. P. aeruginosa was isolatedand showed susceptibility to amikacin, gentamicin, and polymyxin-B; intermediate susceptibility to azithromycin, and ciprofloxacin; and resistance to cephalexin, ceftiofur, chloramphenicol, and enrofloxacin. The treatment consisted of cleaningof the oral cavity, local infiltration of lidocaine for debridement of the caseous area that were later cauterized with iodine.Systemic antibiotic therapy was used, with intramuscular administration of amikacin (5 mg/kg) for the first dose and (2.5mg/kg) for the other doses with intervals of 72 h, and oral administration of metronidazole...

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A linfadenite caseosa (LC) é uma enfermidade que acomete pequenos ruminantes, caracterizada clinicamente por lesões abscedantes em linfonodos, pele e órgãos, causada principalmente pela bactéria Corynebacterium pseudotuberculosis. O presente estudo investigou a prevalência da LC em criatórios de pequenos ruminantes do estado do Amazonas, bem como a sensibilidade microbiana in vitro de C. pseudotuberculosis aos antimicrobianos. Foi realizado exame clínico em 1.280 animais, dos quais 4,53% (58/1.280) dos animais apresentavam abscessos e/ou cicatrizes na pele e/ou linfonodos. No perfil de sensibilidade in vitro aos antimicrobianos, 100% dos isolados de C. pseudotuberculosis obtidos de ovinos foram sensíveis à ampicilina (8/8), amoxicilina/ácido clavulânico (8/8), cefotaxima (8/8), ciprofloxacina (8/8), norfloxacino (8/8), sulfazotrim e tetraciclina (8/8). Nos isolados de C. pseudotuberculosis obtidos de caprinos, verificou-se 100% de sensibilidade in vitro diante da amoxicilina/ácido clavulânico (5/5), cefotaxima (5/5), ciprofloxacina (5/5) e norfloxacino (5/5). Ratifica-se a importância do primeiro isolamento do agente em pequenos ruminantes no estado, bem como o primeiro estudo epidemiológico na Região Norte, constatando que a enfermidade possui baixa prevalência em ovinos e caprinos no Amazonas.(AU)

Caseous lymphadenitis (CL) is a disease that affects small ruminants, clinically characterized by abscessing lesions in lymph nodes, skin and organs, caused mainly by the bacterium Corynebacterium pseudotuberculosis. The present study investigated the prevalence of CS in small ruminant farms in the state of Amazonas, as well as the in vitro microbial sensitivity of C. pseudotuberculosis to antimicrobials. A clinical examination was carried out on 1,280 animals evaluated, of which 4.53% (58 / 1,280) of the animals had abscesses and / or scars on the skin and / or lymph nodes. In the in vitro sensitivity profile to antimicrobials, 100% of C. pseudotuberculosis isolates obtained from sheep were sensitive to ampicillin (8/8), amoxicillin / clavulanic acid (8/8),cefotaxime (8/8), ciprofloxacin (8 / 8), norfloxacin (8/8), sulfazotrim and tetracycline (8/8). In isolates of C. pseudotuberculosis obtained from goats, there was 100% sensitivity in vitro to amoxicillin / clavulanic acid (5/5), cefotaxime (5/5), ciprofloxacin (5/5) and norfloxacin (5/5). The importance of the first isolation of the agent in small ruminants in the state is ratified, as well as the first epidemiological study in the North Region, confirming that the disease has a low prevalence in sheep and goats in Amazonas.(AU)

La linfadenitis caseosa (LC) es una enfermedad que afecta a pequeños rumiantes, caracterizada clínicamente por lesiones de absceso en los ganglios linfáticos, la piely los órganos, causada principalmente por la bacteria Corynebacterium pseudotuberculosis. El presente estudio investigó la prevalencia de LC en pequeñas granjas de rumiantes en el estado de Amazona, así como la sensibilidad microbiana in vitro de C. pseudotuberculosis a los antimicrobianos. Se realizó un examen clínico en 1.280 animales evaluados, de los cuales 4.53% (58 / 1,280) de los animales tenían abscesos y / o cicatrices en la piel y / o ganglios linfáticos. En el perfil de sensibilidad in vitro a los antimicrobianos, el 100% de los aislados de C. pseudotuberculosis obtenidos de ovejas eran sensibles a ampicilina (8/8), amoxicilina / ácido clavulánico (8/8), cefotaxima (8/8), ciprofloxacina (8 / 8), norfloxacino (8/8), sulfazotrim y tetraciclina(8/8). En los aislados de C. pseudotuberculosis obtenidos de cabras, 100% de sensibilidad in vitro a amoxicilina / ácido clavulánico (5/5), cefotaxima (5/5), ciprofloxacina (5/5) y norfloxacino (5/5). Se ratifica la importancia del primer aislamiento del agente en pequeños rumiantes en el estado, así como el primer estudio epidemiológico en la Región Norte, lo que confirma que la enfermedad tiene una baja prevalencia en ovejas y cabras en Amazona.(AU)

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RESUMO

A linfadenite caseosa (LC) é uma enfermidade que acomete pequenos ruminantes, caracterizada clinicamente por lesões abscedantes em linfonodos, pele e órgãos, causada principalmente pela bactéria Corynebacterium pseudotuberculosis. O presente estudo investigou a prevalência da LC em criatórios de pequenos ruminantes do estado do Amazonas, bem como a sensibilidade microbiana in vitro de C. pseudotuberculosis aos antimicrobianos. Foi realizado exame clínico em 1.280 animais, dos quais 4,53% (58/1.280) dos animais apresentavam abscessos e/ou cicatrizes na pele e/ou linfonodos. No perfil de sensibilidade in vitro aos antimicrobianos, 100% dos isolados de C. pseudotuberculosis obtidos de ovinos foram sensíveis à ampicilina (8/8), amoxicilina/ácido clavulânico (8/8), cefotaxima (8/8), ciprofloxacina (8/8), norfloxacino (8/8), sulfazotrim e tetraciclina (8/8). Nos isolados de C. pseudotuberculosis obtidos de caprinos, verificou-se 100% de sensibilidade in vitro diante da amoxicilina/ácido clavulânico (5/5), cefotaxima (5/5), ciprofloxacina (5/5) e norfloxacino (5/5). Ratifica-se a importância do primeiro isolamento do agente em pequenos ruminantes no estado, bem como o primeiro estudo epidemiológico na Região Norte, constatando que a enfermidade possui baixa prevalência em ovinos e caprinos no Amazonas.

Caseous lymphadenitis (CL) is a disease that affects small ruminants, clinically characterized by abscessing lesions in lymph nodes, skin and organs, caused mainly by the bacterium Corynebacterium pseudotuberculosis. The present study investigated the prevalence of CS in small ruminant farms in the state of Amazonas, as well as the in vitro microbial sensitivity of C. pseudotuberculosis to antimicrobials. A clinical examination was carried out on 1,280 animals evaluated, of which 4.53% (58 / 1,280) of the animals had abscesses and / or scars on the skin and / or lymph nodes. In the in vitro sensitivity profile to antimicrobials, 100% of C. pseudotuberculosis isolates obtained from sheep were sensitive to ampicillin (8/8), amoxicillin / clavulanic acid (8/8),cefotaxime (8/8), ciprofloxacin (8 / 8), norfloxacin (8/8), sulfazotrim and tetracycline (8/8). In isolates of C. pseudotuberculosis obtained from goats, there was 100% sensitivity in vitro to amoxicillin / clavulanic acid (5/5), cefotaxime (5/5), ciprofloxacin (5/5) and norfloxacin (5/5). The importance of the first isolation of the agent in small ruminants in the state is ratified, as well as the first epidemiological study in the North Region, confirming that the disease has a low prevalence in sheep and goats in Amazonas.

La linfadenitis caseosa (LC) es una enfermedad que afecta a pequeños rumiantes, caracterizada clínicamente por lesiones de absceso en los ganglios linfáticos, la piely los órganos, causada principalmente por la bacteria Corynebacterium pseudotuberculosis. El presente estudio investigó la prevalencia de LC en pequeñas granjas de rumiantes en el estado de Amazona, así como la sensibilidad microbiana in vitro de C. pseudotuberculosis a los antimicrobianos. Se realizó un examen clínico en 1.280 animales evaluados, de los cuales 4.53% (58 / 1,280) de los animales tenían abscesos y / o cicatrices en la piel y / o ganglios linfáticos. En el perfil de sensibilidad in vitro a los antimicrobianos, el 100% de los aislados de C. pseudotuberculosis obtenidos de ovejas eran sensibles a ampicilina (8/8), amoxicilina / ácido clavulánico (8/8), cefotaxima (8/8), ciprofloxacina (8 / 8), norfloxacino (8/8), sulfazotrim y tetraciclina(8/8). En los aislados de C. pseudotuberculosis obtenidos de cabras, 100% de sensibilidad in vitro a amoxicilina / ácido clavulánico (5/5), cefotaxima (5/5), ciprofloxacina (5/5) y norfloxacino (5/5). Se ratifica la importancia del primer aislamiento del agente en pequeños rumiantes en el estado, así como el primer estudio epidemiológico en la Región Norte, lo que confirma que la enfermedad tiene una baja prevalencia en ovejas y cabras en Amazona.

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RESUMO

La colitis estercorácea se describe como un proceso inflamatorio que afecta a la pared colónica en relación con el aumento de la presión intraluminal por impactación fecal . Se presenta generalmente en ancianos con múltiples comorbilidades, lo que puede facilitar la aparición de complicaciones potencialmente mortales. Debido a sus síntomas inespecíficos, requiere del uso de imágenes diagnósticas para instaurar un tratamiento precoz . Se presenta un caso clínico, diagnosticado en nuestro centro, de colitis estercorácea complicada con múltiples abscesos hepáticos piógenos.

Stercoral colitis is an inflammatory process of the colonic wall caused by increased luminal pressure resulting from fecal impaction. It is generally seen in elderly patients with multiple comorbidities which facilitate potentially fatal complications. Diagnostic imaging is required for initiation of prompt treatment as its symptoms are non-specific. We present a clinical case of stercoral colitis complicated by multiple pyogenic hepatic abscesses diagnosed in our centre.

RESUMO

BACKGROUND: Cat-scratch disease (CSD) is a zoonotic infection caused by Bartonella henselae and B. clarridgeiae. The typical manifestations of CSD include regional lymphadenitis and fever. However, CSD can have a wide variety of clinical manifestations that can lead to incorrect diagnoses and prolonged hospital stays. CASE PRESENTATION: We present a case of a 3-year-old boy admitted to the pediatric service due to prolonged fever and abdominal pain. He received empirical antimicrobial treatment due to suspicion of infection. Abdominal ultrasound showed hepatosplenic abscesses. An IFA detected the presence of IgG antibodies against B. henselae (1:256). Patient was successfully treated with azithromycin and discharged after 7 weeks. CONCLUSIONS: Hepatosplenic abscesses in CSD are rarely reported, particularly in immunocompetent children, with this, only 36 cases in PubMed, Web of Sciences and Scopus bibliographical databases. High rate of suspicion and serological tests availability are of utmost importance in order to detect it and treat it successfully and promptly.

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