RESUMO
Typhlitis, is also known as neutropenic enterocolitis, affects the cecum and distal ileum. It was frequently encountered in pediatric patients who were undergoing treatment for leukemia. Nonetheless, it can affect adult patients, regardless of the cause of the immunosuppression. We report the case of a 20-year-old patient who was receiving chemotherapy for Osteosarcoma, who had a 6-day history of nausea and vomiting, fever sensation, diarrhea, and diffuse abdominal pain. Physical examination was relevant for hemodynamic instability, a distended and tender abdomen predominantly in the right iliac fossa. The laboratory workup showed severe neutropenia, thrombocytopenia, and electrolyte disturbances. The image studies evidenced edema of the ascending colon and cecum. Treatment was started with vasopressor support, correction of electrolyte alterations, blood cell and platelet transfusion, G-CSF, hydration, broad spectrum antibiotic therapy, initially with adequate clinical and laboratory response. After a few days, he presented lower gastrointestinal bleeding which was treated by conservative management. In conclusion, typhlitis must be suspected in every patient developing neutropenia as a reaction to chemotherapy and who also presents gastrointestinal symptoms, such as nausea, vomiting, diarrhea, and intense abdominal pain.
Assuntos
Enterocolite Neutropênica , Neutropenia , Tiflite , Masculino , Adulto , Humanos , Criança , Adulto Jovem , Enterocolite Neutropênica/diagnóstico , Enterocolite Neutropênica/etiologia , Enterocolite Neutropênica/terapia , Tiflite/complicações , Neutropenia/complicações , Dor Abdominal/etiologia , Diarreia , VômitoRESUMO
Histomonas meleagridis and Tetratrichomonas gallinarum are two protozoans responsible for mortality associated with typhlohepatitis in poultry. In this study, the etiology of high mortality in Chukar partridges suspected of infection with these agents was investigated pathologically and molecularly. Twelve healthy partridges during the laying period and 30 partridges that died due to disease and were included in the study. In blood analysis, increased levels of WBC, NEU, LYM, MONO, EO and BASO suggesting bacterial and/or parasitic infection; decreased levels of HGB, MCH and MCHC, which are markers of anemia; and increased AST and LDH levels, which are important for liver degenerations. In the liver, which is one of the most pathologically affected organs, multifocal necrosis foci that sometimes merge with each other and spread to large areas, and severe fibrino-necrotic typhlitis were detected. There was amyloid deposition in the space of Disse and vascular sinuses in the liver. PAS positive protozoal agents were observed in and around the lesioned areas. By PCR analyzes using specific primers, 11 of the samples were positive for H. meleagridis only, whereas 5 were positive for T. gallinarum only; 14 samples tested positive for both agents. Sequence analysis showed 100% identity between all samples resulting in positive PCR. In addition, Escherichia coli was produced in microbiological culture (27 of 30). When all the results were evaluated together, it was concluded that H. meleagridis and T. gallinarum and secondary E. coli may cause high mortality in partridges under lay stress.
Histomonas meleagridis e Tetratrichomonas gallinarum são dois protozoários responsáveis pela mortalidade associada à tiflohepatite em aves. Neste estudo, a etiologia da alta mortalidade em perdizes Chukar com suspeita de infecção por esses agentes foi investigada patologicamente e molecularmente. Foram incluídas no estudo 30 perdizes que morreram devido à doença e 12 perdizes saudáveis durante o período de postura. Na análise sanguínea, níveis aumentados de WBC, NEU, LYM, MONO, EO e BASO sugerindo infecção bacteriana e/ou parasitária; diminuição dos níveis de HGB, MCH e MCHC, que são marcadores de anemia; e aumento dos níveis de AST e LDH, que são importantes para as degenerações hepáticas. No fígado, que é um dos órgãos patologicamente mais acometidos, foram detectados focos de necrose multifocais que às vezes se fundem e se espalham para grandes áreas, e tiflite fibrino-necrótica grave no ceco. Houve deposição de amiloide no espaço de Disse e seios vasculares no fígado. Agentes protozoários PAS positivos foram observados dentro e ao redor das áreas lesionadas. Pelas análises de PCR com primers específicos, 11 das amostras foram positivas apenas para H. meleagridis, enquanto 5 foram positivas apenas para T. gallinarum; 14 amostras testaram positivo para ambos os agentes. A análise de sequência mostrou 100% de identidade entre todas as amostras resultando em PCR positivo. Além disso, Escherichia coli foi produzida em cultura microbiológica. Quando todos os resultados foram avaliados em conjunto, concluiu-se que H. meleagridis e T. gallinarum e E. coli secundária podem causar alta mortalidade em perdizes sob estresse de postura.
Assuntos
Animais , Feminino , Infecções Protozoárias em Animais , Galliformes/parasitologia , Galliformes/sangue , Tiflite/etiologia , Hepatite Animal/etiologia , Turquia , Escherichia coli , Tiflite/veterináriaRESUMO
Background: Histomoniasis is a disease caused by Histomonas meleagridis, a flagellated protozoan that can cause severenecrotizing hepatitis and typhlitis in several bird species. The disease has a cosmopolitan distribution. In experimentalinfection, peacocks (Pavo spp.) showed susceptibility to histomoniasis, however there are few reports on natural histomoniasis in this species. In northeastern Brazil, reports about its occurrence in avian species are scarce and nonexistent inpeacocks. Therefore, this report aims to describe the epidemiological and clinicopathological aspects of a histomoniasiscase in a peacock (Pavo cristatus) in the Brazilian semiarid region.Case: A 3-month-old male peacock with a history of apathy and anorexia was attended in the Veterinary Hospital of theUniversidade Federal Rural do Semi-Árido (UFERSA), Mossoró, RN, Brazil. The animal was raised extensively in a farmwithout basic sanitary measures, also with a history of living with animals of different species. After clinical examination, inwhich intense apathy and weight loss were confirmed, the bird was submitted to emergency therapeutic measures, howeverthere was no clinical improvement and the bird died. At necropsy, intense diffuse bilateral necrotizing typhlitis and multifocalto coalescent necrotizing hepatitis were observed. Fragments of the organs were collected in 10% neutral buffered formalinfor histopathological analysis and cecal content were collected for microbiological analysis. Histopathology of the cecumrevealed transmural necrotizing typhlitis associated with myriads of trophozoites morphologically compatible with Histomonasmeleagridis. The same microorganisms were observed in association with necrotizing hepatitis lesions, which allowed thediagnosis of histomoniasis. Also, the bacterium Pantoea agglomerans was isolated from the cecal content...(AU)
Assuntos
Animais , Masculino , Aves Domésticas/parasitologia , Aves Domésticas/microbiologia , Infecções por Protozoários , Infecções por Enterobacteriaceae/veterinária , Contagem de Células Sanguíneas/veterinária , Pantoea/isolamento & purificação , Tiflite/veterinária , Hepatite AnimalRESUMO
Background: Histomoniasis is a disease caused by Histomonas meleagridis, a flagellated protozoan that can cause severenecrotizing hepatitis and typhlitis in several bird species. The disease has a cosmopolitan distribution. In experimentalinfection, peacocks (Pavo spp.) showed susceptibility to histomoniasis, however there are few reports on natural histomoniasis in this species. In northeastern Brazil, reports about its occurrence in avian species are scarce and nonexistent inpeacocks. Therefore, this report aims to describe the epidemiological and clinicopathological aspects of a histomoniasiscase in a peacock (Pavo cristatus) in the Brazilian semiarid region.Case: A 3-month-old male peacock with a history of apathy and anorexia was attended in the Veterinary Hospital of theUniversidade Federal Rural do Semi-Árido (UFERSA), Mossoró, RN, Brazil. The animal was raised extensively in a farmwithout basic sanitary measures, also with a history of living with animals of different species. After clinical examination, inwhich intense apathy and weight loss were confirmed, the bird was submitted to emergency therapeutic measures, howeverthere was no clinical improvement and the bird died. At necropsy, intense diffuse bilateral necrotizing typhlitis and multifocalto coalescent necrotizing hepatitis were observed. Fragments of the organs were collected in 10% neutral buffered formalinfor histopathological analysis and cecal content were collected for microbiological analysis. Histopathology of the cecumrevealed transmural necrotizing typhlitis associated with myriads of trophozoites morphologically compatible with Histomonasmeleagridis. The same microorganisms were observed in association with necrotizing hepatitis lesions, which allowed thediagnosis of histomoniasis. Also, the bacterium Pantoea agglomerans was isolated from the cecal content...
Assuntos
Masculino , Animais , Aves Domésticas/microbiologia , Aves Domésticas/parasitologia , Infecções por Enterobacteriaceae/veterinária , Infecções por Protozoários , Contagem de Células Sanguíneas/veterinária , Hepatite Animal , Pantoea/isolamento & purificação , Tiflite/veterináriaRESUMO
Trichuris spp. infections can cause typhlitis or typhlocolitis in many species, but there are no published studies about its pathology in cats. Trichuris sp. infection in cats appears to be rare in most parts of the world but is frequent in some tropical and subtropical regions. The purpose of this study was to describe intestinal lesions associated with natural Trichuris sp. infections in cats of St. Kitts, West Indies. Comprehensive autopsies, histopathological assessment of small and large intestine, and total worm counts were performed in a cross-sectional study of 30 consecutive feline mortalities. Trichuris were found in 17 of 30 (57%; 95% confidence interval, 39%-74%) of the study cats with a median worm count of 11 (range, 1-170), indicating most cats had a low-intensity infection. Trichuris infection was associated with typhlitis but not consistency of feces or body condition score. In most cats examined, the typhlitis was categorized as mild (10/15, 67%) and, less frequently, moderate (2/15, 13%) or marked (3/15, 20%). The inflammatory infiltrate varied from predominantly eosinophilic (5/15, 33%) to neutrophilic (4/15, 27%), a mixture of eosinophilic and neutrophilic (2/15, 13%), a mixture of neutrophilic and lymphoplasmacytic (1/15, 7%), or a mixture of eosinophilic, neutrophilic, and lymphoplasmacytic (3/15, 20%). In some cats, surface erosions and catarrhal exudate were adjacent to adult worms. These findings are similar to those reported with low-intensity Trichuris infections in other species.
Assuntos
Doenças do Gato/parasitologia , Gastroenteropatias/veterinária , Tricuríase/veterinária , Trichuris/isolamento & purificação , Tiflite/veterinária , Animais , Doenças do Gato/epidemiologia , Doenças do Gato/patologia , Gatos , Estudos Transversais , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/parasitologia , Gastroenteropatias/patologia , Prevalência , Tricuríase/epidemiologia , Tricuríase/parasitologia , Tricuríase/patologia , Tiflite/epidemiologia , Tiflite/parasitologia , Tiflite/patologia , Índias Ocidentais/epidemiologiaRESUMO
Diseases related to the alimentary system are the main cause of death in horses. This retrospective study aimed to describe the pathological findings of fatal parasite-induced enteritis and typhlocolitis caused by cyathostominae, Eimeria leuckarti, Balantidium coli, and Strongyloides westeri in horses. The records of parasite-induced intestinal lesions in horses necropsied in Southern Brazil between 2005 and 2017 were reviewed. Ten horses had fatal parasitic enteritis and/or typhlocolitis, and the main causes were: cyathostominae typhlocolitis (6/10), E. leuckarti enteritis (1/10), S. westeri enteritis (1/10), B. coli colitis related to cyathostominae (1/10), and infection by multiple agents (1/10). Cyathostominae typhlocolitis showed marked mucosal thickening, with multifocal elevated nodules containing tangled filiform parasites. Microscopic examination revealed that the mucosa and submucosa had encysted parasitic structures surrounded by eosinophilic and granulomatous inflammation. E. leuckarti enteritis was microscopically characterized by macrogamonts, microgamonts, and oocysts inside the host cells. S. westeri enteritis showed microscopic atrophy of the villi with numerous mucosal encysted parasitic structures. B. coli typhlocolitis showed severe diffuse mucosal reddening, with microscopic superficial mucosal necrosis associated with multiple protozoan trophozoites. Fatal parasite-induced enteritis and typhlocolitis are important causes of death in horses in Southern Brazil.
Assuntos
Balantidium/isolamento & purificação , Colite/parasitologia , Eimeria/isolamento & purificação , Enterite/parasitologia , Doenças dos Cavalos/parasitologia , Strongyloides/isolamento & purificação , Tiflite/parasitologia , Animais , Colite/mortalidade , Enterite/mortalidade , Fezes/parasitologia , Feminino , Doenças dos Cavalos/mortalidade , Cavalos , Masculino , Estudos Retrospectivos , Estações do Ano , Tiflite/mortalidadeRESUMO
Abstract Diseases related to the alimentary system are the main cause of death in horses. This retrospective study aimed to describe the pathological findings of fatal parasite-induced enteritis and typhlocolitis caused by cyathostominae, Eimeria leuckarti, Balantidium coli, and Strongyloides westeri in horses. The records of parasite-induced intestinal lesions in horses necropsied in Southern Brazil between 2005 and 2017 were reviewed. Ten horses had fatal parasitic enteritis and/or typhlocolitis, and the main causes were: cyathostominae typhlocolitis (6/10), E. leuckarti enteritis (1/10), S. westeri enteritis (1/10), B. coli colitis related to cyathostominae (1/10), and infection by multiple agents (1/10). Cyathostominae typhlocolitis showed marked mucosal thickening, with multifocal elevated nodules containing tangled filiform parasites. Microscopic examination revealed that the mucosa and submucosa had encysted parasitic structures surrounded by eosinophilic and granulomatous inflammation. E. leuckarti enteritis was microscopically characterized by macrogamonts, microgamonts, and oocysts inside the host cells. S. westeri enteritis showed microscopic atrophy of the villi with numerous mucosal encysted parasitic structures. B. coli typhlocolitis showed severe diffuse mucosal reddening, with microscopic superficial mucosal necrosis associated with multiple protozoan trophozoites. Fatal parasite-induced enteritis and typhlocolitis are important causes of death in horses in Southern Brazil.
Resumo Doenças relacionadas ao sistema alimentar são as principais causas de morte em equinos. Esse estudo teve o objetivo de descrever aspectos patológicos de enterites e tiflocolites parasitárias fatais por ciatostomíneos, Eimeria leuckarti, Balantidium coli e Strongyloides westeri, em equinos. Foi revisado o banco de dados de lesões intestinais parasitárias em equinos necropsiados de 2005 a 2017, no Sul do Brasil. Dez equinos apresentaram enterite e/ou tiflocolite parasitária fatal, e as principais foram: tiflocolite por ciatostomíneos (6/10), enterite por E. leuckarti (1/10), enterite por S. westeri (1/10), colite por B. coli com ciatostomíneos (1/10), e infecção por múltiplos agentes (1/10). A tiflocolite por ciatostomíneos exibia acentuado espessamento da mucosa, com nódulos multifocais elevados contendo parasitas filiformes. Microscopicamente, a mucosa e submucosa apresentavam estruturas parasitárias encistadas envoltas por inflamação eosinofílica e granulomatosa. A enterite por E. leuckarti era caracterizada microscopicamente por macrogamontes, microgamontes e oocistos no interior de células do hospedeiro. Microscopicamente, a enterite por S. westeri apresentava atrofia de vilosidades com numerosas estruturas parasitárias encistadas na mucosa. A tiflocolite por B. coli exibia avermelhamento acentuado difuso da mucosa, e microscopicamente necrose superficial associada a múltiplos trofozoítos protozoáricos. Enterites e tiflocolites fatais parasitárias são importantes causas de morte em equinos no Sul do Brasil.
Assuntos
Animais , Masculino , Feminino , Strongyloides/isolamento & purificação , Balantidium/isolamento & purificação , Colite/parasitologia , Eimeria/isolamento & purificação , Enterite/parasitologia , Tiflite/parasitologia , Doenças dos Cavalos/parasitologia , Estações do Ano , Estudos Retrospectivos , Colite/mortalidade , Enterite/mortalidade , Tiflite/mortalidade , Fezes/parasitologia , Doenças dos Cavalos/mortalidade , CavalosRESUMO
Background: Edwardsiella tarda has been report as etiology of gastroenteritis in both human and veterinary medicine,usually associated with exposure to aquatic environments in immunocompromised individuals. The present report describesa case of typhlocolitis in a cow in the west region of Santa Catarina state, Brazil.Case: After clinically evaluation of animal and proceeding euthanasia and realized the necropsy. Tissue samples were collected, and routinely processed for histological examination. Histopathological lesions were described as mild, moderateand severe. Tissue and swabs samples of small and large intestine were sent to standard microbiological culture processing.At necropsy, cattle presented severe dehydration and emaciation. Eye and vaginal mucosa were severely congested. Theopening of the abdominal cavity revealed a great amount of greenish fluid and a large amount of fecal material, associatedwith diffuse severe peritonitis, evidenced by hyperemia and severe deposition of fibrin in the visceral and parietal peritonealsurface. In the serosa of the cecum, there were two points of rupture, observed in the proximal colon. The mucosa of cecumand colon were severely edematous, hyperemic, and presented diffusely distributed pinpoint round hemorrhages, as wellas fibrinonecrotic material adhered to the surface. Histologically, in the mucosa of cecum and colon, moderate to severediffuse inflammatory infiltrate of neutrophils, lymphocytes and plasma cells associated with multifocal severe necrosiswere observed. Moderate diffuse fibrin deposition was evidenced in the submucosa and muscular, as well as multifocalmoderate necrosis in the muscular layer. In the serous, severe diffuse inflammatory infiltrate of neutrophils associated withfibrin deposition and innumerous coccoid bacterial colonies were observed. The samples subjected to bacterial isolationshowed growth of Edwardsiella tarda. All samples were negative for Salmonella spp. and...(AU)
Assuntos
Animais , Feminino , Bovinos , Edwardsiella tarda , Colite/veterinária , Tiflite/veterinária , Doenças do Ceco/veterinária , Colo/patologia , Gastroenterite/veterináriaRESUMO
Background: Edwardsiella tarda has been report as etiology of gastroenteritis in both human and veterinary medicine,usually associated with exposure to aquatic environments in immunocompromised individuals. The present report describesa case of typhlocolitis in a cow in the west region of Santa Catarina state, Brazil.Case: After clinically evaluation of animal and proceeding euthanasia and realized the necropsy. Tissue samples were collected, and routinely processed for histological examination. Histopathological lesions were described as mild, moderateand severe. Tissue and swabs samples of small and large intestine were sent to standard microbiological culture processing.At necropsy, cattle presented severe dehydration and emaciation. Eye and vaginal mucosa were severely congested. Theopening of the abdominal cavity revealed a great amount of greenish fluid and a large amount of fecal material, associatedwith diffuse severe peritonitis, evidenced by hyperemia and severe deposition of fibrin in the visceral and parietal peritonealsurface. In the serosa of the cecum, there were two points of rupture, observed in the proximal colon. The mucosa of cecumand colon were severely edematous, hyperemic, and presented diffusely distributed pinpoint round hemorrhages, as wellas fibrinonecrotic material adhered to the surface. Histologically, in the mucosa of cecum and colon, moderate to severediffuse inflammatory infiltrate of neutrophils, lymphocytes and plasma cells associated with multifocal severe necrosiswere observed. Moderate diffuse fibrin deposition was evidenced in the submucosa and muscular, as well as multifocalmoderate necrosis in the muscular layer. In the serous, severe diffuse inflammatory infiltrate of neutrophils associated withfibrin deposition and innumerous coccoid bacterial colonies were observed. The samples subjected to bacterial isolationshowed growth of Edwardsiella tarda. All samples were negative for Salmonella spp. and...
Assuntos
Feminino , Animais , Bovinos , Colite/veterinária , Colo/patologia , Doenças do Ceco/veterinária , Edwardsiella tarda , Tiflite/veterinária , Gastroenterite/veterináriaRESUMO
Antecedentes: la diverticulitis cecal es una patología poco común en los países occidentales. Clínicamente es indistinguible de una apendicitis aguda. Objetivos: exhibir los resultados de acuerdo con diferentes abordajes terapéuticos. Material y métodos: se presentan cinco casos de diverticulitis cecal tratados en nuestra institución entre enero de 2013 y diciembre de 2015. Revisión retrospectiva de historias clínicas e imágenes. Revisión de la literatura. Resultados: fueron incluidos cinco pacientes. En cuatro hubo resolución quirúrgica y uno tuvo buena evolución con tratamiento médico. Conclusiones: si bien es poco frecuente, la diverticulitis cecal debe considerarse dentro de los diagnósticos diferenciales frente a un cuadro de dolor abdominal localizado en fosa ilíaca derecha acompañado de estudios por imágenes no categóricos de apendicitis aguda.
Background: cecal diverticulitis is a rare disease in western countries. It is clinically indistinguishable from acute appendicitis. Objetive: to show outcome with different therapeutic approaches. Material and methods: we present five cases of cecal diverticulitis treated at our institution between January 2013 and December 2015. Retrospective review of medical records and images. Review of the literature. Results: five patients were included. Four cases required surgical treatment while one patient resolved with medical treatment. Conclusions: Although it is rare, cecal diverticulitis must be considered within the differential diagnoses in the face of abdominal pain located in the right iliac fossa and non-categorical imaging of acute appendicitis.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Diverticulite/cirurgia , Tiflite/patologia , Gentamicinas/administração & dosagem , Tomografia Computadorizada por Raios X , Dor Abdominal/complicações , Ultrassonografia , Laparoscopia , Colectomia/métodos , Diverticulite/tratamento farmacológico , Diverticulite/diagnóstico por imagem , Abdome Agudo/complicações , Metronidazol/administração & dosagemRESUMO
INTRODUCTION: Typhlitis is an abdominal complication of cancer chemotherapy, affecting mostly patients receiving intensive chemotherapeutic regimens with high potential to induce mucosal damage, such as patients with acute leukemia. Despite being relatively frequent, there are no randomized trials or high-quality cohort studies addressing important aspects of the diagnosis and management of the disease. Areas covered: In this review we discuss the gaps in the literature, acknowledging that the evidences for recommendations regarding the management of typhlitis are mostly expert opinion. We performed a computerized search of the MEDLINE database (PubMed version) for appropriate articles published from 1963 through July, 2016 in English language. Thereafter the reference lists of all identified studies were screened, reviewing the abstracts of all potentially pertinent articles for inclusion. Expert commentary: The diagnosis of typhlitis still relies on clinical and radiologic features consisting of fever, abdominal pain and thickness of a segment of the bowel wall, as seen by ultrasonography or CT scan. The treatment consists in antimicrobial therapy with a regimen that covers the most frequent pathogens, taking into consideration the local epidemiology. Other measures include bowel rest, and the use of G-CSF. Surgery is indicated only in selected situations.
Assuntos
Leucemia/complicações , Tiflite/etiologia , Doença Aguda , Adulto , Terapia Combinada , Gerenciamento Clínico , Humanos , Incidência , Imagem Multimodal , Fenótipo , Prognóstico , Fatores de Risco , Resultado do Tratamento , Tiflite/diagnóstico , Tiflite/epidemiologia , Tiflite/terapia , Adulto JovemAssuntos
Bacillus/fisiologia , Tiflite/microbiologia , Tiflite/patologia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neutropenia , Adulto JovemRESUMO
BACKGROUND: Sepsis- associated encephalopathy (SAE) is an early and common feature of severe infections. Oxidative stress is one of the mechanisms associated with the pathophysiology of SAE. The goal of this study was to investigate the involvement of NADPH oxidase in neuroinflammation and in the long-term cognitive impairment of sepsis survivors. METHODS: Sepsis was induced in WT and gp91(phox) knockout mice (gp91(phox-/-)) by cecal ligation and puncture (CLP) to induce fecal peritonitis. We measured oxidative stress, Nox2 and Nox4 gene expression and neuroinflammation in the hippocampus at six hours, twenty-four hours and five days post-sepsis. Mice were also treated with apocynin, a NADPH oxidase inhibitor. Behavioral outcomes were evaluated 15 days after sepsis with the inhibitory avoidance test and the Morris water maze in control and apocynin-treated WT mice. RESULTS: Acute oxidative damage to the hippocampus was identified by increased 4-HNE expression in parallel with an increase in Nox2 gene expression after sepsis. Pharmacological inhibition of Nox2 with apocynin completely inhibited hippocampal oxidative stress in septic animals. Pharmacologic inhibition or the absence of Nox2 in gp91(phox-/-) mice prevented glial cell activation, one of the central mechanisms associated with SAE. Finally, treatment with apocynin and inhibition of hippocampal oxidative stress in the acute phase of sepsis prevented the development of long-term cognitive impairment. CONCLUSIONS: Our results demonstrate that Nox2 is the main source of reactive oxygen species (ROS) involved in the oxidative damage to the hippocampus in SAE and that Nox2-derived ROS are determining factors for cognitive impairments after sepsis. These findings highlight the importance of Nox2-derived ROS as a central mechanism in the development of neuroinflammation associated with SAE.
Assuntos
Proteínas de Bactérias/metabolismo , Transtornos Cognitivos/etiologia , NADH NADPH Oxirredutases/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Sepse/complicações , Acetofenonas/uso terapêutico , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Aprendizagem da Esquiva/efeitos dos fármacos , Quimiocina CCL2/metabolismo , Modelos Animais de Doenças , Hipocampo/metabolismo , Hipocampo/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , NADPH Oxidases/metabolismo , Receptores Imunológicos/deficiência , Sepse/tratamento farmacológico , Sepse/patologia , Tiflite/complicações , Tiflite/etiologiaRESUMO
This is a case of a 34 years old male Hispanic patient with history of AIDS who presented to the ER with severe right lower quadrant abdominal pain of three days of evolution, associated with fever, chills, nausea, vomiting, watery diarrhea, weakness and general malaise. Acute appendicitis, Clostridium Difficile Colitis and Ischemic Colitis were the most important clinical conditions to consider in the differential diagnosis. Abdominal CT with IV contrast demonstrated thickening of the ascending colonic wall a finding highly suggestive of a transmural inflammatory necrotizing colitis of infectious etiology. Broad-spectrum antibiotic therapy, cancidas and ganciclovir were started with mark clinical improvement. IgG antibodies against CMV were elevated. Typhlitis is a serious illness that affects patients with impairment in immunity. It is important to include it in the differential diagnosis of an HIV/AIDS patient that presents with RLQ pain and fever. Contrast enhanced CT-Scan is mandatory to establish the diagnosis and to differentiate typhlitis from other intra-abdominal pathologies. Therapy needs to be individualized.