Archive for August 18, 2019

Epstein-Barr Virus-Induced Mononucleosis as an Imitator of Severe Preeclampsia.

AJP Rep. january 2017 V.7 N.1 :e5-e7. doi: 10.1055/s-0036-1597265.

Staley SA1, Smid MC2, Dotters-Katz SK2, Stringer EM2.

1 Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

2 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

Abstract

Background

In pregnancy, conditions presenting with hematologic abnormalities, transaminitis, and proteinuria pose diagnostic challenges in pregnancy.

Case

We present the case of an 18-year-old woman, G1P0, at 33 weeks’ gestation with fever of unknown cause, who developed progressively elevated liver enzymes, proteinuria, and thrombocytopenia, due to Epstein-Barr virus (EBV) infection.

Conclusion

Acute infection with EBV should be included in the differential diagnosis of preeclampsia with severe features, particularly in the setting of fever. Supportive treatment and observation may prevent iatrogenic preterm birth.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303016/pdf/10-1055-s-0036-1597265.pdf

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August 18, 2019 at 7:36 pm

Identification of Epstein-Barr Virus in the Human Placenta and Its Pathologic Characteristics.

J Korean Med Sci. December 2017 V.32 N.12 P.1959-1966. doi: 10.3346/jkms.2017.32.12.1959.

Kim Y1,2, Kim HS3, Park JS3, Kim CJ4, Kim WH5.

1 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.

2 Laboratory of Epigenetics, Cancer Research Institute, Seoul National University, Seoul, Korea.

3 Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.

4 Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

5 Department of Pathology, Seoul National University College of Medicine, Seoul, Korea. woohokim@snu.ac.kr.

Abstract

Epstein-Barr virus (EBV), a common pathogen in humans, is suspected as the cause of multiple pregnancy-related pathologies including depression, preeclampsia, and stillbirth. Moreover, transmission of EBV through the placenta has been reported. However, the focus of EBV infection within the placenta has remained unknown to date. In this study, we proved the expression of latent EBV genes in the endometrial glandular epithelial cells of the placenta and investigated the cytological characteristics of these cells. Sixty-eight placentas were obtained from pregnant women. Tissue microarray was constructed. EBV latent genes including EBV-encoding RNA-1 (EBER1), Epstein-Barr virus nuclear antigen 1 (EBNA1), late membrane antigen (LMP1), and RPMS1 were detected with silver in situ hybridization and/or mRNA in situ hybridization. Nuclear features of EBV-positive cells in EBV-infected placenta were compared with those of EBV-negative cells via image analysis. Sixteen placentas (23.5%) showed positive expression of all 4 EBV latent genes; only the glandular epithelial cells of the decidua showed EBV gene expression. EBV infection status was not significantly correlated with maternal, fetal, or placental factors. The nuclei of EBV-positive cells were significantly larger, longer, and round-shaped than those of EBV-negative cells regardless of EBV-infection status of the placenta. For the first time, evidence of EBV gene expression has been shown in placental tissues. Furthermore, we have characterized its cytological features, allowing screening of EBV infection through microscopic examination.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680494/pdf/jkms-32-1959.pdf

August 18, 2019 at 7:35 pm

REVISION – Microbiología del género Raoultella, características clínicas y dificultades para su diagnóstico

Rev Med Inst Mex Seguro Soc. 2018 V.56 N.4 P.486-90

Alberto Castillo-Macías, Amador Flores-Aréchiga, Jorge Llaca-Díaz,a Fernando Pérez-Chávez, Néstor CasillasVega

Universidad Autónoma de Nuevo León, Hospital Universitario “Dr. José Eleuterio González”, Departamento de Patología Clínica. Monterrey, Nuevo León, México

El género Raoultella, perteneciente a la familia Enterobacteriaceae, engloba bacilos gram negativos, oxidasa negativos, aeróbicos, encapsulados e inmóviles. Actualmente se han descrito cuatro especies de este género: Raoultella terrigena (R. terrigena), Raoultella planticola (R. planticola), Raoultella ornithinolytica (R. ornithinolytica) y Raoultella electrica (R. electrica), entre las que la R. planticola y la R. ornithinolytica son las más importantes por su probable asociación como agentes patógenos. Se ha subestimado la incidencia del género por la dificultad que presenta su caracterización al ser mal

identificado como Klebsiella spp., al usar métodos fenotípicos manuales y automatizados convencionales. La rápida y correcta detección de Raoultella spp. ha ido aumentando desde la llegada de espectrómetros de masas (MALDI-TOF MS), útiles en la diferenciación entre Klebsiella spp. y Raoultella spp. Se han identificado 80 casos de bacteremia por Raoultella spp., con infección primaria en diversos sitios, por lo que es importante hacer énfasis en su correcta detección en los hospitales y centros de atención médica

PDF

https://www.medigraphic.com/pdfs/imss/im-2018/im185i.pdf

August 18, 2019 at 5:49 pm

Emerging role of Raoultella ornithinolytica in human infections: a series of cases and review of the literature

International Journal of Infectious Diseases April 2016 V.45 P.65-71

Highlights

  • Raoultella ornithinolytica pneumonia and pleural effusion were observed in 24% of cases.
  • Cases of osteomyelitis, meningitis, and cerebral abscess are reported for the first time.
  • The proportion of R. ornithinolytica isolates resistant to antibiotics was relatively high.
  • The mortality rate related to infection was 5% of cases.
  • R. ornithinolytica is underreported and particularly associated with invasive procedures.

Background

Raoultella ornithinolytica is known to inhabit aquatic environments. The clinical features and outcomes of human infections caused by R. ornithinolytica have been reported for only a limited number of cases.

Methods

A retrospective study of cases of infection caused by R. ornithinolytica managed at four university hospital centres during the period before and after the introduction of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was performed. The aim was to describe the clinical and microbiological characteristics, treatments, and outcomes.

Results

Among 187 R. ornithinolytica isolates identified for which clinical information was available, 71 were considered colonizers and 116 were pathogenic. A total of 112 cases of R. ornithinolytica infection were identified. Urinary tract infections, gastrointestinal infections, wound and skin infections, and bacteraemia were observed in 36%, 14%, 13%, and 5% of cases, respectively. Associated infections that have been poorly reported, such as respiratory infections, i.e. pneumonia and pleural effusion, were observed in 24% of cases. Additional diseases reported here for the first time included osteomyelitis, meningitis, cerebral abscess, mediastinitis, pericarditis, conjunctivitis, and otitis. The proportion of R. ornithinolytica isolates resistant to antibiotics was found to be relatively high: 4% of isolates were resistant to ceftriaxone, 6% to quinolones, and 13% to co-trimoxazole. The mortality rate related to infection was 5%.

Conclusions

R. ornithinolytica is an underreported, emerging hospital-acquired infection and is particularly associated with invasive procedures. R. ornithinolytica should never be considered simply a saprophytic bacterium that occasionally contaminates bronchial lavage or other deep respiratory samples or surgical sites. Physicians should be aware of the high rates of antimicrobial resistance of R. ornithinolytica isolates so that immediate broad-spectrum antibiotic treatment can be established before accurate microbiological results are obtained.

FULL TEXT

https://www.sciencedirect.com/science/article/pii/S1201971216000345

PDF (CLIC en PDF)

 

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August 18, 2019 at 5:47 pm


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