Search Results (120)

Background/Objectives: Caseous lymphadenitis (CLA), caused by Corynebacterium pseudotuberculosis, is difficult to control on goat farms because of subclinical infection, abscess rupture, environmental contamination, and repeated herd-level exposure. This study evaluated a Korean inactivated CLA vaccine under commercial goat farm conditions and combined vaccination outcomes with farm-level bacteriological profiling. Methods: Goats from three commercial farms were allocated according to baseline CLA serostatus and vaccination status into seropositive vaccinated, seronegative vaccinated, seropositive non-vaccinated, and seronegative non-vaccinated control groups. Vaccinated goats received two intramuscular doses at weeks 0 and 4. Clinical signs, external abscess occurrence, growth performance, CLA-specific antibody responses, and abscess bacterial loads were monitored. Farm-level microbial profiles were assessed using culture, MALDI-TOF MS, and targeted PCR. Results: Baseline antibody classification showed strong agreement between the commercial CLA ELISA and the in-house whole-bacterial IgG ELISA, with a Spearman’s rho of 0.89 (p < 0.001) and 96.7% classification agreement. Vaccination induced CLA-specific antibody responses in both assays and was not associated with a persistent reduction in growth performance. External abscesses were observed only in baseline seropositive goats. Abscesses occurred in 1/30 vaccinated and 2/15 non-vaccinated seropositive goats, but the difference was not statistically significant (p = 0.254). Microbial profiling showed farm-dependent detection patterns. Conclusions: The vaccine induced CLA-specific antibody responses (immunogenicity) with acceptable tolerability. The exploratory abscess endpoint was underpowered, and clinical protection was not confirmed; larger studies are needed. Full article

Introduction: Hairy cell leukemia is a rare, indolent chronic B cell lymphoproliferative disorder characterized by cytopenia, splenomegaly and profound immune dysfunction, predisposing affected individuals to opportunistic infections including non-tuberculous mycobacteria. Concurrent presentation with disseminated mycobacterial infection is un-common and may pose significant diagnostic challenges. Case Presentation: We report the case of a 68-year-old Caucasian man with a history of splenectomy who presented with fever, lymphadenopathy, leukopenia and a generalized rash. Initial investigations including infectious, hematological and vasculitis workups were inconclusive. Lymph node histology demonstrated necrotizing lymphadenitis, which in the context of an otherwise negative investigations was initially suggestive of Kikuchi–Fujimoto disease. Subsequently, cultures from lymph node tissue and blood yielded Mycobacterium avium complex, establishing a diagnosis of disseminated infection. Further bone marrow evaluation with flow cytometry ultimately confirmed underlying hairy cell leukemia. Conclusions: This case highlights how an impaired immune milieu may obscure classic clinical and histopathological features, contributing to diagnostic delay and potentially inappropriate immunosuppressive treatment. Clinicians should maintain a high index of suspicion for underlying hematological malignancy in patients presenting with unexplained cytopenia in association with atypical infections. Early consideration of bone marrow evaluation can be crucial. Full article

Pathogenicity islands (PAIs) are regions of bacterial genomes that harbor genes encoding virulence factors. Identifying molecules that enhance pathogenicity is crucial for understanding the mechanisms pathogens employ to cause disease and their evolution. Corynebacterium pseudotuberculosis (C. pseudotuberculosis) is a pathogenic microorganism that causes caseous lymphadenitis (CLA) in sheep and goats. Despite its prevalence in Mexico, its genetic material has not been analyzed for virulence factors acquired through horizontal gene transfer. Therefore, the aim of this study was to characterize the complete genomes of Mexican C. pseudotuberculosis strains and identify virulence-related genes harbored with PAIs. Seventeen strains of C.pseudotuberculosis biovar ovis isolated from Mexico were whole-genome sequenced using illumina technology, assembled de novo with SPAdes, and annotated using Prokka. PAIs were predicted with GIPSy based on genomic signatures associated with horizontal gene transfer, including G + C deviation, codon usage, virulence factors, transposases, and tRNA-flanking regions. Positive selection was assessed using POTION v1.2 by identifying orthologous groups enriched in non-synonymous substitutions. This represents the first comprehensive PAI analysis of Mexican C. pseudotuberculosis strains, identifying 14 putative pathogenicity islands harboring 51 virulence-associated genes. Additionally, positive selection analysis identified five coding sequences, including radA and rpiB, that are undergoing adaptive evolutionary changes. These findings elucidate the pathogenic mechanisms and genomic plasticity of Mexican C. pseudotuberculosis strains. They also highlight novel genetic targets for vaccine and therapeutic development against CLA. Full article

C. pseudotuberculosis is a Gram-positive pathogenic bacterium that infects various animals, causing diseases such as caseous lymphadenitis, leading to significant economic losses in the livestock industry and posing zoonotic risks. This study targeted the conserved gyrA gene fragment of this bacterium, designed specific primers, optimized the reaction system and conditions, and established a high-resolution melting curve (HRM) detection method with potential utility for preliminary molecular screening. Validation showed that this method exhibits strong specificity, producing specific amplification only for the target biovars. The melting temperatures (Tm values) for the two biovars were 86.16 ± 0.05 °C and 86.92 ± 0.05 °C, respectively, allowing clear differentiation. It demonstrated high sensitivity, with minimum detection limits of 28 copies/μL and 25 copies/μL for standard plasmids of the ovis and equi biovars, respectively. The method also showed good reproducibility, with intra- and inter-batch coefficients of variation both below 1.0%. Applied to 133 clinical nasal swab samples from goats in Fujian Province, the method detected a positivity rate of 19.5% and indicates that a biovar equi-like gene fragment was detected in goat nasal swabs from Fujian Province via molecular screening. The HRM method developed in this study is sensitive, specific, simple, and cost-effective, enabling rapid detection and biovar differentiation of C. pseudotuberculosis. It is suitable for large-scale clinical sample screening and provides an efficient technical approach for epidemiological monitoring and precise control of the disease. Full article

Background: Cervicofacial actinomycosis is an uncommon chronic bacterial infection that can mimic neoplasia or granulomatous disease because of its infiltrative presentation. Diagnosis is often delayed, particularly in pregnant patients in whom imaging and invasive procedures may be limited. Case report: A 25-year-old woman at 14 weeks of gestation presented with a multiple-fistulized cervical mass. The lesion was initially diagnosed as a cutaneous furuncle in a private dermatology practice and treated with topical therapy, resulting in only transient improvement. Two weeks later, multiple fistulizations developed, prompting consultation in the emergency department. ENT assessment and ultrasound raised suspicion of cervical actinomycosis versus fistulized tuberculous lymphadenitis. Considering the pregnancy, drainage of the collection was performed under local anesthesia and empiric antibiotic therapy with amoxicilin-clavulanic acid was started. Microbiological confirmation of Actinomyces (Schaalia) georgiae led to infectious disease evaluation that established a long-term antibiotic therapy while monitoring fetal safety. Progressive clinical improvement was observed, with complete resolution after three months. The pregnancy progressed without complications and fetal morphology remained normal under therapy. Conclusions: This case illustrates the diagnostic complexity of cervicofacial actinomycosis caused by A. georgiae during pregnancy, representing the first such report in the current literature, and emphasizes the need for a multidisciplinary approach. Full article

Antitubercular drug-induced liver injury (ATDILI) poses a significant obstacle to successful tuberculosis treatment, including for tuberculous lymphadenitis. Its global incidence varies considerably, typically ranging from 2% to 30%, influenced by factors like patient demographics, co-morbidities, and geographical context. Despite some findings suggesting potentially lower rates in tuberculous lymphadenitis, the inherent hepatotoxic nature of standard anti-TB drugs means the risk remains clinically relevant. Key risk factors for ATDILI encompass older age, female gender, pre-existing liver conditions, HIV co-infection, malnutrition, alcoholism, and genetic polymorphisms, particularly in N-acetyltransferase 2 which affects isoniazid metabolism. The mechanisms of injury are drug-specific: isoniazid primarily causes hepatocellular damage via oxidative stress from toxic metabolites, while rifampicin induces cholestasis and endoplasmic reticulum stress, and pyrazinamide is linked to mitochondrial dysfunction. Management involves prompt withdrawal of antitubercular therapy when liver enzyme thresholds are exceeded, followed by careful reintroduction. Challenges are amplified in resource-limited settings due to higher prevalence of risk factors and limited access to consistent monitoring and sophisticated diagnostics. Promising advancements include safer regimens like the 3-month once-weekly isoniazid-rifapentine (3HP) for latent TB, which significantly reduces hepatotoxicity. The development of shorter active TB regimens and novel anti-TB drugs with improved safety profiles further aims to enhance treatment adherence and reduce ATDILI incidence, ultimately improving patient outcomes globally. Full article

Extrapulmonary tuberculosis (EPTB) is an infectious disease characterized by the invasion of Mycobacterium tuberculosis beyond the lungs. Diagnosis is frequently delayed due to nonspecific clinical presentations that vary by organ system, making diagnostic imaging essential for disease detection, characterization, and treatment monitoring. The objective of this review is to examine and summarize imaging-based approaches for the diagnostic evaluation of EPTB across multiple body systems, including the central nervous system, spine, cardiovascular system, lymphatic system, abdominal and hepatic organs, genitourinary tract, cutaneous and soft tissue, and other rare sites. While computed tomography, magnetic resonance imaging, positron emission tomography, and ultrasound are widely used in the evaluation of EPTB, their ability to provide a definitive diagnosis is often limited by nonspecific radiologic findings. Emerging techniques, including perfusion-weighted MRI, contrast-enhanced ultrasound, and machine learning, have been discussed, as they improve lesion characterization and EPTB differentiation. By organizing imaging findings according to affected organ systems, this review highlights both shared diagnostic challenges and site-specific patterns that can inform clinical suspicion. Together, these developments underscore the value of a multimodal, organ-specific imaging approach integrated with the clinical context to improve the recognition and management of EPTB. Full article

Caseous lymphadenitis (CLA), an infectious disease caused by Corynebacterium pseudotuberculosis (C. pseudotuberculosis), poses a significant economic burden to the global small ruminant industry. This study aimed to investigate genetic variations in the CP40 gene of C. pseudotuberculosis and to develop a rapid detection assay for enhanced pathogen identification. Homology analysis was performed to compare the CP40 gene sequence of the FJ-PN strain with other Corynebacterium species. Specific primers targeting CP40 were designed, and a SYBR Green I-based real-time PCR protocol was optimized. The assay’s specificity, sensitivity, and reproducibility were subsequently validated. The FJ-PN strain exhibited ≥99.65% nucleotide identity and ≥98.94% amino acid identity with C. pseudotuberculosis biovar ovi reference strains, showing 90.18–91.84% nucleotide identity and 88.63–90.77% amino acid identity with C. pseudotuberculosis biovar equi, and ≤82.71% nucleotide identity and ≤78.63% amino acid identity with other Corynebacterium species. The established qPCR assay demonstrated high specificity, the limit of detection was 52 copies/μL, and it demonstrated good reproducibility (intra- and inter-assay CV < 1.0%). Clinical sample testing revealed 18.8% positivity rates in nasal swabs, which was higher than that detected by conventional PCR (16.3%). These results indicate that the CP40 gene is evolutionarily conserved and represents a specific molecular marker for the identification of C. pseudotuberculosis biovar ovis. The developed SYBR Green I real-time PCR assay enables the efficient detection of C. pseudotuberculosis and provides technical support for CLA surveillance and control. Full article

Nontuberculous Mycobacteria (NTM), often referred to as environmental or atypical mycobacteria, are opportunistic pathogens phylogenetically as well as clinically distinct from both the Mycobacterium tuberculosis complex and Mycobacterium leprae. In the pediatric age group, NTM disease manifests with a diverse range of clinical phenotypes. Cervicofacial lymphadenitis stands out as the most common presentation among children who are immunocompetent. Conversely, skin and soft tissue infections, pulmonary disease and disseminated infections constitute less prevalent, yet clinically important, disease forms. Accurate identification is paramount, as differentiating NTM infections from tuberculosis (TB) remains challenging based solely on clinical symptoms, initial laboratory analyses, or standard radiological findings. This distinction is critical because treatment protocols for NTM infections differ substantially from those for tuberculosis. This narrative review offers a comprehensive and up-to-date summary of NTM infections in children. It examines the spectrum of clinical presentations and their prevalence, addresses the complexities of diagnosis and therapy, and underscores the importance of differential diagnosis against tuberculosis. Furthermore, we explore current diagnostic strategies, available therapeutic options, and the link between specific clinical syndromes and tailored management, pointing out existing knowledge gaps and suggesting priorities for future research. The absence of rapid, species-specific diagnostic tools often results in delayed initiation of targeted treatment, while overlapping clinical features with TB can lead to misdiagnosis. Therapeutic management is complicated by the necessity for prolonged drug courses, frequent occurrences of drug intolerance, limited availability of child-appropriate formulations, and the rising tide of antimicrobial resistance. Successfully tackling these issues demands enhanced surveillance, precise species-level identification, the creation of child-friendly drug formats, and the development of evidence-based treatment guidelines specifically designed for the pediatric population. Full article

Caseous lymphadenitis (CL), caused by Corynebacterium pseudotuberculosis, typically affects small ruminants but is rarely reported in cattle. This case report describes an outbreak of CL in a dairy herd in southern Portugal, where 55 of 500 animals (11%) were clinically affected. Diagnosis was based on characteristic lesions and laboratory confirmation by bacterial culture and PCR. Control measures included isolation, culling, environmental disinfection, and vector management. An autogenous vaccine was prepared from herd isolates and administered under veterinary supervision. No further clinical cases occurred following vaccination. Although immunological and efficacy assessments were not performed, the apparent control of the outbreak suggests that autogenous vaccination, combined with strict biosecurity, may support disease management in atypical hosts. This report underscores the importance of recognizing C. pseudotuberculosis infections in cattle and highlights the need for further evaluation of autogenous vaccines under controlled conditions. Full article

Lower airway diseases are a major health concern in sheep, often presenting with overlapping clinical signs that hinder accurate diagnosis. This study evaluated the diagnostic value of computed tomography (CT) in 58 adult sheep examined in northeastern Spain between 2017 and 2024. All animals underwent full clinical examination, CT under general anaesthesia, and post-mortem investigation. CT identified 82 pulmonary lesions, including interstitial pneumonia, respiratory complex, gangrenous pneumonia, caseous lymphadenitis, parasitic pneumonia, pulmonary adenocarcinoma, and pulmonary hydatidosis. Tissue density measurements provided additional information regarding disease stage and severity. The level of agreement between CT findings and definitive diagnoses consistently exceeded that of clinical evaluation, reaching almost perfect concordance for several conditions. Moreover, CT revealed concomitant respiratory pathologies within the same animal, many of which were not detected by conventional diagnostic methods. Although thorough individual clinical examination remains essential for the correct interpretation of imaging findings and the accurate diagnosis of respiratory disorders in the field, these results demonstrate that CT provides superior diagnostic accuracy compared with standard approaches and yields valuable insights for both clinical practice and research. Despite its practical limitations, CT could represent a major advance in improving health, welfare, and productivity in sheep farming. Full article

Nontuberculous mycobacteria (NTM) represent a heterogeneous group of environmental opportunistic pathogens that have emerged particularly in immunocompromised individuals and patients with underlying pulmonary disorders. NTM infections primarily affect the lungs, but can also manifest as lymphadenitis, skin and soft tissue infections, and disseminated disease. This retrospective study took into consideration 425 NTM-positive samples collected between May 2011 and December 2023, analyzed by sample type, sex, and age group (0–17, 18–49, 50–65, >65 years). Antimicrobial susceptibility analysis was performed on the 223 NTM strains with greater pathogenic power and most frequently isolated, from 2016 to 2023. Pulmonary NTM disease (NTM-PD) infections were most prevalent in patients over 65 years (52.1%), while extrapulmonary NTM disease (NTM-EPD) occurred most frequently in the 0–17 age group (56.4%). Women were slightly more affected (54.4%) than men (45.6%), with the highest incidence in female individuals over 65 years old. The most frequently isolated NTM species was the Mycobacterium avium complex (MAC) (47% of isolates). Antimicrobial susceptibility testing of 223 isolates from 2016 to 2023 revealed species-specific resistance patterns, with high susceptibility to clarithromycin in MAC (94.7%) and Mycobacterium chelonae (100%), but notable resistance in Mycobacterium abscessus complex (MABC). The increasing incidence of NTM infections underscores the need for improved diagnostic techniques and targeted treatment strategies. Full article

Background and Clinical Significance: Preoperative planning is crucial for improving surgical safety and outcomes, particularly in minimally invasive surgery, where tactile feedback is absent. Three-dimensional (3D) printing offers patient-specific anatomical models that can enhance surgical planning. Its application in diverticular disease remains underexplored. Case Presentation: We present the case of a 65-year-old male with recurrent diverticulitis involving the sigmoid and descending colon. After conservative management of an acute episode, preoperative imaging revealed extensive diverticulosis. A patient-specific 3D-printed model was created from CT images to plan the surgical approach. The model helped determine the need for a left hemicolectomy rather than a simple sigmoidectomy, anticipated technical challenges such as lowering the left colic flexure and ligating the inferior mesenteric artery, and improved patient counseling. The surgery was performed laparoscopically without complications, and the patient was discharged on postoperative day six. Histology confirmed diverticulosis with perivisceritis and reactive lymphadenitis. Conclusions: This case demonstrates the potential of 3D printing to optimize surgical planning in diverticular disease, enabling tailored resections and improving operative strategy. Broader adoption may be limited by time and cost but offers clear educational and clinical benefits. Full article

Epithelioid sarcoma (ES) is an extremely rare sarcoma categorized into classic and proximal types. Proximal ES is characterized by its occurrence in older individuals, proximal locations, deep tissue involvement, and a tendency to be larger in size. We present a case of an extremely small proximal ES occurring in the inguinal region, which posed significant diagnostic challenges. Clinically, the lesion presented as a painful mass, and magnetic resonance imaging findings suggested lymphadenitis or other inflammatory lesions due to its small size and internal signal patterns. Despite being monitored, the mass showed progression, prompting an incisional biopsy that raised suspicion for ES. Positron emission tomography–computed tomography confirmed the absence of metastases, leading to wide excision. Pathological examination of the excised specimen confirmed proximal ES with negative margins. In this case, characteristic features of proximal ES were scarcely observed, and imaging findings were not distinctive, likely due to the small size of the lesion. Furthermore, the broad differential diagnoses for inguinal masses necessitate careful attention during diagnosis. For sarcomas and tumors in general, reliance solely on clinical and imaging findings can lead to diagnostic pitfalls, emphasizing the importance of active pathological evaluation through biopsy. Full article

Corynebacterium pseudotuberculosis is the causative agent of caseous lymphadenitis, a significant infectious disease that affects small ruminants and poses economic challenges to livestock production. This study aimed to assess the seroprevalence of C. pseudotuberculosis in goats from Espírito Santo state, Brazil, and identify risk factors associated with infection by the bacterium. Serum samples from 145 goats were analyzed using an indirect enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence was found to be 34.5%. The risk factors significantly associated with infection included the presence of abscesses and the absence of veterinary assistance on farms. The findings emphasize the need for improved management practices and veterinary oversight to mitigate caseous lymphadenitis transmission. This research provides critical insights into the epidemiology of caseous lymphadenitis in goats from Espírito Santo, informing effective disease control strategies. Full article