Capnocytophaga canimorsus Meningitis: Three Cases and a Review of the Literature

Bacterial meningitis is a disease with a high morbidity and mortality. It may be caused by the zoonotic pathogen Capnocytophaga canimorsus, which is part of the commensal oral flora in dogs and cats. We report three cases of C. canimorsus meningitis in a nationwide cohort study of bacterial meningitis patients and performed a review of the literature. Three episodes of C. canimorsus meningitis were identified in three patients included in a nationwide cohort study from 2006 through 2014. The calculated annual incidence was 0.03 per million adults. When combined with the literature, 33 patients were identified of which 28 were male (85%). The median age was 63 years, and 13 (42%) were immunocompromised, which consisted of alcoholism in 7 (21%). Animal contact could be established in 29 of 30 patients (93%) and consisted of dog bites in 22 of 29 (76%). One patient died (3%) and 8 had neurological sequelae upon discharge (25%), most often hearing loss (n = 6, 19%). Capnocytophaga canimorsus meningitis is associated with dog bites. Although mortality is relatively low, survivors often have neurological sequelae.     

致仔猪脑膜炎猪链球菌的分离鉴定

旨在从脑膜炎症状仔猪的脑组织及其他脏器中分离鉴定病原菌。采集患病仔猪脏器分离病原,通过PCR及血清凝集试验鉴定其种属及血清型;透射电镜观察分离株的超微结构;经多序列位点分型分析,鉴定其ST型;通过测定最小抑菌浓度分析其耐药性;经小鼠攻毒试验分析其毒力。结果:最终从患脑膜炎仔猪的脑组织中分离到一株猪链球菌,血清型为9型,将其命名为WH1609。电镜结果显示WH1609有荚膜结构。多位点序列分型结果表明WH1609属于一个新的ST型。耐药性试验结果表明WH1609对多种抗生素耐药;对万古霉素、青霉素及氨苄西林敏感。BALB/c小鼠毒力试验测得LD50为1.89×10~2 CFU·mL^-1,病理组织学观察结果显示WH1609感染小鼠可出现明显的脑组织病变。本研究从患脑膜炎的仔猪脑组织中分离到一株猪链球菌9型强毒株,其在BALB/c小鼠的半数致死量为已发现的猪链球菌强毒株的10~5倍以上,对猪链球菌致脑膜炎分子机制的研究有重要的意义。     

An 8‐week Brain MRI Follow‐up Analysis of Rat Eosinophilic Meningitis Caused by Angiostrongylus cantonensis Infection

Early differential diagnosis and timely follow‐up are advantageous in the management of Angiostrongylus cantonensis infection. This study aimed to characterize angiostrongyliasis in the rat brain for an 8‐week period using magnetic resonance imaging (MRI) with contrast‐enhanced T1‐weighted images (T1WI), T2‐weighted imaging (T2WI), fluid attenuation inversion recovery (FLAIR) and R2 mapping sequences. The data were analysed with Mathematica and Matlab software programs for weekly changes in each brain following the infection of 20, 50, 100 and 300 third‐stage larvae (L3), respectively. The results showed that the average subarachnoid space detected by T2WI technique was peaked up to 10% increase of original size on day 35 after 100 or 300 larvae infection, while those infected with 20 or 50 larvae showed less than 4% increase during the entire course of observation. This increase was relevant to the mortality of the infected rats, because those with 100 or 300 larvae infections showed a sharp decrease in survival rate before day 40. After day 40, the average subarachnoid space was decreased, but the average ventricle size was persistently increased, with the highest increase observed in the group infected with 300 larvae on day 56. Furthermore, the R2 mapping mean and R2 mapping size were significantly different between the brains with severe infection (100 and 300 larvae groups together) and those with mild infection (20 and 50 larvae groups together) on day 49, but not on day 35. Our results showed that diagnosis for different quantity of larvae infection using MRI is possible and follow‐up characterization is informative in revealing the effects of angiostrongyliasis on different brain areas. In conclusion, our results support the use of MRI as a non‐invasive diagnostic technique for eosinophilic meningitis caused by A. cantonensis infection.     

Rhodococcus equi occipital bone osteomyelitis,septic arthritis and meningitis in a neurological foal

This case report describes a 3‐month‐old female Thoroughbred foal that presented following the acute onset of apparent respiratory distress, abnormal head carriage and severe neurological deficits referable to the brainstem or cranial cervical spinal cord. Ultrasonography revealed an abscessing pneumonia. Radiographs did not show evidence of bony pathology at the atlanto‐occipital region, an area consistent with the observed neurological deficits. With magnetic resonance imaging, atlantal and occipital osteomyelitis, atlanto‐occipital septic arthritis, and atlanto‐axial synovitis were diagnosed. Brainstem meningitis and extradural compression were also revealed. Culture of the right occipitoatlantal joint and cerebrospinal fluid yielded a pure culture of Rhodococcus equi. These findings and multifocal R. equi abscessation were confirmed at necropsy.     

Idiopathic eosinophilic meningoencephalitis in a Dutch Warmblood gelding

An increased content of eosinophils in cerebrospinal fluid (CSF) and eosinophilic infiltration of brain tissue are observed in eosinophilic meningoencephalitis (EME). After exclusion of various infectious diseases and further known causes of EME in other species, the diagnosis idiopathic EME was made at necropsy in the case reported here. To the authors' knowledge, this is the first report of idiopathic EME in a horse similar to the disorder occurring in dogs.     

Parenteral administration of copper as cerate to cattle and sheep

Extract

Under the grassland farming regime in New Zealand, copper deficiency in cattle and sheep can be effectively controlled by topdressing all the pastures on the farm each year with 5 pounds of copper sulphate per acre. Such treatment removes the deficiency by increasing the copper content of the herbage to a level that is adequate for grazing animals.     

大肠杆菌K1侵袭血脑屏障的研究进展

大肠杆菌K1株是引起新生儿败血症和脑膜炎的代表菌株,经血液循环进入大脑而致病。大肠杆菌K1黏附、侵袭脑微血管内皮细胞（BMECs）并穿越血脑屏障（BBB）的分子机制一直是众多学者研究探讨的热点。文章重点阐述致脑膜炎大肠杆菌K1穿越BBB的基因调控和信号介导通路,旨在了解致脑膜炎大肠杆菌感染的分子机理,为预防和治疗脑膜炎提供参考。     

基于毒邪理论辨治神经感染性疾病及代谢性脑病——中医脑病理论与临床实证研究(七)

应用毒邪理论指导神经感染性疾病及代谢性脑病的辨治。认为其病机关键是内外之毒,毒损脑络、脑膜、玄府,伤及脑髓;毒邪壅滞,损伤津、血、精、髓等,脑髓失养;由脑府神机受损致全身脏腑功能失调,神机失用。通过列举病毒性脑膜炎、尿毒症性脑病、肺性脑病、一氧化碳中毒迟发性脑病4个医案,阐明针对六淫特征及兼夹内邪特征辨证用药的中药解毒方法,祛邪即解毒,排毒即解毒,扶正即解毒。同时,针对毒邪特征必须注重选择配伍芳香或者苦寒入脑药物解毒。     

MAGNETIC RESONANCE IMAGING FINDINGS IN 25 DOGS WITH INFLAMMATORY CEREBROSPINAL FLUID

To describe the signs that may be associated with intracranial inflammatory conditions, magnetic resonance (MR) images of 25 dogs that had inflammatory cerebrospinal fluid (CSF) were mixed with those of a control group of 40 dogs that had CSF negative for inflammatory disease and reviewed without knowledge of the clinical signs or diagnosis. CSF was considered inflammatory if the protein level was > 0.25 g/l and the white cell count was > 5 mm(-3). Abnormalities were found by MR imaging in 19 (76%) dogs with inflammatory CSF. Two dogs had focal lesions, 10 had multifocal lesions, and seven had diffuse lesions. Lesions affected all divisions of the brain. Mass effect was identified in seven (28%) dogs, including one that had a choroid plexus carcinoma. Lesions were hyperintense in T2-weighted images in 18 dogs and hypointense in T1-weighted images in six dogs. Multifocal or diffuse intraaxial lesions that were hyperintense in T2-weighted images were observed in 17 (68%) dogs with inflammatory CSF. Administration of gadolinium resulted in enhancement of intraaxial lesions in nine (36%) dogs and enhancement of meninges in seven (28%) dogs. Six (24%) dogs with inflammatory CSF had images interpreted as normal.