Diarrheic Syndrome Research Articles

Toxin gene pattern in Bacillus cereus group strains isolated from sheep ricotta cheese

Milk and milk whey products processed at high temperatures and then stored by chilling are particularly sensitive to the health risks associated with microorganisms of the Bacillus cereus group (Heyndrickx and Scheldeman 2002). Sheep ricotta cheese is often contaminated by these spore forming microorganisms and it provides a substrate in which they can develop (Corona et al. 2002). B. cereus may cause diarrhoeic or emetic food poisoning outbreaks. Diarrhoeic syndrome is mainly due to HBL and NHE enterotoxins produced when the micro organisms multiply in the small intestine (Granum and Lund 1997; Hansen and Hendriksen 2001). Emetic syndrome is caused by emetic toxins or cereulide, a dodecapeptide produced when the microorganisms multiply in the food (Kramer and Gilbert 1989; Agata et al. 1996). Their pathogenic profile is also characterized by the ability to produce enterotoxin T, which shows toxic activity only in vitro (Agata et al. 1995), and cytotoxin K, which is necrotizing and hemolytic. Sporadic cases of death from food poisoning have been attributed to cytotoxin K producing strains (Lund et al. 2000). These microorganisms also produce hemolysins (cereolysins, hemolysin II, sphingomyelinases) and different phospholipases C (PIH, PCH and SM) (Granum 1994; Beecher and Wong 2000). The present work reports the molecular profile of the pathogenicity factors of “ B. cereus ” group strains isolated from fresh and ripened sheep ricotta-cheese. The ability of these strains to produce the hemolytic fraction L 2 of HBL and the fraction A of NHE was also tested.

Diarrheic syndrome as a clinical sign of intestinal infiltration in progressive B-cell chronic lymphocytic leukemia

Gastrointestinal involvement is a rare event in patients with B-cell chronic lymphocytic leukemia (B-CLL) and is usually associated to lymphomatous transformation. However, in autopsy studies the reported incidence of microscopic infiltration can reach up to 50% of cases. Seven B-CLL patients in advanced stage/progressive disease were evaluated by colonoscopy because of continuous diarrhea. Five out of seven patients (71%) presented histological evidence of colonic infiltration. Persistent diarrhea in patients with progressive/advanced B-CLL can be a clinical sign of intestinal infiltration and justifies endoscopic examinations.

Enfermedad de Whipple. Estudio de 6 casos

Whipple's disease (WD) is an infrequent multisystemic process, with a bacterial etiology and with a marked variability in relation to its clinical manifestations. The diagnosis is established by histopathologic study or by polymerase chain reaction (PCR) test. Our objective was to analyze the clinical characteristics and evolution of these patients. We have reviewed the patients diagnosed with WD in our hospital during the last 20 years (1987-2007). We describe 6 patients with WD (5 men and one woman), with a mean age of 47 years. Most patients presented articular symptoms (n = 5), in 3 cases with intermittent rheumatism. The mean period of time previous to diagnosis was 59 months. All patients developed a chronic diarrheic syndrome, constitutional syndrome and polyadenopathies at the time of diagnosis. Laboratory studies showed increased erythrocyte sedimentation rate and C-reactive protein values, ferropenic microcytic anemia and low serum levels of cholesterol. The clinical diagnosis was confirmed by pathologic study in 5 patients, and by means of PCR study of spleen tissue in one patient. All patients were treated with cotrimoxazole for 2 years, with resolution of the symptoms. After a mean follow-up of 98 months, no recurrence of the symptoms has been observed in any case. Articular symptoms in the form of intermittent rheumatism are the most common form of presentation of WD. Diarrheic and constitutional syndrome, which are observed later in all patients, as well as the presence of adenopathies, oblige us to discard this process.

ETIO-PATHOGENETICAL RESEARCHES IN COCCIDIOSIS OF THE LAMBS BRED IN BIG GROUPS, IN AN UNIT FROM THE WEST OF ROMANIA

The diarrheic syndrome can be attributed to various causes: biotic agents (bacteria, parasites, fungi and viruses), alimentary, inobservance of the hygiene conditions, intervention of some maternal, genetic, immunity and human factors. An important place in producing this syndrome in l ambs devolves upon the Eimeria . In this study we had in view the qualitative estim ation of the value of the biotic agents which inter vene in the beginning of the diarrheic syndrome in lambs , from the neonatal period till to the age of 3 mon ths. Observations concerning the share of the coccidian infection in producing this syndrome in lambs were performed. Clinical exam were accomplished, specifying the incidence of the diarrheic syndrome, the lo sses by mortality in lambs, also anatomo-pathological exams by necropsy, histo-pathological exam (hematoxilin- eosine method). The coproscopical exam was done, using the Blagg modified byuteu, McMaster, sedimentation by centrifugation and Baermann methods. The coccidian species were determined by micrometry, according to the morphological features cited by various authors. Fo r determining the bacterial charge in faeces sample s from lambs, selective (Istrate-Maitert) and differentiat ion (MIU, TSI, MILF, citrate Simmons) mediums were used for enterobacteria, Chapmann medium for enterococc and agar with blood for the investigation of the hemoly tic capacity. The presence of Corona and Corona viruses were investigated by electrophoresis in poliacryla mide gel, respectively the hemagglutination assay with mouse red cells. As a result of the etio-pathogenetical and diagnost ic investigations performed, we came to the conclusions: the diarrheic syndrome evolved in the lambs aged from 4 weeks to 3 months, with an incidence of 26%. The mortality occurred in 16% of the sick lambs; the clinical aspects were represented by diarrhe a with aqueous yellow-chocolate colored feces, with abunda nt mucus, anomaly, then anorexia and dehydration; anatomo-pathologically, catharal enterocolitis, wit h punctiform hemorrhages, whitish foci on the intes tinal mucous membrane, hypertrophy of the mesenteric lymph nodes were observed. As a histopathologic result, the necrotic catharal enteritis, caused by coccidian ev olution forms, and mesenteric hyperplastic lymph ad enitis were observed. The diarrheic syndrome in lambs took place by the intervention of some unor multiple biotic agents: protozoa like Eimeria (extensivity 95%, intensivity 17500 EPG); Cryptosporidium (17.82%) and Giardia (22%); and the suprainfection with bacterial germs, unpath ogen, firstly E. coli (45%) and Proteus (65%). We didn't find Rota and Corona-viruses by the usual methods. The specific structure of the Eimeria population in the lambs with diarrheic syndrome is: E. ovinoidalis (42%); E. crandallis (28%); E. faurei (10%); E. parva (17%) and E. pallida (3%).

Histopathological investigations of rabbit colibacteriosis, caused by enteropathogenic escherichia coli (O15:H-)

The histopathological alterations in the intestinal tract of recently weaned rabbits with experimental and spontaneous Eschercihia coli (O15:H-) infection were followed. A considerable shortening and thickening of well epithelized intestinal villi were observed, whose tips, after a Warthin-Starry staining, were profusely colonized with coliform bacteria. The observed pathological pattern was a permanent finding in such infections and could be used as a pathognomic feature in the differential diagnosis of spontaneous diarrhoeic syndromes. The adhesion of colibacteria to enterocytes, together with the data from the bacteriological studies (isolation, identification, determination of the O-serogroup affiliation and the biochemical behaviour) allowed the assignment of isolates to the group of enteropathogenic E. coli (EPEC). Only when required, more detailed diagnostical procedures as PCR, could be performed.

Gut-trophic feed additives and their effects upon the gut structure and intestinal metabolism. State of the art in the pig, and perspectives towards humans.

The correct functional development of the gastrointestinal tract is of special importance during the neonatal and weaning phases of reared piglets. Nutrition is obviously a critical determinant in the growth of the gut in the young swine. The mucosal epithelium of the small intestine is reputed anatomically and functionally immature in neonatal pigs, a feature that appears to be exacerbated at weaning, when a colonization of the gut occurs by "new" microorganisms entering the alimentary canal with the solid feed. This frequently exposes piglets to diarrhoeic syndromes and other intestinal disturbances. Functional feed additives, also called nutraceuticals, appear as promising alternative substances to the use of chemotherapeutics as growth promoters in the rearing farm, above all considering the near banning of them by the European Parliament in the view of reducing antibiotic resistance phenomena in human therapies. Several feed additives are available that may play a role in the pig nutritional plan because of their trophic and cyto-protective effects on the gastrointestinal apparatus. Paying special attention to the quantitative consequences (histometry) upon the gut of the examined dietary supplements, this review, even if not fully exhaustive, will focus on the function (and possibly the mechanism/s of action) of certain gut-trophic nutrient substrates. This in turn will sustain the potential use of these substances in human therapy, especially the one directed at resolving intestinal diseases, both in adult and infant ages. In nutritional studies as well as in other biomedical research fields, the swine is an excellent animal model.

Variations in the distribution of okadaic acid in organs and biological fluids of mice related to diarrhoeic syndrome.

Okadaic acid (OA) is the main toxin produced by dinoflagellates which can accumulate in the hepatopancreas of mussels and cause diarrhetic shellfish poisoning in consumers. This toxin is also a tumour promoter and a specific potent inhibitor of protein phosphatases 1 and 2A. No specific target organ is known for this toxin. This study concerns the distribution of [3H]OA in organs and biological fluids of Swiss mice having received a single dose per os of AO (50 microg/kg). The determination of the toxin extracted from mouse organs 24 h after administration of [3H]OA and derivatised with 9-anthryldiazomethane (ADAM) before HPLC and fluorescent detection showed the highest concentration in intestinal tissue and stomach. This distribution was even more pronounced in intestinal tissue, when animal were given per os 90 microg/kg which induced diarrhoea. The high concentrations of [3H]OA in intestinal tissues and contents 24 h after administration demonstrates a slow elimination of OA. When the dose of OA was increased from 50-90 microg/kg, the concentrations of the toxin in the intestinal content and faeces increased proportionally. A good correlation was found between an increase of OA in the intestinal tissue and the diarrhoea in animals given 90 microg/kg orally. Moreover OA was present in liver and bile and in all organs including skin and also fluids. Altogether these results confirmed an enterohepatic circulation of OA as previously shown. These data also revealed that in acute OA intoxication the concentration of the toxin in the intestinal tissues reaches cytotoxic concentrations in accordance with the diarrhoea which is the main symptom of OA poisoning.

Intestinal Microsporidiosis in a Chilean Patient with Acquired Immunodeficiency Syndrome (AIDS)

A 24-year-old male patient with AIDS diagnosed in 1989, and with several episodes of pneumocystosis, was admitted because of a chronic diarrheic syndrome and severe epigastric pain. Endoscopy showed a granular duodenal mucosa. Light microscopy showed a moderate villous atrophy with round-cell inflammatory infiltration of the chorion. Giemsa, Ziehl-Neelsen, and Gram stains showed microsporidial spores measuring between 1.5 and 2 microns in the supranuclear cytoplasm of some enterocytes. Electron microscopy showed sporoblasts and spores consistent with Enterocytozoon bieneusi, with an apparently non-tubular, rather electron-dense polar filament showing up to 7 coils and also a microtubular internal structure with annular disposition, a finding which has not been adequately emphasized in the pertinent literature, probably representing a contractile property of the polar filament, rather than a mere duct for the parasitic sporoplasm to be inoculated.

A new diarrhoeic syndrome with ataxia in young Charolais calves: clinical and microbiological studies

A new diarrhoeic syndrome was examined clinically in 19 one to two-week old Charolais calves. It differs from other digestive disorders in calves of this age in the discrete diarrhoeic signs, the absence of dehydration and the presence of signs of ataxia. The microbiological study carried out for three consecutive years in 58 sick calves and nine healthy control calves demonstrated the special role of E coli possessing virulence markers from septicaemic strains (CS31A, Col V). The clinical signs could be the result of bacteraemia with subacute E coli endotoxaemia.

Testing strains of Clostridium perfringens type A isolated from diarrhoeic piglets for the presence of the enterotoxin gene.

A diarrhoeic syndrome in piglets has been linked to Clostridium perfringens type A because this organism has been isolated in large numbers from all cases. The strains isolated from these cases and strains isolated from healthy piglets were screened for the enterotoxin gene of C perfringens by DNA-hybridisation. Using two different synthetic DNA-probes, none of the strains isolated from diseased pigs was positive in this reaction, indicating that the enterotoxin of C perfringens is not involved in the syndrome.

Biotypes and O serogroups of Escherichia coli involved in intestinal infections of weaned rabbits: clues to diagnosis of pathogenic strains.

A total of 575 Escherichia coli strains isolated from weaned rabbits experiencing diarrhea in 119 French commercial farms were tested for O serogroups. The results showed a strong predominance of serogroup O103 strains. A sample of 126 strains were further checked for simplified biotypes by using five carbohydrate fermentation reactions. Of 72 O103 strains, 70 were shown to belong to biotypes characterized by a rhamnose-negative reaction. Four of nine serogroup O68 strains also showed this type of reaction. Thirty-nine strains, representative of the serotypes and biotypes found, were further tested for experimental pathogenicity in weaned rabbits and for antibiotic susceptibility. All the rhamnose-negative strains produced life-threatening watery or hemorrhagic diarrhea, whereas rhamnose-positive strains induced only mild diarrheic syndrome without any mortality or no clinical signs at all. Rhamnose-negative, highly pathogenic strains did not belong to related antibiotypes. We think that O serogrouping together with biotyping, or even rhamnose fermentation testing, may be an important clue in the diagnosis of enteropathogenic strains from rabbits in France, permitting rapid identification of highly pathogenic strains and leading to improved prognosis and treatment.

Prospective study of enteric Campylobacter infections in children from birth to 6 months in the Central African Republic.

A survey of enteric Campylobacter infections was performed in Bangui, Central African Republic, with a cohort of 127 children from birth to 6 months of age by biweekly culture of stools; 82 infections were observed, and 41.7% of the children presented at least 1 infection before 6 months of age. Only 15.9% of the infected children had a diarrheic syndrome; moreover, 61.5% of these diarrheic children had another enteropathogen associated with Campylobacter species. In about half the cases, Campylobacter spp. were excreted for more than 4 days. More than half of the children had at least one diarrheic episode, for which an enteropathogen was identified in one third of the cases, before 6 months of age.

Studies of Neonatal Calf Diarrhorea V. Water Balances in Calves with Mixed Infections

SUMMARY An investigation is described of a diarrhoeic syndrome in neonatal calves whose faeces were heavily contaminated with Pseudomonas spp. or Proteus vulgaris in addition to Escherichia coli. Dying affected calves were very dull and died quickly with little weight loss (4 per cent). One calf produced bulky faeces and gained virtually no weight in eight days but was never diarrhoeic.

The epidemiology of the "collapse syndrome" in suckled calves.

Cases of a diarrhoeic syndrome characterised by acute collapse were seen in single-suckled beef calves on hill farms during a three year period. The association between the occurrence of this syndrome, which we have termed the "collapse syndrome", and various epidemiological parameters, is investigated and discussed.

Studies of Neonatal Calf Diarrhoea. III. Water Balance Studies in Neonatal Salmonellosis

Studies of body fluid balance of calves with salmonellosis indicated that more profound disturbances occur than in other neonatal calf diarrhoeic syndromes. Thus, there was a greater insensible water loss associated with pyrexia and greater reduction of input combined with a larger solid matter output in severely affected animals which resulted in considerable weight loss (18 · 7 ± 2 · 4 per cent). Even when not diarrhoeic, there were exaggerated faecal outputs although their water content was similar to that of normal faeces. Des études de l’équilibre des sécrétions chez des veaux avec de la salmonellose indiquèrent que des troubles plus profonds surviennent qu’avec des syndromes du type diarrhée chez le veau nouveau-né. De cette façon, il y eut une perte insensible en eau plus importante en association avec la pyrexie et une réduction plus importante de l’absorption accompagnée d’une sortie plus grande de matières solides chez les animaux gravement atteints, ce qui conduisit à une perte de poids considérable (18,7 ± 2,4 pour cent). Même quand elles ne furent pas du type diarrhée, on observa des sorties fécales exagérées bien que leur teneur en eau fût semblable à celle de fèces normales. Untersuchungen der Flüssigkeitsbilanz bei Kälbern mit Salmonellose wiesen darauf hin, dass hier grundlegendere Störungen vorliegen als bei anderen diarrhoischen Syndromen neugeborener Kälber. So gab es einen grösseren Wasserverlust, der bei schwererkrankten Tieren von Fieber und verringerter Nahrungsaufnahme und einer vermehrten Ausscheidung geformten Materials begleitet war. Dies führte zu erheblichem Gewichtsverlust (18,7 ± 2,4 prozent). Selbst ohne Diarrhoe war die Menge der produzierten Faeces vermehrt, auch wenn ihr Wassergehalt dem normaler Faeces ähnelte. Los estudios del equilibrio de los fluidos corporales en terneros con salmonellosis indicaron que ocurren trastornos más profundos que en el caso de otros síndromes de diarrea neonatal del ternero. Así, se dió una mayor pérdida insensible de agua en asociación con pirexia y una mayor reducción en la toma de agua en combinación con una mayor salida de materia sólida en animales gravemente enfermos que resultaron en una considerable pérdida de peso (18,7 ± 2,4 por ciento). Aun cuando no hubo diarrea, se dieron salidas fecales exageradas aunque su contenido acuoso fue similar al de las heces normales.

Diarrhoea in horses associated with ulceration of the colon and caecum resulting from S vulgaris larval migration.

The clinical manifestations of a diarrhoeic syndrome of horses with ulceration of the mucosae of the colon and caecum are described. Patients could be divided into three groups according to their presenting symptoms and the disease is probably caused by the thrombo-embolism associated with migrating larvae of Strongylus vulgaris. The differential diagnosis, prognosis and treatment are outlined with particular reference to the use of antithrombotic agents.

Amprolium poisoning of preruminant lambs: an investigation of the encephalopathy and the haemorrhagic and diarrhoeic syndromes.

An experiment was conducted to investigate the mechanisms responsible for the brain lesions, diarrhoea and haemorrhages produced by amprolium poisoning of preruminant lambs. The encephalopathy was preceded by a reduction of cerebrocortical transketolase activity. Diarrhoea was not associated with histological evidence of pathological change in the small intestine, and in lambs with severe diarrhoea the small intestinal levels of alkaline phosphatase and lactase were unaffected. Haemorrhages were associated with a thrombocytopenia which was attributed to degeneration of bone marrow megakaryocytes. The bone marrow of the majority of the lambs which had received amprolium for 3 wk or more was severely depopulated, erythrocyte precursors being the most severely affected. The marrow depopulation was atrributed to decreased cell production, as the majority of the remaining cells showed little evidence of degeneration and the number of mitotic figures in the marrow of amprolium-treated lambs was considerably reduced as compared with the controls.

Stomach function in relation to a scour syndrome in the piglet.

1. Piglets were left to suckle their dam for about 2 days after birth to obtain colostrum and were then divided into four groups. One group was left with the sow, the second was given a standard liquid diet based on cow's milk, the third the standard diet with lactic acid added to give a pH of 4.8, and the fourth the standard diet with the casein content increased by 50%. Stomach samples were removed at intervals by stomach tube for pH measurements and bacteriological investigations. The tube was used immediately to give barium sulphate for radiographic examinations and was then withdrawn. Comparisons were made between treatments and between scouring and non-scouring piglets.2. A diarrhoeic (scour) syndrome frequently developed; this was always preceded by diminishing gastric activity leading to gastric stasis. When spontaneous recovery occurred, there was a return of gastric function before recovery from scours and before the resumption of normal weight gain.3. The incidence, duration and severity of the scour syndrome was less in piglets left on the sow; these differences could not be ascribed to the effect of colostrum. Piglets receiving the lactic acid milk diet had an average gastric pH of 1 unit less than the other piglets. Although the severity of scour and loss of clinical condition was less in the piglets given lactic acid milk the duration of reduced stomach motility was the same as in the other artificially fed piglets.4. No obvious correlation was shown between the scour syndrome and the bacterial flora of the stomach or the intestines. The gastro-intestinal tracts of the piglets given lactic acid milk contained fewer bacteria than those of the piglets on the other diets.5. Gross between-treatment differences at post-mortem were evident only in the stomach.6. The spontaneous scour syndrome observed under the conditions of these experiments appeared not to be of bacterial origin but to be associated with a physiological malfunction of the stomach.

Rectoscopy in the diarrheic syndrome of the infant

Rectoscopy in the diarrheic syndrome of the infant