Microabscess Formation Research Articles

P17 Hepatobiliary parasitic infestation: a case report

Abstract Background Hepatic parasitic lesions can present with multiple cystic lesions that may simulate inflammatory pseudo-tumour or malignancy in appropriate clinical settings. Here we present a known case of renal cell carcinoma with liver lesions that showed parasitic infestation on histology. Patient case A 70-year-old male with a history of right partial nephrectomy for clear cell renal cell carcinoma having an uneventful postoperative follow-up for 2 years underwent a surveillance CT scan. Multiple hepatic cystic lesions were identified, which on subsequent MRI and PET scan were suspicious for metastasis. Partial hepatectomy was performed for histological evaluation. Results Multiple discrete cystic hepatic lesions were noted on macroscopy. Histological examination revealed multiple necrotic hyalinized nodules with granulomatous inflammation within the liver and dense neutrophil infiltration with microabscess formation. Within the central necrotic area, there were non-viable parasite eggs and parts of worm, in keeping with parasitic infestation. On further expert opinion, this was diagnosed as Enterobius infestation of liver. Conclusions Hepatobiliary parasitic infestations may be encountered as clinically and biochemically asymptomatic lesions, especially in immunocompromised patients. Strong clinical history of travel and parasite serology screen is always helpful to clinch the diagnosis but may not be always available during histological examination. This case highlights the importance of thorough histological and microbiological examination as all nodular lesions in liver are not malignant and could be infective.

Tumor infiltrating neutrophil microabscess in OSCC: A poorly understood histopathologic prognosticator

ObjectiveRole of neutrophils in shaping the tumor microenvironment is well known in oral squamous cell carcinoma (OSCC). However, neutrophil microabscess (NM) formation within the tumor islands is distinctive phenomenon and has never been investigated in the literature. This pilot observational study identifies the incidence of NM in OSCC and its clinicopathologic correlation as a platform for the future studies. MethodologyA retrospective study was carried out on archival specimens of 121 cases of surgically excised OSCC specimens for identification of NM formations within the tumor islands using compound microscope. Mean NM density was calculated based on the quantification done at five randomly selected hotspots. ResultsOut of total 121 cases of OSCC, thirteen (10.74%) cases showed a frank evidence of NM within tumor islands. The hotspot analysis showed that the NM density ranges from 2 to 7 with mean of 3.76 ± 1.39 per high power field. NM density was higher in moderately differentiated OSCC (3.76 ± 1.93) than well differentiated (3.76 ± 1.93) however the differences were not statistically significant (p = 0.165). Similarly, higher NM density was reported in advanced T stage, lymph node involvement, advanced TNM stage and lymphovascular invasion, however, the results were statistically insignificant. ConclusionThere is evidence of NM formation in the tumor islands of OSCC, however their exact role as a prognosticator needs further exploration with large sample size and follow-up data.

Morphological assessment of changes in internal organs of rats with introduction of targeted drug “Sutent” in experiment

Objective. To establish in the experiment the changes in histological structure of the internal organs and blood indices in laboratory rats with intragastric introduction of the drug Sutent in the doses of 7 mg/kg and 35 mg/kg of the weight.
 Materials and methods. The study was conducted on 48 breedless white rats divided into the following groups: groups 1 and 4 received cytotoxic drug Sutent in the dose of 7 mg/kg (therapeutic dose), groups 2 and 5 Sutent in the dose of 35 mg/kg (fivefold exceeding the therapeutic dose), groups 3 and 6 the control groups. In groups 1, 2, 3 animal were killed 30 days after the onset of the experiment, in groups 4, 5, 6 two weeks after the drug withdrawal. Every day during 30 days, the experimental groups were introduced the intragastric drug Sutent in the form of aqueous suspension in the purified water; in the control group the rats received the purified water in the equivalent volume. The histological preparations of organs stained with hematoxylin and eosin as well as the hematological indices of blood were investigated.
 Results. The development of hypochromic anemia, thrombocytopenia and granulocytopenia in the was identified. While studying the histological structure of organs, in all experimental groups there was detected a disturbed circulation in the form of venous hyperemia and blood stasis in the capillaries, the development hemorrhages in the lung, liver, kidneys, adrenal glands, pancreas, gastric and esophageal mucosa. In the liver, pancreas and adrenal glands, dystrophic changes in the cells and necrosis foci were observed. In group 2, affection of the cerebral cortex nerve cells, heart cardiomyocytes, thyroid cells, acute duodenitis with formation of microabscesses was established.
 Conclusions. Introduction of Sutent in the dose of 35 mg/kg, compared with the dose of 7 mg/kg, caused a more expressed hematological, hepatological, cardiological and neurological toxicity, more obvious lesion of endocrine organs; it also contributed to the development of associated secondary infection and acute duodenitis.

A rupioid rash.

A 72-year-old man presented for a thick hyperkeratotic skin rash on the shins that had erupted 7 months earlier after minimal local trauma (Fig. 1A, B). Topical treatments with glucocorticoids and antibiotics were ineffective, although a slight improvement was noted during summer. Additionally, low-grade fevers and an asymmetric oligoarthritis of the upper and lower limbs and dactylitis of the thumb and fourth toe on the left appeared over the last weeks. Mild non-specific onychodystrophy of the toes was found, whereas no inflammatory back pain or enthesitis was present. Plain radiographs did not reveal disease-specific deformities, erosions or osteo-proliferative lesions. Laboratory tests showed raised inflammatory markers (CRP: 17.7 mg/dl, ESR: 107 mm/h), leukopoenia (2.580/μL) and anaemia (haemoglobin: 10.3 g/dl). Differential diagnosis of the rash included crusted scabies, secondary syphilis, neutrophilic dermatoses, histoplasmosis and a hyperkeratotic psoriasis variant [1]. Skin biopsy revealed psoriasiform acanthosis, thick parakeratosis, dense neutrophilic infiltration and microabscess formation (Fig. 1C). Based on the type of musculoskeletal involvement and the skin histopathology, the patient was diagnosed with psoriatic arthritis with rupioid psoriasis. Treatment with medium-to-low dose systemic glucocorticoids and infliximab led to arthritis remission, skin (Fig. 1D) and laboratory improvement. Rupioid psoriasis (derived from the Greek word ρύπος = dirt) is a rare hyperkeratotic variant of psoriasis characterized by well-demarcated plaques with thick, dirty-appearing adherent crusts. It is associated with local treatment failure [2], psoriatic arthritis and male sex and it may present challenges in the diagnosis of patients with arthritis and systemic inflammation. Written informed consent has been obtained from the patient.

Clonal population expansion of Staphylococcus aureus occurs due to escape from a finite number of intraphagocyte niches

Staphylococcus aureus is a human commensal and also an opportunist pathogen causing life threatening infections. During S. aureus disease, the abscesses that characterise infection can be clonal, whereby a large bacterial population is founded by a single or few organisms. Our previous work has shown that macrophages are responsible for restricting bacterial growth such that a population bottleneck occurs and clonality can emerge. A subset of phagocytes fail to control S. aureus resulting in bacterial division, escape and founding of microabscesses that can seed other host niches. Here we investigate the basis for clonal microabscess formation, using in vitro and in silico models of S. aureus macrophage infection. Macrophages that fail to control S. aureus are characterised by formation of intracellular bacterial masses, followed by cell lysis. High-resolution microscopy reveals that most macrophages had internalised only a single S. aureus, providing a conceptual framework for clonal microabscess generation, which was supported by a stochastic individual-based, mathematical model. Once a threshold of masses was reached, increasing the number of infecting bacteria did not result in greater mass numbers, despite enhanced phagocytosis. This suggests a finite number of permissive, phagocyte niches determined by macrophage associated factors. Increased understanding of the parameters of infection dynamics provides avenues for development of rational control measures.

Skin manifestations of inborn errors of NF-κB.

More than 400 single gene defects have been identified as inborn errors of immunity, including many arising from genes encoding proteins that affect NF-κB activity. We summarise the skin phenotypes in this subset of disorders and provide an overview of pathogenic mechanisms. NF-κB acts cell-intrinsically in basal epithelial cells during differentiation of skin appendages, influences keratinocyte proliferation and survival, and both responses to and amplification of inflammation, particularly TNF. Skin phenotypes include ectodermal dysplasia, reduction and hyperproliferation of keratinocytes, and aberrant recruitment of inflammatory cells, which often occur in combination. Phenotypes conferred by these rare monogenic syndromes often resemble those observed with more common defects. This includes oral and perineal ulceration and pustular skin disease as occurs with Behcet's disease, hyperkeratosis with microabscess formation similar to psoriasis, and atopic dermatitis. Thus, these genotype-phenotype relations provide diagnostic clues for this subset of IEIs, and also provide insights into mechanisms of more common forms of skin disease.

Clinicopathological characteristics of anti-PD-1 associated gastroenteritis

Objective: To investigate the clinicopathological features of anti-PD-1 related gastroenteritis, understand and recognize the disease, and avoid misdiagnoses. Methods: Three cases of anti-PD-1 related gastroenteritis diagnosed and treated at the Zhongshan Hospital Affiliated to Fudan University, Shanghai, China from 2020 to 2021 were collected. The clinical and pathological features were analyzed and the patients were followed up by telephone. Results: The three patients were all male and aged 63, 39 and 73 years, respectively. They had previously developed gastrointestinal symptoms as a result of immunotherapy for a malignant tumor. Endoscopically, 2 patients presented with pancolitis, and 1 patient presented with a large antral ulcer involving the pyloric canal in the stomach. Histologically, there were marked atrophy and thinning of the epithelium, diffuse infiltration of numerous neutrophils in the lamina propria, formation of micro-abscesses in the crypt/glandular lumen, structural changes (branching and distortion) of the glands, and significant glandular dilatation. In addition, chronic inflammatory features (e.g., lymphoplasmacytosis) were focally seen in 2 cases. Cytomegalovirus immunohistochemical stains were negative in all 3 cases. Based on the history and morphology, all 3 cases were diagnosed as anti-PD-1 related gastroenteritis. According to the above diagnosis, the treatment for all 3 patients was to stop anti-PD-1 therapy and use corticosteroids. Clinical follow-up was conducted. The gastrointestinal symptoms of all 3 patients improved significantly and diarrhea symptoms were relieved after stopping immunotherapy. Conclusions: Anti-PD-1 related gastroenteritis is not rare, but pathologists may lack sufficient understanding of it. Combined with clinical history and pathologic characteristics of the lesion, pathologists should consider this disease to avoid the misdiagnoses and missed diagnoses.

P221 Deep dermatophytosis presented as multiple exophytic masses caused by Trichophyton rubrum in immunocompromised patient with rheumatoid arthritis; a case report

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Dermatophyte invades the stratum corneum and infects the skin, nails, and hair, mostly resulting in superficial infection. Deep dermatophytosis involving dermis and subcutaneous layer was rarely reported in immunocompromised state. Herein, we report a case with deep dermatophytosis caused by Trichophyton (T.) rubrum. A 71-year-old woman presented with multiple erythematous exophytic and subcutaneous nodules located on both lower legs. She was taking immunosuppressive agents for rheumatoid arthritis and had taken antifungal agents for tinea pedis and onychomycosis, which was improperly ceased. Histopathologic examination revealed pseudoepitheliomatous epidermal hyperplasia with microabscess formation in epidermis and diffuse granulomatous inflammation consisting of multinucleated giant cells, lymphocytes, neutrophils, and histiocytes in dermis. Imuunohistochemical staining with periodic acid-schiff (PAS) and Gomori methenamine silver (GMS) showed septate and branched fungal hyphae in dermis. Trichophyton rubrum was identified in fungal culture with tissue and confirmed through phylogenetic analysis of internal transcribed spacer (ITS) and large subunit regions (LSU) in ribosomal RNA. Prior to identification of causative organism, her condition deteriorated into septic shock. Amphotericin B was administered empirically for 6 days in order to prevent hematogenous dissemination and skin lesions were simultaneously resolved. Since deep dermatophytosis appears in various clinical manifestations, it is easy to be mistaken for another disease. If treatment is delayed, immunocompetent patients can progress to severe disease courses like hematogenous dissemination, so clinicians should differentiate this disease and conduct treatment at an appropriate time.

Clinical Challenge in Urology: A Nonhealing Wound on the Glans Penis

A 63-year-old male presented to his surgeon 6 months following circumcision for phimosis with complaints of a nonhealing wound on the glans penis. He reported persistent bleeding, pain, and progressive difficulty urinating in the months following the procedure. He was noted to have a grossly dehisced circumcision, with erythematous, beefy granulation tissue involving the entire glans (Fig. 1). Biopsy taken from the glans demonstrated pseudoepitheliomatous hyperplasia, intraepidermal microabscess formation, and focal subepidermal vesiculation overlying brisk inflammation including neutrophils, plasma cells, eosinophils, and lymphocytes (Fig. 2). Infectious workup revealed MRSA on tissue culture (treated without clinical improvement), negative HSV PCR, and negative special stains and tissue cultures for mycobacterial and fungal species. Further laboratory evaluation included rapid plasma reagin (RPR), antineutrophilic cytoplasmic autoantibody (ANCA), Hepatitis A/B/C, HIV, Lyme, antineutrophilic antibody (ANA), and tuberculosis interferon-γ release assay (IGRA)—all were unremarkable/negative. There was no clinical improvement with topical lidocaine, antibiotic ointment, testosterone, halobetasol cream, and courses of oral antibiotics and fluconazole.

Микроабсцессы как возможная причина рецидива хронического остеомиелита

Introduction It is known that the density of the cortical plate of long bones in patients with chronic osteomyelitis changes throughout its extension. However, the nature of structural disorders in the cortical layer outside the inflammation zone has not been studied well. Purpose To study the structural features of the cortical plate of the femur and tibia outside the focus of inflammation to identify microcavities and microabscesses. Material and methods The study is retrospective conducted at one center. Evidence level IV. In 92 patients with chronic osteomyelitis of long bones of the lower extremities, using polypositional radiography and multislice computed tomography (MSCT), the features of radiological morphology of the femur and tibia were studied in order to reveal structural features of the cortical plate and identify microcavities. Results The cause of osteomyelitis in 5 cases was a consequence of hematogenous osteomyelitis, and in 87 cases it developed due to trauma or surgery. The most common location of chronic osteomyelitis was the distal femur and tibia. Anatomical changes in the femur and tibia in all patients had individual differences. Radiological morphological manifestations such as local and general osteoporosis, foci of osteosclerosis, architectonic disorders occurred in all patients. However, the severity of changes in the bone structure was extremely diverse, including the changes in bone density. Conclusion The data obtained indicate that radiological morphological changes in the cortical plate outside the zone of destruction are manifested by formation of microcavities and microabscesses in 15.6 % of patients, what plays an important role in possible recurrence of osteomyelitis.

Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report

BackgroundGranulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare instances, this condition has been reported to be associated with extramammary manifestations such as erythema nodosum and arthritis. We describe this rare condition in an adolescent female.Case presentationA 16-year-old, Hispanic female presented with right-sided painful breast swelling, polyarthritis, and erythema nodosum on bilateral shins and lower thighs. Physical examination was negative for lymphadenopathy and pulmonary, gastrointestinal, and cardiovascular findings. Ophthalmologic examination for uveitis and serologic tests for autoimmune diseases were negative. Diagnosis of idiopathic granulomatous mastitis was made by exclusion of other etiologies and conditions. Confirmation was made by histopathologic examination demonstrating noncaseating granuloma within breast lobules with neutrophils and microabscess formation. After wide local excision and a short course of trimethoprim–sulfamethoxazole, our patient was placed on naproxen and prednisone, the latter being tapered off over 3 months, with steady and complete resolution of all symptoms.ConclusionThis is the first reported case of idiopathic granulomatous mastitis in a pediatric patient who also had extramammary manifestations, including erythema nodosum and polyarthritis. In this case-based review, we summarize the phenotype, risk factors, prognosis, and treatment options of this rare condition, chiefly to make the readers cognizant of such a diagnostic possibility in similar clinical presentation in the future.

Idiopathic granulomatous mastitis: a clinical case and a review of the literature

Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease of the breast with an unknown etiology, characterized by the presence of sterile non-caseous granulomas and the formation of microabscesses in the lobules of the breast. The exact prevalence of this disease is still unknown. This is mainly due to the relatively small number of the reported cases, as well as the diagnostic difficulties. The aim of the study: to highlight the clinical experience of managing a patient with IGM, to explain the role of pathomorphological examination in diagnostic search, to discuss differential diagnosis and treatment modalities according to the review of English-language literature sources. When the patient visited the clinic, the chief complaint was pain in the right breast. On examination, a painless mass with indistinct border and stone-like density up to 2.5 cm was revealed at the union of the inner quadrants of the right breast. The patient underwent a number of tests: ultrasound, MSCT, mammography, MRI, which were indicative of breast cancer. The final diagnosis was made after the double histopathologically verified examination with differential diagnosis. Considering the young age of the patient, the successful experience of conservative management of patients covered in the world literature, the possible cosmetic effects after surgery, it was decided to treat with cytostatics and glucocorticoids. A 3.5- and 7.0-month follow-up of treatment results by a mammologist showed neither visible pathological changes in the breasts nor palpatory nodular or tumor mass. The state after idiopathic granulomatous mastitis was reconvalescence. The paper also discusses other methods of treatment: surgery, drug therapy such as corticosteroids (topical, oral), immunosuppressants (methotrexate, azathioprine) or a conventional follow-up of patients with mild symptoms. However, considering severe pain and significant aesthetic defects as a result of inadequate therapy, the follow-up is not dominant in the patient management. A delay in the diagnosis can lead to treatment errors, causing chronic changes and increasing the inflammatory size in the breast, influence the severity of the disease and subsequent therapy. Conclusions. The clinical case of the patient with IGM, diagnostic search and effective conservative treatment tactics have been described. The significance and indispensability of pathohistological examination in the diagnostic search have been explained. The most effective treatment regimens for IGM patients have been discussed.

Mycotic Aortic Pseudoaneurysm Following ECMO Cannulation

<h3>Introduction</h3> Mycotic aortic pseudoaneurysms (MAP) are a rare but often fatal complication of thoracic surgery. Recently, our institution has transitioned to performing all lung transplants on venous-arterial extracorporeal membrane oxygenation (VA-ECMO) support when possible. Reinforcement of aortic cannulation sites with pledgeted sutures is often necessary to control bleeding; however, pledgets could also represent an iatrogenic risk for infection. Here we present a fatal case of MAP at the cannulation site in a lung transplant recipient (LTR). <h3>Case Report</h3> We present a 56-year-old female who underwent bilateral lung transplant for scleroderma-related interstitial lung disease. Two months following transplant, she was admitted with methicillin-resistant staphylococcus aureus bacteremia. Initial echocardiogram was inconclusive for endocarditis and thus she was treated with IV vancomycin for six weeks with clinical improvement. Unfortunately, two months later she presented with recurrent bacteremia. Initial imaging revealed evidence of ascending MAP formation, confirmed by positron emission tomography (Figure 1). She underwent surgical repair with identification of a palpable MAP and pathology consistent with acute and organizing inflammation with microabscess formation. Despite aggressive medical and surgical management, our patient suffered a catastrophic embolic stroke. <h3>Summary</h3> While performing lung transplant on ECMO support has many potential benefits, it is not without risk. Closure of ECMO cannulation sites with pledgets in immunosuppressed patients may lead to the development of an infected MAP and can have devastating consequences. To our knowledge this is the first case of an infected MAP at pledget site in a LTR.

Superficial Dermatophytic Infection Prevention and Its Management: A Review

Dermatophytes are a group of parasitic fungi that live at the expense of the keratin in the skin, nails and hair. They are generally confined to the stratum corneum of the epidermis and skin appendages, particularly in the tropics, where heat and humidity provide the ideal conditions for the growth of fungi that cause cutaneous infections. The dermatophytes that usually cause only superficial infections of the skin are grouped into three genera: Trichophyton, Microsporum, and Epidermophyton. They can be classified into three groups according to their normal habitats: anthropophilic species, zoophilic species and geophilic species. Dermatophyte infections are subclassified in Latin names according to the sites of skin involved, e.g. Tinea faciei, Tinea manuum, Tinea corporis, Tinea cruris, Tinea pedis, Tinea capitis, Tinea unguium. Trichophyton rubrum is the most common cause worldwide for superficial dermatophytosis. By their metabolic activity they produce inflammatory responses in the form of erythema, scaling, postulation and micro-abscess formation giving rise to itching and discomfort. The high prevalence rate of superficial dermatophytic infection has shown that 20-25% of the world’s population. The diagnosis was confirmed on the basis of clinical presentation, KOH examination of skin and would light examination. The article also discusses the main treatments for superficial dermatophytosis, with a practical approach to the most commonly used topical and systemic drugs, referring also to their dosage and duration of use in different types of the dermatophytic infection. Keywords: Dermatophytosis; Trichophyton rubrum; Tinea; KOH examination.

Investigation of brain mast cells in ovine encephalitic listeriosis

ABSTRACT Mast cells in the brain are associated with increased inflammation during the acute period following exposure to infection; these cells are important for destroying the infectious agents. We investigated the relation between histopathological lesions and mast cells in sheep brains infected with Listeria. Pons and medulla regions from 17 infected and eight normal sheep brains were examined. Microabscesses and perivascular infiltration were assessed for histopathology. Mast cells were identified using toluidine blue and Listeria monocytogenes were investigated immunohistochemically. We found a significant increase in mast cells in infected sheep brains that was related directly to the extent of brain lesions. A strong correlation was found between mast cells and microabscess formation. A correlation between bacteria level and brain lesions also was observed, but not between bacteria level and mast cells. Our findings indicate that mast cells are increased following Listeria infection in sheep in proportion to the severity of brain lesions; the increase may contribute to acute inflammatory reactions and also may destroy bacteria directly.

Comparative Experimental Study of Dermal Stability: Acellular Dermal Matrix versus Crayopreserved Dermis.

BACKGROUNDGiven the potential usefulness of Acellular Dermal Matrices (ADM) for wound healing, we aimed to evaluate the stability, histological characteristics, and effectiveness of ADM compared with cryopreserved dermis (CPD) in rat models.METHODSThis experimental study was conducted in the Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran, from January to March 2015. The prepared ADM and CPD were transplanted to the full-thickness skin defects on the back of Sprague-Dawley rats. Forty-five days after grafting, the tissues were harvested for histological examination. These two types of the dermis' quality and stability were compared with consideration of the following factors; inflammation, fibroblasts migration, vascularization, collagen formation, capsule formation, and microabscess formation.RESULTSFrom 19 selected rates, nine received CPD, and ten were treated with ADM. After transplantation, the mean (SD) weight of ADM and CPD grafts were 1.74 (0.07) and 1.45 (0.77), respectively (P<0.001). The frequency of inflammation was significantly higher in CPD grafts (P<0.01). Higher grades of collagen organization, fibroblast spreading, and vascularization were more frequent in ADM grafts (P<0.01). The frequency of capsule and microabscesses formation was not significantly different between studied groups.CONCLUSIONADM have a superior effect than CPD in the wound healing process. Both samples had a similar effect in capsule and microabscesses formation and higher costs of ADM preparation. According to the physicians' decision and evaluation of the process's cost-effectiveness, CPD could be appropriately used as an alternative to ADM.

Granulomatous mastitis − treatment options and our experience

Granulomatous mastitis (GM) is a rare benign inflammatory disease of the breast, first described by Kessler and Wolloch in 1972. Clinically, it can present as unilateral, sometimes painful, increasing breast resistance, or as a hard, irregular mass. Sonography is the most useful diagnostic method for GM evaluation. The only method for definitive diagnosis is the use of biopsy. In histological findings, GM is characterized by non-caseifying granulomas, often associated with microabscess and fistula formation. There is considerable heterogeneity in treatment options; this may explain the high recurrence rate which is close to 50%. Such a high recurrence rate is alarming and proves that current treatments are suboptimal. Two treatment options are discussed worldwide: conservative strategies involving drug therapy with corticosteroids versus a surgical approach involving partial or total mastectomy. All conservative treatment options are associated with a high risk of recurrence, and most patients require surgery in the end. Thorough excision of inflammatory tissue is crucial for successful treatment while negative surgical margins are associated with a low recurrence rate. The surgical approach to GM requires sufficient radicality and presumes knowledge in the field of reconstructive breast surgery, similarly to oncosurgical breast conservation operations. However, alternatives to GM treatment with oral steroids may be acceptable for patients concerned about surgery. This article presents six case reports of patients treated at our department.

Comparison of the response of mammary gland tissue from two divergent lines of goat with high and low milk somatic cell scores to an experimental Staphylococcus aureus infection

Mastitis represents one of the major economic and health threats to the livestock sector associated with reduction in milk quality, loss of production and is a major reason for culling. Somatic cell score (SCS) is used as a criterion in breeding programmes to select cows genetically less susceptible to mastitis. The relevance of SCS as a predictor of udder health and susceptibility to mastitis is still untested in goats. In this study, two lines of French Alpine goats selected for extreme breeding values for somatic cell scores, one line with high SCS (HSCS) and the other with low SCS (LSCS), were used to test the hypothesis that the mammary response and function differed between the lines. The aim of the present study was to investigate differences in the early immune response in caprine mammary gland tissues challenged with Staphylococcus aureus, one of the main pathogens responsible for the intra-mammary infection in small ruminants, using transcriptomic and histopathology analyses.The comparison between HSCS and LSCS goat lines, showed differences in the response at the histological level for inflammation, presence of neutrophils and micro-abscess formation, and at the molecular level in the expression of CXCL8, IL-6, NFKBIZ and IL-1β. CXCL8 and CXCL2 genes, which showed a higher level of expression in the experimentally infected HSCS line. The molecular data and histopathology both suggested that following S. aureus infection, mobilization, recruitment, infiltration, and chemotaxis of neutrophil, leads to a more severe inflammation in the HSCS compared to LSCS animals. Our results represent an initial basis for further studies to unravel the genetic basis of early mastitis inflammatory responses and the selection of dairy animals more resistant to bacterial mastitis.

Granulomatous Mastitis: A Clinical and Diagnostic Dilemma.

Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the difficulties in evaluating trucut biopsies, and the results of different therapeutic approaches. We retrospectively analysed the clinical, radiological and morphological features of 114 GM cases diagnosed with fine needle aspiration, and trucut, incisional, and excisional biopsy. The mean age was 35.8. Only eight cases were older than 45 years. Bilateral involvement was observed in 4 (3.5%) cases. The most common clinical symptoms were breast mass/abscesses, tenderness, and skin changes. Microbiological culture was positive in 4 cases for gram-positive bacteria. Only 3 cases showed a positive tuberculin/PCR test for tuberculosis. The major USG finding was a hypoechoic well-defined or ill-defined mass/abscess; MRI finding was heterogeneous non-mass contrast enhancement. Cases diagnosed with cytology (35 cases) did not have breast malignancy either in their history or clinical follow up period. Fine needle aspiration cytology materials revealed epitheloid granulomas mixed with neutrophils, lymphocytes accompanied by giant cells, and suppurative necrosis. Histopathological reevaluation of 65 trucut/incisional/ excisional biopsies revealed granuloma formation in 65 (100%), Langhans type giant cells in 59 (90.7%), microabscess formation in 41 (63%), caseous necrosis in 1 (1.5%), neutrophilic cysts in 30 (46.1%), eosinophilic infiltration in 48 (73.8%), interlobular inflammation in 14 (21.5%), fat necrosis in 5 (7.6%), ductal ectasia in 6 (9.2%), and lactational changes in 4 (6.1%) cases. Granulomas were lobulocentric in 58 cases, foreign body type/fat necrosis-related in 6 case, and periductular in 1 case. Cystic neutrophilic granulomatous mastitis was observed in one case. We also evaluated the histochemical stains of these 65 biopsies. Only one sample was positive for acido-resistant bacilli (ARB) by the EZN method and one sample was positive for gram-positive bacilli by gram stain. Small, superficial trucut biopsies may cause difficulties in determining the etiology and differential diagnosis of granulomatous mastitis. For optimal management and timing the appropriate therapy, the ideal biopsy procedure, special stains, and a multidisciplinary team consisting of the surgeon, pathologist, and radiologist are the most important issues.

Histopathological alterations due to different phylogroups of Escherichia coli isolated from clinical cases of bovine endometritis in rat model

In the present study, E. coli isolates representing four different phylogroups viz. A, B1, D, and F were used in rat model to study their pathogenic potential for the development of endometritis. Animal were classified into four infected groups and one group served as negative control. Isolates representing respective phylogroups were inoculated by intrauterine route in twenty diestrus rats. Histopathological changes noted in all the experimental groups with varying intensity of lesions of endometritis characterized by invasion of neutrophils in endometrial superficial epithelium, stratum compactum, uterine cavity, and microabscess formation. Experimental group 4 (phylogroup D) showed highest mean histopathological score, followed by group 2 (phylogroup A), group 3 (phylogroup B1) and group 5 (phylogroup F). However, no statistical significant difference could be observed between the infected groups. The present study concluded that, different phylogroups of E. coli do not differ significantly to induce the lesions of endometritis in diestrus rats.