Intestinal Abscess Research Articles

COMPARATIVE IN VITRO ANTIBACTERIAL ACTIVITY OF ETHANOLIC EXTRACT OF PLUMBAGO ZEYLENICA

Ethanolic extract of leaf, flower and root of Plumbago zeylenica L. (white variety) traditionally used in the treatment of gastrointestinal disorders were screened for antibacterial activity against bacterial pathogens Staphyllococcus aureus, Escerchia coli, Klebsiella pneumoniae, Enterobacter aurugens, Proteus vulgaris, Shigella sonnei, Salmonella typhi which are known to cause different type of gastrointestinal disorders. The results showed that leaf and root extracts exhibited strong antibacterial action at concentration of 2-8 mg/ mL of the bacterial pathogen tested. However, powdered flower extract showed moderate activity. Thus the present data reveals that leaves and flowers are equally potential for the treatment of bacterial pathogens, which causes intestinal catarrh, indigestion, and colic intestinal abscesses.

Comparative study on WHO Western Pacific Region and World Federation of Chinese Medicine Societies international standard terminologies on traditional medicine: Diseases in External Medicine (Part 1)

External medicine, also frequently described as surgery, has a history as long as that of traditional Chinese medicine (TCM). There were important doctors in each dynasty who devoted themselves to the study and practice of external medicine. In TCM external medicine, diseases are named either according to their location (such as neck abscess and back carbuncle), or viscera involved (such as intestinal abscess and lung abscess), or causes (such as tetanus and chilblain,

Intestinal Abscess Caused by Botulism

Introduction: Botulism is a rare but life threatening neuroparalytic condition caused by bacterium Clostridium botulinum. We report a case of a middle-aged male who developed intestinal abscesses that were secondary to Botulism. Case: A 43-year-old male was admitted to our institution with abdominal pain, blurred vision and dysarthria for one day duration. He denied any fever, headache or neck stiffness. Past medical history was significant for diabetes mellitus, hypertension and gout. Examination revealed normal vital signs, inability to protrude the tongue with no evidence of palpable adenopathy or rash. MRI brain was unremarkable. Laboratory values showed leukocytosis of 20.3 K/microliter and platelet count of 602 K/microliter. CT scan abdomen and pelvis showed multiloculated gas containing fluid collections in the perigastric area and in left anterior abdominal wall. Abscesses were incised and drained and culture from the abscess was positive for Clostridium botulinum type A toxin. Serum, stool and gastric aspirate were assayed using mouse bioassay which were positive for type A botulinum toxin. Subsequently, patient developed respiratory failure and was intubated requiring mechanical ventilatory support. The patient got botulinum antitoxin and was treated with imipenem. Subsequently, his condition started improving and is recovering neurologically in the last three weeks of follow-up. Discussion: Botulism is an acute neuroparalytic condition characterized by cranial nerve palsies followed by descending symmetrical flaccid paralysis which can cause respiratory arrest and can be fatal. Botulism is caused by botulinum neurotoxin types A, B, E or F and G produced by Clostridium species (C. botulism, C. baratti, C. butyricum). Three major forms of botulism are: 1) Food borne botulism from ingestion of food contaminated by preformed botulism neurotoxin. 2) Intestinal botulism caused by colonization from Clostridium botulinum followed by in situ production of toxin. 3) Wound botulism caused by contamination of wound by Clostridium botulinum and production of neurotoxin in situ. A careful history and physical examination, serum assays, analysis of stool and suspected food item may also reveal neurotoxin which is diagnostic when coupled with appropriate clinical and neurological findings. If clinical suspicion for botulism is high, Centers for Disease Control and Prevention (CDC) should be contacted for administration of botulism antitoxin which is the standard of care followed by antibiotics. To summarize, our case reiterates the importance of early and prompt diagnosis of botulism which is a fatal disease to initiate therapy in a timely fashion.

Dramatic Increase in Glycerol Biosynthesis upon Oxidative Stress in the Anaerobic Protozoan Parasite Entamoeba histolytica

Entamoeba histolytica, a microaerophilic enteric protozoan parasite, causes amebic colitis and extra intestinal abscesses in millions of inhabitants of endemic areas. Trophozoites of E. histolytica are exposed to a variety of reactive oxygen and nitrogen species during infection. Since E. histolytica lacks key components of canonical eukaryotic anti-oxidative defense systems, such as catalase and glutathione system, alternative not-yet-identified anti-oxidative defense strategies have been postulated to be operating in E. histolytica. In the present study, we investigated global metabolic responses in E. histolytica in response to H2O2- and paraquat-mediated oxidative stress by measuring charged metabolites on capillary electrophoresis and time-of-flight mass spectrometry. We found that oxidative stress caused drastic modulation of metabolites involved in glycolysis, chitin biosynthesis, and nucleotide and amino acid metabolism. Oxidative stress resulted in the inhibition of glycolysis as a result of inactivation of several key enzymes, leading to the redirection of metabolic flux towards glycerol production, chitin biosynthesis, and the non-oxidative branch of the pentose phosphate pathway. As a result of the repression of glycolysis as evidenced by the accumulation of glycolytic intermediates upstream of pyruvate, and reduced ethanol production, the levels of nucleoside triphosphates were decreased. We also showed for the first time the presence of functional glycerol biosynthetic pathway in E. histolytica as demonstrated by the increased production of glycerol 3-phosphate and glycerol upon oxidative stress. We proposed the significance of the glycerol biosynthetic pathway as a metabolic anti-oxidative defense system in E. histolytica.

Global analysis of gene expression in response to L-Cysteine deprivation in the anaerobic protozoan parasite Entamoeba histolytica

BackgroundEntamoeba histolytica, an enteric protozoan parasite, causes amebic colitis and extra intestinal abscesses in millions of inhabitants of endemic areas. E. histolytica completely lacks glutathione metabolism but possesses L-cysteine as the principle low molecular weight thiol. L-Cysteine is essential for the structure, stability, and various protein functions, including catalysis, electron transfer, redox regulation, nitrogen fixation, and sensing for regulatory processes. Recently, we demonstrated that in E. histolytica, L-cysteine regulates various metabolic pathways including energy, amino acid, and phospholipid metabolism.ResultsIn this study, employing custom-made Affymetrix microarrays, we performed time course (3, 6, 12, 24, and 48 h) gene expression analysis upon L-cysteine deprivation. We identified that out of 9,327 genes represented on the array, 290 genes encoding proteins with functions in metabolism, signalling, DNA/RNA regulation, electron transport, stress response, membrane transport, vesicular trafficking/secretion, and cytoskeleton were differentially expressed (≥3 fold) at one or more time points upon L-cysteine deprivation. Approximately 60% of these modulated genes encoded proteins of no known function and annotated as hypothetical proteins. We also attempted further functional analysis of some of the most highly modulated genes by L-cysteine depletion.ConclusionsTo our surprise, L-cysteine depletion caused only limited changes in the expression of genes involved in sulfur-containing amino acid metabolism and oxidative stress defense. In contrast, we observed significant changes in the expression of several genes encoding iron sulfur flavoproteins, a major facilitator super-family transporter, regulator of nonsense transcripts, NADPH-dependent oxido-reductase, short chain dehydrogenase, acetyltransferases, and various other genes involved in diverse cellular functions. This study represents the first genome-wide analysis of transcriptional changes induced by L-cysteine deprivation in protozoan parasites, and in eukaryotic organisms where L-cysteine represents the major intracellular thiol.

Anti-inflammatory effects of methanol extract of Patrinia scabiosaefolia in mice with ulcerative colitis

Patrinia scabiosaefolia Fisch is used in folk medicines to treat intestinal abscesses, acute appendicitis, and dysentery in Asia. Although recent reports indicate that Patrinia scabiosaefolia has sedative and anti-tumor effects, its effects on ulcerative colitis have not been previously explored. To determine the effects and the mode of action of the methanol extract of the roots of Patrinia scabiosaefolia (PME) on a model of colitis in mice induced by dextran sulfate sodium (DSS). We induced colitis using DSS in 5-week-ICR mice over 7 days and estimated disease activity index (DAI), which took into account body weight, stool consistency, gross bleeding, and tissue myeloperoxidase (MPO) accumulation. Colon lengths and spleen weights were measured. Histological changes were observed by H&E staining. Pro-inflammatory mediators, namely, nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6), were determined using Griess assays, immunoassays, and by quantitative real-time reverse-transcriptase polymerase chain reaction (qRT-PCR), respectively. PME significantly attenuated DSS-induced DAI scores and tissue MPO accumulation, which implied that it suppressed weight loss, diarrhea, gross bleeding, and the infiltrations of immune cells. PME administration also effectively and dose-dependently prevented shortening of colon length and enlargement of spleen size. Histological examinations indicated that PME suppressed edema, mucosal damage, and the loss of crypts induced by DSS. Furthermore, PME inhibited the abnormal secretions and mRNA expressions of pro-inflammatory cytokines, such as, TNF-α, IL-1β, and IL-6. These results suggest that PME has an anti-inflammatory effect at colorectal sites that is due to the down-regulations of the productions and expressions of inflammatory mediators, and that it may have therapeutic value in the setting of inflammatory bowel disease (IBD).

Reconnecting the Baseball Star

Reconnecting the Baseball Star Irving Rein and Ben Shields If Babe Ruth were a sports star in the digital age, how would the media handle him? Consider the event enshrined as the "bellyache heard round the world," Ruth's physical setback before the 1925 season. The crisis begins at spring training, where he started to feel ill but remained with the team and kept playing. On April 7 his condition worsened to the point where he collapsed while in Asheville, North Carolina, and was sent home to New York the next night for treatment. After arriving in New York, Ruth's personal physician, Dr. Edward King, ultimately diagnosed him with an intestinal abscess, which he said was caused by Ruth's diet. In the media, sportswriter W. O. McGeehan recast the doctor's conclusion, claiming that Ruth's collapse was the result of a hot dog overdose, a story that led to the event's now famous bellyache label.1 Despite this seemingly convincing story, lurking questions about what caused Ruth's illness have always underlain the bellyache episode. Was it merely overindulgence in brats and Coca Colas that caused the intestinal abscess? Or was it the result of the hard drinking, womanizing, and gluttonous lifestyle that Ruth had been leading? Some sportswriters even privately speculated that Ruth suffered from gonorrhea, a condition contracted from his notorious late-night partying.2 While these theories questioned Ruth's lifestyle and his penchant for alcohol and women, sportswriters at the time never printed a word of speculation, and Ruth survived not only a medical problem but a surefire communications nightmare. This situation would have been drastically different if today's all-pervasive, technology-driven media covered Ruth's illness. A cable television sports network would be following the Yankees in spring training, covering the team in advance of the season with a behind-the-scenes look at the players. At the first suggestion that Ruth was suffering from stomach cramps and a fever, news would be flashed on sports Web sites and text messaged to cell phone users—"Ruth Has Bellyache, 102.3 Fever. Listed as Day-to-Day"—and the television [End Page 62] anchors and newspaper reporters would file instant reports on his condition, often belligerently debating its causes and solutions as if they all went to medical school. And the crawler on the cable stations all morning, afternoon, and night would read: "BREAKING NEWS: Ruth in serious but stable condition," followed by: "Sources close to the team hint at lifestyle causes." Adding to the media barrage would be the key opinion-leading bloggers and podcasters, who would join the media blitz by writing or recording their own thoughts and interpretations of the illness, with the traditional media using this information in their own reports. Fans themselves would also travel to the training facility with their video recorders and digital cameras, hoping to capture a video to upload on YouTube and take a picture to post on their MySpace page. All of this is just day one of the Ruth bellyache. As new information about his condition is released, the sports world would expect updates in all channels until his illness was resolved and recovery time completed. During his era Ruth was glorified for not only his home runs but also his outsized persona, receiving a pass in the prime of his career for behavior that today's baseball stars could never attempt without significant consequences. In today's media environment, it is unlikely that stories of Ruth's excessive lifestyle would go unnoticed, and his image would almost certainly be tarnished. In light of this comparison, would Babe Ruth still be considered as not only the greatest baseball star of all time but also the gold standard of the golden age if he played under such media scrutiny? Although it is impossible to compare players across historical generations in sports, it is certainly less likely. Placing a Babe Ruth crisis in a modern-baseball context demonstrates how the contemporary communications environment in the sports industry has evolved over the course of baseball history. Ruth played in an era in which, despite his wildly careening off-the-field decisions, his...

Recurrent Complicated Colon Diverticulitis in Renal Transplanted Patient

Colon perforation due to diverticulitis is a life-threatening complication in the postoperative course of kidney transplantation. In the immunocompromised patient a diagnosis of diverticulitis is difficult to make. We report a 53-year-old woman being kidney transplanted 14 years ago with known diverticulosis. She was admitted with acute severe pain in the lower left abdomen. Abdominal computed tomography (CT) scan indicated a diagnosis of intestinal abscess in the small pelvis. Laparotomy showed a covered sigma perforation with abscess located in the small pelvis (Hinchey-I). Because of the immunocompromised situation of the patient we performed a Hartmann procedure. Her postoperative course was uneventful. In a 6-month interval the intestinal continuity restoration was performed. Twelve days after discharge the patient was readmitted with reduced renal function and increased infection parameters. During physical examination the abdomen was tender. The patient complained of abdominal pain in the left upper abdomen and additional pain in the left shoulder. An antibiotic therapy using ciprofloxacin was already initiated owing to a urinary tract infection. An abdominal CT scan was performed and indicated an intestinal abscess in the left upper abdomen. Laparotomy showed an abscess involving transverse colon, distal jejunum, and proximal ileum (Hinchey-II). Segmental resection of the left colonic flexure, proximal jejunum, and ileum was performed. The postoperative course was uneventful and the patient was discharged on the 8th postoperative day. The present casuistry emphasizes that the immunocompromised patient can undergo diverticulitis twice, and that primary anastomosis is a feasible option for patients with localized peritonitis due to complicated diverticulitis.