Non-specific Antibiotics Research Articles

Clinical Presentation of Cat Scratch Disease in Pediatric Patients-A Single-Center Study.

Cat scratch disease (CSD) is the infectious disease caused by Bartonella henselae. Its typical presentation is regional lymphadenopathy. Also it may present with symptoms related to involved organs or disseminated disease with fever of unknown origin (FUO). Here children with CSD are evaluated to increase awareness about disease. A total of 29 children diagnosed with CSD between 2019 and 2022 were involved in the study. Patients' demographic characteristics, clinical, laboratory and radiological findings, treatments, and outcomes were analyzed. Seventeen of the patients were male, 12 were female, and their mean age was 116.5 ± 51 months. About 69.6% of them had a history of cat contact. Twenty-seven patient (93.1%) had lymphadenopathy, mostly axillary involved (61.5%). Other manifestations were disseminated disease presented with FUO, neuroretinitis, and encephalopathy. Twenty-seven patients (93.1%) had received antibiotics before admission without any improvement. Ultrasound showed that the affected lymph nodes were conglomerated, lobulated contoured, and cortical thickened, with one-third having cystic suppurative components. Serologic tests were positive in 24 of 27 patients. Twenty-one patients gave response to 5 days azithromycin treatment, in 8 patients this treatment extended to 10-14 days, rifampicin with/without doxycycline was given to 6 patients, and steroids were given to 3 patients. In case of regional lymphadenopathy, especially axillary, not responding to nonspecific antibiotics CSD should be suspected. Cat contact history and serological and ultrasonographic findings are useful for diagnosis. Even if CSD responds well to azithromycin, sometimes prolongation of azithromycin and addition of other antibiotic or steroid may be required.

Successful treatment of Keratitis caused by Mycobacterium chelonae and an overview of previous cases in Europe

Introduction and purposeMycobacterium (M.) chelonae is responsible for a half of relatively rare nontuberculous mycobacteria (NTM) keratitis. We report a case of M. chelonae keratitis in a woman following sclerocorneal suture extraction after cataract surgery.ResultsA 70-year-old woman presented with a red eye and corneal infiltration of her left eye six weeks following sclerocorneal suture extraction after an elective cataract surgery in another institute. She complained of a sharp, cutting pain and photophobia. Since initial corneal scrapes and conjunctival swabs proved no pathogen using culture and PCR methods, non-specific antibiotics and antifungal agents were administered. As keratitis was complicated by an inflammation in the anterior chamber and vitreous, samples of the vitreous fluid were sent for microbiologic examination. DNA of Epstein-Barr virus (EBV) was repeatedly detected. Since the intrastromal abscess had formed, corneal re-scrapings were performed and M. chelonae was detected using culture, MALDI-TOF MS and PCR methods. Therapy was changed to a combination of oral and topical clarithromycin, intravitreal, topical and intracameral amikacin, and oral and topical moxifloxacin. The successful therapy led to stabilization. The optical penetrating keratoplasty was performed and no signs of the infection recurrence were found.ConclusionsThe diagnosis of nontuberculous mycobacterial keratitis is difficult and often delayed. An aggressive and prolonged antimicrobial therapy should include systemic and topical antibiotics. Surgical intervention in the form of corneal transplantation may be required in the active and nonresponsive infection. In the presented case this was necessary for visual rehabilitation due to scarring.

Block copolymer-derived recessed nanodisk-array electrodes for electrochemical detection of β-lactam antibiotics

Antimicrobial resistance (AMR) is one of the major socio-economic factors contributing to public health. β-lactams are most commonly prescribed drugs for variety of bacterial infections. Frequent use of antibiotics leads to AMR in humans and animals. The present work is focused on developing an electro-immunosensor to control and regulate the excessive use of antibiotics in animal-based food products. An amphiphilic block co-polymer poly(ethylene oxide-block-methyl methacrylate)(PEO-b-PMMA) was used to fabricate recessed nano-disk array electrode (RNE) and immobilized with Pen-Ab and Cef-Ab antibodies. The Limit of detection (LOD) of RNE working electrode was found to be 14.8 pM for penicillin and 13.8 pM for cefalexin with good selectivity in presence of non-specific antibiotics. Fabricated RNE electrode could detect trace amounts of spiked antigen in real samples of milk, egg and meat extract. Further, mesoporous thin film and microarrays can eventually be used to develop point-of-care diagnosis of antibiotics in animal-based food products.

Diagnostic challenges of brucellosis in humans and livestock in Tanzania: A thematic review

Abstract Brucellosis is an endemic bacterial zoonosis in Tanzania, and is among the most prioritized zoonotic diseases in the country. Brucellosis affects public health and livestock production in developing countries. Most human and livestock cases are not detected by the existing surveillance systems resulting in significant underestimation of the disease burden, and poor management of human cases by using nonspecific antibiotics may potentially contribute to antimicrobial resistance. To quantify the factors related to underreporting and those associated with the challenges in the diagnosis of brucellosis in Tanzania, search terms including “Brucella” “diagnosis” and “challenges” were used to query in Google search engine and publisher databases such as MEDLINE, PUBMED, NCBI, Springer, Hindawi, and Elsevier. The search parameters were limited to publications between 1995 and 2020. The searches returned 319 publications and grey articles which were screened and 57 were eligible for inclusion in this study. Four main areas were identified that cause underreporting of brucellosis and hinder brucellosis diagnosis: (1) inadequate knowledge of brucellosis among stakeholders in the livestock value chain, (2) limited diagnostic capacity for brucellosis due to unawareness of diagnostic tests and lack of epidemiological background of brucellosis among human and livestock health service workers (3) challenges associated with diagnostic tests, which include unreliable availability of diagnostic tests and unskilled workers, and (4) the uneven distribution of brucellosis surveillance studies in the country. This study suggests that there is a need for (1) training on public health education and brucellosis awareness among stakeholders in the livestock value chain; (2) providing scheduled continuing professional education with regard to brucellosis and other zoonotic diseases to health and livestock workers; (3) future brucellosis surveillance studies must focus on unrepresented regions; and (4) lastly, we recommend that the rose Bengal plate test (RBPT) and competitive enzyme-linked immunosorbent assay (cELISA) should be considered in brucellosis diagnostic schemes as a complementary tool to hasten the implementation of an ongoing national strategy for the prevention and control of brucellosis in humans and livestock in Tanzania. We suggest that these recommendations be considered for inclusion in the national strategy for brucellosis control in Tanzania. One Health Impact Statement Brucellosis is a disease caused by bacteria of genus Brucella and is transmitted from animals to humans. Humans get infected through ingestion of infected animal products but also through contact with bacteria via broken skin or inhalation of aerosolized bacteria particles during culture in the laboratory. Humans working with animals or animal products and laboratory personnel are at higher risk of infection. Tanzania has recently established a One-Health desk in the Prime Minister’s Office to address all matters related to One Health. However, the desk is in the infancy stage, more studies must be done to fill knowledge gaps so that working instruments became realistic. This review provides a synthesis of information that could be used by the One Health desk and other One Health stakeholders in the country on how to improve the existing brucellosis surveillance structures for improvement of One-Health service delivery in the country.

Gold Nanorod-Incorporated Halloysite Nanotubes Functionalized with Antibody for Superior Antibacterial Photothermal Treatment.

The global spread of antibiotic-resistant strains, and the need to protect the microflora from non-specific antibiotics require more effective and selective alternatives. In this work, we demonstrate for the first time a superior antibacterial photothermal effect of plasmonic gold nanorods (AuNRs) via their incorporation onto natural clay halloysite nanotubes (HNTs), which were functionalized with anti-E. coli antibodies (Ab-HNTs). AuNRs were incorporated onto the Ab-HNTs through a facile freeze–thaw cycle, and antibody integrity following the incorporation was confirmed via infrared spectroscopy and fluorescence immunolabeling. The incorporation efficiency was studied using UV-Vis absorption and transmission electron microscopy (TEM). Mixtures of E. coli and AuNR-Ab-HNTs hybrids or free AuNRs were irradiated with an 808 nm laser at 3–4 W cm−2, and the resulting photothermal antibacterial activity was measured via plate count. The irradiated AuNR-Ab-HNTs hybrids exerted an 8-fold higher antibacterial effect compared to free AuNR under 3.5 W cm−2; whereas the latter induced a 6 °C-higher temperature elevation. No significant antibacterial activity was observed for the AuNR-Ab-HNTs hybrid against non-target bacteria species (Serratia marcescens and Staphylococcus epidermidis). These findings are ascribed to the localization of the photothermal ablation due to the binding of the antibody-functionalized clay to its target bacteria, as supported through TEM imaging. In the future, the HNTs-based selective carriers presented herein could be tailored with other antibacterial nanoparticles or against another microorganism via the facile adjustment of the immobilized antibody.

Pre and Post Test Clinical Study to Assess the Combined Effect of Brihatyadi Ksheera Kashaya, Chandraprabhavati and Shweta Parpati in Urinary Tract Infection


 
 Purpose: UTI is the broad term used to describe infection of any part of urinary tract and is a problem frequently encountered by health care providers today. E.coli is found to be the main causative agent for causing UTI (80%). The prevalence of UTI are increasing and the present standard of care includes the usage of antibiotics. The alarming and exponential use of nonspecific antibiotics, increased resistance and the high cost of prescribed medications for the management of the infective microorganisms will raise the need for alternate and safe medication. The signs and symptoms of Mutrakruchra and UTI are similar in nature. The combination of Brihatyadi Ksheera Kashaya, Chandraprabhavati and Shweta Parpati is widely practiced in Mutrakruchra. The present study was aimed at exploring the combined effect of the above combination in UTI.
 Materials and Methods: The present study was a single group study with pre and post test study design. 20 diagnosed cases of UTI based on ICD10N39.0 diagnostic criteria and proper exclusion were selected from IPD and OPD of Amrita Ayurveda Hospital. They were administered Brihatyadi Ksheera Kashaya, Chadraprabhavati and Shweta Parpati for 15 days.
 Result: The obtained data were analyzed statistically with symptoms of UTI, Urine analysis and urine culture by using Wilcoxon signed rank test done on the 0th and 16th day. There was significant change with 100% of improvement in clinical symptoms of UTI after treatment. Statistically significant result was obtained in reduction of WBC with p value 0.001, Epithelial cells with p value 0.005, and Nitrites, Leucocyte esterase, Bacteria with p value 0.0001. There was reduction in growth of E.coli in urine culture with statistically significant p value 0.0001. Conclusion: The combination of Brihatyadi Ksheera Kashaya, Chandraprabhavari and Shwetaparpati is effective in UTI.

Alterations of gut microbiota in patients with active pulmonary tuberculosis in China: a pilot study

Background: The aim of this study was to identify the differences in diversity, composition, and function of the gut microbiota between tuberculosis (TB) patients and healthy controls (HCs).Methods: A cross-sectional study was conducted in three cities of China. Stool samples from 94 treatment-naive TB patients and 62 HCs were analyzed by 16S rRNA gene sequencing. TB patients were further divided into antibiotic-free and antibiotic-exposure according to their use of non-specific antibiotics before the TB diagnosis.Results: Compared with HCs, antibiotic-free TB patients presented a different gut microbial community (P < 0.005) and decreased Shannon diversity (P < 0.005). Among TB patients, the relative abundances of short-chain fatty acid (SCFA)-producing genera such as Lachnospiraceae ND3007 group (log2(FC) = −2.74) were lower, while several conditional pathogen-related genera such as Enterococcus (log2(FC) = 12.05) and Rothia (log2(FC) = 6.322) were at higher levels. In addition, 41% of patients received antibiotics before TB diagnosis. Antibiotic exposure was correlated with an additional reduction in α diversity and depletion of SCFA-producing bacteria. Microbial functional analysis revealed that the biosynthesis capacity of amino acids and fatty acids was lower among TB patients compared to HCs.Conclusions: Significant alterations in gut microbiota composition and metabolic pathways of TB patients were observed. Antibiotic exposure could alter the gut microbiota of TB patients, which should be considered in anti-TB treatment.

Alteration of Intestinal Microbiome of Clostridioides difficile-Infected Hamsters during the Treatment with Specific Cow Antibodies.

Clostridioides difficile infection (CDI) often develops after pretreatment with antibiotics, which can lead to damage of the intestinal microbiome. The approach of this study was to use specific polyclonal antibodies isolated from the milk of immunized cows to treat CDI, in contrast to the standard application of nonspecific antibiotics. To gain a deeper understanding of the role of the microbiome in the treatment of CDI with bovine antibodies, stool and intestinal fluid samples of hamsters were collected in large quantities from various treatments (>400 samples). The results show that the regeneration of the microbiome instantly begins with the start of the antibody treatment, in contrast to the Vancomycin-treated group where the diversity decreased significantly during the treatment duration. All antibody-treated hamsters that survived the initial phase also survived the entire study period. The results also show that the regeneration of the microbiome was not an antibody-induced regeneration, but a natural regeneration that occurred because no microbiota-inactivating substances were administered. In conclusion, the treatment with bovine antibodies is a functional therapy for both the acute treatment and the prevention of recurrence in hamsters and could meet the urgent need for CDI treatment alternatives in humans.

A Comprehensive Review and Perspective of Herbal Medicines in the Treatment of COVID-19

Background: An emergent COVID-19 outbreak originated in Wuhan City, in December 2019. The COVID-19 contamination has swiftly unfold from Wuhan to maximum different provinces and different 24 countries. WHO declared a public health emergency of global concern over this worldwide COVID-19 outbreak on 30th January 2020. Manifold research has been intensely initiated for immunization and drug development for COVID-19 till date no specific vaccine or approved drugs are accessible for COVID-19. Alternatively, therapy consists of supportive care and non-specific anti-viral, anti-malarial, and antibiotics are being testedas drugs for COVID-19. Though, novel approaches could play a crucial role to combat mortality rate and patient recovery in the treatment of COVID-19.&#x0D; Objective: To reveal the epidemiology, pathophysiology, and comparison of promising synthetic and natural drug targets to avert and cure of COVID-19.&#x0D; Method: This article sets a brief understanding of the viral characteristics, its life cycle, infection to humans, and the pathophysiology of the disease. It also throws light on the currently used synthetic medicines. we have reviewed the effect of natural products to prevent or treat COVID-19 infection. Their mechanisms of action have been elaborately discussed. literature research was undertaken using PubMed, Google Scholar, Scopus, and WHO website. The different herbal products (extracts) and their moieties which are promising as anti-SARS-CoV-2 by direct inhibition of the virus replication or entry has also been discussed.&#x0D; Results and Conclusion: In conclusion we have highlighted that natural therapeutics either alone or in combinationcould be used as alternative medicines to treat/prevent COVID-19 infection. Moreover, their structures may offer clues for the development of anti-SARS-CoV-2 drugs.The integration of nanocarriers for effectively delivering the conventional as well as the herbal drugs becomes a key point for their efficacy and safety.

Medical progress: Stem cells as a new therapeutic strategy for COVID-19.

Currently, the world is facing the SARS-CoV-2 pandemic, coronavirus of acute respiratory distress syndrome 2, causes of COVID-19. Coronaviruses are RNA single-stranded viruses that have an envelope. In addition, coronaviruses are classified into four subfamilies: alpha, beta, gamma and delta coronaviruses. The first of them, cause mildly symptomatic or asymptomatic infections, while beta-coronaviruses are responsible for severe diseases. SARS-CoV-2 belongs to the group of beta-coronaviruses. Current available therapies use corticosteroids to reduce inflammation, non-specific antiviral drugs or antibiotics in the treatment of secondary bacterial infections. In addition, therapies based on the use of hydroxychloroquine, chloroquine, remdesvir, ribavirin, interferon or lopinavir-ritonavir were also initially used. Mesenchemical stem cells (MSCs) are widely used in cell therapies, which include both basic research and clinical trials. Their exceptional effectiveness and safety have been confirmed and documented in many clinical studies, which include a number of inflammatory diseases involving the immune system – one of them is systemic lupus erythematosus. Available data indicate the ability to differentiate MSCs and their immunomodulatory effects. In addition, through interactions with immune cells, which include, but are not limited to, macrophages and dendritic cells, or paracrine secretion, MSCs are able to secrete a number of types of cytokines. MSCs are also characterized by tissue regeneration and regulation of inflammation. Due to their properties, researchers turned to determine whether MSC transplantation is able to improve the outcome of patients with COVID-19 viral pneumonia. The presented review provides not only new knowledge in the field of molecular mechanisms of pro-regenerative action of stem cells, but also have the potential to open up new prospects of action to improve lung tissue regeneration in COVID-19 patients. In addition, in review mentioned about clinical trials using MSCs with a complete status, as well as the latest discoveries in molecular biology, a platform model of pluripotent stem cells in the SARS-CoV-2 study on 3D animal models and nanoconjugates based on stem cells.

Medical Progress: Stem Cells as a New Therapeutic Strategy for COVID-19

Abstract: Currently, the world is facing the SARS-CoV-2 pandemic, coronavirus of acute respiratory distress syndrome 2, causes of COVID-19. Coronaviruses are RNA single-stranded viruses that have an envelope. In addition, coronaviruses are classified into four subfamilies: alpha, beta, gamma and delta coronaviruses. The first of them, cause mildly symptomatic or asymptomatic infections, while beta-coronaviruses are responsible for severe diseases. SARS-CoV-2 belongs to the group of beta-coronaviruses. Current available therapies use corticosteroids to reduce inflammation, non-specific antiviral drugs or antibiotics in the treatment of secondary bacterial infections. In addition, therapies based on the use of hydroxychloroquine, chloroquine, remdesvir, ribavirin, interferon or lopinavir-ritonavir were also initially used. Mesenchemical stem cells (MSCs) are widely used in cell therapies, which include both basic research and clinical trials. Their exceptional effectiveness and safety have been confirmed and documented in many clinical studies, which include a number of inflammatory diseases involving the immune system - one of them is systemic lupus erythematosus. Available data indicate the ability to differentiate MSCs and their immunomodulatory effects. In addition, through interactions with immune cells, which include, but are not limited to, macrophages and dendritic cells, or paracrine secretion, MSCs are able to secrete a number of types of cytokines. MSCs are also characterized by tissue regeneration and regulation of inflammation. Due to their properties, researchers turned to determine whether MSC transplantation is able to improve the outcome of patients with COVID-19 viral pneumonia. The presented review provides not only new knowledge in the field of molecular mechanisms of pro-regenerative action of stem cells, but also have the potential to open up new prospects of action to improve lung tissue regeneration in COVID-19 patients. In addition, in review mentioned about clinical trials using MSCs with a complete status, as well as the latest discoveries in molecular biology, a platform model of pluripotent stem cells in the SARS-CoV-2 study on 3D animal models and nanoconjugates based on stem cells.Funding: MGP acknowledges support fromthe Iuventus Plus project of Polish Ministry of Science and Higher Education No IP 2015 022074. Declaration of Interest: None to Declare

Comparative field study on bioassay responses and micropollutant uptake of POCIS, Speedisk and SorbiCell polar passive samplers

Routine water quality monitoring is generally performed with chemical analyses of grab samples, which has major limitations. First, snapshot samples will not give a good representation of the water quality. Second, it is not sufficient to analyze only a limited number of (priority) pollutants. These limitations can be circumvented by an alternative environmental risk assessment that combines time-integrated passive sampling (PS) with effect-based methods. This study aimed to select which of three polar PS devices was best suited for effect-based monitoring strategies.In the first part of this study, Speedisk, SorbiCell and POCIS polar PS devices were compared by simultaneous deployment at five sites. Chemical analyses of 108 moderately polar compounds (-1.82 < log D < 6.28) revealed that highest number of compounds, with the widest range of log KOW, log D and pKa, were detected in extracts of POCIS, followed by Speedisk. SorbiCell samplers accumulated the lowest numbers and concentrations of compounds, so they were not further investigated. In a follow-up study, bioassay responses were compared in extracts of POCIS and Speedisk devices deployed at eight sites. The passive sampler extracts were subjected to bioassays for non-specific toxicity, endocrine disruption, and antibiotics activities. More frequent and higher responses were induced by POCIS extracts, leading to more exceedances of effect-based trigger values for environmental risks. As POCIS outperformed Speedisk, it is better suited as PS device targeting polar compounds for semi-quantitative effect-based water quality monitoring.

Evaluating the role of methicillin-resistant Staphylococcus aureus (MRSA)-specific antibiotic prophylaxis for neurosurgical patients

ObjectiveSurgical site infection (SSI) in neurosurgical patients increases morbidity. Despite the rise of methicillin-resistant Staphylococcus aureus (MRSA) colonization, there is little consensus regarding antibiotic prophylaxis for SSI in MRSA-colonized neurosurgical patients. Our objective was to examine the incidence of SSI in MRSA-colonized neurosurgical patients and interrogate whether MRSA-specific antibiotic prophylaxis reduces SSIs. MethodsWe performed a retrospective analysis of adult patients undergoing neurosurgical procedures between 2013 and 2018. The primary outcome was SSI in patients with MRSA colonization receiving MRSA-specific antibiotics. Secondary outcomes included predictors of SSI, including whether broad use of MRSA-specific antibiotics affects SSI rate. ResultsOf 9739 procedures, 376 had SSI (3.9 %). Seven hundred forty-four procedures (7.6 %) were performed on patients screened preoperatively for MRSA, including 54 procedures on MRSA-colonized patients. MRSA-colonized patients were more likely than MRSA-non-colonized patients to receive MRSA-specific antibiotics (35.2 % vs. 17.8 %, p = 0.002) for prophylaxis. Nevertheless, MRSA-colonized patients had higher SSI rates compared to MRSA-non-colonized patients (22.2 % vs. 6.4 %, p = 0.00002). MRSA-colonization led to 3.49 greater odds (95 % CI 1.52–7.65, p = 0.002) of SSI relative to MRSA-non-colonization. MRSA-colonized patients receiving MRSA-specific antibiotics, compared to those receiving non-MRSA-specific antibiotics, had lower SSI rates, but this difference was not statistically significant (15.8 % vs. 25.7 %, p = 0.40). In the non-screened population, those receiving MRSA-specific antibiotics, compared to those receiving non-MRSA-specific antibiotics, had significantly higher SSI rates (6.9 % vs. 3.0 %, p = 0.00001). The use of MRSA-specific antibiotic prophylaxis in the non-screened population increased the odds of SSI (OR 1.90, 95 % CI 1.45−2.46, p = 0.0001). ConclusionMRSA-colonized neurosurgical patients had a higher SSI rate compared to MRSA-non-colonized patients. While MRSA-specific antibiotics may benefit those with MRSA colonization, the difference in SSI rate between MRSA-colonized patients receiving MRSA-specific antibiotics vs. non-specific antibiotics requires further investigation. The broader use of MRSA-specific antibiotics may paradoxically confer an increased risk of SSI in a non-screened neurosurgical population.

Innate immune function of serine/threonine-protein kinase from Macrobrachium rosenbergii in response to host-pathogen interactions

The occurrences of multiple drug-resistant strains have been relentlessly increasing in recent years. The aquaculture industry has encountered major disease outbreaks and crucially affected by this situation. The usage of non-specific chemicals and antibiotics expedites the stimulation of resistant strains. Triggering the natural defense mechanism would provide an effective and safest way of protecting the host system. Hence, we have investigated the innate immune function of serine/threonine-protein kinase (STPK) in Macrobrachium rosenbergii (Mr). The in-silico protein analysis resulted in the identification of cationic antimicrobial peptide, MrSL-19, with interesting properties from STPK of M. rosenbergii. Antimicrobial assay, FACS and SEM analysis demonstrated that the peptide potentially inhibits Staphylococcus aureus by interacting with its membrane. The toxic study on MrSL-19 demonstrated that the peptide is not toxic against HEK293 cells as well as human erythrocytes. This investigation showed the significant innate immune property of an efficient cationic antimicrobial peptide, MrSL-19 of STPK from M. rosenbergii.

Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders

Small intestinal bacterial overgrowth (SIBO) has been implicated in symptoms associated with functional gastrointestinal disorders (FGIDs), though mechanisms remain poorly defined and treatment involves non-specific antibiotics. Here we show that SIBO based on duodenal aspirate culture reflects an overgrowth of anaerobes, does not correspond with patient symptoms, and may be a result of dietary preferences. Small intestinal microbial composition, on the other hand, is significantly altered in symptomatic patients and does not correspond with aspirate culture results. In a pilot interventional study we found that switching from a high fiber diet to a low fiber, high simple sugar diet triggered FGID-related symptoms and decreased small intestinal microbial diversity while increasing small intestinal permeability. Our findings demonstrate that characterizing small intestinal microbiomes in patients with gastrointestinal symptoms may allow a more targeted antibacterial or a diet-based approach to treatment.

A rare cause of native tricuspid valve endocarditis: Abortus

A 28-year-old female patient, who at her 7 weeks of pregnancy, admitted to hospital with abdominal pain and vaginal bleeding. She had been hospitalized in another center with the diagnosis of spontaneous complete abortion. After discharge, her clinical process, deteriorated due to fever, chills and fatigue there-fore she had been admitted to emergency unit of that hospital once again, and received non-specific anti-biotics. She was referred to our clinic because of persistant complaints. Transthoracic echocardiography showed vegetations on the tricuspid valve leading to diagnosis of infective endocarditis, so treatment was started at our clinic. No microorganism isolated in blood cultures. Following 15-days antibiotic therapy no reduction was seen in the diameter of the vegetation, therefore surgical operation was planned and a bio-prosthetic tricuspid valve was put into place. In this article we aimed to report the development of sponta-neous abortus at 7 weeks of pregnancy, in order to emphasize that tricuspid valve endocarditis can be developed secondary to very rare causes.

Microbiota restoration: natural and supplemented recovery of human microbial communities

In a healthy host, a balance exists between members of the microbiota, such that potential pathogenic and non-pathogenic organisms can be found in apparent harmony. During infection, this balance can become disturbed, leading to often dramatic changes in the composition of the microbiota. For most bacterial infections, nonspecific antibiotics are used, killing the non-pathogenic members of the microbiota as well as the pathogens and leading to a substantial delay in the restoration of a healthy microbiota. However, in some cases, infections can self-resolve without the intervention of antibiotics. In this Review, we explore the mechanisms underlying microbiota restoration following insult (antibiotic or otherwise) to the skin, oral cavity, and gastrointestinal and urogenital tracts, highlighting recovery by natural processes and after probiotic administration.

Solitary Neck Swelling of 2-Week Duration in a 27-Year-Old Woman

Solitary Neck Swelling of 2-Week Duration in a 27-Year-Old Woman

Syndrome de Currarino cause rare de méningites purulentes récidivantes

The authors report a case of partial Currarino syndrome in a three and a half year old child with a left hemisacrum agenesis and a presacral mature teratoma. The special aspect of the observation was the apparition of repetitive polymicrobial purulent meningitis (Escherichia coli, Streptococcus B, Hæmophilus influenzae) treated several times with non-specific antibiotics without normalization of CSF, particularly the CSF glucose, which remained low, justifying the use of an antimycobacterial treatment, especially since there was no local or general cause explaining the relapse. During a relapse of meningitis after ten months of antituberculosis treatment, the teratoma was discovered by a spine MRI done to detect any cerebrospinal defect. The authors insist on the fact that the Currarino syndrome must be investigated in case of repetitive purulent meningitis after ruling out the usual causes of meningitis.

Primary Mucosa-Associated Lymphoid Tissue Lymphoma of Hypopharynx

Mucosa-associated lymphoid tissue lymphomas are low-grade B-cell lymphomas that arise from a number of extranodal sites, including both nonmucosal and mucosal organs such as the hypopharynx. We reported a patient with a primary hypopharynx mucosa-associated lymphoid tissue lymphoma presenting with a swallowing dysfunction and severe throat pain. The clinical, radiologic, and histopathologic findings are presented. The patient was followed up for 5 years and treated with nonspecific antibiotics, chemotherapy, and radiation therapy. Because of prevertebral fascia invasion at the initial presentation, surgical treatment was not preferred. The last biopsies of the hypopharynx revealed no evidence of lymphoid infiltrate. Mucosa-associated lymphoid tissue lymphoma involving the hypopharynx is rare and there is no consensus on its treatment. The treatment protocol is presented and the relevant literature is reviewed.