Wednesday, February 20, 2013

Serratia marcescens: an unusual pathogen associated with snakebite cellulitis.

Serratia marcescens: an unusual pathogen associated with snakebite cellulitis.

Feb 2013 


Sri Devaraj Urs Academy of Higher Education and Research, Tamaka, Kolar, India.


This study reports a case of Serratia marcescens cellulitis following a snakebite in a 50-year-old woman. The bite was on the dorsum of the right hand with symptoms of envenomation. She developed swelling and cellulitis with tissue necrosis. Wound debridement was performed.  Pus and tissue biopsy cultures yielded Serratia marcescens sensitive to fluoroquinolones, aminoglycosides, third-generation cephalosporins and carbapenems. The patient responded to anti-snake venom (ASV) therapy, ciprofloxacin, local wound management and recovered uneventfully.
Full Text Article

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Saturday, February 16, 2013

Innate immune cocktail partially protects broilers against cellulitis and septicemia.

Innate immune cocktail partially protects broilers against cellulitis and septicemia.



Vaccine and Infectious Disease Organization (VIDO), International Vaccine Centre (Intervac), University of Saskatchewan, 120 Veterinary Road, Saskatoon, SK, Canada, S7N 5E3.


Antimicrobial/host defense peptides (A/HDP) are natural compounds that are found in leucocyte cells and on the skin and bodily fluids of birds, reptiles, and mammals. Not only do they possess antibacterial, antiviral, and antiparasitic characteristics but they also stimulate the host immune system to combat infectious diseases and may play a role in the promotion of wound repair. Gamma-amino butyric acid (GABA) is an amino acid-based inhibitory neurotransmitter in the brain that has also been shown to promote wound healing on skin. The objective of this study was to establish a therapeutic cocktail that protects birds against Escherichia coli-related disease and lesions in broilers. We injected a cocktail of six A/HDPs with or without GABA into 3-wk-old broilers by a subcutaneous or intramuscular route followed 24 hr later by challenge with a field isolate of serogroup O2 E. coli. Birds were examined for 5-6 days post-E. coli challenge and clinical, pathologic, and bacteriologic assessments were conducted. Birds that were subcutaneously injected with an A/HDP plus GABA cocktail had significantly higher survival rates and lower levels of bacteremia (P < 0.05), but a similar percentage of the surviving birds had large cellulitis lesions compared to the surviving phosphate-buffered saline-injected control birds. When this cocktail was administered intramuscularly, there was a trend towards protection against E. coli-related death, although the results were not statistically significant and there was no reduction in bacteremia. A significant number of birds had a reduced bacterial load on cellulitis lesions but no reduction in lesion size, which suggests that when the cocktail was administered intramuscularly it failed to protect against cellulitis. These results suggest that the route of administration of the cocktail influences disease outcome. Gene expression analysis was performed to investigate whether the cocktail induced immunomodulatory functions in avian cells that complemented their antimicrobial and anti-endotoxic effects. A/HDP plus GABA mediated temporal induction of pro-inflammatory cytokines but no induction of any of the chemokines under investigation. This cocktail shows potential to protect against E. coli-related death, which is a major economic burden to the poultry industry.

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Friday, February 08, 2013

CD56 Negative Extranodal NK/T-cell Lymphoma of the Orbit Mimicking Orbital Cellulitis.

CD56 Negative Extranodal NK/T-cell Lymphoma of the Orbit Mimicking Orbital Cellulitis.

Feb 2013


Oculofacial Plastic and Orbital Surgery, KU Eye, University of Kansas , Kansas City, Kansas , USA , and.


To report a case of Extranodal NK/T-cell lymphoma of the orbit mimicking orbital cellulitis. Case Description: A 52-year-old healthy male presented to our institution after 3 months of treatment for sinusitis with antibiotics and steroids. The patient was transferred due to the presence of an "orbital abscess" on CT with orbital signs that not responding to antibiotics. Clinical examination was significant for decreased vision in the affected orbit of 20/50, a trace RAPD OS, elevated IOP of 30 OS, proptosis and grossly decreased motility with diplopia, periorbital edema and chemosis. Dilated funded exam was unremarkable. CT imaging demonstrated a left sided pan-sinusitis, a medial "orbital process" with proptosis and erosion of the cribiform plate. The patient was taken for an emergent orbital exploration for histopathologic diagnosis. Intraorbital and sinus biopsy was consistent with extranodal NK/T-cell lymphoma, with extension into the skull base and left orbital space. The patient was started on radiation therapy followed by chemotherapy. Comments: The authors demonstrate how the acute presentation of an aggressive extranodal NK/T-cell lymphoma can present in a similar fashion as orbital cellulitis. Additionally, the case highlights that a unilateral pansinusitis with involvement of the skull base and orbit is likely due an aggressive malignant process in an immune competent patient.

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Friday, February 01, 2013

Ciprofloxacin-resistant Aeromonas hydrophila cellulitis following leech therapy.

Ciprofloxacin-resistant Aeromonas hydrophila cellulitis following leech therapy.

Jan 2013


David Geffen School of Medicine, Department of Pathology and Laboratory Medicine.


We report a case of surgical site infection following leech-therapy caused by ciprofloxacin-resistant Aeromonas hydrophila. Antimicrobial and genetic analyses of leech and patient isolates demonstrated resistant isolates originated from the leech-gut-microbiota. These data suggest that ciprofloxacin-monotherapy as a prophylaxis regime prior to leech-therapy may not be effective in preventing infection.

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