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Query: UMLS:C0014070 (encephalomyelitis)
 13,017 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fatal disseminated toxoplasmosis was diagnosed in a Risso's dolphin (Grampus griseus) dam and its fetus on the basis of pathologic findings, immunohistochemistry, and structure of the parasite. The dolphin was stranded alive on the Spanish Mediterranean coast and died a few hours later. At necropsy the dam was in good condition. From the standpoint of pathology, however, it had generalized lymphadenomegaly and splenomegaly, enlargement of and multifocal hemorrhage in the adrenal glands, diffuse mucosal hemorrhage of the glandular and pyloric stomach, ulcerative glossitis and stomatitis, focal erosions and reddening of the laryngeal appendix, and severe paraotic sinusitis with intralesional nematodes Crassicauda grampicola. The dolphin was pregnant, most probably in the first gestational trimester. The most prominent microscopic lesions were multifocal granulomatous encephalomyelitis, diffuse subacute interstitial pneumonia, mild multifocal necrotizing hepatitis and nonsuppurative cholangiohepatitis, gastritis and adrenalitis, mild lymphoid depletion, medullary sinus and follicular histyocitosis, and systemic hemosiderosis. The fetus had foci of coagulative and lytic necrosis in the kidneys, the lung, and the heart. Most lesions were associated with tachyzoites and tissue cysts of Toxoplasma gondii. The diagnosis was confirmed immunohistochemically. This is the first report on toxoplasmosis in a Risso's dolphin (G. griseus) and on transplacental transmission to an early-stage fetus in any cetaceans.
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PMID:Disseminated toxoplasmosis in a Mediterranean pregnant Risso's dolphin (Grampus griseus) with transplacental fetal infection. 1243 53

Alexander disease is a neurological condition associated with prominent white matter deterioration. Its rarity and relatively rapid disease course have provided limited understanding into the cognitive effects of the illness. We report the serial neuropsychological findings of a 21-year-old with normal development and no medical history until age 9, when he experienced refractory sinusitis, stabbing headaches with vertigo, disorientation, and decline in academic and social settings. An MRI scan of the brain found acute demyelinating encephalomyelitis, with a preponderance of white matter degeneration in the bilateral frontal lobes. Interval MRIs showed continued degeneration. Confirmation of Alexander disease was made at age 20 through genetic testing. Four evaluations completed from ages 15 to 21 showed impairment across all cognitive domains. Cognitive deficits were most prominent in new learning and recent memory, executive functions, and fine motor dexterity, and less apparent in information processing and visual scanning speed. These results present evidence for a particular cognitive pattern in individuals with juvenile-onset Alexander disease. Despite extensive white matter degeneration in the frontal lobes, certain tasks associated with frontal lobe integrity were relatively preserved. Further research into the neuropsychological presentation of the subtypes of Alexander disease can enhance diagnostic clarity and treatment planning.
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PMID:Neurocognitive decline in Alexander disease. 2190 66

France has recently witnessed a nationwide outbreak of measles. Data on severe forms of measles in adults are lacking. We sought to describe the epidemiologic, clinical, treatment, and prognostic aspects of the disease in adult patients who required admission to an intensive care unit (ICU). We performed a retrospective analysis of a cohort of 36 adults admitted to a total of 64 ICUs throughout France for complications of measles from January 1, 2009, to December 31, 2011. All cases of measles were confirmed by serologic testing and/or reverse transcription polymerase chain reaction.The cohort consisted of 21 male and 15 female patients, with a median age of 29.2 years (25th-75th interquartile range [IQR], 27.2-34.2 yr) and a median Simplified Acute Physiology Score (SAPS II) of 13 (IQR, 9-18). Among the 26 patients whose measles vaccination status was documented, none had received 2 injections. One patient had developed measles during childhood. Underlying comorbid conditions included chronic respiratory disease in 9 patients, immunosuppression in 7 patients, and obesity in 3 patients, while measles affected 5 pregnant women.Respiratory complications induced by measles infection led to ICU admission in 32 cases, and measles-related neurologic complications led to ICU admission in 2 cases. Two patients were admitted due to concurrent respiratory and neurologic complications.Bacterial superinfection of measles-related airway infection was suspected in 28 patients and was documented in 8. Four cases of community-acquired pneumonia, 6 cases of ventilator-associated pneumonia, 1 case of tracheobronchitis, and 2 cases of sinusitis were microbiologically substantiated.Of 11 patients who required mechanical ventilation, 9 developed acute respiratory distress syndrome (ARDS). Among the patients with ARDS, extraalveolar air leak complications occurred in 4 cases. Five patients died, all of whom were severely immunocompromised.On follow-up, 1 patient had severe chronic respiratory failure related to lung fibrosis, and 2 patients had mild lower limb paraparesis along with bladder dysfunction, both of which were ascribable to measles-induced encephalitis and myelitis. Among the 5 pregnant patients, the course of measles infection was uneventful, albeit 1 patient underwent emergent cesarean delivery because of fetal growth restriction.Measles is a disease with protean and potentially deceptive clinical manifestations, especially in the immunocompromised patient. Measles-associated pneumonitis and its complications, and less commonly postinfectious encephalomyelitis, are the main source of morbidity and mortality. In contrast with the usually benign course of the disease in immunocompetent patients, measles occurring in immunocompromised patients gives rise to lethal complications including ARDS, with or without bacterial superinfection. Other patients potentially at high risk for severe measles are young adults and pregnant women. Measles pneumonitis may predispose to air leak disease in patients using mechanical ventilation. To date, vaccination remains the most potent tool to control measles infection.
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PMID:Severe Measles Infection: The Spectrum of Disease in 36 Critically Ill Adult Patients. 2398 57

Ernest Edward Tyzzer (1875-1965) was a physician, specializing at first (1902-1916) in cancer research and then from 1916 as a parasitologist. He was born of English parents in Wakefield, Massachusetts, where he lived all his life. Educated in Wakefield public schools, Brown University (Ph.B., A.M., Hon. Sc.D.), and Harvard University (M.D.), he established during his 40-yr career (1902-1942) an international reputation in oncology, pathology, virology, bacteriology, parasitology, and taxonomic zoology in relation to human and veterinary medicine. His contributions to knowledge of avian diseases were outstanding and wide-ranging. Seminal work included: new descriptions of tumors in chickens; the first record of Cryptosporidium in birds; studies on the biology, morphology, in vitro culture, and epizootiology of the blackhead (histomonosis) parasite and its reclassification under a new genus Histomonas; descriptions of eight new taxa of amebae and flagellates in chickens, turkeys, and ruffed grouse; descriptions of seven new species of Eimeria in chickens, turkeys, pheasants, and quail as well as studies on their biology, immunogenicity, virulence, and epizootiology; a description of the trematode Collyriclum in English sparrows; the first record of mycosis in ruffed grouse; the recognition of birds as a source of equine encephalomyelitis infections of humans; the first American record of infectious sinusitis in turkeys and discovery of a curative treatment; and studies of Newcastle disease and avian influenza during the war research program of the 1940s. Application of Tyzzer's histomonosis research to farm practice saved the Massachusetts turkey industry from extinction in the 1920s and significantly influenced the recovery of turkey farming nationally.
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PMID:A prepared mind--Ernest Edward Tyzzer's legacy of research into avian diseases. 2459 13