Disseminated nocardiosis due to Nocardia farcinica: diagnosis by thyroid abscess culture Nocardiose disseminada por Nocardia farcinica diagnosticada através do cultivo de abscesso da tireóide

A previously healthy 75-year-old white male dentist presented with a 6-month history of low-back pain treated with chronic steroid therapy had a Nocardia farcinica infection diagnosed by aspirate of thyroid abscess and six blood cultures. Despite the treatment with parenteral combination of trimethoprim/sulfamethoxazole, the patient failed to respond and died after two days of therapy. Autopsy revealed disseminated nocardiosis, involving lungs with pleural purulent exudate in both sides, heart, thyroid, kidneys, brain, bones, and lumbosacral soft tissue with destruction of L2-L4.<br>Paciente previamente hígido, homem de 75 anos, branco, dentista, apresentou história de seis meses de dor lombar, fez uso crônico de corticoterapia e teve diagnóstico de infecção por Nocardia farcinica através do aspirado de abscesso da tireóide e seis hemocultivos positivos. Apesar do tratamento com a combinação de sulfametoxazol/trimetoprim, o paciente não respondeu indo a óbito dois dias após. A necropsia revelou nocardiose disseminada, envolvendo ambos os pulmões, empiema bilateral, coração, tireóide, rins, cérebro, ossos, e tecidos moles lombossacrais, com destruição da L2-L4

Enterotoxemia em caprinos no Rio Grande do Sul Caprine enterotoxaemia in Rio Grande do Sul, Brazil

São descritos surtos de enterotoxemia em caprinos em cinco propriedades no Estado do Rio Grande do Sul. Os animais afetados eram, normalmente, encontrados mortos ou apresentavam evolução aguda de 2 a 3 horas com acentuada depressão, cólicas abdominais e diarréia profusa com fibrina. Em duas propriedades relataram-se casos com a evolução de até 12 horas. Em treze animais necropsiados observaram-se aumento de líquidos nas cavidades abdominal, torácica e pericárdica, congestão e hiperemia da serosa e mucosa do intestino, conteúdo do cólon líquido com fibrina além de hemorragias de serosa e fibrina. Em um animal constatou-se microangiopatia cerebral caracterizada por acúmulo de material homogêneo e eosinofílico no espaço perivascular. No conteúdo intestinal, colônias com bastonetes morfológica e bioquimicamente sugestivos de Clostridium perfringens foram caracterizadas no estudo bacteriológico. A soroneutralização em camundongos com conteúdo intestinal dos animais afetados, revelou a presença da toxina épsilon. Estes achados evidenciam a enterotoxemia como doença de importância para criação de caprinos no Rio Grande do Sul.<br>Five outbreaks of caprine enterotoxaemia in Rio Grande do Sul, Brazil, were studied. The animals were found dead or had a clinical course that usually lasted 2-3 hours. From two farms a clinical manifestation period of 12 hours was reported. Clinical signs were characterized by depression, marked abdominal discomfort, profuse watery diarrhea with fibrin clots, and death. Thirteen necropsies were performed and hydropericardium, hydrothorax and hydroperitoneum were commonly found. The mucosa and serosa of the colon were congested, and its contents was watery with multiple fibrin clots. Serosal hemorrhages and fibrin clots in the gallbladder were also seen. Fibrinous colitis and thyphilitis were the most frequent histological changes. Cerebral microangiopathy was observed in one case, which was characterized by acute perivascular proteinaceous edema around arterioles of the nucleus caudatus and thalamus. Large numbers of Gram-positive rods, often in clumps and with morphology consistent with Clostridium perfringens, were seen in intestinal smears. The intestinal contents of six goats were positive for epsilon toxin by mouse neutralization test. These findings suggest that enterotoxaemia is an important disease of goat flocks in southern Brazil