Surgical treatment and histopathology of different forms of olecranon and presternal bursitis in cattle and buffalo

Thirty seven cases of bursitis presented to our Veterinary Teaching Hospital from 2001 to 2005. There were 10 adult female buffalos with olecranon bursitis (one had bilateral bursitis) and 26 calves (7 cattle and 19 buffalos, 16 males and 10 females) with presternal bursitis. There were 10 out of 11 cases of olecranon bursitis and 21 out of 26 cases of presternal bursitis with different forms (cystic, proliferative and fibrous) that were removed surgically. The remaining 6 cases, cystic bursitis (olecranon = 1, presternal = 5), were treated by aspiration of their contents and injection of 4% iodine tincture intrabursally. Only 2 cases recovered, 3 cases progressed to fibrosis and required further surgical treatment 2 to 3 weeks later, and 1 case continued to have a cystic lesion. Histopathological examination of tissue specimens from different forms of bursitis revealed that the acquired bursae were generally lined with synovial-like membrane formed from 2-3 cellular layers that covered the connective tissue capsule. The connective tissue capsule differed from one type to another and consisted of fibrous tissues containing numerous small blood vessels, blood capillaries, lymphatics and nerves. There was also evidence for inflammation within the capsule represented by congestion of blood vessels and the presence of perivascular inflammatory cells, mostly mononuclear. In conclusion, surgical treatment was successful and effective for treatment of olecranon and presternal bursitis particularly for the chronic proliferative and fibrous form in cattle and buffalo. The histological structure of the acquired bursae was relatively similar consisting of a synovial-like membrane and a connective tissue capsule with varying degrees of the inflammatory process

Treatment of Septic arthritis of the coxofemoral joint in 12 foals

Objective: To describe the clinical signs, surgical treatment, and outcome of septic arthritis of the coxofemoral joint in foals. Study Design: Retrospective clinical study. Sample Population: Foals (n = 12) with confirmed sepsis of the coxofemoral joint. Methods: Lameness was localized to the coxofemoral joint based on physical examination. Sepsis was confirmed by cytological analysis of synovial fluid obtained under ultrasonographic guidance, during general anesthesia or standing sedation. Intra-articular analgesia was used as an adjunct diagnostic modality in 2 foals. Surgical lavage of the affected joint was performed via arthroscopy or needle lavage, with repeated lavage performed in 7 foals. Results: Synovial fluid contained 4.4 to 173 × 109/L white blood cells (WBCs), and 38-63 g/L total protein. Cultures were positive in 10/12 foals. Isolated organisms included Salmonella spp., Streptococcus spp., Rhodococcus spp., Enterococcus spp., Escherichia spp., Staphylococcus spp., Acinetobacter spp., Methicillin-resistant Staphylococcus aureus and Bacillus spp. Ten foals were discharged from hospital (83%). One of these was euthanized 15 days later due to chronic intestinal salmonellosis and renal failure, and 9 foals survived with no residual lameness detected 1 year after discharge from hospital. Conclusions: Sepsis of the coxofermoral joint can be effectively treated with a combination of arthroscopic lavage and the use of systemic and local antimicrobials

Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review.

Background: Severe malaria remains a major cause of pediatric hospital admission across Africa. Invasive bacterial infection (IBI) is a recognized complication of Plasmodium falciparum malaria, resulting in a substantially worse outcome. Whether a biological relationship exists between malaria infection and IBI susceptibility remains unclear. We, therefore, examined the extent, nature and evidence of this association.Methods: We conducted a systematic search in August 2012 of three major scientific databases, PubMed, Embase and Africa Wide Information, for articles describing bacterial infection among children with P. falciparum malaria using the search string (malaria OR plasmodium) AND (bacteria OR bacterial OR bacteremia OR bacteraemia OR sepsis OR septicaemia OR septicemia). Eligiblity criteria also included studies of children hospitalized with malaria or outpatient attendances in sub-Saharan Africa.Results: A total of 25 studies across 11 African countries fulfilled our criteria. They comprised twenty cohort analyses, two randomized controlled trials and three prospective epidemiological studies. In the meta-analysis of 7,208 children with severe malaria the mean prevalence of IBI was 6.4% (95% confidence interval (CI) 5.81 to 6.98%). In a further meta-analysis of 20,889 children hospitalised with all-severity malaria and 27,641 children with non-malarial febrile illness the mean prevalence of IBI was 5.58 (95% CI 5.5 to 5.66%) in children with malaria and 7.77% (95% CI 7.72 to 7.83%) in non-malaria illness. Ten studies reported mortality stratified by IBI. Case fatality was higher at 81 of 336, 24.1% (95% CI 18.9 to 29.4) in children with malaria/IBI co-infection compared to 585 of 5,760, 10.2% (95% CI 9.3 to 10.98) with malaria alone. Enteric gram-negative organisms were over-represented in malaria cases, non-typhoidal Salmonellae being the most commonest isolate. There was weak evidence indicating IBI was more common in the severe anemia manifestation of severe malaria.Conclusions: The accumulated evidence suggests that children with recent or acute malaria are at risk of bacterial infection, which results in an increased risk of mortality. Characterising the exact nature of this association is challenging due to the paucity of appropriate severity-matched controls and the heterogeneous data. Further research to define those at greatest risk is necessary to target antimicrobial treatment. © 2014 Church and Maitland; licensee BioMed Central Ltd