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Case 96: Diarrhoea and Proximal Weakness
Published in Layne Kerry, Janice Rymer, 100 Diagnostic Dilemmas in Clinical Medicine, 2017
The patient presents with a 4-day history of diarrhoea with raised inflammatory markers and a presumed severe acute kidney injury. Possible causative agents of the diarrhoea include Campylobacter jejuni, Clostridium perfringens, Escherichia coli, Salmonella spp., and Shigella spp. Escherichia coli O157:H7 is a particularly serious strain that can cause haemolytic-uraemic syndrome, where patients develop microangiopathic haemolytic anaemia, thrombocytopenia, renal failure and neurological sequelae. Shigellosis is now an increasingly prevalent sexually transmitted infection among gay and bisexual men in the United Kingdom.
Infections of the Alimentary Canal
Published in Keith Struthers, Clinical Microbiology, 2017
A bloody stool can be associated with Campylobacter or Shigella infection. It is also an alert for infection by Escherichia coli O157 (or O104); lack of fever in the setting of frank blood in the stool can direct the clinical team to consider a non-infectious cause. However, Escherichia coli O157 infection must be considered, as it can present in this way.
Practice Paper 6: Questions
Published in Anthony B. Starr, Hiruni Jayasena, David Capewell, Saran Shantikumar, Get ahead! Medicine, 2016
Anthony B. Starr, Hiruni Jayasena, David Capewell
A 14-year-old boy has a 3-day history of diarrhoea and vomiting. Blood tests show a serum urea of 23.1 mmol/L, a creatinine of 400 μmol/L, a potassium of 5.9 mmol/L and a sodium of 134 mmol/L. The full blood count and blood film show a normocytic anaemia with fractionated red blood cells. A stool sample later confirms the presence of Escherichia coli O157.
Multiple coinfections and Guillain Barré syndrome following outdoor travel to the American Northeast
Published in Baylor University Medical Center Proceedings, 2023
William Farrington, Farzam Farahani, Kevin Garrett Tayon, Jaclyn Rudzinski, Mark Feldman, Kartavya Sharma
A thick blood smear (Figure 1) demonstrated intraerythrocytic parasites with ringed, wisped, appliqué, and dual-organism morphology. Positive microbiology studies included Babesia microti polymerase chain reaction (PCR), IgM and IgG antibodies for Ehrlichia chaffeensis, IgM, IgG viral capsid antigen antibodies to Epstein Barr virus (EBV) and qualitative EBV PCR, and stool culture detecting Arcobacter butzleri. Stool culture was negative for Salmonella, Shigella, and Campylobacter species as well as Escherichia coli O157:H7. Cytomegalovirus serology was positive only for IgG antibodies. Testing for Borrelia burgdorferi, human immunodeficiency virus, and West Nile virus was negative. Given the lack of central nervous system involvement, meningismus, or cerebrospinal fluid pleocytosis, further testing for meningoencephalitis with an arbovirus panel or Ehrlichia chaffeensis PCR of the cerebrospinal fluid was not pursued. He did not have a past medical history of frequent infections or use of immunosuppressive medications. Tick paralysis was considered clinically but the patient’s timeline of symptomatic onset was too gradual, and sensory involvement was inconsistent with this diagnosis.
Healthy Intestinal Function Relies on Coordinated Enteric Nervous System, Immune System, and Epithelium Responses
Published in Gut Microbes, 2021
Fatima B. Saldana-Morales, Dasom V. Kim, Ming-Ting Tsai, Gretchen E. Diehl
Short-chain fatty acids (SCFAs), such as butyrate, acetate and propionate, are microbial metabolites that regulate epithelium, immune system and nervous system functions. SCFAs are recognized by common receptors including GPCR41 and GPCR43 as well as can also signal through unique receptors such as GPCR109a for butyrate and PSGR for acetate and propionate.57–59 SCFA are byproducts of fiber breakdown and are produced by obligate anaerobes Firmicutes, Bacteroidetes, and Clostridium.59 Acetate, by protecting IECs from apoptosis can protect from lethal infection with enterohaemorrhagic Escherichia coli O157:H7.60 The majority of butyrate, the primary energy source for colonic epithelial cells,61 is found in the colon lumen.62,63 Colonic epithelial cells metabolize butyrate through β-oxidation and the tricarboxylic acid pathway, consuming oxygen to favor anaerobic commensal bacteria over facultative anaerobic pathogens such as Escherichia coli and Salmonella enterica therefore preventing pathogen infection.61,64 This anaerobic environment stabilizes hypoxia inducible factor-1 (HIF-1), a transcription factor that regulates epithelial barrier function.65,66 In vitro, SCFA induce expression of tight junction and other barrier proteins, thereby increasing barrier function.67 Overall, the recognition of SCFAs by IECs maintains mucosal barrier function and protects the host against pathogen infection.
Inhibition of Candida albicans and Staphylococcus aureus biofilms by centipede oil and linoleic acid
Published in Biofouling, 2020
Yong-Guy Kim, Jin-Hyung Lee, Jae Gyu Park, Jintae Lee
In nature, most microorganisms coexist in multispecies communities comprised of bacteria, fungi, insects, plants, and animals. Recently, insects have attracted interest as potential sources of antimicrobial agents, proteins, and fatty acids that benefit human health (Zasloff 2002; Guil-Guerrero et al. 2018). Arthropods are abundant in diverse terrestrial ecosystems, which in turn means they possess protective defense systems against invading pathogens (Basset et al. 2012). The centipede Scolopendra subspinipes mutilans L. Koch (Scolopendridae) is used traditionally to treat spasms, childhood convulsions, seizures, poisonous nodules, and diphtheria (Lee et al. 2016), and it has been reported that this centipede contains the antimicrobial peptides and scolopendin, which are able to increase the membrane permeability of Candida. albicans and Escherichia coli O157:H7 (Lee et al. 2015). In addition, the hydrolyzed lipid portion of centipede extract is known to contain various fatty acids (Moon et al. 1996). Recently, several unsaturated fatty acids were found to efficiently inhibit biofilm formation by S. aureus (Lee et al. 2017; Kim et al. 2018). The saturated capric acid has been reported to inhibit C. albicans filamentous growth and biofilm formation (Murzyn et al. 2010).