Escherichia coli O157 infection mimicking acute appendicitis: usefulness of computed tomography for differential diagnosis

Escherichia coli 0157 enterohaemorrhagic colitis associated with pyelonephritis: CT findings

Escherichia coli 0157:H7 is increasingly being recognized as a cause of infectious colitis, which typically results in bloody diarrhoea in an afebrile patient. The absence of fever often means that an infectious process is not considered in the differential diagnosis, particularly as this organism will not be detected in routine stool cultures. Inappropriate antibiotic therapy may increase the risk of development of haemolytic uraemic syndrome, a potentially fatal complication of this form of colitis, hence the importance of accurate diagnosis. On CT, it is characterized by severe diffuse colonic wall thickening, with little or no pericolic inflammatory changes. The radiologist may be the first to suspect the correct diagnosis and so should be aware of its imaging appearances. We report the case of a 19-year-old man who presented with typical radiological findings of enterohaemorrhagic colitis and whose CT also showed evidence of acute pyelonephritis; we suggest that this combination of abnormalities should further heighten radiologists' suspicions of infection due to E. coli 0157:H7, despite the absence of fever.

Inhibition of pro-inflammatory mediators and tumor cell proliferation by Anisomeles indica extracts

Anisomeles indica (L.) Kuntze (Labiatae), is a traditional anti-inflammatory herb used in Taiwan. The aqueous and methanolic extracts of whole plants, leaves, flowers and stems; and chloroform and n-butanol fractions of methanol extract, from A. indica were investigated for their anti-inflammatory activity on murine peritoneal macrophages. In addition, the tumor cells proliferation inhibition activities of these extracts were also evaluated against a panel of tumor cell lines such as Colon 205, PC 3, HepG2 and MCF 7. Treatment with A. indica extracts did not reduce cell viability at any dose used. However, all the extracts significantly inhibited the enhanced production of NO radicals, and pro-inflammatory cytokines (TNF-alpha, and IL-12) induced by LPS/IFN-gamma in a dose-dependent manner. Furthermore, methanolic extracts of leaves and flowers significantly and dose-dependently arrest mitogen-stimulated spleen cells in G0/G1 stage, in addition to their cell proliferation inhibition against Colon 205, MCF 7 and PC 3 by 94, 82; 98, 71; 82, 98%, respectively, at 200 microg/mL concentration. This is the first report on A. indica extracts for their growth inhibitory activities, against inflammatory mediator production, and human tumor cell lines, colon, prostate, hepatoma and breast cells proliferation.