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Marciulynaite J, Sileikiene R, Snipaitiene A. Severe Post-Viral Polymyositis after COVID-19 in Childhood: A Case Report and Literature Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:1011. [PMID: 39201945 PMCID: PMC11352915 DOI: 10.3390/children11081011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/02/2024] [Accepted: 08/17/2024] [Indexed: 09/03/2024]
Abstract
Polymyositis is a rarely reported complication of COVID-19 illness, especially in children. Molecular mimicry may be a cause of hyperactivated autoimmunity, leading to various clinical manifestations, including myopathies. Symptoms vary from mild muscle weakness to severe rhabdomyolysis. We review the literature on post-COVID myositis and report a case of severe polymyositis in a 7-year-old boy, following undefined viral infection 3 weeks before the onset of muscle pain. Patient's condition deteriorated from physical activity-associated pain in the lower limbs to severe muscle weakness leading to dysphagia and mechanical ventilation. As antibodies against SARS-CoV-2 were detected and other possible conditions causing myositis were excluded, the diagnosis of post-COVID polymyositis was considered as the most likely. The patient was treated with high doses of methylprednisolone and cyclophosphamide, resulting in improvement. Although COVID-19 is becoming a seasonal disease, the infection itself and post-viral disorders, such as polymyositis, are still of great interest and require better investigation to ensure appropriate management for each individual. Our experience suggests that aggressive immunosuppressive therapy might be a solution for severe post-COVID-related diseases. This literature review is provided in addition to the case report presented at the 29th European Paediatric Rheumatology Congress; the abstract is available online in the Proceedings of the 29th European Paediatric Rheumatology Congress.
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Affiliation(s)
- Jurgita Marciulynaite
- Department of Pediatrics, Medical Academy, Lithuanian University of Health Sciences, Eiveniu Str., 50161 Kaunas, Lithuania; (R.S.); (A.S.)
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Zhou C, Wang Q, Cao H, Jiang J, Gao L. Nanozybiotics: Advancing Antimicrobial Strategies Through Biomimetic Mechanisms. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2403362. [PMID: 38874860 DOI: 10.1002/adma.202403362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/09/2024] [Indexed: 06/15/2024]
Abstract
Infectious diseases caused by bacterial, viral, and fungal pathogens present significant global health challenges. The rapid emergence of antimicrobial resistance exacerbates this issue, leading to a scenario where effective antibiotics are increasingly scarce. Traditional antibiotic development strategies are proving inadequate against the swift evolution of microbial resistance. Therefore, there is an urgent need to develop novel antimicrobial strategies with mechanisms distinct from those of existing antibiotics. Nanozybiotics, which are nanozyme-based antimicrobials, mimic the catalytic action of lysosomal enzymes in innate immune cells to kill infectious pathogens. This review reinforces the concept of nanozymes and provides a comprehensive summary of recent research advancements on potential antimicrobial candidates. Initially, nanozybiotics are categorized based on their activities, mimicking either oxidoreductase-like or hydrolase-like functions, thereby highlighting their superior mechanisms in combating antimicrobial resistance. The review then discusses the progress of nanozybiotics in treating bacterial, viral, and fungal infections, confirming their potential as novel antimicrobial candidates. The translational potential of nanozybiotic-based products, including hydrogels, nanorobots, sprays, bandages, masks, and protective clothing, is also considered. Finally, the current challenges and future prospects of nanozybiotic-related products are explored, emphasizing the design and antimicrobial capabilities of nanozybiotics for future applications.
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Affiliation(s)
- Caiyu Zhou
- CAS Engineering Laboratory for Nanozyme, Key Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang, Beijing, 100101, China
- School of Life Sciences, University of Chinese Academy of Sciences, Haidian, Beijing, 100049, China
| | - Qian Wang
- CAS Engineering Laboratory for Nanozyme, Key Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang, Beijing, 100101, China
- School of Life Sciences, University of Chinese Academy of Sciences, Haidian, Beijing, 100049, China
| | - Haolin Cao
- CAS Engineering Laboratory for Nanozyme, Key Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang, Beijing, 100101, China
- School of Life Sciences, University of Chinese Academy of Sciences, Haidian, Beijing, 100049, China
| | - Jing Jiang
- CAS Engineering Laboratory for Nanozyme, Key Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang, Beijing, 100101, China
| | - Lizeng Gao
- CAS Engineering Laboratory for Nanozyme, Key Laboratory of Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Chaoyang, Beijing, 100101, China
- Nanozyme Laboratory in Zhongyuan, Henan Academy of Innovations in Medical Science, Zhengzhou, Henan, 450052, China
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Watanabe K, Yamamoto M, Matsubayashi T. Unilateral gluteal myositis as a unique presentation in mesenteric Kikuchi-Fujimoto disease. Mod Rheumatol Case Rep 2024; 8:357-360. [PMID: 38128073 DOI: 10.1093/mrcr/rxad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/19/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Kikuchi-Fujimoto disease (KFD) is a self-limiting disease, characterised by fever and cervical lymphadenopathy. Lymphadenopathy without cervical lymph node involvement is rare and may mimic lymphoma. Although KFD can be associated with extranodal involvement, muscle involvement has not been reported. Herein, we report a novel case of unilateral gluteal myositis associated with mesenteric KFD in a patient who presented with persistent fever and right hip pain. Radiological imaging revealed an inflammatory lesion on the right gluteal muscle and multiple enlarged abdominal lymph nodes. No cervical lymphadenopathy was observed. A mesenteric lymph node biopsy was performed, and the histopathological findings led to a diagnosis of KFD. By day 29, the patient's body temperature gradually returned to normal without any therapeutic intervention. Follow-up radiological imaging showed resolution of the gluteal lesion and a significant decrease in abdominal lymph node size. Considering the clinical course, the unilateral myositis may have developed as an extranodal involvement of KFD. Even if the clinical findings appear unrelated to those of KFD, a differential diagnosis that includes KFD should be considered in patients with unknown origin of fever.
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Affiliation(s)
- Kazuhisa Watanabe
- Department of Pediatrics, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Masaki Yamamoto
- Department of Pediatrics, Seirei Hamamatsu General Hospital, Shizuoka, Japan
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Alomar T, Liong K, Alsheikh J, Boddupalli D. An Atypical Presentation of Viral Myocarditis Masquerading as Non-ST-Elevation Myocardial Infarction (NSTEMI). Cureus 2024; 16:e63768. [PMID: 39100024 PMCID: PMC11296737 DOI: 10.7759/cureus.63768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Coxsackie B virus is primarily associated with fever, pharyngitis, and gastrointestinal symptoms, while myocarditis is rarely reported. We present a rare case of a 47-year-old male with a history of hypertension and obesity, who developed Coxsackie B virus-induced myositis, myocarditis, and polyarthralgia. The patient presented with worsening back pain radiating to his chest, migratory arthralgia, exertional dyspnea, and bilateral shoulder pain with arm weakness. Initial investigations revealed elevated creatinine kinase (CK) levels and troponin I, alongside a high white blood cell (WBC) count and C-reactive protein (CRP) levels. Given the patient's symptoms and uptrending troponin without EKG changes, there was a high concern for non-ST-elevation myocardial infarction (NSTEMI), leading to initial treatment with aspirin and IV heparin. However, further questioning revealed a recent sore throat and contact with an ill family member, prompting investigations for an infectious etiology. A viral panel confirmed Coxsackie B virus infection. The patient made a full recovery with supportive care. This case highlights the importance of considering viral causes, particularly the Coxsackie B virus, in patients presenting with muscle pain, cardiac symptoms, and joint pain. Comprehensive viral testing is crucial for early identification and appropriate management to prevent long-term complications. Understanding the mechanisms of Coxsackie B virus infection is essential for developing effective treatment strategies addressing both the viral infection and the inflammatory response.
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Affiliation(s)
- Talal Alomar
- Internal Medicine, Creighton University School of Medicine, Phoenix, USA
| | - Katerina Liong
- Internal Medicine, Creighton University School of Medicine, Phoenix, USA
| | - Jad Alsheikh
- Internal Medicine, Creighton University School of Medicine, Phoenix, USA
| | - Deepti Boddupalli
- Internal Medicine, Creighton University School of Medicine, Phoenix, USA
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Jiang S, Li J, Cao J, Ou Y, Duan Y, Gan X. Clinical Characteristics of 118 Pediatric Patients With Acute Benign Myositis Associated With Influenza A Virus Infection. Pediatr Infect Dis J 2024; 43:626-629. [PMID: 38535510 DOI: 10.1097/inf.0000000000004320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the clinical and laboratory features of acute benign myositis associated with influenza A virus infection in children. METHODS A retrospective analysis was performed on the clinical data of 118 children with acute benign myositis associated with influenza A virus infection who were admitted to the Children's Hospital of Chongqing Medical University during the epidemic period of influenza A from February 2023 to May 2023. RESULTS (1) Most of the 118 children were preschool- or school-age. The most common symptom was sudden lower limb pain after fever, and bilateral calf myalgia was more common. The muscle enzyme spectrum ranged from 187.21 to 32191.00 μg/L (median: 3053 μg/L). Creatine kinase isoenzymes ranged from 5.15 to 749.7 μg/L (median 41.82 μg/L). Myoglobin ranged from 102.79 to 1200 μg/L (median 674.9 μg/L). (3) Examination: electromyography, muscle color Doppler ultrasound, radiograph and cardiac color Doppler ultrasound in Benign acute childhood myositis in children were rarely positive. (4) Treatment and prognosis: besides bed rest and a reduction of physical activity, oseltamivir treatment, drugs to improve energy metabolism, fluid replacement and alkalinization of symptomatic treatment. All children had a good prognosis without sequelae. CONCLUSIONS This study summarized and analyzed the clinical characteristics of acute benign myositis associated with influenza A infection in children with the aim of allowing rapid and early diagnosis of the disease and reducing unnecessary diagnostic tests and treatments. Closely monitoring myalgia and the muscle enzyme spectrum is recommended to exclude other neuromuscular and metabolic diseases.
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Affiliation(s)
- Shaoqun Jiang
- From the Department of Medical General Ward, Children's Hospital of Chongqing Medical University, Chongqing, China
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Netea SA, Messina NL, Gardiner K, Pittet LF, Curtis N. Inappropriate prescribing contributes to high antibiotic exposure in young children in Australia. J Antimicrob Chemother 2024; 79:1289-1293. [PMID: 38629145 DOI: 10.1093/jac/dkae090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 03/05/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Antibiotic exposure increases antimicrobial resistance and has also been associated with long-term harms, including allergies, inflammatory diseases and weight gain. We assessed antibiotic exposure in the first 2 years of life in Australian children, the factors influencing this and its appropriateness. METHODS Data from 1201 participants in the MIS BAIR randomized controlled trial were used. Multivariable logistic regression was used to identify factors associated with antibiotic exposure. RESULTS At 1 and 2 years of age, exposure to at least one course of antibiotics was 43% and 67%, with the highest first antibiotic prescription rate between 9 and 18 months. Amoxicillin was the most frequently used antibiotic (59%), followed by cefalexin (7%). The most common diagnoses for which antibiotics were prescribed were respiratory tract infections from 0 to 6 months of age and otitis media from 6 to 12 months. Factors associated with antibiotic exposure from 0 to 12 months of age were delivery by Caesarean section (adjusted odd-ratio (aOR) 1.5, 95%CI 1.1-1.9), birth in winter (aOR 1.7, 95%CI 1.2-2.4), maternal antibiotic exposure during the last trimester of pregnancy (aOR 1.6, 95%CI 1.1-2.3), cessation of breastfeeding by 6 months of age (aOR 1.5, 95%CI 1.1-2.0) and day-care attendance (aOR 1.4, 95%CI 1.1-1.8). Based on parent-reported questionnaires, 27% of infants were treated in the first year of life for conditions unlikely to need antibiotic treatment. CONCLUSION At least two-thirds of children were prescribed antibiotics in the first 2 years of life, and more than a quarter of these exposures may have been unnecessary.
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Affiliation(s)
- Stejara A Netea
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatric Immunology, Rheumatology and Infectious Disease, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nicole L Messina
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Kaya Gardiner
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Research Operations, The Royal Children's Hospital Melbourne, Parkville, Australia
| | - Laure F Pittet
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia
- Immunology and Vaccinology Unit, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, University Hospitals of Geneva, Geneva, Switzerland
| | - Nigel Curtis
- Infectious Diseases Research Group, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Australia
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia
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Bogovič P, Lotrič-Furlan S, Ogrinc K, Avšič Županc T, Korva M, Kastrin A, Trampuš Bakija A, Strle K, Strle F. Elevated levels of serum muscle enzymes in the initial phase of tick-borne encephalitis. Infect Dis (Lond) 2024; 56:504-509. [PMID: 38564769 DOI: 10.1080/23744235.2024.2335349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
PURPOSE Since some patients with tick-borne encephalitis (TBE) have pronounced myalgias, and since myositis is reported in Flavivirus diseases such as dengue, we performed systematic search for abnormalities of muscle enzymes in a group of patients in whom the presence of tick-borne encephalitis virus (TBEV) RNA in the first phase of the disease was demonstrated and who developed second phase of TBE. METHODS Total leukocyte and platelet blood counts were determined routinely at the initial examination during the first and the second phase of TBE. Activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine kinase (CK), myoglobin and troponin was determined from the available stored serum specimens; the first and second phase disease specimens were tested simultaneously. RESULTS Of 24 patients with biphasic course of TBE, 83% had leukopenia, 65% thrombocytopenia, 83% elevated AST and 4% elevated ALT level. Furthermore, 33% had elevated serum CK, 26% myoglobin and 22% troponin activity; at least one of the muscle enzymes was elevated in 42% of patients. Leukopenia, thrombocytopenia, elevated liver enzymes and elevations of CK and myoglobin were present in the initial phase but resolve later, while troponin abnormalities were also found in the second phase of TBE. CONCLUSIONS The present study exposes that in addition to previously known leukopenia, thrombocytopenia and increased liver enzymes activity, the initial phase of TBE is relatively often associated also with elevated muscle enzymes. Clinical relevance of these findings remains to be determined.
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Affiliation(s)
- Petra Bogovič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Stanka Lotrič-Furlan
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Katarina Ogrinc
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tatjana Avšič Županc
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miša Korva
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Andrej Kastrin
- Institute for Biostatistics and Medical Informatics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Alenka Trampuš Bakija
- Clinical Institute of Special Laboratory Diagnostic, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Klemen Strle
- Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, MA, USA
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Sangaran LR, Smith JP, Menegotto F, Ramanan AV. Of oranges and lemons: you are what you eat. Arch Dis Child Educ Pract Ed 2024:edpract-2024-327057. [PMID: 38744456 DOI: 10.1136/archdischild-2024-327057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/20/2024] [Indexed: 05/16/2024]
Abstract
A young boy presented with increasing lower limb pain and swelling for a month. At the time of his hospitalisation, he was unable to walk. We report the patient's clinical journey with clinical commentary throughout, highlighting the importance that uncommon diseases may be diagnosed with a high index of suspicion and thorough history taking.
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Affiliation(s)
- La Reina Sangaran
- Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
| | | | - Flavia Menegotto
- Paediatric Radiology, Bristol Royal Hospital for Children, Bristol, UK
| | - Athimalaipet V Ramanan
- Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
- Translational Health Sciences, University of Bristol, Bristol, UK
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Chou YC, Hsu YH, Lee D, Yang JW, Yu YH, Chan EC, Liu SJ. Novel Bioresorbable Drug-Eluting Mesh Scaffold for Therapy of Muscle Injury. ACS Biomater Sci Eng 2024; 10:2595-2606. [PMID: 38480510 DOI: 10.1021/acsbiomaterials.3c01669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
A novel bioresorbable drug-eluting polycaprolactone (PCL) mesh scaffold was developed, utilizing a solvent-cast additive manufacturing technique, to promote therapy of muscle injury. The degradation rate and mechanical properties strength of the PCL mesh were characterized after immersion in a buffer solution for different times. The in vitro release characteristics of vancomycin, ceftazidime, and lidocaine from the prepared mesh were evaluated using a high-performance liquid chromatography (HPLC) assay. In addition, the in vivo efficacy of PCL meshes for the repair of muscle injury was investigated on a rat model with histological examinations. It was found that the additively manufactured PCL meshes degraded by 13% after submission in buffered solution for four months. All PCL meshes with different pore sizes exhibited greater strength than rat muscle and survived through 10,000 cyclic loadings. Furthermore, the meshes could offer a sustained release of antibiotics and analgesics for more than 3 days in vitro. The results of this study suggest that drug-loaded PCL mesh exhibits superior ability to pure PCL mesh in terms of effectively promoting muscle repair in rat models. The histological assay also showed adequate biocompatibility of the resorbable meshes. The additively manufactured biodegradable drug-eluting meshes may be adopted in the future in humans for the therapy of muscle injuries.
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Affiliation(s)
- Ying-Chao Chou
- Bone and Joint Research Center, Department of Orthopedics, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Yung-Heng Hsu
- Bone and Joint Research Center, Department of Orthopedics, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Demei Lee
- Department of Mechanical Engineering, Chang Gung University, Taoyuan 33302, Taiwan
| | - Jheng-Wei Yang
- Department of Mechanical Engineering, Chang Gung University, Taoyuan 33302, Taiwan
| | - Yi-Hsun Yu
- Bone and Joint Research Center, Department of Orthopedics, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Err-Cheng Chan
- Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan 33302, Taiwan
| | - Shih-Jung Liu
- Bone and Joint Research Center, Department of Orthopedics, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
- Department of Mechanical Engineering, Chang Gung University, Taoyuan 33302, Taiwan
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Milcheva R, Hurníková Z, Todorova K, Dilcheva V, Petkova S, Janega P, Babál P. Down-regulation of neuronal form of Nitric oxide synthase in the Nurse cell of Trichinella spiralis. Helminthologia 2024; 61:40-45. [PMID: 38659468 PMCID: PMC11038256 DOI: 10.2478/helm-2024-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/16/2023] [Indexed: 04/26/2024] Open
Abstract
The free radical nitric oxide (NO) and Ca2+ are critical regulators of skeletal muscle exercise performance and fatigue. The major source of NO in skeletal muscle cells is the neuronal form of the enzyme Nitric oxide synthase (nNOS). One of the most peculiar characteristics of the Nurse cell of Trichinella spiralis (T. spiralis) is the complete loss of the contractile capabilities of its derivative striated muscle fiber. The aim of the present study was to clarify the expression of nNOS protein and mRNA in striated muscles during the muscle phase of T. spiralis infection in mice. Muscle tissue samples were collected from mice at days 0, 14, 24, and 35 post infection (d.p.i.). The expression of nNOS was investigated by immunohistochemistry, and the expression levels of mRNA of mouse Nitric oxide synthase 1 (Nos1) by real-time PCR. The presence of nNOS protein was still well observable in the disintegrated sarcoplasm at the early stage of infection. The cytoplasm of the developing and mature Nurse cell showed the absence of this protein. At least at the beginning of the Nurse cell development, Trichinella uses the same repairing process of skeletal muscle cell, induced after any trauma and this corroborates very well our results concerning the nNOS expression on day 14 p.i. At a later stage, however, we could suggest that the down-regulation of nNOS in the Nurse cell of T. spiralis either serves a protective function or is an outcome of the genetic identity of the Nurse cell.
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Affiliation(s)
- R. Milcheva
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., block 25, Sofia1113, Bulgaria
| | - Z. Hurníková
- Institute of Parasitology, Slovak Academy of Sciences, Hlinkova 3, 04 001Košice, Slovak Republic
| | - K. Todorova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., block 25, Sofia1113, Bulgaria
| | - V. Dilcheva
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., block 25, Sofia1113, Bulgaria
| | - S. Petkova
- Institute of Experimental Morphology, Pathology and Anthropology with Museum, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., block 25, Sofia1113, Bulgaria
| | - P. Janega
- Department of Pathology, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08Bratislava, Slovak Republic
| | - P. Babál
- Department of Pathology, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08Bratislava, Slovak Republic
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Pippin M, Stansbury W, Budde P. Viral Myositis in an Eight-Year-Old. Cureus 2024; 16:e56887. [PMID: 38659543 PMCID: PMC11042762 DOI: 10.7759/cureus.56887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Benign acute childhood myositis (BACM) is a pediatric syndrome characterized by mild self-limiting sudden onset of muscle pain during or following recovery from a viral illness. The case discussed in this report is of an eight-year-old female diagnosed with the common cold after presenting to her primary care physician. Five days later, the patient presented to the emergency department with lower extremity pain. The patient was sent home with supportive care and mild analgesics. Twelve hours later, the patient was seen again in the emergency department with severe bilateral lower extremities pain and difficulty walking. BACM most commonly affects school-age children and is usually caused by influenza A and B. The main goal of this case report is to help primary care and emergency medicine physicians diagnose benign acute childhood myositis as early as possible and treat the condition appropriately.
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Affiliation(s)
- Micah Pippin
- Family Medicine, Louisiana State University Health Sciences Center, Alexandria, USA
| | - William Stansbury
- Family Medicine, Louisiana State University Health Sciences Center, Alexandria, USA
| | - Praveen Budde
- Family Medicine, Louisiana State University Health Sciences Center, Alexandria, USA
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Nazir HF, Al Yazidi L. Disseminated Enterovirus Infection Complicated by Rhabdomyolysis in a Child with Acute Lymphoblastic Leukemia. Oman Med J 2024; 39:e617. [PMID: 38988800 PMCID: PMC11233936 DOI: 10.5001/omj.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/06/2023] [Indexed: 07/12/2024] Open
Abstract
Enterovirus is not a common cause of myositis and rhabdomyolysis in children. We report a case of a two-year-old boy with acute lymphoblastic leukemia with disseminated enterovirus infection complicated by hepatitis, myositis, and rhabdomyolysis. The case was managed successfully with supportive care and high-dose intravenous immunoglobulins.
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Affiliation(s)
- Hanan Fawzy Nazir
- Department of Pediatrics, Alexandria Faculty of Medicine, Alexandria, Egypt
| | - Laila Al Yazidi
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
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Miyahara S, Mori H, Fukuda K, Ogawa M, Saito M. Non-purulent myositis caused by direct invasion of skeletal muscle tissue by Leptospira in a hamster model. Infect Immun 2024; 92:e0042023. [PMID: 38240601 PMCID: PMC10870730 DOI: 10.1128/iai.00420-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/22/2023] [Indexed: 02/15/2024] Open
Abstract
Myalgia is a common symptom of Leptospira infection in humans. Autopsies have reported that muscle tissue shows degeneration and necrosis of the myofibers and infiltration of inflammatory cells composed mainly of macrophages and lymphocytes. It remains unclear whether Leptospira directly infects the muscle and how the infiltrating inflammatory cells are involved in muscle fiber destruction. This study evaluated the relationship between histopathological changes and leptospiral localization in the muscle tissue of a hamster model. The influence of macrophages in skeletal muscle injury was also investigated, using selective depletion of macrophages by administration of liposomal clodronate. Hamsters infected subcutaneously with Leptospira interrogans serovar Manilae strain UP-MMC-SM showed myositis of the thighs adjacent to the inoculated area beginning at 6 days post-infection. The myositis was non-purulent and showed sporadic degeneration and necrosis of muscle fibers. The degeneration of myofibers was accompanied by aggregations of macrophages. Immunofluorescence staining revealed leptospires surrounding the damaged muscle fibers. Subcutaneous injection of formalin-killed Leptospira or intraperitoneal injection of live Leptospira caused no myositis in hamster thighs. Liposomal clodronate treatment in infected hamsters reduced macrophage infiltration in muscle tissue without impacting bacterial clearance. Muscle necrosis was still observed in the infected hamsters treated with liposomal clodronate, and there was no significant change in serum creatine kinase levels compared to those in animals treated with liposomes alone. Our findings suggest that leptospiral invasion of muscle tissue from an inoculation site leads to the destruction of muscle fibers and causes non-purulent myositis, whereas the infiltrating macrophages contribute less to muscle destruction.
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Affiliation(s)
- Satoshi Miyahara
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Hiroshi Mori
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
- Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kazumasa Fukuda
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Midori Ogawa
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mitsumasa Saito
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
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14
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Kumar S, Kumar N, Panda PK, Jandrasupalli KK. Burkholderia-associated polymyositis. BMJ Case Rep 2024; 17:e255782. [PMID: 38232996 PMCID: PMC10806993 DOI: 10.1136/bcr-2023-255782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
A diagnosis of polymyositis can readily be made when there is a typical history of proximal muscle weakness together with clinical findings, and there is corroboratory evidence in the form of elevated creatine kinase lactate dehydrogenase, aldolase, and serum glutamic-oxaloacetic transaminase (aspartate aminotransferase). A muscle biopsy usually helps in making the confirmatory diagnosis. A female in her 50s presented with non-healing multiple deep necrotic ulcers with muscle weakness. The initial possibility of vasculitis ulcers remained. Later, this proved to be a case of polymyositis with mildly elevated creatine kinase (which is usually not the case), atypical skin manifestations (usually there is no skin involvement), and negative extended myositis specific antibody panel with the growth of Burkholderia cepacia (perhaps the triggering factor). Hence, polymyositis can present with a myriad of atypical findings. Thus, thorough clinical examination and an integrated approach are necessary for early identification and treatment of the disease.
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Affiliation(s)
- Sahil Kumar
- General Medicine, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
| | - Nitin Kumar
- General Medicine, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
| | - Prasan Kumar Panda
- General Medicine, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
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15
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Corman VM, Preusse C, Melchert J, Benveniste O, Koll R, Goebel HH, Jones TC, Drosten C, Schara-Schmidt U, Leonard-Louis S, Stenzel W, Radke J. Deep RNA sequencing of muscle tissue reveals absence of viral signatures in dermatomyositis. FREE NEUROPATHOLOGY 2024; 5:5-1. [PMID: 38205217 PMCID: PMC10774810 DOI: 10.17879/freeneuropathology-2024-5149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024]
Abstract
Objective: To explore a possible connection between active viral infections and manifestation of dermatomyositis (DM). Methods: Skeletal muscle biopsies were analyzed from patients diagnosed with juvenile (n=10) and adult (n=12) DM. Adult DM patients harbored autoantibodies against either TIF-1γ (n=7) or MDA5 (n=5). Additionally, we investigated skeletal muscle biopsies from non-diseased controls (NDC, n=5). We used an unbiased high-throughput RNA sequencing (HTS) approach to detect viral sequences. To further increase sequencing depth, a host depletion approach was applied. Results: In this observational study, no relevant viral sequences were detected either by native sequencing or after host depletion. The absence of detectable viral sequences makes an active viral infection of the muscle tissue unlikely to be the cause of DM in our cohorts. Discussion: Type I interferons (IFN) play a major role in the pathogenesis of both juvenile and adult DM. The IFN response is remarkably conserved between DM subtypes classified by specific autoantibodies. Certain acute viral infections are accompanied by a prominent type I IFN response involving similar downstream mechanisms as in DM. Aiming to elucidate the pathogenesis of DM in skeletal muscle tissue, we used deep RNA sequencing and a host depletion approach to detect possible causative viruses.
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Affiliation(s)
- Victor M. Corman
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany and German Centre for Infection Research (DZIF), Partner Site Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Corinna Preusse
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, 10117 Berlin, Germany
| | - Julia Melchert
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany and German Centre for Infection Research (DZIF), Partner Site Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Olivier Benveniste
- Department of Internal Medicine and Clinical Immunology, Pitié-Salpêtrière University Hospital, 75013 Paris, France
| | - Randi Koll
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, 10117 Berlin, Germany
| | - Hans-Hilmar Goebel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, 10117 Berlin, Germany
| | - Terry C. Jones
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany and German Centre for Infection Research (DZIF), Partner Site Berlin, Charitéplatz 1, 10117 Berlin, Germany
- Centre for Pathogen Evolution, Department of Zoology, University of Cambridge, Cambridge, United Kingdom
| | - Christian Drosten
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Virology, 10117 Berlin, Germany and German Centre for Infection Research (DZIF), Partner Site Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Schara-Schmidt
- Department of Pediatric Neurology and Centre for Neuromuscular Disorders in children and adolescents, Center for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, Essen, Germany
| | - Sarah Leonard-Louis
- Department of Neuropathology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, INSERM, Hôpital Pitié-Salpêtrière, France
| | - Werner Stenzel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, 10117 Berlin, Germany
| | - Josefine Radke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Neuropathology, 10117 Berlin, Germany
- Institute of Pathology, Universitätsmedizin Greifswald, Greifswald, Germany
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16
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Ahmed SB, Ahmad S, Pan H. Case Report and Literature Review of an Atypical Polymyalgia Rheumatica and Its Management. Int Med Case Rep J 2023; 16:873-885. [PMID: 38163043 PMCID: PMC10757773 DOI: 10.2147/imcrj.s440486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024] Open
Abstract
Polymyalgia rheumatica (PMR) is a systemic inflammatory disease of the elderly population that increases in incidence as age advances. It is characterised by the sudden or sub-acute onset of symptoms affecting the shoulder and pelvic girdles, often accompanied by constitutional symptoms. Due to the lack of consensual diagnostic criteria and specific laboratory or radiological investigations for PMR, its diagnosis can be very challenging, particularly because it can be mimicked or masked by other geriatric syndromes. PMR responds well to glucocorticoid treatment, but if left untreated, can lead to morbidity and poor quality of life. We present the case of an 87-year-old male who presented with a one-week history of localised pain in the left hip joint, later involving the contralateral hip. Previously able to ambulate unaided, his mobility was now severely impaired. Due to his Alzheimer's dementia and multiple comorbid geriatric conditions, extensive investigations were undertaken before a diagnosis of atypical PMR was reached. Treatment with a low dose of prednisolone led to a full recovery. This case highlights the inconsistency between an atypical presentation and the classic presentation of PMR and draws attention to the possibility of missed diagnosis in older, frail patients. Atypical symptomatology on top of cognitive impairment and language barriers can be easily overlooked and left untreated and could lead to severe adverse outcomes. Accurate diagnosis is crucial, as PMR is readily diagnosed, but the treatment with glucocorticoids, though generally straightforward, can pose challenges, particularly when dealing with polypharmacy and multiple coexisting health conditions.
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Affiliation(s)
- Saad Bilal Ahmed
- Monash Health Rehabilitation and Aged Care Services, Melbourne, Australia
| | - Saara Ahmad
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
| | - Hanmei Pan
- Monash Health Rehabilitation and Aged Care Services, Melbourne, Australia
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17
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Gaelen JI, Awoyemi T, Okematti E, Ramanathan M. Wheel of misfortune: A unique case of MRSA pyomyositis of the adductor muscle group from blunt unicycle trauma. Clin Case Rep 2023; 11:e8295. [PMID: 38111512 PMCID: PMC10726000 DOI: 10.1002/ccr3.8295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/20/2023] Open
Abstract
In patients with infectious symptoms and severe muscle pain, it is crucial to consider pyomyositis as a significant potential cause. A normal complete blood count should not exclude this possibility early in the course. Early advanced imaging modalities and blood cultures are crucial in narrowing the differential. Methicillin resistant Staphylococcus aureus is increasingly implicated.
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Affiliation(s)
- Jordan I. Gaelen
- Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Toluwalase Awoyemi
- Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Emmanuel Okematti
- Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Meera Ramanathan
- Department of MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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18
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Kim KH, Park D, Cho SY, Cho Y, Lee B, Jeong H, Lee Y, Lee Y, Nam KT. Role of histamine-mediated macrophage differentiation in clearance of metastatic bacterial infection. Front Immunol 2023; 14:1290191. [PMID: 38035074 PMCID: PMC10682073 DOI: 10.3389/fimmu.2023.1290191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Macrophages are highly heterogeneous immune cells with a role in maintaining tissue homeostasis, especially in activating the defense response to bacterial infection. Using flow cytometric and single-cell RNA-sequencing analyses of peritoneal cells, we here show that small peritoneal macrophage and immature macrophage populations are enriched in histamine-deficient (Hdc -/-) mice, characterized by a CD11bmiF4/80loCCR2+MHCIIhi and CD11bloF4/80miTHBS1+IL-1α+ phenotype, respectively. Molecular characterization revealed that immature macrophages represent an abnormally differentiated form of large peritoneal macrophages with strong inflammatory properties. Furthermore, deficiency in histamine signaling resulted in significant impairment of the phagocytic activity of peritoneal macrophage populations, conferring high susceptibility to bacterial infection. Collectively, this study reveals the importance of histamine signaling in macrophage differentiation at the molecular level to maintain tissue homeostasis, offering a potential therapeutic target for bacterial infection-mediated diseases.
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Affiliation(s)
- Kwang H. Kim
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Donghwan Park
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Soo Young Cho
- Department of Molecular and Life Science, Hanyang University College of Science and Convergence Technology, Ansan, Republic of Korea
| | - Yejin Cho
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Buhyun Lee
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Haengdueng Jeong
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yura Lee
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yourim Lee
- Department of Pathology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ki Taek Nam
- Department of Biomedical Sciences, Yonsei University College of Medicine, Seoul, Republic of Korea
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19
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Khoo T, Lilleker JB, Thong BYH, Leclair V, Lamb JA, Chinoy H. Epidemiology of the idiopathic inflammatory myopathies. Nat Rev Rheumatol 2023; 19:695-712. [PMID: 37803078 DOI: 10.1038/s41584-023-01033-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 10/08/2023]
Abstract
The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of systemic autoimmune diseases that affect the skeletal muscles and can also involve the skin, joints, lungs and heart. The epidemiology of IIM is obscured by changing classification criteria and the inherent shortcomings of case identification using healthcare record diagnostic coding. The incidence of IIM is estimated to range from 0.2 to 2 per 100,000 person-years, with prevalence from 2 to 25 per 100,000 people. Although the effects of age and gender on incidence are known, there is only sparse understanding of ethnic differences, particularly in indigenous populations. The incidence of IIM has reportedly increased in the twenty-first century, but whether this is a genuine increase is not yet known. Understanding of the genetic risk factors for different IIM subtypes has advanced considerably. Infections, medications, malignancy and geography are also commonly identified risk factors. Potentially, the COVID-19 pandemic has altered IIM incidence, although evidence of this occurrence is limited to case reports and small case series. Consideration of the current understanding of the epidemiology of IIM can highlight important areas of interest for future research into these rare diseases.
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Affiliation(s)
- Thomas Khoo
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
| | - James B Lilleker
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Manchester Centre for Clinical Neuroscience, Manchester Academic Health Science Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Bernard Yu-Hor Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Valérie Leclair
- Department of Medicine, Division of Rheumatology, McGill University, Montreal, Canada
| | - Janine A Lamb
- Epidemiology and Public Health Group, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Hector Chinoy
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK.
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20
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Shimada H, Hirata R, Yamashita S, Hirakawa Y, Nakashima O, Nakamura M, Yaita S, Tokushima M, Tokushima Y, Aihara H, Fujiwara M, Tago M. Helicobacter cinaedi Infection Presenting with Myalgia and Cellulitis. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e941777. [PMID: 37859341 PMCID: PMC10598506 DOI: 10.12659/ajcr.941777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Helicobacter cinaedi is a rare bacterium, accounting for only 0.2% of the positive isolates in blood cultures. Previous reports note that patients with H. cinaedi infection often have underlying diseases. H. cinaedi infection is diagnosed by blood culture. However, because of the slow growth of this bacterium in blood culture, the diagnosis can be missed. CASE REPORT A 78-year-old man gradually developed erythema and pain in his left arm, then left shoulder and both lower legs. The patient presented to our hospital on day 17. He was afebrile, but the examination was remarkable for tenderness in both gastrocnemius muscles and erythema from the distal left lower leg to the ankle. We suspected pyomyositis and cellulitis and started oral administration of amoxicillin-clavulanate. On day 22, H. cinaedi was detected in blood cultures. Based on these findings, we diagnosed pyogenic myositis and cellulitis caused by H. cinaedi bacteremia. On day 24, antibiotic therapy was changed to intravenous ampicillin, and symptoms improved. Additional examination did not reveal any underlying immunodeficiency disorder, such as malignancy or HIV infection. CONCLUSIONS H. cinaedi infection can occur in healthy patients. Myalgia can be caused by pyogenic myositis because of bacteremia. In cases of myalgia or cellulitis of unknown etiology, blood cultures can be useful when bacteremia is suspected; blood samples should be monitored over an extended period.
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Affiliation(s)
- Hitomi Shimada
- Department of General Medicine, Saga University Hospital, Saga, Japan
- Shimada Hospital of Medical Corporation Chouseikai, Saga, Japan
| | - Risa Hirata
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Shun Yamashita
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Yuka Hirakawa
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Orisa Nakashima
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Masahiko Nakamura
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Shizuka Yaita
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Midori Tokushima
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | | | - Hidetoshi Aihara
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Motoshi Fujiwara
- Department of General Medicine, Saga University Hospital, Saga, Japan
| | - Masaki Tago
- Department of General Medicine, Saga University Hospital, Saga, Japan
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21
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Almuhayawi MS, Alruhaili MH, Gattan HS, Alharbi MT, Nagshabandi M, Al Jaouni S, Selim S, Alanazi A, Alruwaili Y, Faried OA, Elnosary ME. Staphylococcus aureus Induced Wound Infections Which Antimicrobial Resistance, Methicillin- and Vancomycin-Resistant: Assessment of Emergence and Cross Sectional Study. Infect Drug Resist 2023; 16:5335-5346. [PMID: 37605760 PMCID: PMC10440082 DOI: 10.2147/idr.s418681] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
Background Wound infection is a prevalent concern in the medical field, being is a multi-step process involving several biological processes. Methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA) infections often occur in areas of damaged skin, such as abrasions and open wounds. Methods This research aims to light the incidence of MRSA and VRSA in wound swabs, the antimicrobial susceptibility configuration of isolated S. aureus patterns in pus/wound samples collected from Saudi Arabian tertiary hospital. The cross section study, β- lactamase detection, VRSA genotyping, MAR index, D-test and VRSA genotyping are methods, which used for completed this research. Results Patients of several ages and genders delivered specimens from two hospitals in the Al jouf area, in the northern province of Saudi Arabia. S. aureus was found in 188 (34.7%) of the 542 wounds. The traumatized wounds provided 71 isolates (38.8%), surgical wound provided 49 isolates (26.8%) and abscess were represented 16 by isolates (8.7%). In the study, 123 (65.4%) out of 188 were MRSA, 60 (31.9%) were MSSA, and five (2.7%) were VRSA. Linezolid and rifampin were found to be the most effective antimicrobials with 100% in vitro antibacterial activity against S. aureus isolates. The Multiple antimicrobials resistance (MAR) index revealed 73 isolates (38.9%) with a MAR index greater than 0.2, and 115 (61.1%) less than 0.2. The D-test showed that of MLSb phenotypes among S. aureus, 22 (11.7%) strains were D-test positive (MLSbi phenotype), 53 (28.2%) strains were constitutive MLSc phenotypes, and 17 (9%) strains were shown to have MSb phenotypes. All VRSA isolates (n=5) were found to be positive for vanA, and no vanB positive isolates were detected in the study. Conclusion Regular monitoring and an antimicrobials stewardship program should be in place to provide critical information that can be utilized for empirical therapy and future prevention strategies.
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Affiliation(s)
- Mohammed S Almuhayawi
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Mohammed H Alruhaili
- Department of Clinical Microbiology and Immunology, Faculty of Medicine, King AbdulAziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research Center, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Hattan S Gattan
- Special Infectious Agents Unit, King Fahad Medical Research Center, King AbdulAziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohanned Talal Alharbi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, 23218, Saudi Arabia
| | - Mohammed Nagshabandi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, 23218, Saudi Arabia
| | - Soad Al Jaouni
- Department of Hematology/Oncology, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
- Yousef Abdulatif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Awadh Alanazi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Yasir Alruwaili
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Osama Ahmed Faried
- Medical Microbiology and Immunology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed E Elnosary
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Cairo, Egypt
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22
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Chen B, Wang Y, Hou D, Zhang Y, Zhang B, Niu Y, Ji H, Tian Y, Liu X, Kang X, Cai H, Li Z. Transcriptome-Based Identification of the Muscle Tissue-Specific Expression Gene CKM and Its Regulation of Proliferation, Apoptosis and Differentiation in Chicken Primary Myoblasts. Animals (Basel) 2023; 13:2316. [PMID: 37508090 PMCID: PMC10376263 DOI: 10.3390/ani13142316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Skeletal muscle is an essential tissue in meat-producing animals, and meat-producing traits have been a hot topic in chicken genetic breeding research. Current research shows that creatine kinase M-type-like (CKM) is one of the most abundant proteins in skeletal muscle and plays an important role in the growth and development of skeletal muscle, but its role in the development of chicken skeletal muscle is still unclear. Via RNA sequencing (RNA-seq), we found that CKM was highly expressed in chicken breast muscle tissue. In this study, the expression profile of CKM was examined by quantitative real-time PCR (qPCR), and overexpression and RNA interference techniques were used to explore the functions of CKM in the proliferation, apoptosis and differentiation of chicken primary myoblasts (CPMs). It was shown that CKM was specifically highly expressed in breast muscle and leg muscle and was highly expressed in stage 16 embryonic muscle, while CKM inhibited proliferation, promoted the apoptosis and differentiation of CPMs and was involved in regulating chicken myogenesis. Transcriptome sequencing was used to identify genes that were differentially expressed in CPMs after CKM disruption, and bioinformatics analysis showed that CKM was involved in regulating chicken myogenesis. In summary, CKM plays an important role in skeletal muscle development during chicken growth and development.
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Affiliation(s)
- Bingjie Chen
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yanxing Wang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Dan Hou
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yushi Zhang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Bochun Zhang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yufang Niu
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Haigang Ji
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Yadong Tian
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
| | - Xiaojun Liu
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
| | - Xiangtao Kang
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
| | - Hanfang Cai
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
| | - Zhuanjian Li
- College of Animal Science and Technology, Henan Agricultural University, Zhengzhou 450001, China
- Key Laboratory of Livestock and Poultry Resources (Poultry) Evaluation and Utilization, Ministry of Agriculture and Rural Affairs, Zhengzhou 450001, China
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Nakata M, Yokota N, Kenzaka T. Diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression was useful in a patient with isolated myocardial abscess confined to the right atrial wall: a case report. BMC Cardiovasc Disord 2023; 23:341. [PMID: 37407924 DOI: 10.1186/s12872-023-03366-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 06/24/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Myocardial abscess is often associated with infective endocarditis (IE), and isolated myocardial abscess without IE is rare. Echocardiography and computed tomography (CT) are often used to diagnose myocardial abscess; however, to the best of our knowledge, diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression (DWIBS) has not been used. Here, we present a case of myocardial abscess without IE that was diagnosed using DWIBS. CASE PRESENTATION A 72-year-old Japanese man with a history of hypertension, dyslipidemia, and retinitis pigmentosa presented to our hospital with malaise and a fever lasting 10 days. Blood test results showed elevated inflammatory marker levels (white blood cell count 18,700/µL and C-reactive protein level 23.0 mg/dL). Infection was suspected; however, the source of the infection could not be identified. DWIBS, which was performed on day 7 of admission to determine the source of infection, showed a high signal surrounding the right wall, suggesting inflammation. Contrast-enhanced CT performed on day 1 of hospitalization revealed a low-density area in the same region; however, the pathological implications of this finding could not be determined. Based on DWIBS findings, we concluded that the condition presented as a myocardial abscess that was confined specifically to the right atrial wall. Three sets of blood cultures revealed negative findings, and echocardiography showed no vegetation or valve regurgitation. Therefore, the patient was diagnosed with an isolated myocardial abscess uncomplicated with IE. An electrocardiogram on admission showed no P waves, and the patient had a junctional rhythm. However, on day 20 of hospitalization, he developed a complete atrioventricular block. After complete myocardial abscess healing following antibiotic treatment was confirmed, the patient underwent pacemaker implantation. Ten months after surgery, the patient had no signs of infection recurrence. CONCLUSIONS Based on history and physical examination alone, diagnosis of an isolated myocardial abscess can be challenging. In addition to CT and echocardiography, DWIBS might be helpful for the diagnosis of myocardial abscesses.
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Affiliation(s)
- Marohito Nakata
- Department of Cardiology, Urasoe General Hospital, Urasoe, Japan
- Department of Cardiology, Naha City Hospital, Naha, Japan
| | - Naoko Yokota
- Department of Cardiology, Urasoe General Hospital, Urasoe, Japan
- Department of Cardiology, Naha City Hospital, Naha, Japan
| | - Tsuneaki Kenzaka
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, Hyogo, Japan.
- Division of Community Medicine and Career Development, Kobe University Graduate School of Medicine, 2-1-5, Arata-cho, Hyogo-ku, Kobe, 652-0032, Hyogo, Japan.
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24
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Castillo-Vásquez KC, Cerviño Camino S, Condorhuamán-Alvarado PY, Morales Mena GI. [Myositis in an older patient: About a case]. Rev Esp Geriatr Gerontol 2023; 58:101355. [PMID: 36967254 DOI: 10.1016/j.regg.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Affiliation(s)
| | | | - Patricia Ysabel Condorhuamán-Alvarado
- Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación Biomédica, Hospital Universitario La Paz (IdiPaz), Madrid, España
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25
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Nguyen J, Singh P, Gajjar T. Streptococcal pyomyositis in asplenia and underlying connective tissue disease. Proc AMIA Symp 2023; 36:518-520. [PMID: 37334073 PMCID: PMC10269408 DOI: 10.1080/08998280.2023.2210483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
Pyomyositis is an infection of skeletal muscles, commonly affecting deep longitudinal muscles of the lower extremities. Primary pyomyositis is uncommon in the United States. Staphylococcus aureus is the most common cause of pyomyositis, but Streptococcus pneumoniae is the most common cause of life-threatening bacterial infection in asplenic patients. Most cases of S. pneumoniae pyomyositis occur in immunocompromised patients. We describe a 31-year-old man with S. pneumoniae pyomyositis whose diagnosis and hospital course were complicated by an immunocompromised state from asplenia and an underlying connective tissue disease, Stickler syndrome. Underlying connective tissue diseases such as systemic lupus erythematosus and polymyositis can predispose patients to infection, but susceptibility with Stickler syndrome is less known. While pyomyositis is only seen in up to 0.2% of US hospital admissions, it remains a pertinent differential for patients with asplenia and connective tissue disease.
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Affiliation(s)
- John Nguyen
- Department of Internal Medicine, Baylor Scott & White Medicine Center – Round Rock, Round Rock, Texas
| | - Pardeep Singh
- Department of Internal Medicine, Baylor Scott & White Medicine Center – Round Rock, Round Rock, Texas
| | - Tapas Gajjar
- Department of Internal Medicine, Baylor Scott & White Medicine Center – Round Rock, Round Rock, Texas
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26
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Ura K, Motoya M, Ishii H. Rapidly-Progressing Pyomyositis After Chest Contusion in a Patient With Well-Controlled Diabetes Mellitus. J Med Cases 2023; 14:124-129. [PMID: 37188298 PMCID: PMC10181290 DOI: 10.14740/jmc4099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 05/17/2023] Open
Abstract
Pyomyositis is an uncommon acute bacterial infection of the skeletal muscle. It is sometimes referred to as "tropical pyomyositis" because it has been primarily reported as an endemic disease in tropical regions. In temperate climates, it is mainly diagnosed in immunocompromised persons, such as those with human immunodeficiency virus infection, malignancy, diabetes, and various other medical conditions. Early diagnosis and appropriate antimicrobial therapy for pyomyositis are important, however, it is often missed in its early stage. Herein, we report the case of a patient with obesity and well-controlled diabetes in whom rapid onset pyomyositis developed in only 2 days after chest contusion and induced bacteremia in its early stage. He was successfully treated by antimicrobials without any drainage or surgical intervention. Even in patients with well-controlled diabetes or in healthy persons, pyomyositis should be considered for patients who present with fever and muscle swelling and pain, especially when they have obesity and a history of blunt trauma. It should also be noted that pyomyositis, mimicking muscle contusion or hematoma can appear very early after blunt muscle trauma. Prompt diagnosis and antimicrobial treatment for pyomyositis can lead to a favorable outcome, without surgical drainage.
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Affiliation(s)
- Kazuya Ura
- Department of General Internal Medicine, Saiseikai Futsukaichi Hospital, Fukuoka, Japan
- Corresponding Author: Kazuya Ura, Department of General Internal Medicine, Saiseikai Futsukaichi Hospital, Chikushino-City, Fukuoka-Prefecture 818-8516, Japan.
| | - Misato Motoya
- Department of Diabetology, Saiseikai Futsukaichi Hospital, Fukuoka, Japan
| | - Hidehiro Ishii
- Department of Diabetology, Saiseikai Futsukaichi Hospital, Fukuoka, Japan
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27
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Wang YJ, Lin CH, Lu CC, Chen HC, Yeh FC. Streptococcus agalactiae pyomyositis in a patient with primary biliary cholangitis: A case report. Int J Rheum Dis 2023. [PMID: 36793153 DOI: 10.1111/1756-185x.14612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/27/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Abstract
Pyomyositis is an uncommon clinical scenario; it is usually associated with predisposing factors, including poorly controlled diabetes mellitus, trauma history, and immunocompromise. We discuss the case of an elderly woman with a 20-year history of diabetes mellitus and remissive breast cancer after modified radical mastectomy and subsequent chemotherapy 28 years previously. The patient presented with severe shoulder pain and gradual swelling. After examination, pyomyositis was diagnosed and debridement surgery was performed. Culture of the wound samples showed the growth of Streptococcus agalactiae. During hospitalization, primary biliary cholangitis (PBC) was diagnosed incidentally, accompanied by poor glycemic control. After treatment with antibiotics for pyomyositis and ursodeoxycholic acid for PBC, the infection resolved in 8 weeks, and her glycemic control was improved after PBC treatment. It is possible that the long-term untreated PBC worsened insulin resistance and aggravated diabetes mellitus in this patient. To the best of our knowledge, this is the first reported case of pyomyositis caused by an unusual pathogen, S. agalactiae, in a patient with newly diagnosed PBC.
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Affiliation(s)
- Yi-Jie Wang
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Hua Lin
- Division of Dermatology, Penghu Branch, Tri-Service General Hospital, Penghu, Taiwan
| | - Chun-Chi Lu
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsiang-Cheng Chen
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Chiang Yeh
- Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Division of Rheumatology, Immunology, and Allergy, Department of Internal Medicine, Penghu Branch, Tri-Service General Hospital, Penghu, Taiwan
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28
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NMR-based metabolomics of plasma from dairy calves infected with two primary causal agents of bovine respiratory disease (BRD). Sci Rep 2023; 13:2671. [PMID: 36792613 PMCID: PMC9930073 DOI: 10.1038/s41598-023-29234-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/01/2023] [Indexed: 02/17/2023] Open
Abstract
Each year, bovine respiratory disease (BRD) results in significant economic loss in the cattle sector, and novel metabolic profiling for early diagnosis represents a promising tool for developing effective measures for disease management. Here, 1H-nuclear magnetic resonance (1H-NMR) spectra were used to characterize metabolites from blood plasma collected from male dairy calves (n = 10) intentionally infected with two of the main BRD causal agents, bovine respiratory syncytial virus (BRSV) and Mannheimia haemolytica (MH), to generate a well-defined metabolomic profile under controlled conditions. In response to infection, 46 metabolites (BRSV = 32, MH = 33) changed in concentration compared to the uninfected state. Fuel substrates and products exhibited a particularly strong effect, reflecting imbalances that occur during the immune response. Furthermore, 1H-NMR spectra from samples from the uninfected and infected stages were discriminated with an accuracy, sensitivity, and specificity ≥ 95% using chemometrics to model the changes associated with disease, suggesting that metabolic profiles can be used for further development, understanding, and validation of novel diagnostic tools.
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29
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Nuclear localization signal peptides enhance genetic transformation of Dunaliella salina. Mol Biol Rep 2023; 50:1459-1467. [PMID: 36482029 DOI: 10.1007/s11033-022-08159-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Dunaliella salina (D. salina) expression system shows a very attractive application prospect, but it currently has a technical bottleneck, namely the low or unstable expression of recombinant proteins. Given the characteristics of cell-penetrating peptides or/and nuclear localization signal (NLS) peptides, this study is the first attempt to improve the transformation rate of foreign gene with trans-activating transcriptional (TAT) protein or/and NLS peptides. METHODS AND RESULTS Using salt gradient method, exogenous plasmids were transferred into D. salina cells with TAT or TAT/NLS complexes simultaneously. The β-glucuronidase gene expression was identified by means of histochemical stain and RT-qPCR detection. Through observation with light microscope, TAT-mediating cells exhibit an apparent cytotoxicity even at ratios of 0.5, no significant toxicity was noted in the TAT/plasmid/NLS complex group. It is obvious that with the addition of peptides the toxicity decreases significantly. Histochemical staining showed that the transformants presented blue color under light microscope, but the negative control and blank control are not. Furthermore, based on a TAT/plasmids ratio of 4 with 10 µg NLS peptides mediation, RT-qPCR results demonstrated that the transcripts of target gene were increased by 269 times than that of control group. CONCLUSIONS This study demonstrated that combination of TAT and NLS peptides can significantly improve the transformation rate and expression level of foreign gene in D. salina system. It offers a promising way for promoting the application and development of D. salina bioreactor.
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30
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Emerging nanosonosensitizers augment sonodynamic-mediated antimicrobial therapies. Mater Today Bio 2023; 19:100559. [PMID: 36798535 PMCID: PMC9926023 DOI: 10.1016/j.mtbio.2023.100559] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/07/2023] [Accepted: 01/19/2023] [Indexed: 01/22/2023] Open
Abstract
With the widespread prevalence of drug-resistant pathogens, traditional antibiotics have limited effectiveness and do not yield the desired outcomes. Recently, alternative antibacterial therapies based on ultrasound (US) have been explored to overcome the crisis of bacterial pathogens. Antimicrobial sonodynamic therapy (aSDT) offers an excellent solution that relies on US irradiation to produce reactive oxygen species (ROS) and achieve antibiotic-free mediated antimicrobial effects. In addition, aSDT possesses the advantage of superior tissue penetrability of US compared to light irradiation, demonstrating great feasibility in treating deep infections. Although existing conventional sonosensitizers can produce ROS for antimicrobial activity, some limitations, such as low penetration rate, nonspecific distribution and poor ROS production under hypoxic conditions, result in suboptimal sterilization in aSDT. Recently, emerging nanosonosensitizers have enormous advantages as high-performance agents in aSDT, which overcome the deficiencies of conventional sonosensitizers as described above. Thus, nanosonosensitizer-mediated aSDT has a bright future for the management of bacterial infections. This review classifies the current available nanosonosensitizers and provides an overview of the mechanisms, biomedical applications, recent advances and perspectives of aSDT.
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31
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Coxsackie B virus myositis in a healthy young man with mumps co-infection. IDCases 2023; 31:e01691. [PMID: 36704025 PMCID: PMC9871301 DOI: 10.1016/j.idcr.2023.e01691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Infection is an established but uncommon etiology of myositis, and Coxsackie B virus has only been rarely described as a causative agent. We present a case of a 38-year-old male who presented with weakness, myalgias, and testicular pain following two weeks of upper respiratory infection. Laboratory tests revealed an elevated creatine kinase and positive serology for Coxsackie B4 and mumps. This unusual presentation of Coxsackie B myositis and mumps co-infection in a previously healthy young patient illustrates the importance of including infectious etiologies in the differential diagnosis and the potential life-threatening consequences of biased clinical reasoning.
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32
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Impaired muscle stem cell function and abnormal myogenesis in acquired myopathies. Biosci Rep 2023; 43:232343. [PMID: 36538023 PMCID: PMC9829652 DOI: 10.1042/bsr20220284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Skeletal muscle possesses a high plasticity and a remarkable regenerative capacity that relies mainly on muscle stem cells (MuSCs). Molecular and cellular components of the MuSC niche, such as immune cells, play key roles to coordinate MuSC function and to orchestrate muscle regeneration. An abnormal infiltration of immune cells and/or imbalance of pro- and anti-inflammatory cytokines could lead to MuSC dysfunctions that could have long lasting effects on muscle function. Different genetic variants were shown to cause muscular dystrophies that intrinsically compromise MuSC function and/or disturb their microenvironment leading to impaired muscle regeneration that contributes to disease progression. Alternatively, many acquired myopathies caused by comorbidities (e.g., cardiopulmonary or kidney diseases), chronic inflammation/infection, or side effects of different drugs can also perturb MuSC function and their microenvironment. The goal of this review is to comprehensively summarize the current knowledge on acquired myopathies and their impact on MuSC function. We further describe potential therapeutic strategies to restore MuSC regenerative capacity.
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33
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Debs P, Al-Zaghal A, Solnes LB, Alavi A. Sarcopenia and Myositis Revisited. PET Clin 2023; 18:31-38. [DOI: 10.1016/j.cpet.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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34
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Salastekar N, Su A, Rowe JS, Somasundaram A, Wong PK, Hanna TN. Imaging of Soft Tissue Infections. Radiol Clin North Am 2023; 61:151-166. [DOI: 10.1016/j.rcl.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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35
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Primary MRSA Myositis Mimicking Septic Arthritis. Case Rep Crit Care 2023; 2023:5623876. [PMID: 36895204 PMCID: PMC9991464 DOI: 10.1155/2023/5623876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/09/2022] [Accepted: 02/11/2023] [Indexed: 03/04/2023] Open
Abstract
As the incidence of bacterial myositis and pyomyositis in the United States is rising, we aim to highlight the presentation of bacterial myositis which is known as a great imitator in tropical regions. This is a case report of a 61-year-old female patient with poorly controlled diabetes who presented initially with lateral hip pain and tenderness. This was initially believed to be septic arthritis and warranted arthrocentesis. What makes this case interesting is that what was believed to be a primary community-acquired MRSA myositis, which progressed to a life-threatening septic shock, happened in a nontropical area (Northeastern USA) and in a patient with no underlying recent muscle injury. This case serves to remind clinicians that infectious myositis is gaining more incidence in nontropical regions and can masquerade as septic arthritis, requiring a high index of suspicion. Normal muscle enzymes like CK and aldolase do not rule out myositis.
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36
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Kaba İ, Peltek Kendirci HN, Demirbaş SC. Evaluation of Clinical and Laboratory Findings in Acute Benign Myositis in Childhood. GÜNCEL PEDIATRI 2022. [DOI: 10.4274/jcp.2022.73558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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37
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De Paepe B. The Cytokine Growth Differentiation Factor-15 and Skeletal Muscle Health: Portrait of an Emerging Widely Applicable Disease Biomarker. Int J Mol Sci 2022; 23:ijms232113180. [PMID: 36361969 PMCID: PMC9654287 DOI: 10.3390/ijms232113180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 12/04/2022] Open
Abstract
Growth differentiation factor 15 (GDF-15) is a stress-induced transforming growth factor-β superfamily cytokine with versatile functions in human health. Elevated GDF-15 blood levels associate with multiple pathological conditions, and are currently extensively explored for diagnosis, and as a means to monitor disease progression and evaluate therapeutic responses. This review analyzes GDF-15 in human conditions specifically focusing on its association with muscle manifestations of sarcopenia, mitochondrial myopathy, and autoimmune and viral myositis. The use of GDF-15 as a widely applicable health biomarker to monitor muscle disease is discussed, and its potential as a therapeutic target is explored.
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Affiliation(s)
- Boel De Paepe
- Neuromuscular Reference Center, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
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38
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Rao A, Nawaz I, Arbi FM, Ishtiaq R. Proximal myopathy: causes and associated conditions. Discoveries (Craiova) 2022; 10:e160. [PMID: 37483534 PMCID: PMC10360994 DOI: 10.15190/d.2022.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 07/25/2023] Open
Abstract
Proximal myopathy presents as generalized muscle weakness commonly involving the muscles of upper and/or lower limbs. Toxins, long-term use of statins, corticosteroids, alcohol, SGLT2 inhibitors, COVID-19 vaccination, and antimalarials have been attributed to its development. In endocrine and metabolic disorders, adrenal dysfunction including both overproduction and insufficiency of the adrenal gland hormones has been reported to cause myopathy. Moreover, parathyroid and thyroid disorders along with pituitary gland disorders can also directly or indirectly contribute to this condition. In idiopathic inflammatory myopathies including polymyositis, dermatomyositis, inclusion body myositis (IBM), and Systemic Lupus Erythematosus (SLE), Sjögren's Syndrome, and overlap syndromes, moderate to severe muscle weakness has been observed. IBM has been reported to be the most prevalent acquired myopathy above the age of 50. Hereditary or congenital myopathies include limb girdle muscular dystrophies, facioscapulohumeral muscular dystrophy, Duchenne and Becker muscular dystrophy, and proximal myotonic myopathy. In addition to these, glycogen storage diseases such as the McArdle disease can also cause fast exhaustion, myalgia, and cramping in working muscles. It is pertinent to mention here that a class of hereditary metabolic myopathies, referred to as "lipid deposition myopathy" causes lipids to accumulate in skeletal muscle fibers, leading to lesions and degeneration. Among viral causes, HIV, dengue virus, influenza virus, hepatitis B virus, hepatitis C virus, SARS-CoV2 are also associated with muscle weakness. Sarcoidosis, an inflammatory disease, can also manifest as muscle weakness and myalgia. Owing to this complicated pathophysiology of proximal myopathy, this review aims to summarize the existing literature on conditions associated with this phenomenon and other recent developments that have been made regarding events leading to development of generalized muscle weakness. To the authors' knowledge this is the first narrative review that discusses causes and conditions associated with proximal myopathy in thorough detail.
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Affiliation(s)
- Amina Rao
- Quaid-e-Azam Medical College, Bahawalpur, Pakistan
| | - Iqra Nawaz
- Quaid-e-Azam Medical College, Bahawalpur, Pakistan
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Abstract
PURPOSE OF REVIEW The global spread of severe acute respiratory syndrome coronavirus 2 resulted in many cases of acute and postacute muscular symptoms. In this review, we try to decipher the potential underlying pathomechanisms and summarize the potential links between viral infection and muscle affection. RECENT FINDINGS Disregarding single case studies that do not allow safe conclusions due to the high number of infections, histopathological evidence of myositis has only been reported in deceased individuals with severe COVID-19. Postacute myalgia and weakness seem to occur in a subset of patients up to one year after initial infection, reminiscent of postinfectious syndromes (PIS) described in prior epidemics and pandemics of the past. SUMMARY COVID-19 associated myopathy likely comprises different entities with heterogeneous pathomechanisms. Individual factors such as disease severity and duration, age, sex, constitutional susceptibilities, and preexisting conditions are important to consider when formulating a diagnosis. Persisting symptoms show overlapping features with PIS or postintensive care syndrome. In lack of strong evidence for a direct infection of myocytes, inflammatory myopathies associated with COVID-19 are presumably immune-mediated. Differential diagnosis of rheumatological and nonmuscular neurological origin coinciding with the infection need to be considered, due to the extremely high numbers of newly occurring infections the last 2 years.
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Affiliation(s)
- Tom Aschman
- Department of Neuropathology, Charité - Universitätsmedizin, Berlin, Germany
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40
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Kim JH, Lee JS, Choi BY, Cheon YH, Yoo SJ, Ju JH, Shin K, Kim ES, Baek HJ, Park W, Song YW, Hong WH, Lee YJ. Isolated Tuberculous Myositis: A Systematic Review and Multicenter Cases. JOURNAL OF RHEUMATIC DISEASES 2022; 29:243-253. [PMID: 37476423 PMCID: PMC10351410 DOI: 10.4078/jrd.22.0014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/07/2022] [Accepted: 06/28/2022] [Indexed: 07/22/2023]
Abstract
Objective To investigate the clinical features and associated underlying conditions of isolated tuberculous myositis (ITBM), a rare extrapulmonary tuberculosis (TB). Methods A systematic literature search and a multicenter survey were performed using a triangulation strategy. Data from the identified ITBM cases were extracted and analyzed to determine the underlying conditions, clinical presentations, treatments, and outcomes. Results Based on the systematic review, we identified 58 ITBM, including 9 pediatric, cases in the literature published from 1981 to 2021 25 (43.1%) immunocompromised and 33 (56.9%) non-immunocompromised patients. Immunocompromised cases had a significant shorter symptom duration (median 30.0 vs. 75.0 days) and a higher prevalence of multilocular involvement (20.8% vs. 0%). Among 24 immunocompromised adult patients, dermatomyositis/polymyositis (DM/PM; n=10, 41.7%) were the most common underlying diseases in adults with ITBM identified in the systematic review. Over the past 20 years, 11 Korean adults with ITBM were identified in the multicenter survey. Of 7 immunocompromised cases, two (28.6%) were DM/PM patients. TB death rate of immunocompromised patients was 0.0% and 5/23 (21.7%) in the pediatric and adult ITBM cases identified in the systematic review, respectively, and 3/7 (42.9%) in survey-identified ITBM cases. Conclusion ITBM has a unique clinical presentation including fever, tenderness, local swelling, overlying erythema, abscess formation and was associated with a grave outcome, especially in immunocompromised hosts. DM/PM was a highly prevalent underlying disease in both systematic review-identified and survey-identified immunocompromised ITBM patients.
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Affiliation(s)
- Ji Hyoun Kim
- Division of Rheumatology, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jeong Seok Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Byoong Yong Choi
- Division of Rheumatology, Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Yun-Hong Cheon
- Division of Rheumatology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Su-Jin Yoo
- Daejeon Rheumatoid & Degenerative Arthritis Center, Chungnam National University Hospital, Daejeon, Korea
| | - Ji Hyeon Ju
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kichul Shin
- Division of Rheumatology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Eu Suk Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Han Joo Baek
- Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Won Park
- Medicine/Rheumatology, School of Medicine, Inha University, Incheon, Korea
| | - Yeong Wook Song
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Woi-Hyun Hong
- College of Medicine and Medical Research Information Center (MedRIC), Chungbuk National University, Cheongju, Korea
| | - Yun Jong Lee
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea
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41
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Costa Azevedo A, Costa E Silva A, Juliana Silva C, Poço Miranda S, Costa M, Martinho I. Benign acute childhood myositis: A 5-year retrospective study. Arch Pediatr 2022; 29:490-493. [PMID: 36109287 DOI: 10.1016/j.arcped.2022.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/30/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Benign acute childhood myositis (BACM) is a rare, transient, and self-limited inflammatory condition of the skeletal muscle that usually occurs after a viral infection. It affects pre-school and school-aged children at a median age of 6-9 years, with a male predominance. Patients can be managed with analgesia, rest, and adequate hydration at home. METHODS A retrospective review was carried out of patients' clinical records with an elevated level of creatine phosphokinase (CPK) who presented to the pediatric emergency department between January 1, 2015 and December 31, 2019. RESULTS Out of 174 cases of elevated CPK values, 100 corresponded to BACM-compatible clinical presentations (n = 96). There was a male predominance (77%) with a median age of 6 years. There were more cases registered in 2019 compared with the previous years. The most frequently reported prodromal symptoms were fever, cough, and rhinorrhea. Bilateral calf pain was the most frequently reported BACM symptom, followed by gait complaints and refusal to walk. Hospitalization was an independent predictor of CPK levels. In two cases there was myoglobinuria. The most common hematological findings were leukopenia and thrombocytopenia. CONCLUSION Our results regarding male predominance, median age, and hematological findings are similar to the published reports. The outbreak during 2019 coincided with the 2019/2020 flu season. During this period, influenza B was the most prevalent virus and it is known to be the most myotrophic one. Physicians often take into consideration CPK levels during inpatient admission. All patients recovered fully, emphasizing the fact that BACM is benign, self-limited, and with an excellent prognosis.
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Affiliation(s)
- A Costa Azevedo
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal.
| | - A Costa E Silva
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
| | - C Juliana Silva
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
| | - S Poço Miranda
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
| | - M Costa
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
| | - I Martinho
- Pediatrics Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
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Arnaert S, Malfait T, Deruyck A, Desoete F, Nersisjan M, Matthijs I, Maes B. RSV induced rhabdomyolysis: a case report. Acta Clin Belg 2022:1-3. [DOI: 10.1080/17843286.2022.2121364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Stijn Arnaert
- Department of Nephrology, AZ Delta,Roeselare, Belgium
| | | | | | - Farah Desoete
- Department of Nephrology, AZ Delta,Roeselare, Belgium
| | | | - Inge Matthijs
- Department of Pediatrics, AZ Delta,Roeselare, Belgium
| | - Bart Maes
- Department of Nephrology, AZ Delta,Roeselare, Belgium
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43
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Bhangle DS, Sun K, Wu JS. Imaging Features of Soft Tissue Tumor Mimickers: A Pictorial Essay. Indian J Radiol Imaging 2022; 32:381-394. [PMID: 36177289 PMCID: PMC9514899 DOI: 10.1055/s-0042-1756556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Soft tissue lesions are commonly encountered and imaging is an important diagnostic step in the diagnosis and management of these lesions. While some of these lesions are true neoplasms, others are not. These soft tissue tumor mimickers can be due to a variety of conditions including traumatic, iatrogenic, inflammatory/reactive, infection, vascular, and variant anatomy. It is important for the radiologist and clinician to be aware of these common soft tissue tumor mimickers and their characteristic imaging features to avoid unnecessary workup and provide the best treatment outcome.
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Affiliation(s)
- Devanshi S. Bhangle
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Kevin Sun
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Jim S. Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
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44
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Valencia Deray KG, Taylor MG, Blessing MM, Bocchini CE, Schallert EK, Ruderfer D, Srivaths PR, Malatesta Muncher R. Necrotizing enterovirus myositis in a pediatric renal transplant recipient. Pediatr Transplant 2022; 26:e14275. [PMID: 35340121 DOI: 10.1111/petr.14275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 02/08/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Enteroviruses can cause severe infections, including viral myocarditis, meningitis, acute flaccid myelitis, and viral myositis. METHODS/RESULTS We report a 3-year-old female renal transplant recipient who presented to a tertiary care hospital with elevated serum liver aminotransferases and subsequently developed proximal muscle pain, weakness, and respiratory distress during the first week of hospitalization. Imaging of the lower extremities revealed diffuse myositis of the proximal thigh and pelvic muscles. A muscle biopsy was obtained and revealed necrotizing myositis with immunostaining positive for enterovirus, consistent with a diagnosis of enterovirus necrotizing myositis. She had complete resolution of symptoms with steroids, intravenous immune globulin, reduced tacrolimus dose, and physical therapy. CONCLUSIONS Enterovirus myositis should be included in the differential diagnosis for necrotizing myositis following renal transplantation in children.
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Affiliation(s)
- Kristen G Valencia Deray
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Margaret G Taylor
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Melissa M Blessing
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA
| | - Claire E Bocchini
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Erica K Schallert
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Daniel Ruderfer
- Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Poyyapakkam R Srivaths
- Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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45
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Jacob S, Kapadia R, Soule T, Luo H, Schellenberg KL, Douville RN, Pfeffer G. Neuromuscular Complications of SARS-CoV-2 and Other Viral Infections. Front Neurol 2022; 13:914411. [PMID: 35812094 PMCID: PMC9263266 DOI: 10.3389/fneur.2022.914411] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022] Open
Abstract
In this article we review complications to the peripheral nervous system that occur as a consequence of viral infections, with a special focus on complications of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). We discuss neuromuscular complications in three broad categories; the direct consequences of viral infection, autoimmune neuromuscular disorders provoked by viral infections, and chronic neurodegenerative conditions which have been associated with viral infections. We also include discussion of neuromuscular disorders that are treated by immunomodulatory therapies, and how this affects patient susceptibility in the current context of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is associated with direct consequences to the peripheral nervous system via presumed direct viral injury (dysgeusia/anosmia, myalgias/rhabdomyolysis, and potentially mononeuritis multiplex) and autoimmunity (Guillain Barré syndrome and variants). It has important implications for people receiving immunomodulatory therapies who may be at greater risk of severe outcomes from COVID-19. Thus far, chronic post-COVID syndromes (a.k.a: long COVID) also include possible involvement of the neuromuscular system. Whether we may observe neuromuscular degenerative conditions in the longer term will be an important question to monitor in future studies.
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Affiliation(s)
- Sarah Jacob
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ronak Kapadia
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tyler Soule
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Honglin Luo
- Centre for Heart and Lung Innovation, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kerri L. Schellenberg
- Division of Neurology, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Renée N. Douville
- Division of Neurodegenerative Disorders, Department of Biology, Albrechtsen St. Boniface Research Centre, University of Winnipeg, Winnipeg, MB, Canada
| | - Gerald Pfeffer
- Hotchkiss Brain Institute, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Medical Genetics, Alberta Child Health Research Institute, University of Calgary, Calgary, AB, Canada
- *Correspondence: Gerald Pfeffer
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Suzuki I, Nakao R, Unai Y, Miyazaki Y. [A case of anti-SRP antibody-positive immune-mediated necrotizing myopathy triggered by human parvovirus B19 infection]. Rinsho Shinkeigaku 2022; 62:363-368. [PMID: 35474284 DOI: 10.5692/clinicalneurol.cn-001684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
We have reported a case of a 44-year-old woman with anti-signal recognition particle (SRP) antibody-positive immune-mediated necrotizing myopathy triggered by human parvovirus B19 (PVB19) infection. She was admitted to the hospital because of lower leg edema and muscle weakness after erythema infectiosum. Magnetic resonance imaging of the lower extremities revealed high signals in the proximal muscles and subcutaneous edema on STIR. Muscle biopsy showed myofiber regenerative changes and variation in fiber size. A myositis-specific autoantibody profile indicated a positive result for anti-SRP antibodies. We diagnosed the patient with immune-mediated necrotizing myopathy (IMNM). Muscle strength and subcutaneous edema improved gradually in 3 months following immunotherapy. This is the first case report of an IMNM associated with PVB19 infection.
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Affiliation(s)
- Iku Suzuki
- Department of Neurology, Hyogo Prefectural Awaji Medical Center
| | - Ryohei Nakao
- Department of Neurology, Hyogo Prefectural Awaji Medical Center
| | - Yuki Unai
- Department of Neurology, Hyogo Prefectural Awaji Medical Center
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Bawale R, Watson J, Yusuf K, Pillai D, Singh B. Acute pyomyositis of the adductor magnus muscle involving the posterior and lateral thigh compartments: a case report of diagnosis and management. JOURNAL OF TRAUMA AND INJURY 2022. [DOI: 10.20408/jti.2021.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Waring AL, Hill J, Allen BM, Bretz NM, Le N, Kr P, Fuss D, Mortimer NT. Meta-Analysis of Immune Induced Gene Expression Changes in Diverse Drosophila melanogaster Innate Immune Responses. INSECTS 2022; 13:insects13050490. [PMID: 35621824 PMCID: PMC9147463 DOI: 10.3390/insects13050490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/05/2022]
Abstract
Simple Summary Organisms can be infected by a wide range of pathogens, including bacteria, viruses, and parasites. Following infection, the host mounts an immune response to attempt to eliminate the pathogen. These responses are often specific to the type of pathogen and mediated by the expression of specialized genes. We have characterized the expression changes induced in host Drosophila fruit flies following infection by multiple types of pathogens, and identified a small number of genes that show expression changes in each infection. This includes genes that are known to be involved in pathogen resistance, and others that have not been previously studied as immune response genes. These findings provide new insight into transcriptional changes that accompany Drosophila immunity. They may suggest possible roles for the differentially expressed genes in innate immune responses to diverse classes of pathogens, and serve to identify candidate genes for further empirical study of these processes. Abstract Organisms are commonly infected by a diverse array of pathogens and mount functionally distinct responses to each of these varied immune challenges. Host immune responses are characterized by the induction of gene expression, however, the extent to which expression changes are shared among responses to distinct pathogens is largely unknown. To examine this, we performed meta-analysis of gene expression data collected from Drosophila melanogaster following infection with a wide array of pathogens. We identified 62 genes that are significantly induced by infection. While many of these infection-induced genes encode known immune response factors, we also identified 21 genes that have not been previously associated with host immunity. Examination of the upstream flanking sequences of the infection-induced genes lead to the identification of two conserved enhancer sites. These sites correspond to conserved binding sites for GATA and nuclear factor κB (NFκB) family transcription factors and are associated with higher levels of transcript induction. We further identified 31 genes with predicted functions in metabolism and organismal development that are significantly downregulated following infection by diverse pathogens. Our study identifies conserved gene expression changes in Drosophila melanogaster following infection with varied pathogens, and transcription factor families that may regulate this immune induction.
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Roy S, Nag S, Saini A, Choudhury L. Association of human gut microbiota with rare diseases: A close peep through. Intractable Rare Dis Res 2022; 11:52-62. [PMID: 35702576 PMCID: PMC9161125 DOI: 10.5582/irdr.2022.01025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 11/05/2022] Open
Abstract
The human body harbors approximately 1014 cells belonging to a diverse group of microorganisms. Bacteria outnumbers protozoa, fungi and viruses inhabiting our gastrointestinal tract (GIT), commonly referred to as the "human gut microbiome". Dysbiosis occurs when the balanced relationship between the host and the gut microbiota is disrupted, altering the usual microbial population there. This increases the susceptibility of the host to pathogens, and chances of its morbidity. It is due to the fact that the gut microbiome plays an important role in human health; it influences the progression of conditions varying from colorectal cancer to GIT disorders linked with the nervous system, autoimmunity, metabolism and inheritance. A rare disease is a lethal and persistent condition affecting 2-3 people per 5,000 populaces. This review article intends to discuss such rare neurological, autoimmune, cardio-metabolic and genetic disorders of man, focusing on the fundamental mechanism that links them with their gut microbiome. Ten rare diseases, including Pediatric Crohn's disease (PCD), Lichen planus (LP), Hypophosphatasia (HPP), Discitis, Cogan's syndrome, Chancroid disease, Sennetsu fever, Acute cholecystitis (AC), Grave's disease (GD) and Tropical sprue (TS) stands to highlight as key examples, along with personalized therapeutics meant for them. This medicinal approach addresses the individual's genetic and genomic pathography, and tackles the illness with specific and effective treatments.
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Affiliation(s)
- Souvik Roy
- Department of Biotechnology, St. Xavier's College (Autonomous), Kolkata, India
| | - Sagnik Nag
- Department of Biotechnology, School of Biosciences & Technology, Vellore Institute of Technology (VIT), Tamil Nadu, India
| | - Ankita Saini
- Department of Microbiology, University of Delhi (South Campus), New Delhi, India
| | - Lopamudra Choudhury
- Department of Microbiology, Sarsuna College (under Calcutta University), Kolkata, India
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Schetz D, Sztormowska-Achranowicz K, Foerster J, Kocić I. Muscle pain and muscle weakness in COVID19 patients: Cross-talk with statins - Preliminary results. Biomed Pharmacother 2022; 148:112757. [PMID: 35231696 PMCID: PMC8866076 DOI: 10.1016/j.biopha.2022.112757] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Muscle pain and muscle weakness, common symptoms among statin-treated patients, may worsen with COVID-19 infection. Aims The aim of the paper was to find out if concomitant COVID-19 infections increase the frequency of specific side effects of statins such as muscle pain and muscle weakness. Method A total of 66 patients diagnosed with COVID-19 without comorbidities participated in the study. The patients were divided into two groups: statin-users who had not experienced adverse effects of statins in the past (statin group (SG)) and patients who had not used any drugs in the past six months (control group (CG)). The severity of muscle pain and creatinine kinase (CK) activity was evaluated in each patient, and muscle weakness was confirmed by a dynamometer test (grip strength on both hands). Results In SG, muscle pain was more common and it was characterized by a high level of intensity. Muscle weakness occurred more frequently in the SG and it was more frequent compared to CG. The CK parameter was observed to be higher in the SG compared to the CG and was often associated with the severity of muscle pain in the range of moderate to severe. Conclusions Our study indicates that COVID-19 is associated with the higher risk of occurrence of typical statin-related side effects, especially with more advanced age, which should be considered in future trials and treatments.
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Affiliation(s)
- Daria Schetz
- Department of Pharmacology, Faculty of Medicine, Medical University of Gdańsk, Poland.
| | | | - Jerzy Foerster
- Division of Social and Clinical Gerontology, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Poland
| | - Ivan Kocić
- Department of Pharmacology, Faculty of Medicine, Medical University of Gdańsk, Poland
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