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A 34-year-old woman entered the emergency room with abdominal pain in the right upper quadrant. Computed tomography scan showed a nutmeg liver suspected for increased venous pressure by thrombosis of the liver veins, Budd-Chiari malformation, or right-sided heart failure. Interestingly, the diagnosis was pelvic inflammatory disease complicated by the Fitz-Hugh-Curtis syndrome (FHCS).Pelvic inflammatory disease resulted from an ascended infection by Chlamydia trachomatis. FHCS was caused by perihepatitis defined as inflammation of the peritoneal capsule of the liver. Fast diagnosis and treatment is crucial. Therefore, we report a case of FHCS characterized by a nutmeg liver on computed tomography. Keywords: Fitz-Hugh-Curtis syndrome, Perihepatitis, Hepatomegaly, Nutmeg liver, Pelvic Inflammatory disease, Chlamydia trachomatis

Fitz-Hugh–Curtis syndrome, a rare complication of pelvic inflammatory disease, is an inflammation of the liver capsule (thus called perihepatitis) and the surrounding peritoneum. It occurs extremely rarely in men and is typically characterized by a sudden onset of severe pain in the right upper abdominal quadrant. Ultrasound examination of the liver does not reveal any morphologic changes, and liver function tests are usually normal. Computerized tomography shows the thickening of the perihepatic fat, but definitive diagnosis is only possible by direct visualization by laparoscopy or laparotomy. We present a 33-year-old HIV-positive man with Chlamydia trachomatis proctitis who developed severe right upper abdominal quadrant pain. Abdominal ultrasound did not show any liver pathology, while computerized tomography revealed hepatic capsular thickening. After 21 days of doxycycline therapy, the patient’s symptoms subsided. Based on the clinical presentation and liver computerized tomography examination, the diagnosis of proctitis and the resulting Fitz-Hugh–Curtis syndrome was made. Although it is rarely seen in male patients, it should be a part of differential diagnosis in patients who present with right upper abdominal quadrant pain, especially in men who have sex with other men.

Fitz-Hugh-Curtis’s syndrome (FHCS) is defined as an inflammation of the liver capsule associated with pelvic inflammatory disease (PID). Here, we report a case of FHCS of a 37-year-old woman, presented with a history of the right upper quadrant (RUQ) abdominal pain. Physical examination revealed RUQ abdominal tenderness and vaginal secretions, pelvic pain that was denied by the patient. The diagnosis has been raised and a computed tomography (CT) scan was realized showing inflammatory changes in both pelvic and perihepatic regions.

The present study was the first postmortem examination of a barn owl in Bangladesh. A female Barn owl weighing 450grams was brought to the Teaching Veterinary Hospital (TVH) at Chittagong Veterinary and Animal Sciences University (CVASU) by the forest department, Chittagong. The history of traumatic injury on left wing by an electric fan one day back was recorded. Clinical and radiographic examination revealed an open overriding proximal left metacarpal fracture and was decided for pinning to correct the fracture. Retrograde intramedullary pinning was performed and immobilized the wing by bandage. At postoperative day one, owl was found death and PM was performed to find out the actual clues. Gross postmortem examination revealed chalky whitish layer formed over the heart and liver which indicates pericarditis and perihepatitis. Hemorrhage in the left thigh muscle was also observed. Biochemical examination revealed salmonella organism in the samples of liver and heart. Histopathological examination found tissue changes in the suspected organs. In conclusion, it is revealed that the probable causes of death were inanition, pain shock, unfavorable environment and with salmonella infection.International Journal of Natural Sciences (2014), 4(2) 34-37

THIS study aimed to investigate the pathogenesis of locally isolated Salmonella Gallinarum biovar Gallinarum in experimentally infected Broiler chicks. One hundred and forty Broiler chicks -one day old- were randomly divided into two groups. The first group was kept as a control group. The second group was inoculated with S. Gallinarum biovar Gallinarum at a dose 0.2ml of sterile saline containing 3×108 CFU/ml through crop gavage. After inoculation, all experimental birds were kept under strict daily observation for recording clinical signs and mortality rate. Tissue samples were collected from dead and sacrificed chicks of each group at the 12th h, 1st, 2nd, 3rd, 4th, 7th, 14th, 21st and the 28th day post infection (dpi). Postmortem examination revealed severe congestion of internal organs. Microscopical findings illustrated congestion, thrombosis, focal hemorrhages, aggregation of bluish masses of bacterial colonies scattered in the hepatic parenchyma and thickening of hepatic capsule with bile duct hyperplasia. Fibrinous and granulomatous pericarditis were seen. Pulmonary congestion and thrombosis with focal hemorrhages and enteritis with desquamation of villar epithelium and goblet cells activation were observed. In conclusion, experimental inoculation of chicks with S. Gallinarum biovar Gallinarum was characterized by early septicemic lesions followed by perihepatitis, serofibrinous pericarditis and enteritis appeared after the 2nd dpi.

The outbreak of Riemerella anatipestifer (RA) infection has been confirmed in meat-type domestic ducks (Anas platyrhynchos) for the first time in 27 years in Japan. In January 2014, increased mortality in a 14- to 21-day-old duck flock was reported to veterinary officials by the owner. The affected ducks exhibited reduced movement, ataxia and dorsal recumbency with leg paddling. Pathological findings were typical for an RA infection. Fibrinous and heterophilic pericarditis, airsacculitis, perihepatitis, ventriculitis and meningitis were observed. The bacterial isolate from duck organs was identified as RA by PCR-based 16S ribosomal RNA sequencing.

Perihepatic capsulitis is associated with various diseases, such as Fitz-Hugh-Curtis syndrome, systemic lupus erythematosus, perforated cholecystitis, perforated hepatic abscess, and tuberculous peritonitis. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and is characterized by the widespread millet-like hematogenous dissemination of Mycobacterium tuberculosis. We describe a 24-year-old virgin patient presenting with right upper quadrant and costovertebral angle pain. Diffuse perihepatic capsular enhancement was observed in abdominal computed tomography scans. Chest radiography showed miliary tuberculosis, and a polymerase chain reaction hybridization assay of sputum revealed the presence of M. tuberculosis. Symptoms improved after administering anti-tuberculosis medications. This report describes a rare case of miliary tuberculosis accompanying perihepatitis.

У статті на прикладі клінічного випадку розглянуті сучасні уявлення про етіологію та патогенез синдрому Фітц-Х’ю-Куртіса, як причини болю у правому підребер’ї. Визначені основні аспекти клініко-анамнестичної діагностики хламідійної інфекції при постхолецистектомічному синдромі, наведений приклад лікувальної тактики. В статье на примере клинического случая рассмотрены современные представления об этиологии и патогенезе синдрома ФитцХью-Куртиса, как причины боли в правом подреберье. Определены основные аспекты клинико-анамнестической диагностики хламидийной инфекции при постхолецистэктомическом синдроме, приведен пример лечебной тактики. Fitz-Hugh Curtis syndrome is an important and understudied factor that significantly affects the quality of life of patients. To date, there are no diagnostic standards that would enable to verify the Fitz-Hugh-Curtis syndrome. In the article on the example of a clinical case we considered the contemporary ideas about etiology and pathogenesis of Fitz-HughCurtis syndrome as the causes of pain in the right upper quadrant of abdominal cavity. A 52-year woman presented with right-upper quadrant pain and digestive disorders during long time after laparoscopic cholecystectomy with no organic reason. Clinical and anamnestic features allow us to find the real reason of complaints and to use target antibacterial therapy. Widening of the ideas about the Fitz-Hugh-Curtis syndrome and orientation of general physicians and surgeons to the search for signs of generalized chlamydia is a direction of improvement of individual therapeutic and diagnostic tactics which helps to optimize the therapeutic process and avoid unnecessary surgical interventions.

Fitz-Hugh-Curtis syndrome (FHCS) is a perihepatitis that results from the intraperitoneal extension of pelvic inflammatory disease (PID) and classically occurs in reproductive-aged women with sexual activity. This syndrome usually presents with right upper quadrant (RUQ) abdominal pain together with lower abdominal pain and vaginal discharge. However, some patients may present with isolated RUQ abdominal pain mimicking other hepatobiliary pathologies and posing a diagnostic challenge to many physicians. Resumen: El síndrome de Fitz-Hugh-Curtis (SFHC) es una perihepatitis secundaria a la extensión intraperitoneal de una enfermedad inflamatoria pélvica (EPI), que habitualmente afecta a mujeres sexualmente activas. Generalmente se presenta con dolor abdominal en hipocondrio derecho (HD) junto con dolor en hipogastrio y aumento de flujo vaginal. No obstante, algunos pacientes pueden presentar dolor en HD de forma aislada, simulando otras enfermedades hepatobiliares, lo cual supone un verdadero reto diagnóstico para muchos especialistas. Keywords: Fitz-Hugh-Curtis syndrome, Pelvic inflammatory disease, RUQ abdominal pain, Cholangitis, Palabras clave: Síndrome de Fitz-Hugh-Curtis, Enfermedad Inflamatoria Pélvica, Dolor en hipocondrio derecho, Colangitis

El diagnóstico de la enfermedad pélvica inflamatoria (EPI) puede ser difícil por lo variable de su presentación, y abarca desde una paciente agudamente enferma hasta cuadros asintomáticos. El síntoma más común es el dolor abdominal bajo (90%), otros síntomas son dispareunia, flujo vaginal y sangrado vaginal anormal, urgencia miccional, náuseas, vómitos y tenesmo rectal, entre otros. Para el diagnóstico se necesita uno de los siguientes hallazgos: dolor a la movilización cervical, a la palpación del útero o en la palpación anexial. Algunos exámenes auxiliares mejoran el criterio diagnóstico: aumento de leucocitos en la secreción vaginal, aumento de la velocidad de eritrosedimentación y la identificación de N. gonorrhoeae o C. trachomatis a nivel cervical. Otras pruebas útiles son los estudios por imágenes: ultrasonido, tomografía computarizada y resonancia magnética. El estándar de oro es el examen laparoscópico, aunque existen comunicaciones que señalan que la biopsia de endometrio puede complementar el diagnóstico, cuando no existe evidencia de enfermedad durante el examen laparoscópico. Se recomienda tener un umbral bajo para el diagnóstico de EPI, para que las complicaciones agudas perihepatitis, periapendicitis o rotura del absceso tuboovárico- o las crónicas -dolor pélvico crónico, infertilidad y embarazo ectópico- comprometen la salud sexual y reproductiva de las pacientes.

Avian pathogenic Escherichia coli (APEC) cause extra intestinal disease in chickens, turkeys, and other avian species via respiratory tract infection, giving rise to typical signs related to colibacillosis, such as: septicaemia, enteritis, granulomas, omphalitis, sinusitis, airsacculitis, arthritis/synovitis, peritonitis, pericarditis, perihepatitis, cellulitis, and swollen head syndrome. Disease caused by APEC strains results in significant financial losses to the poultry industry worldwide. This review provides essential information on the diagnosis of APEC. The information cited in this review will elucidate the various forms of APEC diagnosis while demonstrating the, lack of a precise diagnosis of this strain. The diagnoses mentioned herein reinforce the necessity to make progress toward a more accurate diagnosis of APEC to contribute to its reduction in poultry flocks.

To study interactions between avian leukosis virus subgroup J (ALV-J) and reticuloendotheliosis virus (REV) and the effects of co-infection on pathogenicity of these viruses, 1-day-old broiler chicks were infected with ALV-J, REV or both ALV-J and REV. The results indicated that co-infection of ALV-J and REV induced more growth retardation and higher mortality rate than ALV-J or REV single infection (P < 0.05). Chickens co-infected with ALV-J and REV also showed more severe immunosuppression than those with a single infection. This was manifested by significantly lower bursa of Fabricius and thymus to body weight ratios and lower antibody responses to Newcastle disease virus and H9-avian influenza virus (P < 0.05). Perihepatitis and pericarditis related to severe infection with Escherichia coli were found in many of the dead birds. E. coli was isolated from each case of perihepatitis and pericarditis. The mortality associated with E. coli infection in the co-infection groups was significantly higher than in the other groups (P < 0.05). Among 516 tested E. coli isolates from 58 dead birds, 12 serotypes of the O-antigen were identified in two experiments. Different serotypes of E. coli strains were even isolated from the same organ of the same bird. Diversification of O-serotypes suggested that perihepatitis and pericarditis associated with E. coli infection was the most frequent secondary infection following the immunosuppression induced by ALV-J and REV co-infection. These results suggested that the co-infection of ALV-J and REV caused more serious synergistic pathogenic effects, growth retardation, immunosuppression, and secondary E. coli infection in broiler chickens.

[Purpose] This study aimed to investigate the clinical diagnostic value of dynamic enhanced multislice computed tomography (MSCT) for Fitz-Hugh-Curtis syndrome (FHCS). [Subjects and Methods] This study retrospectively analyzed the clinical features and manifestations of scanning and dynamic enhanced MSCT in 19 patients with FHCS. [Results] MSCT scans showed different degrees of liver capsule thickness in the lesion area: seven cases of sub-capsular effusion and three cases with a small amount of pleural effusion; thickness of the liver capsular arterial phase showing significant enhancement in 17 cases, and slight enhancement in two; portal venous and delayed phase enhancement decreased with no clear boundary of the liver parenchyma; and adjacent hepatic parenchymal involvement in five cases, in which the arterial phase appeared to have patchy or triangular enhancement, and unclear portal vein and delayed phase imaging findings. MSCT revealed pelvic inflammatory disease in 14 cases, peritonitis in two, endometritis combined with bilateral ovarian abscesses in two, and a tube-ovarian abscess in one. [Conclusion] Dynamic enhanced MSCT can accurately display liver capsule lesions and possible pelvic inflammatory diseases related to FHCS, suggest the infection source, and have high application value for making early, accurate diagnoses and improved prognosis.

Hepatic impairment has a great significance in the pig, and the frequency of their occurrence depends on the types and categories of animals, feeding and housing conditions. From three slaughterhouses in the territory of Srem, liver samples were taken from fattening pigs. With all three slaughterhouses were examined 200 fattening pigs of both sexes with age of about 180 days and the average weight of 110.5 kg. Each liver were examined to determined shape, size, color, consistency and appearance of the cross section, as well as visible pathomorphological changes on liver. Of the 60 total reviewed the liver with the first sacrifices, dominant changes that were observed in both sexes are perihepatitis (21.67%), necrosis focalise hepatitis (11.67%) and hyperaemia passiva hepatitis (10%). On the other sacrifices, of the 90 total reviewed liver, dominant changes that were observed in both sexes are necrosis focalise hepatitis (26.67%), perihepatitis (13.3%), and hepatitis lipidosis (5.55%). While the third sacrifice, a total of 50 examined the liver, the dominant changes that were observed in both sexes are necrosis focalise hepatitis (38%), perihepatitis (16%) and cholangitis (6%).

PURPOSE This study aimed to evaluate the relationship between the degree of perihepatitis and the severity of pelvic inflammatory disease (PID) on multidetector computed tomography (MDCT). METHODS A total of 177 women with PID who underwent biphasic abdominal computed tomography (CT) scans were enrolled. Two reviewers retrospectively reviewed the CT scans with consensus and subjectively categorized the severity of PID into 4 grades (normal, mild, moderate, and severe). Another reviewer independently assigned the extent (grades 0 to 4) and the depth (grades 0 to 4) of hepatic surface enhancement in terms of the degree of perihepatitis. Relationships between the degree of perihepatitis and the CT severity as well as each CT manifestation of PID were evaluated using the χ test or a cumulative logistic regression analysis. RESULTS Of the 177 patients, 99 (55.9%) showed hepatic surface enhancement. The severity of PID on MDCT was significantly related with the degree of perihepatitis (all P < 0.001). Salpingitis, oophoritis, pelvic fat haziness, complicated ascites, and omental/mesenteric fat infiltration were significantly related with the degree of perihepatitis (all P < 0.05). Among these variables, omental/mesenteric fat infiltration (odds ratio = 10.9) and salpingitis (odds ratio = 6.0) were the CT manifestations that were most associated with the presence of perihepatitis in PID. CONCLUSIONS The degree of perihepatitis seems to show a relationship with the severity of PID on MDCT. Omental/mesenteric fat infiltration and salpingitis can be strongly related with perihepatitis in PID.

Fitz-Hugh-Curtis syndrome (FHCS) is a condition characterized by inflammation of the liver capsule (perihepatitis) and adjacent peritoneal surfaces. We report a case of FHCS developing in a peritoneal dialysis (PD) patient in whom catheter removal due to recurrent peritonitis was complicated by post-operative wound infection. To the best of our knowledge, this is the first case description of FHCS in the context of PD.

Background Fitz-Hugh-Curtis syndrome or acute perihepatitis is considered a rare complication of pelvic inflammatory disease, mostly associated with chlamydial or gonococcal salpingitis. Peritoneal tuberculosis is a rare site of extra-pulmonary infection caused by Mycobacterium tuberculosis. Infection usually occurs after reactivation of latent tuberculous foci in the peritoneum and more seldom after contiguous spread from tuberculous salpingitis. Case presentation We describe a case of a 21-year old female of Somalian origin diagnosed with Fitz-Hugh Curtis syndrome associated with tuberculous salpingitis and peritonitis, presenting with new onset ascites. Acid fast stained smear and polymerase chain reaction for Mycobacterium tuberculosis on ascitic fluid, endocervical culture and tuberculin skin test were all negative. Eventually, the diagnosis was made laparoscopically, showing multiple peritoneal white nodules and perihepatic “violin string” fibrinous strands. Conclusions To our knowledge, this is the first case where Fitz-Hugh-Curtis syndrome is associated with both peritoneal and genital tuberculosis and where ascites was the primary clinical finding. Female genital tuberculosis has only rarely been associated with Fitz-Hugh-Curtis syndrome and all cases presented with chronic abdominal pain and/or infertility. Ascites and peritoneal involvement was not present in any case. Moreover, most patients with Fitz-Hugh-Curtis syndrome show no evidence of generalized intra-abdominal infection and only occasionally have concomitant ascites.

A young woman presented with right upper quadrant abdominal pain exacerbated by movement and breathing. Extensive evaluation revealed no gallstones or any other specific cause. Urine polymerase chain reaction results for Chlamydia trachomatis were positive, so the clinical diagnosis of Fitz-Hugh-Curtis syndrome was confirmed. This type of localized peritonitis is thought to be a complication of an ascending genital infection leading to pelvic inflammatory disease. The diagnosis is established on clinical grounds after excluding alternative, more common conditions. Proper antibiotic treatment usually leads to recovery and prevents long-term complications. LEARNING POINTS Right upper quadrant pain in a sexually active woman may be due to Fitz-Hugh-Curtis syndrome, a type of localized peritonitis also called perihepatitis. This condition is considered to be a complication of an ascending genital infection leading to pelvic inflammatory disease. Sexually active women with right upper quadrant abdominal pain without gallstones should be tested for Chlamydia trachomatis and Neisseria gonorrhoeae.

We studied whether antibody to two chlamydial proteins (TroA and HtrA) could be used as biomarkers of Chlamydia trachomatis infection. Methods: Recombinant proteins C. trachomatis TroA and HtrA were used as antigens in enzyme immunoassay (EIA). Both IgG and IgA antibody responses were studied. Results: IgG or IgA antibody to either protein was infrequently detected in sera from healthy blood donors or virgin girls. Patients attending the STI Clinic and patients with perihepatitis had often IgG antibody against TroA (25 and 50 % respectively) and HtrA (21 and 38 % respectively). Especially in sera from patients with chlamydial perihepatitis, the A(450nm) values with TroA were high (mean 1.591). A positive correlation between C. trachomatis MIF antibody and TroA (r = 0.7) as well as HtrA (r = 0.5) antibody was observed in sera from STI clinic patients and perihepatitis patients. Individuals with C. trachomatis infection and positive serology already when seeking medical attention had higher A(450nm) values for TroA (0.638) and HtrA (0.836) than patients with no marker of previous exposure or with no infection (0.208 and 0.234 respectively). Diagnosis of genital C. trachomatis infection is often NAAT-based, whereas serology has little value in testing for uncomplicated genital C. trachomatis infection. TroA and HtrA antibodies are potential biomarkers for evaluation of ascending and repeated C. trachomatis infection.

We performed postmortem examinations on seven Misaki feral horses (Equus caballus) and evaluated Misaki feral horses, Japanese wild boars (Sus scrofa leucomystax), domestic pigs (Sus scrofa), and wild Japanese macaques (Macaca fuscata fuscata) from 2015 to 2017 in Cape Toi, Kushima, Miyazaki Prefecture, southern Japan, for antibodies against Japanese encephalitis virus (JEV). Strongylus vulgaris infection with severe arterial lesions and hemomelasma ilei was present in all necropsied horses. We frequently found intestinal ulcers, perihepatitis filamentosa, and poor body condition. We recorded degenerative arthropathy in metacarpophalangeal joints in two cases and a fracture of the rib with diaphragmatic rupture in one case. A total of 73% (177/242) of horses were seropositive for JEV as tested by hemagglutination inhibition (HI). The HI data also revealed that 74% (59/80) of the wild boars, 67% (60/90) of the pigs, and 29% (22/75) of the wild monkeys were seropositive for JEV. Our findings showed that Strongylus spp. are still a risk to horses in this region, and that environmental factors such as topographic location of the pasture and steep slope may have caused of degenerative arthropathy and bone fracture. Our results showed that JEV is endemic in Japan. The wild boars and pigs were presumed to act as strong amplifiers and sources of infection, with subsequent risk to humans.

Four carcasses of 4-5 days old chicks were submitted for post-mortem examination to the Department of Veterinary Pathology, College of Veterinary and Animal Sciences, Mannuthy, Thrissur. The owner reported 60% mortality in the flock. Grossly, chalky deposits could be observed on the pericardium, liver and in mesonephric tubules of the kidneys. Histopathology revealed focal pneumonia and congestion, uric acid pericarditis, fatty degeneration with capsular thickening in liver, degeneration and uric acid crystals in the renal tubules. Spleen and bursa revealed lymphoid depletion. Reverse-transcriptase polymerase chain reaction carried out with the pooled tissue samples gave positive results for both IB and IBD. The nephrogenic form of IB would have resulted in nephrosis, uric acid pericarditis and perihepatitis. Though the bursa did not reveal any striking gross pathology, the histopathological changes in the bursa and positive PCR results for IBD suggest a sub-clinical infection.

Fasciolosis is an important parasitic disease of domestic ruminants and occurs worldwide as a result of infection with liver fluke species. This report describes the macroscopic and microscopic characteristics of acute fasciolosis in a goat with unusual migration to lung. A 10-month-old goat was presented with history of weakness and acute recumbency from 12 h ago. The clinicians didn’t report clinical evidence of systemic disease. Hematological analysis showed no significant changes in blood parameters except a mild reduction in lymphocyte population and about 6 % eosinophilia and also normocytic normochromic anemia. A noticeable increase in the level of serum ALP, AST and also GLDH were observed. Moreover, total protein and albumin showed a slight decrease in value comparing to reference intervals. In macroscopic examination numerous short vermiform cords were noted on the liver surface and the surface had an uneven appearance. A large number of immature, wandering flukes were seen on the cut surface. Histopathologically, a wide range of hepatic lesions was found. The most important lesions were moderate to severe perihepatitis and haemorrhagic tracts on the hepatic surface. These lesions corresponded to migratory tunnels filled with blood, fibrin and cellular debris. However histopathological findings of lung revealed chronic suppurative bronchopneumonia, but this lesion is not only associated with larval migration.

Seventy of commercial broiler chicks of 2 week old ages were used to study the efficiency of either or both Danofloxacin and Tilmicosin in experimental chronic respiratory diseases (CRD) infection. The latter was induced by simultaneous infection of both mycoplsama gallisepticum with E.coli. Experimental groups divided into 7 groups (Gps) of 10 chicks. Gp. 1 was left without treatment, gp. 2 was orally given 2 ml distilled water, gp. 3 received 0.1ml/kg B.wt danofloxacin, gp. 4 received 1.2 ml/kg B.wt from tilmicosin and gp. 5 were inoculated with 0.2 ml inoculum of both mycoplasma gallisepticum (MG) and E.coli (O78) intra-tracheally route. Meanwhile Gp .6 and 7 were the experimental groups where the infected chicks received 0.1ml/kg B.wt danofloxacin and 1.2 from tilmicosin orally for five consecutive days after the clinical signs appeared by 24 h respectively. Necropsy was performed weekly; clinical signs and gross lesions were recorded. Specimens from liver, heart, lungs, kidneys, air sac, brain, spleen, bursa of fabricus were collected from all the necropsied chicks. In gp.5, the main clinical signs were severe depression, anorexia and respiratory signs, while macroscopically were septicemic lesions were seen 1 and 2 weeks post inoculation (PI) together with fibrinous perihepatitis, pericarditis and airsacuilitis. Microscopically, the liver showed several areas of central cavitations surrounded with a zone of coagulative necrosis with perihepatitis represented by thickening in the hepatic capsule by fibrinous exudates and leukocytes infiltrations. The heart showed thickened pericardium with serofibrinous exudate entrapping macrophages, lymphocytes and few heterophils. The trachea showed focal areas of necrosis or ulceration with extensive replacement of the mucosa with leukocytes.The lungs revealed more serious lesions which represented by severe bronchitis and focal pneumonia.The air sacsshowed heterophils and mononuclear cells infiltrations, particularly at the first 2 weeks. The spleen showed necrosis and depletion of lymphocytes from white pulp. Meanwhile in gp 6, the danofloxacin were alleviated the severity of the lesions and in gp. 7 tilmicosin complete absent of the lesions.

Aim: To know the prevalence of antibiotic resistant Escherichia coli among dead and/or diarrhoic pigeons in and around greater Guwahati. Materials and Methods: Samples were cultured from dead and/or diarrhoic pigeons and identification was done by standard methods. The sensitivity of the isolated E.coli strains to 15 antibiotics of human and veterinary use was also determined. Organs from those dead birds from which E.coli were recovered were processed according to the routine procedure for histopathological studies. Results: Out of 150 pigeons subjected to microbiological investigation, 91(60.67 %) samples were found positive for E. coli.The most frequently occurring serotypes were O157 (9.89%), followed by O68, O121 (7.69%), O9, O75, O131 (5.49%), O2, O13, O22 (3.30%). Antibiogram investigation of the isolates revealed that 91isolates (100%) exhibited resistance against Ampicillin followed by Nitro-furantoin (73.62%), Tetracycline (65.93 %), Oxytetracycline (62.63 %) and Streptomycin (61.54). Gross changes of some birds showed fibrinous pericarditis and perihepatitis and coligranuloma in different organs like liver and serosal surface of intestine. Microscopically, severe congestion and haemorrhages in different organs such as liver, kidney, lung and intestine. In some cases thick layer of fibrinous exudates with large number of heterophills over the surface of liver and heart with early degenerative changes as well as focal necrosis. Conclusion: The result of this study suggests that antimicrobial-resistant pathogenic E.coli is present in pigeons in and around greater Guwahati. Surveillance programs may be introduced to monitor antimicrobial resistance of pathogenic E.coli in pigeons in and around greater guwahati. [Vet World 2013; 6(2.000): 91-94]

We investigated the prevalence of infectious duck diseases using 156 ducks reared in 18 farms of western Gyeong-nam province. As a result, duck viral hepatitis (12.8%), colibacillosis (7.1%), and fungal disease (9.0%) were detected. However, avian influenza and riemerellosis were not detected. During autopsies, we could grossly observed red swollen liver (12.8%), petechial or ecchymotic hemorrhage on liver (11.5%), and fibrinous perihepatitis (9.0%). Gray-white necrotic spot (23.1%), swollen spleen (22.8%), swollen kidney (20.5%), hyperemia or hemorrhage on tracheal mucous membrane (8.3%), and nodule in long or air sac (9.0%) were also found.

Background There are a lot of different causes of abdominal pain; in this case, a young woman suffers from three diseases with similar symptoms. Adult intestinal mal-rotation is a rare condition of deviation from the normal 270° counter clockwise rotation of the midgut resulting in, not only mal-position of the small intestine, but also mal-fixation of the mesentery. Fitz-Hugh-Curtis syndrome is a rare complication of pelvic inflammatory disease; it involves liver capsule inflammation associated with genital tract infection, which is usually caused by Neisseria gonorrhoea and Chlamydia trachomatis. Neuroendocrine tumors are enterochromaffin cell neoplasms that arise from cells of the endocrine (hormonal) and nervous systems; the appendicular one is the most common primary malignant lesion of these tumors, it’s incidence is about 0.3 – 0.9 % of appendectomies done. Just for knowledge, this is the first described case of concomitant presence of all these diseases with clinical symptoms attributable to each one. Case presentation 40-years-old woman suffers from acute abdominal pain, predominantly on the right quadrants, without abdominal distension, no guarding nor rigidity and normal intestinal peristalsis. She has a long history of abdominal intermittent pain, with cramps every 30–40 min, resolving spontaneously. She was diagnosed as intestinal mal-rotation through computed tomography scan which has evidenced a mobilized intra - peritoneal duodenum with cecum/ascending colon predominately lying on the left side and the small intestine almost entirely lying on the right side of abdomen, without evidence of effusion, edema or signs of intestinal ischemia or infarction. Exploratory laparoscopy demonstrated an inflammatory process in the hepatic-renal space, with bloody adhesions above the liver capsule; this is additional to the typical pelvic inflammatory disease signs (Fitz-Hugh-Curtis syndrome). Appendectomy was performed with histological analysis resulting in appendicular neuroendocrine tumor. Conclusions Although the patient has an intestinal mal-rotation which could explain the abdominal painful symptoms, it is not possible to exclude other concomitant causes, such as perihepatitis on pelvic inflammatory disease or neuroendocrine tumors. Even if all these diseases are rarely seen in daily clinical practice, they should be considered in the differential diagnosis of chronic intermittent abdominal pain in a young woman.

Fitz-Hugh-Curtis (FHC) syndrome, also known as acute perihepatitis, was discovered in 1930 and is a rare disorder characterised by inflammation of the peritoneum and the tissues surrounding the liver. This syndrome can arise as a potential complication from a pelvic inflammatory disease caused by Neisseria gonorrhoeae or Chlamydia trachomatis. This syndrome is not well known in the medical community and is often underdiagnosed. In this case report, we revisit FHC syndrome, particularly its noninvasive diagnosis and complications.

Introduction: The Fitz-Hugh-Curtis syndrome is a perihepatitis produced by secondary peritonitis the rise of bacteria, as a result of pelvic inflammatory disease. In the chronic stage can be observed adhesions between abdominal wall and the liver surface characterized by the similarity to "violin strings". This image is considered diagnostic criterion. Clinical case: Female 37 years-old, Gesta 7, Births 5, Abortion 1, Cesarean Section 0, who intervenes surgically open to present intermittent pain for gallstone cholecystitis two years of evolution. Normal vital signs; Laboratory test preoperative: erythrocytes 3.40 × 106, hemoglobin 9.9 g/dl, hematocrit 33.8%, lymphocytes 19%, leukocytes 11.86 × 103/mm3, total neutrophil 86%. Glucose 139 mg/dl, BUN 4.35 mg/dl, urea 9.3 mg/dl, SGOT (AST) 80 U/I, SGPT (ALT) 66 U/I, Proteins 6.0 g/dl, serum albumin 3.4 mg/dl. VDRL Neg. Urinalysis: Urobilinogen 2 mg/dl; Leukocyte 15-20 x field and postoperatory pregnancy test (+). It proceeds to open cholecystectomy and during exposure of the gallbladder is located in hepatic parenchyma multiple adhesions and congestive liver. Discussion: The combination of a painful liver without biochemical evidence of hepatitis or biliary obstruction, and menorrhagia raised the suspicion of perihepatitis Fitz-Hugh-Curtis, an inflammatory process of the liver capsule due to pelvic inflammatory disease mostly caused by Chlamydia trachomatis or Neisseria gonorrhoeae. The pathophysiology of perihepatitis FHC is unclear, but direct infection of the liver capsule, hematologic or lymphatic spread as well as an exaggerated immune response has been suggested.

RESUMO: O estudo objetivou identificar e avaliar as principais causas e frequências de condenações de vísceras bovinas em frigoríficos sob regime de inspeção estadual no município de Itaituba – PA. Para elaboração da pesquisa, foram consultados relatórios mensais de dois abatedouros frigoríficos denominados A e B referentes ao ano de 2016. No período avaliado, foram abatidos 9.913 bovinos, dos quais 2.791 eram machos e 7.122 fêmeas, com total de 5.119 casos de condenações de vísceras. O pulmão foi o órgão que apresentou maior índice de condenações com 36,02%, seguido pelo fígado (25.12%); rins (22.47%) e coração (16.39%). A aspiração de conteúdo ruminal respondeu por 25.65% das condenações, seguida pela aspiração de sangue (19.74%); congestão (14.37%); pleurite (13.34%); contaminação (11.28%); enfisema (11.23%) e bronquite (3.31%). Em fígados, a telangiectasia foi a que apresentou maior índice com 29.21% dos casos, seguido da congestão (26.51%); contaminação (25.16%) e periepatite (18.41%). Nos rins, o cisto urinário foi a causa que apresentou maior frequência de condenação, respondendo por 30.87% seguido de isquemia (30%); congestão (22.35%) e nefrite (16.61%). Nos corações, a principal ocorrência que registrou maior frequência foi a congestão, representando 51.25% das condenações; seguida de pericardite (28,72%); contaminação (18.24%) e cisticercose (1.19%). Dentre as vísceras inspecionadas, os pulmões foram os mais afetados, seguido dos fígados, rins e coração, sendo a maioria dos descartes efetuados por falhas tecnológicas nos abatedouros.PALAVRAS-CHAVE: Abate, Patologia, Telangiectasia.

Experimental infection with Chlamydia trachomatis, immunotype K, was carried out in six grivet monkeys. Three routes of infection were used: (A) into the uterine cavity through the cervical canal: (B) into the uterine cavity, but after ligature of the tubal isthmus, followed by curettement of the endometrium: (C) into the cervical epithelium. Two monkeys were used for each type of experiment. All monkeys inoculated by routes (A) and (C) developed marked signs of inflammation in the Fallopian tubes. Characteristically, the tubes were reddened and swollen. Exudate appeared in the abdominal ostia and in the cul-de-sac. In three of the four monkeys studied, a yellowish discharge was seen in the posterior vaginal fornix. An exudate composed mostly of lymphocytes and clusters of desquamated cells was found in the lumen of the tubes. The epithelium was injured in some areas and there were adhesions between the mucosal folds. In two of the monkeys, tubal occlusion was present two months after the inoculation. With one exception, all monkeys presented a significant rise in antibodies to C. trachomatis. In the two monkeys inoculated by route (B), no signs of inflammation in the upper genital tract were seen, but one of the animals died day 14 post inoculation;autopsy showed peritonitis and perihepatitis. One monkey was inoculated with non-infected yolk sac specimen by route (A) and another by route (B). Practically no inflammatory changes in the genital organs or elsewhere could be detected in these monkeys. The results indicate that C. trachomatis can cause salpingitis in female grivet monkeys by canalicular spread from the lower genital tract. The histological findings and the infection route in this experimentally induced salpingitis in the grivet monkeys closely resemble those ascribed to «gonococcal« salpingitis in man.

Background: To evaluate the prevalence and image characteristics of perihepatitis, as well as the relationship with some computed tomography (CT) manifestations of pelvic inflammatory disease (PID). Methods: Between January 2006 and December 2007, 93 consecutive patients examined with three-phase abdominal CT scans and clinically diagnosed and treated for PID were included. Three radiologists retrospectively reviewed CT scans with consensus, and examined the location (12 areas) and thickness (four grades) of enhancement of the hepatic surface. Several CT manifestations of PID were also evaluated and statistical analysis was performed to determine the relationship of these findings. Results: Out of the 93 patients, 55 (59%) showed enhancement of the hepatic surface. The right anteroinferior hepatic surface was the most common site (89%) and lower hepatic division showed thicker parenchymal enhancement. Oophoritis (P = 0.020) and extension of mesenteric infiltration (P < 0.001) were revealed as statistically significant factors associated with the presence of perihepatitis in PID. Conclusions: Perihepatits commonly occurs in PID; 59% of PID patients in this study had perihepatitis. The predominant site was the right anteroinferior hepatic surface. Perihepatitis seems not to be associated with various CT findings of PID reflecting disease severity, except oophoritis and upper extension of mesenteric infiltration.

Genital infections with Chlamydia trachomatis occur in all social groups in Germany. About 100,000 German women are sterile because of tubal scarring due to chlamydiae. Genital chlamydial infections are asymptomatic in 70% of patients, even if salpingitis occurs. Typical symptoms of chlamydial infection are purulent cervicitis with vaginal discharge, painful cervical bleeding because of endometritis, lower abdominal pain with dyspareunia, and upper abdominal pain because of perihepatitis. DNA amplification tests on first voided urine or cervical swab are the most sensitive routine tests. Specific serum antibodies to C. trachomatis indicate a previous infection in sterile women. For treatment, a 10-14 day course of doxycycline 200 mg daily or a macrolide antibiotic in the patient as well as in the sexual partner is recommended. In the male, C. trachomatis causes urethritis and epididymitis. Opinions differ about involvement of the prostate gland and seminal vesicles. Identification of C. trachomatis antigen or DNA in the accessory gland secretions is not sufficiently reproducible. The two vectors are easily diagnosed in urethral swabs or in urine. The occurrence of chlamydial antibodies in serum or in seminal fluid is not a sign of current infection. Reliable studies which indicate a reduced fertility of men infected with C. trachomatis are not available.

A gota úrica é uma doença metabólica caracterizada pela deposição de cristais de urato e ácido úrico em tecidos do corpo, que pode acometer répteis, mamíferos e aves. Neste trabalho, relata-se um caso de achados post mortem compatíveis com gota úrica visceral em um exemplar de coruja suindara (Tyto alba) de vida livre. Macroscopicamente, o pericárdio apresentava-se completamente esbranquiçado, espesso e aderido ao miocárdio e o fígado e ambos os rins apresentavam áreas esbranquiçados sugerindo acúmulo de urato. A microscopia do tecido cardíaco e hepático revelou pericardite fibrinosa e perihepatite necrosante respectivamente. Congestão pulmonar e infiltrado inflamatório heterofílico multifocal no parênquima renal também foram visualizados. As alterações encontradas são compatíveis com as descritas na literatura para gota úrica visceral em aves, podendo até serem consideradas como lesões patognomônicas. Este é o primeiro relato de gota úrica visceral em um rapinante de vida livre no Brasil. Gout, a metabolic disease characterized by deposition of uric acid crystals in tissue, can affect reptiles, mammals and birds. We studied a postmortem case of this disease in a free-living owl (Tyto alba). The pericardium was covered a whitish thick layer adhered to the myocardium, and the liver and both kidneys showed whitish areas. The microscopic examination of the heart and hepatic tissue revealed fibrinous pericarditis and necrotizing perihepatitis. Diffuse and multifocal heterophilic inflammatory infiltrate in the renal parenchyma pulmonary congestion were also displayed. The changes found are consistent with those described in the literature for uric visceral gout in birds and may even be considered as pathognomonic lesions. This is the first report of visceral gout uric on a predator-free life in Brazil

We report the case of a 42-year old male patient was admitted to our hospital because of a two weeks history of severe dry cough and right upper quadrant pain. He had been diagnosed as LES with diffuse proliferative lupus nephritis (class IV) in 2006 treated intially by intravenous steroid pulse therapy combined with an immunosuppressant and benefited in 2007 of Hemodialysis. In July 2013, he suffered of constant abdominal pain located at the right upper quadrant with dry cough. C-reactive protein (CRP) was 17 mg/L (normal = 8 mg/L) on admission with positive antinuclear antibodies title at 1/1280. The chest-abdominal computed tomography scan showed a pleural effusion a regular hepatomegaly with a rim of enhancement involving the right lobe of the liver. No ascites was present and there was no ancillary evidence of cholecystitis. The findings were thought to be most consistent with a perihepatitis. Pleural fluid examination showed an exudative pleural effusion with a negative culture. The diagnosis of perihepatitis associated with SLE complicated by a right pleural effusion was taken. The patient condition was treated with two antibiotics (vibramycin and amikacyn) and oral prednisolone. On review 4 weeks later his pain, cough and the right pleural disappeared. Perihepatitis is a rare disease, normally associated with pelvic inflammatory disease. It has rarely been reported in association with systemic lupus erythematosus (SLE) particularly in patients with lupus hemodialysis nephritis.

Objectives: To assess the prevalence of incidental Fitz-Hugh–Curtis syndrome in women undergoing diagnostic laparoscopy for sterilization, infertility or chronic pelvic pain. Methods: This was a prospective study over a 4-year period in which a total of 320 women undergoing diagnostic laparoscopy for sterilization [Group I, 200 women (62.5%)], infertility [Group II, 60 women (18.7%)], or chronic pelvic pain [Group III, 60 women (18.7%)] were enrolled. After examination of the pelvic area and abdominal cavity, the liver area was visualized in all cases for evidence of perihepatitis and adhesions between liver and anterior abdominal wall or diaphragm (Fitz-Hugh–Curtis syndrome). Statistical analysis was performed using the chi-square test, with a P-value set at 0.05 for significance. Results: The mean age was similar in the three groups, while mean parity was obviously less in the infertility group. Fitz-Hugh–Curtis syndrome was observed in 16 women (8%) in Group I, 10 women (16.6%) in Group II, and 18 women (30%) in Group III. The prevalence was highest in Group III and the difference was statistically highly significant in Group III vs. Group I (P

Gross and microscopic pathology caused by an atypical strain of Pasteurella gallinarum (Fresno strain) was compared in chickens with that caused by the American Type Culture Collection type strain. Ten 21-day-old broiler chickens were inoculated intranasally with 10(7) colony forming units or intramuscularly with 10(5) colony forming units of either strain. The birds were killed 7 days later, and gross and microscopic lesions were studied. Grossly, there was extensive white discoloration of pectoral muscles with mild fibrinous exudate in birds inoculated intramuscularly with the Fresno strain of P. gallinarum. Most of these birds also had severe fibrinous exudation over the heart, the capsule of the liver, the air sac, and in the hock joints. Microscopically, there was severe chronic pyogranulomatous airsacculitis, pericarditis, perihepatitis, myositis, synovitis, and granulomatous pneumonia. One bird had severe acute multifocal hepatitis. From this study, it is evident that the Fresno strain of P. gallinarum was more pathogenic than the American Type Culture Collection type strain when given intramuscularly.

Chronic Respiratory Disease (CRD) is a major problem causing morbidity and mortality which leads to economic loss to the poultry industry. The present research was carried out to study the gross, microscopic and ultrastructural changes in target tissues of natural cases of CRD and to detect the presence of causative pathogenic M. gallisepticum and M. synoviae. Routine post mortem examination of birds submitted to Avian Health Laboratory, DPR, Hyderabad were carried out and from selected CRD cases, the presence of M. gallisepticum and M. synoviae was confirmed by PCR. Results showed a higher prevalence of M. synoviae (25.98%) than M. gallisepticum (9.45%) in samples collected from CRD affected birds. Gross lesions included cloudiness of air sacs, presence of caseous mass in the air sacs, congested tracheal mucosa with catarrhal exudates and caseous materials and congestion and oedema of lungs. Occasionally, sinusitis, conjunctivitis, pericarditis, perihepatitis and salpingitis were also observed. Microscopic changes were edema, congestion and infiltration of mononuclear cells. Ultrastructural studies showed nucleoplasmolysis, margination of nuclear chromatin and swelling of perinuclear cisternae, dilatation of RER and swollen and damaged mitochondria in the air sac and trachea of birds suffering from CRD and positive for M. synoviae.

A disease outbreak in a duck farm of 5,000 birds from Thrissur, Kerala was investigated. Three ducks of 8 month, with the history of droopiness and sudden death were presented to the Department of Veterinary Pathology, College of Veterinary and Animal Sciences, Mannuthy for necropsy examination. On necropsy, fibrinous pericarditis, perihepatitis, airsacculitis and hydropericardium could be observed. Blood smear examination revealed clumps of coccobacilli interspersed among the blood cells. Affected tissue samples were collected for histopathology and bacteriological examination. Histopathology revealed fibrinous pericarditis with infiltration of heterophils, vasculitis, vacuolation of hepatic parenchyma and pulmonary congestion with interstitial haemorrhages. Bacteriological studies showed gram negative small rods, which when serotyped were confirmed as Salmonella gallinarum serotype 9, 12, thus confirming fowl typhoid. This report points out the importance of better management practices, proper disease investigation and surveillance for achieving efficient growth rate and profitability in poultry industry.

Perihepatitis associated with pelvic inflammatory disease (Fitz-Hugh-Curtis syndrome). Diagnostic utility of computed tomography Abstract Perihepatitis associated with pelvic inflammatory disease or Fitz-Hugh-Curtis syndrome is an inflammatory process that involves the liver capsule and adjacent peritoneum and is related to pelvic infections due to Chlamydia trachomatis and Neisseria gonorrhoeae. Diagnosis may be difficult because the clinical picture is nonspecific, especially when manifes- tations of pelvic inflammatory disease are scarce or absent. In the last few years, computed tomography has been shown to be a highly useful and non-invasive diagnostic procedure in the proper clinical context. We present two cases of perihepatitis associated with pelvic inflamma- tory disease, diagnosed with computed tomography.

“Acute seroma syndrome” in augmented breast represents a new clinical entity completely different from early postoperative seroma and late seromas. It is an acute bilateral and symmetrical breast enlargement with severe local inflammatory reaction, during an infection located into another body area, most commonly on the throat. There is no connection with any kind of trauma on the breasts. The acute seroma on augmented breast during a regional infection (bacterial or viral) is similar to other serous membrane reaction as acute mesenteric lymphadenitis (simulating acute appendicitis) and the acute gonococchal perihepatitis in Fitz Hugh-Curtis syndrome (simulating acute cholecystitis). This serous membrane reaction comes during the regional inflammatory reaction, when the lymphatic channels and lymph nodes are under stress and a high hydrostatic pressure and hyperpermeability lead to acute fluid extravasations, without any local bacterial or viral contamination. For these reasons, the authors define it as pericapsular lymphangitis and acute seroma syndrome in augmented breast.

Because of its anatomical position, the liver may be involved in many protozoan and helminthic gastrointestinal infections. Visceral larva migrans caused by Toxocara canis is rarely taken into account in adult patients with cholestatic syndrome, especially when liver disease is not associated with hypereosinophilic reaction. We report on a 74-year-old immunocompetent woman who presented with fever, bronchospasm, erythema nodosum, weight loss and progressive jaundice. A liver biopsy showed caseating granulomatous hepatitis with secondary portal fibrosis and paucity of interlobular bile ducts. A step-by-step search for aetiological factors led us to a diagnosis of toxocariasis (positive enzyme-linked immunosorbent assay IgG test). An excellent clinical response to combined treatment with steroid and diethylcarbamazine, and a reduction in the antibody level against T. canis supported the diagnosis. Computed tomography and laparoscopy demonstrated multiple small mass lesions and fibrous perihepatitis. This report shows that visceral larva migrans may be a cause of prostrating chronic liver disease and should be suspected in every febrile patient with cryptogenic cholestatic hepatitis.

In two experiments, broilers were challenged with one of several field strains of Escherichia coli to determine whether the source of the E. coli and age of the bird at time of inoculation affected the development of cellulitis lesions. In the first experiment, birds inoculated at 52 days of age with E. coli of faecal, airsacculitis and cellulitis origin exhibited a cellulitis lesion incidence of 47.5, 25 and 77.5%, respectively. This study confirms earlier observations that E. coli strains isolated from cellulitis lesions express a higher propensity for producing these same lesions than other strains, including those associated with airsacculitis. In the second experiment, birds were inoculated at 4, 7, 10, 16, 28, and 52 days of age with an E. coli strain of cellulitis origin and necropsied 2 days post-infection. The resulting incidence of cellulitis ranged from 20% (day 7) to 95% (days 16 and 28), indicating that cellulitis can develop in any age of bird, although the lesions were frequently associated with other manifestations of colibacillosis (perihepatitis, pericarditis, airsacculitis) in birds challenged from 4 to 16 days of age.

Pelvic inflammatory disease (PID) refers to infection of the uterus, fallopian tubes, and adjacent pelvic structures that is not associated with surgery or pregnancy. PID causes major medical, social, and economic problems worldwide. Long-term sequelae, most notably tubal factor infertility and ectopic pregnancy, are common and extremely costly to the healthcare system. The most important causative micro-organisms are Chlamydia trachomatis, Neisseria gonorrhoeae, and micro-organisms associated with bacterial vaginosis. The clinical spectrum of PID ranges from subclinical endometritis to severe salpingitis, pyosalpinx, tubo-ovarian abscess, pelvic peritonitis, and perihepatitis. Clinical diagnosis of PID has limitations. The clinical diagnostic criteria are insensitive and nonspecific, and false-positive and false-negative diagnosis is common; however, direct visual diagnosis is not always feasible, requires general anesthesia, and is costly. More research is needed of noninvasive diagnosis of PID. Current treatment guidelines call for broad-spectrum antimicrobial coverage. Screening for asymptomatic chlamydial infection is the mainstay of prevention of PID. Emerging evidence from randomized controlled trials provides strong evidence that intervention with selective screening for chlamydial infection effectively reduces the incidence of PID.