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This article discusses a case report of a 36-year-old woman with chronic hand eczema and lymphedema. The patient experienced frequent flare-ups of lesions on her hands, which often led to infections and worsening lymphedema. After failed treatments with corticosteroids and alitretinoin, the patient was prescribed dupilumab, a monoclonal antibody, which resulted in significant improvement of the eczema, lymphedema, and episodes of lymphangitis. The article suggests that dupilumab may be an effective treatment option for severe chronic hand dermatitis associated with lymphedema. [Extracted from the article]

Nodular lymphangitis, also known as lymphocutaneous syndrome or sporotrichoid lymphangitis, presents with inflammatory nodules along the lymphatic vessels, typically involving the upper or lower extremities. Although the most common cause of nodular lymphangitis is infection due to Sporothrix schenckii, Nocardia brasiliensis, Mycobacterium marinum, or Leishmania braziliensis, it is important for clinicians to be aware of methicillin-resistant Staphylococcus aureus as a rare cause of nodular lymphangitis and perform gram stain, bacterial culture, and antibiotic sensitivity profiles when appropriate. History of recent travel or exposures, incubation time, presence of systemic symptoms, and presence of ulceration, suppuration, or drainage can serve as diagnostic clues, but microbiological tissue cultures and histopathologic studies confirm the diagnosis. Herein, we present a case of nodular lymphangitis caused by methicillin-resistant Staphylococcus aureus (MRSA); tissue culture and antibiotic sensitivities were used to guide treatment.

Background: Affection with Corynebacterium pseudotuberculosis (C. pseudotuberculosis) and development of cellulitis and/or abscess formation with cutaneous lymphangitis in cattle is rare to some extent, so literature about the biochemical changes that would accompany this infection is rare. Aim: In this context, the present study was designed to screen the effect of the infection with C. pseudotuberculosis cutaneous lymphangitis on the release of some immune molecules, organ functions, and redox state in Baladi cows. Methods: Fourteen Baladi cows from a small dairy farm in El-Behira, Egypt, were selected to complete this study. After bacteriological culture confirmation, seven of them were found suffering from cutaneous lesions due to infection with C. pseudotuberculosis (Diseased group), while the others were healthy (Healthy group). Serum samples were obtained to evaluate the presumptive changes in some clinicopathological parameters. Results: Serum analysis revealed a significant decrease in the levels of interferon-gamma (IFN-γ) and interleukin-17 (IL-17) as well as a significant decrement in the concentration of beta-defensin (β-defensin) and lipocalin-2 (LCN-2). While serum level of interleukin-10 (IL-10) recorded a significant increase in these animals when compared to healthy control animals. Concurrently, the affected animals recorded a significant elevation in serum levels of hepato-cardiac enzymes, urea, and creatinine in addition to disturbance in the serum redox state. Conclusion: In conclusion, infection with C. pseudotuberculosis cattle may disturb the defensive immune state, body organ function, and redox state of the animals. [Open Vet J 2024; 14(1.000): 25-31]

Background: Affection with Corynebacterium pseudotuberculosis (C. pseudotuberculosis) and development of cellulitis and/or abscess formation with cutaneous lymphangitis in cattle is rare to some extent, so literature about the biochemical changes that would accompany this infection is rare. Aim: In this context, the present study was designed to screen the effect of the infection with C. pseudotuberculosis cutaneous lymphangitis on the release of some immune molecules, organ functions, and redox state in Baladi cows. Methods: Fourteen Baladi cows from a small dairy farm in El-Behira, Egypt, were selected to complete this study. After bacteriological culture confirmation, seven of them were found suffering from cutaneous lesions due to infection with C. pseudotuberculosis (Diseased group), while the others were healthy (Healthy group). Serum samples were obtained to evaluate the presumptive changes in some clinicopathological parameters. Results: Serum analysis revealed a significant decrease in the levels of interferon-gamma and interleukin-17 as well as a significant decrement in the concentration of beta-defensin (β-defensin) and lipocalin-2. While serum level of interleukin-10 recorded a significant increase in these animals when compared to healthy control animals. Concurrently, the affected animals recorded a significant elevation in serum levels of hepato-cardiac enzymes, urea, and creatinine in addition to disturbance in the serum redox state. Conclusion: In conclusion, infection with C. pseudotuberculosis cattle may disturb the defensive immune state, body organ function, and redox state of the animals. [ABSTRACT FROM AUTHOR]

Herpes simplex virus (HSV) is one of the most prevalent infections worldwide. It consists of two types: HSV1 and HSV2 that primarily cause orofacial and genital disease. However, both types can infect any site. Rarely, HSV infection of the hand occurs and is often documented as herpetic whitlow. Herpetic whitlow is primarily recognized as an HSV infection of the digits and thus HSV infection of the hand is largely associated with infection of the fingers. This is problematic, as HSV is often left off the differential diagnosis of non-digit hand pathology. We present two cases of non-digit HSV infection of the hand that were misdiagnosed as bacterial infections. As our cases and others demonstrate, the lack of knowledge that HSV infections can occur on the hand leads to confusion and delayed diagnosis among a myriad of providers. Therefore, we seek to introduce the term "herpes manuum" to increase awareness that HSV can appear on the hand in locations aside from the digits and thus differentiate it from herpetic whitlow. By doing so, we hope to encourage more timely diagnosis of HSV hand infections to decrease associated morbidity.

Background: Lymphangitis is an inflammation of lymphatic channels caused by infectious or non-infectious agents, presenting with characteristic linear erythematous streaks draining toward regional lymph nodes. Objective: To describe the clinical characteristics and etiological factors involved in acute superficial lymphangitis in a retrospective descriptive study. Materials and Methods: Records of patients were analyzed retrospectively who presented with linear erythematous streaks, diagnosed as superficial lymphangitis, in the outpatient department of dermatology during the last 5 years (January 2018--December 2022) in a tertiary care hospital. Patients were evaluated for their demographic profile, detailed history, complete physical examination, and standard blood tests (if necessary). Results: A total of 11 patients were found, out of which 7 (63%) were males and 4 (37%) were females. The mean/median age of these patients was 30 years (range 9-52 years). The minimum duration of development of lymphangitis was within minutes in the case of a mosquito bite reaction and around 72 hours in the case of trauma or infection induced, with a median interval of 48 hours. The site most commonly involved was the upper extremity in 8 (72%) patients, followed by the trunk in 2 (18%) and the lower extremity in 1 (9%). Arthropod bite reactions (63%) were the most common etiological agent. All patients presented with linear erythematous streaks extending towards draining lymph nodes. Conclusion: Lymphangitis is often considered to be a bacterial infection and is mostly treated with antibiotics; however, non-bacterial and non-infectious causes should be kept in mind while treating superficial lymphangitis to make judicious use of systemic antibiotics. [ABSTRACT FROM AUTHOR]

Background: Lymphangitis is an inflammation of lymphatic channels caused by infectious or non-infectious agents, presenting with characteristic linear erythematous streaks draining toward regional lymph nodes. Objective: To describe the clinical characteristics and etiological factors involved in acute superficial lymphangitis in a retrospective descriptive study. Materials and Methods: Records of patients were analyzed retrospectively who presented with linear erythematous streaks, diagnosed as superficial lymphangitis, in the outpatient department of dermatology during the last 5 years (January 2018–December 2022) in a tertiary care hospital. Patients were evaluated for their demographic profile, detailed history, complete physical examination, and standard blood tests (if necessary). Results: A total of 11 patients were found, out of which 7 (63%) were males and 4 (37%) were females. The mean/median age of these patients was 30 years (range 9–52 years). The minimum duration of development of lymphangitis was within minutes in the case of a mosquito bite reaction and around 72 hours in the case of trauma or infection induced, with a median interval of 48 hours. The site most commonly involved was the upper extremity in 8 (72%) patients, followed by the trunk in 2 (18%) and the lower extremity in 1 (9%). Arthropod bite reactions (63%) were the most common etiological agent. All patients presented with linear erythematous streaks extending towards draining lymph nodes. Conclusion: Lymphangitis is often considered to be a bacterial infection and is mostly treated with antibiotics; however, non-bacterial and non-infectious causes should be kept in mind while treating superficial lymphangitis to make judicious use of systemic antibiotics.

Ulcerative lymphangitis in equine is characterized by formation of skin ulcers with involvement of lymph vessels of limb. It heals by either secondary intention healing or by granulation normally. Horses with the history of local swelling and edema at the canon regions of both fore limbs were clinically treated out of which 6 horses suffering from lymphangitis were selected for therapeutic study after confirmation by ultrasonography within 30 -40 days from first day of treatment. Along with common antibiotic therapy, these six horses were divided into two equal groups. The first group of selected horses were treated with normal saline, hydrogen peroxide and gentamicin whereas collagen granules with gentamicin was used for dressing in second group. All the animals of group 2 recovered uneventfully and returned back to the exercise after 90 days whereas only two animals from group 1 recovered after 90 days with small scars. In the present study, collagen-based dressing led to clearly satisfactory, faster, and better recovery as compared to normal dressing in the management of ulcerative lymphangitic wounds in equines.

Streptococcus equi subspecies zooepidemicus septicemia of alpacas and llamas, also called alpaca fever, is characterized clinically by fever, depression, recumbency, and death, and pathologically by polyserositis. Although a few natural and experimental cases of the disease have been reported, very little information about the pathology of spontaneous cases has been published. We present a detailed gross and microscopic description of 3 spontaneous cases of alpaca fever and review the literature on this condition. Typical of spontaneous and experimental infections with S. equi ssp. zooepidemicus, the 3 animals had disseminated fibrinosuppurative polyserositis with vascular thrombosis and intralesional gram-positive cocci. In addition, 2 of the animals had severe fibrinosuppurative pneumonia, endocarditis, and myocardial necrosis; the third animal had transmural pleocellular enteritis with prominent lymphangitis. The enteric lymphangitis observed in the latter suggests that dissemination of S. equi ssp. zooepidemicus occurred through lymphatic circulation and that, at least in this animal, the portal of entry of infection was the alimentary system.

Summary: Limb cellulitis/lymphangitis is a well‐recognised syndrome in horses, but there are limited published reports concerning outcomes and complications. This report describes a horse with hindlimb cellulitis/lymphangitis that developed ischaemia of the distal limb resulting in necrosis of the suspensory ligament branches and avulsion of the hoof capsule. A 16‐year‐old Thoroughbred mare was referred for further investigation and treatment of a left hindlimb cellulitis/lymphangitis. The culture of a swab taken from superficial pustules on the leg yielded a moderate growth of coliform bacteria and a profuse growth of Staphylococcus aureus. Treatment included systemic antimicrobials (based on the results of culture and sensitivity), phenylbutazone, dexamethasone, morphine and paracetamol. Following some initial clinical improvement, hyperextension of the metatarsophalangeal joint was noted on Day 5 of hospitalisation. Complete avulsion of the ipsilateral hoof capsule occurred on Day 10, and the horse was immediately euthanised. A limited post‐mortem examination revealed necrosis of the suspensory ligament branches. Fibrin thrombi, interstitial haemorrhage and oedema were identified in the suspensory ligament branches and adjacent subcutaneous tissues, with thrombi in relatively large vessels. The dermal laminae were extensively necrotic, and the majority of the lamellar vasculature contained fibrin thrombi. [ABSTRACT FROM AUTHOR]

Background: Necrotizing fasciitis is a life-threatening soft-tissue infection, often characterized by soft-tissue destruction, systemic toxicity, and high mortality. No single laboratory value can diagnose necrotizing fasciitis; ultimately, necrotizing fasciitis is a clinical diagnosis and therefore presents a diagnostic dilemma for many physicians. The finger probe test is useful in confirming the diagnosis when imaging studies are unobtainable or nondiagnostic.Case Report: We present the case of a 70-year-old woman presenting nonverbal and obtunded with a soft-tissue infection of the right lower extremity. The only pertinent positive vital sign was tachypnea with a respiratory rate of 22 breaths/min. Physical examination revealed nonpitting edema, cold-to-touch lower extremity, and Nikolsky-positive hemorrhagic bullae. Initial laboratory test results showed white blood cell count of 38 x 109/L and lactic acid of 8.2 mg/dL. Advanced imaging was unobtainable, given the patient's worsening clinical status, and the decision was made to perform the finger probe test, which revealed absence of bleeding and presence of friable tissue and "dishwater" discharge. Consequently, the general surgery team took the patient to the operating room and performed an above-the-knee amputation and surgical debridement. Postoperative report noted nonviable tissue consistent with necrotizing fasciitis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Necrotizing fasciitis is a life-threatening emergency that can destroy soft-tissue at a rate of 1 inch/h. When imaging is unobtainable or nondiagnostic, the finger probe test can be used in select patients to aid with diagnosis. [ABSTRACT FROM AUTHOR]

Summary: Background: Cellulitis is a commonly recognised condition in first opinion equine practice yet there is little published information regarding its diagnosis, treatment and management. Objectives: To describe current approaches of veterinary surgeons working in the United Kingdom (UK) to the diagnosis, treatment and management of distal limb cellulitis in horses. Study design: Cross‐sectional survey. Methods: An online questionnaire was distributed via email and social media sites for a period of 12 weeks. Descriptive statistics were produced and chi‐square or Fisher's exact tests were used to assess associations between categorical variables, with critical probability set at 0.05. Results: Distal limb cellulitis is frequently encountered in the UK, with 83.5% (n = 224/268) of respondents having treated >5 cases in the preceding 12 months. Diagnosis was predominantly made based on clinical signs alone (89.2%; n = 239/268). The majority of respondents (95.5%; n = 256/268) treated cases with nonsteroidal anti‐inflammatory drugs (NSAIDs) and antimicrobials. Phenylbutazone (93.8%; n = 240/256) and trimethoprim sulphonamide (TMPS) (72.3%; n = 185/256) were most frequently prescribed and 61.7% (n = 148/240) of respondents prescribed these drugs in combination. Duration of treatment was most frequently five days for NSAIDs (33.5%; n = 64/191), TMPS (84.4%; n = 119/141) and doxycycline (62.5%; n = 25/40), the longest prescribed duration of any treatments being 10 days. Corticosteroids were administered by 41.0% of respondents (n = 110/268). Management recommendations included cold hosing/ice packing of the affected limb (79.4%; n = 212/267) with light exercise (turnout or hand walking) if the horse was comfortable enough to do so (97.4%; n = 260/267). Main limitations: Small sample size (n = 268) and low level of item omission for a small number of questions. Conclusions: Cellulitis is common in the UK and is usually treated with NSAIDs and antimicrobials for 5–10 days, plus cold hosing and light exercise. Further study on the topics of diagnosis and treatment, with particular emphasis on the aetiology and necessity of antimicrobials, is warranted. [ABSTRACT FROM AUTHOR]

Sporotrichosis is a subacute to chronic subcutaneous mycosis caused by dimorphic fungi of the Sporothrix spp. complex. It is considered the most frequent subcutaneous mycosis in Latin America and predominates in tropical areas. In Argentina, its prevalence is estimated at 0.01-0.02%. In half of the patients, it manifests as lymphocutaneous sporotrichosis. Infection results from the agent's inoculation on the skin or mucous membrane by trauma with contaminated plants. There are also cases of zoonotic transmission by contact with animals, such as armadillos, birds, rats, horses, fish, mosquitoes, and cats. Here we describe the case of a 14-year-old female patient who consulted due to nodular lymphangitic syndrome for two months and, given the lack of response to multiple antibiotic regimens, a biopsy was performed and a culture of the lesion was done, which confirmed the diagnosis of lymphocutaneous sporotrichosis., (Sociedad Argentina de Pediatría.)

Ulcerative lymphangitis in equine is characterized by formation of skin ulcers with involvement of lymph vessels of limb. It heals by either secondary intention healing or by granulation normally. Horses with the history of local swelling and edema at the canon regions of both fore limbs were clinically treated out of which 6 horses suffering from lymphangitis were selected for therapeutic study after confirmation by ultrasonography within 30 -40 days from first day of treatment. Along with common antibiotic therapy, these six horses were divided into two equal groups. The first group of selected horses were treated with normal saline, hydrogen peroxide and gentamicin whereas collagen granules with gentamicin was used for dressing in second group. All the animals of group 2 recovered uneventfully and returned back to the exercise after 90 days whereas only two animals of group 1 recovered after 90 days with small scars. In the present study, collagen-based dressing led to clearly satisfactory, faster and better recovery as compared to normal dressing in management of ulcerative lymphangitic wound in equines. [ABSTRACT FROM AUTHOR]

Eosinophil efferocytosis, a process of engulfment and removal of apoptotic eosinophils by professional phagocytes, has been described in several chronic inflammatory disorders (such as asthma) in human medicine. Eosinophil efferocytosis was recognized in naturally occurring chronic inflammatory disorders affecting lymphatic vessels of the bovine rumen. Twelve adult Holstein–Friesian dairy cows that were conventionally slaughtered exhibited regional emphysematous thickening of the ruminal submucosa. Histopathology revealed multiple emphysematous eosinophilic lymphangitis, characterized by cystic dilations of submucosal lymphatics in association with fibrous proliferation, neovascularization, and infiltration by large numbers of eosinophils, macrophages, multinucleated giant cells, and smaller numbers of mast cells. Neither parasites nor other pathogenic organisms were identified in the inflammatory lesions. The composition of gaseous constituents within dilated lymphatics was not known. Based on the histopathological findings, an allergic pathogenesis was considered to be possibly implicated in this disorder. In the inflamed lesions of seven cows, macrophages, and giant cells frequently phagocytized and disposed of large numbers of apoptotic eosinophils, demonstrating high efferocytic activity on promoting the resolution of this lymphangitis. From perspectives of cellular kinetics, eosinophil efferocystois by these professional phagocytes indicated a regularized pattern of progress steps toward the degradation of apoptotic eosinophils as follows: first, nuclei of apoptotic eosinophils were displaced and disintegrated, then, cytoplasmic granules were agglomerated and dissolved, and finally, cell bodies totally disappeared from cytoplasmic vacuoles (efferosomes) of phagocytes. It is revealed that older eosinophils undergoing constitutive, spontaneous apoptosis in inflammatory lesions were cleared via the lymphatic system in cattle. [ABSTRACT FROM AUTHOR]

N/a.

Corynebacterium pseudotuberculosis is an important animal pathogen, which is also able to infect humans. An optimal treatment of infections with this pathogen is not available today and consequently, more research is necessary to understand the infection process. Here, we present a combined -omics and bioinformatics approach to characterize C. pseudotuberculosis 12CS0282. The genome sequence of strain 12CS0282 was determined, analyzed in comparison with the available 130 C. pseudotuberculosis sequences and used as a basis for proteome analyses. In a reverse vaccinology approach, putative vaccine and drug targets for 12CS0208 were identified. Mass spectrometry analyses revealed the presence of multiple virulence factors even without host contact. In macrophage interaction studies, C. pseudotuberculosis 12CS0282 was highly resistant against human phagocytes and even multiplied within human THP-1 cells. Taken together, the data indicate a high pathogenic potential of the strain.

Little is known regarding the differences in microbiology associated with cellulitis or abscess with or without lymphangitic streaking. The objective of our study is to assess whether there are differences in the pathogens identified from wound cultures of patients with paronychia with and without associated lymphangitis. Retrospective cross-sectional study at a tertiary pediatric emergency department over 25 years. We opted to assess patients with paronychia of the finger, assuming that these cases will have a greater variety of causative pathogens compared to other cases of cellulitis and soft tissue abscess that are associated with nail biting. Case identification was conducted using a computerized text-screening search that was refined by manual chart review. We included patients from 1 month to 20 years of age who underwent an incision and drainage (I&D) of a paronychia and had a culture obtained. The presence or absence of lymphangitis was determined from the clinical narrative in the medical record. We excluded patients treated with antibiotics prior to I&D as well as immune-compromised patients. We used descriptive statistics for prevalence and χ2 tests for categorical variables. Two hundred sixty-six patients met inclusion criteria. The median age was 9.7 years [IQR 4.7, 15.4] and 45.1% were female. Twenty-two patients (8.3%) had lymphangitic streaking associated with their paronychia. Patients with lymphangitis streaking were similar to those without lymphangitis in terms of age and sex (p = 0.52 and p = 0.82, respectively). Overall, the predominant bacteria was MSSA (40%) followed by MRSA (26%). No significant differences were found between the pathogens in the 22 patients with associated lymphangitis compared to the 244 patients without. Staphylococcus aureus represent the majority of pathogens in paronychia, although streptococcal species and gram-negative bacteria were also common. Among patients with paronychia of the finger, there seems to be no association between pathogen type and presence of lymphangitic streaking. • Little is known regarding the differences in microbiology of an abscess with or without lymphangitic streaking • We chose paronychia of the finger, an abscess caused by a greater variety of pathogens due to nail biting • In paronychia of the finger, we found no association between pathogen type and presence or absence of lymphangitic streaking [ABSTRACT FROM AUTHOR]

Abstract Background Herpetic whitlow is a viral infection caused by the herpes simplex virus (HSV) types 1 or 2, and occurs in the pediatric population primarily on the fingers and toes due to autoinoculation from oral secretions. Because of this cited prevalence, other locations of herpetic whitlow may go unrecognized. Case presentation We present an atypical presentation of palmar herpetic whitlow with delayed recognition and associated viral lymphangitis. The patient presented as a transfer from an outside hospital with a progressive, three-day history of a suspected left hand abscess preceded by left hand pain and itching. She was initially evaluated by Orthopedic Surgery, who described an erythematous, edematous, tender, left palmar abscess with associated erythematous streaking up her forearm. The lesion was surgically managed with an incision and drainage. Wound cultures were obtained during which “minimal drainage” was noted. After admission to the General Pediatrics Hospital service, the lesion was noted to appear vesicular and subsequently obtained PCR samples were positive for HSV type 1, confirming her diagnosis of herpetic whitlow. Although she remained afebrile with negative wound cultures throughout her hospitalization, a secondary bacterial infection could not be conclusively excluded due to the accompanying lymphangitis. Thus, she was discharged with oral antibiotics and anticipatory guidance of potential recurrence of palmar lesions. Conclusions Herpetic whitlow should be included in the differential diagnosis of palmar lesions that appear vesicular or abscess-like to ensure appropriate treatment. Additionally, these palmar lesions may present with associated lymphangitis without evidence of bacterial infection.

We present a 57-year-old woman with ovarian cancer that presented to the Emergency Room with a proximal small bowel obstruction. Exploratory laparotomy evidenced a thickened 10 cm extension of the proximal jejunum without bowel peristalsis, with stenotic enteric lumen, with a lesion apparently originating from its submucosal and muscular layers. The patient underwent an exploratory laparotomy with total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, small bowel resection and peritoneal biopsies. Final pathology and immunohistochemistry confirmed the intra-operative suspicion of lymphatic intestinal spread of malignant cells originating from a high grade serous carcinoma of ovarian origin. To the best of our knowledge, this is the first report in the literature of intestinal carcinomatous lymphangitis related to ovarian cancer, and the first report of involvement of the proximal portion of the jejunum.

Primary lymphoedema arises from congenital disorders of Veins and Lymphatic Vessels. The diagnosis of congenital oedema leg is confirmed by the absence of Venous and Lymphatic Vessels and by Vascular Doppler and Lymphoscintigraphy. Congenital lymphoedema of leg is defined as lymphoedema that is present at birth. It may be due to defect of the venous and lymphatic systems which results in excessive fluid load at the tissue level. The important evaluations that aid in the diagnosis of lymphoedema are detection of circulating adult filarial antigen, lymphoscintigraphy to identify patient lymphatic vessels and duplex ultrasound of leg to detect patency and competency of venous system. Physiotherapy and compression stocking can control swelling and prevent development of irreversible skin changes. Surgical intervention may help by creating alternate pathways. In this case report, a 35-year-old man reported for treatment of his bilateral oedema leg which was present since childhood. The patient consulted the surgeons and physicians of different super-specialist hospitals of the state. He was treated with antibiotics and analgesics for the last five years without any effect. After that, patient was presented to the author, where the diagnosis of patient was made as Congenital Lymphoedema based on Vascular Doppler and Lymphoscintigraphy.

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Summary: A 17‐year‐old Irish Draught cross gelding with a history of chronic recurrent right hindlimb cellulitis was evaluated due to acute onset of severe lameness affecting this limb. Scintigraphic examination identified marked radiopharmaceutical uptake within the central and third tarsal bones and the lameness improved following tibial and peroneal nerve blocks. Distal intertarsal joint collapse was observed but the radiographic changes were considered insufficient to explain the lameness severity. Magnetic resonance imaging revealed marked bone pathology affecting both the central and third tarsal bones. A subcutaneous abscess developed on the dorsolateral aspect of the limb, but clear evidence of joint infection was not established. Computed tomography showed lytic lesions affecting mainly the third tarsal bone, so the animal was treated surgically for suspected osteomyelitis involving this bone by implantation of gentamicin impregnated polymethylmethacrylate. Shortly following surgery the horse developed gastric rupture and was euthanased. Osteonecrosis of the third tarsal bone was identified, but sepsis was not demonstrated to be the cause. It is hypothesised that osteonecrosis developed as a sequel to chronic osteomyelitis which may have responded to previous antimicrobial treatment. The report also highlights the importance of gastric disorders as a differential for discomfort in animals undergoing treatment for orthopaedic disease. [ABSTRACT FROM AUTHOR]

Cellulitis and erysipelas are common skin infections usually caused by Staphylococcus aureus and streptococci. Gram-negative rods are rarely implicated. We report here a case of dermohypodermitis and bactaeremia caused by Erwinia billingiae, a Gram-negative bacteria usually pathogenic and epiphytic to pome fruit tree.

Primary lymphoedema arises from congenital disorders of Veins and Lymphatic Vessels. The diagnosis of congenital oedema leg is confirmed by the absence of Venous and Lymphatic Vessels and by Vascular Doppler and Lymphoscintigraphy. Congenital lymphoedema of leg is defined as lymphoedema that is present at birth. It may be due to defect of the venous and lymphatic systems which results in excessive fluid load at the tissue level. The important evaluations that aid in the diagnosis of lymphoedema are detection of circulating adult filarial antigen, lymphoscintigraphy to identify patient lymphatic vessels and duplex ultrasound of leg to detect patency and competency of venous system. Physiotherapy and compression stocking can control swelling and prevent development of irreversible skin changes. Surgical intervention may help by creating alternate pathways. In this case report, a 35-year-old man reported for treatment of his bilateral oedema leg which was present since childhood. The patient consulted the surgeons and physicians of different super-specialist hospitals of the state. He was treated with antibiotics and analgesics for the last five years without any effect. After that, patient was presented to the author, where the diagnosis of patient was made as Congenital Lymphoedema based on Vascular Doppler and Lymphoscintigraphy. [ABSTRACT FROM AUTHOR]