A 38-year-old diabetic woman, with history of cholecystectomy and ventral hernia repair, was hospitalized due to sudden-onset abdominal pain and fever. Computed tomography revealed a mixed collection containing necrotic debris and emphysematous change in the left lobe of the liver mainly in segments II and III. These radiological findings suggested emphysematous hepatitis (EH). The patient’s condition deteriorated rapidly, and she was rushed to the operating room for urgent exploratory laparotomy where debridement was performed. Intraoperatively the patient was found to have an abscess with incomplete capsule concurrent with hepatic necrosis suggesting the co-occurrence of abscess and EH. The patient survived and was discharged after 13 days. Relevant literature was reviewed, and to the best of our knowledge, EH is an extremely rare entity with limited data regarding its pathogenesis, causative organisms, and management. EH is a rapidly invasive disease process that can be fatal if appropriate therapeutic intervention is delayed. Initial presentations are usually subtle, thus high clinical and radiological suspicion is required for early diagnosis and management to decrease associated mortality and morbidity. We hence report the first successfully treated case of EH with review of the literature.

Abstract:The entomopathogenic fungus conidia viability and sporulation may be affected by different environmental factors or by bio-pesticides and chemical products used to protect cultivated plants. In this research, we investigated the compatibility of Metarhizium anisopliae DEMI 001 isolates with three insecticides: fipronil, pyriproxyfen and hexaflumuron. The effect of fipronil, pyriproxyfen and hexaflumuron on sporulation, vegetative growth and conidial germination of the fungus was studied based on measuring the vegetative growth and sporulation. SDA medium was mixed with fipronil (10, 40 and 120 ppm), pyriproxyfen (10, 500 and 1 000 ppm), hexaflumuron (20, 50 and 120 ppm). SAD medium excluding insecticides was designated as blank. To determine the sporulation rate, spores was counted on surface area and vegetative growth was measured on the basis of colony diameter. The results showed that hexaflumuron at the concentration of 120 ppm reduced the vegetative growth to 0% showing the highest reduction effect compared to pyriproxyfen (24.59%) and fipronil (24.31%). All three insecticides reduced drastically the conidial germination at the highest concentrations (0-15%). Hexaflumuron treatment with 0% germination at all three concentrations and fipronil and pyriproxyfen with 32.36% and 9.7% germination at 200 ppm were not significantly different. Regarding the highest negative effect of hexaflumuron on germination at all three concentrations, this insecticide should not be applied together with the entomopathogenic fungus.

No abstract