Ears from slaughter pigs with auricular elephantiasis (n = 24) and the corresponding lymph nodes (lnn.) (n = 26) were grossly, histopathologically and microbiologically examined. Immunostaining for IgM, IgG, Cd3epsilon and bacterial antigens of Arcanobacterium pyogenes and Staphylococcus aureus was performed by indirect enzyme-based techniques. Ears were variably thickened depending on the sampled area (basis, centre and apex). However, at all locations the thickness, the length from basis to apex and the weigh of whole ears with elephantiasis were significantly increased (P < 0.01). The corresponding lnn., that is, ln. parotideus superficialis and profundus, had also increased significantly (P < 0.01) in volume. Histopathologically, lesions of the ears and the corresponding lnn. revealed changes characterized by diffuse fibrosis intermingled with multiple pyogranulomatous foci containing asteroid bodies. In the majority of lesions, four distinct zones due to different cellular infiltrates encircled the central core of the asteroid bodies. In several lesions, the pyogranulomatous foci were contained within the lymph vessels. Immunohistochemically, only the bacterial antigen of S. aureus was detected within the cytoplasm of the macrophages and/or in the asteroid bodies of the ears (41.5%) and in the regional lnn. (30.8%). An abundant number of IgM, IgG and CD3epsilon-positive cells were present in all the pyogranulomatous lesions, whereas a positive IgG-staining was observed only in a single asteroid body. Thus, porcine auricular elephantiasis is a chronic pyogranulomatous inflammation that is frequently positive for S. aureus and is lymphogenically spread. Therefore, the lesions of the ears with auricular elephantiasis and the corresponding lnn. should be termed auricular botryomycosis and botryomycotic lymphadenitis, respectively. Moreover, as the disease is observed frequently in slaughter pigs it must also be considered according to the welfare of the animals and in relation to post-mortem meat inspection.
Background Hearing loss and deafness are well-known sequelae from bacterial meningitis (ABM) and may result in social dysfunction and learning difficulties. Yet, the timely development of hearing loss and restitution is poorly studied, especially among adults. Hearing loss was revisited using otoacoustic emissions (OAE) to determine the occurrence, magnitude, and development of hearing loss among adults with ABM. Methods Distortion product otoacoustic emissions (OAE) were measured in patients with ABM the day of admission and days 2, 3, 5-7, 10-14 and at follow up 30 to 60 days after discharge. Frequencies were categorized as Low (1,1.5,2 kHz), Mid (3,4,5 kHz), Mid-high (6,7,8, kHz) and High (9,10 kHz). Audiometry was performed on discharge and 60 days after. Results were compared to 158 healthy controls. Results OAE was obtained in 32 patients. ABM was due to S. pneumoniae in 12 patients (38%). All patients were treated with dexamethasone. OAE emission threshold levels (ETL’s) were significantly decreased upon admission and at follow up in all frequencies compared to healthy controls. A substantial and significant decrease in ETL’s was found in S. pneumoniae meningitis. Sensorineural hearing loss (SNHL) >20 dB was present in 13 of 23 (57%) at discharge and in 11 of 18 patients (61%) 60 days after discharge. Hearing recovery decreased from day 3. Conclusion Hearing loss in ABM still affects more than 60% of patients despite treatment with dexamethasone. In S. pneumoniae meningitis SNHL is profound and permanent. A window of opportunity for systemic or local treatments aiming to preserve cochlear function is proposed.
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