No abstract

Regional suppurative meningoencephalitis and ventriculitis of variable chronicity was diagnosed in three young dogs residing in Colorado. Grass awns were grossly identified in the right occipital cortex of one dog and in the right lateral ventricle of another. Intralesional plant material was microscopically evident in the dura mater overlying the right occipital cortex of the third dog. One grass awn was identified as a floret of Hordeum jabatum. In each case, aerobic culture of brain tissue identified multiple isolates of bacteria. The dogs presented with clinically variable, rapidly progressive neurologic dysfunction, including tetraplegia, depressed mentation, and episodic extensor rigidity, ataxia, circling, stupor, vocalization, and head-pressing. Encephalitis due to bacteria introduced from migrating plant foreign material is a potential sequela of intranasal, periocular, or pharyngeal foreign bodies.

Bartonella henselae is occasionally associated with neurological dysfunction in people and some experimentally infected cats. The purpose of this study was to determine whether B henselae seroprevalence or titer magnitude varies among cats with neurological disease, cats with non-neurological diseases, and healthy cats while controlling for age and flea exposure. There was no difference in B henselae seroprevalence rates between cats with seizures and cats with other neurological diseases. Cats with non-neurological disease and healthy cats were more likely than cats with neurological disease to be seropositive. While the median B henselae antibody titer was greater in cats with seizures than in cats with other neurological disease, the median B henselae antibody titer was also greater in healthy cats than cats with seizures. The results suggest that titer magnitude cannot be used alone to document clinical disease associated with B henselae infection and that presence of B henselae antibodies in serum of cats with neurological disease does not prove the clinical signs are related to B henselae.

Bartonella species infection is associated with central nervous system (CNS) disease in some humans and cats but the diagnosis is difficult to confirm with blood or serum test results. In this retrospective study of 100 client-owned cats, serum and cerebral spinal fluid (CSF) were assayed for Bartonella species IgG antibodies and CSF was assayed for Bartonella species DNA. Bartonella species IgG antibodies were detected in serum of 36 cats, Bartonella species C-values>1 (suggesting antibody production by the CNS) were detected in CSF of 11 cats, and B henselae DNA was amplified from the CSF of 10 cats. While the clinical significance of these findings cannot be assessed without a control group, the development of neurological signs in some cats inoculated with B henselae and the results of this study warrant prospective evaluation of the association of Bartonella species with feline CNS disease.

To many Americans, the idea of home birth, the use of a "direct-entry midwife," or both seem archaic. Although much of the professional medical community disapproves of either, state laws regarding birth choices vary dramatically and are not necessarily based on empirical findings of childbirth outcomes. Public health practitioners, policymakers, and consumers view childbirth from the perspectives of safety, cost, freedom of choice, quality of the care experience, and legality, yet the professional, policy, and lay literatures have not offered an unemotional, balanced presentation of evidence. Reviewing the full spectrum of literature from the United States and abroad, we present a Constitutional medical-legal analysis of whether home birth with direct-entry midwives is in fact a safe alternative to physician-attended hospital births, and whether there is a legal basis for allowing alternative health policy choices is such an important yet personal family matter as childbirth. The literature shows that low- to moderate-risk home births attended by direct-entry midwives are at least as safe as hospital births attended by either physicians or midwives. The policy ramifications include important changes in state regulation of medical and alternative health personnel, the allowance of the home as a medically acceptable and legal birth setting, and reimbursement of this lower-cost option through private and public health insurers.