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Fulltext The association between obesity and dengue virus (DENV) infection in hospitalised patients

Tan VPK, Ngim CF, Lee EZ, Ramadas A, Pong LY, Ng JI, et al.

PLoS One, 2018;13(7):e0200698.
PMID: 30016369 DOI: 10.1371/journal.pone.0200698

Both obesity and DENV infections are growing public health concerns that have far-ranging socioeconomic effects, especially in developing countries. Despite the increasing prevalence of these conditions, there is a scarcity of data investigating the potential relationships between these two entities. Our study aims to examine the influence of obesity on various clinical and laboratory parameters amongst patients with DENV infections. A total of 335 hospitalized patients aged >12 years who were DENV non-structural protein 1 (NS1) antigen-positive were enrolled in this study. Clinical and laboratory variables were compared between patients with and without obesity. Multivariate analysis showed that the following admission clinical findings and laboratory results were independently associated with obesity; chills and rigors (AOR:2.653, 95% CI: 1.286-5.474), higher temperature (AOR:1.485, 95% CI: 1.080-2.042), higher systolic BP (AOR:1.057, 95% CI:1.037-1.078), raised haematocrit (AOR: 1.953, 95% CI: 1.010-3.778), elevated creatinine (AOR:3.504, 95% CI:1.351-9.008) and elevated ALT (AOR: 4.146, 95% CI:1.878-9.154). Obesity was found to be significantly associated with hospitalization >3 days (AOR: 1.990, 95% CI: 1.134-3.494) and the presence of increasing haematocrit with decreasing platelets (AOR: 2.134, 95% CI = 1.235-3.688). Serial assessment of laboratory data revealed that peak haematocrit was significantly higher and nadir platelets levels were significantly lower in obese patients. Both peak and admission levels of leukocyte counts, AST, ALT and creatinine were significantly higher in the obese group. Conversely, both admission and nadir albumin levels were lower for the obese group, although only nadir albumin levels achieved statistical significance. These findings support closer clinical monitoring of obese patients who present with DENV infections, as this patient cohort may possess an increased tendency towards developing more severe clinical manifestations of DENV infections as compared to non-obese patients.

Matched MeSH terms: Leukocyte Count
Fulltext Predictive Factors of Major Lower Extremity Amputations in Diabetic Foot Infections: A Cross-sectional Study at District Hospital in Malaysia

Kow RY, Low CL, Ruben JK, Zaharul-Azri MZ, Lim BC

Malays Orthop J, 2019 Nov;13(3):45-52.
PMID: 31890110 DOI: 10.5704/MOJ.1911.008

Introduction: Diabetic foot infection, a complication which can lead to lower limb amputation, is a major source of morbidity and mortality in Malaysia. The objective of this study was to determine the predictive factors of major lower limb amputation among patients with diabetes mellitus in a cluster of three district hospitals in Pahang, Malaysia. Materials and Methods: This cross-sectional study involved 170 patients who had undergone surgical interventions for diabetic foot infections at three district hospitals from 1st of September 2014 to 31st December 2015. The predictors for major amputation of lower limb were determined using simple logistic regression (LR) and forward LR multiple logistic regression. Results: A total of 21 patients had undergone major amputations of lower limb (15 transtibial and 6 transfemoral). The following factors were associated with major amputation of lower limb; longer duration of disease, age ≥ 60 years, patients from Bentong Hospital, presence of hypertension, presence of fever, history of multiple limb-salvaging surgeries, monomicrobial culture, necrotising fasciitis, anemia and leukocytosis. Upon forward LR multiple logistic regression, only duration of disease, history of more than three previous limb-salvaging surgeries and total white blood cell count ≥15X109/L were found to be significant as predictive factors of major amputation of lower limb. Conclusion: Among the factors analysed in this study, a longer duration of disease, raised total white blood cell count and history of more than three limb-salvaging surgeries were identified as predictors for major amputation of lower limb in diabetic foot infections using stepwise logistic regression analysis.

Matched MeSH terms: Leukocyte Count
Fulltext Necrotizing fasciitis of the upper back presenting with left shoulder pain

Mohamad Isa MZ, Mohamed-Yassin MS, Abdul Kadir RF

Clin Pract, 2020 Mar 31;10(1):1218.
PMID: 32373307 DOI: 10.4081/cp.2020.1218

Necrotizing fasciitis is a severe and progressive infection of deep soft tissues which results in destruction of the fascia and overlying subcutaneous fat. We report a case of a 45-year-old diabetic gentleman who initially presented with left shoulder pain, which was treated symptomatically. Upon representation, he had fever and the pain extended to his left upper back. There was a warm, firm and mildly tender purplish swelling on his mid to the left upper back. Blood tests revealed significantly elevated white cell counts and C-reactive protein. A CT thorax showed extensive soft tissue gas within the deep and superficial fascial layers of his left upper back. Necrotizing fasciitis was confirmed intraoperatively. The diagnosis of this condition is often difficult as early symptoms can be mild and nonspecific. A high Laboratory Risk Indicator for NECrotizing fasciitis (LRINEC) score may be helpful to rule in this diagnosis and guide further management.

Matched MeSH terms: Leukocyte Count
Fulltext Survival predictors in paraquat intoxification and role of immunosuppression

Koh KH, Tan CH, Hii LW, Lee J, Ngu LL, Chai AJ, et al.

Toxicol Rep, 2014;1:490-495.
PMID: 28962262 DOI: 10.1016/j.toxrep.2014.06.010

Paraquat poisoning resulted in multiorgan failure and is associated with high mortality. We audited 83 historical cases of paraquat poisoning in past 2 years treated with conventional decontamination and supportive treatment, followed by enrolling 85 patients over a 2 year period into additional immunosuppression with intravenous (i.v.) methylprednisolone and i.v. cyclophosphamide. Our results showed that age, poor renal function and leucocytosis are the main predictors of fatal outcome. Immunosuppression regime rendered higher survival (6 out of 17 patients (35.3%)) versus historical control (1 out of 18 patients (5.6%)) (p = 0.041) in the cohort with admission eGFR < 50 ml/min/1.73 m(2) and WBC count > 11,000/μL. In contrast, there was no difference in survival with immunosuppression regime (38 out of 64 patients (59.4%)) compared to historical control (30 out of 52 patients (57.7%)) (p = 0.885) in those with eGFR > 50 ml/min/1.73 m(2) or WBC < 11,000/μL at presentation. Multivariable logistic regression showed survival probability = exp(logit)/(1 + exp(logit)), in which logit = 13.962 - (0.233 × ln(age (year))) - (1.344 × ln(creatinine (μmol/L))) - (1.602 × ln(rise in creatinine (μmol/day))) - (0.614 × ln(WBC (,000/μL))) + (2.021 × immunosuppression) and immunosuppression = 1 if given and 0 if not. Immunosuppression therapy yielded odds ratio of 0.132 (95% confidential interval: 0.029-0.603, p = 0.009). In conclusion, immunosuppression therapy with intravenous methylprednisolone and cyclophosphamide may counteract immune mediated inflammation after paraquat poisoning and improve survival of patients with admission eGFR < 50 ml/min/1.73 m(2) and WBC count > 11,000/μL.

Matched MeSH terms: Leukocyte Count
Molecular Modulation of Stress Induced to Abnormal Haematological Indices in Medical Students, Malaysian Perspective

Al-Hatamleh MAI, Baig AA, Simbak NB, Nadeem MI, Khan SU, Ariff TM

Pak J Biol Sci, 2017;20(10):478-488.
PMID: 30187724 DOI: 10.3923/pjbs.2017.478.488

Medical students in Malaysia and globally were considered among the most exposure groups in the community to stress due to several sources. The most significant and severe sources of stress in medical students is an academic sources, includes a lot of exams/tests, lack of time and facilities for entertainment, stay in a hostel, high parental expectations and vastness of syllabus, in addition to emotional problems and others personal sources. Stress is a very important issue that leads to a worsening of health problems. Stress develops in the body and leads to oxidative stress which in turn leads to a disorder in the whole body. Oxidative stress may lead to abnormal haematological indices elevated white blood cells (WBCs) count. Oxidative stress can lead to massive destruction of red blood cells (RBCs). The brain and the gastrointestinal system (GI) are intimately connected as one system. The brain has a direct impact on the GI tract. A stressful brain can send signals to the gut, just as a troubled intestine can send signals to the brain. Therefore, stress can be the cause of block the breakdown and assimilation of food for energy and nutriment. This malabsorption can then lead to a reciprocal negative effect to the stress and can be another cause of anaemia through malabsorption minerals and vitamins that are to erythropoiesis. So, stress can be one of the leading causes of anaemia among medical students. Stress is a chronic epidemic in the most medical students and can directly affect how well body works. This review article discovers the effect of stress in medical students that can be effect on their studies and further create researcher's interest to generate database that help to reduce stress response and bring about the empowerment of balanced life among Malaysian medical students besides the increasing level of health and academic performance.

Matched MeSH terms: Leukocyte Count
Fulltext Hepatoprotective Effects of Zerumbone against Paracetamol-Induced Acute Hepatotoxicity in Rats

Hamid A, Lee LS, Karim SR, Jufri NF

Malays J Med Sci, 2018 Mar;25(2):64-71.
PMID: 30918456 MyJurnal DOI: 10.21315/mjms2018.25.2.7

Background: Zerumbone (ZER) is a major bioactive compound of Zingiber zerumbet, a wild ginger plant that has been documented to have anti-proliferative, anti-inflammatory and anti-oxidant properties. To investigate its hepatoprotective potential, this study was designed to determine the treatment effects of ZER on acute hepatotoxicity induced by paracetamol (PCM) in rats.
Methods: The control group was administered with phosphate buffer solution (PBS) while the other two groups received PCM alone (1000 mg/kg) and PCM + 25 mg/kg ZER, respectively, at 0 h and 4 h after PCM injection. After 24 h, the blood and liver were collected for differential white blood cell count, liver histological observation and biochemical analysis including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total protein concentration in serum and liver.
Results: Treatment with ZER was found to significantly reduce ALT (P = 0.041), AST (P = 0.044) and total hepatic protein (P = 0.045) in comparison to PCM-induced rats. Rats treated with ZER exhibited the normal structure of hepatocytes with no vacuolisation or necrosis and showed significantly reduced neutrophil count (P = 0.037). This finding suggests its ability to suppress the inflammatory processes caused by PCM overdosage and decrease the hepatocytes tendency to go through necrotic processes.
Conclusion: ZER possessed protective activity against PCM-induced acute hepatotoxicity in a rat model.

Matched MeSH terms: Leukocyte Count
The effect of different degrees of feed restriction on heat shock protein 70, acute phase proteins, and other blood parameters in female broiler breeders

Najafi P, Zulkifli I, Soleimani AF, Kashiani P

Poult Sci, 2015 Oct;94(10):2322-9.
PMID: 26316343 DOI: 10.3382/ps/pev246

The aim of the current study was to determine the physiological response to feed restriction in female broiler breeders using a range of conventional and novel indicators. One hundred female breeders were subjected to one of five feeding regimens from d 28 to 42 as follows (i) ad libitum feeding (AL), (ii-v) 75, 60, 45, and 30% of ad libitum feed intake. Blood heterophil to lymphocyte ratio (HLR), and plasma circulating corticosterone (CORT), ghrelin (GHR), serotonin (5-HT), and dopamine (DA) and serum acute phase proteins (APP) concentrations together with brain heat shock protein (HSP) 70 level were measured. The results showed a significant effect of feed restriction on blood HLR and plasma CORT, GHR, 5-HT, DA, and brain HSP 70 levels. However, feed restriction had no effect on serum levels of APP of alpha-1 acid glycoprotein, ovotransferin, and ceruloplasmin. Serum levels of 5-HT and GHR varied curvilinearly with the feed restriction level. The relationship between brain HSP 70 and level of feed restriction was negligible. However, significant linear relationships between HLR, CORT, DA, and the level of feed restriction were noted. Thus, these 3 parameters appear to represent a straight forward relation with severity of feed restriction.

Matched MeSH terms: Leukocyte Count/veterinary*
Worm burden and leukocyte response in Angiostrongylus malaysiensis-infected rats: the influence of testosterone

Kamis AB, Ahmad RA, Badrul-Munir MZ

Parasitol Res, 1992;78(5):388-91.
PMID: 1495916

Gonadectomized male albino rats aged 7 weeks were given 1.5 mg/kg testosterone propionate daily and inoculated with 50 third-stage larvae of Angiostrongylus malaysiensis. The treatment significantly increased the number of larvae and adult worms recovered from the brain and pulmonary arteries, respectively, and the rats exhibited smaller thymus glands. The total numbers of leukocytes, monocytes, neutrophils, and especially eosinophils increased significantly post-infection, but the counts were higher in the untreated infected controls. Presumably, immunosuppressive effects of testosterone may at least partly be responsible for the higher loads of A. malaysiensis worms found in male rats as compared with females in the field.

Matched MeSH terms: Leukocyte Count/veterinary
Fulltext Performance, biochemical and haematological responses, and relative organ weights of laying hens fed diets supplemented with prebiotic, probiotic and synbiotic

Tang SGH, Sieo CC, Ramasamy K, Saad WZ, Wong HK, Ho YW

BMC Vet Res, 2017 Aug 17;13(1):248.
PMID: 28814309 DOI: 10.1186/s12917-017-1160-y

BACKGROUND: The increasing trend of ban on the use of antibiotic growth promoters (AGPs) across the globe in the poultry industry has led to a growing need for alternatives to AGPs. Prebiotic, probiotic and their combination as a synbiotic have been considered as potential alternatives. This study aimed to investigate the effects of a prebiotic (isomaltooligosaccharide, IMO), a probiotic (PrimaLac®), and their combination (synbiotic) on hen performance, biochemical and haematological responses, and relative organ weights from 20 to 52 weeks of age.
RESULTS: Supplementation of 1% IMO (PRE), 0.1% PrimaLac® (PRO) and 1% IMO + 0.1% PrimaLac® (SYN) improved (P

Matched MeSH terms: Leukocyte Count/veterinary
Fulltext MOSQUITO-BORNE HAEMORRHAGIC FEVER IN MALAYA

RUDNICK A, TAN EE, LUCAS JK, OMAR MB

Br Med J, 1965 May 15;1(5445):1269-72.
PMID: 14278815
Matched MeSH terms: Leukocyte Count*
Retinal findings in adult leukaemia: correlation with leukocytosis

Jackson N, Reddy SC, Hishamuddin M, Low HC

Clin Lab Haematol, 1996 Jun;18(2):105-9.
PMID: 8866143

The associations between retinal findings and haematological parameters in acute leukaemia are controversial. Sixty-three newly-diagnosed acute leukaemia patients, aged 12-77 years, were studied prospectively for the presence of intra-retinal haemorrhages (IRH), white-centred haemorrhages (WCH), cotton wool spots (CWS) and macular haemorrhages (MH), Thirty-three patients (52.4%) showed at least one retinal abnormality. The prevalence of individual findings was: IRH (30 cases), WCH (20 cases), CWS (5 cases), MH (11 cases). In contrast to previous studies, there was no association between any of these retinal findings and the haemoglobin level or the platelet count. There was a higher median WBC in patients with IRH (68 x 10(9)/l) than in those without IRH (15.4 x 10(9)/l), P = 0.037. When the acute myeloblastic leukaemia cases were considered separately, an association was also found between higher WBC and the presence of WCH and CWS. There was no association between retinal findings and FAB type in the AML cases. We conclude that a high WBC may be at least as important as anaemia and thrombocytopenia in the pathogenesis of the retinopathy of acute leukaemia.

Matched MeSH terms: Leukocyte Count*
Fulltext Acupuncture and immune function in chronic prostatitis/chronic pelvic pain syndrome: a randomized, controlled study

Lee SW, Liong ML, Yuen KH, Krieger JN

Complement Ther Med, 2014 Dec;22(6):965-9.
PMID: 25453515 DOI: 10.1016/j.ctim.2014.10.010

Objective: The immune system has been implicated as one mechanism underlying the benefits of acupuncture therapy. Evidence suggests that acupuncture can ameliorate symptoms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), but the association between clinical response and the immune system has not been investigated.

Design/setting: We investigated 12 CP/CPPS patients participating in a prospective randomized clinical trial comparing acupuncture versus sham acupuncture for effects on cellular immunity. Blood samples were taken before the first needling and after the last of 20 treatment sessions (week 10). Patients also completed questionnaires examining their CP/CPPS symptoms and mood status at the baseline and end of study visits.

Results: At the end of study 8 of 12 participants (67%) were classified as treatment responders, four participants each from the acupuncture and sham groups. The acupuncture group averaged a 5% increase in natural killer cell levels compared to corresponding sham (-13%; p=0.03). Similarly, patients randomized to acupuncture reported a reduction in other white blood cell parameters examined, supporting the possibility that immunity might be important in the pathophysiology of CP/CPPS.

Conclusions: The specific effect of acupuncture on CP/CPPS remains unclear. Further research is warranted to examine the mechanisms by which acupuncture therapy may improve clinical symptoms in patients with CP/CPPS.

Trial registration: ClinicalTrials.gov number, NCT00260637).

Keywords: Acupuncture; Chronic prostatitis/chronic pelvic pain syndrome; Immune system; Neuroendocrine system; Traditional Chinese medicine.

Matched MeSH terms: Leukocyte Count
Effect of mangosteen (Garcinia mangostana L.) extracts as a feed additive on growth and hematological parameters of African catfish (Clarias gariepinus) fingerlings

Soosean C, Marimuthu K, Sudhakaran S, Xavier R

Eur Rev Med Pharmacol Sci, 2010 Jul;14(7):605-11.
PMID: 20707250

The efficacy of dietary inclusion of various parts of mangosteen (Garcinia mangostana L.) extract on growth and hematological parameters of African catfish (Clarias gariepinus) fingerlings were investigated.

Matched MeSH terms: Leukocyte Count
Fulltext The correlation between cytopenia and esophageal varices in patients with liver cirrhosis

Gue CS, Yap CK, Ng HS

Med J Malaysia, 2004 Dec;59(5):604-8.
PMID: 15889562

This retrospective study analysed the case records of 200 patients in the Department of Gastroenterology, Singapore General Hospital from February 2000 to January 2001 who had liver cirrhosis and underwent gastroscopy for the detection of varices. The aim of this study was to determine any relationship between leucopenia, thrombocytopenia and the occurrence of esophageal varices in a cirrhotic population. Our results showed that the diagnostic yield of varices grade 2 and 3 was 6.3% if platelet count was > 150,000/mm3, 25% if platelet count was 100,000 to 150,000/mm3, 38.9% if platelet count was 50,000-99,000/mm3 and 100% if platelet count was <50,000/mm3. Similarly, the diagnostic yield of varices grade 2 and 3 was 19.4% if total white count was > 4,000/mm3, 66.7% if total white count was 3,000- 4,000/mm3 and 94.8% if total white count was < 3,000/mm5. We conclude that thrombocytopenia and leucopenia can be used to stratify risk for occurrence of esophageal varices in cirrhotic patients and gastroscopy will have a high yield for varices when platelet count is < 150,000/mm3 or total white is < 4,000/mm.

Matched MeSH terms: Leukocyte Count
The effect of early age feed restriction on subsequent response to high environmental temperatures in female broiler chickens

Zulkifli I, Che Norma MT, Israf DA, Omar AR

Poult Sci, 2000 Oct;79(10):1401-7.
PMID: 11055844

This study was conducted to determine whether early age feed restriction improves heat tolerance in female broiler chickens. Chicks were brooded for 3 wk and then maintained at 24+/-1 C. On Day 0, chicks were assigned to one of four feeding regimens; each regimen was applied to four cages of chicks. The feeding regimens were 1) ad libitum feeding (ALF); 2) 40% feed restriction at 4, 5, and 6 d of age (F40); 3) 60% feed restriction at 4, 5, and 6 d of age (F60); and (4) 80% feed restriction at 4, 5, and 6 d of age (F80). From 35 to 41 d of age, all birds were exposed to 38+/-1 C for 2 h/d. Serum concentrations of glucose were elevated by the heat challenge, but were not affected by the feeding regimen. The heat treatment resulted in hypocholesteremia among ALF and F80 chicks, whereas the concentrations increased and remained constant in the F60 and F40 birds, respectively. Subjecting chicks to F60 improved growth and survivability and reduced heterophil to lymphocyte ratios (H/L) in response to the heat treatment as compared with the ALF and F80 regimens. The survivability rate and H/L of F40 chicks were similar to those attained by chicks on other regimens. Newcastle disease antibody titer of ALF birds declined with duration of heat treatment. It is concluded that the F60 regimen is beneficial for alleviating, at least in part, the detrimental effects of heat stress in female broiler chickens.

Matched MeSH terms: Leukocyte Count
Fulltext Differences in pleural fluid characteristics, white cell count and biochemistry of tuberculous and malignant pleural effusions

Liam CK, Lim KH, Wong CMM

Med J Malaysia, 2000 Mar;55(1):21-8.
PMID: 11072486

Tuberculosis and malignancy are two common causes of exudative pleural effusions. In this retrospective study of 52 patients with tuberculous pleural effusions and 32 patients with malignant effusions, the median age of patients with malignant effusions (68.5 years) was older than that of patients with tuberculous effusions (34.5 years) (p < 0.001). Both types of effusion occurred more frequently on the right side and there was no difference between them in terms of right-sided dominance. A higher percentage of patients with malignant pleural effusions (44%) presented with large effusions than patients with tuberculous effusions (12%) (x2 = 11.33, p = 0.001). A higher proportion of patients with tuberculous effusion had lymphocyte predominant effusions and tuberculous effusions had higher lymphocyte percentage, lower red cell count, and higher protein content. However, there was considerable overlap of these characteristics of both types of effusions.

Matched MeSH terms: Leukocyte Count
Fulltext M3-variant of acute promyelocytic leukaemia. A case report in a Malay boy

Jazilah W, Ariffin W, Jackson N

Med J Malaysia, 1995 Mar;50(1):105-7.
PMID: 7752961

The variant form of acute promyelocytic leukaemia (AML-M3) possesses its own characteristic morphology, although usually a few of the cells may have cytoplasmic features of typical AML-M3. In contrast to typical AML-M3, this M3-variant form commonly presents with hyperleucocytosis. As in typical AML-M3, disseminated intravascular coagulopathy (DIVC) occurs in the M3-variant. A boy with this morphological variant of AML-M3 is described. Uncharacteristically, his presenting white blood count was low, and DIVC was present before treatment was started. Six days into intensive chemotherapy his coagulopathy worsened and he subsequently died of intracranial haemorrhage. An alternative approach to the treatment of AML-M3, with the use of retinoids, is discussed.

Matched MeSH terms: Leukocyte Count
Carbimazole-induced agranulocytosis treated with granulocyte-macrophage colony stimulating factor--a case report

Ng SC

Ann Acad Med Singap, 1995 May;24(3):465-6.
PMID: 7574435

Drug-induced agranulocytosis is a potentially fatal complication despite advances in supportive care. A patient with carbimazole-induced agranulocytosis associated with marked depletion of granulocytic precursors in the marrow was treated with granulocyte-macrophage colony stimulating factor (GM-CSF) at a dose of 5 micrograms/kg subcutaneously daily for one week. The absolute neutrophil count rose above 1 x 10(9)/L after one week of GM-CSF therapy. The GM-CSF probably expedited the recovery of the neutrophil count. Further studies are warranted to delineate the role of GM-CSF in the treatment of drug-induced agranulocytosis.

Matched MeSH terms: Leukocyte Count
Effects of testosterone on blood leukocytes in plasmodium berghei-infected mice

Kamis AB, Ibrahim JB

Parasitol Res, 1989;75(8):611-3.
PMID: 2671986

Gonadectomized male mice aged 5 weeks were given 5 mg testosterone propionate daily for 14 days. The treatment significantly decreased the number of blood leukocytes. The number of all individual types of leukocytes except basophils in vehicle-treated gonadectomized mice was increased. Testosterone-treated mice consistently had a lower number of leukocytes after being infected with Plasmodium berghei than did vehicle-treated mice. The results suggest that testosterone suppresses the production of leukocytes and that testosterone-treated mice become more susceptible to parasite infection.

Matched MeSH terms: Leukocyte Count
Fulltext A review on rhodococcus equi: horse, cat and human

Aslam, M.W.

Jurnal Veterinar Malaysia, 2019;31(2):1-12.
MyJurnal

In recent years, Rhodococcus equi has emerged as pathogen of importance in respiratory and non-respiratory infectious diseases of animals and humans. Its distribution is worldwide and incidence of disease is increasing in nonequine species like cats and humans. Sporadic infection in human and cat is hypothesized to infect immunocompromised cases largely. While predominantly in foals, infection is quite endemic/epidemic in nature depending on virulence of strain, and incidence is 10 – 20% since birth till weaning. Mode of acquisition is quite variable in humans, cats and foals and depends on the route of exposure. Pathogenesis is well understood in natural host but in cats and humans it is still in its infancy because of the manifestation of unusual cases with low to no exposure to contaminated elements. Clinical signs depend on the site of infection but respiratory manifestations are quite common in foals and human cases. In cats extra-pulmonary disorders are hypothesized as more common presentation. Definitive diagnosis is based on the microbiological culture and cytology from tracheobronchial aspirate for respiratory cases and site of sample for non-respiratory lesions. White blood cells and fibrinogen have some correlation in degree of diagnosis in foals but not in cats and humans. Macrolides especially clarithromycin along with rifampin are considered best combination at the moment and recently resistance is being reported against erythromycin and rifampin. In foals, consensus statements by ACVIM published detailed control and preventions but in humans and cats so far hygiene and isolation of infected patients are for the time being the methods to control nosocomial spread.

Matched MeSH terms: Leukocyte Count

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