Helio Autran de Morais

Hemoplasma infection in HIV-positive patient, Brazil.

Hemotrophic mycoplasmas infect a variety of mammals. Although infection in humans is rarely reported, an association with an immunocompromised state has been suggested. We report a case of a Mycoplasma haemofelis–like infection in an HIV-positive patient co-infected with Bartonella henselae.

Ehrlichiosis in Brazil.

Erliquiose e uma doenca causada por rickettsias pertencentes ao genero Ehrlichia. No Brasil, estudos sorologicos e moleculares tem avaliado a ocorrencia de especies de Ehrlichia em caes, gatos, animais selvagens e seres humanos. Ehrlichia canis e a principal especie em caes no Brasil, embora a infeccao por E. ewingii tenha, recentemente, despertado suspeita em cinco caes. O DNA de E. chaffeensis foi detectado e caracterizado em cervo-do-pantanal, enquanto que E. muris e E. ruminantium ainda nao foram identificadas no Brasil. A erliquiose monocitica canina causada pela E. canis parece ser altamente endemica em muitas regioes do Brasil, embora dados de prevalencia nao estejam disponiveis em muitas delas. O DNA de E. canis tambem foi detectado e caracterizado em tres gatos domesticos, enquanto anticorpos contra E. canis foram detectados em felideos neotropicais de vida livre. Evidencias sorologicas sugerem a ocorrencia de erliquiose humana no Brasil, entretanto, o agente etiologico ainda nao foi identificado. A melhoria do diagnostico molecular promovera a identificacao e caracterizacao de especies associadas a erliquiose humana no Brasil.Ehrlichiosis is a disease caused by rickettsial organisms belonging to the genus Ehrlichia. In Brazil, molecular and serological studies have evaluated the occurrence of Ehrlichia species in dogs, cats, wild animals and humans. Ehrlichia canis is the main species found in dogs in Brazil, although E. ewingii infection has been recently suspected in five dogs. Ehrlichia chaffeensis DNA has been detected and characterized in mash deer, whereas E. muris and E. ruminantium have not yet been identified in Brazil. Canine monocytic ehrlichiosis caused by E. canis appears to be highly endemic in several regions of Brazil, however prevalence data are not available for several regions. Ehrlichia canis DNA also has been detected and molecularly characterized in three domestic cats, and antibodies against E. canis were detected in free-ranging Neotropical felids. There is serological evidence suggesting the occurrence of human ehrlichiosis in Brazil but its etiologic agent has not yet been established. Improved molecular diagnostic resources for laboratory testing will allow better identification and characterization of ehrlichial organisms associated with human ehrlichiosis in Brazil.

Co-infection with Mycoplasma haemofelis and ‘Candidatus Mycoplasma haemominutum’ in three cats from Brazil☆

The two most common haemotropic Mycoplasma of cats, Mycoplasma haemofelis and ‘Candidatus Mycoplasma haemominutum’ have been identified using molecular techniques in all continents, except Antarctica. We report the first molecular characterization in South America of a dual infection with M haemofelis and ‘Candidatus Mycoplasma haemominutum’ in three domestic cats. The 16S ribosomal RNA gene was amplified in three anaemic cats in which haemoplasma organisms were seen attached to the erythrocytes in the peripheral blood smear. Bands of the expected size for M haemofelis and ‘Candidatus Mycoplasma haemominutum’ were observed in all three cats. The 393 bp segment of one of the amplicons had a similarity value of 100% to M haemofelis, whereas the other amplicon, a 192 bp segment, was 100% similar to ‘Candidatus Mycoplasma haemominutum’. After diagnosis, two cats received blood transfusion and they were all treated with doxycycline. All three cats recovered uneventfully.

Metabolic Acid-Base Disorders in the Critical Care Unit

The recognition and management of acid-base disorders is a commonplace activity in the critical care unit, and the role of weak and strong acids in the genesis of metabolic acid-base disorders is reviewed. The clinical approach to patients with metabolic alkalosis and metabolic acidosis is discussed in this article.

URATE NEPHROLITHIASIS IN A NORTHERN ELEPHANT SEAL (MIROUNGA ANGUSTIROSTRIS) AND A CALIFORNIA SEA LION (ZALOPHUS CALIFORNIANUS)

Abstract Nephrolithiasis has rarely been reported in marine mammals. During 2004 and 2005, two cases of nephrolithiasis were diagnosed during routine necropsy examination, one in a northern elephant seal (Mirounga angustirostris) and one in a California sea lion (Zalophus californianus). Nephroliths were found throughout both kidneys during necropsy examination, varying in size from 1–10 mm in diameter in the northern elephant seal and from 1–15 mm in diameter in the California sea lion. Necropsy and histopathology revealed nephroliths in association with renal pelvic dilation and pyelonephritis in both animals. In addition, hydronephrosis was noted in the sea lion. Nephroliths were composed of uric acid and ammonium urate in the northern elephant seal and of ammonium urate in the California sea lion. The underlying disease leading to nephrolith formation was not determined; however, it is hypothesized that unknown metabolic derangements due to morphologic or physiologic differences may have played a role. This is the first report of urate nephrolithiasis in the California sea lion and northern elephant seal.

Anion Gap and Strong Ion Gap: A Quick Reference

This article serves as a quick reference for the anion gap and strong ion gap. Guidelines for analysis and interpretation of changes are presented.

Metabolic Alkalosis: A Quick Reference

This article serves as a quick reference for metabolic alkalosis. Guidelines for analysis and causes, signs, and a stepwise approach are presented.

Hyponatremia: a quick reference.

This article serves as a quick reference for hyponatremia. Guidelines for analysis and causes, signs, and a stepwise approach are presented.

Hyperkalemia: A Quick Reference

This article serves as a quick reference for hyperkalemia. Guidelines for analysis and causes, signs, and a stepwise approach are presented.

Chloride: a quick reference.

This article serves as a quick reference for the analysis of chloride abnormalities. Guidelines for causes, signs, and stepwise approaches for corrected hypochloremia and hyperchloremia are presented.