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Philippe J Sansonetti - One of the best experts on this subject based on the ideXlab platform.
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rhinoscleroma pathogenesis the type k3 capsule of Klebsiella Rhinoscleromatis is a virulence factor not involved in mikulicz cells formation
PLOS Neglected Tropical Diseases, 2018Co-Authors: Barbara Corelli, Ana S Almeida, Fabiane Sonego, Virginia Castiglia, Cindy Fevre, Sylvain Brisse, Philippe J SansonettiAbstract:Rhinoscleroma is a human specific chronic granulomatous infection of the nose and upper airways caused by the Gram-negative bacterium Klebsiella pneumoniae subsp. Rhinoscleromatis. Although considered a rare disease, it is endemic in low-income countries where hygienic conditions are poor. A hallmark of this pathology is the appearance of atypical foamy monocytes called Mikulicz cells. However, the pathogenesis of rhinoscleroma remains poorly investigated. Capsule polysaccharide (CPS) is a prominent virulence factor in bacteria. All K. Rhinoscleromatis strains are of K3 serotype, suggesting that CPS can be an important driver of rhinoscleroma disease. In this study, we describe the creation of the first mutant of K. Rhinoscleromatis, inactivated in its capsule export machinery. Using a murine model recapitulating the formation of Mikulicz cells in lungs, we observed that a K. Rhinoscleromatis CPS mutant (KR cps-) is strongly attenuated and that mice infected with a high dose of KR cps- are still able to induce Mikulicz cells formation, unlike a K. pneumoniae capsule mutant, and to partially recapitulate the characteristic strong production of IL-10. Altogether, the results of this study show that CPS is a virulence factor of K. Rhinoscleromatis not involved in the specific appearance of Mikulicz cells.
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infection due to Klebsiella Rhinoscleromatis in two patients infected with human immunodeficiency virus
Clinical Infectious Diseases, 1993Co-Authors: C Paul, Philippe J Sansonetti, Gilles Pialoux, B Dupont, Jean Fleury, Gustavo Gonzalezcanali, Muriel Eliaszewicz, Thierry GenereauAbstract:Two cases of rhinoscleroma in patients infected with the human immunodeficiency virus (HIV) who had stayed in an area of endemic Klebsiella Rhinoscleromatis are reported. One of the patients presented with oropharyngeal lesions, an unusual clinical picture. Both patients suffered from a major cellular immune deficiency. The importance of Klebsiella Rhinoscleromatis infection in AIDS-related oropharyngeal pathology and the possible treatment of such infection in HIV-positive patients are not yet clearly established.
Melanie W Pound - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of Klebsiella Rhinoscleromatis bacteremia with levofloxacin
Pharmacotherapy, 2007Co-Authors: Melanie W Pound, Kathey B Fulton, Chukwuemeka O ChimaAbstract:A 71-year-old Caucasian woman was admitted to the hospital with right-sided weakness and slurred speech. Glioblastoma multiforme was diagnosed, and resection of the tumor was performed. During the patient's hospitalization, blood and urine cultures were obtained after her temperature rose to 103.3 degrees F. Four blood cultures revealed Klebsiella Rhinoscleromatis sensitive to trimethoprim-sulfamethoxazole, levofloxacin, cefazolin, gentamicin, and tetracycline, but resistant to ampicillin. The patient had no recent history of foreign travel. After a 3-week course with levofloxacin, the patient was afebrile, and repeat blood cultures were negative. To our knowledge, this was the first case of K. Rhinoscleromatis bacteremia in the United States to be treated successfully with levofloxacin.
Jun Hayashi - One of the best experts on this subject based on the ideXlab platform.
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a case of lobar pneumonia and sepsis with death caused by invasive Klebsiella Rhinoscleromatis infection
Journal of Infection and Chemotherapy, 2016Co-Authors: Eri Kumade, Norihiro Furusyo, Norito Takeshima, Yasuhiro Kishihara, Fujiko Mitsumotokaseida, Yoshitaka Etoh, Masayuki Murata, Jun HayashiAbstract:Klebsiella pneumoniae often causes pneumonia and other infections in heavy drinkers and patients with diabetes. Pneumonia caused by Klebsiella Rhinoscleromatis, a subspecies of K. pneumoniae, has not been previously reported. We report a case of pneumonia caused by K. Rhinoscleromatis. A 68-year-old man with type 2 diabetes visited our department complaining fever and fatigue for 10 days and cough and bloody sputum for two days. His Japan Coma Scale score was I-1, body temperature 38.3 °C, blood pressure 85/51 mmHg, pulse 135 bpm, and peripheral capillary oxygen saturation level 92% (room air). He had no abnormal breathing sounds. His white blood cell count had decreased to 2600/μL, and his C-reactive protein level was high, at 35.9 mg/dL. Chest computed tomography revealed lobar pneumonia in the right upper lobe and pneumonia in the left upper division. Klebsiella was suspected based on the result of a sputum smear examination. He was diagnosed with septic shock due to pneumonia and was immediately admitted. Intravenous antibacterial (levofloxacin) treatment was initiated, however, he died 13 h after presenting at the hospital. Subsequently, K. Rhinoscleromatis was detected in sputum and blood culture. Additional testing determined the bacteria to be a highly pathogenic hypermucoviscosity phenotype and the cause of the fatal lobar pneumonia. Although cases of rhinoscleroma and bacteremia caused by K. Rhinoscleromatis infection have been reported, this is the first report of a case with sepsis caused by fulminant pneumonia.
Marco De Vincentiis - One of the best experts on this subject based on the ideXlab platform.
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social geography of rhinoscleroma and qualitatively and quantitatively abnormal cell mediated immunity
Infection Genetics and Evolution, 2018Co-Authors: Massimo Fusconi, Antonio Greco, Carlo Guglielmo Cattaneo, Andrea Ciofalo, Massimo Ralli, Marco De VincentiisAbstract:Abstract Rhinoscleroma is a progressive chronic granulomatous disease of the upper respiratory tract that may extend to the tracheobronchial tract. It is common belief that the pathology is determined by Klebsiella Rhinoscleromatis. In the authors' opinion, the infection with Klebsiella Rhinoscleromatis may not represent the only etiopathogenic factor of the disease. Rhinoscleroma is reported in many countries, but has a peculiar social and geographic distribution, in that it assumes an endemic character only in some regions of the Middle East, West Russia, North Africa, Indonesia, Central and South America. In Europe, most of the cases are reported in Poland, Hungary and Romania. In Italy, Rhinoscleroma is almost exclusively located in the southern and island regions. Rhinoscleroma is predominantly reported in rural areas, in the presence of poor socio-economic conditions, which according to many authors would be a co-factor triggering the disease. In this article, the authors review some inconsistencies in etiology, histology and epidemiology of Rhinoscleroma. Based on the overall picture, they propose that intrinsic factors, possibly of genetic origin, may give rise to the disease, and suggest possible lines of research to distinguish between extrinsic and intrinsic factors as determinants for Rhinoscleroma.
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B Lymphocyte Subsets in Patients with Rhinoscleroma
'SAGE Publications', 2011Co-Authors: Massimo Fusconi, Antonio Greco, Andrea Gallo, Armando De Virgilio, S. Natalizi, Giampietro Zambetti, Marco De VincentiisAbstract:Objective. To identify the presence of B lymphocytes in the rhinoscleroma granulomas as a possible precursor of plasma cells, whose presence has always been described but whose role is still unclear. Study Design. Case series with chart review. Setting. Sapienza University of Rome. Methods. The study was carried out on 6 patients (3 women, 3 men). The following parameters were examined for each patient: clinical manifestations, number of leukocytes, lymphocytes and lymphocyte subsets (CD3+, CD4+, CD8+, and CD19+) in blood samples, time from the onset of symptoms, biopsies, and expression of CD3, CD4, CD8, and CD20 antigens in tissue samples with immunohistochemical techniques. Results. In this study, the values of CD3+, CD4+, and CD8+ T lymphocyte subsets in venous peripheral blood are in line with previously reported data, whereas CD19+ lymphocyte cells tended to show an ambiguous behavioral pattern. In tissue samples, approximately one-third of the T lymphocyte population showed a CD3+/CD8+ immunophenotype (cytotoxic/suppressor), and two-thirds of the T lymphocytes expressed a CD3+/CD4+ immunophenotype (helper/inducer). The authors also identified an unexpected large amount of CD20+ non-plasmacellular B cells in addition to the plasma cells usually detected in rhinoscleroma biopsies. Conclusions. This study demonstrates the presence of B lymphocytes in rhinoscleroma tissue. It is presumable that the mature B cells activated by antigenic stimulation of Klebsiella Rhinoscleromatis are the precursors of the plasma cells typically found in the granuloma of rhinoscleroma
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Modification of lymphocyte subsets in patients with rhinoscleroma.
American journal of otolaryngology, 2006Co-Authors: Massimo Fusconi, Gianna Pulice, Flora Ippoliti, Romina Mastronicola, Giovanni Ralli, Marco De VincentiisAbstract:Abstract Purpose Rhinoscleroma is a rare, chronic, granulomatous disorder of the upper airways. This disease presents some etiopathogenetic aspects that are not yet clear. Infection by Klebsiella Rhinoscleromatis is fundamental for the onset of the disease, but it is impossible to reproduce rhinoscleroma experimentally only via infection with the bacteria both in man and in animals. Furthermore, this disease mainly affects blood-related people and occurs in certain geographic areas. In this context, we present a study that brings to light some of the quantitative abnormalities of the lymphocyte subsets. Materials and methods The study group consisted of 5 patients with rhinoscleroma. The following parameters were studied for each patient: clinical manifestations, histologic examinations, number of leukocytes, lymphocytes, and lymphocyte subsets. Results In all patients, we noted the following: There was a relative reduction of the CD4+ cells, an absolute increase of the CD8+ cells, and an inversion of the CD4+/CD8+ ratio. There was an absolute increase of the CD56+ cells and cytotoxic cells that coexpress CD8+CD56+ antigens. There was a relative reduction of the CD3+ cells, and the CD19+ cells tended to show an ambiguous behavioral pattern. Conclusion We believe that K. Rhinoscleromatis does not play a major role in the etiopathogenesis of rhinoscleroma. However, we do believe that the anomalous behavior of the immune system can favor rhinoscleroma.
Chukwuemeka O Chima - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of Klebsiella Rhinoscleromatis bacteremia with levofloxacin
Pharmacotherapy, 2007Co-Authors: Melanie W Pound, Kathey B Fulton, Chukwuemeka O ChimaAbstract:A 71-year-old Caucasian woman was admitted to the hospital with right-sided weakness and slurred speech. Glioblastoma multiforme was diagnosed, and resection of the tumor was performed. During the patient's hospitalization, blood and urine cultures were obtained after her temperature rose to 103.3 degrees F. Four blood cultures revealed Klebsiella Rhinoscleromatis sensitive to trimethoprim-sulfamethoxazole, levofloxacin, cefazolin, gentamicin, and tetracycline, but resistant to ampicillin. The patient had no recent history of foreign travel. After a 3-week course with levofloxacin, the patient was afebrile, and repeat blood cultures were negative. To our knowledge, this was the first case of K. Rhinoscleromatis bacteremia in the United States to be treated successfully with levofloxacin.