Category: Ileum mesothelium

Infection of ileum mesothelium: Conclusions

Ileum serosa had a linear band of cells

Numerous calretinin-positive mesothelial cells also had HSV cytopathic atypia and reacted with HSV IHC antibodies (Figure 3). To our knowledge, this was the first documentation of HSV type II infecting the mesothelium. This finding was not surprising because other herpes virus subtypes are known to infect mesothelium. Human herpes virus-8 was identified in mesothelial cells of three of five patients with pleural effusions and Kaposi’s…

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Infection of ileum mesothelium: Discussion (Part 4)

Ileal ulcer bed with herpes simplex virus

HSV colon infection is classically a diffuse colitis with confluent ulceration. Ulcers may be diamond-shaped and most numerous in the sigmoid. Five of the 10 reported ante-mortem cases had a pancolitis. However, in one case, ulcers were described as symmetric and possibly diamond shaped. Other descriptions included aphthoid, punctate, stric-turing and indurated ulceration in one case each. Three of 10 patients had perforating ulcers.

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Infection of ileum mesothelium: Discussion (Part 3)

HSV infection is usually restricted to the anorectum in the homosexual population, but rare examples of fulminant left-sided colitis have been identified. Of the 10 reported cases of HSV enteritis/colitis diagnosed antemortem, seven subjects were immunocompromised or on immunosuppressive therapy. One of the remaining three had type IIb diabetes mellitus as a predisposing condition . One patient had confirmed Epstein-Barr virus pharyngitis and another had…

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Infection of ileum mesothelium: Discussion (Part 2)

substandard immunity

Individuals with substandard immunity (pregnancy and newborns) have a greater propensity for HSV-related illnesses. Anecdotal cases of HSV viremia, proctocolitis and hemorrhagic cystitis have also been described in patients with diabetes mellitus. HSV infection in immunocompetent patients is usually a localized mucocutaneous or neural ganglia disease. However, data suggest that subclinical dissemination may be common. Acute HSV infection of genitalia is associated with a mild…

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Infection of ileum mesothelium: Discussion (Part 1)

Polymerase chain reaction

High power examination of the submucosal ulcer bed delineated rare spindle shaped cells with a ground glass nuclear appearance, circumscribed by a rim of dense chromatin. These cells also had irregular nuclear membranes and were occasionally multinucleated. Similar cytopathic atypia was in the vicinity of the serosa beneath the ulcer. No viral atypia was detected in endothelial cells or mucosal epithelium. Cells with viral cytopathic…

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Infection of ileum mesothelium: Results

Positive HSV sequences are 474 base pairs versus 241 base pairs for VZV . All specimens were also analyzed for genes p27 and p21 to quantitate the DNA and screen for PCR inhibitors. Real-time (light cycler) PCR used DNA extracted from paraffin blocks according to the QIAamp DNA Mini Kit (Qiagen, Canada) recommendations. Extracted DNA was tested on the LightCycler employing the LightCycler HSV xh…

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Infection of ileum mesothelium: Methods IHC (Part 2)


In situ hybridization Dewaxed and dehydrated sections were digested with 100 ^L of pepsin (Carezyme II, Biocare Medical, USA) at 37°C for 5 min. Slides were rinsed in Tris-buffered saline, dehydrated in ethanol and air dried. Ten microlitres to 20 ^L of biotin-labelled HSV type I, HSV type II, CMV and adenovirus probes (ENZOLife Sciences Inc, USA) were placed on slides and cover slipped. The…

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Infection of ileum mesothelium: Methods IHC (Part 1)

Confirmation of HSV overgrowth at the bowel perforation site (by histology, IHC, ISH and PCR) and in bronchial secretions (direct fluorescence antibody) prompted intravenous acyclovir therapy. She defervesced two days later with improvement of hypoxia and the radiological pulmonary infiltrates. At no time were mucocutaneous vesicles identified in oral, genital or perianal sites. A negative lumbar puncture excluded encephalitis. Serology was negative for HIV and…

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Infection of ileum mesothelium: Case presentation (Part 2)


Medications included clopidogrel 75 mg per day, insulin (neutral protamine Hagedorn: 16 U every morning and 14 U every night; Humulin-R [Eli Lilly Canada Inc]: 8 U to 15 U every morning and 8 U to 14 U every night) and losartan 25 mg per day. Her past surgical history was significant for resection of an ovarian fibroma, an iliac vein thrombectomy, caesarian section and…

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Infection of ileum mesothelium: Case presentation (Part 1)

HSV cytopathic atypia and HSV IHC staining was confined to myofibrocytes and mesothelial cells without involvement of epithelium. HSV was isolated in bronchial secretions postoperatively by direct fluorescence antibodies. To our knowledge, this is the first documentation of the distribution of HSV cytopathic changes in the ileum of a patient with symptomatic disseminated HSV infection complicating type I diabetes. Our case portends that disseminated HSV…

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