Browsing by Author "Allen, Stephen D."

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    Cutaneous presentation of progressive disseminated histoplasmosis nine years after renal transplantation
    (Wiley, 2013) Rosado-Odom, Vera M.; Daoud, Jacques; Johnson, Raymond; Allen, Stephen D.; Lockhart, Shawn R.; Iqbal, Naureen; Shieh, Wun-Ju; Zaki, Sherif; Sharfuddin, Asif; Medicine, School of Medicine
    Initial presentation of invasive fungal infections such as histoplasmosis can include non-specific clinical manifestations, especially in immunocompromised patients. A high index of suspicion is required to identify atypical manifestations of these diseases, which carry a high risk of mortality, if the diagnosis is delayed or missed. We describe a case of a kidney transplant recipient with cutaneous lesions as initial manifestation of progressive disseminated histoplasmosis where a skin biopsy was crucial to an early diagnosis.
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    A STUDY OF THE BETA-2 TOXIN GENE AND THE BETA-2 TOXIN IN CLOSTRIDIUM PERFRINGENS STRAINS ISOLATED FROM HUMAN SOURCES
    (2008-10-09T17:36:13Z) Roskens Dalzell, Heidi M.; Allen, Stephen D.
    Clostridium perfringens is an important human pathogen known to cause a range of diseases including diarrhea, necrotizing bowel disease and gas gangrene. Though potentially pathogenic, this microorganism is commonly identified in the fecal microbiota of healthy individuals. The major clinical findings associated with C. perfringens diseases are linked to production of potent toxins. In 1997, Gibert et al. identified a new toxin, the beta2 toxin, from a C. perfringens strain from a piglet with necrotic enteritis. Subsequently, this new beta2 toxin gene (cpb2) has been identified in C. perfringens from dogs, horses, and other animals. The principal objective of this investigation was to study cpb2 and the beta2 toxin in C. perfringens isolates from human sources. The C. perfringens isolates were grouped into three different populations: 1) fecal samples from patients suspected of having C. perfringens gastrointestinal illnesses (e.g. antibiotic-associated diarrhea or colitis), 2) extraintestinal specimen sources (e.g. wounds, abscesses, blood cultures), 3) a control group of isolates from healthy volunteers. Results of studies using different PCR methods and nucleotide sequencing revealed that cpb2 was present in the genome of isolates from all populations, and that the genetic variation between cpb2 from the different C. perfringens isolates was greater then expected. Using western blotting techniques, it was found that the beta2 protein was not expressed by all cpb2 positive C. perfringens isolates. Finally, different variants of cpb2 were cloned into E. coli, and the recombinant beta2 protein used in cell cytotoxicity assays. Results from these assays demonstrated that recombinant beta2 proteins caused a range of cellular damage at different levels of protein concentration and different lengths of time. Our results from these experiments provided new information regarding cpb2 in C. perfringens isolates from human sources; as well as on the range of variation of cpb2 genes, differences in beta2 toxin expression, and differences in the effects of recombinant beta2 toxin on enterocytes. This information could help to explain differences in virulence between C. perfringens isolates, differences in diseases and disease severity.