A free-range wild raccoon dog (Nyctereutes procyonoides) was rescued with cachexia. Physical examination revealed generalized hyperkeratosis and alopecia typical of scabies as well as hypothermia (35.6°C). The patient was obtunded and severely dehydrated (10%). Hematological parameters included a low packed cell volume (PCV; 15%) and hemoglobin concentration, leukocytosis, and hypoglycemia. A blood smear revealed different subtypes of hypochromic leptocytes, indicating a regenerative response against severe anemia. This case was initially tentatively diagnosed as a severe anemia due to chronic external bleeding presumed to be caused by scabies-induced skin injuries. Darbepoetin alpha (DPO), iron dextran, and fluralaner were administered at the initial presentation, and supportive care including oxygen supplementation, warming, and nutritional support was provided. However, on day 5, the PCV dropped to 5.9% presumably caused by rapid rehydration due to drinking water ad libitum. DPO was boosted on days 5 and 6 along with daily iron dextran. On day 21, the PCV had recovered to 19.8%, and a blood smear evaluation showed a strong regenerative response. This case shows that even if severe anemia occurs in a raccoon dog, it can be managed with an appropriate response. In particular, since the rehydration rate due to food intake is faster than the hematopoietic response rate of raccoon dogs, the PCV may decrease rapidly in the early stage of treatment; therefore, diagnostic examination and additional medical management for hematopoiesis are necessary.

Myiasis is an infestation of maggot, which is frequently associated with poor personal hygiene and environmental sanitation. A 78-year-old female breast cancer patient visited clinic complaining of irritation, itching, and pain within the ulcerous cancer lesion for 3 weeks. Many maggots were found in the lesion. A total of 30 maggots were removed and identified to be 3rd stage of larvae of metallic fly. This is the first case of wound myiasis in advanced breast carcinoma as a complication of untreated or drug-induced ulcer.

BACKGROUND: More than 140 million people drink arsenic-contaminated groundwater. It is unknown how much arsenic exposure is necessary to cause neurological impairment. Here, we evaluate the relationship between neurological impairments and the arsenic concentration in drinking water (ACDW). PARTICIPANTS AND METHODS: A cross-sectional study design was employed. We performed medical examinations of 1867 residents in seven villages in the Thabaung township in Myanmar. Medical examinations consisted of interviews regarding subjective neurological symptoms and objective neurological examinations of sensory disturbances. For subjective neurological symptoms, we ascertained the presence or absence of defects in smell, vision, taste, and hearing; the feeling of weakness; and chronic numbness or pain. For objective sensory disturbances, we examined defects in pain sensation, vibration sensation, and two-point discrimination. We analyzed the relationship between the subjective symptoms, objective sensory disturbances, and ACDW. RESULTS: Residents with ACDW ≥ 10 parts per billion (ppb) had experienced a "feeling of weakness" and "chronic numbness or pain" significantly more often than those with ACDW < 10 ppb. Residents with ACDW ≥ 50 ppb had three types of sensory disturbances significantly more often than those with ACDW < 50 ppb. In children, there was no significant association between symptoms or signs and ACDW. CONCLUSION Subjective symptoms, probably due to peripheral neuropathy, occurred at very low ACDW (around 10 ppb). Objective peripheral nerve disturbances of both small and large fibers occurred at low ACDW (> 50 ppb). These data suggest a threshold for the occurrence of peripheral neuropathy due to arsenic exposure, and indicate that the arsenic concentration in drinking water should be less than 10 ppb to ensure human health.
Adolescent ; Adult ; Arsenic ; analysis ; toxicity ; Cross-Sectional Studies ; Dietary Exposure ; adverse effects ; Dose-Response Relationship, Drug ; Drinking Water ; adverse effects ; chemistry ; Female ; Groundwater ; chemistry ; Humans ; Male ; Middle Aged ; Myanmar ; epidemiology ; Peripheral Nervous System Diseases ; chemically induced ; epidemiology ; physiopathology ; Sensation Disorders ; chemically induced ; epidemiology ; physiopathology ; Water Pollutants, Chemical ; analysis ; toxicity ; Young Adult