Leptospirosis is a zoonotic disease that can cause severe acute kidney injury (AKI) in dogs. A three-year-old intact male Border Collie, unvaccinated against leptospirosis, with a history of exposure to urban stagnant water presented with acute vomiting, diarrhea, and moderate dehydration. Initial evaluation revealed extreme azotemia (blood urea nitrogen, 175.8 mg/dL; creatinine, 11.10 mg/dL) and hyperphosphatemia (13.6 mg/dL), consistent with International Renal Interest Society (IRIS) AKI Grade V; urine output remained within the non-oliguric range (2.15-3.0 mL/kg/h) throughout the catheterized period (Day 0-4). Clinical and imaging findings supported acute intrinsic renal injury over chronic kidney disease. A multiplex real-time PCR targeting the Leptospira LipL32 gene was positive in urine (Ct 31.10), providing molecular evidence supporting active infection or shedding of pathogenic Leptospira spp., without identifying the infecting serovar. Empirical antimicrobial therapy targeting suspected leptospirosis, together with intravenous fluid therapy, was initiated on clinical suspicion prior to the PCR result. Renal and inflammatory biomarkers improved progressively over 22 days without extracorporeal kidney support; the patient's non-oliguric status, hemodynamic stability, and objective clinical improvement supported this management approach. This report documents, in detail, the clinicopathological recovery trajectory of a dog with non-oliguric IRIS Grade V AKI associated with suspected leptospirosis, information that may assist clinicians in recognizing and managing similarly severe presentations without assuming that dialysis is always required.

Rapid and accurate identification of enteric pathogens is essential for the management of acute infectious diarrhoeal diseases. Multiplex PCR panels have emerged as first-line screening tools to conventional stool culture by providing broad pathogen coverage and shorter turnaround times. This study evaluated the diagnostic performance of the Cepheid Xpert gastrointestinal (GI) research-use-only (RUO) panel in routine clinical practice across multiple European centres. A multicentre study was conducted in four hospitals across France, Germany and Italy. Stool specimens collected as part of routine care were tested using local standard-of-care (SoC) methods, including conventional stool culture, BDMax[®] Enteric Panels, or BioFire FilmArray[®] GI Panel, and subsequently analysed using the Cepheid Xpert GI RUO panel. A total of 11 bacterial, viral and parasitic enteropathogens were targeted. Discordant results underwent additional testing, and a consensus result based on a two-out-of-three agreement rule was used as the reference standard. Diagnostic performance metrics, agreement with SoC methods, microbiological findings and turnaround times were assessed. Of 508 samples, 115 (22.6%) were identified as positive for at least one pathogen according to the consensus result, including 12 samples with co-detection of more than one pathogen (10.4% of positive samples), resulting in a total of 128 pathogens detected. The most frequently detected pathogens were Campylobacter spp. (37 specimens), Norovirus (26 specimens), and Salmonella spp. (25 specimens). Compared with the consensus reference standard, Xpert achieved an overall sensitivity of 98% (95% CI: 94-100%), specificity of 100% (95% CI: 100-100%), positive predictive value of 95% (95% CI: 90-98%), and negative predictive value of 100% (95% CI: 100-100%). Sensitivity was ≥95% and specificity ≥99% for all evaluable targets. Agreement with routine diagnostic methods was high, with overall positive and negative percent agreements exceeding 90% and a Cohen's kappa coefficient of 0.91. Median analytical turnaround time was 1 h 18 min for Xpert, compared with 3 h for BDMax, 1 h 15 min for BioFire and 48 h for conventional stool culture. The Cepheid Xpert GI (RUO) panel provided highly accurate detection of enteric pathogens across heterogeneous European diagnostic settings and reduced turnaround time by more than 95% compared with conventional stool culture. A future IVD version of this test could provide rapid and accurate detection of enteric pathogens for potential routine management of patients with suspected acute infectious gastroenteritis.

A previously healthy 23-year-old woman presented with acute diarrhea, abdominal pain, and bloody mucoid stool following raw beef consumption, with a fever of 37.8 °C. On admission, her vital signs were unremarkable. Blood tests revealed elevated C-reactive protein, hypokalemia, and hypoproteinemia. Abdominal ultrasonography clearly demonstrated severe right-sided colitis characterized by marked circumferential bowel-wall thickening (~2 cm), loss of normal wall stratification, and continuous involvement from the ascending to proximal transverse colon. To avoid unnecessary radiation exposure in this young, clinically stable patient, computed tomography (CT) was omitted. Stool culture yielded enterohemorrhagic Escherichia coli (EHEC) O157 and Campylobacter jejuni. While ultrasonography effectively delineated the severity and continuous extent of colitis, imaging alone could not differentiate between these pathogens or identify the concurrent coinfection. Furthermore, this dual infection presented a major therapeutic challenge: guidelines suggest macrolides for severe Campylobacter enteritis, but antimicrobials are strictly discouraged in EHEC O157 infection due to the risk of hemolytic uremic syndrome (HUS). Managed conservatively with fluid replacement and probiotics without antimicrobial therapy, she recovered uneventfully and was discharged on hospital day 9. This case highlights the primary diagnostic utility and safety of ultrasonography in evaluating acute right-sided colitis and underscores the importance of cautious supportive care when navigating conflicting therapeutic guidelines in rare gastrointestinal coinfections.

The goat industry is a pivotal livestock sector in China, but bacterial diseases severely restrict its sustainable development and production efficiency. Antibiotic overuse in goat farming causes adverse effects and food safety risks, highlighting the urgent need for safe and effective antibacterial functional feed additives. Bile acids are endogenous cholesterol metabolites with hepatoprotective, antioxidative, and intestinal barrier-enhancing functions. They directly inhibit pathogenic Escherichia coli by disrupting bacterial membrane structure and indirectly suppress pathogen colonization via regulating intestinal microflora. Clostridium butyricum maintains intestinal microecological balance, inhibits pathogens by secreting butyric acid to increase intestinal acidity, and promotes intestinal epithelial repair and tight junction protein expression, thereby alleviating -induced intestinal injury, diarrhea and inflammation. Goat bile acid and C. butyricum shows great potential against E. coli-induced diarrhea. Goat bile acid directly suppresses pathogens, while C. butyricum repairs intestinal homeostasis. Their combination provides a comprehensive strategy covering acute pathogen control and long-term mucosal recovery, serving as a promising biological alternative to reduce or replace antibiotics, especially for antibiotic-associated dysbiosis and antimicrobial resistance. This study first established an E. coli-infected mouse model to determine optimal modeling and therapeutic doses. Results showed that 200 mg/kg goat bile acid plus 0.1 g/kg C. butyricum freeze-dried powder significantly alleviated infection-induced damage. A diarrheal goat kid model was further developed, and the combination of a dose of 1.0 g of goat bile acid per kid and a dose of 5.0 g of C. butyricum per kid powder enhanced antioxidant capacity, reduced intestinal inflammation, improved jejunal structure, strengthened intestinal barrier and increased microbiota diversity in goat kids. Consistent beneficial effects were observed in both models. The combination improved jejunal morphology, upregulated mRNA expression of tight junction proteins ZO-1, Occludin and Claudin-1, decreased malondialdehyde content and enhanced superoxide dismutase activity in the liver, jejunum and serum. It also upregulated anti-inflammatory cytokines IL-4 and IL-10, and downregulated pro-inflammatory cytokines IL-1β and TNF-α, with better efficacy than goat bile acid alone.This study confirms that dietary supplementation with goat bile acid and C. butyricum effectively protects goat kids against E. coli infection, providing a practical approach for ruminant health management and helping reduce antibiotic dependence in commercial goat farming.

Diarrhea is an acute disease of cattle that has been extensively studied in calves; however, it has been far less investigated in adult cattle, despite its significant impact on milk production and animal health. In this study, we investigated an outbreak in a dairy herd in Uruguay for which initial diagnostic testing for the main known pathogens yielded negative results. Therefore, the outbreak was further investigated in depth using shotgun metagenomic sequencing, molecular virology assays and viral isolation. Of the three fecal samples from affected cows that were submitted for diagnostic testing and were negative for the main enteric pathogens, including BCoV, two were positive for bovine torovirus (BToV) by RT-qPCR. Next-generation sequencing-based virome analysis revealed over 3,300 viral operational taxonomic units (vOTUs), predominantly bacteriophages, but also eukaryotic viruses from 11 families. The complete genome of BToV was obtained and a putative novel protoparvovirus species was characterized. In addition, two distinct enteroviruses belonging to the species Enterovirus fitauri and Enterovirus idromi were identified. Notably, Enterovirus idromi had previously been reported exclusively in dromedaries; its detection in cattle expands the known host range of this species. Furthermore, the Enterovirus idromi strain appears to represent an interspecies recombinant enterovirus. These results highlight the importance of emerging approaches such as next-generation sequencing for identifying novel pathogens in cattle diseases and may serve as a basis for evaluating their potential role in disease pathogenesis, as well as for incorporating them into routine initial diagnostic testing.

Immune effector cell (IEC) therapies using chimeric antigen receptor T cells (CAR-T) targeting B-cell maturation antigen or CD19 are FDA-approved treatments for refractory B -cell lymphoma, B-lymphoblastic leukemia, and multiple myeloma. Increasing evidence has suggested that these therapies can induce gastrointestinal injury, but the clinicopathologic spectrum and its association with clonal T-cell proliferation remain poorly defined. We retrospectively analyzed 42 GI biopsy specimens from 11 CAR-T-treated patients (8 with multiple myeloma, 2 diffuse large B-cell lymphoma, 1 acute B-lymphoblastic leukemia), comprising 4 women and 7 men (median age 68 years), with diarrhea as the predominant symptom (94%), arising at a median 4.9 months post CAR-T. Histologic evaluation, particularly of the duodenum, revealed a distinctive four-component composite histologic signature, termed a "CVID-peptic-celiac-autoimmune enteropathy-like" enteritis, characterized by plasma cell paucity (CVID-like), gastric foveolar metaplasia and Brunner gland hyperplasia (peptic duodenitis-like), intraepithelial lymphocytosis (celiac-like), and goblet cell loss with villous blunting and increased crypt epithelial apoptosis (autoimmune enteropathy-like), accompanied with atypical lamina propria lymphoid infiltrates. Those changes were most prominent in the duodenum and jejunum, less so in the ileum, and were generally mild to absent in the stomach, colon, and esophagus. Integration of histology with T-cell clonality analysis stratified the cases into two groups: the not tested/likely non-clonal group (n = 6) showed limited histologic features with isolated CVID-, peptic-, and/or autoimmune enteropathy-like changes, milder, transient symptoms, and favorable outcomes. The clonal group (n = 5) demonstrated more severe enteritis with a full composite CVID-peptic-celiac-autoimmune enteropathy-like enteritis, persistent symptoms, repeat biopsies, and higher mortality (40%). Our findings suggest a spectrum of histopathologic features of IEC-associated enteritis, characterized by a composite histologic signature that may progress to atypical lymphocytosis, often in association with clonal T-cell expansion. Recognition of this histologic pattern and incorporation of clonality testing may aid in diagnosis, risk stratification, and prognostication.

Arthritis is a recognised extraintestinal manifestation of inflammatory bowel disease and can rarely precede gastrointestinal recognition, mimicking septic arthritis. Communication barriers in patients with learning disabilities may obscure systemic symptoms.A man in his early 30s with a mild learning disability presented with acute left-knee pain, swelling, erythema and fevers with concurrent low-back and hip pain. Arthrocentesis yielded turbid fluid with a white blood cell count (WBC) of 20.4×10[9]/L (93% neutrophils); Gram stain, crystals and cultures (including gonococcal testing) were negative. CT abdomen/pelvis showed mild colonic wall thickening suggestive of colitis. He received empiric antibiotics, but synovial and blood cultures remained negative. A repeat, simplified interview with collateral history uncovered a year of intermittent diarrhoea. Colonoscopy and biopsy findings were compatible with Crohn's disease. Antibiotics were stopped and prednisone plus methotrexate, then infliximab, led to clinical and laboratory improvement with no active bowel inflammation on follow-up MR enterography.