Listeria Monocytogenes

choi

(f)
(i) There is no animal model for Amniotic Fluid Embolism (AFE). So its cause and pathophysiology is hard to pin down.
(ii) About humans. During pregnancy, fetal cells enter the bloodstream of a mother. Certainly in the midst of childbirth, amniotic fluid 羊水 and fetal blood enter the mother.  But in neither case, we know how much. Also most of the time, nothing bad happens to the mother.
(iii) The current thinking about AFE is as follows. Amniotic fluid that enters maternal bloodstream sometimes somehow triggers vasoconstriction (blood vessels contract in diameter) of blood vessels (hence patient feeling lack of air). The resulting pulmonary hypertension (high blood pressure in LUNGS, but not necessarily in the est of the body)  brings about right-sided heart failure (right ventricle unable to pump blood into lungs). Then left ventricle of the heart can not get blood, causing systemic hypotension. In the second phase, DIC sinks in.
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Lisa Sanders, What Didn't Hurt. He thought he was getting the same stomach bug that his co-worker had. But his symptoms wound up being completely different. New York Times Magazine, Aug 6, 2017.
https://www.nytimes.com/2017/08/ ... s-so-different.html

My comment:
(a) Dr Jennifer Girard of Beth Israel Deaconess Hospital

The French surname Gerard (Girard is a variant) came from the personal name Gerard. The accent is on the second syllable.

(b) Listeria monocytogenes
(i) pronunciation
http://medical-dictionary.thefre ... teria+monocytogenes
(ii) (a facultative anaerobic bacterium, capable of surviving in the presence or absence of oxygen; is one of the most virulent foodborne pathogens; Gram positive, rod-shaped)  en.wikipedia.org
(A) This species of bacteria is ubiquitous.
(B) The genus is named after Joseph Lister (1827 – 1912; an English surgeon).

(c) What you have to know about the symptoms of Listeriosis is that in a normal, healthy person, the description of this NYT article is representative: "Once back [to Boston, Massachusetts -- from Edinburgh], his co-worker, a young woman half his age, developed a horrible stomach illness — lots of pain and diarrhea — that kept her home for the next two days."  Nausea and vomiting, too.

(d) The NYT article continues, "In pregnant women, people over 65 or anyone with an impaired immune system, however, the infection can break out of the digestive tract — sometimes without manifesting the typical symptoms — and get into the bloodstream. From there it can spread like wildfire through the entire body. This form of the infection, called invasive listeriosis, can be fatal up to 30 percent of the time in these patients."
(i) L Monocytogenes enters orally and infect intestinal mucosa. In healthy persons, immunity kicks in and that is. In susceptible persons (mentions above, plus newborns) , the bacterium invades the bloodstream and disseminates.
(ii) The (male) patient in this article is compromised in his immunity, due to the medication (etanercept) to treat Sjogren's syndrome.
(A) Sjögren's syndrome
https://www.merriam-webster.com/medical/Sjögren's%20syndrome
(pronunciation)
(B) The Swedish surname Sjögren consists of sjö sea + gren  (tree) branch.
(iii) etanercept
https://en.wikipedia.org/wiki/Etanercept
("Etanercept is a fusion protein produced by recombinant DNA. It fuses the TNF receptor to the constant end of the IgG1 antibody")

Basically, etanercept mops up (removes) TNF (with its TNF receptor).  
(iv) tumor necrosis factor (TNF, sometimes referred to as TNF alpha) : produced chiefly by activated macrophages; is able to induce fever and inflammation; produced as a transmembrane protein arranged in stable homotrimers (3 identical TNFs bind together). Then the stalks are cut and the soluble trimers are released d free-floating molescules.  

It was thought to kill cancer cells, but the excitement soon dissipated.