A bifid rib is a congenital abnormality of the rib cage and associated muscles and nerves which occurs in about 1.2% of humans. Bifid ribs occur in up to 8.4% of Samoans. The sternal end of the rib is cleaved into two. It is usually unilateral. Bifid ribs are usually asymptomatic, and are often discovered incidentally by chest X-ray. Effects of this neuroskeletal anomaly can include respiratory difficulties, neurological difficulties, limitations, and limited energy from the stress of needing to compensate for the neurophysiological difficulties. An unstable bifid rib may lead to slipping rib syndrome.Another association is with odontogenic keratocysts of the jaw, which may behave aggressively and have a high propensity to recur when treated with simple enucleation and curettage. When seen together, the patient is likely to have nevoid basal-cell carcinoma syndrome (Gorlin-Goltz syndrome). See also
List of radiographic findings associated with cutaneous conditions


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Neorickettsia helminthoeca is a bacterium in the Neorickettsia genus that causes Salmon poisoning disease. Salmon poisoning disease
Salmon poisoning disease (SPD) is a fatal disease of dogs and other canids caused by a rickettsial bacterium, Neorickettsia helminthoeca. It results from eating raw salmon, trout, or salamander and is common in the Pacific Northwest. These fish and amphibians are infected with the larvae of a fluke, Nanophyetus salmincola through an intermediate host, the snail Oxytrema plicifer. The larvae attaches to the intestine of the dog and the rickettsial bacteria are released, causing severe gastrointestinal disease and systemic infection. Neorickettsia elokominica, carried by the same fluke, causes a similar disease known as Elokomin fluke fever (EFF) in canids, bears, raccoons, and ferrets. Symptoms
Symptoms of SPD begin about one week after eating the salmon and include vomiting, diarrhea, loss of appetite, depression, high fever, and enlarged lymph nodes. Untreated, mortality reaches 90 percent. Death occurs seven to ten days after symptoms begin.EFF has less severe symptoms than SPD, with less gastrointestinal signs and more lymph node involvement. The mortality in untreated cases is about 10 percent.A similar disease has been identified in Brazil. Diagnosis
Diagnosis is through finding the fluke eggs microscopically in a stool sample. A needle aspiration biopsy of an enlarged lymph node will reveal rickettsial organisms within macrophages in many cases. The rickettsial infection can be successfully treated with tetracycline, and the fluke infection can be treated with fenbendazole. == References ==