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B Nachmias, E Orenbuch-Harroch, C Makranz, H Nechusthan, R Eliahou, D Ben-Yehuda, A Lossos
Listeria monocytogenes is a gram-positive bacterium with a predilection to infect the central nervous system, often affecting immunocompromised or elderly patients. The most common manifestations are meningitis and rhomboencephalitis. We report two cases of Listeria meningitis complicated by acute hydrocephalus several days after presentation and we further review the literature of similar cases. We conclude that acute hydrocephalus is a significant, not often recognized, complication of Listeria meningitis, usually occurring several days from onset when coverage did not include anti-Listeria antimicrobials...
2018: IDCases
Adarsh Barwad, Shamresh Kumar Singh, Ravi Phulware
Filariasis is a global health problem and is a major social and economical burden in tropical countries in Asia, Africa and few of the South American countries [1,2]. In india, filariasis endemic in number of states including Bihar, Kerala, Uttar Pradesh, Andhra Pradesh and Tamil Nadu is found chiefly along the banks of rivers and sea coastal areas. We present a case of 28 year female patient who presented with lump in her left breast for three months and was not associated with pain or discharge from nipple...
2018: IDCases
Tyler D Oostra, Lynn R Schoenfield, Thomas F Mauger
A 45-year-old female with history of contact lens wear presented with a persistent corneal ulcer that was unresponsive to topical moxifloxacin. The patient's exam was concerning for fungal keratitis. Cultures were obtained, and the patient was started on fortified amphotericin B drops and oral voriconazole. The cultures identified Candida dubliniensis as the causative organism. The patient's exam worsened despite treatment, and the decision was made for surgery. At the time of surgery, her cornea was found to have unexpectedly perforated...
2018: IDCases
Alena Janda, Mather R D Jogendra
Daptomycin is a lipopeptide antimicrobial used to treat gram positive organisms including multi-drug resistant infections. It has been shown to occasionally cause abnormalities in liver function but more commonly is associated with elevations in serum creatinine phosphokinase (CK) (Hair and Keam, 2007) [1]. We describe a case where a patient being treated for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia with daptomycin developed asymptomatic elevated transaminases without evidence of multiorgan failure, hyperbilirubinemia or elevation of CK levels...
2018: IDCases
Thomas Lofaro, Aritra Saha, Kavita Raj, Richard Dillon
Patients with haematological malignancy are often profoundly immune suppressed, and more so if they require more than one line of therapy. Infection should always be considered when they become unwell. We discuss the differential diagnoses of a young man with multiply-relapsed Philadelphia chromosome-positive B-cell acute lymphoblastic leukaemia who presented with neurological symptoms and cerebrospinal fluid lymphocytosis. The diagnostic approach needs to be rapid and structured, and may require microbiology and neurology support...
2018: IDCases
Sarah Nangle, Subhashis Mitra, Steven Roskos, Daniel Havlichek
Cytomegalovirus (CMV) infection in immunocompetent patients generally resolves with few sequelae. However, it can cause severe and relapsing symptoms that can last for several weeks. Due to the self-limiting nature of CMV disease in immunocompetent individuals, criteria for specific antiviral therapy in this cohort are not well established. Additionally the adverse effect profile of currently available anti-CMV therapy limits its use in specific patient populations .We describe 3 immunocompetent adults who developed symptomatic CMV infection and were ill for several weeks...
2018: IDCases
Abu-Sayeef Mirza, Vivian Vega Rodriguez
[This corrects the article DOI: 10.1016/j.idcr.2018.03.020.].
2018: IDCases
Cátia Dias, Filipa Duarte-Ribeiro, Sara Pipa, Ana Rita Barbosa, Margarida Mota, Fernando Rosas Vieira
The newer oral treatments for chronic hepatitis C virus infection are one of the greatest revolutions in modern medicine. These drugs promise to eradicate the infection, showing high cure rates even in difficult to treat populations with very few side effects. Nevertheless, some cases of recurrence and de novo hepatocellular carcinoma after treatment with these drugs have been reported. We describe two cases of patients treated with direct-acting antiviral agents that developed hepatocarcinoma during follow-up post-treatment...
2018: IDCases
Hiroshi Sugimoto, Keitaro Furukawa
A clinical case is presented here of a patient with fever and ear pain. Physical examination revealed "Milian's ear sign", which supports the diagnosis of erysipelas rather than cellulitis. After intravenous antibacterial treatment, the patient recovered.
2018: IDCases
Cátia Dias, Sara Pipa, Margarida Mota
The diagnosis of acute hepatitis C (HCV) infection is rare since the majority of cases are asymptomatic, which makes the infection usually detected in a chronic phase, most of the time using serological tests. The main route of HCV transmission is percutaneous, with sexual transmission occurring more often in men who have sex with men. The analytical alterations of acute hepatitis C are varied but usually present with ALT elevation higher than AST, very rarely with hepatic insufficiency. We report a case of a patient with a clinical and analytical picture compatible with toxic acute hepatitis, accompanied by hepatic insufficiency, with negative serology for hepatotropic viruses and with no history compatible with the use of substances with hepatic toxicity other than alcohol...
2018: IDCases
Celina Gonçalves, Ana Cipriano, Fábio Videira Santos, Miguel Abreu, Josefina Méndez, Rui Sarmento E Castro
Introduction: Cytomegalovirus (CMV) infection in healthy adults is usually asymptomatic or causes a mild mononucleosis syndrome, while severe infections are rare in immunocompetent patients and poorly documented. When described, gastrointestinal tract and the central nervous systems are the most frequent sites of severe CMV infection. Lung disease can occur, but it's rare. Clinical case: A 29 years old man presenting with a 2-weeks history of fever, headache, malaise, dry non-productive cough and thoracic pleuritic pain, without improvement after one-week therapy with levofloxacin...
2018: IDCases
Kida Yohei, Oiwa Takehiro, Deguchi Ryusuke
A 61-year-old woman was evaluated because of 2 days of anuria, fever, anorexia, and progressive decline in mental status. On admission, she appeared confused with a GCS score of E2V2M4, and her blood ammonia level was elevated (176 μg/dL). Abdominal computed tomography showed bilateral hydronephrosis and bladder fullness with wall thickness in spite of indwelling bladder catheter. Her catheter was obstructed by blood clot. Blood cultures, blood clot culture, and one urine culture all yielded Proteus mirabilis ...
2018: IDCases
Sarah Khan, Jolie Guevara, Ana Barbosa, Awista Ayuby, Fred Bien-Aime, Larissa Verda, Nancy Glick, Vikas Mehta
AIDS-related Kaposi sarcoma (KS) is a vascular malignancy that usually presents with mucocutaneous lesions. Bronchopulmonary involvement as an initial manifestation is a rare phenomenon. This case describes a young male presenting with pulmonary symptoms mimicking HIV-related opportunistic infection who was eventually diagnosed with primary pulmonary KS. The aim of this report is to emphasize that KS should be recognized as a differential diagnosis in AIDS patients presenting with pulmonary symptoms. Making the diagnosis may be a difficult task, at times, requiring invasive procedures such as lung biopsy...
2018: IDCases
C Delwaide, P De Leeuw, A François, P Beckers, V Hennaux, Ph Lefèvre
Chronic meningococcemia is an uncommon disorder, representing a diagnostic challenge. Classically, this pathology would be considered in young adults with a history of episodes of fever, disseminated cutaneous vasculitis and arthralgia. Exact and rapid diagnosis is often further challenged by the fact that routine microbiological investigations frequently failed to identify incriminated micro-organism, Neisseria meningitidis . Here we present the case of a young man not presenting with the classical triad.
2018: IDCases
Forat Lutfi, Arpan Patel, Dawn Becker, Mohammad Shahid, Kairav Shah
A 51-year-old previously healthy woman presenting with two-weeks of fever, flu-like symptoms, jaundice, and abdominal pain was found to have pancytopenia, transaminitis, and significantly elevated ferritin in the setting of an Epstein-Barr Virus (EBV) infection. Bone marrow biopsy revealed phagocytic macrophages consistent with findings of hemophagocytic lymphohistiocytosis (HLH). Given bone marrow findings and that the patient had five of the eight clinical criteria supporting the diagnosis of HLH, chemotherapy was initiated as per the HLH-94 protocol with initial improvement in patient's symptoms and overall functional status...
2018: IDCases
Tejus Pradeep, Rahul Bhoite, Lisa Rooper, Jiaying Zhang
We present the second confirmed report of HSV laryngitis in an adult stroke patient, resulting in complicated airway management issues. This rare presentation of laryngeal HSV in a stroke patient can interfere with speech, language, and swallowing functions and confounds the etiology of these issues, which can impact subsequent management.
2018: IDCases
Carly Sedlock, Mindy Tokarczyk, Mitchell Sternlieb, Phyllis Flomenberg
Since its identification as a unique species in 1982, Escherichia hermannii has been implicated as a pathogenic organism in very few cases of human disease. Our report discusses a case of bacteremia with Escherichia hermannii identified by Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and RapID™ ONE analysis in a patient getting TPN through a peripherally-inserted CVC (PICC). The PICC was removed. The bloodstream infection was successfully treated with empiric piperacillin-tazobactam, which was then narrowed to trimethoprim-sulfamethoxazole based on sensitivity data for a 14 day course of antimicrobial therapy...
2018: IDCases
Martin Gnoni, Kamran Zaheer, Melinda M Vasser, Monider Singh, Aman Ajmeri, Stephanie R Harter, Abdul Mughees Rana, Rodrigo Aguilar
Varicella Zoster when described has the typical presentation of a dermatomal distribution of a rash and can further lead to CNS complications. This can be treated accordingly with the proper protocol, but if the presentation is atypical and the protocol is challenged or changed per specific patient outcomes, new developments can occur. Here we present a case of a 29-year-old Caucasian female that presented to the emergency department with headache, photophobia, and chills for 5 days. She was previously healthy and immunocompetent; CSF PCR analysis revealed a VZV infection causing acute aseptic meningitis with no shingles rash eruption on physical examination...
2018: IDCases
Preudtipong Noopetch, Teerada Ponpinit, Chusana Suankratay
Bartonella is among the most common causes of culture-negative infective endocarditis, with B. henselae being one of the most frequently reported species. The clinical presentation of Bartonella endocarditis is similar to that of subacute bacterial endocarditis caused by other bacteria and the diagnosis can be challenging since the organism is difficult to isolate using standard microbiologic culture techniques. In clinical practice, Bartonella endocarditis is usually diagnosed based on serology. To date, only a handful of cases of infective endocarditis caused by Bartonella have been reported in Thailand...
2018: IDCases
S S B Naqvi, V Nagendra, A Hofmeyr
Lactobacilli are commensals in the gastrointestinal and genitourinary tracts and considered as having low pathogenicity. Many species including Lactobacillus rhamnosus are now available as probiotics and their use has widely increased in recent years. Lactobacilli have the propensity to cause invasive infections such as bacteraemia and endocarditis predominantly in an immunocompromised host. We report a case of fatal Lactobacillus rhamnosus endocarditis involving a young patient with a history of complicated cirrhosis and prior Clostridium difficile colitis; and present a literature review and discussion of the possible association of systemic infection with 'probiotic' formulations containing lactobacilli...
2018: IDCases
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