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Yasmina Rhofir, Rachida Zahraoui, Nabil Tiress, Hicham Naji-Amrani, Mouna Soualhi, Jamal Eddine Bourkadi
Nocardiosis is a rare but severe infection caused by bacteria of the genus nocardia, which belong to the order actinomycetales. If they can affect immunocompetent adult, nocardioses are pathologies affecting the individuals with weakened immune system. Pulmonary involvement is the most common manifestation, its correct management is based on diagnosis, which is often delayed due to non-specific symptoms and inconclusive specimens. We here report two cases of nocardiosis in immunocompetent patients. The first case concerns a 24-year old man with a history of smoking and alcoholism, hospitalized for chest pain and hemoptysis of low abundance evolving for two months, associated with the occurrence of dorsal subcutaneous fistulized abscess...
2017: Pan African Medical Journal
Justin Arockiaraj, Rajiv Karthik, Veena Jeyaraj, Rohit Amritanand, Venkatesh Krishnan, Kenny Samuel David, Gabriel David Sundararaj
STUDY DESIGN: Retrospective clinical analysis. PURPOSE: To delineate the clinical presentation of melioidosis in the spine and to create awareness among healthcare professionals, particularly spine surgeons, regarding the diagnosis and treatment of melioidotic spondylitis. OVERVIEW OF LITERATURE: Melioidosis is an emerging disease, particularly in developing countries, associated with a high mortality rate. Its causative pathogen, Burkholderia pseudomallei, has been labeled as a bio-terrorism agent...
December 2016: Asian Spine Journal
Hans Mouser, Frank H Miller, Senta M Berggruen
History A 35-year-old man from the upper Midwest region of the United States who had no relevant medical history initially presented to an acute care clinic with multiple small tender skin lesions. His temperature was 38.1°C, and physical examination revealed several small fluctuant masses that were draining purulent material. Skin culture of one of the draining lesions was performed at this time, but there was no subsequent bacterial growth. A diagnosis of furunculosis was made, and Bactrim (sulfamethoxazole-trimethoprim; AR Scientific, Philadelphia, Pa) and a regimen of chlorhexidine washes were prescribed...
September 2016: Radiology
Laura J Avino, Shane M Naylor, Andrew M Roecker
OBJECTIVE: Summarize data on the pathophysiology, treatment, and prevention options for non-AIDS immunocompromised patients who have Pneumocystis jirovecii pneumonia (PJP); review the epidemiology of patients presenting with PJP; and discuss the first and second-line pharmacological options for treatment and prophylaxis of PJP in this population. DATA SOURCES: MEDLINE (1989-February 2016) searched. Terms searched included combinations of Pneumocystis jirovecii, Pneumocystis carinii, non-HIV, infected, patients, prevention, prophylaxis, Bactrim, treatment, AIDS, opportunistic, immunocompromised, cancer, and pathophysiology STUDY SELECTION AND DATA EXTRACTION: Articles included had the most relevant information on PJP pathophysiology, and first-/second-line treatment and prophylactic options...
August 2016: Annals of Pharmacotherapy
Tariq Yousuf, Jason Kramer, Adam Kopiec, Brody Jones, Joy Iskandar, Khansa Ahmad, Hesam Keshmiri, Muhyaldeen Dia
Post-transplant immunosuppression is necessary to prevent organ rejection. Immunosuppression itself can introduce complications arising from opportunistic infections. We present a case of disseminated blastomycosis manifested only as a skin lesion in an asymptomatic patient post-orthotopic heart transplantation. A 64-year-old female who had recently undergone orthotopic heart transplant for end-stage ischemic cardiomyopathy presented for a scheduled routine cardiac biopsy. The patient had no current complaints other than a crusted plaque noticed at her nasal tip...
February 2016: Journal of Clinical Medicine Research
A Giordano, M Cohen-Salmon, B Joly, C Maffiolo
INTRODUCTION: Nocardia sinusitis is exceptional, as a Medline search revealed only one published case. The authors report a case of sphenoid sinusitis complicated by infratemporal fossa abscess, which raised several diagnostic problems. CASE REPORT: The patient was referred with temporal headache, subacute trigeminal neuralgia and subsequent infectious syndrome. Computed tomography imaging revealed left sphenoid sinusitis with osteolysis and infratemporal fossa abscess, as well as suspicious lung nodules suggestive of the initial site of infection...
April 2016: European Annals of Otorhinolaryngology, Head and Neck Diseases
Santosh Keshipeddy, Stephanie M Reeve, Amy C Anderson, Dennis L Wright
While antifolates such as Bactrim (trimethoprim-sulfamethoxazole; TMP-SMX) continue to play an important role in treating community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA), resistance-conferring mutations, specifically F98Y of dihydrofolate reductase (DHFR), have arisen and compromise continued use. In an attempt to extend the lifetime of this important class, we have developed a class of propargyl-linked antifolates (PLAs) that exhibit potent inhibition of the enzyme and bacterial strains...
July 22, 2015: Journal of the American Chemical Society
Rory M Murphy, Belal Bakir, Colm O'Brien, Janey L Wiggs, Louis R Pasquale
PURPOSE: We performed a literature synthesis to identify the full spectrum of compounds implicated in drug-induced, bilateral secondary angle-closure glaucoma (2° ACG). METHODS: Systematic PubMed literature review identified relevant bilateral 2° ACG case reports. We evaluated these reports with both the Naranjo adverse drug reaction probability scale to assess the causality of reported drug reactions and a 2° ACG scale scoring system we developed to determine the likelihood that the event represented bilateral 2° ACG...
February 2016: Journal of Glaucoma
Cristos Ifantides, Oscar R Batlle, David Mushatt, Ramesh S Ayyala
PURPOSE: To report the first documented case of Nocardia exalbida blebitis. METHODS: A 57-year-old immunocompetent African American man with a long-standing history of open-angle glaucoma in both eyes treated with trabeculectomy presented with a diffusely hyperemic, thin, cystic, leaky bleb with no discharge in his left eye. The patient underwent bleb revision using an amniotic membrane patch graft followed by 1 month of antibiotics. He presented second time with an inflamed eye and brisk leakage and underwent a second bleb revision...
April 2015: Journal of Glaucoma
Nieves Perdigones, Mariela Morales, Philip Mason, Monica Bessler
We describe a case of paroxysmal nocturnal hemoglobinuria (PNH) in a woman who is heterozygous for the glucose-6-phosphate dehydrogenase A-   ( G6PDA-) allele. PNH is associated with one or more clones of cells that lack complement inhibition due to loss of function somatic mutations in the PIGA gene.  PIGA encodes the enzyme phosphatidylinositol glycan anchor biosynthesis, class A, which catalyses the first step of glycosylphosphatidylinisotol ( GPI)  anchor synthesis. Two GPI anchored red cell surface antigens regulate complement lysis...
2014: F1000Research
Jianbin Shen, Kevin O'Keefe, Lisa B Webb, Angela DeGirolamo
BACKGROUND: Acute porphyria and Arnold Chiari malformation are both uncommon genetic disorders without known association. The insidious onset, non-specific clinical manifestations, and precipitating factors often cause diagnosis of acute porphyria to be missed, particularly in patients with comorbidities. CASE REPORT: A women with Arnold Chiari malformation type II who was treated with oxybutynin and antibiotics, including Bactrim for neurogenic bladder and recurrent urinary tract infection, presented with non-specific abdominal pain, constipation, and diarrhea...
2015: American Journal of Case Reports
Johanna Lee Wickemeyer, Sudhir Sekhsaria
INTRODUCTION: Immunodeficiency can occur both in patients undergoing radiation therapy, as well as in patients who have had thymectomies. However, few studies have examined the immune recovery of a patient following both procedures. We aim to emphasize the need for assessment and consistent monitoring of patients with thymoma prior to and after combined treatment of thymectomy and radiation, both of which are likely to result in an increased risk for immunodeficiency. CASE PRESENTATION: We describe the longitudinal progress of a 59-year-old Asian male who underwent thymectomy followed by radiation therapy and subsequently presented with generalized urticaria...
2014: Journal of Medical Case Reports
Nibal Saad, Pornchai Leelasinjaroen, Eguakhide Inegbenebor
SESSION TITLE: ILD Student/Resident Case Report PostersSESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Pulmonary alveolar proteinosis (PAP) is a diffuse lung disease characterized by the accumulation of amorphous, periodic acid-Schiff (PAS)-positive lipoproteinaceous material in the distal airspaces, with preserved lung architecture and no lung inflammation. Three forms of PAP are recognized: congenital, secondary, and acquired form...
October 1, 2014: Chest
Maan Moualla, Ali Saeed
SESSION TITLE: Infectious Disease Student/Resident Case Report Posters IISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Immunosuppressive therapy in transplant patient can increase sensibility and incidence of Pneumocystis Jiroveci infection usually seen with HIV. Bronchoscopy plays an important role in diagnosing Pneumocystis Jiroveci pneumonia. Pneumocystis Jiroveci in mediastinal lymph node using endobronchial ultrasound has never been reported...
October 1, 2014: Chest
Samer AlSamman, Christopher Hayner, Stephen Blatt
Infectious Disease Student/Resident Case Report Posters ISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Nocardiosis is a bacterial infection caused by gram positive aerobic actinomycetes. Diagnosing Nocardiosis can be challenging and easily missed because of disease rarity, diversity of presentations, and inadequacy of specimens obtained by non-invasive means.CASE PRESENTATION: A 64 year old man presented with an episode of seizures...
October 1, 2014: Chest
E K Foster, C R Bandawe
INTRODUCTION: This qualitative and quantitative exploratory study was conducted to assess patients'/customers' knowledge, beliefs and practices about antibiotics and other prescription only medication (POM) in 10 community pharmacies in Blantyre, Malawi. METHOD: 5 out of 10 pharmacies were selected by simple random sampling and 54 participants attending the selected pharmacies were interviewed. RESULTS: The major antibiotic drugs frequently requested without a doctor's prescription were Bactrim (Cotrimoxazole) and amoxicillin...
March 2014: Malawi Medical Journal: the Journal of Medical Association of Malawi
Qiuyan Shen, Dini Lin, Hong Zhu, Shengjie Ge, Wenjun Wu, Xiaoyan Pan, Xuejiang Gu, Xuemei Gu, Feixia Shen
OBJECTIVE: To explore the microbiological profiles and antibiotic susceptibility patterns of organisms isolated from diabetic foot ulcers so as to provide selection rationales of antibiotics. METHODS: A retrospective study was conducted on the microbiological profiles and antibiotic susceptibilities in 754 strains of pathogens isolated from 519 patients with diabetic foot ulcers at our hospital from January 2010 to August 2013. The inter-group data were compared by Chi-square test...
April 1, 2014: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Chiao Yuen Lim, Angela Takano, Steve Yang, Pyng Lee
A middle-aged Indian woman with knee pain had consumed ayurvedic medicine (Ostolief and Arthrella tablets) daily for 6 months. She presented to the respiratory clinic with worsening dyspnea, cough and weight loss of 2 months' duration. She was a homemaker, never-smoker and did not keep birds. Physical examination detected fine end-inspiratory crackles. There was no clubbing of the fingers, joint deformity or swelling, skin lesion or enlarged cervical lymphadenopathy. High-resolution computed tomography showed diffuse centrilobular nodules with ground-glass attenuation...
2014: Respiration; International Review of Thoracic Diseases
Ryan B Rush
A 52 year-old, contact lens-wearing man presented with progressive right eye pain and redness for one month. He had been evaluated and treated for necrotizing scleritis by multiple eye care specialists prior to presentation. He underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis, including a culture. The culture revealed heavy growth of Nocardia asteroides complexes. The patient was treated with topical amikacin and oral Bactrim. Following several weeks of antibiotic treatment, the patient's infection resolved completely, and his visual acuity returned to baseline status...
August 2013: Korean Journal of Ophthalmology: KJO
A Marathe, K Parikh
Cystoisospora belli, formerly known as Isospora belli, protozoal parasite endemic to many regions of the world including the Caribbean, Central and South America, Africa, and South-East Asia. It is frequently encountered in patients with acquired immunodeficiency syndrome (AIDS) and is considered to be an AIDS-defining illness. Chronic severe watery diarrhoea due to C. belli has also been reported in other immunodeficiency states. C. belli infection in immunosuppressed patients has rarely been described. We describe severe diarrhoea due to C...
April 2013: Indian Journal of Medical Microbiology
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