JAMMI最新文献

We describe a case of Ignatzschineria indica bacteremia in a patient with maggot infestation of a necrotic left leg wound. Ignatzschineria spp are an infrequent cause of infection in patients with wound myiasis. We review 16 cases described in published literature. Microbiologists and clinicians should be aware of uncommon bacteria, including Ignatzschineria spp, that may cause infection in patients with maggot-infested wounds such that these organisms are appropriately worked up and treated when found in clinical specimens.

We present a case of pericarditis with pericardial effusion secondary to Listeria monocytogenes. A 56-year-old man presented with signs of acute pericarditis, but with prior chronic lymphocytic leukemia treated with stem cell transplantation, chronic graft-versus-host disease, and a recent diagnosis of untreated diffuse large B-cell lymphoma. He developed cardiac tamponade requiring pericardiocentesis. Blood and pericardial cultures grew Listeria monocytogenes. He responded to ampicillin but later died from gram-negative sepsis. A systematic review found 10 other published English-language cases of pericarditis caused by Listeria. The most common risk factors were cirrhosis and malignancy. Only three patients survived both the listeriosis and their underlying infections. Listeria monocytogenes is a rare and often fatal cause of pericarditis, typically occurring in immunocompromised patients. Cultures showing gram-positive bacilli in the context of pericarditis in an immunocompromised patient should prompt consideration of this rare cause.

Head and neck masses are usually indicative of infectious, neoplastic, or congenital entities. Most head and neck masses are related to local or regional disease, although systemic neoplastic disease can present in the cervical area. We present an interesting case report of a young woman with a neck mass caused by an organism most commonly associated with sexually transmitted infections, and not with the more common causes of cervical head and neck masses.

We present a case of persistent Staphylococcus aureus bacteremia (SAB) with delayed diagnosis of deep-seated asymptomatic abscesses leading to an unnecessarily prolonged hospital stay and significant morbidity. This case suggests that early empiric nuclear imaging might have led to earlier source control and, in turn, reduced morbidity. In addition, the case illustrates that even with a presumed superficial source of infection, one should still search thoroughly for additional and perhaps clinically occult secondary foci in patients with high-risk SAB.

Background: BK virus is implicated most commonly in causing BK virus-associated nephropathy in renal transplant recipients. However, on rare occasions, it can also produce symptomatic cystitis in other solid organ transplant recipients.

Methods: Retrospective review of 2,149 non-renal solid organ transplant recipients over a 6-year period to evaluate patients for cases of symptomatic BK virus cystitis.

Results: Three patients (two heart transplant recipients and one lung transplant recipient) are reported herein with symptomatic BK virus cystitis. These patients responded to reduced immunosuppressive medication with a reduction in viral load in two instances, and the third patient appeared to have an apparent response to prolonged levofloxacin treatment.

Conclusions: A high index of suspicion should be exercised in non-renal solid organ transplant recipients (particularly heart and lung transplant recipients) who have symptoms consistent with cystitis but have a negative urine bacterial culture.