IDCases最新文献

In humans, solitary renal involvement or primary renal echinococcosis is rare, accounting for about 2–4 % of cases. Usually, patients shpw no obvious symptoms, but they can manifest as renal pain, renal mass, gross hematuria, and hydatiduria in rare cases. We report a case of primary renal cystic echinococcosis, which was originally misdiagnosed as a tuberculous renal abscess.

Ecthyma grangrenosum is an unusual condition, mostly related to Pseudomonas septicemia. Ecthyma-like skin lesions caused by cutaneous phaeohyphomycosis are extremely rare. Here, we report a case of a 20-year-old Thai man, previously healthy, presenting multiple ecthyma-like skin lesions in both arms and both legs for 2 months. Physical examination revealed ill-defined erythematous plaque with central necrotic crust at both arms and both legs. Tissue biopsy showed a neutrophil collection identified by GMS stain revealing septate hyphae organisms in the vascular lumen. The skin culture was positive for Curvularia lunata, while the final diagnosis was cutaneous phaeohyphomycosis caused by Curvularia lunata. He was empirically treated with amphotericin B and then voriconazole. Itraconazole was administered as a definitive regimen, resulting in complete resolution after 2 months of treatment. Cutaneous phaeohyphomycosis is also an uncommon cause of ecthyma-like lesions and should be considered for investigation when initial results do not demonstrate a bacterial etiology.

Ralstonia pickettii is a rare, emerging opportunistic pathogen that has been previously limited to nosocomial infections, often associated with contaminated sterile solutions. Here, we present the case of a neck abscess caused by R. pickettii, the first documented case of a deep neck space infection caused by this bacterium. The patient in this case had no risk factors for R. pickettii infection. By highlighting the atypical presentation and microbiology in this case, we aim to highlight the emergence of a wide spectrum of disease caused by R. pickettii.

Rhinosporidiosis is one of the granulomatous diseases endemic in Asia, Africa, and Europe, with Southern India and Sri Lanka having the greatest prevalence rates. It is typically understood to affect the upper respiratory system. Involvement of the lungs beyond the trachea is infrequent as compared to the upper respiratory tract. We revealed an uncommon case of disseminated rhinosporidiosis in a diabetic patient, who initially presented with shortness of breath associated with cough and fever. Two months prior to these symptoms, he was having oral ulcer and dysphagia and, subsequently, loss of weight. Chest radiograph and CT thorax revealed military nodules with multiple suppurative neck and mediastinal lymphadenopathy and bilateral adrenal lesions. He was initially investigated for tuberculosis, metastatic malignancy, or lymphangitic carcinomatosis before a biopsy revealed Rhinosporidiosis. Hence, histopathological or laboratory evidence is frequently crucial to back up imaging concerns so the appropriate treatment can be given.

Introduction

Coronaviruses have been suspected to be associated with neurological manifestations in patients with respiratory tract infections. Corona Virus disease (COVID-19) develop seizures as a consequence of hypoxia, metabolic derangements, organ failure, or even cerebral damage that may happen in people with COVID-19. There is scarce data about the development of seizures after recovery from acute COVID-19 illness, especially in those who have had a mild disease.

Case

A thirty three year old male patient with recent history of mild COVID-19 disease, with no known comorbidities, no history of substance abuse, presented with history of transient loss of consciousness. On examination had no lateralising signs, tongue bite was present. Inflammatory markers were found to be raised. MRI brain showed no significant abnormality. EEG done showed bilateral intermittent slowing.

Conclusion

Post COVID-19 infection, the post-infectious inflammatory response can give rise to many neurological complication, seizure being one among them, as noted in our patient.

Introduction

Case

Discussion

Scedosporium, a widespread filamentous fungus found in diverse environments, has experienced a rise in cases due to escalating malignancies and chronic immunosuppression. Clinical manifestations span mycetoma, airway involvement, and various infections, with osteomyelitis being a notable complication. We present a case of a 77-year-old female initially displaying cutaneous Scedosporium signs, which progressed to osteomyelitis. The patient, with a history of trauma, chronic low dose steroid use, and underlying conditions, presented with a foot injury caused by her dog. Despite initial management, worsening symptoms led to the identification of Scedosporium. A comprehensive approach involving debridement, antimicrobial therapy, and reduction of immunosuppression resulted in clinical improvement. The rarity of zoonotic transmission, diagnostic challenges, and antifungal efficacy are also discussed. The patient's positive trajectory emphasizes early diagnosis, targeted treatment, and vigilance in managing immunosuppression. An adaptable treatment protocol is proposed based on risk factors. Considering the rising opportunistic fungal infections and delayed culture results, initiating empirical antifungals based on clinical judgment and regional prevalence is vital for favorable outcomes.

Tuberculous meningitis (TBM) is a potentially life-threatening form of tuberculosis (TB) that affects the central nervous system. Its management in patients with concomitant chronic liver disease (CLD) presents unique challenges due to altered drug metabolism with potentially impaired spinal fluid drug penetration and hepatotoxicity. The standard regimen for TBM includes isoniazid (INH) and rifampin (RIF), and Pyrazinamide (PZA) which are metabolized by the liver and may cause hepatotoxicity, which can exacerbate preexisting liver disease. Thus, careful consideration is required to balance therapeutic efficacy with potential drug-induced hepatotoxicity. Regular monitoring of liver function tests and clinical response is essential to minimize adverse effects and optimize treatment outcomes. Further research is needed to establish evidence-based guidelines for the tailored management of TBM in this vulnerable patient subset. Overall, the treatment of TBM in patients with severe liver disease should be individualized and closely monitored.