IDCases最新文献

英文中文

Clostridium associated emphysematous gastritis: A case report and review of literature 梭菌相关性肺气性胃炎1例报告及文献复习

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02507

Roma Tarar , Chinedu Ezekekwu , Chibuike Enwereuzo , Anishur Rahman

Emphysematous gastritis is a rare, often fatal infection of the stomach wall characterized by gas formation and tissue necrosis, most frequently associated with polymicrobial infections. Cases with demonstration of tissue invasion by Clostridium species are exceptionally uncommon. We report the case of a 77-year-old woman with multiple comorbidities, including diabetes mellitus, obesity, atherosclerosis, and chronic kidney disease, who presented with severe abdominal pain, nausea, and vomiting. Imaging revealed gastric emphysema with pneumoperitoneum. Emergent laparotomy demonstrated full-thickness necrosis of the stomach along the lesser curvature, necessitating total gastrectomy with Roux-en-Y esophagojejunostomy and splenectomy. Histopathology confirmed extensive necrosis with gas dissection and abundant gram-positive, boxcar-shaped bacilli consistent with Clostridium perfringens. This case highlights the pathogenic potential of C. perfringens to cause spontaneous, necrotizing emphysematous gastritis in the absence of trauma or malignancy. Vascular compromise from severe atherosclerosis and thrombosis likely contributed to tissue hypoxia, creating a permissive environment for clostridial invasion. A literature review identified only a handful of human cases of emphysematous gastritis with definitive Clostridium identification, most with fatal outcomes unless surgically managed.

Conclusion

Emphysematous gastritis associated with Clostridium species is exceedingly rare and rapidly progressive. Early recognition and aggressive surgical resection appear to offer the best chance of survival. Clinicians should maintain a high index of suspicion in high-risk patients presenting with acute abdominal symptoms and gastric wall emphysema.

肺气肿性胃炎是一种罕见的，通常是致命的胃壁感染，其特征是气体形成和组织坏死，最常与多微生物感染有关。梭状芽胞杆菌侵袭组织的病例是非常罕见的。我们报告一位77岁的女性，她患有多种合并症，包括糖尿病、肥胖、动脉粥样硬化和慢性肾脏疾病，她表现为严重的腹痛、恶心和呕吐。影像学显示胃气肿伴气腹。紧急剖腹手术显示沿胃小弯全层坏死，需要全胃切除术并Roux-en-Y食管空肠吻合术和脾切除术。组织病理学证实广泛坏死伴气体解剖，大量革兰氏阳性箱形杆菌与产气荚膜梭菌一致。本病例强调了产气荚膜梭菌在没有外伤或恶性肿瘤的情况下引起自发性坏死性肺气肿性胃炎的致病潜力。严重动脉粥样硬化和血栓形成的血管损害可能导致组织缺氧，为梭菌入侵创造了一个宽松的环境。一项文献综述发现，只有少数人的肺气肿性胃炎病例与明确的梭状芽孢杆菌鉴定，大多数致命的结果，除非手术处理。结论与梭状芽胞杆菌相关的气肿性胃炎极为罕见，且进展迅速。早期识别和积极的手术切除似乎提供了最好的生存机会。临床医生应对出现急性腹部症状和胃壁肺气肿的高危患者保持高度怀疑。

{"title":"Clostridium associated emphysematous gastritis: A case report and review of literature","authors":"Roma Tarar , Chinedu Ezekekwu , Chibuike Enwereuzo , Anishur Rahman","doi":"10.1016/j.idcr.2026.e02507","DOIUrl":"10.1016/j.idcr.2026.e02507","url":null,"abstract":"<div><div>Emphysematous gastritis is a rare, often fatal infection of the stomach wall characterized by gas formation and tissue necrosis, most frequently associated with polymicrobial infections. Cases with demonstration of tissue invasion by <em>Clostridium</em> species are exceptionally uncommon. We report the case of a 77-year-old woman with multiple comorbidities, including diabetes mellitus, obesity, atherosclerosis, and chronic kidney disease, who presented with severe abdominal pain, nausea, and vomiting. Imaging revealed gastric emphysema with pneumoperitoneum. Emergent laparotomy demonstrated full-thickness necrosis of the stomach along the lesser curvature, necessitating total gastrectomy with Roux-en-Y esophagojejunostomy and splenectomy. Histopathology confirmed extensive necrosis with gas dissection and abundant gram-positive, boxcar-shaped bacilli consistent with <em>Clostridium perfringens</em>. This case highlights the pathogenic potential of <em>C. perfringens</em> to cause spontaneous, necrotizing emphysematous gastritis in the absence of trauma or malignancy. Vascular compromise from severe atherosclerosis and thrombosis likely contributed to tissue hypoxia, creating a permissive environment for clostridial invasion. A literature review identified only a handful of human cases of emphysematous gastritis with definitive <em>Clostridium</em> identification, most with fatal outcomes unless surgically managed.</div></div><div><h3>Conclusion</h3><div>Emphysematous gastritis associated with <em>Clostridium</em> species is exceedingly rare and rapidly progressive. Early recognition and aggressive surgical resection appear to offer the best chance of survival. Clinicians should maintain a high index of suspicion in high-risk patients presenting with acute abdominal symptoms and gastric wall emphysema.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02507"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary tuberculosis of the thyroid gland complicated with abscess: Case report 原发性甲状腺结核合并脓肿1例

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02498

Wondwosen Mengist Dereje , Desalegn Kefale Aegash , Alem Demissie Bogale , Samuel Addisu Abera , Mengist Asmamaw Tegegne , Abel Girma Demessie

Introduction and importance

Tuberculosis (TB), caused by Mycobacterium tuberculosis, mainly affects the lungs and lymph nodes but rarely involves the thyroid. Thyroid TB is usually secondary to infection elsewhere, while primary thyroid TB, where the thyroid is the initial site, is extremely rare and more common in patients with preexisting thyroid disease. Its nonspecific presentation often delays diagnosis and treatment. This case highlights the need for a high index of suspicion for early detection and management.

Case presentation

A 40-year-old female farmer presented with a 20-year history of anterior neck swelling, which increased in size over two months. She developed pain, bilateral cervical lymphadenopathy, and low-grade fever. Examination revealed a sinus tract with purulent discharge from the right thyroid lobe and multiple cervical lymph nodes. Ultrasound suggested thyroid TB; CT scan suggested thyroid cancer with nodal metastasis. Fine needle aspiration cytology confirmed TB. Right thyroid lobectomy with left subtotal thyroidectomy was performed, and histopathology confirmed thyroid tuberculosis. She was treated with first-line anti-TB medications and followed for six months, showing full improvement.

Conclusion

Primary thyroid TB is exceptionally rare and can mimic malignancy. FNAC and biopsy can confirm TB by demonstrating granulomatous inflammation with caseation and identifying Mycobacterium tuberculosis. Clinicians should consider TB in thyroid lesions, particularly in endemic areas, to ensure timely diagnosis and appropriate treatment.

结核（TB）由结核分枝杆菌引起，主要累及肺和淋巴结，很少累及甲状腺。甲状腺结核通常继发于其他部位的感染，而原发性甲状腺结核（以甲状腺为初始部位）极为罕见，在既往存在甲状腺疾病的患者中更为常见。其非特异性表现常常延误诊断和治疗。这一病例突出表明，需要高度的怀疑指数，以便及早发现和管理。病例表现：一名40岁女性农民，有20年的前颈部肿胀史，两个多月后肿大。她出现疼痛、双侧颈淋巴肿大和低烧。检查发现右甲状腺叶窦道有脓性分泌物及多处颈部淋巴结。超声提示甲状腺结核；CT提示甲状腺癌伴淋巴结转移。细针穿刺细胞学证实结核。行右甲状腺叶切除及左甲状腺次全切除术，病理证实为甲状腺结核。她接受了一线抗结核药物治疗，并随访了6个月，病情完全好转。结论原发性甲状腺结核极为罕见，可模拟恶性肿瘤。FNAC和活检可以通过显示肉芽肿性炎症伴干酪化反应和识别结核分枝杆菌来确诊结核病。临床医生应考虑甲状腺病变中的结核，特别是在流行地区，以确保及时诊断和适当治疗。

{"title":"Primary tuberculosis of the thyroid gland complicated with abscess: Case report","authors":"Wondwosen Mengist Dereje , Desalegn Kefale Aegash , Alem Demissie Bogale , Samuel Addisu Abera , Mengist Asmamaw Tegegne , Abel Girma Demessie","doi":"10.1016/j.idcr.2026.e02498","DOIUrl":"10.1016/j.idcr.2026.e02498","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Tuberculosis (TB), caused by <em>Mycobacterium tuberculosis</em>, mainly affects the lungs and lymph nodes but rarely involves the thyroid. Thyroid TB is usually secondary to infection elsewhere, while primary thyroid TB, where the thyroid is the initial site, is extremely rare and more common in patients with preexisting thyroid disease. Its nonspecific presentation often delays diagnosis and treatment. This case highlights the need for a high index of suspicion for early detection and management.</div></div><div><h3>Case presentation</h3><div>A 40-year-old female farmer presented with a 20-year history of anterior neck swelling, which increased in size over two months. She developed pain, bilateral cervical lymphadenopathy, and low-grade fever. Examination revealed a sinus tract with purulent discharge from the right thyroid lobe and multiple cervical lymph nodes. Ultrasound suggested thyroid TB; CT scan suggested thyroid cancer with nodal metastasis. Fine needle aspiration cytology confirmed TB. Right thyroid lobectomy with left subtotal thyroidectomy was performed, and histopathology confirmed thyroid tuberculosis. She was treated with first-line anti-TB medications and followed for six months, showing full improvement.</div></div><div><h3>Conclusion</h3><div>Primary thyroid TB is exceptionally rare and can mimic malignancy. FNAC and biopsy can confirm TB by demonstrating granulomatous inflammation with caseation and identifying <em>Mycobacterium tuberculosis</em>. Clinicians should consider TB in thyroid lesions, particularly in endemic areas, to ensure timely diagnosis and appropriate treatment.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02498"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Three’s Company: Cardiac myxoma, bicuspid aortic valve with severe aortic stenosis and ascending thoracic aortic aneurysm uncovered by anaplasmosis infection 三个一组：心脏黏液瘤，伴有严重主动脉狭窄的二尖瓣主动脉瓣，无形体病感染发现的胸升主动脉瘤

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02504

Bishoy Abraham , Elizabeth M. Akfaly , Christopher Sigakis , FNU Shweta , Andrew D. Calvin

A 62-year-old man presented to the emergency department with chest pain, nausea, fever and hypotension consistent with sepsis. A contrast-enhanced CT revealed a 5.5 cm ascending thoracic aortic aneurysm, bicuspid aortic valve, and a left atrial mass. Transesophageal echocardiography showed a tumor in the left atrium attached to the fossa ovalis. Infectious evaluation was undertaken, and polymerase chain reaction was positive for anaplasmosis. Coronary angiography found severe coronary artery disease. After completing a course of antibiotics and recovering from his acute illness, the patient underwent left atrial tumor resection, aortic valve replacement, aortic aneurysm repair, and coronary artery bypass grafting. Pathology confirmed the tumor was a myxoma. This case illustrates that allowing time for clinical stabilization and completion of a course of antibiotics for sepsis due to anaplasmosis prior to urgent cardiovascular surgery may be a reasonable approach.

一名62岁男性因胸痛、恶心、发烧和低血压与败血症一致而被送往急诊室。增强CT显示一个5.5 cm的上升胸主动脉瘤、二尖瓣主动脉瓣和左心房肿块。经食道超声心动图显示左心房有一肿瘤与卵圆窝相连。进行了感染性评估，聚合酶链反应无形体病阳性。冠状动脉造影发现严重的冠状动脉疾病。在完成一个疗程的抗生素治疗并从急性疾病中恢复后，患者接受了左心房肿瘤切除术、主动脉瓣置换术、主动脉瘤修复术和冠状动脉旁路移植术。病理证实为黏液瘤。本病例表明，在紧急心血管手术之前，允许临床稳定和完成无形体病引起的脓毒症的抗生素疗程可能是一种合理的方法。

引用次数: 0

Bacteroides fragilis as an unusual cause of neonatal pyogenic arthritis: A case report 脆弱拟杆菌是新生儿化脓性关节炎的一种罕见病因：1例报告

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02473

Huda Aldhanhani , Nourhan Elsayed , Eyman Shebani

We present a rare case of neonatal bone infection caused by Bacteroides fragilis without predisposing risk factors in an otherwise healthy newborn. The infant initially presented with symptoms of sepsis, including fever, irritability, and reduced limb movement, prompting an extensive workup that eventually revealed Bacteroides fragilis in joint fluid PCR analysis. Treatment involved multi-agent antibiotics targeting anaerobic organisms and a joint washout procedure. This case highlights the importance of molecular diagnostics in detecting uncommon pathogens in neonatal bone infections and guiding effective antibiotic therapy. This report contributes valuable knowledge to understanding and managing bone and joint infections in neonatal populations.

我们提出一个罕见的病例新生儿骨感染引起的脆弱拟杆菌没有易感危险因素在一个健康的新生儿。婴儿最初表现为败血症症状，包括发烧、易怒和肢体活动减少，促使进行了广泛的检查，最终在关节液PCR分析中发现脆弱拟杆菌。治疗包括针对厌氧生物的多药抗生素和联合冲洗程序。本病例强调了分子诊断在新生儿骨感染中发现罕见病原体和指导有效抗生素治疗的重要性。本报告为了解和管理新生儿人群的骨和关节感染提供了宝贵的知识。

引用次数: 0

Liver abscess and bacteremia caused by Streptococcus constellatus with suspected ileocecal valve lesion as the entry point 以怀疑回盲瓣病变为切入点的星形链球菌引起的肝脓肿及菌血症

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02485

Yuma Takeda , Takaaki Kobayashi , Nicholas Van Sickels , Akihito Yoshida

Pyogenic liver abscess (PLA) is a rare but potentially life-threatening condition. Streptococcus constellatus, part of the Streptococcus anginosus group, is an uncommon causative agent of PLA, though its incidence has been increasingly reported. We present the case of a 68-year-old man with a history of hypertension, type 2 diabetes, and dyslipidemia, who was admitted after a traffic accident. Medical evaluation revealed bacteremia and liver abscesses caused by S. constellatus, and the patient was treated successfully with drainage and antibiotics. While the patient denied gastrointestinal symptoms, a colonoscopy was performed to investigate a possible portal of entry for the organism, which revealed an inflammatory lesion at the ileocecal valve. This case underscores the importance of colonoscopy in identifying potential sources of infection in cryptogenic PLA and highlights the need for thorough evaluation of gastrointestinal lesions in patients with S. constellatus bacteremia. The patient's loss of consciousness during the traffic accident was attributed to sepsis, reinforcing the critical role of comprehensive internal investigations in trauma patients with unexplained symptoms.

化脓性肝脓肿（PLA）是一种罕见但可能危及生命的疾病。星座链球菌属血管链球菌属，是一种罕见的PLA病原体，但其发病率已越来越多的报道。我们报告一位68岁的男性，有高血压、2型糖尿病和血脂异常病史，在一次交通事故后入院。医学鉴定发现细菌血症和肝脓肿引起的星形葡萄球菌，并成功治疗患者引流和抗生素。当患者否认胃肠道症状时，进行了结肠镜检查以调查细菌可能的入口，结果显示回盲瓣处有炎症灶。该病例强调了结肠镜检查在确定隐源性聚乳酸潜在感染源中的重要性，并强调了对星座葡萄球菌菌血症患者的胃肠道病变进行全面评估的必要性。患者在交通事故中失去意识被认为是脓毒症，这加强了对症状不明的创伤患者进行全面内部检查的关键作用。

{"title":"Liver abscess and bacteremia caused by Streptococcus constellatus with suspected ileocecal valve lesion as the entry point","authors":"Yuma Takeda , Takaaki Kobayashi , Nicholas Van Sickels , Akihito Yoshida","doi":"10.1016/j.idcr.2025.e02485","DOIUrl":"10.1016/j.idcr.2025.e02485","url":null,"abstract":"<div><div>Pyogenic liver abscess (PLA) is a rare but potentially life-threatening condition. <em>Streptococcus constellatus</em>, part of the <em>Streptococcus anginosus</em> group, is an uncommon causative agent of PLA, though its incidence has been increasingly reported. We present the case of a 68-year-old man with a history of hypertension, type 2 diabetes, and dyslipidemia, who was admitted after a traffic accident. Medical evaluation revealed bacteremia and liver abscesses caused by <em>S. constellatus</em>, and the patient was treated successfully with drainage and antibiotics. While the patient denied gastrointestinal symptoms, a colonoscopy was performed to investigate a possible portal of entry for the organism, which revealed an inflammatory lesion at the ileocecal valve. This case underscores the importance of colonoscopy in identifying potential sources of infection in cryptogenic PLA and highlights the need for thorough evaluation of gastrointestinal lesions in patients with <em>S. constellatus</em> bacteremia. The patient's loss of consciousness during the traffic accident was attributed to sepsis, reinforcing the critical role of comprehensive internal investigations in trauma patients with unexplained symptoms.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02485"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of concurrent longitudinally extensive myelitis and retinal vein occlusion 罕见的纵向广泛脊髓炎并发视网膜静脉阻塞1例

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02501

Junais Koleri, Musaed Saad A. Al Samawi, Hasan Syed Ahmedullah, Sreethish Sasi, Ajithkumar V. Ittaman, Muna Al Maslamani

Neurosyphilis can affect multiple organ systems, but simultaneous involvement of the spinal cord and retinal vasculature is exceedingly rare. We report a 36-year-old man presenting first with unilateral branch retinal vein occlusion (BRVO) and, two weeks later, progressive paraparesis due to longitudinally extensive transverse myelitis. Serologic tests were positive for syphilis, and cerebrospinal fluid (CSF) VDRL confirmed neurosyphilis. Spinal MRI showed a longitudinal T2-hyperintense lesion from C4 to the conus. Intravenous penicillin led to clinical and radiographic improvement. This case highlights the clinical relevance of syphilis as a “great imitator” – manifesting concurrently as ocular vasculitis and spinal cord demyelination. This case highlights an exceedingly rare, concurrent presentation of BRVO and longitudinally extensive myelitis as the primary manifestation of neurosyphilis. We propose syphilitic vasculitis as the unified underlying mechanism. This report underscores the critical need for clinicians, particularly ophthalmologists and neurologists, to maintain a high index of suspicion for syphilis in patients with unexplained neurologic or vascular ophthalmologic findings.

神经梅毒可影响多个器官系统，但同时累及脊髓和视网膜血管系统极为罕见。我们报告一名36岁的男性，首先表现为单侧视网膜静脉分支闭塞（BRVO），两周后，由于纵向广泛的横贯脊髓炎，进行性截瘫。血清学试验梅毒阳性，脑脊液VDRL证实神经梅毒。脊柱MRI显示从C4到圆锥的纵向t2高信号病变。静脉注射青霉素导致临床和影像学改善。该病例强调了梅毒作为“大模仿者”的临床相关性-同时表现为眼部血管炎和脊髓脱髓鞘。这个病例强调了一个极其罕见的，同时出现BRVO和纵向广泛的脊髓炎作为神经梅毒的主要表现。我们提出梅毒血管炎是统一的潜在机制。本报告强调，临床医生，特别是眼科医生和神经科医生，在出现不明原因的神经或血管眼科症状的患者中保持对梅毒的高度怀疑。

{"title":"A rare case of concurrent longitudinally extensive myelitis and retinal vein occlusion","authors":"Junais Koleri, Musaed Saad A. Al Samawi, Hasan Syed Ahmedullah, Sreethish Sasi, Ajithkumar V. Ittaman, Muna Al Maslamani","doi":"10.1016/j.idcr.2026.e02501","DOIUrl":"10.1016/j.idcr.2026.e02501","url":null,"abstract":"<div><div>Neurosyphilis can affect multiple organ systems, but simultaneous involvement of the spinal cord and retinal vasculature is exceedingly rare. We report a 36-year-old man presenting first with unilateral branch retinal vein occlusion (BRVO) and, two weeks later, progressive paraparesis due to longitudinally extensive transverse myelitis. Serologic tests were positive for syphilis, and cerebrospinal fluid (CSF) VDRL confirmed neurosyphilis. Spinal MRI showed a longitudinal T2-hyperintense lesion from C4 to the conus. Intravenous penicillin led to clinical and radiographic improvement. This case highlights the clinical relevance of syphilis as a “great imitator” – manifesting concurrently as ocular vasculitis and spinal cord demyelination. This case highlights an exceedingly rare, concurrent presentation of BRVO and longitudinally extensive myelitis as the primary manifestation of neurosyphilis. We propose syphilitic vasculitis as the unified underlying mechanism. This report underscores the critical need for clinicians, particularly ophthalmologists and neurologists, to maintain a high index of suspicion for syphilis in patients with unexplained neurologic or vascular ophthalmologic findings.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02501"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146077516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anaerobic pericarditis due to Clostridium ramosum: First known case report 梭状芽胞杆菌引起的厌氧性心包炎：首例已知病例报告

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02431

Rohan Mylavarapu , Moamen Al Zoubi

Anaerobic pathogens are uncommon etiologies of pericardial infections. Clostridium ramosum, an obligate anaerobic gram-positive bacillus and member of the normal gastrointestinal flora, is generally considered of low virulence but has been implicated in invasive infections in elderly or immunocompromised individuals. We report the first documented case of Clostridium ramosum pericarditis. An 85-year-old male with atrial fibrillation, hypertension, hyperlipidemia, splenomegaly with bicytopenia, and depression was found to have a moderate pericardial effusion on transthoracic echocardiography. Follow-up imaging revealed a reduced ejection fraction, progressive aortic dilation, and early tamponade physiology. Despite being asymptomatic, he underwent pericardiocentesis, which yielded 400 mL of fluid. Gram stain demonstrated gram-positive bacilli, later identified on anaerobic culture as Clostridium ramosum. Blood cultures remained negative. He was treated with intravenous ampicillin-sulbactam followed by oral metronidazole, with resolution of the effusion and no recurrence on follow-up. This case highlights that anaerobic pericarditis can occur in the absence of systemic symptoms or sepsis, particularly in elderly patients with comorbidities that predispose to bacterial translocation. Timely drainage and targeted antimicrobial therapy are essential for favorable outcomes. Importantly, routine anaerobic cultures of pericardial fluid should be considered to avoid missed diagnoses. Recognition of rare anaerobic pathogens in pericardial infections expands the understanding of their pathogenic potential and informs future diagnostic and therapeutic approaches.

厌氧病原菌是心包感染的罕见病因。雷氏梭状芽胞杆菌是一种专性厌氧革兰氏阳性杆菌，属于正常胃肠道菌群，通常被认为毒性较低，但与老年人或免疫功能低下个体的侵袭性感染有关。我们报告第一例有文献记载的雷蒙梭状芽胞杆菌心包炎病例。一位85岁男性患者，经胸超声心动图发现有中度心包积液，伴有房颤、高血压、高脂血症、脾肿大伴双氧体减少症和抑郁症。随访影像显示射血分数降低，主动脉进行性扩张，早期心包填塞。尽管无症状，他接受了心包穿刺，产生400 mL液体。革兰氏染色显示革兰氏阳性杆菌，后来在厌氧培养中鉴定为拉莫梭菌。血培养呈阴性。经静脉滴注氨苄西林-舒巴坦并口服甲硝唑治疗，积液消失，随访无复发。本病例强调无系统性症状或败血症时可发生厌氧性心包炎，特别是在有易发生细菌易位的合并症的老年患者中。及时引流和靶向抗菌治疗是获得良好结果的必要条件。重要的是，应考虑常规心包液厌氧培养以避免漏诊。心包感染中罕见的厌氧病原体的识别扩大了对其致病潜力的理解，并为未来的诊断和治疗方法提供了信息。

{"title":"Anaerobic pericarditis due to Clostridium ramosum: First known case report","authors":"Rohan Mylavarapu , Moamen Al Zoubi","doi":"10.1016/j.idcr.2025.e02431","DOIUrl":"10.1016/j.idcr.2025.e02431","url":null,"abstract":"<div><div>Anaerobic pathogens are uncommon etiologies of pericardial infections. <em>Clostridium ramosum</em>, an obligate anaerobic gram-positive bacillus and member of the normal gastrointestinal flora, is generally considered of low virulence but has been implicated in invasive infections in elderly or immunocompromised individuals. We report the first documented case of <em>Clostridium ramosum</em> pericarditis. An 85-year-old male with atrial fibrillation, hypertension, hyperlipidemia, splenomegaly with bicytopenia, and depression was found to have a moderate pericardial effusion on transthoracic echocardiography. Follow-up imaging revealed a reduced ejection fraction, progressive aortic dilation, and early tamponade physiology. Despite being asymptomatic, he underwent pericardiocentesis, which yielded 400 mL of fluid. Gram stain demonstrated gram-positive bacilli, later identified on anaerobic culture as <em>Clostridium ramosum</em>. Blood cultures remained negative. He was treated with intravenous ampicillin-sulbactam followed by oral metronidazole, with resolution of the effusion and no recurrence on follow-up. This case highlights that anaerobic pericarditis can occur in the absence of systemic symptoms or sepsis, particularly in elderly patients with comorbidities that predispose to bacterial translocation. Timely drainage and targeted antimicrobial therapy are essential for favorable outcomes. Importantly, routine anaerobic cultures of pericardial fluid should be considered to avoid missed diagnoses. Recognition of rare anaerobic pathogens in pericardial infections expands the understanding of their pathogenic potential and informs future diagnostic and therapeutic approaches.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02431"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Weissella confusa infection in an immunocompromised patient: A case report 免疫功能低下患者的混淆韦塞尔菌感染1例报告

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2026.e02491

Fatema Juma , Sarah Alangari , Oqab AlMutairi , Talal AlMutairi , Khalifa Binkhamis

Weissella confusa, a gram-positive, facultative anaerobic bacterium, is typically associated with fermented foods. However, the bacterium is increasingly being linked to various human infections.

A 59-year-old woman with a history of type 2 diabetes mellitus, chronic anemia, multiple myeloma, and lymphoma presented with severe back pain, reduced appetite, and swelling. During hospitalization, she developed a fever and was diagnosed with a Weissella confusa infection. Despite antibiotic treatment, the patient’s health deteriorated, resulting in her death.

Although Weissella confusa is often regarded as a nonpathogenic bacterium, this case underscores the potential pathogenicity of the organism in immunocompromised patients. Adequate identification and understanding of this bacterium are vital to ensure appropriate treatment and management.

魏塞拉菌是一种革兰氏阳性兼性厌氧细菌，通常与发酵食品有关。然而，这种细菌越来越多地与各种人类感染联系在一起。59岁女性，有2型糖尿病、慢性贫血、多发性骨髓瘤和淋巴瘤病史，表现为严重背痛、食欲减退和肿胀。在住院期间，她出现发烧，并被诊断为韦塞尔菌感染。尽管接受了抗生素治疗，但病人的健康状况恶化，最终导致死亡。虽然通常被认为是一种非致病性细菌，但本病例强调了该生物在免疫功能低下患者中的潜在致病性。充分识别和了解这种细菌对于确保适当的治疗和管理至关重要。

引用次数: 0

Infectious abdominal aortic pseudoaneurysm 感染性腹主假性动脉瘤

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02481

Zheng Zhang , Xiaoying Li , Haijie Che

引用次数: 0

Disseminated drug-resistant nocardiosis in a patient with advanced HIV 1例晚期HIV患者播散性耐药诺卡菌病

IF 1 Q4 INFECTIOUS DISEASES

IDCases

Pub Date : 2026-01-01 DOI: 10.1016/j.idcr.2025.e02463

Brian P. Epling , Maura Manion , Elizabeth Laidlaw , Michael S. Abers , Irini Sereti

Disseminated nocardiosis is an opportunistic infection seen primarily in patients with impaired phagocyte function, and less frequently in people with advanced HIV. Nocardia pseudobrasiliensis is a species that exhibits high rates of antimicrobial resistance, including to carbapenems, co-trimoxazole, and aminoglycosides. In this article, we present a case of an individual with advanced HIV infection and disseminated N. pseudobrasiliensis. Prior to completion of antimicrobial susceptibility testing, he was treated empirically with imipenem, co-trimoxazole, and amikacin, but demonstrated radiologic progression. Directed therapy with linezolid and azithromycin was ultimately initiated, resulting in marked symptomatic and radiologic improvement after one year of treatment alongside suppressive antiretroviral therapy.

播散性诺卡菌病是一种机会性感染，主要见于吞噬细胞功能受损的患者，在晚期艾滋病毒感染者中较少见。伪巴西诺卡菌是一种表现出高耐药性的物种，包括对碳青霉烯类、复方新诺明和氨基糖苷类。在这篇文章中，我们提出了一个病例的个人与晚期艾滋病毒感染和传播伪巴西奈瑟菌。在完成抗菌药物敏感性试验之前，他接受了亚胺培南、复方新诺明和阿米卡星的经验性治疗，但放射学表现出进展。最终开始了利奈唑胺和阿奇霉素的定向治疗，经过一年的治疗和抑制性抗逆转录病毒治疗后，症状和放射学明显改善。

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

IDCases

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀