IDCases最新文献

71-year-old male with history of obstructive sleep apnea presented with persistent drainage from the surgical incision site over the recently implanted hypoglossal nerve stimulator. Wound cultures from device pocket identified the pathogen as Turicella otitidis. Clinical course included treatment with broad-spectrum intravenous antibiotics and device explantation. This case is the first known T. otitidis device associated infection.

In this case report, we present a patient with a history of splenectomy and two recent hospital admissions for severe gastroenteritis with sepsis. The first hospital admission was for Yersinia enterocolitica and the second admission was for Campylobacter fetus gastroenteritis with bacteremia. During both admissions, the patient was treated with a prolonged course of antibiotics and later discharged with full recovery. In our review, we address the risk of enterocolitis in splenectomized patients.

Background

Bedaquiline (BDQ) is an effective drug currently used for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) and pre-extensively drug-resistant TB (pre-XDR-TB) treatment. However, resistance to this new drug is emerging. We discussed the characteristics of the first patient in Ethiopia who acquired BDQ and fluoroquinolones (FQs) resistance during treatment follow-up.

Case report

In this case report, we present the case of a 28-year-old male pulmonary TB patient diagnosed with MDR-TB who is a resident of the Oromia Region of North Shewa, Mulona Sululta Woreda, Ethiopia. Sputum specimen was collected initially and for treatment monitoring using culture and for phenotypic drug susceptibility testing (DST) to first-line and second-line TB drugs. Initially, the patient was infected with a mycobacterial strain resistant to the first-line anti-TB drugs Rifampicin (RIF), Isoniazid (INH), and Pyrazinamide (PZA). Later, during treatment, he acquired additional drug resistance to ethambutol (EMB), ofloxacin (OFX), levofloxacin (LFX), moxifloxacin (MFX), and BDQ. The patient was tested with MTBDRplus and MTBDRsl to confirm the presence of resistance-conferring mutation and mutation was detected in rpoB, katG, and gyrA genes. Finally, the patient was registered as having extensively drug-resistant tuberculosis (XDR-TB) and immediately started an individualized treatment regimen.

Conclusion

This case report data has revealed the evolution of BDQ resistance during treatment with a BDQ-containing regimen in Ethiopia. Therefore, there is a need for DST to new second-line drugs to monitor and prevent the spread of DR-TB.

Azoles are frequently used to treat systemic mycoses but have been associated with a number of adverse effects of the skin and skin appendages. Herein we describe two cases of chronic paronychia in pediatric patients receiving fluconazole for coccidioidomycosis. Their clinical characteristics are described, and the literature reviewed.

Melioidosis is an emerging tropical infectious disease in travelers. We present a case of travel related melioidosis in a 65-year-old man with chronic obstructive pulmonary disease and end stage renal disease following a two-week business trip to Thailand and attendance of the Songkran festival. This case emphasizes that vigilance, heightened clinical suspicion, and use of appropriate microbiology diagnostic tools are of paramount importance for a timely diagnosis and successful management. With the ever-increasing global travel, infectious diseases specialists, microbiologists, and public health professionals are constantly challenged by unfamiliar infections in returned travelers.

Introduction

TB is a well-recognized cause of pulmonary infection. Empyema Necessitans is a rare complication of untreated empyema, mainly caused by mycobacterium tuberculosis. It mainly affects immunocompromised individuals.

Case presentation

We present a case of 28 years old gentleman, Sudanese, with intermittent fever, non-productive cough, weight loss and night sweats. Chest X-ray then CT chest revealed a large right pleural collection invading the chest wall. Chest tube was inserted, fluid analysis was taken, and a bronchoscopy was done. A diagnosis of Empyema Necessitans was confirmed and patient was started on anti-TB regimen with clinical improvement.

Conclusion

Empyema Necessitans is a severe disease, complicating pulmonary tuberculosis. Diagnosis can be a challenge. Surgical and medical approaches are both crucial in the treatment of EN. This case highlights the importance of early recognition and diagnosis of this rare but aggressive condition particularly in TB endemic area.

Mucormycosis is a devastating disease with a high mortality rate, typically affecting immunosuppressed individuals. Postoperative surgical site infections due to mucromycosis are rare, with only a handful of cases reported in the literature. Here, we describe a fatal case of post operative abdominal wound infection caused by mucormycosis in an immunocompetent man in his 70 s, who developed the infection following a laparotomy for bowel perforation. Initially, the growth of fungal species from a superficial wound swab was not considered significant until the patient exhibited signs of worsening sepsis. Limited operative debridement was performed for prognostication, in accordance with the family’s wishes. There was evidence of extensive significant invasive fungal infection, marked by necrosis extending into the abdominal wall fat and muscle. The patient was then transitioned to comfort measures and subsequently died. This case emphasizes the importance of maintaining a high level of clinical suspicion for mucormycosis, even in patients with minimal risk factors, and highlights the importance of prompt and aggressive treatment.

A 49-year-old female with multiple myeloma complicated by renal failure had dysuria. The urine culture revealed multidrug-resistant aeromonas caviae during her hospital stay. Her symptoms and signs significantly improved after receiving a seven-day course of piperacillin-tazobactam treatment. She had no history of urinary tract infections(UTIs). On follow-up, she felt clinically well. Aeromonas caviae is a rare cause of UTI. We review previous cases of aeromonas caviae UTIs. The purpose of this case report is to assist in the diagnosis and management of aeromonas caviae cystitis.