Echinococcosis, commonly referred to as hydatid disease, is a prevalent condition in regions where sheep and cattle farming flourishes, representing a significant public health challenge in endemic areas. As one of the most neglected tropical diseases worldwide, this zoonotic infection caused by Echinococcus tapeworms often forms cysts in the liver and lungs. Cardiac involvement, a rare condition, can be insidious with vague symptoms or even remain asymptomatic until acute complications or fatal outcomes arise. The occurrence of silent, solitary cardiac hydatid cysts is exceptionally uncommon. This case report presents a rare and potentially life-threatening situation in which a substantial hydatid cyst nestled within the right ventricle of a healthy adult's heart culminating swiftly in sudden death. Postmortem findings revealed an outward bulge in the right ventricle, housing a fluid-filled cystic cavity. Histological evaluation confirmed the presence of a hydatid cyst, and death was attributed to cardiac arrhythmias. This case highlights the ubiquitous potential of hydatid cysts to manifest at various bodily sites, accentuating their silent but life-threatening nature. Sudden death, a recurrent feature of this disease in endemic settings, emphasizes the importance of timely diagnosis and intervention to avoid fatal repercussions. Increased awareness of this infrequent presentation among healthcare providers, particularly in endemic regions, can help save lives by fostering early recognition and prompt management.
{"title":"Sudden death related to an unrecognized solitary cardiac hydatid cyst: A case report and literature review.","authors":"Alemayehu Shiferaw Lema, Tesfaye Kidane Habtewold, Beza Tasew Degefu, Suresh Kumar Rajamani Sekar, Selamawit Tadesse Wendimagegn","doi":"10.1016/j.idcr.2025.e02339","DOIUrl":"10.1016/j.idcr.2025.e02339","url":null,"abstract":"<p><p>Echinococcosis, commonly referred to as hydatid disease, is a prevalent condition in regions where sheep and cattle farming flourishes, representing a significant public health challenge in endemic areas. As one of the most neglected tropical diseases worldwide, this zoonotic infection caused by Echinococcus tapeworms often forms cysts in the liver and lungs. Cardiac involvement, a rare condition, can be insidious with vague symptoms or even remain asymptomatic until acute complications or fatal outcomes arise. The occurrence of silent, solitary cardiac hydatid cysts is exceptionally uncommon. This case report presents a rare and potentially life-threatening situation in which a substantial hydatid cyst nestled within the right ventricle of a healthy adult's heart culminating swiftly in sudden death. Postmortem findings revealed an outward bulge in the right ventricle, housing a fluid-filled cystic cavity. Histological evaluation confirmed the presence of a hydatid cyst, and death was attributed to cardiac arrhythmias. This case highlights the ubiquitous potential of hydatid cysts to manifest at various bodily sites, accentuating their silent but life-threatening nature. Sudden death, a recurrent feature of this disease in endemic settings, emphasizes the importance of timely diagnosis and intervention to avoid fatal repercussions. Increased awareness of this infrequent presentation among healthcare providers, particularly in endemic regions, can help save lives by fostering early recognition and prompt management.</p>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"e02339"},"PeriodicalIF":1.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-05eCollection Date: 2025-01-01DOI: 10.1016/j.idcr.2025.e02337
Rahma Aldhaheri, Caitlin A Trottier, Treeva Jassim, Zoe Freeman Weiss
Strongyloides stercoralis can complete its entire life cycle within the human host, allowing infections to persist for years. While it may cause chronic, often asymptomatic infection in immunocompetent individuals, it can lead to life-threatening hyperinfection syndrome or disseminated disease in those who are immunocompromised. We report a case of Strongyloides hyperinfection syndrome in a heart transplant recipient who had tested negative on conventional serologic screening as part of his pretransplant workup three years prior to transplantation. The patient developed severe disease characterized by ileus and respiratory failure, and was treated with a combination of oral, rectal, and veterinary-formulated subcutaneous ivermectin. The patient demonstrated a favorable response and achieved full recovery. This case contributes to the growing literature supporting the use of subcutaneous ivermectin as a viable treatment option in patients with compromised gastrointestinal absorption.
{"title":"Strongyloidiasis in a heart transplant recipient: Exploring the use of veterinary-formulated subcutaneous ivermectin and a review of the literature.","authors":"Rahma Aldhaheri, Caitlin A Trottier, Treeva Jassim, Zoe Freeman Weiss","doi":"10.1016/j.idcr.2025.e02337","DOIUrl":"10.1016/j.idcr.2025.e02337","url":null,"abstract":"<p><p><i>Strongyloides stercoralis</i> can complete its entire life cycle within the human host, allowing infections to persist for years. While it may cause chronic, often asymptomatic infection in immunocompetent individuals, it can lead to life-threatening hyperinfection syndrome or disseminated disease in those who are immunocompromised. We report a case of <i>Strongyloides</i> hyperinfection syndrome in a heart transplant recipient who had tested negative on conventional serologic screening as part of his pretransplant workup three years prior to transplantation. The patient developed severe disease characterized by ileus and respiratory failure, and was treated with a combination of oral, rectal, and veterinary-formulated subcutaneous ivermectin. The patient demonstrated a favorable response and achieved full recovery. This case contributes to the growing literature supporting the use of subcutaneous ivermectin as a viable treatment option in patients with compromised gastrointestinal absorption.</p>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"e02337"},"PeriodicalIF":1.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.idcr.2025.e02218
W. Adamski, M. Pankowski , C. Dzióbich
Necrotising eyelid inflammation, also known as necrotising fasciitis (NF) of the orbit, is a rare but severe soft tissue infection. Prompt and appropriate treatment is crucial, as delayed intervention can result in the bacteria entering the bloodstream.
Typical predisposing factors for NF include skin breaks after surgery or trauma, which may be small and overlooked. NF is mainly caused by group A beta-haemolytic streptococci, with significant cases also attributed to Pseudomonas aeruginosa and Staphylococcus aureus.Symptoms include swelling, fever and pallor in the orbital region. Untreated NF can lead to serious complications such as exophthalmos of the orbit or death. The COVID-19 pandemic has led to an increase in the incidence of certain infectious diseases, including streptococcal infections, which can increase the risk of necrotising fasciitis. We present here two report cases of NF that were successfully cured by prompt and aggressive treatment.
{"title":"NECROTIZING EYELID FASCIITIS – series of two cases and three eyelids","authors":"W. Adamski, M. Pankowski , C. Dzióbich","doi":"10.1016/j.idcr.2025.e02218","DOIUrl":"10.1016/j.idcr.2025.e02218","url":null,"abstract":"<div><div>Necrotising eyelid inflammation, also known as necrotising fasciitis (NF) of the orbit, is a rare but severe soft tissue infection. Prompt and appropriate treatment is crucial, as delayed intervention can result in the bacteria entering the bloodstream.</div><div>Typical predisposing factors for NF include skin breaks after surgery or trauma, which may be small and overlooked. NF is mainly caused by group A beta-haemolytic streptococci, with significant cases also attributed to Pseudomonas aeruginosa and Staphylococcus aureus.Symptoms include swelling, fever and pallor in the orbital region. Untreated NF can lead to serious complications such as exophthalmos of the orbit or death. The COVID-19 pandemic has led to an increase in the incidence of certain infectious diseases, including streptococcal infections, which can increase the risk of necrotising fasciitis. We present here two report cases of NF that were successfully cured by prompt and aggressive treatment.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02218"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-31DOI: 10.1016/j.idcr.2025.e02210
Qinglong Ye , Yizhen Xu , Jing Chen , Ning Wang , Binwen Wu , Xiuling Zhou
Background
Ascariasis, caused by Ascaris lumbricoides, is a common parasitic infection predominantly affecting children and adolescents in developing countries.
Clinical manifestations range from asymptomatic cases to complications such as cholangitis and pancreatitis. Despite the prevalence of ascariasis, atypical presentations in adults are rare and pose diagnostic challenges.
Case summary
This case report describes an unusual presentation of ascariasis in a 41-year-old male, with nonspecific gastrointestinal symptoms: abdominal pain, bloating, heartburn, and alternating diarrhea and constipation, which led to a misdiagnosis of chronic gastritis initially. Finally, multiple colon polyps were detected by colonoscopy. Histopathological examination of the polyps unexpectedly revealed Ascaris eggs, leading to the final diagnosis of ascariasis.
Conclusion
This case highlight the importance of considering parasitic infections in patients with atypical gastrointestinal symptoms, even in the absence of typical risk factors. The incidental finding of Ascaris eggs within a colonic polyp is exceedingly rare, highlighting the need for thorough diagnostic evaluation in persistent, unexplained cases. This report contributes to the expanding knowledge of ascariasis presentation and diagnosis.
{"title":"Colonic polyps with Ascaris Lumbricoides eggs","authors":"Qinglong Ye , Yizhen Xu , Jing Chen , Ning Wang , Binwen Wu , Xiuling Zhou","doi":"10.1016/j.idcr.2025.e02210","DOIUrl":"10.1016/j.idcr.2025.e02210","url":null,"abstract":"<div><h3>Background</h3><div><em>Ascariasis</em>, caused by <em>Ascaris lumbricoides</em>, is a common parasitic infection predominantly affecting children and adolescents in developing countries.</div><div>Clinical manifestations range from asymptomatic cases to complications such as cholangitis and pancreatitis. Despite the prevalence of ascariasis, atypical presentations in adults are rare and pose diagnostic challenges.</div></div><div><h3>Case summary</h3><div>This case report describes an unusual presentation of ascariasis in a 41-year-old male, with nonspecific gastrointestinal symptoms: abdominal pain, bloating, heartburn, and alternating diarrhea and constipation, which led to a misdiagnosis of chronic gastritis initially. Finally, multiple colon polyps were detected by colonoscopy. Histopathological examination of the polyps unexpectedly revealed <em>Ascaris</em> eggs, leading to the final diagnosis of ascariasis.</div></div><div><h3>Conclusion</h3><div>This case highlight the importance of considering parasitic infections in patients with atypical gastrointestinal symptoms, even in the absence of typical risk factors. The incidental finding of <em>Ascaris</em> eggs within a colonic polyp is exceedingly rare, highlighting the need for thorough diagnostic evaluation in persistent, unexplained cases. This report contributes to the expanding knowledge of ascariasis presentation and diagnosis.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02210"},"PeriodicalIF":1.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The genus Capnocytophaga, which is part of the oral microbiome of both humans and animals, has the potential to cause severe infections in humans following animal bites. A 59-year-old man with systemic lupus erythematosus (SLE) on hemodialysis presented with cellulitis of the left upper limb after being bitten by his cat and was admitted to our hospital. Blood cultures were obtained, and empiric treatment with ampicillin/sulbactam was initiated. The patient developed a non-severe drug eruption on the 3rd hospital day, prompting a switch to ceftriaxone. Thin spindle-shaped Gram-negative bacilli were isolated from the blood cultures 127 h (5 days and 7 h) after obtained blood sample, and the patient completed a 2-weeks course of ceftriaxone with complete recovery. The isolate was identified as Capnocytophaga cynodegmi by MALDI-TOF MS and 16S rRNA gene sequencing. This case highlights the importance of considering C. cynodegmi in cat bite-associated infections. Obtaining blood cultures and extending incubation periods may be crucial for identifying the causative pathogen and guiding appropriate treatment in such cases.
{"title":"Capnocytophaga cynodegmi bacteremia associated with a cat bite in a patient with systemic lupus erythematosus on hemodialysis: A case report","authors":"Masahiko Nakao , Naoto Hosokawa , Wang Ziren , Takeru Yamamoto , Yosuke Ebisu , Naoki Watanabe , Tomohisa Watari , Yoshihito Otsuka , Ryosuke Osawa","doi":"10.1016/j.idcr.2025.e02240","DOIUrl":"10.1016/j.idcr.2025.e02240","url":null,"abstract":"<div><div>The genus <em>Capnocytophaga</em>, which is part of the oral microbiome of both humans and animals, has the potential to cause severe infections in humans following animal bites. A 59-year-old man with systemic lupus erythematosus (SLE) on hemodialysis presented with cellulitis of the left upper limb after being bitten by his cat and was admitted to our hospital. Blood cultures were obtained, and empiric treatment with ampicillin/sulbactam was initiated. The patient developed a non-severe drug eruption on the 3rd hospital day, prompting a switch to ceftriaxone. Thin spindle-shaped Gram-negative bacilli were isolated from the blood cultures 127 h (5 days and 7 h) after obtained blood sample, and the patient completed a 2-weeks course of ceftriaxone with complete recovery. The isolate was identified as <em>Capnocytophaga cynodegmi</em> by MALDI-TOF MS and 16S rRNA gene sequencing. This case highlights the importance of considering <em>C. cynodegmi</em> in cat bite-associated infections. Obtaining blood cultures and extending incubation periods may be crucial for identifying the causative pathogen and guiding appropriate treatment in such cases.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02240"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887974","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}
Pub Date : 2025-01-01DOI: 10.1016/j.idcr.2025.e02245
Maryam Akbari , Nahal Hadi , Farhad Moradi
Due to infrequent detection and reporting of enteric infections caused by Aeromonas species compared to other enteric bacteria, this report describes a case of enteric infection caused by Aeromonas species in a child girl after eating fresh fish and drinking from a river near her village in southern Fars province, Iran. In this case, a rectal swab culture and stool examination were requested for investigation due to diarrhea. Bacteriological laboratory tests revealed an intestinal infection with Aeromonas species. Confirmation was therefore carried out using the automated BD Phoenix system and biochemical reactions. The results showed Aeromonas veronii biovar sobria. Fortunately, in our cases, the intestinal infection was self-limiting and no antibiotics were given. This case highlights a rare occurrence of Aeromonas intestinal infection and demonstrates the risk of river and freshwater fish in transmitting Aeromonas to humans, especially in infants and child, which can be dangerous for this age group. It highlights the potential health risks associated with drinking water from natural sources, especially in rural areas or in underserved areas where the quality of the water may be compromised. To understand the prevalence of Aeromonas infections in similar settings and develop targeted prevention strategies, we recommend further epidemiological studies and healthcare providers should be vigilant and consider Aeromonas as a potential pathogen in patients with gastrointestinal symptoms, especially after exposure to contaminated water.
{"title":"Aeromonas veronii biovar sobria intestinal infection in a child girl after eating freshwater fish and drinking from a natural river in Southern Fars Province, Iran","authors":"Maryam Akbari , Nahal Hadi , Farhad Moradi","doi":"10.1016/j.idcr.2025.e02245","DOIUrl":"10.1016/j.idcr.2025.e02245","url":null,"abstract":"<div><div>Due to infrequent detection and reporting of enteric infections caused by <em>Aeromonas</em> species compared to other enteric bacteria, this report describes a case of enteric infection caused by <em>Aeromonas</em> species in a child girl after eating fresh fish and drinking from a river near her village in southern Fars province, Iran. In this case, a rectal swab culture and stool examination were requested for investigation due to diarrhea. Bacteriological laboratory tests revealed an intestinal infection with <em>Aeromonas</em> species. Confirmation was therefore carried out using the automated BD Phoenix system and biochemical reactions. The results showed <em>Aeromonas veronii</em> biovar <em>sobria</em>. Fortunately, in our cases, the intestinal infection was self-limiting and no antibiotics were given. This case highlights a rare occurrence of <em>Aeromonas</em> intestinal infection and demonstrates the risk of river and freshwater fish in transmitting <em>Aeromonas</em> to humans, especially in infants and child, which can be dangerous for this age group. It highlights the potential health risks associated with drinking water from natural sources, especially in rural areas or in underserved areas where the quality of the water may be compromised. To understand the prevalence of <em>Aeromonas</em> infections in similar settings and develop targeted prevention strategies, we recommend further epidemiological studies and healthcare providers should be vigilant and consider <em>Aeromonas</em> as a potential pathogen in patients with gastrointestinal symptoms, especially after exposure to contaminated water.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02245"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911575","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}
Pub Date : 2025-01-01DOI: 10.1016/j.idcr.2025.e02165
Neaam Al-Bahadili, Ibrahim Shamasneh, Chinelo Meniru, Zola Nlandu
Ehrlichiosis is a bacterial illness primarily transmitted through the bite of an infected lone star tick. According to the Centers for Disease Control (CDC), the United States is experiencing a rising number of reported cases, with a case fatality rate of approximately 1 %. The disease typically manifests as a non-specific flu-like illness, however in rare cases, it can progress to severe disease with multi-organ failure and mortality. We present a case of a 70-year-old male who was transferred to the intensive care unit of our facility for the management of septic shock associated with multi-organ failure. He had a history of recent exposure to multiple tick-bites while performing yard work. He was diagnosed with Ehrlichiosis based on positive serum IgM and IgG antibodies against Ehrlichia chaffeenesis. A lumbar puncture also confirmed meningoencephalitis. The patient completed intravenous Doxycycline treatment for 14 days, resulting in clinical improvement. Identifying Ehrlichia as the causal organism for meningoencephalitis and severe disease is challenging due to its low prevalence. This case emphasizes the significance of promptly suspecting and identifying ehrlichiosis in patients who exhibit meningoencephalitis symptoms or end-organ failure and have a recent history of engaging in outdoor activities with a risk of exposure to ticks, especially in endemic regions. It also signifies the importance of empirically treating with doxycycline even before its diagnosis as delay in providing doxycycline can significantly lead to more complications compared with patients who receive it early on during hospital admission.
{"title":"A case of ehrlichiosis with meningoencephalitis and multi-organ failure","authors":"Neaam Al-Bahadili, Ibrahim Shamasneh, Chinelo Meniru, Zola Nlandu","doi":"10.1016/j.idcr.2025.e02165","DOIUrl":"10.1016/j.idcr.2025.e02165","url":null,"abstract":"<div><div>Ehrlichiosis is a bacterial illness primarily transmitted through the bite of an infected lone star tick. According to the Centers for Disease Control (CDC), the United States is experiencing a rising number of reported cases, with a case fatality rate of approximately 1 %. The disease typically manifests as a non-specific flu-like illness, however in rare cases, it can progress to severe disease with multi-organ failure and mortality. We present a case of a 70-year-old male who was transferred to the intensive care unit of our facility for the management of septic shock associated with multi-organ failure. He had a history of recent exposure to multiple tick-bites while performing yard work. He was diagnosed with Ehrlichiosis based on positive serum IgM and IgG antibodies against Ehrlichia chaffeenesis. A lumbar puncture also confirmed meningoencephalitis. The patient completed intravenous Doxycycline treatment for 14 days, resulting in clinical improvement. Identifying Ehrlichia as the causal organism for meningoencephalitis and severe disease is challenging due to its low prevalence. This case emphasizes the significance of promptly suspecting and identifying ehrlichiosis in patients who exhibit meningoencephalitis symptoms or end-organ failure and have a recent history of engaging in outdoor activities with a risk of exposure to ticks, especially in endemic regions. It also signifies the importance of empirically treating with doxycycline even before its diagnosis as delay in providing doxycycline can significantly lead to more complications compared with patients who receive it early on during hospital admission.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02165"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.idcr.2025.e02154
Yukiko Fukui-Watanabe , Mai Suzuki , Asako Ochiai , Karin Ashizawa , Harumi Saeki , Toshio Naito
A 30-year-old woman presented with infertility and irregular menstruation. Physical examination revealed obesity and slightly pale conjunctivae. Transvaginal ultrasound revealed polycystic ovary, bilateral hydrosalpinx, and endometrial thickening. Magnetic resonance imaging of the pelvis showed several large cystic lesions and elongated fallopian tubes. An endometrial biopsy was performed to investigate the endometrial thickening. Pathological findings included small non-caseating epithelioid cell granulomas with scattered plasma cell infiltration. The microbiological analysis of the endometrial biopsy sample showed a negative result for Ziehl–Neelsen staining; however, after four weeks, the Mycobacterium culture was positive for Mycobacterium tuberculosis. Thus, a definitive diagnosis of tuberculous endometritis was made. The patient was effectively treated with the standard treatment comprising isoniazid, rifampicin, ethambutol, and pyrazinamide for 6 months.
{"title":"A case of infertility diagnosed with tuberculous endometritis","authors":"Yukiko Fukui-Watanabe , Mai Suzuki , Asako Ochiai , Karin Ashizawa , Harumi Saeki , Toshio Naito","doi":"10.1016/j.idcr.2025.e02154","DOIUrl":"10.1016/j.idcr.2025.e02154","url":null,"abstract":"<div><div>A 30-year-old woman presented with infertility and irregular menstruation. Physical examination revealed obesity and slightly pale conjunctivae. Transvaginal ultrasound revealed polycystic ovary, bilateral hydrosalpinx, and endometrial thickening. Magnetic resonance imaging of the pelvis showed several large cystic lesions and elongated fallopian tubes. An endometrial biopsy was performed to investigate the endometrial thickening. Pathological findings included small non-caseating epithelioid cell granulomas with scattered plasma cell infiltration. The microbiological analysis of the endometrial biopsy sample showed a negative result for Ziehl–Neelsen staining; however, after four weeks, the Mycobacterium culture was positive for <em>Mycobacterium tuberculosis</em>. Thus, a definitive diagnosis of tuberculous endometritis was made. The patient was effectively treated with the standard treatment comprising isoniazid, rifampicin, ethambutol, and pyrazinamide for 6 months.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02154"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.idcr.2024.e02144
Kelly Larimore , Claudia R. Libertin
This case report presents a patient with exogenous endophthalmitis caused by Fusarium falciformis, highlighting the risks associated with immunosuppressive therapy using Adalimumab for rheumatoid arthritis. The patient's compromised immune system, likely exacerbated by gardening exposure, facilitated the fungal infection, marking the first documented instance of Fusarium-related endophthalmitis linked to Adalimumab. Fusarium species are prevalent in the environment but are infrequently recognized as pathogens in humans, particularly in immunocompromised individuals. The differentiation between infectious and non-infectious ocular inflammation poses a significant challenge for clinicians. In this case, early involvement of ophthalmology was critical, leading to effective treatment strategies. Notably, in vitro testing revealed unexpected sensitivity of the isolated Fusarium strain to amphotericin B, which, combined with posaconazole, proved beneficial when combined with intravitreal injections of amphotericin B. This underscores the importance of tailored therapeutic approaches for rare ocular fungal infections and the necessity for increased awareness among healthcare providers regarding potential ocular adverse effects of biologic therapies. Ultimately, this case serves as a vital reminder of the complexities in managing ocular infections in patients receiving immunomodulatory treatments, advocating for vigilant assessment and prompt intervention to preserve vision.
{"title":"A rare encounter: Fusarium falciformis and the challenges of ocular infection in the context of biologic therapy","authors":"Kelly Larimore , Claudia R. Libertin","doi":"10.1016/j.idcr.2024.e02144","DOIUrl":"10.1016/j.idcr.2024.e02144","url":null,"abstract":"<div><div>This case report presents a patient with exogenous endophthalmitis caused by <em>Fusarium falciformis</em>, highlighting the risks associated with immunosuppressive therapy using Adalimumab for rheumatoid arthritis. The patient's compromised immune system, likely exacerbated by gardening exposure, facilitated the fungal infection, marking the first documented instance of <em>Fusarium</em>-related endophthalmitis linked to Adalimumab. <em>Fusarium</em> species are prevalent in the environment but are infrequently recognized as pathogens in humans, particularly in immunocompromised individuals. The differentiation between infectious and non-infectious ocular inflammation poses a significant challenge for clinicians. In this case, early involvement of ophthalmology was critical, leading to effective treatment strategies. Notably, in vitro testing revealed unexpected sensitivity of the isolated <em>Fusarium</em> strain to amphotericin B, which, combined with posaconazole, proved beneficial when combined with intravitreal injections of amphotericin B. This underscores the importance of tailored therapeutic approaches for rare ocular fungal infections and the necessity for increased awareness among healthcare providers regarding potential ocular adverse effects of biologic therapies. Ultimately, this case serves as a vital reminder of the complexities in managing ocular infections in patients receiving immunomodulatory treatments, advocating for vigilant assessment and prompt intervention to preserve vision.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02144"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.idcr.2025.e02206
Zahra Sheidae Mehne , Ali Akbar Heydari , Kiana Ketabi , Ali Samimi , Elham Honarjou
Pseudomonas species are environmental Gram-negative bacteria recognized for their potential to cause opportunistic infections, particularly among immunocompromised patients and those with a history of surgical procedures. Community-acquired meningoencephalitis resulting from Pseudomonas infection is rare but poses a significant risk of mortality. This case describes an unusual instance of primary Pseudomonas meningoencephalitis in a patient with diabetes mellitus, highlighting the necessity of early recognition and timely management.
{"title":"Community acquired Pseudomonas meningoencephalitis in a middle-aged diabetic woman: A case report","authors":"Zahra Sheidae Mehne , Ali Akbar Heydari , Kiana Ketabi , Ali Samimi , Elham Honarjou","doi":"10.1016/j.idcr.2025.e02206","DOIUrl":"10.1016/j.idcr.2025.e02206","url":null,"abstract":"<div><div><em>Pseudomonas</em> species are environmental Gram-negative bacteria recognized for their potential to cause opportunistic infections, particularly among immunocompromised patients and those with a history of surgical procedures. Community-acquired meningoencephalitis resulting from <em>Pseudomonas</em> infection is rare but poses a significant risk of mortality. This case describes an unusual instance of primary <em>Pseudomonas</em> meningoencephalitis in a patient with diabetes mellitus, highlighting the necessity of early recognition and timely management.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02206"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839060","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}
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