IDCases最新文献

Human fascioliasis, caused by Fasciola hepatica and Fasciolagigantica, is a neglected tropical disease of increasing public health significance. Reported cases are rare, with only one serologically confirmed instance in Ethiopia to date. We present the case of a male patient in his late twenties, without identified risk factors, who presented with bilateral upper quadrant pain persisting for a year and a history of repeated treatment for H. pylori gastritis. Initial ultrasound findings prompted further investigation with abdominal CT, contrast-enhanced MRI, and MRCP, leading to a diagnostic shift confirmed by a positive enzyme-linked assay for Fasciola hepatica. This case highlights the diagnostic challenges and the critical role of radiological imaging—ultrasound, CT, and MRIin identifying key features such as biliary dilation and parenchymal abnormalities, crucial for early detection and effective management of human fascioliasis.

Lomentospora prolificans is a rare, filamentous fungus, that causes a disseminated infection in immunocompromised individuals. Disseminated infections caused by the fungus are difficult to diagnose early. It is resistant to multiple antifungal agents and has a high mortality rate. We encountered a case in which the involvement of this fungus was indicated by a history of antifungal prophylaxis and an elevated serum 1,3-beta-D-glucan (BDG) level. A 76-year-old female with myelodysplastic syndrome that developed into overt leukemia was administered oral posaconazole as antifungal prophylaxis. She was admitted to the hospital to determine the cause of her fever, where no new abnormalities other than an elevated serum BDG level were observed. Unfortunately, the patient died due to acute respiratory failure on the same day of admission. The day after her death, L. prolificans was detected in a blood culture taken upon her admission. L. prolificans should be suspected based on the history of antifungal prophylaxis and an elevated serum BDG level, as these are risk factors for infection by this pathogen. Blood cultures are useful to provide a diagnosis. If treated early, before it is detected in culture, the mortality rate can be decreased.

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