Pub Date : 2025-01-01DOI: 10.1016/j.idcr.2025.e02158
Dhara Rana , Anson Marsh , Mahum Sami , Hiral Shukla , Dimitris Barbouletos , Nicholas Calder
Influenza A viral infection classically presents as pulmonary manifestations which often require symptomatic management. It can rarely be complicated by pericarditis with concurrent pericardial effusion. We present a unique case of myopericarditis with a pericardial effusion caused by Influenza A. Our patient was presented with elevated troponin and BNP. Chest x-ray showed an enlargement of the cardiac silhouette and clear lungs. CT angiography was remarkable for pericardial effusion. An echocardiogram was performed which demonstrated mild concentric left ventricular hypertrophy with small to moderate circumferential pericardial effusion, and no echocardiographic signs of cardiac tamponade. The significance of our case makes clinicians aware that acute myopericarditis with concurrent pericardial effusion can lead to fatal complications such as cardiac tamponade or cardiogenic shock if left untreated. Early diagnosis and treatment as presented in our case could reduce the risk of such severe cardiac events from occurring.
{"title":"Influenza A Virus Complicated by Myopericarditis with Pericardial Effusion","authors":"Dhara Rana , Anson Marsh , Mahum Sami , Hiral Shukla , Dimitris Barbouletos , Nicholas Calder","doi":"10.1016/j.idcr.2025.e02158","DOIUrl":"10.1016/j.idcr.2025.e02158","url":null,"abstract":"<div><div>Influenza A viral infection classically presents as pulmonary manifestations which often require symptomatic management. It can rarely be complicated by pericarditis with concurrent pericardial effusion. We present a unique case of myopericarditis with a pericardial effusion caused by Influenza A. Our patient was presented with elevated troponin and BNP. Chest x-ray showed an enlargement of the cardiac silhouette and clear lungs. CT angiography was remarkable for pericardial effusion. An echocardiogram was performed which demonstrated mild concentric left ventricular hypertrophy with small to moderate circumferential pericardial effusion, and no echocardiographic signs of cardiac tamponade. The significance of our case makes clinicians aware that acute myopericarditis with concurrent pericardial effusion can lead to fatal complications such as cardiac tamponade or cardiogenic shock if left untreated. Early diagnosis and treatment as presented in our case could reduce the risk of such severe cardiac events from occurring.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02158"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081521","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.e02194
Miguel Franco Álvarez , Andrea Jardi Cuadrado , Mariño Francisco Fernández Cambeiro , Adrián Domínguez Lago , José Antonio Díaz Peromingo
Veillonella atypica is an anaerobic Gram-negative coccus, a common commensal of the human oral, vaginal and intestinal microbiota, which rarely causes infections in the human host. To date, only two cases of bacteraemia caused by this germ have been reported in the literature. We present the case of a 50-year-old male patient with liver cirrhosis who developed V. atypica bacteraemia in the context of acute diverticulitis complicated by an enterovesical fistula.
{"title":"Veillonella atypica bacteraemia: Case report and literature review","authors":"Miguel Franco Álvarez , Andrea Jardi Cuadrado , Mariño Francisco Fernández Cambeiro , Adrián Domínguez Lago , José Antonio Díaz Peromingo","doi":"10.1016/j.idcr.2025.e02194","DOIUrl":"10.1016/j.idcr.2025.e02194","url":null,"abstract":"<div><div><em>Veillonella atypica</em> is an anaerobic Gram-negative coccus, a common commensal of the human oral, vaginal and intestinal microbiota, which rarely causes infections in the human host. To date, only two cases of bacteraemia caused by this germ have been reported in the literature. We present the case of a 50-year-old male patient with liver cirrhosis who developed V. atypica bacteraemia in the context of acute diverticulitis complicated by an enterovesical fistula.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02194"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143570576","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.e02259
Kevin Kurator , Leona Mason , David Bruckner , Hongying Tan , Glenn Mathisen
Cystoisosporiasis is caused by a coccidian parasite that is found worldwide and can cause diarrheal illness. It is more common in the immunocompromised, in whom it can cause extended and severe disease courses. Diagnosis is not always straightforward as oocytes are not always present in routine stool samples, but it is possible to visualize the organism with specialized staining techniques as well as within enterocytes on intestinal biopsies. We present a case in which this mode of diagnosis was crucial for determining the cause of diarrhea in a patient with HIV and CD4 count above 200 cells/mm3.
{"title":"Diagnosis of cystoisosporiasis in a patient with HIV and modestly decreased CD4 counts","authors":"Kevin Kurator , Leona Mason , David Bruckner , Hongying Tan , Glenn Mathisen","doi":"10.1016/j.idcr.2025.e02259","DOIUrl":"10.1016/j.idcr.2025.e02259","url":null,"abstract":"<div><div>Cystoisosporiasis is caused by a coccidian parasite that is found worldwide and can cause diarrheal illness. It is more common in the immunocompromised, in whom it can cause extended and severe disease courses. Diagnosis is not always straightforward as oocytes are not always present in routine stool samples, but it is possible to visualize the organism with specialized staining techniques as well as within enterocytes on intestinal biopsies. We present a case in which this mode of diagnosis was crucial for determining the cause of diarrhea in a patient with HIV and CD4 count above 200 cells/mm<sup>3</sup>.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02259"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124714","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.e02254
Zhuo Wang
This paper introduced the diagnosis and treatment of a case of severe Dabie bandavirus infection. The disease is called severe fever with thrombocytopenia syndrome (SFTS). The disease is an acute natural epidemic disease. The disease is usually endemic in mountainous and hilly areas, in summer and autumn. Most often associated with tick bites. The main clinical manifestations of SFTS are fever, leukopenia and/or thrombocytopenia, lymphadenopathy, fatigue and gastrointestinal symptoms. The most of the prognosis is good. Aged, with underlying diseases or delay seeking medical attention, the disease can progress to a severe state. In severe cases, death can result from multiple organ failure.
{"title":"Severe fever with thrombocytopenia syndrome (Dabie bandavirus infection)","authors":"Zhuo Wang","doi":"10.1016/j.idcr.2025.e02254","DOIUrl":"10.1016/j.idcr.2025.e02254","url":null,"abstract":"<div><div>This paper introduced the diagnosis and treatment of a case of severe Dabie bandavirus infection. The disease is called severe fever with thrombocytopenia syndrome (SFTS). The disease is an acute natural epidemic disease. The disease is usually endemic in mountainous and hilly areas, in summer and autumn. Most often associated with tick bites. The main clinical manifestations of SFTS are fever, leukopenia and/or thrombocytopenia, lymphadenopathy, fatigue and gastrointestinal symptoms. The most of the prognosis is good. Aged, with underlying diseases or delay seeking medical attention, the disease can progress to a severe state. In severe cases, death can result from multiple organ failure.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02254"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147170","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}
Erysipelothrix rhusiopathiae is a zoonotic, facultatively anaerobic, non-spore-forming, gram-positive bacillus. Although the serotypes and phylogenetic clades of E. rhusiopathiae strains isolated from animals have been shown to be closely related, the serotype identification of clinical isolates from human patients remains limited. We report a case of a 66-year-old woman with bacteremia caused by E. rhusiopathiae serotype 6. The patient had been admitted with aspiration pneumonia and heat stroke. She had no animal-related occupational history and had been receiving long-term oral prednisolone therapy for mixed connective tissue disease. Upon confirmation of E. rhusiopathiae positivity on blood cultures, she was treated with intravenous ampicillin for 10 days and achieved complete recovery. Agar gel precipitation and polymerase chain reaction tests identified the isolate as serotype 6. Surface protective antigen (Spa) typing by sequence analysis suggested a marine animal origin of infection. To the best of our knowledge, this is the first reported case of bacteremia caused by E. rhusiopathiae serotype 6 in humans. Spa typing through sequence analysis may provide variable information for identifying the infection source. E. rhusiopathiae carrying the SpaB gene should be considered in immunosuppressed patients, regardless of animal exposure history. Further studies are needed to elucidate the epidemiological distribution of serotypes among human clinical isolates.
{"title":"Bloodstream infection caused by Erysipelothrix rhusiopathiae serotype 6: Case report and literature review","authors":"Asumi Suzuki, Mariko Hakamata, Syunya Tanikawa, Naoto Kanno, Ikumi Yamagishi, Masahiro Ui, Hayato Tsuruma, Yuuki Bamba, Hideyuki Ogata, Satoshi Shibata, Hiromi Cho, Mizuho Sato, Nobumasa Aoki, Hiroshi Moro, Toshiaki Kikuchi","doi":"10.1016/j.idcr.2025.e02329","DOIUrl":"10.1016/j.idcr.2025.e02329","url":null,"abstract":"<div><div><em>Erysipelothrix rhusiopathiae</em> is a zoonotic, facultatively anaerobic, non-spore-forming, gram-positive bacillus. Although the serotypes and phylogenetic clades of <em>E. rhusiopathiae</em> strains isolated from animals have been shown to be closely related, the serotype identification of clinical isolates from human patients remains limited. We report a case of a 66-year-old woman with bacteremia caused by <em>E. rhusiopathiae</em> serotype 6. The patient had been admitted with aspiration pneumonia and heat stroke. She had no animal-related occupational history and had been receiving long-term oral prednisolone therapy for mixed connective tissue disease. Upon confirmation of <em>E. rhusiopathiae</em> positivity on blood cultures, she was treated with intravenous ampicillin for 10 days and achieved complete recovery. Agar gel precipitation and polymerase chain reaction tests identified the isolate as serotype 6. Surface protective antigen (Spa) typing by sequence analysis suggested a marine animal origin of infection. To the best of our knowledge, this is the first reported case of bacteremia caused by <em>E. rhusiopathiae</em> serotype 6 in humans. Spa typing through sequence analysis may provide variable information for identifying the infection source. <em>E. rhusiopathiae</em> carrying the <em>SpaB</em> gene should be considered in immunosuppressed patients, regardless of animal exposure history. Further studies are needed to elucidate the epidemiological distribution of serotypes among human clinical isolates.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02329"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704006","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.e02316
Sabeen Zara , Junais Koleri , Maisa Ali , Fatma Abid , Jabeed Parengal , Manal Mahmoud Hamed , Muna Al Maslamani
Splenic abscess is a rare, life-threatening condition often resulting from hematogenous spread or contiguous infection. We report a 14-year-old immunocompetent male presenting with fever, diarrhea, and left upper quadrant pain. A CT scan revealed a 14-cm splenic abscess. Initial blood and aspirate cultures were negative, and empirical ceftriaxone and metronidazole yielded poor response. Multiplex PCR Gastrointestinal Panel and 16S rRNA sequencing identified Campylobacter jejuni, prompting targeted therapy with azithromycin and meropenem. Percutaneous drainage and antibiotics led to resolution. This case underscores the role of molecular diagnostics in culture-negative infections and highlights Campylobacter as a rare cause of splenic abscess in immunocompetent patients.
{"title":"Molecular diagnosis of campylobacter splenic abscess in an immunocompetent adolescent: A case report and literature review","authors":"Sabeen Zara , Junais Koleri , Maisa Ali , Fatma Abid , Jabeed Parengal , Manal Mahmoud Hamed , Muna Al Maslamani","doi":"10.1016/j.idcr.2025.e02316","DOIUrl":"10.1016/j.idcr.2025.e02316","url":null,"abstract":"<div><div>Splenic abscess is a rare, life-threatening condition often resulting from hematogenous spread or contiguous infection. We report a 14-year-old immunocompetent male presenting with fever, diarrhea, and left upper quadrant pain. A CT scan revealed a 14-cm splenic abscess. Initial blood and aspirate cultures were negative, and empirical ceftriaxone and metronidazole yielded poor response. Multiplex PCR Gastrointestinal Panel and 16S rRNA sequencing identified <em>Campylobacter jejuni,</em> prompting targeted therapy with azithromycin and meropenem. Percutaneous drainage and antibiotics led to resolution. This case underscores the role of molecular diagnostics in culture-negative infections and highlights <em>Campylobacter</em> as a rare cause of splenic abscess in immunocompetent patients.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02316"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653526","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.e02307
Xiao-Ling Zhong, Chen-Li Yang, Xiao-Long Yu, Ling Wang
Herpes simplex virus-1 (HSV-1) encephalitis is a severe neurological disease with high mortality and morbidity despite antiviral therapy. The role of adjunctive immunomodulatory treatments like intravenous immunoglobulin (IVIG) and glucocorticoids remains uncertain. We report a fatal case of severe HSV-1 encephalitis in a 59-year-old man who developed hemorrhagic necrosis despite combined treatment with acyclovir, IVIG (0.4 g/kg/day), and methylprednisolone (80 mg/day). CSF PCR and MRI confirmed the diagnosis, with subsequent imaging showing progressive left hemispheric hemorrhage requiring surgical evacuation. The patient deteriorated neurologically and died on day 56. This case adds to growing evidence questioning the efficacy of adjunctive IVIG/steroids in advanced HSV-1 encephalitis, particularly with hemorrhagic complications. While some studies suggest potential benefits during the inflammatory phase, our experience highlights their limitations in critical cases. More research is needed to identify which patients might benefit from immunomodulation and optimal treatment timing.
{"title":"Limited efficacy of adjunctive therapy in a case of severe herpes simplex virus encephalitis: A case report and literature review","authors":"Xiao-Ling Zhong, Chen-Li Yang, Xiao-Long Yu, Ling Wang","doi":"10.1016/j.idcr.2025.e02307","DOIUrl":"10.1016/j.idcr.2025.e02307","url":null,"abstract":"<div><div>Herpes simplex virus-1 (HSV-1) encephalitis is a severe neurological disease with high mortality and morbidity despite antiviral therapy. The role of adjunctive immunomodulatory treatments like intravenous immunoglobulin (IVIG) and glucocorticoids remains uncertain. We report a fatal case of severe HSV-1 encephalitis in a 59-year-old man who developed hemorrhagic necrosis despite combined treatment with acyclovir, IVIG (0.4 g/kg/day), and methylprednisolone (80 mg/day). CSF PCR and MRI confirmed the diagnosis, with subsequent imaging showing progressive left hemispheric hemorrhage requiring surgical evacuation. The patient deteriorated neurologically and died on day 56. This case adds to growing evidence questioning the efficacy of adjunctive IVIG/steroids in advanced HSV-1 encephalitis, particularly with hemorrhagic complications. While some studies suggest potential benefits during the inflammatory phase, our experience highlights their limitations in critical cases. More research is needed to identify which patients might benefit from immunomodulation and optimal treatment timing.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02307"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523901","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.e02311
Shay Nakahira , Marcus Yamamoto , Terry Wood
Purpose
Cryptococcal meningitis is a severe fungal infection that can present with a highly variable range of neuro-ophthalmic and systemic symptoms. Although more classically associated with immunocompromised individuals, it has increasingly been reported in immunocompetent hosts. Cryptococcus neoformans is typically linked to opportunistic infections in immunosuppressed populations, whereas Cryptococcus gattii more commonly affects immunocompetent individuals.
Observations
A healthy 40-year-old female presented with new onset recurrent headaches. After a normal MRI, she was re-assured by multiple physicians and given a presumptive diagnosis of stress induced migraine, as she had recently experienced the sudden unexpected death of her husband. Persistent and progressive headaches, focusing difficulties, and extreme photosensitivity prompted her to seek further evaluation by an ophthalmologist, who diagnosed her with Cryptococcal meningitis based on her lumbar puncture results.
Discussion and importance
Despite the initial clinical impression being suggestive of migraines, the patient was ultimately diagnosed with cryptococcal meningitis one month from the initial onset of her symptoms, with rapid advancement to an emergent situation ultimately resulting in two hospitalizations where she received numerous spinal fluid drainages, anti-fungal medications and a lumbar shunt. This case underscores the importance of comprehensive history-taking, clinical vigilance, and maintaining a broad differential diagnosis in the workup of any patient. Ocular symptoms, in this instance, served as an early manifestation of cryptococcal meningitis in an immunocompetent patient, highlighting the need for heightened awareness in clinical practice to ensure timely diagnosis and appropriate management.
{"title":"An unusual clinical presentation of Cryptococcal meningitis: The importance of a detailed history and physical","authors":"Shay Nakahira , Marcus Yamamoto , Terry Wood","doi":"10.1016/j.idcr.2025.e02311","DOIUrl":"10.1016/j.idcr.2025.e02311","url":null,"abstract":"<div><h3>Purpose</h3><div>Cryptococcal meningitis is a severe fungal infection that can present with a highly variable range of neuro-ophthalmic and systemic symptoms. Although more classically associated with immunocompromised individuals, it has increasingly been reported in immunocompetent hosts. Cryptococcus neoformans is typically linked to opportunistic infections in immunosuppressed populations, whereas Cryptococcus gattii more commonly affects immunocompetent individuals.</div></div><div><h3>Observations</h3><div>A healthy 40-year-old female presented with new onset recurrent headaches. After a normal MRI, she was re-assured by multiple physicians and given a presumptive diagnosis of stress induced migraine, as she had recently experienced the sudden unexpected death of her husband. Persistent and progressive headaches, focusing difficulties, and extreme photosensitivity prompted her to seek further evaluation by an ophthalmologist, who diagnosed her with Cryptococcal meningitis based on her lumbar puncture results.</div></div><div><h3>Discussion and importance</h3><div>Despite the initial clinical impression being suggestive of migraines, the patient was ultimately diagnosed with cryptococcal meningitis one month from the initial onset of her symptoms, with rapid advancement to an emergent situation ultimately resulting in two hospitalizations where she received numerous spinal fluid drainages, anti-fungal medications and a lumbar shunt. This case underscores the importance of comprehensive history-taking, clinical vigilance, and maintaining a broad differential diagnosis in the workup of any patient. Ocular symptoms, in this instance, served as an early manifestation of cryptococcal meningitis in an immunocompetent patient, highlighting the need for heightened awareness in clinical practice to ensure timely diagnosis and appropriate management.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02311"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714588","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.e02326
Siddartha Guru , Jyoti Saroya , Navami Guru , Poonam Bai
Non-tuberculous mycobacteria are a rare cause of olecranon bursitis. We present a case of a 65-year-old man with history of chronic olecranon bursitis status post bursectomy two years prior, presented with two weeks of right elbow swelling but no pain or redness. On exam, bursa was enlarged with mild warmth present but no concern for elbow joint involvement. The bursa was aspirated, fluid analysis revealed leukocytosis with monosodium urate crystals consistent with gout. Ten days later, the mycobacterial cultures grew Mycobacterium kansasii. Two weeks later, on repeat aspiration of right elbow bursa, fluid cultures grew M. kansasii. He was treated with rifampin, ethambutol and azithromycin. After two months on triple therapy his symptoms resolved. For source control he underwent bursectomy. Histopathology revealed necrotizing granulomas and bursa culture grew M. kansasii. After six months on triple therapy, patient developed ethambutol induced optic neuropathy, thus ethambutol was stopped. Rifampin and azithromycin were continued for total duration of eight months of antibiotic therapy post bursectomy. At six months follow up, patient had no symptoms but vision deficits had not improved from cessation of ethambutol. We did a literature review and compiled the previously three reported cases of M. kansasii olecranon bursitis.
{"title":"Mycobacterium kansasii chronic olecranon bursitis: A rare case report and literature review","authors":"Siddartha Guru , Jyoti Saroya , Navami Guru , Poonam Bai","doi":"10.1016/j.idcr.2025.e02326","DOIUrl":"10.1016/j.idcr.2025.e02326","url":null,"abstract":"<div><div>Non-tuberculous mycobacteria are a rare cause of olecranon bursitis. We present a case of a 65-year-old man with history of chronic olecranon bursitis status post bursectomy two years prior, presented with two weeks of right elbow swelling but no pain or redness. On exam, bursa was enlarged with mild warmth present but no concern for elbow joint involvement. The bursa was aspirated, fluid analysis revealed leukocytosis with monosodium urate crystals consistent with gout. Ten days later, the mycobacterial cultures grew <em>Mycobacterium kansasii</em>. Two weeks later, on repeat aspiration of right elbow bursa, fluid cultures grew <em>M. kansasii</em>. He was treated with rifampin, ethambutol and azithromycin. After two months on triple therapy his symptoms resolved. For source control he underwent bursectomy. Histopathology revealed necrotizing granulomas and bursa culture grew <em>M. kansasii</em>. After six months on triple therapy, patient developed ethambutol induced optic neuropathy, thus ethambutol was stopped. Rifampin and azithromycin were continued for total duration of eight months of antibiotic therapy post bursectomy. At six months follow up, patient had no symptoms but vision deficits had not improved from cessation of ethambutol. We did a literature review and compiled the previously three reported cases of <em>M. kansasii</em> olecranon bursitis.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02326"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662161","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}
Esophageal tuberculosis (TB) is an exceptionally rare manifestation of extra-pulmonary TB, often presenting diagnostic challenges due to its nonspecific symptoms and similarity to malignancies. We report the case of a 30-year-old female from rural Gondar, Ethiopia, who presented with progressive dysphagia and significant weight loss. Diagnosis was confirmed through endoscopic biopsy, revealing tuberculous esophageal ulcer. Our case underscores the importance of considering TB in the differential diagnosis of esophageal ulcers, particularly in TB-endemic regions. In addition, we compare this case with the existing literature, which highlights the varied clinical presentations and diagnostic challenges of esophageal TB.
{"title":"Esophageal tuberculosis presenting as progressive dysphagia in a 30-year-old female from rural Gondar, Ethiopia","authors":"Segenet Bizuneh Mengistu , Alula Abebe Kirub , Chalew Mengesha Abebe , Samuel Addisu Abera","doi":"10.1016/j.idcr.2025.e02345","DOIUrl":"10.1016/j.idcr.2025.e02345","url":null,"abstract":"<div><div>Esophageal tuberculosis (TB) is an exceptionally rare manifestation of extra-pulmonary TB, often presenting diagnostic challenges due to its nonspecific symptoms and similarity to malignancies. We report the case of a 30-year-old female from rural Gondar, Ethiopia, who presented with progressive dysphagia and significant weight loss. Diagnosis was confirmed through endoscopic biopsy, revealing tuberculous esophageal ulcer. Our case underscores the importance of considering TB in the differential diagnosis of esophageal ulcers, particularly in TB-endemic regions. In addition, we compare this case with the existing literature, which highlights the varied clinical presentations and diagnostic challenges of esophageal TB.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02345"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858533","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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