Case Reports in Infectious Diseases最新文献

Nocardia species constitute a diverse group of microorganisms classified as aerobic actinomyces. Among these species, many have been implicated as causative agents of severe human infections, particularly in immunocompromised patients, affecting lungs, skin, and nervous system. Here, we described a rare species, identified as Nocardia kroppenstedtii, isolated at the Complex Operative Unit of Virology and Microbiology from the subxiphoid formation and pseudonodular formation in the left leg of a 69-year-old immunocompetent patient, who was hospitalized and treated at the Complex Operative Unit of Internal Medicine and Geriatrics of the University Hospital of Campania "Luigi Vanvitelli" in an antimicrobial diagnostic stewardship context. This rare pathogen was first isolated in 2014 from a bronchoalveolar lavage sample obtained from a lung transplant recipient. Since then, only five cases of clinical interest have been described in literature.

Carbapenemases have had increasing prevalence within the United States and worldwide. Here, we present a case of carbapenem-resistant Klebsiella pneumoniae (CRKP) which is unique due to the rarity of multiple mechanisms of resistance within the Klebsiella pneumoniae harboring New Delhi metallo-β-lactamases (NDM), oxacillinase-48 (OXA-48)-like, and cefotaximase (CTX-M) resistance genes, detected in a patient following an international travel. This case demonstrates the need for a multidisciplinary approach to optimize the treatment of multidrug-resistant Gram-negative organisms.

Background: Trueperella bernardiae is a Gram-positive rod that has been described as an opportunistic pathogen in immunocompromised patients. In a significant number of documented cases, infections with Trueperella bernardiae have been associated with polymicrobial infections, which highlight the fact that important bacteria-bacteria relations might be involved in the natural course of these infections, especially in patients with chronic disease courses and a history of multiple antibiotic treatments. Case Presentation: We present a case of a 24-year-old woman with a 3-year history of a chronic pressure ulcer on the right foot associated with varus and cavus deformity. As per relevant medical history, she was positive for multiple wound healing sessions with wound debridement and a large number of antibiotic treatments with minimal improvement. Microbiological cultures were taken from the wound, and a soft tissue infection diagnosis was initially made. Empirical treatment was initiated with levofloxacin. At 48 h, cultures were positive for Providencia stuartii, Pseudomonas aeruginosa, Proteus penneri, Streptococcus agalactiae, and Trueperella bernardiae, and the susceptibility test was performed. Three weeks later, the symptoms progressed to purulent exudate of the wound and foul-smelling with the positive probe-to-bone test. Diagnosis was changed to polymicrobial osteomyelitis, and antibiotic therapy with ciprofloxacin and trimethoprim-sulfamethoxazole was prescribed for a 4-week course of treatment, achieving the complete remission of symptoms. Conclusions: Trueperella bernardiae represents an emerging bacterium that can be isolated in various clinical presentations. On osteoarticular infections, the presence of comorbidities, mobility limitations, and a history of multiple antibiotic treatments may be determinant. Their isolation as part of polymicrobial infections highlights relevant interspecies interactions. Research is still lacking in determining standardized methodologies for susceptibility testing and specific clinical breakpoints to guide clinical decisions.

We present the case of a fully vaccinated 39-year-old male with no pertinent past medical history who initially presented with De Quervain's tenosynovitis which was successfully treated with a corticosteroid injection. His symptoms recurred during a COVID-19 infection, which was treated with a repeat corticosteroid injection. Symptoms recurred during an influenza infection and were subsequently treated with a first dorsal compartment release. The etiology of De Quervain's tenosynovitis remains unclear. It has classically been categorized as a noninflammatory degenerative process, but recent evidence suggests a possible inflammatory connection. Here, we present a case of recurrent De Quervain's tenosynovitis exacerbated by two distinct viral infections. We hypothesize that viral-induced systemic inflammation led to localized recurrence of inflammation within the tendon sheath. Further studies including cytokine analysis and inflammatory markers are needed to advance this hypothesis.

Cytomegalovirus (CMV) infection in immunocompromised patients can cause significant morbidity and mortality. Early recognition and treatment helps to improve outcome. We present a case of postrenal transplant CMV infection causing both upper and lower gastrointestinal infection and symptoms. Patient developed significant co-morbidity which required multiple hospital admissions and therapeutic interventions.

Psittacosis is a zoonotic disease caused by Chlamydia psittaci and is commonly found in birds and poultry. Human infection is uncommon, and most cases are sporadic. Infection of extrapulmonary organs by Chlamydia psittaci is extremely rare. A rare case of infective endocarditis complicated by pneumonia caused by Chlamydia psittaci was reported, which was diagnosed using metagenomic next-generation sequencing (mNGS). The patient recovered after receiving appropriate anti-infective treatment. Discussion on the pathogenesis, diagnosis, and treatment of this disease based on recent literature reports aimed to improve the prognosis of similar patients and enhance the understanding of clinicians.

Whipple's disease is a rare bacterial infection that is often present for years prior to diagnosis. Symptoms are nonspecific in the early stages of presentation and are primarily gastrointestinal in nature. The disease may progress with more systemic symptoms including arthralgia, fever, lymphadenopathy, cardiovascular disease, and central nervous system involvement. This case describes a man with a history of long-standing, nonspecific symptoms who only began to show significant improvement after an incidental finding of Whipple's disease. Due to its rare nature, other instances of the disease have likely gone undiagnosed. A brief review of relevant literature is also included.

Introduction: Mycobacterium marinum was first described in humans in 1954, known to infect fish species and contaminate water and fish products. Inoculation to humans occurs through injured skin resulting in the formation of a solitary nodule known as "fish tank granuloma." Disseminated infections have been reported in the immunocompromised and can present with extracutaneous manifestations such as arthritis and osteomyelitis. Nonaquatic transmission has not been previously reported. Case Presentation: A 63-year-old lady with rheumatoid arthritis and bronchiectasis was referred to dermatology with widespread soft dermal plaques, pustules, erosions, and necrotic wounds. Multiple bacterial and viral swabs were negative. A biopsy was performed that showed a neutrophilic dermatosis suggestive of Sweet's Syndrome. The patient initially improved with prednisolone, but subsequently deteriorated with a worsening rash, joint pains, and neutropenic sepsis. Repeat biopsies eventually revealed abundant acid-fast bacilli, later confirmed to be Mycobacterium marinum. Our patient had no history of exposure to aquatic organisms but had previously cared for an inland bearded dragon with an unknown illness. Although infection with M. marinum has been reported in reptiles, cases of nonaquatic zoonotic transmission have not been described in the literature. Conclusion: Mycobacterium marinum infection should be considered in patients with indicative clinical and histological features, especially in the immunocompromised, even in the absence of an obvious aquatic source of infection. Awareness of this entity could lead to earlier diagnoses and reduced morbidity and mortality.

Background: Lemierre's syndrome (LS), first described by Andre Lemierre in the early 20th century, is a rare but potentially life-threatening condition typically caused by Fusobacterium necrophorum. However, recent literature has reported cases of LS caused by various other bacteria, including Klebsiella pneumoniae. In this report, we present a rare case of LS in a patient with diabetes caused by K. pneumoniae. Case Report: A 62-year-old Vietnamese male with a history of type 2 diabetes mellitus, presented with an 8-day history of progressive left neck swelling, fever, dysphagia, odynophagia, and reduced appetite. Despite initial antibiotic therapy, his condition deteriorated, leading to pulmonary abscesses and septic shock. Abscess content culture revealed K. pneumoniae. The patient required intubation, mechanical ventilation, and surgical drainage of the neck abscess. Treatment with meropenem, along with glycemic control, led to clinical improvement. The patient was subsequently extubated, achieved complete wound healing, and was discharged with normal biochemical parameters. Conclusion: This case highlights that LS can be caused by pathogens not initially outlined by Andre Lemierre, such as K. pneumoniae. Clinicians should consider a broader spectrum of causative organisms when there is a strong clinical suspicion of LS and adjust antimicrobial coverage accordingly. The association between K. pneumoniae-related LS and diabetes mellitus warrants further investigation, as current evidence suggests that diabetes may predispose patients to this particular pathogen.

Invasive mucormycosis is an aggressive fungal infection characterized by rapid progression, primarily impacting immunocompromised individuals. Herein, we report a case of splenic infarction in association with gastrointestinal fistula and brain abscess as a rare presentation of mucormycosis biopsy, proven in a 56-year-old patient diagnosed with acute myeloid leukemia. The patient initially sought medical attention with a 3-week history of fever, night sweats, and malaise. Considering the chest computed tomography findings compatible with fungal disease and neutropenia, he underwent broad-spectrum antifungal therapy. Following the occurrence of splenic infarctions and a gastric fistula, the patient underwent a partial gastrectomy and splenectomy. Despite the interventions, the patient did not have a successful outcome and died on the second postoperative day. This case highlights the importance of timely suspicion, immediate antifungal therapy, and surgical intervention to improve the survival prospects of patients with multifaceted manifestations of mucormycosis.