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Persistent Methicillin-Susceptible Bacteremia Rapidly Cleared with Cefazolin and Ertapenem Combination Therapy in a Patient with COVID-19 头孢唑林联合厄他培南快速清除COVID-19患者持续性甲氧西林敏感菌血症
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-04-20 DOI: 10.1155/2022/6828538
Dan Ilges, G. Krishnan, E. Geng
Methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSIs) are associated with significant morbidity and mortality. MSSA BSIs can rapidly disseminate, resulting in deep-seated infections, prolonged durations of bacteremia, and further metastases. Recently, cefazolin and ertapenem combination therapy has emerged as a potential therapeutic strategy to sterilize the blood in patients with persistent MSSA bacteremia. Here, we present a patient with COVID-19 pneumonia and concomitant MSSA BSI achieving blood culture sterilization within 24 hours of cefazolin and ertapenem combination therapy initiation following 11 days of positive blood cultures.
甲氧西林敏感金黄色葡萄球菌(MSSA)血流感染(bsi)与显著的发病率和死亡率相关。MSSA bsi可迅速传播,导致深层感染,延长菌血症持续时间,并进一步转移。最近,头孢唑林和厄他培南联合治疗已成为一种潜在的治疗策略,用于对持续性MSSA菌血症患者进行血液消毒。在这里,我们报告了一名患有COVID-19肺炎并伴有MSSA BSI的患者,在11天的血培养阳性后,头孢唑林和埃他培南联合治疗开始后24小时内实现了血培养灭菌。
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引用次数: 3
An Unusual Case of Francisella tularensis 罕见的土拉菌一例
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-04-18 DOI: 10.1155/2022/7250294
Samantha Huang, Brad Kaptur, Julius Manu, E. Woldegabriel
A 67-year-old male presented with complaints of weakness, fatigue, and shortness of breath in the context of a recent hospitalization for the same unresolved symptoms. After a largely nonspecific clinical presentation, a chest X-ray revealed a loculated pleural effusion. Culture of the postthoracentesis exudate revealed the culprit to be the aerobic Gram-negative bacterium Francisella tularensis. Amidst reports of potential resurgence, clinicians should be aware of the possible presentations of tularemia and consider it in the case of an ostensibly contributory patient history.
一名67岁男性,近期因同样未解症状住院,主诉虚弱、疲劳和呼吸短促。临床表现基本无特异性,胸部x线片显示室内性胸腔积液。胸腔穿刺后渗出液的培养表明罪魁祸首是需氧革兰氏阴性菌土拉菌。在潜在复发的报告中,临床医生应意识到土拉菌病的可能表现,并在表面上有贡献病史的情况下考虑它。
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引用次数: 1
Unique Presentation of Septic Cavernous Sinus Thrombosis and Pulmonary Embolism in the Setting of Reusable Face Covering 在可重复使用面罩的情况下脓毒性海绵窦血栓形成和肺栓塞的独特表现
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-04-15 DOI: 10.1155/2022/3388537
Javier J Barranco-Trabi, Jazmin C. Scott, Jacob M Fryer, M. Byrne, Adam J. Smith, Kaoru H Song, C. Tagawa, Sharon Chi, V. Ngauy
Identified in December 2019, SARS-CoV-2 quickly spread worldwide with a resultant increase in global morbidity, mortality, and economic disruption on a scale not seen since the 1918 Spanish flu. Health officials recommended universal masking to further reduce human-to-human spread of SARS-CoV-2. The state of Hawaii and the Department of Defense (DOD) adopted strict mask policies early in the pandemic and is shown to be effective at reducing transmission. We report a case of Staphylococcus aureus bacteremia in an immunocompetent 21-year-old man attributed to local skin irritation with resultant infection in the setting of continuous reuse of a mask that resulted in bilateral cavernous venous thrombosis and septic pulmonary embolism.
2019年12月发现的SARS-CoV-2迅速在全球传播,导致全球发病率、死亡率和经济中断的增加,这是自1918年西班牙流感以来从未见过的规模。卫生官员建议普遍口罩,以进一步减少SARS-CoV-2的人际传播。夏威夷州和国防部(DOD)在大流行早期采取了严格的口罩政策,并被证明在减少传播方面有效。我们报告一例免疫功能正常的21岁男性金黄色葡萄球菌菌血症,原因是持续重复使用口罩时局部皮肤刺激导致感染,导致双侧海绵静脉血栓形成和脓毒性肺栓塞。
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引用次数: 1
COVID-19 in an Adult with Down Syndrome: Impact on Autoimmune Response 成人唐氏综合征患者的COVID-19:对自身免疫反应的影响
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-04-13 DOI: 10.1155/2022/6128496
H. Kobayashi, Mana Akiniwa, Y. Yamaguchi, Y. Hirai, A. Aoki
We here report a case of COVID-19 with effusion prior to the development of pneumonia in an adult with Down syndrome. Serositis due to rheumatic disease was initially suspected because of a high titer of serum autoantibodies and leukocytopenia; however, SARS-CoV-2 infection was confirmed by reverse transcription polymerase chain reaction on admission after previous negative tests. Several cases of COVID-19 have been associated with autoimmune responses along with some cases of COVID-19 with autoimmune manifestations. Furthermore, patients with Down syndrome have a higher mortality risk from COVID-19 than the general population, and it is believed that a high sensitivity to the interferon response may contribute to the increased severity of the disease. Thus, careful attention should be paid to autoimmune manifestations due to SARS-CoV-2 infection for ensuring a proper and timely diagnosis, especially in patients with Down syndrome.
我们在此报告一例患有唐氏综合征的成人在发生肺炎之前出现COVID-19积液的病例。由于血清自身抗体滴度高和白细胞减少,风湿病引起的血清炎最初被怀疑;然而,入院时经逆转录聚合酶链反应确诊为SARS-CoV-2感染,此前检测呈阴性。一些COVID-19病例与自身免疫反应以及一些具有自身免疫表现的COVID-19病例有关。此外,唐氏综合征患者比一般人群死于COVID-19的风险更高,据信,对干扰素反应的高敏感性可能导致疾病严重程度增加。因此,应密切关注SARS-CoV-2感染后的自身免疫表现,以确保正确及时的诊断,特别是唐氏综合征患者。
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引用次数: 1
Bullous Scabies in an Immunocompromised Host 免疫功能低下宿主的大疱性疥疮
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-03-28 DOI: 10.1155/2022/3797745
James R. Wester, L. Jackson, Kathryn O Mokgosi, T. Barak, Mahmoud Abu Hazeem
A 40-year-old woman with a history of poorly controlled HIV presented to a district referral hospital in rural Botswana for a generalized skin rash of several months duration. The highly pruritic rash predominantly involved her hands and feet and was associated with bullae that were present for days at a time before rupturing without drainage or discharge. The patient endorsed night sweats, periodic fevers, occasional cough productive of blood-tinged sputum, fatigue, and weight loss. On admission, CD4 count was 46 cells/mm3 and viral load was >750000 copies/mL. Pulmonary tuberculosis testing via sputum was negative twice. A blood count demonstrated eosinophilia. Oral acyclovir was started empirically for disseminated herpes virus infection, with topical beclomethasone and intravenous antibiotics for possible superinfected bullous dermatosis. With inadequate response to treatment, a skin biopsy was obtained and microscopic examination demonstrated scabies mites. The absence of skin burrows, the presence of bullae, and working in a low-resource setting without direct access to microscopic examination delayed diagnosis. The patient was initiated on topical permethrin. Oral ivermectin was not available in country and was obtained from overseas shipment, delaying treatment initiation. Drastic improvement was seen after the patient initiated ivermectin. A local nurse in the patient's village visited her community and found multiple individuals with active scabies infection. The patient's discharge was delayed until these community members were treated successfully with topical permethrin. This case describes an atypical presentation of scabies in an under-resourced setting, demonstrating unique diagnostic, therapeutic, and public health challenges.
一名有艾滋病毒控制不良史的40岁妇女因持续数月的全身皮疹到博茨瓦纳农村的一家地区转诊医院就诊。高度瘙痒性皮疹主要累及她的手和脚,并伴有大疱,在破裂前出现数天,无排水或排出物。患者表现为盗汗、周期性发热、偶有带血痰咳嗽、疲劳和体重减轻。入院时,CD4计数为46个细胞/mm3,病毒载量为50750000拷贝/mL。痰液肺结核检查两次呈阴性。血球计数显示嗜酸性粒细胞增多。经经验开始口服阿昔洛韦治疗播散性疱疹病毒感染,外用倍氯米松和静脉注射抗生素治疗可能的重复感染大疱性皮肤病。由于对治疗反应不足,皮肤活检和显微镜检查显示疥疮螨。没有皮肤破洞,存在大疱,在资源匮乏的环境中工作,没有直接的显微镜检查,延误了诊断。病人开始使用局部氯菊酯。国内没有口服伊维菌素,从海外运输获得,延误了治疗的开始。在患者开始使用伊维菌素后,病情得到了显著改善。患者所在村庄的一名当地护士访问了她所在的社区,发现了多名疥疮感染者。直到这些社区成员用局部氯菊酯治疗成功后,患者才出院。本病例描述了资源不足地区疥疮的非典型表现,展示了独特的诊断、治疗和公共卫生挑战。
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引用次数: 0
Comamonas kerstersii Bacteremia of Unknown Origin 不明原因的克氏共胞菌菌血症
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-03-27 DOI: 10.1155/2022/1129832
Kassie Rong, J. Delport, F. AlMutawa
Comamonas kerstersii (C. kerstersii) is a Gram-negative bacillus abundant in the environment and rarely implicated in human disease. Previously considered nonpathogenic, its scarcity in literature may be partly due to the unreliability of past phenotypic tests used for its identification. In recent years, the development of matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) has enabled fast and accurate laboratory identification of C. kerstersii. Since the first report of human infection in 2013, several others have emerged, with most cases involving peritoneal infection. Here, we present a rare case of C. kerstersii bacteremia in an 82-year-old male patient. With no clear predisposing conditions, the source of his infection is unclear. We accompany this report with a review of C. kerstersii bacteremia cases found in the literature.
克氏单胞菌(C. kerstersii)是一种在环境中丰富的革兰氏阴性杆菌,很少涉及人类疾病。以前被认为是非致病性的,其在文献中的稀缺性可能部分是由于过去用于其鉴定的表型测试的不可靠性。近年来,基质辅助激光解吸电离飞行时间(MALDI-TOF)质谱法(MS)的发展使得实验室对克氏弧菌进行快速、准确的鉴定成为可能。自2013年首次报告人类感染以来,又出现了其他几例,其中大多数病例涉及腹膜感染。在这里,我们提出一个罕见的病例克氏杆菌菌血症在一个82岁的男性患者。由于没有明确的易感条件,他的感染来源尚不清楚。我们伴随这一报告回顾了在文献中发现的克氏杆菌菌血症病例。
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引用次数: 3
P. micra and F. necrophorum: Hepatic Abscesses in a Healthy Soldier 微孢子虫和坏死孢子虫:一个健康士兵的肝脓肿
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-03-26 DOI: 10.1155/2022/5500365
Samuel Strobel, D. Whitaker, E. Choi, Janelle Lindow, K. Lago
Parvimonas micra (P. micra) and Fusobacterium necrophorum (F. necrophorum) are two pathogens known to cause odontogenic and oropharyngeal infections. It is exceedingly rare for these bacteria to cause coinfection and even systemic infection. There is limited literature on liver abscesses and bacteremia involving P. micra. Most cases are found in elderly patients with associated gastrointestinal malignancy (24%) or laryngeal pharynx malignancy (28%). However, a substantial portion of described cases were unable to identify a source (36%). A 36-year-old, otherwise healthy male presented for fevers and chills for 2 weeks. After testing negative for initial infectious workup, including COVID-19 multiple times, he was found to have multiple liver abscesses which grew P. micra and F. necrophorum. This case highlights a rare coinfection of hepatic abscesses in an otherwise healthy young immunocompetent adult with a solitary dental caries, resulting in septic shock.
微细小单胞菌(P. micra)和坏死梭杆菌(F. necrophorum)是已知的两种引起牙源性和口咽感染的病原体。这些细菌引起合并感染甚至全身感染的情况极为罕见。关于微假单胞菌引起的肝脓肿和菌血症的文献有限。大多数病例发现于伴有胃肠道恶性肿瘤(24%)或喉咽恶性肿瘤(28%)的老年患者。然而,所描述的病例中有很大一部分无法确定来源(36%)。一名36岁男性,其他方面健康,表现为发热和发冷2周。在多次包括COVID-19在内的初始感染检查结果为阴性后,发现他有多个肝脓肿,其中生长微微假体和坏死假体。本病例强调了一个罕见的肝脓肿合并感染,在一个健康的年轻免疫能力的成年人与孤立的蛀牙,导致感染性休克。
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引用次数: 0
An Unusual Presentation of Glandular Fever 腺热的一种不寻常表现
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-03-18 DOI: 10.1155/2022/5981070
D. Worku, Li-Hui Chang, I. Blyth
Epstein-Barr virus (EBV) is an ubiquitous DNA herpesvirus with >90% of adults >40 years of age showing a serological response. While in their youth, primary EBV infection may pass unnoticed, young adults have a high incidence of infectious mononucleosis (IM). This is characterized by a triad of pharyngitis, cervical lymphadenopathy, and fever because of a self-limiting lymphoproliferative disease. Common complications include but are not limited to hepatitis, splenomegaly, encephalitis, and haemophagocytic lymphohistiocytosis (HLH) with evidence that Caucasian males and smokers are more likely to suffer severe disease. Here we present a 21-year-old male who presented with a 2-week history of fever, dry cough, and a 4-week history of pharyngitis. He had no exposure to unwell contacts and denied any new sexual partners. Examination revealed general pallor with tender bilateral cervical lymphadenopathy and pharyngeal erythema. Admission bloods revealed pancytopenia (WCC 1.5 × 109/L, Plt 84 × 109/L, and Hb 82 g/L) with normal reticulocyte count and raised mean corpuscular volume (114 fL). Serum vitamin B12 and folate were low with serum ferritin raised (1027 µg/L) suggesting a proinflammatory state. Admission liver function tests, coeliac serology, autoimmune panel (ANA, ANCA, and anti-dsDNA), hepatitic (hepatitis A, B, and E), human immunodeficiency virus (HIV), toxoplasmosis, parvovirus, and CMV serology were normal. The monospot test on day 1 of the presentation was negative. Ultrasound (US) of the abdomen on day 3 of the presentation revealed isolated splenomegaly (16.8 cm). Day 4 EBV serology (VCA IgM, VCA IgG, and EBNA IgG) was negative as such haematological investigations including JAK2, serum free light chains, and BCR-ABL were undertaken alongside cervical lymph node core biopsy. Repeat Monospot testing on day 7 came back positive. Repeat EBV serology now showed equivocal EBV VCA IgG (0.77 OD) and positive VCA IgM (9.04 OD) with concurrent new hepatitis. Histopathology of the core biopsy revealed Sternberg-reed cells and a mixed immunoblastic reaction in keeping with resolving IM. This case highlights the need for physicians to have a strong clinical suspicion of IM and understand the multiple ways in which IM may be present as well as the time lag to positivity in serological testing.
eb病毒(EBV)是一种普遍存在的DNA疱疹病毒,在40岁以上的成人中有90%的人出现血清学反应。而在他们的青年,原发性EBV感染可能会被忽视,年轻人有传染性单核细胞增多症(IM)的高发病率。其特点是咽炎、颈淋巴肿大和由自限性淋巴细胞增生性疾病引起的发热。常见的并发症包括但不限于肝炎、脾肿大、脑炎和嗜血球性淋巴组织细胞增多症(HLH),有证据表明白人男性和吸烟者更容易患严重的疾病。我们报告一位21岁男性患者,有2周的发热、干咳和4周的咽炎病史。他没有接触过不健康的接触,也否认有过新的性伴侣。检查发现全身苍白,双侧颈部有压痛性淋巴结病变和咽红斑。入院血液显示全血细胞减少(WCC 1.5 × 109/L, Plt 84 × 109/L, Hb 82 g/L),网状细胞计数正常,平均红细胞体积升高(114 fL)。血清维生素B12和叶酸低,血清铁蛋白升高(1027µg/L),提示促炎状态。入院时肝功能检查、乳糜泻血清学、自身免疫组(ANA、ANCA和anti-dsDNA)、肝炎(甲型、乙型和戊型肝炎)、人类免疫缺陷病毒(HIV)、弓形虫病、细小病毒和巨细胞病毒血清学均正常。第1天的单斑试验呈阴性。第3天腹部超声显示孤立性脾肿大(16.8 cm)。第4天EBV血清学(VCA IgM、VCA IgG和EBNA IgG)为阴性,血液学检查包括JAK2、血清游离轻链和BCR-ABL,同时进行颈部淋巴结核心活检。第7天重复单斑病检测呈阳性。重复EBV血清学现显示模棱两可的EBV VCA IgG (0.77 OD)和VCA IgM阳性(9.04 OD),并发新发肝炎。核心活检的组织病理学显示Sternberg-reed细胞和混合免疫母细胞反应与溶解IM保持一致。该病例强调医生需要对IM有强烈的临床怀疑,并了解IM可能存在的多种方式以及血清学检测阳性的时间滞后。
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引用次数: 0
Rhino-Orbital-Cerebral Mucormycosis in a Post-COVID-19 Patient from Peru 秘鲁1例covid -19后患者的鼻-眶-脑毛霉菌病
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-03-15 DOI: 10.1155/2022/2537186
Linda Ponce-Rosas, J. Gonzales-Zamora, Nelson Diaz-Reyes, Oliver Alarco-Cadillo, J. Alave-Rosas
Mucormycosis has been reported increasingly in patients affected by COVID-19, especially in India where the first cases were described. In Latin America, there is limited information about this association, mainly coming from Brazil, Mexico, and Peru. Herein, we report the case of a 66-year-old female that presented with rhino-orbital-cerebral mucormycosis, diabetic ketoacidosis, and COVID-19. The patient had the compromise of all the sinuses, orbital invasion, and intracranial extension. Isavuconazole was promptly initiated because amphotericin B was not available. She had a single open surgical debridement of necrotic tissues at the beginning of the diagnosis then multiple manual sessions to clear the residual or recurrent disease during approximately 5 months. Isavuconazole was effective and well-tolerated for 10 months without side effects. We highlight the importance of considering mucormycosis in post-COVID-19 patients with uncontrolled diabetes. The report emphasizes the favorable outcome of isavuconazole as an alternative therapy.
在受COVID-19影响的患者中,毛霉病的报告越来越多,特别是在第一批病例被描述的印度。在拉丁美洲,关于这种关联的信息有限,主要来自巴西、墨西哥和秘鲁。在此,我们报告了一位66岁的女性,她表现为鼻-眶-脑毛霉病、糖尿病酮症酸中毒和COVID-19。患者所有鼻窦受损,眼眶侵犯,颅内扩张。由于两性霉素B无法获得,立即开始使用依唑康唑。在诊断之初,她接受了一次开放性手术清除坏死组织,然后在大约5个月的时间里多次手工清除残留或复发的疾病。Isavuconazole有效且耐受性良好,10个月无副作用。我们强调在covid -19后合并未控制的糖尿病患者中考虑毛霉病的重要性。该报告强调了异戊康唑作为替代疗法的良好结果。
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引用次数: 2
Abiotrophia defectiva Infective Endocarditis: A Rare and Dangerous Cause of Endocarditis 无营养缺陷性感染性心内膜炎:一种罕见而危险的心内膜炎病因
IF 1.1 Q4 INFECTIOUS DISEASES Pub Date : 2022-03-08 DOI: 10.1155/2022/7050257
I. Lancaster, Deepika Patel, C. Tamboli, Patricia Chun, Vikas Sethi, Joseph Namey
Infective endocarditis is an uncommon heart infection, typically involving heart valves. Abiotrophia defectiva is a rare cause of endocarditis, typically found within the GI tract, and is usually difficult to isolate and requires specialized media. We report a case of Abiotrophia defectiva endocarditis following a root canal.
感染性心内膜炎是一种罕见的心脏感染,通常累及心脏瓣膜。无营养缺陷是心内膜炎的一种罕见病因,通常在胃肠道内发现,通常难以分离,需要专门的介质。我们报告一例缺乏性无营养心内膜炎后根管治疗。
{"title":"Abiotrophia defectiva Infective Endocarditis: A Rare and Dangerous Cause of Endocarditis","authors":"I. Lancaster, Deepika Patel, C. Tamboli, Patricia Chun, Vikas Sethi, Joseph Namey","doi":"10.1155/2022/7050257","DOIUrl":"https://doi.org/10.1155/2022/7050257","url":null,"abstract":"Infective endocarditis is an uncommon heart infection, typically involving heart valves. Abiotrophia defectiva is a rare cause of endocarditis, typically found within the GI tract, and is usually difficult to isolate and requires specialized media. We report a case of Abiotrophia defectiva endocarditis following a root canal.","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"270 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79878211","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}
引用次数: 2
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Case Reports in Infectious Diseases
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