- Volume 60, Issue 9, 2011
Volume 60, Issue 9, 2011
- Case Reports
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Pleural effusion in an immunocompetent woman caused by Mycobacterium fortuitum
More LessMycobacterium fortuitum is a non-tuberculous mycobacterium that can cause pneumonia, abscess and empyema in subjects with predisposing lung diseases. However, pleurisy with effusion is rare. Herein, we report the case of a 74-year-old immunocompetent female patient without apparent risk factors, who suffered haemorrhagic pleural effusion as the main clinical manifestation. Pleural nodules were detected by computed tomography scan, and microbiological analysis revealed M. fortuitum in the absence of other pathogens. The patient was treated with ceftriaxone and ciprofloxacin, and full recovery ensued in 4 weeks. To our knowledge, this is the first reported case of haemorrhagic pleural effusion in an immunocompetent patient without underlying diseases. Although non-tuberculous mycobacterial infections are rarely accompanied by pleural involvement, M. fortuitum should be considered in such cases, especially when microbiology fails to detect the usual pathogens, and when the clinical picture is unclear.
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Unusual acute endophthalmitis due to an as yet unclassified Acinetobacter gyllenbergii-like isolate
More LessWe report a case of postoperative endophthalmitis due to an as yet unclassified Acinetobacter gyllenbergii-like isolate. The functional outcome was rapidly negative despite antibacterial therapy. This novel species, which cannot be identified by classical biochemical methods, may represent an underestimated opportunistic pathogen responsible for acute pyogenic infections.
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Hepatobiliary infections due to non-capsulated Haemophilus influenzae
We present two cases of non-capsulated Haemophilus influenzae hepatobiliary infection and review the literature. Such cases are rare, and prior to routine immunization against H. influenzae serotype b invasive Haemophilus disease was largely caused by capsulated strains. The epidemiology of invasive Haemophilus infections has changed and the number of cases of intra-abdominal and hepatobiliary infection may be underestimated due to current microbiological processing practices.
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Nosocomial peripancreatic infection associated with Shewanella xiamenensis
More LessShewanella xiamenensis, a newly established species originally from sea sediments, was repeatedly recovered from peripancreatic drainages in a patient and was the probable pathogen of hospital-acquired peripancreatic infection. A commercially available system misidentified it as Shewanella putrefaciens, suggesting that some previous reported cases with S. putrefaciens infection might have been caused by other Shewanella species. Precise species identification of Shewanella species usually requires gyrB sequencing.
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Severe pneumonia and jaundice in a young man: an atypical presentation of an uncommon disease
More LessWe present a patient with an atypical presentation of Fusobacterium infection, the genus responsible for Lemierre’s syndrome. This syndrome, which often affects healthy, young people and can be fatal if not recognized and treated early, is defined as a history of recent oropharyngeal infection with clinical or radiological evidence of internal jugular vein thrombosis and isolation of anaerobic pathogens, mainly Fusobacterium necrophorum. The history, presentation, investigations and management of the patient are described and then contrasted with the existing literature surrounding Lemierre’s syndrome, once termed the ‘forgotten disease’.
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Gastrointestinal basidiobolomycosis: an emerging fungal infection causing bowel perforation in a child
Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal (GI) tract. We report a 10-year-old boy diagnosed as suffering GI basidiobolomycosis after being misdiagnosed first as suffering intestinal malignancy then schistosomiasis. The patient presented with fever, abdominal pain, vomiting, abdominal tenderness and rigidity with marked blood eosinophilia. Abdominal ultrasonographic and computed tomographic scans revealed a large caecal mass. Biopsy of the mass showed transmural granulomatous inflammation interpreted as schistosomal granuloma, ruling out lymphoma. The patient’s condition deteriorated despite anti-schistosomal therapy. Emergency surgery was then performed, and caecal perforation was found. The mass was excised; cultures were negative and histopathological examination was suggestive of schistosomal granuloma. The mass recurred 3 weeks post-operatively. Second-opinion histopathological examination diagnosed Basidiobolus ranarum infection. Treatment with itraconazole produced marked improvement, with diminution of the mass. B. ranarum was unequivocally identified in the archival formalin-fixed and paraffin-embedded (FFPE) tissue by PCR. This case emphasizes the need to consider GI basidiobolomycosis in children presenting with fever, abdominal mass and eosinophilia, especially those complicated by bowel perforation.
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- Correspondence
- Erratum
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Volumes and issues
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