Extrapulmonary Tuberculosis Leading to Abdominal Wall Mass in Young PatientRead the full article
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Extrapulmonary Tuberculosis Leading to Abdominal Wall Mass in Young Patient
Background. Tuberculosis is a bacterial infection that is caused by Mycobacterium tuberculosis. Tuberculosis has arguably been the largest killer of humans historically, and it remains one of the most important infectious causes of death in the world. Tuberculosis can be classified into different forms and it manifests as pulmonary and out pulmonary, respectively, in 85% and 15% of cases. Only a few cases of tuberculosis with abdominal wall involvement have been reported. Case Presentation. Herein, we present a 27-year-old Persian woman, presented with asymmetric abdominal bulging in the right side of the periumbilical area since 6 months before admission that has no pain or secretion. The patient was oriented and not ill or toxic in general appearance. Vital signs were within normal ranges. An abdominal physical examination revealed a mobile, well-bordered, nontender mass 3 × 3 centimeter (cm) in diameter palpated in the right periumbilical area. The patient underwent surgery which revealed a cystic lesion that was carefully resected. In histopathology examination of the specimen resection, tuberculosis was confirmed. Conclusion. We report a rare case of extrapulmonary tuberculosis that was identified at the abdominal wall. Due to the high number of cases of TB and the development of extrapulmonary forms that can present in an unusual location as an abdominal wall which are difficult to diagnose, it is very important to keep in mind the differential diagnosis of tuberculosis.
Genitourinary Blastomycosis in a Young Male Patient: A Case Report and Review of Diagnostic Challenges
Disseminated blastomycosis is an endemic fungal infection that rarely manifests with genitourinary involvement. We present a unique case of a 28-year-old professional male gamer with a remote history of hemoptysis and cervical lymphadenopathy who presented with hematospermia, lower urinary tract symptoms (LUTS), and persistent groin abscesses after left orchiectomy at an outside hospital. He underwent drainage of groin abscess and prostate biopsy for an abnormal digital rectal exam which revealed disseminated blastomycosis requiring systemic, long-term antifungal treatment. We have also included a review of literature to note clinical patterns in presentations and highlight the diagnostic challenges that this infection presents.
Persistent, Poorly Responsive Immune Thrombocytopenia Secondary to Asymptomatic COVID-19 Infection in a Child
Immune thrombocytopenic purpura (ITP) secondary to asymptomatic COVID-19 infection, especially in children, is not reported. Furthermore, persistent, treatment-resistant ITP secondary to COVID-19 is not reported. We report a previously healthy 14-year-old Asian boy who developed secondary ITP following an asymptomatic COVID-19 infection and is having a relapsing and remitting cause with poor response to immunosuppressants even after 21 months following the diagnosis. This case emphasizes the importance of testing for COVID-19 in newly diagnosed ITP patients and the need for follow-up platelet counts in patients who recover from COVID-19 as it may follow into developing secondary ITP yet being asymptomatic until you present with a bleeding complication of ITP. The poor response to standard immunosuppression warrants more understanding of the pathophysiology of persistently low platelets following COVID-19 infection. Long-term sequelae of the disease highlight the importance of getting vaccinated for COVID-19 despite COVID-19 being no longer a global emergency.
Bacteroides fragilis Acute Hematogenous Osteomyelitis in a Young Female with Sickle Cell Disease
Patients with sickle cell disease are at increased risk for multiple infections including osteomyelitis. The most reported causative organisms are Salmonella spp. and Staphylococcus aureus. Anaerobic infections including Bacteroides fragilis are not commonly seen. Here, we report the first case of a 28-year-old female patient with sickle cell disease and acute hematogenous Bacteroides fragilis tibial osteomyelitis. Diagnosis was made by isolating the organism from blood and tibial fluid cultures. The patient was successfully managed with a course of intravenous followed by oral antibiotics and percutaneous drainage of collection and responded well. This case report will shed light on the importance of Bacteroides fragilis as a causative organism for osteomyelitis in sickle cell disease patients, thereby affecting the management of these patients.
A Case of Trueperella bernardiae Bacteremia due to a PICC-Associated Infection in a Paraplegic Patient
Trueperella bernardiae is a Gram-positive bacterium known to cause a wide variety of opportunistic infections in humans. We report a novel case of T. bernardiae bacteremia in a paraplegic patient due to a peripherally inserted central catheter- (PICC-) associated infection that was treated successfully with piperacillin/tazobactam.
A Case of Myroides odoratimimus Bacteremia due to a Tunneled Dialysis Catheter-Associated Infection in a Paraplegic Patient
Myroides odoratimimus is a Gram-negative opportunistic pathogen known to rarely cause a wide range of opportunistic infections in humans. We report a novel case of M. odoratimimus bacteremia in a paraplegic patient with an extensive medical history likely due to a tunneled dialysis catheter infection that was successfully treated with levofloxacin.