Case Reports in Infectious Diseases https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Invasive Mucormycosis Induced Pneumopericardium: A Rare Cause of Pneumopericardium in an Immunocompromised Patient Wed, 17 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/1424618/ Mucor and Rhizopus cause life-threatening infections primarily involving the lungs and sinuses, which disseminate very rapidly by necrosis and infarction of the contiguous tissues. We present a case of a 64-year-old African American posttransplant patient who presented with a productive cough and weight loss. He had a past surgical history of renal transplant for renal cell carcinoma and was on dual immunosuppressive therapy, that is, mycophenolate and tacrolimus. During his hospital stay, he developed a pneumopericardium due to the direct extension of a lung lesion. The diagnosis was made by radiological imaging and PCR result which was consistent with Mucor species. He was treated with antifungal therapy. The purpose of this report is to highlight the unusual association of mucormycosis with pneumopericardium. Sana Khan, Muhammad Waqar Elahi, Waqas Ullah, Hafez Mohammad Ammar Abdullah, Ejaz Ahmad, Mayar Al Mohajer, and Aneela Majeed Copyright © 2017 Sana Khan et al. All rights reserved. Necrotizing Pseudomonas aeruginosa Community-Acquired Pneumonia: A Case Report and Review of the Literature Wed, 17 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/1717492/ Lung cavities are not typically associated with community-acquired pneumonia (CAP). CAP due to P. aeruginosa is rare and even less commonly causes necrotizing pneumonia. We report a case of P. aeruginosa CAP that progressed to necrotizing pneumonia and was eventually fatal. Procalcitonin (PCT) has been well investigated in guiding antibiotic therapy (especially CAP) in adults. In this case, PCT at presentation and sequentially was negative. We discuss this caveat and present hypotheses as to the sensitivity and specificity of PCT and C-reactive protein (CRP) in these patients. To better characterize P. aeruginosa CAP, we undertook a review of cases indexed in PubMed from 2001 to 2016 (). The data reveal that risk factors for P. aeruginosa CAP include smoking, alcohol use, obstructive lung disease, sinusitis, and hot tub use. The route of infection for P. aeruginosa CAP remains unknown. One of the most interesting findings on reviewing cases was that P. aeruginosa CAP involves the right upper lobe in the vast majority. We suggest that when physicians in the community see patients with distinctly upper lobe necrotizing or cavitary pneumonia, they should consider P. aeruginosa in their differential diagnosis. Further studies are needed to clarify route of infection, role of PCT and CRP, and optimal therapy including drug and duration. Satish Maharaj, Carmen Isache, Karan Seegobin, Simone Chang, and Grant Nelson Copyright © 2017 Satish Maharaj et al. All rights reserved. Yokenella regensburgei Septicemia in a Chinese Farmer Immunosuppressed by HIV: A Case Report and Literature Review Tue, 16 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/5962463/ Yokenella regensburgei is a member in the family Enterobacteriaceae and a few cases have been reported in immunocompromised hosts. Herein, we described a case of septicemia in a human immunodeficiency virus (HIV) infected patient in South West China, which is the first reported case of Y. regensburgei infection in HIV-infected populations. We then reviewed the literature on all the reported cases of Y. regensburgei infection worldwide and presented some common features of them. Our case report and literature review will help increase the knowledge of the bacterium Y. regensburgei and its clinical implications. Xiangbo Chi, Min Liu, and Yaokai Chen Copyright © 2017 Xiangbo Chi et al. All rights reserved. Native Valve Endocarditis due to Veillonella Species: A Case Report and Review of the Literature Sun, 14 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/4896186/ Veillonella species are fastidious bacteria that have been isolated from skin, dental, and respiratory tract infections and rarely have been implicated in serious infections like meningitis, endocarditis, and osteomyelitis. A 76-year-old woman presented to our hospital with fever, vomiting, and generalized weakness for 3 days. A transthoracic echocardiogram showed a mobile structure on anterior mitral valve leaflet measuring 0.9 cm suggestive of vegetation. Empiric therapy with vancomycin and piperacillin-tazobactam was started with clinical resolution of her symptoms. On day 6, the blood culture drawn at admission grew Veillonella species. A transesophageal echocardiogram confirmed a 1.2 0.4 cm echo dense structure attached to the left ventricular side of the anterior mitral leaflet. The patient was discharged home after 10 days of inpatient antibiotic therapy and completed 4 weeks of IV ceftriaxone at home without any adverse events. She was reevaluated in the clinic after completion of treatment and repeat blood cultures remained negative. We report the first case of successful treatment of endocarditis due to Veillonella species with once daily ceftriaxone. Lakshmi Saladi, Cosmina Zeana, and Manisha Singh Copyright © 2017 Lakshmi Saladi et al. All rights reserved. Respiratory Syncytial Virus Associated Myocarditis Requiring Venoarterial Extracorporeal Membrane Oxygenation Mon, 08 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/7074508/ Severe fulminant myocarditis causing cardiogenic shock can be a rapidly progressing, life threatening condition. Respiratory syncytial virus (RSV) is a very rare infectious culprit infrequently described in medical literature as a cause of myocarditis, particularly in adults. We present a case of acute fulminant myocarditis in a patient with PCR positive RSV infection requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO). Anamaria Milas, Aditya Shah, Neesha Anand, Meghan Saunders-Kurban, and Samir Patel Copyright © 2017 Anamaria Milas et al. All rights reserved. Spontaneous Nosocomial Pseudomonas aeruginosa Meningitis Presenting as Trismus Mon, 08 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/8705860/ We describe the case of a 78-year-old female receiving adjuvant postsurgical chemotherapy for colon adenocarcinoma who spontaneously developed nosocomial Pseudomonas meningitis causing severe trismus. The patient was initially admitted for ileus, developing neck stiffness and trismus on the thirteenth day of admission. Cerebrospinal fluid grew pansensitive Pseudomonas aeruginosa. Magnetic resonance imaging of the brain was consistent with bilateral subacute infarcts secondary to meningitis. The patient responded well to 21 days of broad spectrum antimicrobial therapy modified to ceftazidime alone following speciation and sensitivity. Outpatient follow-up at 46 days revealed normal maximal mouth opening with the ability to chew and tolerate a full diet. Trismus is a motor disturbance of the trigeminal nerve with difficulty in opening the mouth. Infectious etiologies commonly described include tetanus, odontogenic infections, or deep neck space infections. This is the first reported case of simultaneous nosocomial Pseudomonas meningitis and trismus in a patient with no history of neurosurgery or lumbar spinal manipulation. C. J. Parr, J. Wheeler, A. Sharma, and C. Smith Copyright © 2017 C. J. Parr et al. All rights reserved. Is It Necessary to Specifically Define the Cause of Surgically Treated Biliary Tract Infections? A Rare Case of Raoultella planticola Cholecystitis and Literature Review Sun, 07 May 2017 07:54:29 +0000 http://www.hindawi.com/journals/criid/2017/4181582/ Raoultella planticola is an aquatic and soil organism that does not notoriously cause invasive infections in humans. Infections in the literature are limited only in case reports. We present a very rare case of R. planticola cholecystitis. A 71-year-old female patient with abdominal pain was diagnosed with acute cholecystitis. Patient received intravenous antibiotic treatment, but the treatment failed and the patient underwent an open cholecystectomy. The final pathological result was gangrenous cholecystitis complicated with R. planticola. Eventually, the patient recovered with appropriate antimicrobial therapy. Patients with acute cholecystitis are usually treated without any microbiological sampling and antibiotic treatment is started empirically. To date, there have only been 5 reported biliary system related R. planticola infections in humans. We believe that Raoultella species might be a more frequent agent than usually thought, especially in resistant cholecystitis cases. Resistant strains should be considered as a possible causative organism when the patient’s condition worsened despite proper antimicrobial therapy. It should be considered safe to send microbiological samples for culture and specifically define the causative microorganisms even in the setting of a cholecystectomized patient. Suat Can Ulukent, İnanc Samil Sarici, Nuri Alper Sahbaz, Yigit Mehmet Ozgun, Ozlem Akca, and Kamuran Sanlı Copyright © 2017 Suat Can Ulukent et al. All rights reserved. A Case of Urinary Tract Infection and Severe Sepsis Caused by Kluyvera ascorbata in a 73-Year-Old Female with a Brief Literature Review Wed, 03 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/3848963/ Infections that are caused by Kluyvera bacteria have been previously reported in the medical literature; however, they seem to be less common. Herein, we report a case of urinary tract infection and severe sepsis caused by Kluyvera ascorbata in a 73-year-old female. We also did a brief literature review of infections caused by this organism in adults. Majd Alfreijat Copyright © 2017 Majd Alfreijat. All rights reserved. Disseminated Mycobacterium chimaera Presenting as Vertebral Osteomyelitis Mon, 24 Apr 2017 09:28:25 +0000 http://www.hindawi.com/journals/criid/2017/9893743/ Mycobacterium chimaera, a member of the Mycobacterium avium complex, is a slow-growing, nontuberculous mycobacterium associated with outbreaks in cardiac-surgery patients supported on heart-lung machines. We report a case of an elderly woman on chronic prednisone who presented with a six-month history of worsening chronic back pain, recurrent low-grade fevers, and weight loss. Imaging identified multilevel vertebral osteomyelitis and lumbar soft-tissue abscess. Abscess culture identified M. chimaera. Daphne M. Moutsoglou, Frank Merritt, and Ethan Cumbler Copyright © 2017 Daphne M. Moutsoglou et al. All rights reserved. Acute Bacterial Meningitis and Systemic Abscesses due to Streptococcus dysgalactiae subsp. equisimilis Infection Sun, 23 Apr 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/8645859/ Disseminated abscesses due to group G β-hemolytic Streptococcus dysgalactiae were observed in a 57-year-old cirrhotic patient with the skin being the putative way of entry for the pathogen. S. dysgalactiae is a rare agent in human infections responsible for acute pyogenic meningitis. The mortality rate associated with S. dysgalactiae bacteraemia and meningitis may be as high as 50%, particularly in the presence of endocarditis or brain abscesses. In our patient, main sites of infections were meningitis and ventriculitis, spondylodiscitis, septic arthritis, and soft-tissue infections. In contrast, no endocarditis was evidenced. Cirrhosis-related immune suppression was considered as a pathophysiological cofactor for the condition. Fortunately, clinical status improved after long-term (3 months) antimicrobial therapy. M. Jourani, T. Duprez, V. Roelants, H. Rodriguez-Villalobos, and P. Hantson Copyright © 2017 M. Jourani et al. All rights reserved. A Case of Early Disseminated Neurological Lyme Disease Followed by Atypical Cutaneous Manifestations Sun, 23 Apr 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/6598043/ Lyme disease (LD) is a tick-borne illness caused by Borrelia burgdorferi sensu stricto. An 80-year-old female from Pennsylvania, USA, presented to an outside hospital with fever, confusion, lower extremity weakness, and stool incontinence. CT head and MRI spine were unremarkable. An infectious work-up including lumbar puncture was negative. She was transferred to our tertiary care hospital. Patient was noted to have mild unilateral right-sided facial droop and a diffuse macular rash throughout the body. She denied any outdoor activities, tick bites, or previous rash. Intravenous ceftriaxone was started for suspected LD. The patient’s symptoms including facial droop resolved within 24 hours of antibiotic therapy. Polymerase chain reaction of the blood, IgM ELISA, and IgM Western blot testing for LD came back positive a few days after initiation of therapy. She was treated for a total of 21 days for neurological LD with complete symptom resolution. Not all patients have the classic “targetoid” EM rash on initial presentation, rash could develop after neurological manifestations, and prompt initiation of antibiotics without awaiting serology is paramount to making a quick and a full recovery. There should be a high index of suspicion for early disseminated LD, as presentations can be atypical. Vamsi Kantamaneni, Vikas Sunder, Mohammad Bilal, and Scott Vargo Copyright © 2017 Vamsi Kantamaneni et al. All rights reserved. Exophiala (Wangiella) dermatitidis Prosthetic Aortic Valve Endocarditis and Prosthetic Graft Infection in an Immune Competent Patient Tue, 18 Apr 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/4839314/ Exophiala (Wangiella) dermatitidis is an emerging dematiaceous fungus associated with high mortality rates and is a rare cause of endocarditis. We describe the first case of E. dermatitidis endocarditis of a prosthetic aortic valve and aortic graft in an immune competent patient with no clear risk factors of hematological acquisition. Jay S. Berger, Lucas R. Cusumano, Joseph J. Derose, and Uzma N. Sarwar Copyright © 2017 Jay S. Berger et al. All rights reserved. Subacute Hypophysitis with Panhypopituitarism as First Presentation of HIV and Syphilis Coinfection Sun, 16 Apr 2017 06:44:15 +0000 http://www.hindawi.com/journals/criid/2017/1489210/ Infection by Treponema pallidum still represents a clinical challenge due to its various forms of presentation. HIV coinfection added diversity and changed the natural history of syphilis as a systemic infection. We present a rare case of subacute hypophysitis and panhypopituitarism due to an early active neurosyphilis in a previously unknown HIV coinfected patient. Rute Alves and Margarida França Copyright © 2017 Rute Alves and Margarida França. All rights reserved. Giant Condyloma Acuminatum of Vulva in an HIV-Infected Woman Thu, 13 Apr 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/5161783/ First described in 1925, giant condyloma acuminatum also known as Buschke-Löwenstein tumor (BLT) is a benign, slow-growing, locally destructive cauliflower-like lesion usually in the genital region. The disease is usually locally aggressive and destructive with a potential for malignant transformation. The causative organism is human papilloma virus. The most common risk factor is immunosuppression with HIV; however, any other cause of immunodeficiency can be a predisposing factor. We present a case of 33-year-old female patient, a known HIV patient on antiretroviral therapy for ten months. She presented with seven-month history of an abnormal growth in the genitalia that was progressive accompanied with foul smelling yellowish discharge and friable. Surgical excision was performed successfully. Pap smear of the excised tissue was negative. Despite being a rare condition, giant condyloma acuminatum is relatively common in HIV-infected patients. Athanase Lilungulu, Bonaventura C. T. Mpondo, Abdallah Mlwati, Dismas Matovelo, Albert Kihunrwa, and Balthazar Gumodoka Copyright © 2017 Athanase Lilungulu et al. All rights reserved. Abdominopelvic Tuberculosis with a Frozen Section Analysis Consistent with Ovarian Cancer Sun, 09 Apr 2017 07:59:11 +0000 http://www.hindawi.com/journals/criid/2017/6401694/ Pelvic tuberculosis is a type of extrapulmonary tuberculosis. The disease is accompanied by clinical and laboratory findings which may be unspecific and present aspects of other diseases, including gynecological malignancies. In this report, the authors presented a case of pelvic tuberculosis associated with peritoneal tuberculosis in a young woman exhibiting imaging and tumor markers consistent with ovarian neoplasm. An intraoperative frozen section analysis detected atypical cells that were suggestive of ovarian borderline or malignant epithelial neoplasia. The pathological analysis showed granulomatous inflammation in the right ovary and fallopian tube with a pattern of mycobacteriosis that was consistent with the presence of mycobacteria morphologically compatible with Mycobacterium tuberculosis. The patient had a complete remission after the use of antituberculosis drugs. Agrimaldo Martins-Filho, Paula Carolina Arvelos Crispim, Renata Margarida Etchebehere, Cristina da Cunha Hueb Barata de Oliveira, Eddie Fernando Candido Murta, and Rosekeila Simões Nomelini Copyright © 2017 Agrimaldo Martins-Filho et al. All rights reserved. Rhodotorula Endogenous Endophthalmitis: A Novel Harbinger of the Injection Drug Epidemic in the United States Wed, 05 Apr 2017 07:51:19 +0000 http://www.hindawi.com/journals/criid/2017/9686353/ Endogenous endophthalmitis is a rare but feared infectious ocular complication of injection drug use (IDU). The recent opioid epidemic in the United States threatens to increase the incidence of this disease. We report the first case of endogenous endophthalmitis in the United States caused by the emerging fungal pathogen Rhodotorula in an injection drug user which led to no light perception vision (NLP). Worldwide experience with Rhodotorula endogenous endophthalmitis is limited, but existing cases suggest infection by this particular fungal genus has a grim prognosis. Preston M. Luong, Basilio Kalpakian, Lawrence J. Jaeger, Timothy Lahey, Christopher B. Chapman, and Michael E. Zegans Copyright © 2017 Preston M. Luong et al. All rights reserved. Melioidosis with Portal Vein Thrombosis Mon, 03 Apr 2017 08:28:18 +0000 http://www.hindawi.com/journals/criid/2017/2891510/ Melioidosis, caused by Burkholderia pseudomallei, is a common infectious disease in tropical regions. The author reports a case of melioidosis with a rare manifestation of portal vein thrombosis and cavernous transformation of the portal vein. Melioidosis should be considered a differential diagnosis in patients with underlying risk factors who present with multiple liver abscesses; moreover, portal vein thrombosis can be a potential complication. Computed tomography is the modality of choice to demonstrate venous thrombosis in various organs. Thanyaporn Direksunthorn Copyright © 2017 Thanyaporn Direksunthorn. All rights reserved. Bilateral Facial Diplegia: A Rare Presenting Symptom of Lyme Thu, 16 Mar 2017 07:17:42 +0000 http://www.hindawi.com/journals/criid/2017/4521526/ Lyme disease is a common disease that is faced by the physician but also acts a mimicker of many other disease processes. Facial palsies, especially bilateral, are a relatively rare presenting symptom of Lyme disease and may warrant further investigation. A thorough history and physical examination coupled with precision testing may aid the physician when faced with a patient with the diagnostic dilemma of facial diplegia. John Ashurst and Matthew Perry Copyright © 2017 John Ashurst and Matthew Perry. All rights reserved. Clinical Implications for the Timely Diagnosis of Mycobacterium marinum in the Age of Biologic Therapy: A Case Report and Review of the Literature Tue, 14 Mar 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/5274302/ Mycobacterium marinum infections typically present as cutaneous nodular lesions with a sporotrichoid lymphatic spread on extensor surfaces of extremities. The natural history of this infection can be altered if the host is immunosuppressed, leading to disseminated presentations. A detailed exposure history and high degree of suspicion for this indolent pathogen are often required for the correct diagnosis of this disease. We present a case of a 67-year-old male misdiagnosed with seronegative rheumatoid arthritis presenting with rheumatic nodules. Initiation of chronic immunosuppressant therapy including biologic monoclonal antibodies resulted in the exacerbation of initially localized disease to broadly disseminated lymphatic, joint, and myotendinous granulomatous disease and led to delay in the correct diagnosis. Cessation of immunosuppressants, with a prolonged course of antimicrobial therapy and multiple surgical debridements were required for cure. Chris J. Lata, Kelle Edgar, and Stephen Vaughan Copyright © 2017 Chris J. Lata et al. All rights reserved. A Case of Recurrent Skin Abscesses: A Conundrum Solved after Obtaining a Thorough Sexual History Mon, 13 Mar 2017 08:25:17 +0000 http://www.hindawi.com/journals/criid/2017/4765697/ Background. Despite the improvement in patient-physician communication techniques, sexuality and sexual health continue to be challenging areas for discussion during a clinical encounter. Most people are not prepared to discuss sexual matters openly as it can be perceived as negative or inappropriate. Consequently, an incomplete health assessment can result in delayed diagnosis or misdiagnosis. Case Report. We present a 33-year-old woman who developed recurrent left breast abscesses. She required multiple incision and drainage procedures in the operating room followed by antimicrobial therapy. Although she always had an initial improvement with this approach, she continued to have recurrences and development of new abscesses in other body areas. The polymicrobial nature of her recurrences prompted an extensive and costly workup to determine the nature of her condition. The cause was finally elucidated when a thorough sexual history was obtained. Poor hygiene practices during her sexual encounters were considered the cause of her recurrent abscesses. After medical therapy and modification of her sexual practices, she has not developed new recurrences for more than two years. Conclusion. Discussions on sexuality and sexual health are important parts of any clinical encounter, yet frequently forgotten or avoided. Becoming aware of their importance would avoid delayed diagnosis or misdiagnosis. Diego P. Peralta, Aymara Y. Chang, and Enrique Soto-Ruiz Copyright © 2017 Diego P. Peralta et al. All rights reserved. Dengue and Scrub Typhus Coinfection in a Patient Presenting with Febrile Illness Mon, 13 Mar 2017 08:21:22 +0000 http://www.hindawi.com/journals/criid/2017/6214083/ Dengue fever and scrub typhus are common causes of acute febrile illness of unclear origin in Asia. Though coinfections of many vector-borne diseases have been described, articles on dengue and scrub typhus coinfection are distinctly limited. In case of coinfection with dengue and scrub typhus, vigilant monitoring of vitals, platelets transfusion, and timely treatment with doxycycline are necessary. High degree of suspicion has to be made for coinfection in a patient presenting with febrile illness with thrombocytopenia and deranged laboratory parameters in postmonsoon season in endemic regions in Asia. Surendra Sapkota, Sudeep Bhandari, Subash Sapkota, and Rabin Hamal Copyright © 2017 Surendra Sapkota et al. All rights reserved. Multidrug Resistant Pseudomonas Mycotic Pseudoaneurysm following Cardiac Transplant Bridged by Ventricular Assistant Device Mon, 13 Mar 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/1402320/ Mycotic pseudoaneurysm of aorta following cardiac surgery is rare but is highly fatal if it is unrecognized and untreated. Here, we report a case of a 45-year-old male patient who presented with rapidly progressive multiple pseudoaneurysms of the ascending aorta infected with multidrug resistant (MDR) Pseudomonas aeruginosa at 5 weeks after cardiac transplantation, on a background of prior bridging therapy with left ventricular assistant device (LVAD). The patient was successfully treated with the newer cephalosporin, Ceftolozane/Tazobactam, in combination with surgery. This is the first reported case of mycotic pseudoaneurysm infected with MDR Pseudomonas. This case also highlights the importance of high vigilance and timely multimodality treatment in the diagnosis and management of mycotic pseudoaneurysm following cardiac transplant, especially in patients who had LVAD. C. Aye, M. Williams, and R. Horvath Copyright © 2017 C. Aye et al. All rights reserved. Leflunomide in the Treatment of a Pseudotumoral Genital Herpes Simplex Virus Infection in an HIV Patient Wed, 08 Mar 2017 10:06:08 +0000 http://www.hindawi.com/journals/criid/2017/1589356/ The patient is a 52-year-old African American man with a past medical history of HIV infection (on antiretroviral therapy, CD4 count 399 cells/µL, and undetectable HIV viral load) and recurrent genital herpes. While on valacyclovir, the patient presented with four tumorous lesions on the perineum and scrotum. A biopsy specimen stained positively with HSV-1 and HSV-2 immunostains and displayed a lymphoplasmacytic infiltrate. The patient received foscarnet and imiquimod for two weeks with minimal improvement. Based on the previous activity of leflunomide, which has both antiviral and immunomodulatory properties, in cytomegalovirus and herpes simplex infections, leflunomide 20 mg orally twice daily was started. The patient received 23 days of foscarnet, 14 days of topical imiquimod, and 11 days of leflunomide with approximately 80% reduction in the size of the perineal lesion. After nine months on leflunomide there was complete regression of the large perineal lesion and only two small ulcerations remained on the scrotum. Pseudotumoral herpes lesions in HIV patients represent an immune reconstitution event and are poorly responsive to the usual anti-herpes agents. This report demonstrates the successful use of leflunomide in the treatment of an HIV patient with pseudotumoral herpes. Thalidomide has also been used with some success. Marie R. Roger and Gregory M. Anstead Copyright © 2017 Marie R. Roger and Gregory M. Anstead. All rights reserved. Meningococcal Neonatal Purulent Conjunctivitis/Sepsis and Asymptomatic Carriage of N. meningitidis in Mother’s Vagina and Both Parents’ Nasopharynx Mon, 06 Mar 2017 09:45:24 +0000 http://www.hindawi.com/journals/criid/2017/6132857/ Neonatal conjunctivitis is usually associated with vagina’s infection by Chlamydia sp., N. gonorrhoeae, and/or other bacteria during delivery. Meningococcal neonatal conjunctivitis is an extremely rare disease. We report a case of neonatal meningococcal sepsis/conjunctivitis and asymptomatic carriage of N. meningitidis from both parents (vagina and nasopharynx). As part of our active surveillance for meningococcal disease at the Tijuana General Hospital (TGH), Mexico, we identified a 3-day-old newborn with meningococcal conjunctivitis and sepsis. The patient had a one-day history of conjunctivitis and poor feeding. Clinical examination confirmed profuse purulent conjunctival discharge, as well as clinical signs and laboratory findings suggestive of bacteraemia. Gram stain from conjunctival exudate revealed intracellular Gram negative diplococci; we presumed the baby had gonorrheal conjunctivitis; however, serogroup Y, N. meningitidis was isolated both from conjunctival exudate and blood. Additionally, isolation of serogroup Y, N. meningitidis was obtained from mother’s vagina and both parents’ nasopharynx. The baby was treated with 7 days of IV ceftriaxone and discharged with no sequelae. Enrique Chacon-Cruz, Jorge Arturo Alvelais-Palacios, Jaime Alfonso Rodriguez-Valencia, Erika Zoe Lopatynsky-Reyes, Maria Luisa Volker-Soberanes, and Rosa Maria Rivas-Landeros Copyright © 2017 Enrique Chacon-Cruz et al. All rights reserved. Haemophilus influenzae Pyomyositis in a Patient with Diabetic Ketoacidosis: A Unique Case and Review of Literature Thu, 02 Mar 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/6307361/ Haemophilus influenzae is a Gram-negative bacillus commonly known to cause upper respiratory tract infections. Skin and soft tissue infections are very uncommon. Of these, the majority were associated with necrotizing fasciitis requiring emergent debridement. We report a case of pyomyositis caused by Haemophilus influenzae in an adult with diabetes. Kamolyut Lapumnuaypol, Sanna Fatima, Pradhum Ram, Gemlyn George, and Antoinette Climaco Copyright © 2017 Kamolyut Lapumnuaypol et al. All rights reserved. Successful Treatment of Clostridium difficile Bacteremia with Aortic Mycotic Aneurysm in a Patient with Prior Endovascular Aortic Aneurysm Repair Mon, 27 Feb 2017 00:00:00 +0000 http://www.hindawi.com/journals/criid/2017/8472930/ The clinical spectrum of Clostridium difficile infection can range from benign gastrointestinal colonization to mild diarrhea and life threatening conditions such as pseudomembranous colitis and toxic megacolon. Extraintestinal manifestations of C. difficile are rare. Here, we report a patient with a history of an endovascular aortic aneurysm repair (EVAR) presenting with an endovascular leak complicated by C. difficile bacteremia and a mycotic aneurysm. He was successfully treated with an explant of the EVAR, an aorto-left renal bypass, and aorto-bi-iliac bypass graft placement along with a six-week duration of intravenous vancomycin and oral metronidazole. Kairav Shah, Rebecca Brauch, and Kartikeya Cherabuddi Copyright © 2017 Kairav Shah et al. All rights reserved. A Rare Form of Brucella Bursitis with Negative Serology: A Case Report and Literature Review Sun, 26 Feb 2017 07:55:37 +0000 http://www.hindawi.com/journals/criid/2017/9802532/ Brucellosis is still endemic in certain parts of the world including the Mediterranean, the Middle East, Latin America, and African regions. Osteoarticular manifestations are common presenting features. Brucellosis presenting as prepatellar bursitis has already been reported. We present a case of seronegative olecranon bursitis with positive blood and aspirate cultures. The patient improved remarkably by treatment with streptomycin and doxycycline with no evidence or relapse. F. M. Almajid Copyright © 2017 F. M. Almajid. All rights reserved. Lemierre’s Syndrome Associated with Mechanical Ventilation and Profound Deafness Sun, 26 Feb 2017 06:50:13 +0000 http://www.hindawi.com/journals/criid/2017/4261429/ Lemierre’s syndrome is a rare disorder that is characterized by anaerobic organisms inducing a thrombophlebitis of the internal jugular vein (IJV) following a course of oropharyngeal infection. It often occurs in young and healthy patients. Clinicians continuously misinterpret early symptoms until infection disseminates systematically and life-threatening sepsis transpires. We report the case of a 58-year-old female developing Lemierre’s syndrome accompanied by invasive ventilation support and a profound deafness requiring the implementation of a cochlear implant. This is one of two reported cases of Lemierre’s syndrome associated with mechanical ventilation support and the only case associated with a cochlear implant. Lukas Birkner Copyright © 2017 Lukas Birkner. All rights reserved. Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, Nonmotile Bacillus megaterium in Disguise of Bacillus anthracis Sun, 26 Feb 2017 06:13:18 +0000 http://www.hindawi.com/journals/criid/2017/2578082/ Bacillus anthracis is a bacterial pathogen of major concern. The spores of this bacteria can survive harsh environmental conditions for extended periods and are well recognized as a potential bioterror weapon with significant implications. Accurate and timely identification of this Bacillus species in the diagnostic laboratory is essential for disease and public health management. Biosafety Level 3 measures and ciprofloxacin treatment were instituted when B. anthracis was suspected from a patient with gangrenous foot. 16S rDNA sequencing was performed to accurately identify the suspected bacterium, due to the superiority of this method to accurately identify clinically isolated bacteria. B. megaterium was identified as the causative agent and the organism was subsequently treated as a Biosafety Level 2 pathogen. Shih Keng Loong, Boon Teong Teoh, Jefree Johari, Chee Sieng Khor, Juraina Abd-Jamil, Siti Sarah Nor’e, Nur Izyan Samsudin, Noor Syahida Azizan, Che Norainon Yaacob, Asma Anati CheMatSeri, Nur Hidayana Mahfodz, and Sazaly AbuBakar Copyright © 2017 Shih Keng Loong et al. All rights reserved. Neisseria meningitidis Infecting a Prosthetic Knee Joint: A New Case of an Unusual Disease Thu, 23 Feb 2017 10:15:50 +0000 http://www.hindawi.com/journals/criid/2017/4545721/ Primary meningococcal meningitis is an infrequent but known disease. However, the infection of a prosthetic joint with Neisseria meningitidis is rare. We hereby describe the second case of an arthroplasty infected with Neisseria meningitidis that responded favourably to prosthesis retention with surgical debridement, in combination with antibiotics treatment. Berta Becerril Carral, Elvira Alarcón Manoja, Salvador López Cárdenas, and Jesús Canueto Quintero Copyright © 2017 Berta Becerril Carral et al. All rights reserved.