scholarly journals Human bovine tuberculosis – remains in the differential

2010 ◽  
Vol 59 (11) ◽  
pp. 1379-1382 ◽  
Author(s):  
Shaukat Bilal ◽  
Mudassir Iqbal ◽  
Philip Murphy ◽  
Joan Power
Keyword(s):  
Bovine Tuberculosis ◽  
Risk Groups ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Antituberculous Therapy ◽  
Isoniazid Resistance ◽  
Source Of Infection ◽  
Unpasteurized Milk ◽  
History Of ◽  
Exposed Case

Mycobacterium bovis is a pathogen of cattle. The unpasteurized milk of affected cattle is a source of infection in humans. Despite the screening of cattle and the pasteurization of milk, M bovis has not been eradicated. A high index of clinical suspicion is needed in symptomatic patients with a history of possible exposure. At risk groups include animal workers, farmers, meat packers, vets and zoo keepers. Humans are usually infected by the aerosol route. We present two cases of human bovine tuberculosis. One was a presumptive case and the second was a confirmed case. Both responded well to antituberculous therapy. In the confirmed case, there was evidence of transmission to the partner living in the same house. Rifampicin prophylaxis was given to the exposed case. The M. bovis from the confirmed case was isoniazid resistant, in addition to having the well known resistance to pyrazinamide. Isoniazid resistance has been described before in those who are immunocompromised. We describe it in an immunocompetent patient.

scholarly journals TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT

2015 ◽  
Vol 57 (3) ◽  
pp. 273-275 ◽  
Author(s):  
Xiao-Hua CHEN ◽  
Yun-Chao GAO ◽  
Yi ZHANG ◽  
Zheng-Hao TANG ◽  
Yong-Sheng YU ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Invasive Candidiasis ◽  
Rare Case ◽  
Spinal Tuberculosis ◽  
Immunocompetent Patient ◽  
Antituberculous Therapy ◽  
Lower Back ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Candida Infections

Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient.

scholarly journals Cryptogenic Pyogenic Liver Abscess Due to Fusobacterium nucleatum in an Immunocompetent Patient

2020 ◽  
Author(s):  
Neeraja Swaminathan ◽  
Francisco Aguilar
Keyword(s):  
Liver Abscess ◽  
Fusobacterium Nucleatum ◽  
Pyogenic Liver Abscess ◽  
Immunocompetent Patient ◽  
Immunocompetent Host ◽  
Source Of Infection ◽  
Function Test ◽  
History Of ◽  
Anaerobic Infections ◽  
Dental Work

In this case, a 76-year-old female presented with 3–4 days of fever with no other localizing signs. Notably, she had had an untreated Fusobacterium bacteraemia approximately 8 weeks prior to admission. She underwent abdominal imaging which demonstrated a liver abscess and had percutaneous drainage of the same. Blood and pus cultures both grew Fusobacterium nucleatum, which is an unusual organism to be associated with a liver abscess, especially in an immunocompetent host with no risk factors for this condition. Interestingly, this patient did not have any history of dental work, instrumentation, liver function test (LFT) abnormalities and no extrahepatic source for the abscess. This case highlights the importance of having a high index of clinical suspicion for an occult source of infection and emphasizes the importance of following up on cultures even after discharge of a patient, since anaerobic infections such as those caused by Fusobacterium can have a largely indolent course.

scholarly journals Infratentorial Epidural Abscess Secondary to Furunculosis: Case Report and a Review of the Literature

2019 ◽  
Vol 10 (01) ◽  
pp. 148-150
Author(s):  
Ricardo Horacio Menéndez ◽  
Santiago German Erice ◽  
Emmanuel Alejandro Vázquez ◽  
Karina Breitburd
Keyword(s):  
Methicillin Resistant Staphylococcus Aureus ◽  
Epidural Abscess ◽  
Immunocompetent Patient ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Neck Stiffness ◽  
Surgical Specimen ◽  
Source Of Infection ◽  
History Of ◽  
Occipital Headache

ABSTRACTThe authors describe a case of infratentorial epidural abscess caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in a patient with a recent history of cutaneous furunculosis. This 29-year-old male presented with an occipital headache associated with fever, vomiting, and neck stiffness. Admission magnetic resonance imaging showed a retrocerebellar epidural abscess. Antimicrobial therapy was started, and the patient underwent craniectomy for evacuation of the abscess. Cultures of the surgical specimen were consistent with CA-MRSA. Postoperatively, the patient's condition improved with the resolution of symptoms, and he was discharged home with indication of 6 weeks of antibiotic therapy. Furunculosis is a very rare cause of intracranial epidural abscess but should be considered as a source of infection in an immunocompetent patient.

A Rare Case of Tuberculous Prostatitis

2016 ◽  
Vol 1 (2) ◽  
pp. 33
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Mohammad Hanafiah ◽  
Marymol Koshy ◽  
Hilmi Abdullah ◽  
Ahmad Izuanuddin Ismail ◽  
...  
Keyword(s):  
Rare Case ◽  
Correct Diagnosis ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Tuberculosis Infection ◽  
Advanced Age ◽  
Immunocompromised Patients ◽  
Prostatic Biopsy ◽  
High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

Verrucous Psoriasis Successfully Treated with Ixekizumab: A Case Report with Review Literature

2020 ◽  
Vol 103 (9) ◽  
pp. 948-951
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Rare Variant ◽  
Psoriasis Vulgaris ◽  
Review Literature ◽  
Antituberculous Therapy ◽  
Plaque Type ◽  
History Of

Verrucous psoriasis is a rare variant of plaque-type psoriasis with only about 35 cases reported. The authors reported a man with a history of psoriasis vulgaris for seven years, presented with progressive verrucous hyperkeratotic plaques on both legs for three years. His earlier investigations favored the diagnosis of tuberculosis verrucosa cutis. After completing the antituberculous therapy, the lesions persisted. The later investigations favored a rare subtype of psoriasis named verrucous psoriasis. Keywords: Verrucous psoriasis, Tuberculosis verrucosa cutis, Mycobacterium tuberculosis, Ixekixumab

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

scholarly journals Granulomatous Hepatitis Following Intra-Vesical Instillation of Bacillus Calmette–Guérin for Treatment of Bladder Cancer

2021 ◽  
Vol 13 (3) ◽  
pp. 611-618
Author(s):  
Elsa Alves Branco ◽  
Raquel Duro ◽  
Teresa Brito ◽  
António Sarmento
Keyword(s):  
Bladder Cancer ◽  
Hepatitis A ◽  
Adverse Reactions ◽  
Superficial Bladder Cancer ◽  
Rare Complication ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Bacillus Calmette Guerin ◽  
Granulomatous Hepatitis ◽  
Appropriate Treatment

Intra-vesical instillation of bacillus Calmette–Guérin (BCG) is an important treatment modality of superficial bladder cancer. It is usually well tolerated, although some adverse reactions can occur. One possible yet rare complication is granulomatous hepatitis, that is thought to be caused either by BCG infection or a hypersensitivity reaction to the bacillus. We present a case of a 79-year-old apparently immunocompetent patient who developed granulomatous hepatitis a few months after BCG administration for bladder cancer immunotherapy. It is important to notice that acid-fast smears and cultures are often negative, and these should not exclude diagnosis nor delay treatment. Our case highlights the importance of clinical suspicion and prompt initiation of appropriate treatment.

scholarly journals Type 4 appendiceal diverticulum within a de Garengeot hernia

2016 ◽  
Vol 98 (7) ◽  
pp. e141-e142 ◽  
Author(s):  
SH Rossi ◽  
E Coveney
Keyword(s):  
Femoral Hernia ◽  
Cystic Lesion ◽  
Vermiform Appendix ◽  
Clinical Suspicion ◽  
Intraluminal Pressure ◽  
Rare Entity ◽  
History Of ◽  
The Right ◽  
De Garengeot Hernia ◽  
Learning Points

A de Garengeot hernia is defined as an incarcerated femoral hernia containing the vermiform appendix. We describe the case of a patient with a type 4 appendiceal diverticulum within a de Garengeot hernia and delineate valuable learning points.A 76-year-old woman presented with a 2-week history of a non-reducible painless femoral mass. Outpatient ultrasonography demonstrated a 36mm × 20mm smooth walled, multiloculated, partially cystic lesion anterior to the right inguinal ligament in keeping with an incarcerated femoral hernia. Intraoperatively, the appendix was found to be incarcerated in the sac of the femoral hernia and appendicectomy was performed. Histopathology demonstrated no evidence of inflammation in the appendix. However, an incidental appendiceal diverticulum was identified.It is widely recognised that a de Garengeot hernia may present with concomitant appendicitis, secondary to raised intraluminal pressure in the incarcerated appendix. Appendiceal diverticulosis is also believed to develop in response to raised pressure in the appendix and may therefore develop secondary to incarceration in a de Garengeot hernia. To our knowledge, only one such case has been described in the literature. A de Garengeot hernia is a rare entity, which poses significant diagnostic challenges. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.

Correlates of Medical Mistrust Among Minority Women at Risk for HIV and Their Networks

2021 ◽  
pp. 109019812098678
Author(s):  
Laura M. Johnson ◽  
Harold D. Green ◽  
Brandon Koch ◽  
Robert Harding ◽  
Jamila K. Stockman ◽  
...  
Keyword(s):  
At Risk ◽  
Black Women ◽  
Hiv Prevention ◽  
Risk Groups ◽  
Medical Mistrust ◽  
Individual Level ◽  
Prevention And Treatment ◽  
Egocentric Network ◽  
History Of ◽  
Sex With Men

Background Medical mistrust is a barrier to engaging in HIV prevention and treatment, including testing and adherence to antiretroviral therapy. Research often focuses on how race and experiences of discrimination relate to medical mistrust, overlooking the role that other characteristics may play (e.g., history of physical abuse, diagnosis of mental illness). Furthermore, studies are often restricted to samples of men who have sex with men and findings may not generalize to other at-risk groups. Aims The current study explores a range of demographic, cognitive, behavioral, and social network correlates of medical mistrust. Method This study employed an egocentric network design among a racially diverse sample of at-risk women and women in their social networks ( n = 165). Results Results from multivariable linear regressions stratified by race (Black vs. others) indicate that medical mistrust is associated with both individual-level and network-level characteristics. Across both groups, age and experiences of racial discrimination were associated with higher medical mistrust. Having a regular sex partner and having a higher proportion of network members who are family was significantly associated with medical mistrust among non-Black women. Discussion Individual-level and network-level variables were significantly associated with medical mistrust. Therefore, interventions that attempt to mitigate medical mistrust as a barrier to HIV prevention and treatment should consider how mistrust may be related to characteristics of individuals and broader contexts. Conclusion Health interventions may benefit from conceiving of medical mistrust as a complex, rational response to cumulative discriminatory life experiences and a reflection of the networks within which individuals are embedded.

Streptococcus salivarius endogenous endophthalmitis

2021 ◽  
Vol 14 (2) ◽  
pp. e239299
Author(s):  
Carl-Joe Mehanna ◽  
Lea Kallassi ◽  
Ahmad M Mansour ◽  
Rola N Hamam
Keyword(s):  
Opportunistic Infections ◽  
External Source ◽  
Endogenous Endophthalmitis ◽  
Streptococcus Salivarius ◽  
Source Of Infection ◽  
Transcatheter Aortic Valve ◽  
History Of ◽  
Atypical Presentations ◽  
High Index Of Suspicion ◽  
Valve Implantation

We describe a case of endogenous endophthalmitis in an elderly man caused by Streptococcus salivarius. An 88-year-old male patient with diabetes with iron deficiency anaemia and history of transcatheter aortic valve implantation presented with an insidious clinical picture of atraumatic endophthalmitis. No internal or external source could be identified. Diagnostic and therapeutic vitrectomy revealed papillomacular abscess and vitreous fluids grew S. salivarius. Despite lack of an identifiable source of infection, a high index of suspicion for atypical presentations is required in patients with multiple comorbidities that could weaken their immune system towards opportunistic infections. Early detection, microbiological evaluation and prompt treatment are critical to avoid disastrous outcomes. While S. salivarius has been implicated in cases of exogenous endophthalmitis, this is the first reported case of endogenous endophthalmitis due to S. salivarius.

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