A case of Capnocytophaga canimorsus endocarditis in a non-immunosuppressed host: the value of 16S PCR for diagnosis

Capnocytophaga canimorsus is a rare cause of endocarditis and is particularly unusual in non-immunosuppressed hosts. It is associated with animal bites, particularly those from dogs. This case describes a healthy 59-year-old woman, with no identifiable risk factors or dog bite history, who presented with fever of unknown origin. Echocardiography demonstrated an aortic valve mass and root abscess, in keeping with endocarditis, requiring urgent valve replacement surgery. Eight sets of blood cultures were drawn in total; after prolonged incubation, one set grew C. canimorusus. There was initial uncertainty over this being the causative organism, given the lack of immunosuppression or dog bite history, but 16S PCR of the valve identified the same organism, permitting targeted treatment. This case highlights the value of valve 16S PCR as a diagnostic tool in endocarditis.

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Localized lymphadenopathy with myelodysplastic syndrome associated with tuberculosis

Hematology Reports ◽

10.4081/hr.2019.8147 ◽

2019 ◽

Vol 11 (4) ◽

Author(s):

Aya Nakaya ◽

Kazuyoshi Ishii ◽

Toshiki Shimizu ◽

Takeshi Tamaki ◽

Yoshihisa Ishiura ◽

...

Keyword(s):

Bone Marrow ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Myelodysplastic Syndrome ◽

Valve Replacement ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Replacement Surgery ◽

Laboratory Examinations ◽

Valve Replacement Surgery

We report the case of a man who developed myelodysplastic syndrome (MDS) and refractory cytopenia of unilineage dysplasia, 5 months after aortic valve replacement surgery. He also developed fever of unknown origin. After bone marrow- and other laboratory examinations, he was diagnosed with tuberculosis.

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Unilateral germinomas involving the basal ganglia and thalamus

Journal of Neurosurgery ◽

10.3171/jns.1981.55.1.0055 ◽

1981 ◽

Vol 55 (1) ◽

pp. 55-62 ◽

Cited By ~ 49

Author(s):

Tatsuya Kobayashi ◽

Naoki Kageyama ◽

Yoshihisa Kida ◽

Jun Yoshida ◽

Naoki Shibuya ◽

...

Keyword(s):

Basal Ganglia ◽

Fever Of Unknown Origin ◽

Unknown Origin ◽

Male Dominance ◽

Cortical Atrophy ◽

Content Type ◽

Radioisotope Scanning ◽

Slow Progression ◽

Eye Symptoms ◽

Symptoms And Signs

✓ Clinical characteristics of six cases of germinoma involving a unilateral basal ganglion and thalamus are summarized. The incidence was estimated as 10% of all intracranial germinomas. The average age at the onset was 10.5 years. The sex incidence showed a male dominance. The clinical course was slowly progressive, and the average duration between onset and diagnosis was 2 years 5 months. Common symptoms and signs were hemiparesis in all cases, fever of unknown origin and eye symptoms in most, mental deterioration and psychiatric signs in three, and convulsions, pubertas praecox, and diabetes insipidus in two. Signs of increased intracranial pressure were found in only two cases in the later state of the disease. Early diagnosis is difficult because of nonspecific symptomatology and slow progression. Carotid angiography and pneumoencephalography showed abnormal findings compatible with basal ganglia and thalamic tumors, but not specific to germinoma. Ipsilateral cortical atrophy and ventricular dilatation might be significant findings. Radioisotope scanning was useful. Computerized tomography scans were the best method of detecting the location and nature of this tumor, and repeat scans showed response to radiation therapy.

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Regional Colitis Presenting as Fever of Unknown Origin: Report of a Case With Three Skip Lesions

Gastroenterology ◽

10.1016/s0016-5085(51)80102-1 ◽

1951 ◽

Vol 17 (2) ◽

pp. 269-274 ◽

Cited By ~ 1

Author(s):

Bertram Kertzner

Keyword(s):

Fever Of Unknown Origin ◽

Unknown Origin ◽

Skip Lesions

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Kikuchi-Fujimoto Disease Is a Rare Cause of Lymphadenopathy and Fever of Unknown Origin in Children: Report of Two Cases and Review of the Literature

Yearbook of Pediatrics ◽

10.1016/s0084-3954(08)70164-7 ◽

2007 ◽

Vol 2007 ◽

pp. 296-298

Author(s):

J.A. Stockman

Keyword(s):

Fever Of Unknown Origin ◽

Unknown Origin ◽

Review Of The Literature

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Patients with fever of unknown origin (FUO): diagnosis by nuclear medicine imaging

Nuklearmedizin ◽

10.1055/s-0038-1623872 ◽

2001 ◽

Vol 40 (03) ◽

pp. 59-70 ◽

Cited By ~ 13

Author(s):

W. Becker ◽

J. Meiler

Keyword(s):

Nuclear Medicine ◽

Fever Of Unknown Origin ◽

Tumor Imaging ◽

White Blood Cells ◽

Unknown Origin ◽

Final Diagnosis ◽

Recurrent Fever ◽

Nuclear Medicine Imaging

SummaryFever of unknown origin (FUO) in immunocompetent and non neutropenic patients is defined as recurrent fever of 38,3° C or greater, lasting 2-3 weeks or longer, and undiagnosed after 1 week of appropriate evaluation. The underlying diseases of FUO are numerous and infection accounts for only 20-40% of them. The majority of FUO-patients have autoimmunity and collagen vascular disease and neoplasm, which are responsible for about 50-60% of all cases. In this respect FOU in its classical definition is clearly separated from postoperative and neutropenic fever where inflammation and infection are more common. Although methods that use in-vitro or in-vivo labeled white blood cells (WBCs) have a high diagnostic accuracy in the detection and exclusion of granulocytic pathology, they are only of limited value in FUO-patients in establishing the final diagnosis due to the low prevalence of purulent processes in this collective. WBCs are more suited in evaluation of the focus in occult sepsis. Ga-67 citrate is the only commercially available gamma emitter which images acute, chronic, granulomatous and autoimmune inflammation and also various malignant diseases. Therefore Ga-67 citrate is currently considered to be the tracer of choice in the diagnostic work-up of FUO. The number of Ga-67-scans contributing to the final diagnosis was found to be higher outside Germany than it has been reported for labeled WBCs. F-l 8-2’-deoxy-2-fluoro-D-glucose (FDG) has been used extensively for tumor imaging with PET. Inflammatory processes accumulate the tracer by similar mechanisms. First results of FDG imaging demonstrated, that FDG may be superior to other nuclear medicine imaging modalities which may be explained by the preferable tracer kinetics of the small F-l 8-FDG molecule and by a better spatial resolution of coincidence imaging in comparison to a conventional gamma camera.

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