scholarly journals Mycobacterium chelonae empyema in an immunocompetent patient

2008 ◽  
Vol 57 (5) ◽  
pp. 664-667 ◽  
Author(s):  
Hsiao-Cheng Hsieh ◽  
Po-Liang Lu ◽  
Tun-Chieh Chen ◽  
Ko Chang ◽  
Yen-Hsu Chen
Keyword(s):  
Wedge Resection ◽  
Bronchopleural Fistula ◽  
Healthy Woman ◽  
Immunocompetent Patient ◽  
Intermittent Fever ◽  
Mycobacterium Chelonae ◽  
Thoracic Empyema ◽  
Complete Treatment ◽  
The Right ◽  
Immunocompetent Patients

Thoracic empyema caused by rapidly growing mycobacteria (RGM) and complicated with bronchopleural fistula is rarely reported, especially in immunocompetent patients. A 53-year-old healthy woman presented initially with a productive cough and intermittent fever. The patient received a complete treatment course following an initial diagnosis of pulmonary tuberculosis. After the anti-tuberculosis agents were discontinued, a right thoracic empyema with bronchopleural fistula occurred, and the pathogens from both pus and sputum were identified as Mycobacterium chelonae. Thoracotomy with decortication and wedge resection of the right middle lung was performed, followed by clarithromycin plus ciprofloxacin therapy for 36 months. This patient has not suffered a relapse in the last 3 years. In addition to the experience of successful treatment, this case indicates that RGM such as M. chelonae can emerge as causative pathogens of thoracic empyema, even in healthy persons.

scholarly journals Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

Abstract Background Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. Conclusions We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

scholarly journals Sepsis byPasteurella multocidain an Elderly Immunocompetent Patient after a Cat Bite

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Lara Caserza ◽  
Gabriella Piatti ◽  
Aldo Bonaventura ◽  
Luca Liberale ◽  
Federico Carbone ◽  
...  
Keyword(s):  
Ct Scan ◽  
Pasteurella Multocida ◽  
Antibiotic Sensitivity ◽  
Immunocompetent Patient ◽  
Antimicrobial Treatment ◽  
Cerebral Computed Tomography ◽  
Total Body ◽  
Laboratory Biomarkers ◽  
The Right ◽  
Immunocompetent Patients

Pasteurella multocidacolonizes animal scratches and bites. This bacterium was described to cause sepsis or endocarditis mainly in immunocompromised patients. We report the case of a 92-year-old woman presenting at the Emergency Department with coma and fever a week after the bite of her cat. The cat bite was misdiagnosed at admission partly due to an underestimation of this event by the patient’s relatives. An inflamed area localized at perimalleolar skin of the right leg was detected. Laboratory biomarkers of inflammation were elevated. The cerebral computed tomography (CT) scan with angiographic sequences showed a complete occlusion of right intracranial vertebral artery. Total body CT scan and abdominal echocardiography were negative for foci of infection. Three consecutive blood cultures were positive forPasteurella multocida. A diagnosis of sepsis byPasteurella multocidawas made, and the patient recovered after a specific antimicrobial treatment. In order to confirm the animal transmission, the cat saliva was cultured and found positive forPasteurella multocidawith a similar antibiotic sensitivity to that isolated from the patient. In conclusion, the case of a patient with coma and fever after a cat bite was presented. The transmission of pathogens from pets has to be carefully considered as an important route of infection in immunocompetent patients.

scholarly journals An Immunocompetent Patient with Isolated Cryptococcosis of the Nasal Cavity: Surgical Treatment without Systemic Antifungal Agents

2017 ◽  
Vol 10 (1) ◽  
pp. 36-38
Author(s):  
Seong K Park ◽  
Do H Kim
Keyword(s):  
Surgical Treatment ◽  
Nasal Cavity ◽  
Antifungal Agents ◽  
Surgical Intervention ◽  
Healthy Woman ◽  
Immunocompetent Patient ◽  
Immunocompetent Patients

ABSTRACT The mode of cryptococcal transmission to humans is believed to be through inhalation of aerosolized droppings, which cause asymptomatic pulmonary granulomata in immunocompetent patients. Extrapulmonary infections have been associated with various immunocompromised states, and these infections are relatively rare in immunocompetent patients. In general, cryp tococcal sinus infections are treated with surgical intervention and administration of systemic antifungal agents. However, there is doubt that systemic antifungal agents are necessary in immunocompetent patients with no complications. We report an otherwise healthy woman with cryptococcosis of the nasal cavity who was treated surgically without systemic antifungal agents. How to cite this article Park SK, Kim DH. An Immunocom petent Patient with Isolated Cryptococcosis of the Nasal Cavity: Surgical Treatment without Systemic Antifungal Agents. Clin Rhinol An Int J 2017;10(1):36-38.

scholarly journals Mycobacterium avium Auricular Infection in an Apparent Immunocompetent Patient: A Case Report

Folia Medica ◽  
2016 ◽  
Vol 58 (2) ◽  
pp. 131-135
Author(s):  
Panagiota Vlachogianni ◽  
Maria Volosyraki ◽  
Maria Stefanidou ◽  
Sabine Krueger-Krasagakis ◽  
George Evangelou ◽  
...  
Keyword(s):  
Case Report ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Immunocompetent Patient ◽  
Soft Tissue Infections ◽  
Tissue Cultures ◽  
Blood Tests ◽  
Ear Injury ◽  
The Right ◽  
Immunocompetent Patients

Abstract Introduction: Soft tissue infections with Mycobacterium avium complex are more likely to appear in immunocompromised patients. However, they may rarely arise in non-immunosuppressed individuals. Aim: To present the case of an ear infection with Mycobacterium avium in the absence of demonstrable immunosuppression. Case Report: Clinical case description, blood tests, routine histology and tissue cultures. Discussion: A female, apparent immunocompetent patient presented with a 6-month reddish, oedematous and painless lesion with fine scaling in the right ear. Histology showed numerous granulomas, composed of epithelioid histiocytes without central necrosis. Cultures grew Mycobacterium avium. An unusual accidental ear injury was the portal of microbial entry. The patient’s lesion fully regressed after a 9-month course of antibiotics. Conclusion: Although M. avium infections are rare in immunocompetent patients, the possibility of such infections should be considered even in these subjects, when relevant clinical features and exposure to risk factors are present.

Primary cutaneous nocardiosis of the head and neck in an immunocompetent patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241217
Author(s):  
Claudio Tirso Acevedo ◽  
Frank Imkamp ◽  
Ewerton Marques Maggio ◽  
Silvio Daniel Brugger
Keyword(s):  
Head And Neck ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Rrna Gene ◽  
Gene Sequence Analysis ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Amoxicillin Clavulanic Acid ◽  
Disseminated Nocardiosis ◽  
The Right

Nocardiosis is known to be an opportunistic infection most commonly affecting immunocompromised patients that can lead to life-threatening conditions. Primary cutaneous disease remains a rare manifestation and unlike pulmonary or disseminated nocardiosis, it usually affects immunocompetent individuals. We present a case of a primary cutaneous nocardiosis of the head and neck after an insect bite in a healthy 50-year-old woman who had recently travelled from Greece. She presented with a painful right-sided swelling of her face and neck and an ulcerated plaque over the right temple. Biopsy of the plaque revealed inflammation with abscess formation indicating underlying infection. Culture from the biopsy showed growth of Nocardia spp and 16S rRNA gene sequence analysis identified Nocardia brasiliensis. The patient was treated with trimethoprim/sulfamethoxazole and subsequently switched to amoxicillin/clavulanic acid due to a drug eruption. Antibiotic therapy was continued for a total of 3 months with complete resolution of the skin lesions.

scholarly journals Nontyphi Salmonella Empyema with Bronchopleural Fistula in a Patient with Human Immunodeficiency Virus

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Douglas Bretzing ◽  
Tasnim Lat ◽  
Andrew Shakespeare ◽  
Mary Lee ◽  
Salim Surani ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Bronchopleural Fistula ◽  
Fibrinolytic Therapy ◽  
Watery Diarrhea ◽  
Increased Risk ◽  
Pulmonary Manifestations ◽  
Immunodeficiency Virus ◽  
Night Sweats ◽  
The Right

Patients with human immunodeficiency virus (HIV) have an increased risk of inoculation with nontyphoid Salmonella compared to the general population. While nontyphoid Salmonella commonly manifests as gastroenteritis, Salmonella bacteremia can be seen in patients with HIV. We present a case of disseminated Salmonellosis in a patient with HIV complicated by bronchopleural fistula and secondary empyema. Case Presentation. A 40-year-old African American male with HIV noncompliant with HAART therapy presented with complaints of generalized weakness, weight loss, cough, night sweats, and nonbloody, watery diarrhea of four weeks’ duration. A computed tomography (CT) scan demonstrated a bilobed large, thick-walled cavitary lesion in the right upper lobe communicating with the pleural space to form a bronchopleural fistula. Thoracentesis yielded growth of nontyphi Salmonella species consistent with empyema; he was treated with intravenous Ceftriaxone and underwent placement of chest tube for drainage of empyema with instillation of alteplase/dornase twice daily for three days. Repeat CT chest showed a hydropneumothorax. The patient subsequently underwent video-assisted thoracoscopy with decortication. The patient continued to improve and follow-up CT chest demonstrated improved loculated right pneumothorax with resolution of the right bronchopleural fistula and resolution of the cavitary lesions. Discussion. We describe one of the few cases of development of bronchopulmonary fistula and the formation of empyema in the setting of disseminated Salmonella. Empyema complicated by bronchopulmonary fistula likely led to failure of intrapleural fibrinolytic therapy and the patient ultimately required decortication in addition to antibiotics. While Salmonella bacteremia can be seen in immunocompromised patients, extraintestinal manifestations of Salmonella infection such as empyema and bronchopleural fistulas are uncommon. Bronchopleural fistulas most commonly occur as a postoperative complication of pulmonary resection. Conclusions. This case highlights the unusual pulmonary manifestations that can occur due to disseminated Salmonella in an immunocompromised patient as well as complex management decisions related to these complications.

scholarly journals Prostatic tuberculosis: case report

2008 ◽  
Vol 126 (4) ◽  
pp. 227-228 ◽  
Author(s):  
Daniel Sáenz-Abad ◽  
Santiago Letona-Carbajo ◽  
José Luis de Benito-Arévalo ◽  
Isabel Sanioaquín-Conde ◽  
Francisco José Ruiz-Ruiz
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Urine Culture ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Tuberculosis Case ◽  
Immunocompetent Patients

CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

scholarly journals Suspected Pulmonary Metastasis of Actinic Cutaneous Squamous Cell Carcinoma

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Monet E. Meter ◽  
David J. Nye ◽  
Christian R. Galvez
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Actinic Keratosis ◽  
Uv Light ◽  
Light Exposure ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Lung Lesion ◽  
The Right

Introduction. It is rare for actinic or squamous cell carcinoma (SCC) in situ to metastasize. Case Presentation. A 67-year-old male had a significant medical history including severe psoriatic arthritis treated with UVB, methotrexate, and rapamycin. He had twenty-five different skin excisions of actinic keratosis four of which were invasive SCC. Our patient developed shortness of breath necessitating a visit to the emergency department. A CT scan of his chest revealed a mass in the right lower lung. A subsequent biopsy of the mass revealed well-differentiated SCC. He underwent thoracoscopic surgery with wedge resection of the lung lesion. Discussion. Actinic keratosis (AK) is considered precancerous and associated with UV exposure. It exists as a continuum of progression with low potential for malignancy. The majority of invasive SCCs are associated with malignant progression of AK, but only 5–10% of AKs will progress to malignant potential. Conclusion. In this case, a new finding of lung SCC in the setting of multiple invasive actinic cutaneous SCC associated with a history of extensive UV light exposure and immunosuppression supports a metastatic explanation for lung cancer.

scholarly journals Pulmonary Nocardiosis in Immunocompetent Patient: A Rare Case Report

2020 ◽  
Author(s):  
Kusum V Shah ◽  
Saket Kumar ◽  
Yash Rana ◽  
Arti D Shah
Keyword(s):  
Case Report ◽  
Bacterial Infection ◽  
Rare Case ◽  
Severe Disease ◽  
Immunocompetent Patient ◽  
Nocardia Species ◽  
Pulmonary Nocardiosis ◽  
Rare Case Report ◽  
Bronchial Alveolar Lavage ◽  
Immunocompetent Patients

Pulmonary nocardiosis is a rare bacterial infection that may lead to severe disease in immunodeficient patients and usually not so common in immunocompetent patients. The report is about a 57-year-old male with Norcardiosis. His sputum and Bronchial Alveolar Lavage (BAL) were negative for acid-fast bacilli. Nocardia species was isolated in BAL culture. He was started on Trimethoprim/Sulfamethoxazole and Clarithromycin, which was later continued for six months.

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