Rare and unusual case of hepatic and disseminated tuberculosis in an immunocompetent patient

Mycobacterium tuberculosis complex disease (tuberculosis (TB)) of the liver is rare and liver abscesses as a result are even rarer. In an immunocompetent individual, the disease tends to be localised. To the best of our knowledge, we report one of the most severe TB involvements of the liver in an immunocompetent individual. A young woman with a history of previous TB infection, presented in septic shock. Scans showed a liver filled with possible abscesses, one of which was aspirated and confirmed TB. Multiple HIV tests were negative but she remained lymphopaenic. Although she improved substantially with anti-tuberculous treatment, she later developed non-tuberculous central nervous system disease that we were unable to fully explain. Despite a stormy recovery period, she continues to do well.

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Unusual presentations of a severe type 2 leprosy reaction mimicking sepsis induced by helminth infection

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009453 ◽

2021 ◽

Vol 15 (7) ◽

pp. e0009453

Author(s):

Sri Linuwih Menaldi ◽

Anastasia Asylia Dinakrisma ◽

Hok Bing Thio ◽

Iris Rengganis ◽

Salma Oktaria

Keyword(s):

Septic Shock ◽

Unusual Case ◽

Helminth Infection ◽

Endoscopic Examination ◽

Course Of Illness ◽

Source Of Infection ◽

Helminth Infections ◽

History Of ◽

Severe Type

We describe an unusual case of type 2 leprosy reaction (T2R) with septic shock–like features induced by helminth infection in a 31-year-old Moluccan male patient with a history of completed treatment of WHO multidrug therapy (MDT)–multibacillary (MB) regimen 2 years before admission. During the course of illness, the patient had numerous complications, including septic shock, anemia, and disseminated intravascular coagulation (DIC). Nevertheless, antibiotic therapies failed to give significant results, and the source of infection could not be identified. Helminth infection was subsequently revealed by endoscopic examination followed by parasitological culture. Resolution of symptoms and normal level of organ function–specific markers were resolved within 3 days following anthelmintic treatment. This report demonstrated the challenge in the diagnosis and treatment of severe T2R. Given that helminth infections may trigger severe T2R that mimics septic shock, health professionals need to be aware of this clinical presentation, especially in endemic regions of both diseases.

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Multiple liver abscesses caused by Streptococcus intermedius bacteremia in the setting of a routine dental cleaning

BMJ Case Reports ◽

10.1136/bcr-2019-233097 ◽

2020 ◽

Vol 13 (2) ◽

pp. e233097 ◽

Cited By ~ 1

Author(s):

Angy Hanna ◽

Zaid Imam ◽

Fadi Odish ◽

Bhavin Dalal

Keyword(s):

Septic Shock ◽

Gastrointestinal Tract ◽

Immunocompetent Patient ◽

Blood Cultures ◽

Immunocompromised Patients ◽

Ultrasound Guided ◽

Streptococcus Intermedius ◽

Liver Abscesses ◽

The Brain ◽

Gram Positive Cocci

Streptococcus intermedius is a Gram-positive cocci, normally found in the oral cavity and gastrointestinal tract. It has been associated with deep-seated purulent abscesses commonly in the brain or liver in immunocompromised patients. Here, we discuss the case of a 21-year-old immunocompetent patient that presented with septic shock in the setting of multiple pyogenic liver abscesses with positive blood cultures for S. intermedius. The patient had a dental cleaning 3 months prior to admission. The abscesses resolved with ultrasound guided drainage and antibiotic therapy.

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A Case of Cerebral Vasculitis Associated with Ulcerative Colitis

Case Reports in Rheumatology ◽

10.1155/2015/598273 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Naveen Raj ◽

Matthew Arkebauer ◽

Barry Waters ◽

Brucha Dickinson

Keyword(s):

Ulcerative Colitis ◽

Central Nervous System Disease ◽

Altered Mental Status ◽

Inflammatory Disorder ◽

Cerebral Lesions ◽

System Disease ◽

Organ Systems ◽

History Of ◽

Inflammatory Bowel ◽

The Brain

Ulcerative colitis (UC) is a chronic, debilitating condition characterized by inflammation of the colonic mucosa. It is regarded as a systemic inflammatory disorder that can affect a number of organ systems. Central nervous system disease associated with UC is a rare sequela of inflammatory bowel disease, occurring in less than 5% of cases. These manifestations include arterial and venous thrombosis, leukoencephalitis, seizures, and vasculitis. We present a case of a 61-year-old female with a two-year history of well-controlled ulcerative colitis, who developed altered mental status and weakness. On brain imaging, she was found to have cerebral lesions which were biopsied. Histopathology subsequently revealed coagulative necrosis and inflammation characteristic of vasculitis. Rheumatology serologies were negative, and the patient was started on steroids that dramatically improved her neurological function, with no residual deficits, and led to resolution of the brain lesions.

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A Case of Pasteurella Multocida Pneumonia, Bacteremia, and Septic Shock

10.21203/rs.3.rs-315527/v1 ◽

2021 ◽

Author(s):

Wesley Tang ◽

Sulagna Das ◽

James Galbraith

Keyword(s):

Septic Shock ◽

Pasteurella Multocida ◽

Relevant Literature ◽

Domestic Animals ◽

Immunocompetent Patient ◽

Hodgkin's Lymphoma ◽

Human Pathogen ◽

Pulmonary Lesions ◽

History Of ◽

Immunocompromised State

Abstract Pasteurella multocida is a ubiquitous organism found in the oropharynx of healthy domestic animals, especially dogs and cats. It is most known as a human pathogen, reported after animal bite incidents. In atraumatic infections, Pasteurella has been associated with patients in an immunocompromised state, such as those with Hodgkin’s lymphoma, patients with known cirrhosis, or those with preexisting cavitary pulmonary lesions. It is rare to isolate Pasteurella in an immunocompetent patient without known trauma. Here, we present a case of Pasteurella multocida pneumonia, bacteremia, and septic shock in an individual without a history of an animal bite, with a review of relevant literature.

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AN EPIDEMIC OF ASEPTIC MENINGITIS SYNDROME DUE TO ECHO VIRUS TYPE 6

PEDIATRICS ◽

10.1542/peds.29.3.432 ◽

1962 ◽

Vol 29 (3) ◽

pp. 432-437

Author(s):

Dudley L. King ◽

David T. Karzon

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Aseptic Meningitis ◽

Virus Type ◽

Central Nervous System Disease ◽

Nervous System Disease ◽

Paralytic Poliomyelitis ◽

System Disease ◽

Echo Virus ◽

History Of

Ninety-three patients with aseptic meningitis syndrome due to ECHO virus type 6 were evaluated 3 years following their acute infection to determine the extent of neuromuscular residua. In addition, 9 patients with aseptic meningitis due to other enteroviruses and 19 patients with paralytic poliomyelitis were similarly evaluated. Forty-four individuals with no history of central nervous system disease were studied for comparison. Residua following aseptic meningitis were minimal and fell into two categories: 1. Approximately 20% gave a history of minor changes in behavior, easy fatigability, headaches or pain, stiffness or subjective weakness of the back or legs, the onsets of which were associated with the acute illness. 2. On examination approximately 25% revealed subtle neuromuscular changes such as altered reflexes, minor weaknesses in anterior neck or trunk muscles, or slight skeletal abnormalities, particularly scoliosis. The group with no history of central nervous system disease demonstrated an appreciable, but somewhat lesser, incidence of minor neuromuscular changes, further tending to minimize the specific significance of the findings in the study group.

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An unusual case of Salmonella Enteritidis causing pneumonia, septic shock and multiple organ failure in an immunocompetent patient

IDCases ◽

10.1016/j.idcr.2016.10.004 ◽

2016 ◽

Vol 6 ◽

pp. 85-89 ◽

Cited By ~ 5

Author(s):

M.L. Thompson Bastin ◽

N.R. Neville ◽

R.E. Parsons ◽

A.H. Flannery ◽

S.J. Tennant ◽

...

Keyword(s):

Septic Shock ◽

Multiple Organ Failure ◽

Organ Failure ◽

Salmonella Enteritidis ◽

Unusual Case ◽

Immunocompetent Patient ◽

Multiple Organ

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1794: AN UNUSUAL CASE OF SALMONELLA CAUSING PNEUMONIA AND SEPTIC SHOCK IN AN IMMUNOCOMPETENT PATIENT

Critical Care Medicine ◽

10.1097/01.ccm.0000510467.58697.55 ◽

2016 ◽

Vol 44 (12) ◽

pp. 524-524

Author(s):

Melissa Thompson Bastin ◽

Nichole Neville ◽

Richard Parsons ◽

Alexander Flannery ◽

Sarah Tennant ◽

...

Keyword(s):

Septic Shock ◽

Unusual Case ◽

Immunocompetent Patient

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NCMP-06. METASTATIC CENTRAL NERVOUS SYSTEM DISEASE SECONDARY TO BURKITT LYMPHOMA IN A PATIENT WITH PRIOR HISTORY OF MELANOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa215.518 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii124-ii124

Author(s):

Uju Momah ◽

Jennifer Brewer ◽

Anthony Tran ◽

David Shapiro

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Central Nervous System Disease ◽

Burkitt’S Lymphoma ◽

Adult Patients ◽

Burkitt's Lymphoma ◽

Prior History ◽

System Disease ◽

History Of ◽

The Central Nervous System

Abstract Sporadic Burkitt’s Lymphoma accounts for only 1–2% of Non Hodgkin’s Lymphoma, and metastasizes to the central nervous system (CNS) is uncommon, occurring in about 13–17% of adult patients. 1 Melanoma is far more likely to metastasize to the CNS, occurring in about 37% of adult patients.2 Here we present the case of a 69 year old Gambian female with a prior medical history of plantar melanoma. She initially presented to her primary care provider with back pain and adenopathy, and was referred to surgical consultation for diagnosis and concern for recurrent melanoma. Her workup revealed metastatic Burkitt’s Lymphoma with disease in the abdomen, lungs and likely CNS involvement. This report chronicles her disease course and approach to management.

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Meningoencephalitis due to Naegleria fowleri in cattle in southern Brazil

Revista Brasileira de Parasitologia Veterinária ◽

10.1590/s1984-29612019021 ◽

2019 ◽

Vol 28 (3) ◽

pp. 514-517 ◽

Cited By ~ 2

Author(s):

Luan Cleber Henker ◽

Raquel Aparecida Sales da Cruz ◽

Fernando Soares da Silva ◽

David Driemeier ◽

Luciana Sonne ◽

...

Keyword(s):

Clinical History ◽

Central Nervous System Disease ◽

Southern Brazil ◽

Naegleria Fowleri ◽

Irrigated Rice ◽

System Disease ◽

History Of ◽

Nægleria Fowleri ◽

The Right ◽

Frontal Lobe Cortex

Abstract Naegleria fowleri is a free-living amoeba commonly found in the environment, mainly in fresh water and soil. This protozoon is occasionally involved in cases of fatal central nervous system disease in humans and other animal species. We describe here a case of meningoencephalitis due to Naegleria fowleri in cattle, in southern Brazil. A four-year-old Angus cow presented a clinical history of initial mild neurological signs that progressed to paddling movements, opisthotonus and lateral recumbency after five days. This animal had been kept in an irrigated rice stubble paddock. Grossly, the main lesions consisted of multiple areas of malacia in the right olfactory bulb, piriform lobes, hippocampus, frontal lobe cortex and fornix, along with severe thickening of the mesencephalon and rhombencephalon leptomeninges. Microscopically, severe multifocal necrosuppurative and hemorrhagic meningoencephalitis associated with a large quantity of amoebic trophozoites was present. The latter were confirmed to be Naegleria spp., through immunohistochemistry. Based on the strong congruence with the histopathological data of known cases reported in the literature, a probable association with Naegleria fowleri was established. To our knowledge, this is only the second report of Naegleria fowleri-associated meningoencephalitis in cattle in South America, and it is the first in southern Brazil.

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