Mycobaterium fortuitum disseminated infection in an immunocompetent patient without predisposing factors

2020 ◽  
Vol 13 (9) ◽  
pp. e235842
Author(s):  
Stephanie d'Incau ◽  
Maria-Isabel Vargas ◽  
Alexandra Calmy ◽  
Jean-Paul Janssens
Keyword(s):  
Risk Factors ◽  
Pulmonary Infection ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Definitive Diagnosis ◽  
Optimal Treatment ◽  
Molecular Techniques ◽  
Surgical Removal ◽  
Mycobacterium Fortuitum ◽  
Direct Inoculation

Most Mycobacterium fortuitum infections described involve direct inoculation through skin lesions. We describe the case of a patient without risk factors who presented with an intracranial mass and a pulmonary infection with M. fortuitum. As M. fortuitum are rarely pathogens, there is little knowledge about the optimal treatment and outcome of such infections: what is the best mode of administration, what is the best therapy duration and is surgery always required are some of the unanswered questions. In our patient, surgical removal of the mass associated with a 1-year antimycobacterial therapy led to a full recovery. Even though M. fortuitum was rapidly identified in sputum, it was initially considered non-pathogenic and the definitive diagnosis required almost 6 weeks of investigations. New molecular techniques will probably lead to more identifications of M. fortuitum in the next few years and a better knowledge of their possible pathogenicity and optimal treatment.

scholarly journals Pulmonary Nocardiosis in an Immunocompetent Patient with Cystic Fibrosis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Lucy Schoen ◽  
Jonathan D. Santoro ◽  
Carlos Milla ◽  
Sumit Bhargava
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Disease ◽  
Bacterial Infections ◽  
Pulmonary Infection ◽  
Immunocompetent Patient ◽  
Primary Site ◽  
Optimal Treatment ◽  
Active Infection ◽  
Pulmonary Nocardiosis ◽  
Immunocompromised Hosts

Nocardiaspp. are bacteria of low virulence that cause infection classically in immunocompromised hosts with the lungs as the primary site of infection in the majority of cases. Patients with cystic fibrosis have pulmonary disease characterized by frequent and progressive bacterial infections. Reports ofNocardiaspp. isolation in CF are rare in the literature and may represent colonization or active infection, the significance and optimal treatment of which are unknown. We report the second case to date ofNocardia transvalensispulmonary infection in an immunocompetent patient with CF and the first in a child under the age of eighteen.

Mycobacterium Fortuitum Cholangitis and Sepsis in an Immunocompetent Patient

2020 ◽  
Keyword(s):  
Wide Spectrum ◽  
Venous Catheter ◽  
Immunocompetent Patient ◽  
Mycobacterium Fortuitum ◽  
Prosthetic Device ◽  
Surgical Equipment ◽  
Clinical Syndromes ◽  
Direct Inoculation ◽  
Immunosuppressed Patients ◽  
History Of

Mycobacterium fortuitum is an ubiquitous, environmental and opportunistic organism belonging to rapid growing mycobacteria (RGM), a distinctive subset of non-tuberculous mycobacteria. It is mainly transmitted by direct inoculation and causes a wide spectrum of clinical syndromes, including skin, bone, soft tissue and disseminated infections, surgical wound infections, catheter-related sepsis and prosthetic device infections. Scientific literature abounds with cases occurred to cancer and immunosuppressed patients, especially in the presence of vascular devices. Hereby we report an event of Mycobacterium fortuitum sepsis and cholangitis, happened to an apparently immunocompetent individual, with no history of neoplasm, nor of immunosuppressive therapy, nor holding a central venous catheter (CVC). The man had previously undergone transitory biliary prosthesis positioning, followed by laparoscopic cholecystectomy; however, investigations on both the endoscopic and surgical equipment, as well as environmental samplings, ruled out a nosocomial infection. After adequate antibiotic treatment, our patient recovered.

scholarly journals Pulmonary infection after cardiopulmonary bypass surgery in children: a risk estimation model in China

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chunnian Ren ◽  
Chun Wu ◽  
Zhengxia Pan ◽  
Quan Wang ◽  
Yonggang Li
Keyword(s):  
Risk Factors ◽  
Cardiopulmonary Bypass ◽  
Prediction Model ◽  
Congenital Heart ◽  
Bypass Surgery ◽  
Pulmonary Infection ◽  
Regression Analyses ◽  
Cardiopulmonary Bypass Surgery ◽  
Independent Risk Factors ◽  
Individualized Prediction

Abstract Objectives The occurrence of pulmonary infection after congenital heart disease (CHD) surgery can lead to significant increases in intensive care in cardiac intensive care unit (CICU) retention time, medical expenses, and risk of death risk. We hypothesized that patients with a high risk of pulmonary infection could be screened out as early after surgery. Hence, we developed and validated the first risk prediction model to verify our hypothesis. Methods Patients who underwent CHD surgery from October 2012 to December 2017 in the Children’s Hospital of Chongqing Medical University were included in the development group, while patients who underwent CHD surgery from December 2017 to October 2018 were included in the validation group. The independent risk factors associated with pulmonary infection following CHD surgery were screened using univariable and multivariable logistic regression analyses. The corresponding nomogram prediction model was constructed according to the regression coefficients. Model discrimination was evaluated by the area under the receiver operating characteristic curve (ROC) (AUC), and model calibration was conducted with the Hosmer-Lemeshow test. Results The univariate and multivariate logistic regression analyses identified the following six independent risk factors of pulmonary infection after cardiac surgery: age, weight, preoperative hospital stay, risk-adjusted classification for congenital heart surgery (RACHS)-1 score, cardiopulmonary bypass time and intraoperative blood transfusion. We established an individualized prediction model of pulmonary infection following cardiopulmonary bypass surgery for CHD in children. The model displayed accuracy and reliability and was evaluated by discrimination and calibration analyses. The AUCs for the development and validation groups were 0.900 and 0.908, respectively, and the P-values of the calibration tests were 0.999 and 0.452 respectively. Therefore, the predicted probability of the model was consistent with the actual probability. Conclusions Identified the independent risk factors of pulmonary infection after cardiopulmonary bypass surgery. An individualized prediction model was developed to evaluate the pulmonary infection of patients after surgery. For high-risk patients, after surgery, targeted interventions can reduce the risk of pulmonary infection.

scholarly journals Primary Tubercular Chest Wall Abscess in a Young Immunocompetent Male

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Shweta Sharma ◽  
R. K. Mahajan ◽  
V. P. Myneedu ◽  
B. B. Sharma ◽  
Nandini Duggal
Keyword(s):  
Chest Wall ◽  
Immunocompetent Patient ◽  
Rare Entity ◽  
Hematogenous Spread ◽  
Clinical Challenge ◽  
Chest Wall Abscess ◽  
Direct Inoculation ◽  
Underlying Pathology ◽  
Patient Infection ◽  
Rule Out

Chest wall tuberculosis is a rare entity especially in an immunocompetent patient. Infection may result from direct inoculation of the organisms or hematogenous spread from some underlying pathology. Infected lymph nodes may also transfer the bacilli through lymphatic route. Chest wall tuberculosis may resemble a pyogenic abscess or tumour and entertaining the possibility of tubercular etiology remains a clinical challenge unless there are compelling reasons of suspicion. In tuberculosis endemic countries like India, all the abscesses indolent to routine treatment need investigation to rule out mycobacterial causes. We present here a case of chest wall tuberculosis where infection was localized to skin only and, in the absence of any evidence of specific site, it appears to be a case of primary involvement.

Chilaiditi Syndrome and Recurrent Colonic Volvulus: A Case Report

2001 ◽  
Vol 87 (2) ◽  
pp. 111-112
Author(s):  
Jon Matthews ◽  
Giles W Beck ◽  
Douglas M G Bowley ◽  
Andrew N Kingsnorth
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Report ◽  
Optimal Treatment ◽  
X Ray ◽  
Colonic Volvulus ◽  
Chilaiditi’S Syndrome ◽  
Chest X Ray ◽  
Chilaiditi’S Sign ◽  
Chilaiditi's Syndrome

AbstractThe case of a 31 year old male presenting as an emergency with a recurrent colonic volvulus is described. A chest X-ray on admission to hospital showed the presence of hepato-diaphragmatic interposition of the colon, Chilaiditi’s Sign, which is known to be a risk factor for colonic volvulus. This is only the fourth reported case of colonic volvulus in association with Chilaiditi’s Syndrome and the first with recurrent colonic volvulus. The optimal treatment for recurrent volvulus in patients with risk factors such as Chilaiditi’s Syndrome or megacolon is also discussed.

Avascular Osteonecrosis of the Talus: Current Treatment Strategies

2021 ◽  
pp. 107110072110510
Author(s):  
Hanci Zhang ◽  
Amanda N. Fletcher ◽  
Daniel J. Scott ◽  
James Nunley
Keyword(s):  
Risk Factors ◽  
Clinical Diagnosis ◽  
Treatment Strategies ◽  
Core Decompression ◽  
Bone Grafts ◽  
Current Treatment ◽  
Optimal Treatment ◽  
Patient Specific ◽  
Avascular Osteonecrosis ◽  
Current Trends

Avascular osteonecrosis (AVN) of the talus (AVNT) is a painful and challenging clinical diagnosis. AVNT has multiple known risk factors and etiologies and presents at different stages in severity. Given these unique factors, the optimal treatment solution has yet to be determined. Both joint-preserving and joint-sacrificing procedures are available, including core decompression and arthrodeses. Recently, new salvage and replacement techniques have been described including vascularized pedicle bone grafts and total talus replacement using patient-specific prosthesis; however, evidence remains limited. This review examines the current trends AVNT treatment and the emerging data behind these novel techniques.

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 Prevalence of Microsporum canis from Pet Cats in Small Animal Hospitals, Chiang Mai, Thailand

2022 ◽  
Vol 9 (1) ◽  
pp. 21
Author(s):  
Vena Chupia ◽  
Jirapat Ninsuwon ◽  
Kakanang Piyarungsri ◽  
Chollada Sodarat ◽  
Worapat Prachasilchai ◽  
...  
Keyword(s):  
Small Animal ◽  
Skin Lesions ◽  
Molecular Techniques ◽  
The Body ◽  
Microsporum Canis ◽  
Chiang Mai ◽  
Important Species ◽  
Fungal Identification ◽  
Hair Samples ◽  
Polymerase Chain

Dermatophytosis is a disease caused by dermatophytes, a group of fungi that can cause disease both in humans and animals. The important genera that are pathogenic in animals include Trichophyton and Microsporum. Microsporum canis is an important species because it can cause zoonosis and is commonly found in domestic animals. Cats, which live very close to humans, may expose humans to this pathogen. This research focused on the epidemiology of M. canis found in cats. Hair samples were collected via the Mackenzie technique from cats with and without skin lesions, preliminarily examined with 10% KOH preparation, and cultured for fungal identification. Samples were confirmed with molecular techniques including polymerase chain reaction, gel electrophoresis, and sequencing. Samples were collected from 138 cats located in 93 households, 43 from cats with skin lesions (31.16%) and 95 from cats without skin lesions (68.84%). Eighteen cats with lesions (13.04%) and ten cats without lesions (7.2%) were found to carry M. canis. In eleven of the eighteen cats both with skin lesions and positive for M. canis (61.11%), the pathogen was found both at the site of the lesion and at other sites in the body. Because the pathogen can be found in the hair of cats with and without skin lesions, owners, keepers, veterinarians, and others who come into contact with these animals are at risk of infection if they are not aware or do not take precautions after contact with them.

scholarly journals Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

2021 ◽  
Vol 15 (11) ◽  
pp. e0009923
Author(s):  
Xiaohua Chen ◽  
Hong-bing Liu ◽  
Tie-Jun Shui ◽  
Shun Zha
Keyword(s):  
Risk Factors ◽  
Physical Disability ◽  
Physical Disabilities ◽  
Delayed Diagnosis ◽  
Skin Lesions ◽  
Nerve Damage ◽  
Advanced Age ◽  
Han Ethnicity ◽  
Leprosy Patients ◽  
Male Sex

Background Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. Methodology/Principal findings We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516–7.073, 3.714–5.212, and 2.063–2.509; for ≥ 10, 5–10 y, and 2–5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843–4.244, and 1.959–3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341–2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052–2.079, 1.075–1.923, 1.261–1.838, and 1.072–1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106–1.960 and 1.498–2.814; for 15–59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522–2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195–1.952), rural occupation (OR: 1.364; 95% CI: 1.128–1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159–1.386), and male sex (OR: 1.128; 95% CI: 1.024–1.243). Conclusions Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.

scholarly journals Primary Cutaneous Cryptococcosis in an Immunocompetent 6-Year-Old Female

2018 ◽  
Vol 2 (4) ◽  
pp. 240-242
Author(s):  
Mitchell Hobbs ◽  
Joy King ◽  
Rana El Feghaly ◽  
Robert Brodell
Keyword(s):  
Cryptococcus Neoformans ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Oral Fluconazole ◽  
Healthy Female ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Cutaneous Cryptococcosis ◽  
Superficial Culture

A 6-year-old otherwise healthy female presented to the ED with a right eyebrow lesion for one month.  Previous I&D attempts and empiric antibiotic treatment had failed to improve the lesion.  Following dermatology referral, superficial culture resulted with growth of Cryptococcus neoformans after which completion of oral fluconazole treatment resolved the lesion.  Though Cryptococcus neoformans infections commonly plague immunocompromised patients, primary cutaneous cryptococcosis in the immunocompetent patient is a rare but documented infection with a paucity of reported pediatric cases, and frontline physicians should be aware of such a diagnosis in the setting of persistent skin lesions without response to more commonly utilized therapies.

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