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

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.

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Emphysematous pyelonephritis with air bubble in the inferior vena cava

African Journal of Urology ◽

10.1186/s12301-020-00081-2 ◽

2020 ◽

Vol 26 (1) ◽

Author(s):

Tiffany A. Perkins ◽

Alberic Rogman ◽

Murali K. Ankem

Keyword(s):

Septic Shock ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Rare Presentation ◽

Emphysematous Pyelonephritis ◽

Case Presentation ◽

Air Bubble ◽

First Case ◽

The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

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Sepsis byPasteurella multocidain an Elderly Immunocompetent Patient after a Cat Bite

Case Reports in Infectious Diseases ◽

10.1155/2017/2527980 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 2

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.

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Primary leiomyoma of the ureter: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02960-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Shingo Morinaga ◽

Shigeyuki Aoki ◽

Motoi Tobiume ◽

Genya Nishikawa ◽

Hiroyuki Muramatsu ◽

...

Keyword(s):

Malignant Tumors ◽

Histopathological Examination ◽

Urine Cytology ◽

Benign Tumors ◽

Case Presentation ◽

Old Japanese ◽

Retrograde Pyelogram ◽

History Of ◽

The Right ◽

Enhanced Computed Tomography

Abstract Background Only 14 cases of leiomyoma with ureteral origin have been reported previously. Such primary leiomyomas often present as hydronephrosis, making the diagnosis difficult. Radical nephroureterectomy is often performed because of the possible diagnosis of a malignant tumor. We report the 15th case of primary leiomyoma with a ureteral origin. Case presentation A 51-year-old Japanese man presented with a chief complaint of asymptomatic gross hematuria with a history of hypertension. Enhanced computed tomography showed a tumor at the upper part of the right ureter that appeared to be the cause of hydronephrosis and contracted kidney; no retroperitoneal lymphadenopathy and distal metastasis were observed. A well-defined 20-mm (diameter) defect was identified at the upper of the right ureter on retrograde pyelogram with no bladder cancer on cystoscopy. Urine cytology and right divided renal urine cytology findings were negative. Laparoscopic nephroureterectomy was performed, and the extracted tumor measured 20 × 13 mm. Histopathological examination revealed primary leiomyoma with no recurrence 16 months after the operation. Conclusions Preoperative examination with the latest available ureteroscopic technology can help preserve renal function in the case of benign tumors by enabling preoperative ureteroscopic biopsy or intraoperative rapid resection. Moreover, nephroureterectomy is recommended in the case of preoperative suspicion of ureteral malignant tumors.

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Extremely high troponin levels induced by septic shock: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-03027-6 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Naoki Matsunaga ◽

Yuki Yoshioka ◽

Yasushi Fukuta

Keyword(s):

Septic Shock ◽

Myocardial Perfusion Scintigraphy ◽

Clinical Course ◽

Myocardial Necrosis ◽

Myocardial Infarctions ◽

Elevated Troponin ◽

Impaired Consciousness ◽

Perfusion Scintigraphy ◽

Case Presentation ◽

Old Japanese

Abstract Background Troponin levels can be elevated in various diseases other than acute myocardial infarction, including sepsis. In diseases without myocardial necrosis, the elevated troponin levels are relatively low and normalize quickly. Case presentation A 61-year-old Japanese man with impaired consciousness was transported to our hospital. He was diagnosed as having pneumonia and septic shock. His condition was severe, but his clinical course was good. However, his troponin level remained extremely high during admission; on the second day, it was higher than the measurable range. We consulted a cardiologist and performed echocardiography and myocardial perfusion scintigraphy but found no new ischemic changes. Conclusion In septic shock, troponin levels can be extremely high, which can persist even after recovery, as in very large myocardial infarctions.

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Disseminated Necrotizing Leukoencephalopathy Complicating Septic Shock in an Immunocompetent Patient

Case Reports in Critical Care ◽

10.1155/2017/1092537 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Pedro Gaspar-da-Costa ◽

Sofia Reimão ◽

Sandra Braz ◽

João Meneses Santos ◽

Rui M. M. Victorino

Keyword(s):

Septic Shock ◽

White Matter ◽

White Matter Lesions ◽

Neurological Impairment ◽

Immunocompetent Patient ◽

Resonance Imaging ◽

Mri Findings ◽

Full Neurological Recovery ◽

Magnetic Resonance Imaging Mri ◽

Immunocompetent Patients

Disseminated necrotizing leukoencephalopathy (DNL) is characterized by multiple microscopic foci of white matter necrosis. DNL was initially thought to be exclusively associated with immunosuppression conditions but it has been recently described in immunocompetent patients in septic shock. A 90-year-old immunocompetent woman with no previous neurological impairment presented with septic shock and drowsiness that responded well to therapy with clinical improvement and a full neurological recovery. Unexpectedly deterioration with progression to coma occurred. Investigation excluded other causes and Magnetic Resonance Imaging (MRI) was consistent with the diagnosis of DNL showing bilateral multifocal white matter lesions with a nonvascular pattern with restricted diffusion. Neurological impairment persisted with progression to death. DNL is an unexpected diagnosis in an immunocompetent patient. We compared the present case to those found in the literature of DNL complicating septic shock and discuss the antemortem diagnosis based on MRI findings.

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Highly Purified Vitamin B2 Presents a Promising Therapeutic Strategy for Sepsis and Septic Shock

Infection and Immunity ◽

10.1128/iai.72.3.1820-1823.2004 ◽

2004 ◽

Vol 72 (3) ◽

pp. 1820-1823 ◽

Cited By ~ 28

Author(s):

Toshio Toyosawa ◽

Mamoru Suzuki ◽

Kohtarou Kodama ◽

Seiichi Araki

Keyword(s):

Septic Shock ◽

Bacterial Infection ◽

Intravenous Infusion ◽

Sodium Phosphate ◽

Therapeutic Strategy ◽

Therapeutic Effects ◽

Vitamin B2 ◽

Gram Positive ◽

Gram Negative ◽

Sepsis And Septic Shock

ABSTRACT Highly purified vitamin B2 (riboflavin 5′-sodium phosphate; purity > 97%) treatment by intravenous infusion at doses above those used clinically to treat vitamin B2 deficiency showed therapeutic effects in mice not only in cases of endotoxin- and exotoxin-induced shock but also in cases of gram-negative and gram-positive bacterial infection even after the toxemia had already begun.

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A cutaneous tuberculosis mimic presented with recurrent soft tissue infection: A case report

Journal of Research in Clinical Medicine ◽

10.34172/jrcm.2021.030 ◽

2021 ◽

Vol 9 (1) ◽

pp. 30-30

Author(s):

Abu Mansor Matardiah Nor Hashimah ◽

Lim Ai Lee ◽

Azman Ali Raymond

Keyword(s):

Risk Factors ◽

Septic Shock ◽

Skin Diseases ◽

Cutaneous Tuberculosis ◽

Small Nodule ◽

Right Hand ◽

History Of ◽

The Right ◽

Work Up ◽

Immunocompetent Patients

Recurrent cellulitis is one of the cutaneous tuberculosis mimickers. As the skin lesion can mimic other skin diseases, the diagnosis can easily be missed especially in immunocompetent patients without any other risk factors. We present a case of a 62-year-old lady with history of right hand extensor tenosynovitis presented with right hand and forearm swelling and pain, associated with fever. Clinically, her right hand and forearm were erythematous with a small nodule at the right elbow. She was treated for recurrent right upper limb cellulitis and thrombophlebitis complicated by septic shock needing several courses of antibiotics. However, she did not show any significant response to the treatment. Multiple septics work up were carried out and all were negative, except aspiration of her right elbow nodule was positive for Mycobacterium tuberculosis. Anti-tuberculous treatment was started but unfortunately, she succumbed due to nosocomial infection.

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Mycobacterium chelonae empyema in an immunocompetent patient

Journal of Medical Microbiology ◽

10.1099/jmm.0.47574-0 ◽

2008 ◽

Vol 57 (5) ◽

pp. 664-667 ◽

Cited By ~ 11

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.

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A case of fulminant septic shock with a rare gram-negative organism (Case Presentation)

Acta Paediatrica ◽

10.1111/j.1651-2227.2008.01098.x ◽

2009 ◽

Vol 98 (7) ◽

pp. 1079-1080

Author(s):

Rusheng Chew ◽

Flora Jessop ◽

Sarah Morley

Keyword(s):

Septic Shock ◽

Case Presentation ◽

Gram Negative

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

Folia Medica ◽

10.1515/folmed-2016-0012 ◽

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.

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