scholarly journals Pyosalpinx due to Cronobacter sakazakii in an elderly woman

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Satoshi Ohira ◽  
Eri Ikeda ◽  
Kyosuke Kamijo ◽  
Tomokuni Nagai ◽  
Koji Tsunemi ◽  
...  

Abstract Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Syeda Sahra ◽  
Abdullah Jahangir ◽  
Neville Mobarakai ◽  
Allison Glaser ◽  
Ahmad Jahangir ◽  
...  

Abstract Introduction Cronobacter sakazakii is an opportunistic Gram-negative, rod-shaped bacterium which may be a causative agent of meningitis in premature infants and enterocolitis and bacteremia in neonates and adults. While there have been multiple cases of C. sakazakii infections, there have been no acute cholangitis cases reported in humans. Case presentation An 81-year-old male with a past medical history of basal cell carcinoma, alcoholic liver cirrhosis, transjugular intrahepatic portosystemic shunt procedure, complicated by staphylococcus bacteremia, pituitary tumor, glaucoma, and hypothyroidism presented to the emergency room with the complaint of diffuse and generalized 10/10 abdominal pain of 1 day’s duration. There was a concern for pancreatitis, acute cholangitis, and possible cholecystitis, and the patient underwent a percutaneous cholecystostomy tube placement. Blood cultures from admission and biliary fluid cultures both grew C. sakazakii. The patient was treated with a carbapenem and clinically improved. Conclusions The case study described a patient with multiple medical comorbidities that presented with C. sakazakii bacteremia and cholangitis. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria is being documented to have caused acute cholangitis.


2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.


Rare Tumors ◽  
2010 ◽  
Vol 2 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Yugo Sawada ◽  
Fumio Ito ◽  
Hayakazu Nakazawa ◽  
Nobuhiko Tsushima ◽  
Hikaru Tomoe ◽  
...  

Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM) of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.


2021 ◽  
Author(s):  
Yili Zhu ◽  
Jun Fan ◽  
Bo Huang ◽  
Ying Wu ◽  
Heshui Shi ◽  
...  

Abstract Background: Since the discovery of the first case of Anaplastic lymphoma kinase (ALK) -positive histiocytosis in 2008, originally described as a systemic, self-limiting disease in infants, the range of ALK-positive histiocytosis has recently been expanded to include localized diseases in older children and young adults. Case presentation: We present the case of an 18-year-old female with periumbilical painless mass for 5 months, who underwent a resection of the mass. Pathological examination showed the tumor consists predominantly of fascicular to storiform growth of nonatypical spindle cells, admixed with lymphocytic infiltrates. The tumor spindle cells were diffusely positive for CD68, CD163 and ALK. Further, molecular tests revealed ALK gene fusion: Kinesin Family Member 5B (KIF5B) (E24)-ALK (E20), confirmed ALK-positive histiocytosis. The tumor has not recurred one and a half years after resection by follow-up examination.Conclusion: ALK-positive histiocytosis in local lesion can achieve remission by complete resection and clinical follow-up showed a favorable prognosis.


2021 ◽  
Author(s):  
Shiwen Nie ◽  
Yadong He ◽  
Shuo Zhang ◽  
Fenghong Cao

Abstract BackgroundInflammatory pseudotumors that grow on the omentum are relatively rare, and inflammatory pseudotumor most often involves the lung. As far as we know, the inflammatory pseudotumor of omentum, which is in the shape of beaded vesicles and contains gas, has never been reported in the literature. Case presentationwe report a 45-year-old Chinese woman who complained of epigastric pain with hematemesis for 9 hours, physical examination showed subxiphoid tenderness, previous history of gastric ulcer and repair of gastric perforation, laboratory examination showed slight increase of white blood cells and decrease of hemoglobin. Computed tomography showed dotted free gas in the abdominal cavity, and the perforation of the hollow organs was considered. The pathological results after emergency operation showed that histiocyte aggregation with multinucleated giant cell reaction could be seen in the omental tissue. Immunohistochemistry :ER (-), PR (-), PAX-8 (-), CK (mesothelial+), MC (mesothelial+), CR (mesothelial+), CD68 (histiocyte+), SMA (smooth muscle+). The abdominal pain was relieved after surgical resection of the tumor, and recovered well after symptomatic treatment.ConclusionInflammatory pseudotumor of omentum containing gas is easily diagnosed as perforation of hollow organs, with few clinical manifestations of acute abdomen, mostly non-specific, and a good prognosis. Understanding its clinicopathological features and pathological examination methods are helpful to diagnose the disease, so as to choose an appropriate treatment plan, and whether surgical treatment is better than conservative treatment remains to be further studied. The disease should be distinguished from perforation of hollow organs, but the source of gas is unknown. It may have something to do with past medical history.


2021 ◽  
Vol 8 ◽  
Author(s):  
Sergio Migliore ◽  
Roberto Puleio ◽  
Gabriella Gaglio ◽  
Domenico Vicari ◽  
Salvatore Seminara ◽  
...  

Sanitary management and population control of feral pigs remains a major problem in public health, particularly in natural parks where hunting is prohibited and the extensive farming of livestock is common. Macracanthorhynchus hirudinaceus is a zoonotic parasite species with a worldwide distribution of which the natural definitive hosts are primarily pigs and wild boars (Sus scrofa). The present study describes the main anatomo-pathological and parasitological findings in the first case of M. hirudinaceus in feral pigs in the Madonie park in Sicily (Southern Italy). Overall, 52 acanthocephalans were collected from the small intestine of four infected feral pigs. The prevalence among the 36 examined animals was 11.1% with a mean Abundance (mA) and mean Intensity (mI) of 1.4 and 13, respectively. Pathological examination revealed grossly visible nodules on the external surface of the intestines, corresponding to the proboscis of M. hirudinaceus attached deeply into the intestinal wall. In these sites, severe inflammatory reactions in the tissue involved and the destruction of normal intestinal architecture, as well as necrosis and ulceration in the mucosa, submucosa, and part of the muscolaris mucosae were described. This is the first official report of this neglected zoonosis in Italy, in particular in a natural park where the extensive farming of domestic pigs is practiced. This could favor the spread of this parasite in domestic animals and the environment, increasing the accidental risk of infection in human residents of these areas.


2017 ◽  
Vol 89 (11) ◽  
pp. 60-68 ◽  
Author(s):  
V I Vasilyev ◽  
S G Palshina ◽  
B D Chaltsev ◽  
S G Radenska-Lopovok ◽  
T N Safonova

The authors have described the world’s first case of necrotizing sarcoid granulomatosis (NSG) in a 22-year-old woman with the clinical presentations of acute abdomen, which are associated with abdominal lymph nodal infiltration and necrosis, obvious constitutional disturbances (fever, nocturnal sweats, and significant weight loss), high inflammatory activity (anemia, leukocytosis, high erythrocyte sedimentation rates and C-reactive protein levels), the gradual appearance of splenic and hepatic necrotic foci, and infiltration into the lung and lacrimal glands with the development of unilateral uveitis. The patient underwent five surgical interventions, several needle biopsies for recurrent abdominal syndrome, and long-term antibiotic treatment for presumed sepsis, which had caused drug-induced hepatitis. Bacteriological examination of blood, puncture samples, and removed abdominal cavity tissues, serological tests, and immunomorphogical study of biopsy samples and removed tissues yielded negative results for the presence of bacterial, fungal, and tuberculosis infections. NSG was diagnosed on the basis of the systemic nature of the lesion, the presence of granulomas with severe abdominal lymph nodal necrosis and necrotizing granulomatous/lymphocytic vasculitis in the mesentery and removed spleen, as well as the absence of granulomas in the spleen, appendix, and biopsy materials of the liver, colonic mucosa, and parotid gland. Fludarabine therapy was first used in world practice due to the inefficient treatment with high-dose glucocorticoids and cyclophosphamide and to a disease relapse when reducing their doses. The paper gives a detailed review of the literature on the clinical, laboratory, radiological, and morphological manifestations of the disease, which allow the differential diagnosis of NSG with different variants of granulomatous lesions. Based on the 5-year follow-up of the patient and on the analysis of clinical, laboratory, radiological, and morphological changes, the authors uphold the concept that the disease is an independent nosological entity: necrotizing angiitis with sarcoid reactions, rather than the entity of nodular or classic sarcoidosis.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Amanda E. Smith ◽  
Amy McKenney ◽  
Laura Rabinowitz ◽  
Anirudha Das

Due to a high rate of fetal demise and premature birth in intrauterine HSV infection, the outcome in neonates is usually adverse. A female preterm infant with a gestational age of 25 1/7 weeks with expected early clinical course tested positive for neonatal herpes simplex virus (HSV) 2 after the neonatologist was informed of positive immunohistochemistry for the virus on the fifth day of life by the pathologist. Pathological examination of the placenta had revealed subacute necrotizing inflammation with stromal cell necrosis suggestive of intrauterine infection, possibly ascending due to prolonged rupture of membranes. To the best of our knowledge, this is the first case wherein placental pathology indicated exposure to HSV in utero before the infant presented with signs or symptoms of neonatal HSV resulting in a favorable outcome for the infant. Due to the variability of presentation of intrauterine HSV infection, pathological examination of the placenta in the first 2–5 days of life in premature infants can provide clues to the diagnosis of neonatal HSV which may significantly impact the outcome.


2003 ◽  
Vol 127 (3) ◽  
pp. 367-369 ◽  
Author(s):  
Michael O. Idowu ◽  
Melissa Contos ◽  
Satinder Gill ◽  
Celeste Powers

Abstract Merkel cell carcinoma (MCC) is an uncommon, highly aggressive cutaneous neoplasm of neuroendocrine differentiation with a poor prognosis. MCC most often presents as a painless, firm, raised lesion in sun-exposed sites of the head and neck region of the elderly. We report a case of a metastatic MCC to the stomach presenting as upper gastrointestinal bleeding. To our knowledge, this is the second reported case of MCC presenting as upper gastrointestinal bleeding and the first case confirmed by the newer immunohistochemical techniques. The literature is reviewed.


2019 ◽  
Vol 12 (10) ◽  
pp. e223740
Author(s):  
Jojin Jose Chitten ◽  
Boblee James

Diffuse idiopathic skeletal hyperostosis (DISH) is a common degenerative enthesopathy seen in the elderly with male preponderance. It is uncommon in patients before 50 years of age and is extremely rare in patients younger than 40 years. We report a case of 33-year-old unmarried woman who presented with inflammatory spinal pain and stiffness, limited chest expansion, decreased range of spinal motion and postural abnormalities, all of which suggested the diagnosis of ankylosing spondylitis, considering the patient’s age. But, further evaluation led us to the final diagnosis of DISH with associated metabolic syndrome and polycystic ovarian syndrome (PCOS). To the best of our knowledge, our patient is the first reported case of DISH in a woman less than 40 years of age, and also the first case of DISH associated with PCOS and metabolic syndrome.


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