New Detection and Treatment for Chlamydia Psittaci: A Case Report

2020 ◽  
Author(s):  
Xiaojing Wu ◽  
Yang Li ◽  
Yingying Feng ◽  
Min Li ◽  
Ye Tian ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Left Lung ◽  
Severe Pneumonia ◽  
Lavage Fluid ◽  
Chlamydia Psittaci ◽  
Premature Delivery ◽  
Correct Treatment ◽  
Case Presentation ◽  
Paired Serum ◽  
Next Generation Sequencing Ngs

Abstract Background: The presentation of psittacosis can vary from subclinical infection to fatal pneumonia with a high mortality rate. Chlamydia psittaci infection during pregnancy is rare and might result in placental involvement, premature delivery or miscarriage. Herein, we report a case of severe pneumonia in a pregnant woman caused by C. psittaci.Case presentation: A 27-year-old female with a pregnancy at 22 weeks was admitted with hyperpyrexia, dry cough and dyspnea. Laboratory tests showed increased white blood cell count and slightly-elevated procalcitonin. Chest computed tomography scan revealed consolidation in the lingual and inferior lobe of the left lung. She suffered rapidly progressing respiratory failure and required mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Her sample of bronchoalveolar lavage fluid (BALF) was collected, from which C. psittaci was detected using next-generation sequencing (NGS). The pathogen was further confirmed by polymerase chain reaction (PCR) with the primers specific for the microorganism. Moreover, paired serum tests showed elevated C. psittaci group titer in both IgG and IgM. She was treated with azithromycin and tigecycline. After 24-day hospitalization, the patient was clinically well and discharged home.Conclusion: We report a case of severe pneumonia in a pregnant woman caused by C. psittaci, which diagnosed by NGS, and was cured without adverse effects on infant with tigecycline. The introduction of NGS and other effective assays might increase the detection rate. C. psittaci infection in pregnant women is very rare, but critical. Early diagnosis and correct treatment may save the mother and fetus. New tetracycline agent, tigecycline, may also be an effective alternative and should be further evaluated in psittacosis.

scholarly journals Severe pneumonia caused by Parvimonas micra: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yu ◽  
Lingling Sun ◽  
Zuqing Xu ◽  
Lumei Fan ◽  
Yunbo Du
Keyword(s):  
Bronchoalveolar Lavage Fluid ◽  
Case Reports ◽  
Severe Pneumonia ◽  
Lavage Fluid ◽  
Due Date ◽  
Case Presentation ◽  
Abdominal Abscesses ◽  
Parvimonas Micra ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing

Abstract Background Parvimonas micra (P. micra) is a gram-positive anaerobic coccus that is detected widely on the skin, in the oral mucosa and in the gastrointestinal tract. In certain circumstances, P. micra can cause abdominal abscesses, bacteraemia and other infections. To the best of our knowledge, there have been no case reports describing the biological characteristics of P. micra-related pneumonia. These bacteria do not always multiply in an aerobic organ, such as the lung, and they could be easily overlooked because of the clinical mindset. Case presentation A 35-year-old pregnant woman was admitted to the emergency department 4 weeks prior to her due date who was exhibiting 5 points on the Glasgow coma scale. A computed tomography (CT) scan showed a massive haemorrhage in her left basal ganglia. She underwent a caesarean section and brain surgery before being admitted to the ICU. She soon developed severe pneumonia and hypoxemia. Given that multiple sputum cultures were negative, the patient’s bronchoalveolar lavage fluid was submitted for next-generation sequencing (NGS) to determine the pathogen responsible for the pneumonia; as a result, P. micra was determined to be the causative pathogen. Accordingly the antibiotic therapy was altered and the pneumonia improved. Conclusion In this case, we demonstrated severe pneumonia caused by the anaerobic organism P. micra, and the patient benefited from receiving the correct antibiotic. NGS was used as a method of quick diagnosis when sputum culture failed to distinguish the pathogen.

scholarly journals Isolation of Mycobacterium talmoniae from a patient with diffuse panbronchiolitis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomoko Suzuki ◽  
Miwako Saitou ◽  
Yuriko Igarashi ◽  
Satoshi Mitarai ◽  
Katsunao Niitsuma
Keyword(s):  
Combination Therapy ◽  
Bronchoalveolar Lavage Fluid ◽  
Left Lung ◽  
Lavage Fluid ◽  
Drug Susceptibility ◽  
Acid Fast Bacillus ◽  
Case Presentation ◽  
Diffuse Panbronchiolitis ◽  
Potential Pathogen ◽  
Culture Positive

Abstract Background Mycobacterium (M) talmoniae isolated from a patient with cystic fibrosis was first described in 2017, and cases of M. talmoniae remain exceedingly rare. Case presentation A 51-year-old woman had respiratory symptoms for 10 years. Diffuse panbronchiolitis (DPB) was detected at the first visit at our hospital. A cavity lesion in the apex of the left lung was found, and sputum and bronchoalveolar lavage fluid were acid-fast bacillus (AFB) smear- and culture-positive besides Pseudomonas aeruginosa. M. talmoniae was finally identified, and the standard combination therapy for non-tuberculous mycobacteria (NTM) was administered for 2 y referring to the drug-susceptibility test. Thereafter, the AFB culture was negative, the wall thickness of the lung cavity was ameliorated, and oxygen saturation improved. Conclusions We encountered a rare case of M. talmoniae with DPB, for which standard combination therapy was effective. M. talmoniae may be considered a potential pathogen of lung disease, especially in patients with bronchiectatic lesions.

scholarly journals A case report and literature review of a death caused by Aeromonas daca complicated with septic shock

2020 ◽  
Author(s):  
Qiquan Zhao ◽  
Xiaoli Han
Keyword(s):  
Septic Shock ◽  
English Language ◽  
Lavage Fluid ◽  
Underlying Disease ◽  
Case Presentation ◽  
Language Studies ◽  
Virulence Potential ◽  
Rescue Treatment ◽  
Next Generation Sequencing Ngs ◽  
Third Generation Cephalosporins

Abstract Background: For decades, Aeromonas daca has often been mistaken for Aeromonas hydrophila by phenotypic identification systems and shows obvious characteristics of virulence. To our knowledge, a total of two English-language studies with relatively complete data were retrieved.Case presentation: The patient, a 26-year-old male with no underlying disease, was admitted to our hospital for 3 days because of cough, expectoration and shortness of breath. According to blood and lavage fluid cultures and next-generation sequencing (NGS), the patient was diagnosed with an A. daca infection. He soon deteriorated to a critical condition complicated with septic shock and died after active rescue treatment. Conclusions: A. daca infection is lethal, and an accurate taxonomy can improve our understanding of the epidemiological distribution and virulence potential of this human pathogen. Third-generation cephalosporins and carbapenems should be used cautiously in the treatment of severe A. daca infection, and the best regimen is cefepime or fluoroquinolones.

scholarly journals Septic Shock Caused By Aeromonas Daca: A Bacterium That We Have Neglected In The Past.

2021 ◽  
Author(s):  
Qiquan Zhao ◽  
Yuguo Zhou ◽  
Xiaoli Han ◽  
Li Jian
Keyword(s):  
Septic Shock ◽  
English Language ◽  
Lavage Fluid ◽  
Underlying Disease ◽  
Case Presentation ◽  
Language Studies ◽  
Virulence Potential ◽  
Rescue Treatment ◽  
Next Generation Sequencing Ngs ◽  
Third Generation Cephalosporins

Abstract Introduction: For decades, Aeromonas daca has often been mistaken for Aeromonas hydrophila by phenotypic identification systems and shows obvious characteristics of virulence. To our knowledge, a total of two English-language studies with relatively complete data were retrieved.Case presentation: The patient, a 26-year-old male with no underlying disease, was admitted to our hospital for 3 days because of cough, expectoration and shortness of breath. According to blood and lavage fluid cultures and next-generation sequencing (NGS), the patient was diagnosed with an A. daca infection. He soon deteriorated to a critical condition complicated with septic shock and died after active rescue treatment.Conclusions: A. daca infection is lethal, and an accurate taxonomy can improve our understanding of the epidemiological distribution and virulence potential of this human pathogen. Third-generation cephalosporins and carbapenems should be used cautiously in the treatment of severe A. daca infection, and the best regimen is cefepime or fluoroquinolones.

scholarly journals Disseminated Tuberculosis Associated Hemophagocytic Lymphohistiocytosis in a Pregnant Woman With Evans syndrome: A Case Report and Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Yun-Feng Shi ◽  
Xiao-Han Shi ◽  
Yuan Zhang ◽  
Jun-Xian Chen ◽  
Wen-Xing Lai ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Literature Review ◽  
Dna Sequence ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Severe Pneumonia ◽  
Corticosteroid Treatment ◽  
Lavage Fluid ◽  
Sputum Smear ◽  
Evans Syndrome ◽  
Nested Polymerase Chain Reaction

BackgroundTuberculosis (TB) is a leading cause of morbidity and mortality in underdeveloped and developing countries. Disseminated TB may induce uncommon and potentially fatal secondary hemophagocytic lymphohistiocytosis (HLH). Timely treatment with anti-tuberculosis therapy (ATT) and downmodulation of the immune response is critical. However, corticosteroid treatment for TB-associated HLH remains controversial. Herein, we report a successful case of disseminated TB-associated HLH in a pregnant woman with Evans syndrome accompanied by a literature review.Case PresentationA 26-year-old pregnant woman with Evans syndrome was transferred to the Third Affiliated Hospital of Sun Yat-Sen University because of severe pneumonia. She presented with cough, fever, and aggravated dyspnea. Nested polymerase chain reaction for Mycobacterium tuberculosis (M. tuberculosis) complex in sputum was positive. Sputum smear sample for acid-fast bacilli was also positive. Metagenome next-generation sequencing (mNGS) of the bronchoalveolar lavage fluid identified 926 DNA sequence reads and 195 RNA sequence reads corresponding to M. tuberculosis complex, respectively. mNGS of blood identified 48 DNA sequence reads corresponding to M. tuberculosis. There was no sequence read corresponding to other potential pathogens. She was initially administered standard ATT together with a low dose of methylprednisolone (40 mg/day). However, her condition deteriorated rapidly with high fever, acute respiratory distress syndrome, pancytopenia, and hyperferritinemia. Bone marrow smears showed hemophagocytosis. And caseating tuberculous granulomas were found in the placenta. A diagnosis of disseminated TB-associated HLH was made. Along with the continuation of four drug ATT regimen, therapy with a higher dose of methylprednisolone (160 mg/day) combined with immunoglobulin and plasma exchange was managed. The patient’s condition improved, and she was discharged on day 19. Her condition was good at follow-up with the continuation of the ATT.ConclusionsClinicians encountering patients with suspected TB accompanied by unexplainable inflammation not responding to ATT should consider complications with HLH. Timely administration of ATT combined with corticosteroids may result in a favorable outcome.

Management in cases of large uterine myomas in pregnancy

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Aleksandra Stupak ◽  
Marcin Bobiński ◽  
Andrzej Miturski ◽  
Barbara Kalbarczyk ◽  
Anna Kwaśniewska ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pain Control ◽  
Clinical Observation ◽  
Uterine Fibroids ◽  
Reproductive Organs ◽  
Benign Tumors ◽  
Premature Delivery ◽  
Case Presentation ◽  
Uterine Myomas ◽  
In Pregnancy

AbstractObjectivesUterine fibroids are the most common benign tumors in women of procreative age. The effects of their occurrence affect the course of pregnancy by increasing the frequency of abortions, premature delivery or premature abruption of the placenta. Medical treatment includes clinical observation, pharmacological pain control, myomectomy during pregnancy or perinatal hysterectomy.Case presentationWe present a survey of literature and the case of a pregnant woman with an enormous uterine fibroid 23×13×16 cm on the basis of which a diagnostic-therapeutic scheme for tumors of the reproductive organs during pregnancy has been developed.ConclusionsThe study presents improved recommendations for management the pregnancies in presence of the uterine myomas based on clinical practice.

Clinical Study of Gud-Amalaka Yoga in Garbhini Mutrakrichra w.s.r to Urinary Tract Infections during Pregnancy

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Sandeep Kumar Rajan ◽  
Rajnish Gautam ◽  
Pankaj Mishra
Keyword(s):  
Pregnant Woman ◽  
Urinary Tract ◽  
The Body ◽  
Premature Delivery ◽  
Healthy Baby ◽  
Patient Reported ◽  
Long Term Result ◽  
Tract Infections ◽  
Prompt Attention

Healthy mother and healthy baby are foremost aim of antenatal care. Progressive anatomical and physiological changes during pregnancy are not only confined to the genital organs however within other systems of the body too, some may be felt as discomfort by a pregnant woman. A pregnant woman having pain or burning micturition, fever with chills, nausea, vomiting and cloudy urine having bad smell can be diagnosed as having Urinary Tract Infection (UTI). UTI is most common bacterial infection encountered during Pregnancy and troublesome to the woman suffering from it. Pyelonephritis, premature delivery and other risk such as PROM, IUGR etc. can be the long term result of UTI hence prompt attention is requisite. In the present study Gud-Amalaka Yoga has been tried in 15 patients for evaluation of its clinical efficacy and adverse / side effects if any. It was observed that Gud-Amalaka Yoga showed better results (25% patients were moderately improved, 75% patients were mildly improved). None of the patient reported any adverse effect during or after the treatment.

scholarly journals A poor prognostic metastatic nongestational choriocarcinoma of the ovary: a case report and the literature review

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Kimihiro Nishino ◽  
Eiko Yamamoto ◽  
Yoshiki Ikeda ◽  
Kaoru Niimi ◽  
Toshimichi Yamamoto ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Tumor Resection ◽  
Left Lung ◽  
Str Analysis ◽  
Case Presentation ◽  
Gestational Choriocarcinoma ◽  
Mucosal Cells ◽  
Malignant Germ Cell Tumor ◽  
Brain Tumor Resection ◽  
Short Tandem

Abstract Background Pure ovarian choriocarcinoma can be gestational or nongestational in origin. Nongestational pure ovarian choriocarcinoma is extremely rare and the prognosis is thought to be worse than that of the gestational type in patients with metastatic disease. We present a case of metastatic pure ovarian choriocarcinoma with poor prognosis in which the origin was identified as nongestational by DNA short tandem repeat (STR) analysis. Case presentation A nulliparous woman in her thirties with metastatic choriocarcinoma was referred to our hospital after initial treatment proved unsuccessful. Two months earlier, she had undergone brain tumor resection and histological examination confirmed choriocarcinoma. Serum human chorionic gonadotropin (hCG) concentration at initial diagnosis was 5030 IU/L. Two cycles of a combination chemotherapy regimen of methotrexate, etoposide, and actinomycin-D (MEA therapy), which is commonly used for gestational choriocarcinoma, was administered. However, the disease could not be controlled. Imaging modalities at presentation revealed tumor present in the left ovary and left lung, but not in the uterus, which led us think that the choriocarcinoma was nongestational. Bleomycin, etoposide, and cisplatin (BEP therapy) which is commonly used for nongestational choriocarcinoma (malignant germ cell tumor) and surgical resection of the uterus, bilateral ovaries, and an affected part of the left lung led to the nadir level of hCG, but the tumor relapsed and levels of hCG again increased. To investigate the origin of choriocarcinoma, we performed DNA STR analysis of tumor cells and oral mucosal cells. Analysis revealed the origin of the choriocarcinoma as nongestational, as the genotype of tumor cells entirely corresponded with that of oral mucosal cells. BEP therapy and chemotherapy regimens administered for nongestational choriocarcinoma and gestational choriocarcinoma proved ineffective, and the patient died 21 months after diagnosis of metastatic choriocarcinoma. Conclusion Metastaic nongestational pure choriocarcinoma of ovary is an extremely rare and an aggressive disease, frequently resulting in poor outcome.

scholarly journals Retroperitoneal fibrous tumor recurring as lung metastases after 10 years: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kozue Matsuishi ◽  
Kojiro Eto ◽  
Atsushi Morito ◽  
Hirokazu Hamasaki ◽  
Keisuke Morita ◽  
...  
Keyword(s):  
Case Report ◽  
Solitary Fibrous Tumor ◽  
Distant Metastasis ◽  
Curative Resection ◽  
Lung Metastases ◽  
Lung Resection ◽  
Left Lung ◽  
Metastatic Lesion ◽  
Case Presentation ◽  
Fibrous Tumor

Abstract Background Solitary fibrous tumor (SFT) is a relatively rare mesenchymal tumor that mainly affects adults. Its prognosis is good after curative resection, but distant recurrences after 10 years or longer have been reported. Recurrent SFT usually arises as a local lesion; distant metastasis is rarely reported. Here, we report lung metastases that recurred a decade after excising a retroperitoneal primary SFT. Case presentation A 44-year-old woman had an SFT resected from her right retroperitoneum at our hospital. Ten years later, at age 54, she underwent a lung resection after CT showed three suspected metastases in her left lung. All three were histologically diagnosed as lung metastases from the retroperitoneal SFT. However, whereas the primary SFT had 1–2 mitotic cells/10 high power fields (HPF), the metastatic lesion increased malignancy, at 50/10 HPF. Conclusion Patients who have had resected SFTs should be carefully followed up, as malignancy may change in distant metastasis, as in this case.

scholarly journals Correlation between α-SMA and ß-catenin levels in bronchoalveolar lavage fluid and severity of pneumonia

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Xiaoying Li ◽  
Zinan Jiang
Keyword(s):  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Pearson Correlation ◽  
Severe Pneumonia ◽  
Lavage Fluid ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Creative Commons ◽  
Mechanical Ventilation Time ◽  
Deterioration Group

Objectives: To assess the association of bronchoalveolar lavage fluid (BALF) α-SMA and ß-catenin levels and the severity of pneumonia. Methods: The records of patients with severe pneumonia treated in our hospital from June 2019 to June 2020 were selected. The clinical outcome was observed within 10 days. For the purpose of analysis, patients were divided into two groups according to the outcome, 47 cases in the improvement group and 39 cases in the deterioration group. The intubation time, mechanical ventilation time and APACHE II score 10 days after admission were compared between the two groups; We assessed pulmonary infections using the clinical pulmonary infection score(CPIS). The levels of α-SMA and ß-catenin in bronchoalveolar lavage fluid at different time points were compared and analyzed, to analyze the association between the levels and the CPIS. Results: The APACHE II score in the improvement group were lower than those in the deterioration group (P<0.05). The expressions of α-SMA and ß-catenin in the BALF of patients in the improvement group were significantly lower than those of patients in the deterioration group on day 1, 3, and 7 (P<0.05); and the expressions of α-SMA and ß-catenin in the BALF of patients in the improvement group decreased with time, while those of patients in the deterioration group increased gradually with time(P<0.05). The expressions of α-SMA and ß-catenin in patients with CPIS>6 was significantly higher than those in patients with CPI≤6(P<0.05). Pearson correlation analysis showed that the levels of α-SMA and ß-catenin in BALF were positively correlated with the CPIS. Conclusion: The levels of α-SMA and ß-catenin in BALF are closely associated with the clinical condition of patients with severe pneumonia; the levels are positively associated with the severity of the disease and they increase with symptomatic worsening. doi: https://doi.org/10.12669/pjms.38.3.5329 How to cite this:Li X, Jiang Z. Correlation between α-SMA and ß-catenin levels in bronchoalveolar lavage fluid and severity of pneumonia. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5329 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sign in / Sign up

Export Citation Format

Share Document