scholarly journals Isolated Mycobacterium Tuberculosis Tenosynovitis and Osteomyelitis of the Foot in an Immunocompetent Patient

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Elgazzar A ◽  
◽  
Cecchini A ◽  
Elmezayen RI ◽  
◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Delayed Diagnosis ◽  
Pulmonary Involvement ◽  
Immunocompetent Patient ◽  
Complete Healing ◽  
Radiological Findings ◽  
Intravenous Antibiotics ◽  
Healing Wounds ◽  
High Index Of Suspicion ◽  
Immunocompetent Patients

Tubercular osteomyelitis must be considered in the differential diagnosis of immunocompetent patients who present with non-healing wounds with underlying osteomyelitis. Clinical and radiological findings may be indistinguishable from typical bacteria osteomyelitis. A high index of suspicion may prevent delayed diagnosis, and early treatment may prevent subsequent complications. This is a case report of an immunocompetent patient who presented with a chronic non-healing foot wound complicated by abscess and osteomyelitis that did not improve with an appropriate course of intravenous antibiotics. Wound cultures subsequently grew Mycobacterium tuberculosis without evidence of pulmonary involvement. The patient was treated with an initial two-month regimen of rifampin, isoniazid, pyridoxine, pyrazinamide and ethambutol, followed by a tenmonth regimen of rifampin, isoniazid and pyridoxine. The patient experienced significant improvement and complete healing of the foot wound after approximately the first two months of therapy.

scholarly journals Prostatic tuberculosis: case report

2008 ◽  
Vol 126 (4) ◽  
pp. 227-228 ◽  
Author(s):  
Daniel Sáenz-Abad ◽  
Santiago Letona-Carbajo ◽  
José Luis de Benito-Arévalo ◽  
Isabel Sanioaquín-Conde ◽  
Francisco José Ruiz-Ruiz
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Urine Culture ◽  
Immunocompetent Patient ◽  
Immunocompromised Patients ◽  
Tuberculosis Case ◽  
Immunocompetent Patients

CONTEXT: Tuberculosis of the prostate has mainly been described in immunocompromised patients. However, it can exceptionally be found as an isolated lesion in immunocompetent patients. CASE REPORT: We report a case of prostatic tuberculosis in a young, healthy and immunocompetent patient with unremarkable findings from intravenous urographic examination. Computed tomography showed an abscess in the prostate and Mycobacterium tuberculosis was isolated in a urine culture. Treatment with isoniazid, rifampin and pyrazinamide was successful.

Disseminated TB in an Immunocompetent Patient: A Case Report

2020 ◽  
Vol 20 ◽  
Author(s):  
Malihe Hassan Nezhad ◽  
Alireza Ganadan ◽  
Seyed Ahmad Seyed Alinaghi ◽  
Fatemeh Nili Ahmad Abadi ◽  
Seyed Ali Dehghan Manshadi ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Weight Loss ◽  
Mycobacterium Tuberculosis ◽  
Abdominal Pain ◽  
Case Report ◽  
Immunocompetent Patient ◽  
Seborrheic Keratosis ◽  
Prolonged Fever ◽  
Immunocompetent Patients

: Tuberculosis considered as a chronic infectious disease caused by Mycobacterium tuberculosis, may invade all organs but mainly affects the lungs [1].In overall, disseminated TB is rare in immunocompetent patients and its association with seborrheic keratosis has never been reported. We reported a54-year-old man with a complaint prolonged fever, abdominal pain, weight loss and lymphadenopathy without any immunosuppression who was eventually treated based on the diagnosis of diffuse tuberculosis.

scholarly journals Post COVID-19 tuberculosis: An emerging threat of pandemic

2021 ◽  
Author(s):  
Aqusa Zahid ◽  
Nousheen Iqbal ◽  
Sarosh Moeen ◽  
Muhammad Irfan
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Severe Acute Respiratory Syndrome ◽  
Opportunistic Infection ◽  
Immunocompetent Patient ◽  
Young Female ◽  
High Index ◽  
The World ◽  
High Index Of Suspicion

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) pandemic has hit the world hard. Millions of people have died due to the infection and several have suffered with what are now known as post COVID-19 squeal. Among these squeals one is immunosuppression which leaves patients prone to severe opportunistic infection. We here report a case of young female who was infected by COVID-19 and later developed cavitary pneumonia which upon investigation turned out to be due to mycobacterium tuberculosis.  Through this report we aim to highlight the importance of high index of suspicion for infection like Mycobacterium tuberculosis after COVID-19 infection which developed in a healthy immunocompetent patient.

scholarly journals Delayed Diagnosis of a Diffuse Invasive Gastrointestinal Aspergillosis in an Immunocompetent Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
S. Guglielmetti ◽  
C. M. Jaccard ◽  
K. Mühlethaler ◽  
A. Bigler ◽  
D. Springe ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Primary Infection ◽  
Surgical Intervention ◽  
Delayed Diagnosis ◽  
Immunocompetent Patient ◽  
High Morbidity ◽  
Delay Of Treatment ◽  
Gastrointestinal Aspergillosis ◽  
Portal Of Entry ◽  
Immunocompetent Patients

Invasive aspergillosis represents a clinical picture frequently associated with host’s immunosuppression which usually involves a high morbidity and mortality. In general, the most frequent fungal entry is the lungs with secondary hematogenous dissemination, but there are other hypotheses like a gastrointestinal portal of entry. There are some rare publications of cases with invasive aspergillosis in immunocompetent patients. We present the case of an immunocompetent patient without any risk factors except for age, ICU stay, and surgical intervention, who developed a septic shock by invasive gastrointestinal aspergillosis as primary infection. Due to the unusualness of the case, despite all the measures taken, the results were obtained postmortem. We want to emphasize the need not to underestimate the possibility for an invasive aspergillosis in an immunocompetent patient. Not only pulmonary but also gastrointestinal aspergillosis should be taken into account in the differential diagnosis to avoid a delay of treatment.

scholarly journals Tuberculosis and pulmonary candidiasis co-infection present in a previously healthy patient

2016 ◽  
pp. 105-108 ◽  
Author(s):  
Dilia Mildret Fontalvo ◽  
Gustavo Jiménez Borré ◽  
Doris Gómez Camargo ◽  
Neylor Chalavé Jiménez ◽  
Javier Bellido Rodríguez ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Candida Albicans ◽  
Fungal Pathogens ◽  
Left Lung ◽  
Immunocompetent Patient ◽  
Clinical Findings ◽  
Massive Hemoptysis ◽  
Fungal Culture ◽  
Fungal Treatment ◽  
Immunocompetent Patients

Background: The coexistance among fungal pathogens and tuberculosis pulmonary is a clinical condition that generally occurs in immunosuppressive patients, however, immunocompetent patients may have this condition less frequently. Objective: We report the case of an immunocompetent patient diagnosed with coinfection Mycobacterium tuberculosis and Candida albicans. Case Description: 22-year-old female patient, previously healthy, who presented an episode of cough, massive hemoptysis and fever. Clinical findings and diagnosis: Physical examination was found crakles in left lung. Microbiological testing includes Ziehl Neelsen, culture for mycobacterium, fungal culture in Sabouraud Dextrose Agar medium and serum filamentation. The tests showed Mycobacterium tuberculosis and Candida albicans. Imaging studies included chest radiography, chest CT scan apicograma and high resolution supported the diagnosis. Treatment and Outcome: The patient was treated with anti-tuberculosis and anti-fungal treatment with good clinical evolution. Clinical relevance: Fungal infection and pulmonary tuberculosis is rare in immunocompetent patients should be suspected in abrupt episodes of hemoptysis.

Fungal laryngitis in immunocompetent patients

2004 ◽  
Vol 118 (5) ◽  
pp. 379-381 ◽  
Author(s):  
Hisham M. Mehanna ◽  
Tony Kuo ◽  
John Chaplin ◽  
Graeme Taylor ◽  
Randall P. Morton
Keyword(s):  
Immunocompetent Patient ◽  
Predisposing Factors ◽  
High Index ◽  
Mucosal Barrier ◽  
Prolonged Treatment ◽  
Steroid Use ◽  
Disease Eradication ◽  
High Index Of Suspicion ◽  
Immunocompetent Patients ◽  
Do So

The diagnosis of fungal laryngitis is often overlooked in systemically immunocompetent patients because it is commonly considered a disease of the immunocompromised, and because it often mimics, clinically and histologically, more common and more serious conditions e.g. leukoplakia. A high index of suspicion is required to make the diagnosis, and should be considered in any immunocompetent patient with persistent or refractory laryngitis and factors predisposing to local mucosal barrier impairment e.g. gastropharyngeal reflux, smoking or inhaled steroid use. In such cases, demonstration of hyperkeratosis, particularly if associated with intraepithelial neutrophils, on biopsy should trigger a search for fungal elements using specialized stains. Prolonged treatment by systemic antimycotics is required. Treatment should also include the elimination of any predisposing factors, as failure to do so may result in difficulty with disease eradication or recurrence of the condition.

PULMONARY TALCOSIS: A Foreign body granulomatous lung disease

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Olufisayo Otusanya
Keyword(s):  
Foreign Body ◽  
Lung Biopsy ◽  
Granulomatous Disease ◽  
Mycobacterial Disease ◽  
Intravascular Injection ◽  
Radiological Findings ◽  
Atypical Mycobacterium ◽  
Mycobacterium Infection ◽  
Granulomatous Lung Disease ◽  
High Index Of Suspicion

Pulmonary Talcosis is a rare foreign body granulomatous disease that occurs as a result of exposure to talc either by inhalation of talc particles or via intravascular injection of talc containing medications. Pulmonary Talcosis is often misdiagnosed as pulmonary tuberculosis, atypical mycobacterium infection or sarcoidosis as many of their clinical and radiological findings overlap. We report a case of talcosis mimicking mycobacterial disease which was eventually diagnosed via lung biopsy. A detailed history and high index of suspicion is required for timely diagnosis and appropriate management.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

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.

Granulomatosis with polyangiitis presenting as pancreatic disease

2021 ◽  
Vol 14 (3) ◽  
pp. e241033
Author(s):  
Jessie Jia Tao ◽  
Arnav Agarwal ◽  
Ari Benjamin Cuperfain ◽  
Christian Pagnoux
Keyword(s):  
Granulomatosis With Polyangiitis ◽  
Epigastric Pain ◽  
Delayed Diagnosis ◽  
Pancreatic Disease ◽  
Small Vessel Vasculitis ◽  
High Dose ◽  
Rapid Progression ◽  
Radiographic Evidence ◽  
High Index Of Suspicion ◽  
Parenchymal Lung

Granulomatosis with polyangiitis (GPA) is a rare necrotising small vessel vasculitis typically associated with oronasal, pulmonary and renal manifestations. Pancreatic disease is an exceedingly rare initial presentation and is associated with delayed diagnosis and rapid progression. We discuss a 66-year-old woman presenting with epigastric pain, elevated lipase and radiographic evidence of focal pancreatitis. She had no relevant medical history and no lithiasis seen on imaging. Pertinent findings include strawberry gingivitis, positive proteinase-antineutrophil cytoplasm antibody (98% specificity) and focal nodular parenchymal lung lesions on CT chest—all of which are consistent with a diagnosis of GPA. She was promptly started on high-dose steroids which resulted in significant clinical and biochemical improvement. Cyclophosphamide was added once biopsy confirmed the absence of malignancy. In order to optimise the clinical outcomes of GPA, physicians must keep a wide differential and high index of suspicion in the setting of unexplained pancreatitis with systemic features.

Case of second primary breast cancer in ectopic breast tissue and review of the literature

2021 ◽  
Vol 14 (4) ◽  
pp. e241361
Author(s):  
Jamin Kweku Addae ◽  
Thomas Genuit ◽  
Joseph Colletta ◽  
Kathy Schilling
Keyword(s):  
Breast Cancer ◽  
Primary Breast Cancer ◽  
Breast Tissue ◽  
Delayed Diagnosis ◽  
Left Breast ◽  
Second Primary ◽  
Female Population ◽  
Accessory Breast ◽  
History Of ◽  
High Index Of Suspicion

Accessory breast tissue (ABT) is found in approximately 2%–6% of the female population and are subject to most of the physiological and pathological changes that occur in pectoral breast. Primary breast cancer occurring in ABT is a rare occurrence and a second primary breast cancer occurring in an accessory breast has never been reported. We report the case of a 60-year-old woman with a history of mastectomy for left breast cancer 5 years prior to presentation, who presented with an enlarging right axilla mass found to be a second primary breast cancer in an accessory tissue on biopsy. Many physicians are unfamiliar with the clinical presentation of accessory breast cancer due to the rarity of the condition and this ultimately results in delayed diagnosis and advanced disease at presentation. It is therefore prudent that physicians have a high index of suspicion when patients present with axillary masses.

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