scholarly journals Pleural Effusion Caused by Mycolicibacterium mageritense in an Immunocompetent Host: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Takayuki Niitsu ◽  
Tomoki Kuge ◽  
Kiyoharu Fukushima ◽  
Yuki Matsumoto ◽  
Yuko Abe ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Treatment Strategies ◽  
Immunocompetent Patient ◽  
Lung Lesion ◽  
Thoracic Cavity ◽  
Immunocompetent Host ◽  
Whole Genome Analysis ◽  
History Of ◽  
First Time ◽  
Immunocompetent Patients

Mycolicibacterium mageritense (M. mageritense) is a rare species among rapidly growing mycobacteria, and M. mageritense pleurisy is very rare. Here, we report for the first time, an immunocompetent patient with pleurisy caused by M. mageritense. The patient had no history of immunodeficiency and no recurrence of lung cancer after surgery. However, 8 months after surgery, he developed a new lung shadow and pleurisy. Although whole-genome analysis of the colony cultured from the patient's pleural fluid revealed M. mageritense, we could not identify it in time, resulting in a poor outcome. M. mageritense pleurisy in this case might have occurred via a bulla rupture of the lung lesion because computed tomography of the patient's chest showed pneumothorax and a lung lesion in contact with thoracic cavity. This case emphasized that nontuberculous mycobacterial pleurisy should be considered in the differential diagnoses of pleural effusion even in immunocompetent patients. Advancement of comprehensive and rapid analyses of genomic data from clinical specimens will lead to better treatment strategies.

scholarly journals Primary Laryngeal Aspergillosis in an Immunocompetent Host

2018 ◽  
Vol 26 (2) ◽  
pp. 131-133
Author(s):  
Kaustuv Das Biswas ◽  
Ankit Choudhary ◽  
Swapan Kumar Ghosh ◽  
Subhradev Biswas
Keyword(s):  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Poor Prognosis ◽  
Rare Case ◽  
Systemic Infection ◽  
Immunocompetent Patient ◽  
Immunocompetent Host ◽  
First Line ◽  
Vocal Cords ◽  
Immunocompetent Patients

Introduction Aspergillosis of Larynx is very rare and may present with symptoms suspicious of malignancy. Prevention of dissemination warrants early diagnosis. It is found mainly in Immunocompromised patients and is usually necrotizing, invasive with disseminated systemic infection, associated with poor prognosis. In Immunocompetent patients it is extremely rare and may present as colonization associated with excellent prognosis. Case Report A 43 year old male patient presented with hoarseness of voice for about 3 months with whitish irregular lesion that involved the anterior 1/3 of both the vocal cords. A cheesy material was found covering indurated lesion of both the vocal cords, intraoperatively. Stripping of mucosa over vocal cords was done and cheesy material collected and sent for HPE which revealed Aspergillus hyphae overlying Mild dysplastic changes. Following diagnosis the patient was followed up with oral dosages of Itraconazole. Discussion The primary Aspergillosis of larynx is extremely rare. Involvement is always secondary to immunocompromised states like AIDS, malignancy, Diabetes, etc. This was a rare case in Immunocompetent patient. Management constitute removal of the vocal cord lesions during biopsy. Amphotericin B is first-line agent for this infection, however aerosolised and liposomal amphotericin B offer effective dosing with less toxicity. Newer antifungal Itraconazole may produce more reliable results.

scholarly journals Cryptogenic Pyogenic Liver Abscess Due to Fusobacterium nucleatum in an Immunocompetent Patient

2020 ◽  
Author(s):  
Neeraja Swaminathan ◽  
Francisco Aguilar
Keyword(s):  
Liver Abscess ◽  
Fusobacterium Nucleatum ◽  
Pyogenic Liver Abscess ◽  
Immunocompetent Patient ◽  
Immunocompetent Host ◽  
Source Of Infection ◽  
Function Test ◽  
History Of ◽  
Anaerobic Infections ◽  
Dental Work

In this case, a 76-year-old female presented with 3–4 days of fever with no other localizing signs. Notably, she had had an untreated Fusobacterium bacteraemia approximately 8 weeks prior to admission. She underwent abdominal imaging which demonstrated a liver abscess and had percutaneous drainage of the same. Blood and pus cultures both grew Fusobacterium nucleatum, which is an unusual organism to be associated with a liver abscess, especially in an immunocompetent host with no risk factors for this condition. Interestingly, this patient did not have any history of dental work, instrumentation, liver function test (LFT) abnormalities and no extrahepatic source for the abscess. This case highlights the importance of having a high index of clinical suspicion for an occult source of infection and emphasizes the importance of following up on cultures even after discharge of a patient, since anaerobic infections such as those caused by Fusobacterium can have a largely indolent course.

scholarly journals Schizophrenia and delusional disorders with onset in later life

2002 ◽  
Vol 24 (suppl 1) ◽  
pp. 81-86 ◽  
Author(s):  
Anne Hassett
Keyword(s):  
Clinical Presentation ◽  
Late Onset ◽  
Early Adulthood ◽  
Treatment Strategies ◽  
Later Life ◽  
Psychotic Symptoms ◽  
Sensory Impairment ◽  
Schizophrenia Spectrum ◽  
History Of ◽  
First Time

Schizophrenia-spectrum illness is most commonly associated with an onset in early adulthood. When non-affective psychotic symptoms emerge for the first time in later life, the clinical presentation has both similarities and differences with earlier-onset syndromes. This situation has resulted in continuing debate about the nosological status of late-onset psychosis, and whether there are particular risk factors associated with this late-life peak in incidence. Although early cognitive decline is frequently identified in these patients, studies, to date, have not established if there is a relationship with the dementing illnesses of old age. Sensory impairment, social isolation, and a family history of schizophrenia have been associated with late-onset psychosis, but appear to exert a nonspecific influence on vulnerability. While diagnostic issues remain unresolved, clinicians need to formulate treatment strategies that most appropriately address the constellation of symptoms in the clinical presentation of their psychotic elderly patients.

scholarly journals Cytomegalovirus Retinitis Associated with Lenalidomide Use for Multiple Myeloma in an Immunocompetent Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Matthew K. Adams ◽  
Christina Y. Weng
Keyword(s):  
Multiple Myeloma ◽  
Immunocompetent Patient ◽  
Fundus Photography ◽  
Cmv Retinitis ◽  
History Of ◽  
Oral Valganciclovir ◽  
Pars Plana ◽  
One Year ◽  
Immunocompetent Patients ◽  
Vitreous Biopsy

Purpose. The aim of this report is to present a case of cytomegalovirus (CMV) retinitis in an immunocompetent patient using lenalidomide. Methods. Case report with fundus photography, spectral-domain optical coherence tomography, and fluorescein angiography imaging. Results. A 55-year-old male with history of multiple myeloma treated with lenalidomide presented with blurriness and floaters in his right eye and was found to have vitreous biopsy-confirmed CMV retinitis. The patient was treated with pars plana vitrectomy, oral valganciclovir, and intravitreal foscarnet. More than one year later, the patient was doing well with visual acuity of 20/25 and no recurrence of retinitis. Conclusion. This represents the second report of CMV retinitis associated with lenalidomide therapy. It suggests that even immunocompetent patients can be affected by CMV retinitis in the context of lenalidomide treatment. It is critical that patients being treated with lenalidomide receive prompt evaluation if they develop ophthalmic symptoms.

Recurrent Subcutaneous Abscess Due to Nocardia farcinica in an Immunocompetent Patient: A Case Report

2021 ◽  
Vol 67 (5) ◽  
pp. 33-39
Author(s):  
Burçin Acuner ◽  
Füsun Cömert
Keyword(s):  
Late Onset ◽  
Immunocompetent Patient ◽  
Wound Dressings ◽  
Multi Drug Resistance ◽  
Minor Trauma ◽  
Surgical Interventions ◽  
Treatment Regimens ◽  
Nocardia Farcinica ◽  
History Of ◽  
Immunocompetent Patients

BACKGROUND: Nocardia farcinica differs from other species of Nocardia due to its multi-drug resistance and propensity to disseminate hematogenously. Cutaneous nocardiosis in immunocompetent patients is rare. PURPOSE: To describe the treatment and clinical trajectory of a 37-year-old male patient who was not immunocompromised and presented with a history of minor trauma from a canister and palpable subcutaneous draining nodules in the forearm. Purulent drainage was present. The injury had occurred 3 months before presentation. RESULTS: Magnetic resonance imaging revealed multiple abscess foci up to 3 cm in diameter in the forearm muscles. The wound culture obtained after debridment indicated Nocardia farcinica as the cause. The case was difficult to manage despite serial debridements, negative pressure wound dressings, and culture-specific antibiotic treatments. The entire treatment process took approximately 7 months. The patient had 5 surgical interventions and more than 6 months of antibiotic treatment. Healing was eventually achieved but with a painful scar. CONCLUSION: Although nocardiosis has been documented to occur primarily in immunocompromised patients, it should be considered in the differential diagnosis of immunocompetent patients if there is a history of skin injury and a late-onset subcutaneous draining abscess resistant to common treatment regimens.

scholarly journals Bartonella henselaeInfection: An Uncommon Mimicker of Autoimmune Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Despoina N. Maritsi ◽  
Diagoras Zarganis ◽  
Zoi Metaxa ◽  
Georgia Papaioannou ◽  
George Vartzelis
Keyword(s):  
Clinical Laboratory ◽  
Imaging Features ◽  
Immunocompetent Host ◽  
X Ray ◽  
Systemic Involvement ◽  
Night Sweats ◽  
History Of ◽  
Chest X Ray ◽  
Systemic Symptoms ◽  
Immunocompetent Patients

We present a case of a seven-year-old immunocompetent female patient who developed systemic symptoms mimicking an autoimmune rather than an infectious disease. The patient presented with rash, biquotidian fever, night sweats, and arthralgias. There was no antecedent history of cat contact. Investigations showed increased inflammatory markers, leukocytosis, thrombocytosis, hypercalcemia, and raised angiotensin-converting enzyme. Interferon-gamma releasing assay for tuberculosis infection was negative. Abdominal imaging demonstrated multifocal lesions of the liver and spleen (later proved to be granulomata), chest X-ray showed enlarged hilar lymph nodes, and ophthalmology review revealed uveitis. Clinical, laboratory, and imaging features pointed towards sarcoidosis. Subsequently, raised titers (IgM 1 : 32, IgG 1 : 256) againstBartonellaconfirmed the diagnosis ofB. henselaeinfection. She was treated with gentamycin followed by ciprofloxacin; repeat investigations showed complete resolution of findings. The presence of hepatic and splenic lesions in children with bartonellosis is well documented. Our case, however, exhibited certain unusual findings such as the coexistence of acute ocular and systemic involvement in an immunocompetent host. Serological testing is an inexpensive and effective way to diagnose bartonellosis in immunocompetent patients; we suggest that bartonella serology is included in the baseline tests performed on children with prolonged fever even in the absence of contact with cats in countries where bartonellosis is prevalent.

scholarly journals Seizure in isolated brain cryptococcoma: Case report and review of the literature

2021 ◽  
Vol 12 ◽  
pp. 153
Author(s):  
Laura Brunasso ◽  
Roberta Costanzo ◽  
Antonio Cascio ◽  
Ada Florena ◽  
Gianvincenzo Sparacia ◽  
...  
Keyword(s):  
Immunocompetent Patient ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Granulomatous Reaction ◽  
Pertinent Literature ◽  
Cranial Nerve Dysfunction ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Nerve Dysfunction ◽  
Immunocompetent Patients

Background: Central nervous system (CNS) cryptococcosis is an invasive fungal infection predominantly seen among immunosuppressed patients causing meningitis or meningoencephalitis. Rarely, cryptococcosis can affect immunologically competent hosts with the formation of localized CNS granulomatous reaction, known as cryptococcoma. Common symptoms of CNS cryptococcoma are headaches, consciousness or mental changes, focal deficits, and cranial nerve dysfunction. Rarely, seizures are the only presenting symptom. Case Description: We report the case of an immunocompetent patient with a solitary CNS cryptococcoma presenting with a long history of non-responsive generalized seizure who has been successfully operated. Conclusion: CNS cryptococcoma is a rare entity, and in immunocompetent patients, its diagnosis can be challenging. The pathophysiology of lesion-related seizure is discussed along with a review of the pertinent literature.

Adam Zalužanský’s “De sexu plantarum” (1592): an early pioneering chapter on plant sexuality

2013 ◽  
Vol 40 (2) ◽  
pp. 244-256 ◽  
Author(s):  
Holger Funk
Keyword(s):  
Nineteenth Century ◽  
English Translation ◽  
History Of Botany ◽  
Main Work ◽  
Botanical History ◽  
History Of ◽  
The University ◽  
First Time

In the history of botany, Adam Zalužanský (d. 1613), a Bohemian physician, apothecary, botanist and professor at the University of Prague, is a little-known personality. Linnaeus's first biographers, for example, only knew Zalužanský from hearsay and suspected he was a native of Poland. This ignorance still pervades botanical history. Zalužanský is mentioned only peripherally or not at all. As late as the nineteenth century, a researcher would be unaware that Zalužanský’s main work Methodi herbariae libri tres actually existed in two editions from two different publishers (1592, Prague; 1604, Frankfurt). This paper introduces the life and work of Zalužanský. Special attention is paid to the chapter “De sexu plantarum” of Zalužanský’s Methodus, in which, more than one hundred years before the well-known De sexu plantarum epistola of R. J. Camerarius, the sexuality of plants is suggested. Additionally, for the first time, an English translation of Zalužanský’s chapter on plant sexuality is provided.

A Confrontation between Two Doctrines: The Birth of Struggle for Hegemony in Hebrew Children's Literature during the 1930s and 1940s

2008 ◽  
Vol 1 (2) ◽  
pp. 139-155 ◽  
Author(s):  
YAEL DARR
Keyword(s):  
Children's Literature ◽  
Educational System ◽  
Single Channel ◽  
Children’S Literature ◽  
The Political ◽  
Literary Creation ◽  
History Of ◽  
High Level ◽  
First Time ◽  
Literary Quality

This article describes a crucial and fundamental stage in the transformation of Hebrew children's literature, during the late 1930s and 1940s, from a single channel of expression to a multi-layered polyphony of models and voices. It claims that for the first time in the history of Hebrew children's literature there took place a doctrinal confrontation between two groups of taste-makers. The article outlines the pedagogical and ideological designs of traditionalist Zionist educators, and suggests how these were challenged by a group of prominent writers of adult poetry, members of the Modernist movement. These writers, it is argued, advocated autonomous literary creation, and insisted on a high level of literary quality. Their intervention not only dramatically changed the repertoire of Hebrew children's literature, but also the rules of literary discourse. The article suggests that, through the Modernists’ polemical efforts, Hebrew children's literature was able to free itself from its position as an apparatus controlled by the political-educational system and to become a dynamic and multi-layered field.

Digging the history. Absolute chronology of the settlement complex at Czermno-Cherven’ (eastern Poland). Research status and perspectives

2020 ◽  
Vol 72 (2) ◽  
Author(s):  
Tomasz Dzieńkowski ◽  
Marcin Wołoszyn ◽  
Iwona Florkiewicz ◽  
Radosław Dobrowolski ◽  
Jan Rodzik ◽  
...  
Keyword(s):  
Interdisciplinary Research ◽  
Qualitative Change ◽  
Archaeological Research ◽  
Research Status ◽  
History Of ◽  
Absolute Dating ◽  
First Time ◽  
Radiocarbon Datings

The article discusses the results of the latest interdisciplinary research of Czermno stronghold and its immediate surroundings. The site is mentioned in chroniclers’ entries referring to the stronghold Cherven’ (Tale of Bygone Years, first mention under the year 981) and the so-called Cherven’ Towns. Given the scarcity of written records regarding the history of today’s Eastern Poland, Ukraine, and Belarus in the 10th and 11th centuries, recent archaeological research, supported by geoenvironmental analyses and absolute dating, brought a significant qualitative change. In 2014 and 2015, the remains of the oldest rampart of the stronghold were uncovered for the first time. A series of radiocarbon datings allows us to refer the erection of the stronghold to the second half/late 10th century. The results of several years’ interdisciplinary research (2012-2020) introduce qualitatively new data to the issue of the Cherven’ Towns, which both change current considerations and confirm the extraordinary research potential in the archeology of the discussed region.

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