Mycobacterium Fortuitum Cholangitis and Sepsis in an Immunocompetent Patient

2020 ◽  
Keyword(s):  
Wide Spectrum ◽  
Venous Catheter ◽  
Immunocompetent Patient ◽  
Mycobacterium Fortuitum ◽  
Prosthetic Device ◽  
Surgical Equipment ◽  
Clinical Syndromes ◽  
Direct Inoculation ◽  
Immunosuppressed Patients ◽  
History Of

Mycobacterium fortuitum is an ubiquitous, environmental and opportunistic organism belonging to rapid growing mycobacteria (RGM), a distinctive subset of non-tuberculous mycobacteria. It is mainly transmitted by direct inoculation and causes a wide spectrum of clinical syndromes, including skin, bone, soft tissue and disseminated infections, surgical wound infections, catheter-related sepsis and prosthetic device infections. Scientific literature abounds with cases occurred to cancer and immunosuppressed patients, especially in the presence of vascular devices. Hereby we report an event of Mycobacterium fortuitum sepsis and cholangitis, happened to an apparently immunocompetent individual, with no history of neoplasm, nor of immunosuppressive therapy, nor holding a central venous catheter (CVC). The man had previously undergone transitory biliary prosthesis positioning, followed by laparoscopic cholecystectomy; however, investigations on both the endoscopic and surgical equipment, as well as environmental samplings, ruled out a nosocomial infection. After adequate antibiotic treatment, our patient recovered.

scholarly journals TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT

2015 ◽  
Vol 57 (3) ◽  
pp. 273-275 ◽  
Author(s):  
Xiao-Hua CHEN ◽  
Yun-Chao GAO ◽  
Yi ZHANG ◽  
Zheng-Hao TANG ◽  
Yong-Sheng YU ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Invasive Candidiasis ◽  
Rare Case ◽  
Spinal Tuberculosis ◽  
Immunocompetent Patient ◽  
Antituberculous Therapy ◽  
Lower Back ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Candida Infections

Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient.

Mycobaterium fortuitum disseminated infection in an immunocompetent patient without predisposing factors

2020 ◽  
Vol 13 (9) ◽  
pp. e235842
Author(s):  
Stephanie d'Incau ◽  
Maria-Isabel Vargas ◽  
Alexandra Calmy ◽  
Jean-Paul Janssens
Keyword(s):  
Risk Factors ◽  
Pulmonary Infection ◽  
Skin Lesions ◽  
Immunocompetent Patient ◽  
Definitive Diagnosis ◽  
Optimal Treatment ◽  
Molecular Techniques ◽  
Surgical Removal ◽  
Mycobacterium Fortuitum ◽  
Direct Inoculation

Most Mycobacterium fortuitum infections described involve direct inoculation through skin lesions. We describe the case of a patient without risk factors who presented with an intracranial mass and a pulmonary infection with M. fortuitum. As M. fortuitum are rarely pathogens, there is little knowledge about the optimal treatment and outcome of such infections: what is the best mode of administration, what is the best therapy duration and is surgery always required are some of the unanswered questions. In our patient, surgical removal of the mass associated with a 1-year antimycobacterial therapy led to a full recovery. Even though M. fortuitum was rapidly identified in sputum, it was initially considered non-pathogenic and the definitive diagnosis required almost 6 weeks of investigations. New molecular techniques will probably lead to more identifications of M. fortuitum in the next few years and a better knowledge of their possible pathogenicity and optimal treatment.

scholarly journals Meningitis caused by Mycobacterium fortuitum mimicking tuberculous meningitis in an immunocompetent patient: a case report and literature review.

2020 ◽  
Author(s):  
Siran Lin ◽  
Qingluan Yang ◽  
Ting Wang ◽  
Wen Jia ◽  
Shu Chen ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Immunocompetent Patient ◽  
Mycobacterium Fortuitum ◽  
Microbiological Analysis ◽  
The Real ◽  
Surgical History ◽  
History Of ◽  
Hsp65 Gene ◽  
Wrong Diagnosis ◽  
One Year

Abstract Background: Nontuberculous mycobacteria (NTM) are a large group of microorganisms that mainly affect persons who have immune deficiency. Mycobacterium fortuitum is one of them, which usually cause soft tissue or pulmonary disease. Meningitis caused by M. fortuitum is extremely rare and is often confused with tuberculous meningitis (TBM) due to its low prevalence. Case presentation: A 35-year-old woman was referred to our hospital with a history of headache, followed by fever, chills, cough, and vomiting. The results of mycobacterial culture and TSPOT. TB of her cerebrospinal fluid were positive. Therefore, she was diagnosed with tuberculous meningitis and was given anti-tuberculous chemotherapy. During the observation, the CSF results were not significantly improved. Finally, hsp65 gene PCR revealed that the real pathogen was M. fortuitum. The treatment therapy was changed and the patient recovered after one-year combined chemotherapy. Conclusions: In this case we described a patient with M. fortuitum meningitis who was immunocompetent with no trauma or surgical history. The wrong diagnosis with TBM was made due to positive results of both blood and CSF TSPOT. TB . The pathological evidence and microbiological analysis of hsp65 gene PCR suggested the real pathogen to be M. fortuitum . The diagnostic accuracy of blood and CSF TSPOT. TB in case of TBM is moderate. Infections of NTM cannot be excluded when the patient does not respond to anti-tuberculous therapy and it is of great significance to do molecular identification for clinical isolates of mycobacterium.

scholarly journals Meningitis caused by Mycobacterium fortuitum mimicking tuberculous meningitis in an immunocompetent patient: a case report and literature review.

2020 ◽  
Author(s):  
Siran Lin ◽  
Qingluan Yang ◽  
Ting Wang ◽  
Wen Jia ◽  
Shu Chen ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Immunocompetent Patient ◽  
Mycobacterium Fortuitum ◽  
Microbiological Analysis ◽  
The Real ◽  
Surgical History ◽  
History Of ◽  
Hsp65 Gene ◽  
Wrong Diagnosis ◽  
One Year

Abstract Background: Nontuberculous mycobacteria (NTM) are a large group of microorganisms that mainly affect persons who have immune deficiency. Mycobacterium fortuitum is one of them, which usually cause soft tissue or pulmonary disease. Meningitis caused by M. fortuitum is extremely rare and is often confused with tuberculous meningitis (TBM) due to its low prevalence. Case presentation: A 35-year-old woman was referred to our hospital with a history of headache, followed by fever, chills, cough, and vomiting. The results of mycobacterial culture and TSPOT. TB of her cerebrospinal fluid were positive. Therefore, she was diagnosed with tuberculous meningitis and was given anti-tuberculous chemotherapy. During the observation, the CSF results were not significantly improved. Finally, hsp65 gene PCR revealed that the real pathogen was M. fortuitum . The treatment therapy was changed and the patient recovered after one-year combined chemotherapy. Conclusions: In this case we described a patient with M. fortuitum meningitis who was immunocompetent with no trauma or surgical history. The wrong diagnosis with TBM was made due to positive results of both blood and CSF TSPOT. TB . The pathological evidence and microbiological analysis of hsp65 gene PCR suggested the real pathogen to be M. fortuitum . The diagnostic accuracy of blood and CSF TSPOT. TB in case of TBM is moderate. Infections of NTM cannot be excluded when the patient does not respond to anti-tuberculous therapy and it is of great significance to do molecular identification for clinical isolates of mycobacterium.

scholarly journals Meningitis caused by Mycobacterium fortuitum mimicking tuberculous meningitis in an immunocompetent patient: a case report and literature review.

2020 ◽  
Author(s):  
Siran Lin ◽  
Qingluan Yang ◽  
Ting Wang ◽  
Wen Jia ◽  
Shu Chen ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Immunocompetent Patient ◽  
Mycobacterium Fortuitum ◽  
Microbiological Analysis ◽  
The Real ◽  
Surgical History ◽  
History Of ◽  
Hsp65 Gene ◽  
Wrong Diagnosis ◽  
One Year

Abstract Background: Nontuberculous mycobacteria (NTM) are a large group of microorganisms that mainly affect persons who have immune deficiency. Mycobacterium fortuitum is one of them, which usually cause soft tissue or pulmonary disease. Meningitis caused by M. fortuitum is extremely rare and is often confused with tuberculous meningitis (TBM) due to its low prevalence. Case presentation: A 35-year-old woman was referred to our hospital with a history of headache, followed by fever, chills, cough, and vomiting. The results of mycobacterial culture and TSPOT. TB of her cerebrospinal fluid were positive. Therefore, she was diagnosed with tuberculous meningitis and was given anti-tuberculous chemotherapy. During the observation, the CSF results were not significantly improved. Finally, hsp65 gene PCR revealed that the real pathogen was M. fortuitum . The treatment therapy was changed and the patient recovered after one-year combined chemotherapy. Conclusions: In this case we described a patient with M. fortuitum meningitis who was immunocompetent with no trauma or surgical history. The wrong diagnosis with TBM was made due to positive results of both blood and CSF TSPOT. TB . The pathological evidence and microbiological analysis of hsp65 gene PCR suggested the real pathogen to be M. fortuitum . The diagnostic accuracy of blood and CSF TSPOT. TB in case of TBM is moderate. Infections of NTM cannot be excluded when the patient does not respond to anti-tuberculous therapy and it is of great significance to do molecular identification for clinical isolates of mycobacterium.

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.

scholarly journals Cancer immunotherapy in special challenging populations: recommendations of the Advisory Committee of Spanish Melanoma Group (GEM)

2021 ◽  
Vol 9 (3) ◽  
pp. e001664
Author(s):  
Maria Gonzalez-Cao ◽  
Teresa Puertolas ◽  
Mar Riveiro ◽  
Eva Muñoz-Couselo ◽  
Carolina Ortiz ◽  
...  
Keyword(s):  
Cancer Immunotherapy ◽  
Multidisciplinary Approach ◽  
Checkpoint Inhibitors ◽  
Solid Organ Transplantation ◽  
Latent Tuberculosis ◽  
Solid Organ ◽  
Chronic Infections ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Evidence Based Guidelines

Cancer immunotherapy based on the use of antibodies targeting the so-called checkpoint inhibitors, such as programmed cell death-1 receptor, its ligand, or CTLA-4, has shown durable clinical benefit and survival improvement in melanoma and other tumors. However, there are some special situations that could be a challenge for clinical management. Persons with chronic infections, such as HIV-1 or viral hepatitis, latent tuberculosis, or a history of solid organ transplantation, could be candidates for cancer immunotherapy, but their management requires a multidisciplinary approach. The Spanish Melanoma Group (GEM) panel in collaboration with experts in virology and immunology from different centers in Spain reviewed the literature and developed evidence-based guidelines for cancer immunotherapy management in patients with chronic infections and immunosuppression. These are the first clinical guidelines for cancer immunotherapy treatment in special challenging populations. Cancer immunotherapy in chronically infected or immunosuppressed patients is feasible but needs a multidisciplinary approach in order to decrease the risk of complications related to the coexistent comorbidities.

scholarly journals Polymeric Nanocarriers: A Transformation in Doxorubicin Therapies

Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2135
Author(s):  
Kamila Butowska ◽  
Anna Woziwodzka ◽  
Agnieszka Borowik ◽  
Jacek Piosik
Keyword(s):  
Drug Delivery ◽  
Wide Spectrum ◽  
Stimuli Responsive ◽  
First Line ◽  
Medical Expenses ◽  
Polymeric Nanocarriers ◽  
Essential Properties ◽  
Life Threatening ◽  
History Of ◽  
Cancerous Cells

Doxorubicin, a member of the anthracycline family, is a common anticancer agent often used as a first line treatment for the wide spectrum of cancers. Doxorubicin-based chemotherapy, although effective, is associated with serious side effects, such as irreversible cardiotoxicity or nephrotoxicity. Those often life-threatening adverse risks, responsible for the elongation of the patients’ recuperation period and increasing medical expenses, have prompted the need for creating novel and safer drug delivery systems. Among many proposed concepts, polymeric nanocarriers are shown to be a promising approach, allowing for controlled and selective drug delivery, simultaneously enhancing its activity towards cancerous cells and reducing toxic effects on healthy tissues. This article is a chronological examination of the history of the work progress on polymeric nanostructures, designed as efficient doxorubicin nanocarriers, with the emphasis on the main achievements of 2010–2020. Numerous publications have been reviewed to provide an essential summation of the nanopolymer types and their essential properties, mechanisms towards efficient drug delivery, as well as active targeting stimuli-responsive strategies that are currently utilized in the doxorubicin transportation field.

scholarly journals Reactivation of BK Polyomavirus in Urine Cytology Is Not Associated with Urothelial Cell Carcinoma

Viruses ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 1412
Author(s):  
Faisal Klufah ◽  
Ghalib Mobaraki ◽  
Axel zur Hausen ◽  
Iryna V. Samarska
Keyword(s):  
Cell Carcinoma ◽  
Urine Cytology ◽  
Urothelial Cell ◽  
The Other ◽  
Urothelial Cell Carcinoma ◽  
Tissue Samples ◽  
Bk Polyomavirus ◽  
Ffpe Tissues ◽  
Immunosuppressed Patients ◽  
History Of

BK polyomavirus (BKPyV) has been associated with some high-grade and special urothelial cell carcinoma (UCC) subtypes in immunosuppressed patients. Here, we evaluated the relationship of BKPyV-positive urine cytology specimens (UCS) with UCC. A large single-institution database was retrospectively searched for UCS positive for decoy cells, suggesting BKPyV infection. These were tested for the presence of BKPyV by PCR and immunohistochemistry (IHC) in urine sediments and formalin-fixed paraffin-embedded (FFPE) tissue samples of UCC. Decoy cells were reported in 30 patients out of the database with 22.867 UCS. Of these 30 patients, 16 (53.3%) had no history of UCC. Six patients out of these 16 had a history of transplantation, 4 had a history of severe chronic medical conditions, and 6 had no chronic disease. The other fourteen patients were diagnosed with either in situ or invasive UCC of the urinary bladder (14/30; 46.6%) prior to the detection of decoy cells in the urine. Nine of these UCC patients received intravesical treatment (BCG or mitomycin) after the first presentation with UCC. However, the clinical data on the treatment of the other five UCC patients was lacking. IHC identified BKPyV-positivity in the urine samples of non-UCC and UCC patients, while no BKPyV positivity was found in FFPE tissues of primary UCCs and metastases. In addition, BKPyV-PCR results revealed the presence of BKPyV DNA in the urine of the UCC cases, yet none in the UCC tissues itself. These data strongly indicate that BKPyV reactivation is not restricted to immunosuppression. It can be found in UCS of the immunocompetent patients and may be related to the intravesical BCG or mitomycin treatment of the UCC patients.

scholarly journals Primary Tubercular Chest Wall Abscess in a Young Immunocompetent Male

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Shweta Sharma ◽  
R. K. Mahajan ◽  
V. P. Myneedu ◽  
B. B. Sharma ◽  
Nandini Duggal
Keyword(s):  
Chest Wall ◽  
Immunocompetent Patient ◽  
Rare Entity ◽  
Hematogenous Spread ◽  
Clinical Challenge ◽  
Chest Wall Abscess ◽  
Direct Inoculation ◽  
Underlying Pathology ◽  
Patient Infection ◽  
Rule Out

Chest wall tuberculosis is a rare entity especially in an immunocompetent patient. Infection may result from direct inoculation of the organisms or hematogenous spread from some underlying pathology. Infected lymph nodes may also transfer the bacilli through lymphatic route. Chest wall tuberculosis may resemble a pyogenic abscess or tumour and entertaining the possibility of tubercular etiology remains a clinical challenge unless there are compelling reasons of suspicion. In tuberculosis endemic countries like India, all the abscesses indolent to routine treatment need investigation to rule out mycobacterial causes. We present here a case of chest wall tuberculosis where infection was localized to skin only and, in the absence of any evidence of specific site, it appears to be a case of primary involvement.

Sign in / Sign up

Export Citation Format

Share Document