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Intracranial hepatitis B virus (HBV) infection following intracerebral hemorrhage in a patient with seronegative occult HBV infection 1例血清阴性隐匿性HBV感染患者脑出血后颅内乙型肝炎病毒（HBV）感染

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-01-20 DOI: 10.1016/j.idcr.2026.e02502

Xiaoyan Ji , Mingyang Wang , Peng Jin , Lingyi Kong , Yongkang Xu , Weili Chen , Bin Liu , Qingquan Wang

{"title":"Intracranial hepatitis B virus (HBV) infection following intracerebral hemorrhage in a patient with seronegative occult HBV infection","authors":"Xiaoyan Ji , Mingyang Wang , Peng Jin , Lingyi Kong , Yongkang Xu , Weili Chen , Bin Liu , Qingquan Wang","doi":"10.1016/j.idcr.2026.e02502","DOIUrl":"10.1016/j.idcr.2026.e02502","url":null,"abstract":"<div><div>Hepatitis B virus (HBV) infection is primarily associated with liver diseases but can also manifest with various extrahepatic complications. While numerous extrahepatic manifestations have been reported in acute or chronic hepatitis B patients, intracranial HBV infection remains clinically rare. A 43-year-old male had a pre-existing diagnosis of serologically negative occult HBV infection (OBI), which was initially diagnosed by detecting HBV DNA in serum while HBsAg, anti-HBs, anti-HBe, and anti-HBc were all negative. Following intracerebral hemorrhage, the patient's consciousness gradually restored through a course of rehabilitation therapy. Subsequently, the patient developed persistent fever and his level of consciousness progressively deteriorated. Serological testing confirmed the presence of HBsAg and HBeAg, the HBV loads in the serum was high, subsequent metagenomic next-generation sequencing (mNGS) of the cerebrospinal fluid (CSF) revealed positivity for HBV. After 8 weeks of treatment with entecavir, the HBV loads in the serum and CSF decreased significantly, the patient's consciousness improved, and the patient's temperature returned to normal. This study first reported a seronegative OBI patient developing intracranial HBV infection following intracerebral hemorrhage and clarified the diagnostic value of mNGS in rare intracranial infections.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02502"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Benign course of hepatitis A and COVID-19 coinfection: A retrospective observational case series with comparative analysis 甲型肝炎和COVID-19合并感染的良性病程：回顾性观察病例系列并进行比较分析

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IDCases Pub Date : 2026-01-01 Epub Date: 2025-12-07 DOI: 10.1016/j.idcr.2025.e02453

Georges Khalil , Alexia Khoury , Marina Antoinette Khalil , Noura Abbas , Mitchelle Issa , Youssef El Toum , Giovanni Yanni

{"title":"Benign course of hepatitis A and COVID-19 coinfection: A retrospective observational case series with comparative analysis","authors":"Georges Khalil , Alexia Khoury , Marina Antoinette Khalil , Noura Abbas , Mitchelle Issa , Youssef El Toum , Giovanni Yanni","doi":"10.1016/j.idcr.2025.e02453","DOIUrl":"10.1016/j.idcr.2025.e02453","url":null,"abstract":"<div><h3>Background</h3><div>In regions where hepatitis A virus (HAV) is endemic, the COVID-19 pandemic has introduced new challenges. While liver involvement in SARS-CoV-2 is well documented, the impact of HAV–COVID-19 coinfection remains unclear.</div></div><div><h3>Objective</h3><div>Evaluate whether COVID-19 coinfection worsens clinical outcomes or liver injury in patients with HAV infection.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study at a tertiary care hospital in Lebanon, including 15 patients with confirmed HAV infection: 7 individuals were infected with COVID-19 (HAV–COVID coinfection group) and 8 with HAV alone (HAV-only group). Clinical characteristics, liver function tests, inflammatory markers, and recovery trends were assessed at admission (Day 1) and follow-up (Day 10) and remote follow-up extended up to 30 days. Group comparisons were made using Mann–Whitney U tests with effect sizes reported as rank-biserial correlations.</div></div><div><h3>Results</h3><div>All patients experienced a mild disease course without hepatic complications or ICU admissions. CRP levels were significantly higher in the HAV–COVID group at both time points (Day 1 <em>p</em> = 0.04; Day 10 <em>p</em> < 0.001), but no statistically significant differences were seen in liver enzymes or recovery rates between the groups.</div></div><div><h3>Conclusion</h3><div>HAV–COVID-19 coinfection in otherwise healthy individuals does not appear to worsen liver injury or delay recovery compared to HAV alone. However, given isolated reports of fulminant hepatitis, clinicians should continue to screen for coinfection in patients presenting with liver injury during with COVID-19, especially in HAV-endemic regions. Larger studies are needed to confirm these findings and explore potential risk modifiers.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02453"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fulminant septic shock from clinically occult deep soft tissue infection in chronic lymphedema: A clinicopathological correlation 慢性淋巴水肿患者临床隐匿性深部软组织感染引起的暴发性感染性休克：临床病理相关性

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-04-18 DOI: 10.1016/j.idcr.2026.e02578

Nimasha Ekanayaka , Ranjan Premaratna

{"title":"Fulminant septic shock from clinically occult deep soft tissue infection in chronic lymphedema: A clinicopathological correlation","authors":"Nimasha Ekanayaka , Ranjan Premaratna","doi":"10.1016/j.idcr.2026.e02578","DOIUrl":"10.1016/j.idcr.2026.e02578","url":null,"abstract":"<div><div>Chronic lymphedema is a well-recognized risk factor for recurrent cellulitis. However, deep soft tissue infections in lymphedematous limbs may present without classical cutaneous signs, leading to delayed diagnosis and rapid clinical deterioration. We report a 35-year-old woman with chronic filarial lymphedema and prior recurrent cellulitis who presented with a three-day history of fever, myalgia, and arthralgia without localizing symptoms. Initial examination revealed no evidence of cellulitis. She rapidly developed severe neutropenia, thrombocytopenia, acute kidney injury, severe metabolic acidosis, followed by refractory shock and acute hypoxic respiratory failure. Despite early broad-spectrum antibiotics, vasopressor support, and intensive care management, she deteriorated and died within 24 h of admission. Blood cultures remained negative. Post-mortem examination demonstrated multiorgan failure consistent with septic shock and revealed deep subcutaneous cellulitis without superficial skin inflammation.This case highlights that chronic lymphedema may predispose to clinically occult deep soft tissue infection, which can progress rapidly to fulminant septic shock in the absence of overt cutaneous findings. A high index of suspicion is essential in patients with systemic inflammatory features, and early empiric antimicrobial therapy should be considered even when classical signs of cellulitis are absent.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"44 ","pages":"Article e02578"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147747231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mitral valve replacement for isolated mitral valve endocarditis: A survival case of Austrian syndrome 二尖瓣置换术治疗孤立性二尖瓣心内膜炎：一例奥氏综合征存活病例

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-03-23 DOI: 10.1016/j.idcr.2026.e02554

Syeda Maryana Mufarrih , Syed Hamza Mufarrih , Mohammed Kazimuddin

{"title":"Mitral valve replacement for isolated mitral valve endocarditis: A survival case of Austrian syndrome","authors":"Syeda Maryana Mufarrih , Syed Hamza Mufarrih , Mohammed Kazimuddin","doi":"10.1016/j.idcr.2026.e02554","DOIUrl":"10.1016/j.idcr.2026.e02554","url":null,"abstract":"<div><div>Austrian syndrome, characterized by the triad of pneumonia, meningitis, and endocarditis due to Streptococcus pneumoniae, is a rare but life-threatening entity. It typically involves the aortic valve, while isolated mitral valve involvement is exceedingly uncommon. We describe a 59-year-old male with type 1 diabetes mellitus and a dual-chamber pacemaker who presented with nausea, vomiting, fever, chills, and altered mentationproductive coug. Laboratory and cerebrospinal fluid analyses confirmed pneumococcal meningitis and bacteremia. Echocardiography revealed large vegetations with severe mitral regurgitation, valvular perforation, and abscess formation, consistent with Austrian syndrome involving the mitral valve only. The patient underwent urgent bioprosthetic mitral valve replacement followed by pacemaker removal and biventricular device implantation. Post-operatively, he completed a four-week course of intravenous ceftriaxone with complete recovery. This case highlights an unusual presentation of Austrian syndrome with isolated mitral valve destruction rather than the typical aortic involvement. Early surgical intervention combined with prompt microbiological diagnosis and targeted antibiotic therapy were crucial for a favorable outcome. Clinicians should maintain a high index of suspicion for Austrian syndrome in patients presenting with meningitis and pneumonia, even when echocardiographic findings suggest isolated mitral valve disease. Early diagnosis and timely surgical management can be lifesaving.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"44 ","pages":"Article e02554"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147656982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated blastomycosis in pregnancy presenting with arthritis and cutaneous lesions 妊娠期播散性芽孢菌病表现为关节炎和皮肤病变

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-05-01 DOI: 10.1016/j.idcr.2026.e02588

Batool Eldos, Mohammad Al-Magableh

引用次数: 0

Atypical multidermatomal herpes zoster in young immunocompetent adults 年轻免疫正常成人的非典型多皮肤带状疱疹

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-05-05 DOI: 10.1016/j.idcr.2026.e02600

Grant M. Pham , Roger N. Pham

引用次数: 0

Secondary pelvic hydatid cyst of the Douglas pouch causing ureteral obstruction and acute pyelonephritis: A rare case report 道格拉斯袋继发性盆腔包虫病致输尿管梗阻及急性肾盂肾炎1例罕见报告

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IDCases Pub Date : 2026-01-01 Epub Date: 2025-12-27 DOI: 10.1016/j.idcr.2025.e02477

Ghazi Lâamiri , Hazem Alouani , Houda Gazzah , Amine Abdelhedi , Mahdi Bouassida , Hassen Touinsi

{"title":"Secondary pelvic hydatid cyst of the Douglas pouch causing ureteral obstruction and acute pyelonephritis: A rare case report","authors":"Ghazi Lâamiri , Hazem Alouani , Houda Gazzah , Amine Abdelhedi , Mahdi Bouassida , Hassen Touinsi","doi":"10.1016/j.idcr.2025.e02477","DOIUrl":"10.1016/j.idcr.2025.e02477","url":null,"abstract":"<div><h3>Introduction</h3><div>Hydatid disease caused by <em>Echinococcus granulosus primarily affects the liver and lungs. Pelvic localization is rare, and cysts in the Douglas pouch are exceptional. Urinary tract involvement through extrinsic compression leading to hydronephrosis and pyelonephritis is exceedingly uncommon.</em></div></div><div><h3>Case presentation</h3><div>We report a 47-year-old Tunisian male with mental retardation who presented with fever, flank pain, and dysuria. Laboratory workup revealed leukocytosis and positive urine culture for <em>Escherichia coli</em>. Contrast-enhanced CT showed multiple hepatic and peritoneal hydatid cysts, the largest measuring 13 × 11 cm in the liver, and a 12 × 10 cm cyst in the Douglas pouch compressing the right ectopic ureter. This caused marked uretero-pyelo-calyceal dilatation and secondary acute pyelonephritis of the right kidney. The patient was treated with intravenous antibiotics and urinary decompression by double-J stenting, followed by albendazole and elective surgery including excision of the pelvic cyst and partial pericystectomy of hepatic lesions. Postoperative recovery was uneventful, and at 6-month follow-up the patient remained asymptomatic without recurrence</div></div><div><h3>Discussion</h3><div>Hydatid cysts of the Douglas pouch are extremely rare and may mimic other pelvic pathologies. Involvement of the urinary tract by extrinsic compression is exceptional and can present as recurrent urinary infections or acute pyelonephritis. Imaging plays a crucial role in diagnosis, while surgery remains the mainstay of treatment, supported by antiparasitic therapy.</div></div><div><h3>Conclusion</h3><div>Hydatid cysts in the Douglas pouch should be considered in the differential diagnosis of pelvic cystic lesions in endemic regions, particularly when associated with urinary tract obstruction.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02477"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Successful three-year levofloxacin treatment for recurrent non-typhoidal Salmonella bacteremia in a patient with a bioprosthetic valve 成功三年左氧氟沙星治疗复发性非伤寒沙门氏菌菌血症患者与生物假体瓣膜

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IDCases Pub Date : 2026-01-01 Epub Date: 2025-12-22 DOI: 10.1016/j.idcr.2025.e02468

Rie Anazawa, Takayuki Sakurai

{"title":"Successful three-year levofloxacin treatment for recurrent non-typhoidal Salmonella bacteremia in a patient with a bioprosthetic valve","authors":"Rie Anazawa, Takayuki Sakurai","doi":"10.1016/j.idcr.2025.e02468","DOIUrl":"10.1016/j.idcr.2025.e02468","url":null,"abstract":"<div><div>Although uncommon, non-typhoidal <em>Salmonella</em> bacteremia is clinically challenging, especially in patients with prosthetic material. Infective endocarditis can occur as a complication of non-typhoidal <em>Salmonella</em> bacteremia, and management typically involves a six-week course of antibiotics in conjunction with surgery. However, the optimal management for patients with retained prosthetic material in the absence of a clear infectious focus remains uncertain. We report a case of recurrent non-typhoidal <em>Salmonella</em> bacteremia in a patient with a bioprosthetic valve. Imaging studies revealed no identifiable infectious focus. Initial two episodes were treated with ceftriaxone; the third was managed with levofloxacin and rifampin, followed by three years of levofloxacin. The patient was cured without surgery. This case highlights the therapeutic challenges of managing non-typhoidal <em>Salmonella</em> bacteremia in the presence of prosthetic material. In cases where extensive imaging studies reveal no infectious focus, long-term antimicrobial therapy without surgical intervention may be a feasible approach, provided that persistent negativity of blood cultures and clinical stability are achieved. Such cases may also enable clinicians to determine the appropriate timing of discontinuing long-term oral antimicrobial therapy.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02468"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145926298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nevirapine-induced Stevens–Johnson Syndrome in an HIV-exposed neonate: A case report 奈韦拉平诱导的史蒂文斯-约翰逊综合征在艾滋病毒暴露的新生儿：一个案例报告。

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-02-12 DOI: 10.1016/j.idcr.2026.e02521

Eimear M. O’Connell , Nthambose Simango , Bryan J. Vonasek , Kelvin Mponda

引用次数: 0

Uncommon intraoral source of generalized tetanus: Case report and review of intensive care strategies 广泛性破伤风的罕见口内来源：病例报告和重症监护策略的回顾。

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IDCases Pub Date : 2026-01-01 Epub Date: 2026-02-19 DOI: 10.1016/j.idcr.2026.e02530

Yehezkiel Edward , Kohar Hari Santoso

{"title":"Uncommon intraoral source of generalized tetanus: Case report and review of intensive care strategies","authors":"Yehezkiel Edward , Kohar Hari Santoso","doi":"10.1016/j.idcr.2026.e02530","DOIUrl":"10.1016/j.idcr.2026.e02530","url":null,"abstract":"<div><h3>Introduction</h3><div>Tetanus is an acute disease caused by the tetanospasmin toxin produced by <em>Clostridium tetani</em>, with a high mortality particularly in developing countries. Although preventable through primary immunization and booster vaccination, cases in adults with uncertain immunization status remain common. Intraoral wounds are uncommonly reported as portals of entry.</div></div><div><h3>Case presentation</h3><div>A 54-year-old male developed generalized tetanus after manipulating a tooth with a toothpick, causing bleeding. Initial dental pain and oral numbness progressed to trismus, opisthotonus, and risus sardonicus. He was admitted to the intensive care unit (ICU) of a tertiary referral hospital in Indonesia for 19 days and received spasm control (diazepam, midazolam, rocuronium, magnesium sulfate), bacterial eradication (metronidazole, procaine penicillin), stepwise mechanical ventilation, and both enteral and parenteral nutritional support. Complications included ventilator-associated pneumonia, candiduria, hypokalemia, hypocalcemia, and hypoalbuminemia, all managed through a multidisciplinary approach. At the end of treatment, the patient demonstrated a favorable clinical outcome despite a complex disease course accompanied by multiple complications.</div></div><div><h3>Conclusion</h3><div>Despite a prolonged and complex clinical course, the patient favorable outcome. This case highlights that intraoral wounds, though uncommon, may serve as clinically relevant source of tetanus infection due to the anaerobic and necrotic environment that facilitates <em>Clostridium tetani</em> spore germination.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02530"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0