IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2024.e02122

Carlos Mejia Irias , Odalis Cerrato , Estephany Díaz Mairena

{"title":"Tuberculous pericarditis in a 71-year-old immunocompetent patient: Case report","authors":"Carlos Mejia Irias , Odalis Cerrato , Estephany Díaz Mairena","doi":"10.1016/j.idcr.2024.e02122","DOIUrl":"10.1016/j.idcr.2024.e02122","url":null,"abstract":"<div><div>Tuberculosis is a transmissible disease caused by the bacterium <em>Mycobacterium tuberculosis</em>. It is the leading cause of mortality due to infectious diseases. Tuberculous pericarditis is one of the manifestations of extrapulmonary tuberculosis and represents the primary cause of pericardial effusion in developing countries. We present the case of a 71-year-old male patient with a history of 1 month of dyspnea, accompanied by paroxysmal nocturnal dyspnea and unintentional weight loss. An echocardiogram revealed the presence of severe pericardial effusion, for which pericardiocentesis was performed, and the pericardial fluid was analyzed using the Xpert MTB/RIF test, which confirmed the presence of <em>Mycobacterium tuberculosis</em> without resistance to Rifampicin. This is a case of Tuberculous Pericarditis as the cause of pericardial effusion, in which the etiological diagnosis was made possible through molecular biological analysis of the pericardial fluid. The importance of disseminating such cases lies in emphasizing that, even in the 21st century, in developing countries like Honduras, it is crucial not to dismiss tuberculosis infection, as it remains the leading cause of pericardial effusion in endemic regions.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02122"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe dual fungal infection after bispecific antibody therapy: A case of invasive aspergillosis and mucormycosis in immunocompromised patient 双特异性抗体治疗后严重双重真菌感染：免疫功能低下患者侵袭性曲霉病和毛霉病1例。

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2024.e02140

Sarah Sakalihasan , Frédéric Lifrange , Mathieu Czajkowski , Veronique Goncette , Bernard Duysinx , Pierre Lovinfosse , Damla Can , Raphael Schils , Marie-Pierre Hayette , Adrien De Voeght

{"title":"Severe dual fungal infection after bispecific antibody therapy: A case of invasive aspergillosis and mucormycosis in immunocompromised patient","authors":"Sarah Sakalihasan , Frédéric Lifrange , Mathieu Czajkowski , Veronique Goncette , Bernard Duysinx , Pierre Lovinfosse , Damla Can , Raphael Schils , Marie-Pierre Hayette , Adrien De Voeght","doi":"10.1016/j.idcr.2024.e02140","DOIUrl":"10.1016/j.idcr.2024.e02140","url":null,"abstract":"<div><div>Bispecific antibody is a new treatment for hematological disease, especially for lymphoma, myeloma and acute lymphoblastic leukemia. This class of treatment presents the same kind of side effect as CAR-T cell which are immune-mediated. Nevertheless, infectious complication remains a major concerns with related mortality. Fungal infection are rarely reported in clinical trial but remains a major concern. We report a case of a co-infection of <em>Aspergillus</em> and <em>Mucorales</em> in a patient with diffuse large B-cell lymphoma (DLBCL) following treatment with the bispecific antibody epcoritamab. The patient developed severe cytokine release syndrome (CRS) and subsequent fungal infections, which were challenging to diagnose and treat due to the complexities of managing immunocompromised patients and co-infection. Advanced diagnostics, including PET-CT, and a combination of antifungal therapies were crucial in achieving remission. The case underscores the need for early diagnosis, multidisciplinary management, and innovative treatment strategies in similar high-risk patients.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02140"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Aspergillus fumigatus pericarditis: A rare case in a lupus patient

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02151

Yousra Sbibih , Abderrazak Saddari , Said Ezrari , Elmostapha Benaissa , Yassine Ben Lahlou , Aziza Hami , Mostafa Elouennass , Adil Maleb

{"title":"Aspergillus fumigatus pericarditis: A rare case in a lupus patient","authors":"Yousra Sbibih , Abderrazak Saddari , Said Ezrari , Elmostapha Benaissa , Yassine Ben Lahlou , Aziza Hami , Mostafa Elouennass , Adil Maleb","doi":"10.1016/j.idcr.2025.e02151","DOIUrl":"10.1016/j.idcr.2025.e02151","url":null,"abstract":"<div><div>Pericardial aspergillosis is a rare but potentially fatal opportunistic infection primarily affecting immunocompromised patients. Diagnosis is challenging due to nonspecific clinical manifestations and difficulties in obtaining definitive microbiological confirmation. Risk factors include immunosuppressive therapies, hematologic malignancies, and solid organ transplantation. While pulmonary involvement is most common, cardiac manifestations such as pericarditis are infrequent and often diagnosed post-mortem. We report a case of <em>Aspergillus fumigatus</em> pericarditis in a 45-year-old female with systemic lupus erythematosus on corticosteroids, presenting with dyspnea, hypotension, and pancytopenia. Diagnostic work-up revealed a large pericardial effusion with subsequent identification of <em>Aspergillus fumigatus</em> in pericardial fluid cultures despite initial negative results. Prompt initiation of empirical antifungal therapy led to clinical improvement, underscoring the importance of early recognition and aggressive management in similar cases. This case highlights the complexities of managing fungal pericarditis and underscores the need for heightened clinical suspicion and tailored therapeutic approaches in immunocompromised patients.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02151"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11787701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Emphysematous osteomyelitis: A rare case report

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02168

Siddartha Guru , Navami Guru , Rezhan Hussein

引用次数: 0

Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02157

Ali Ajmal , Camelia Chirculescu , Tariq Alyamani , Gregory J. Hiett , Dhan Bahadur Shrestha

{"title":"Severe symptomatic hypocalcemia due to Cyclospora cayetanensis infestation: A rare case","authors":"Ali Ajmal , Camelia Chirculescu , Tariq Alyamani , Gregory J. Hiett , Dhan Bahadur Shrestha","doi":"10.1016/j.idcr.2025.e02157","DOIUrl":"10.1016/j.idcr.2025.e02157","url":null,"abstract":"<div><h3>Introduction</h3><div>Severe hypocalcemia can affect multiple systems, causing a wide variety of symptoms ranging from muscle weakness to twitching. In severe cases, it can lead to heart rhythm disturbances and seizures. A rare cause of hypocalcemia is due to malabsorption associated with prolonged gastroenteritis.</div></div><div><h3>Case presentation</h3><div>We present a 35-year-old female with persistent watery diarrhea of eight weeks presented with neuromuscular symptoms. Trousseau sign and Chvostek sign were positive bilaterally. Laboratory test results revealed severe hypokalemia, hypocalcemia, and anemia, with prolonged QT interval in electrocardiogram (EKG). Her stool polymerase chain reaction (PCR) revealed <em>Cyclospora cayetanensis</em>. Her electrolytes were appropriately replaced during her hospital stay. The patient was successfully treated with trimethoprim-sulfamethoxazole, calcium, and oral iron supplementation.</div></div><div><h3>Conclusion</h3><div>This case demonstrates a unique presentation of a healthy young female with symptomatic hypocalcemia resulting from malabsorption due to <em>Cycolospora cayetanensis</em>. This case emphasizes the importance of early diagnosis using newer techniques, such as polymerase chain reaction (PCR) for parasite DNA, which can result in appropriate diagnosis and timely treatment.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02157"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02164

Hira Khalid Kareem , Muhammad Fawad Ashraf , Muhammad Shehryar , Hafsa Fayyaz , Shreyas Patil

{"title":"When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies","authors":"Hira Khalid Kareem , Muhammad Fawad Ashraf , Muhammad Shehryar , Hafsa Fayyaz , Shreyas Patil","doi":"10.1016/j.idcr.2025.e02164","DOIUrl":"10.1016/j.idcr.2025.e02164","url":null,"abstract":"<div><div>Statins are commonly prescribed to reduce cardiovascular risk, but statin-induced myopathy is a leading cause for therapy discontinuation. This case report discusses a 69-year-old female with multiple comorbidities, including smoldering multiple myeloma, who presented with myalgias and a vesicular rash initially suspected to be herpes zoster due to her immunocompromised status. Elevated creatine kinase (CK) levels were noted (>9000 U/L) while the patient was on high-dose atorvastatin. Despite initial suspicions of herpes zoster, the rash’s atypical progression led to further evaluation, revealing a more complex picture. The patient had a significant history of drug allergies, complicating the diagnosis, particularly following recent clindamycin treatment for a dental issue. After discontinuing atorvastatin and clindamycin, her CK levels improved, and subsequent testing confirmed the presence of anti-HMG-CoA reductase antibodies, establishing a diagnosis of statin-induced autoimmune necrotizing myopathy. This case underscores the importance of detailed patient histories and the need to consider drug-induced hypersensitivity reactions in immunocompromised individuals. The resolution of symptoms after stopping the offending medications emphasizes the critical role of careful monitoring and diagnosis in managing patients with complex medical backgrounds.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02164"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Varicella zoster virus triggering Henoch–Schonlein Purpura in an adult: A case report

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02174

Kevin Chung , Natasha Priya Dyal , Sandhya Nagarakanti

{"title":"Varicella zoster virus triggering Henoch–Schonlein Purpura in an adult: A case report","authors":"Kevin Chung , Natasha Priya Dyal , Sandhya Nagarakanti","doi":"10.1016/j.idcr.2025.e02174","DOIUrl":"10.1016/j.idcr.2025.e02174","url":null,"abstract":"<div><div>This case reports highlights a 37-year-old woman who was transferred to Mayo Clinic Arizona for care after development of seizures, altered mental status, and a diffuse petechial rash, along with vesicular lesions near the groin. She received broad-spectrum antimicrobial therapy. CSF testing showed lymphocytic pleocytosis and elevated protein levels, and PCR testing confirmed varicella zoster virus (VZV) infection. MRI of the brain demonstrated chronic microhemorrhages, indicative of vasculitis secondary to disseminated VZV. Dermatology consultation and subsequent biopsy of the skin lesions revealed leukocytoclastic vasculitis with IgA deposition, consistent with Henoch-Schonlein Purpura (HSP). A VZV-positive PCR from the rash further corroborated the diagnosis. This case highlights the first reported instance of VZV induced HSP in an adult. Although this patient had no complications from HSP, early recognition and targeted treatment are necessary in some cases to prevent severe conditions. This case underscores the importance of maintaining a broad differential diagnosis and the importance of biopsy lesions for prompt recognition of uncommon conditions in high-risk patients.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02174"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe invasive streptococcal infection in a patient with COVID-19: A case report

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02169

Yuki Matsuura , Mone Murashita , Takayoshi Oyasu , Akira Kodate , Yoshihiro Sadamoto , Akio Endo , Hisako Sageshima , Takumi Tsuchida

{"title":"Severe invasive streptococcal infection in a patient with COVID-19: A case report","authors":"Yuki Matsuura , Mone Murashita , Takayoshi Oyasu , Akira Kodate , Yoshihiro Sadamoto , Akio Endo , Hisako Sageshima , Takumi Tsuchida","doi":"10.1016/j.idcr.2025.e02169","DOIUrl":"10.1016/j.idcr.2025.e02169","url":null,"abstract":"<div><div>A 63-year-old male with a history of hypertension had contracted Coronavirus Disease-2019 (COVID-19) five days before visiting our hospital and was recovering at home. He was brought to the hospital for emergency care because of bilateral leg pain, diarrhea, and shortness of breath. On arrival to the hospital, the patient was already suffering from multiple organ failure and was admitted to the intensive care unit. <em>Streptococcus dysgalactiae</em> subsp<em>. equisimilis</em> (SDSE) was detected in blood and sputum cultures, and we started antimicrobial therapy for septic shock/streptococcal toxic shock syndrome. However, multiple organ failure progressed, and the patient died one day after admission. This case suggests the possibility of immunosuppression due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The patient had no history of immunodeficiency, and COVID-19 may have contributed to the poor outcome. COVID-19 combined with SDSE sepsis has not been previously reported. Therefore, this case was considered rare.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02169"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Speckled-egg staining appearance of cryptococcal osteomyelitis in an immunocompetent patient

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02171

Matthew Alexander Stack , John-Paul Lavik , Jack G. Schneider , Brynne E. Cross

{"title":"Speckled-egg staining appearance of cryptococcal osteomyelitis in an immunocompetent patient","authors":"Matthew Alexander Stack , John-Paul Lavik , Jack G. Schneider , Brynne E. Cross","doi":"10.1016/j.idcr.2025.e02171","DOIUrl":"10.1016/j.idcr.2025.e02171","url":null,"abstract":"<div><h3>Introduction</h3><div>Cryptococcal infections are typically thought of as occurring in immunocompromised patients, such as patients with HIV/AIDS, solid organ transplant recipients, or patients with rheumatologic diseases that require immunomodulatory therapy. Moreover, <em>Cryptococcus</em> spp. classically appear as variably-sized yeasts with narrow-based budding surrounded by a thick polysaccharide capsule. However, cryptococcal infections are being increasingly reported in atypical hosts, at times with non-characteristic histochemical staining appearances. Herein, we report a case of cryptococcal osteomyelitis in an otherwise immunocompetent individual that had a “speckled-egg” staining appearance on direct-smear Gram stain.</div></div><div><h3>Case</h3><div>The patient is an otherwise healthy 89-year-old male with a past medical history notable only for hypertension who presented with progressive left-sided neck pain that became worse despite lidocaine trigger point injections; imaging was obtained and revealed a C1-C2 prevertebral abscess, C2-C4 osteomyelitis, and a small C2-C4 abscess. An aspiration biopsy from one of the cervical abscesses grew <em>Cryptococcus neoformans.</em> Despite prompt initiation of liposomal amphotericin B as soon as the organism was suspected, the patient’s mentation declined with associated progression of weakness in his upper and lower extremities. The patient was ultimately transitioned to comfort care.</div></div><div><h3>Conclusions</h3><div>Unconventional presentations of cryptococcal disease are becoming increasingly recognized in seemingly immunocompetent patients. Our case was unique given that it occurred in a patient who appeared to be immunocompetent and the Gram stain showed a speckled-egg staining pattern that alone was not distinctive for cryptococcal yeasts. Despite the patient’s lack of any classic comorbidities associated with invasive cryptococcal disease, his advanced age was likely a risk factor.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02171"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Therapeutic role of fluconazole in immunocompetent patients with pulmonary cryptococcosis: A case report

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02188

Huimin Yu , Shuang Hua , Qifei Sha , Tang Tang , Yuzhu Cao

引用次数: 0

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