IDCases最新文献

{"title":"Extraintestinal enterobiasis presenting as a cervical mass in an immunocompromised adult after colorectal cancer surgery: A case report","authors":"Jacek Sokołowski ,&nbsp;Władysław Rozwadowski ,&nbsp;Małgorzata Kołos ,&nbsp;Eliza Brożek-Mądry","doi":"10.1016/j.idcr.2026.e02604","DOIUrl":"10.1016/j.idcr.2026.e02604","url":null,"abstract":"<div><div>Enterobius vermicularis is a common intestinal helminth, whereas extraintestinal disease is rare and may present as a tumor-like lesion. We report a 50-year-old man with common variable immunodeficiency (CVID) and prior right hemicolectomy with adjuvant chemotherapy for cecal adenocarcinoma (pT3N1bM0) who developed a slowly enlarging left-sided cervical mass during oncologic follow-up. The lesion was painless and showed no overlying skin changes. Neck ultrasonography demonstrated a hypoechoic, round mass over the sternothyroid muscle with an elongated hyperechoic compartment and no Doppler flow. Surgical excision was performed; macroscopy suggested a lymph node. Histopathology excluded malignancy and unexpectedly revealed adult Enterobius vermicularis containing eggs embedded within inflammatory stroma. C-reactive protein was mildly elevated without leukocytosis or eosinophilia. Stool examination was negative. Whole-body MRI revealed no other extraintestinal foci. Albendazole was administered in two doses separated by two weeks with clinical resolution; the patient remains under outpatient surveillance. This case highlights that ectopic enterobiasis can mimic cervical lymphadenopathy and metastatic disease, particularly in immunocompromised patients, and that histopathology is critical for diagnosis and management.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"44 ","pages":"Article e02604"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158454","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}

{"title":"Fournier’s gangrene caused by Pediococcus damnosus – A case report and review of the literature","authors":"Osamu Okamoto ,&nbsp;Kayo Yokoyama ,&nbsp;Teruko Suematsu ,&nbsp;Kosuke Akishino ,&nbsp;Sekinori Munemoto ,&nbsp;Yoshitaka Kai","doi":"10.1016/j.idcr.2026.e02496","DOIUrl":"10.1016/j.idcr.2026.e02496","url":null,"abstract":"<div><div>The anaerobic bacterium <em>Pediococcus damnosus</em> is known to be associated with beer or wine spoilage in breweries, and human infection with <em>Pediococcus damnosus</em> has never been reported. A man with severe diabetes mellitus and diabetic nephropathy consulted our clinic because of painful swelling of the scrotal skin and a fever. The patient was diagnosed with Fournier’s gangrene, and <em>Pediococcus damnosus</em> was exclusively isolated from the exudate. Finally, one of the testes became necrotic and was excised. This is the first case of human infection by <em>Pediococcus damnosus</em> and primary skin infection due to <em>Pediococcus</em> species.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02496"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037655","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}

{"title":"Purpura Fulminans Mimicking NSTI: A Limb-saving case of Haemophilus influenzae Infection","authors":"Ryo Watanabe,&nbsp;Akira Kono,&nbsp;Chihiro Narita,&nbsp;Akihiro Miyake,&nbsp;Naoki Tosaka","doi":"10.1016/j.idcr.2026.e02633","DOIUrl":"10.1016/j.idcr.2026.e02633","url":null,"abstract":"<div><h3>Background</h3><div>Purpura fulminans is a life-threatening thrombotic disorder characterized by disseminated intravascular coagulation and hemorrhagic skin necrosis. Severe cases may be complicated by septic cardiomyopathy requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for circulatory support. The clinical presentation of purpura fulminans closely resembles that of necrotizing soft tissue infections (NSTI), which makes differentiation challenging. Accurate differentiation is crucial for limb preservation strategies.</div></div><div><h3>Case Presentation</h3><div>A 52-year-old man with a history of hypertension presented with hypothermia, widespread purpura, and severe bilateral leg pain. Suspecting NSTI, exploratory incisions were performed, revealing asymmetric tissue findings. Despite maximal vasopressor support, he remained hemodynamically unstable and required VA-ECMO. During ECMO management, the patient developed compartment syndrome requiring fasciotomy. Blood and wound cultures grew <em>Haemophilus influenzae</em>. With multidisciplinary management, including prone positioning and fluid removal with continuous renal replacement therapy (CRRT), ECMO was successfully weaned on day 3. Although persistent infection and rhabdomyolysis-induced acute kidney injury (AKI) necessitated amputation of the left leg, the right leg was salvaged with skin grafting. The patient was eventually weaned from dialysis and discharged ambulatory with a prosthetic limb after rehabilitation.</div></div><div><h3>Conclusions</h3><div>This case highlights the diagnostic challenge of distinguishing purpura fulminans from NSTI and emphasizes the importance of early ECMO weaning to improve patient outcomes. A multidisciplinary strategy integrating circulatory stabilization, fasciotomy, and careful limb preservation may optimize survival and functional recovery in patients with severe purpura fulminans. Differentiating between purpura fulminans and NSTI is crucial for preventing unnecessary amputations and preserving limb function.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"45 ","pages":"Article e02633"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148183604","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}

{"title":"Hepatic brucelloma with initially negative antibodies: Diagnostic challenges in an endemic region","authors":"Demetrios Kolokythas ,&nbsp;Dimitra Katsani ,&nbsp;Evangelos Zeis ,&nbsp;Ilia Maria Pappa ,&nbsp;Stamatina Terzi ,&nbsp;Dimitra Tsili ,&nbsp;Pantelis Vassiliu","doi":"10.1016/j.idcr.2026.e02627","DOIUrl":"10.1016/j.idcr.2026.e02627","url":null,"abstract":"<div><div>Hepatic abscess secondary to <em>Brucella</em> infection is an exceptionally rare clinical entity, accounting for approximately 1.7% of patients with brucellosis. Since its first description in 1904, hepatic abscess is reported as a rare complication of chronic brucellosis with a limited number of cases presented in the literature. Brucellosis itself most often follows an indolent or subclinical course, typically manifesting with low-grade fever, weight loss, malaise, myalgias, and arthralgias. Here, we report the case of a 44-year-old farmer from a rural endemic region who was presented with persistent low-grade fever over a period of approximately 2.5 months, characterized by evening exacerbations, associated with fatigue, sweating, and significant weight loss (15–20 kg). Initial serological testing for <em>Brucella</em> antibodies was negative. Due to ongoing diagnostic uncertainty, the patient underwent extensive evaluation across multiple levels of care, including imaging, abscess aspiration, and comprehensive laboratory testing (including tumor markers, cultures, and PCR), without establishment of a definitive diagnosis. He was treated empirically for presumed intra-abdominal infection but showed no clinical improvement. Following further deterioration, repeat serological testing demonstrated seroconversion. In the context of epidemiological exposure and clinical evolution, a diagnosis of probable brucellar hepatic involvement was made. Targeted therapy was initiated, resulting in clinical improvement. This case highlights the diagnostic challenges of brucellosis with initially negative serology and underscores the importance of repeated testing and sustained clinical suspicion in endemic settings.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"44 ","pages":"Article e02627"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184072","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}

{"title":"MRSA mycotic aneurysm associated with infected pacemaker leads","authors":"Anthony Weinstock ,&nbsp;Tung To ,&nbsp;Hamza Rashid ,&nbsp;Devin Sakamoto ,&nbsp;Luke Hsei ,&nbsp;Kashyap Patel","doi":"10.1016/j.idcr.2026.e02617","DOIUrl":"10.1016/j.idcr.2026.e02617","url":null,"abstract":"<div><div>75-year old woman with persistent methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) bacteremia was found to have a descending thoracic mycotic aneurysm, initially identified on 2-deoxy-2-[F-18]fluoroglucose positron emission tomography (FDG-PET) and further characterized on computed tomographic angiography (CTA). Infection was related to a combination of underlying atherosclerosis and an automatic-implantable cardiac defibrillator (AICD) that required explant due to MRSA infected leads.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"44 ","pages":"Article e02617"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184076","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}

{"title":"Late syphilis presenting with extensive granulomatous cutaneous and pulmonary involvement","authors":"Ilona Shurmelova,&nbsp;Angela Oellinger,&nbsp;Helmut J.F. Salzer,&nbsp;Drolaiz H.W. Liu,&nbsp;Emmanuella Guenova,&nbsp;Wolfram Hoetzenecker","doi":"10.1016/j.idcr.2026.e02638","DOIUrl":"10.1016/j.idcr.2026.e02638","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis is a protean infection capable of mimicking various dermatological and systemic diseases, often complicating diagnosis in its later stages.</div></div><div><h3>Case presentation</h3><div>A 26-year-old HIV-negative man with a history of inadequately monitored syphilis presented with headache, cough, and widespread erythematous plaques with central atrophy. Investigations revealed an RPR titer of 1:128 and positive CSF treponemal serology. Chest CT demonstrated peripheral nodular lung consolidations, and ophthalmologic exam showed signs of prior uveitis. A skin biopsy confirmed late-stage syphilis, revealing extensive dermal tuberculoid granulomas and gummatous necrosis. Following a 14-day course of intravenous penicillin G, the pulmonary lesions completely resolved, cutaneous lesions markedly improved, and the RPR titer appropriately declined at the six-month follow-up.</div></div><div><h3>Conclusion</h3><div>This case illustrates a rare presentation of late syphilis with concurrent pulmonary involvement and widespread granulomatous skin lesions, emphasizing the need for clinicians to maintain a high index of suspicion for atypical manifestations of Treponema pallidum.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"45 ","pages":"Article e02638"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354243","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}

{"title":"Cryptogenic brain abscess: Right-to-left shunt in pulmonary arteriovenous malformation and hepatopulmonary syndrome","authors":"Lu You,&nbsp;Wei-GuanLiu Zhang,&nbsp;Jing Bai,&nbsp;Xiang Yin","doi":"10.1016/j.idcr.2026.e02660","DOIUrl":"10.1016/j.idcr.2026.e02660","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary arteriovenous fistula (PAVF) and hepatopulmonary syndrome (HPS) both cause right-to-left shunting, allowing pathogens to bypass the pulmonary filtration barrier and enter systemic circulation, leading to brain abscess. Despite distinct etiologies, both share the same pathological pathway—right-to-left shunt—resulting in the same devastating neurological complication.</div></div><div><h3>Case presentation</h3><div>Two male patients with cryptogenic brain abscesses caused by PAVM (59 years old) and HPS (52 years old), respectively, are reported. The patient with PAVM presented with fever, dyspnea, and headache, and was diagnosed by contrast-enhanced chest computed tomography. Fusobacterium nucleatum was detected in cerebrospinal fluid (CSF). The patient recovered following anti-infective therapy combined with surgical resection of pulmonary lesions, achieving a favorable prognosis at the 3-month follow-up. The HPS patient had a history of hepatitis C complicated by liver cirrhosis. He presented with headache, fever, and orthostatic hypoxemia. Diagnosis was confirmed by a contrast-enhanced transcranial Doppler bubble test (c-TCD). Blood culture identified Streptococcus intermedius. The brain abscess recurred after antibiotic treatment due to refusal of liver transplantation. At the 3-year follow-up, the patient could maintain only a sedentary lifestyle.</div></div><div><h3>Conclusion</h3><div>Both pulmonary arteriovenous fistula (PAVM) and hepatopulmonary syndrome (HPS) can cause cryptogenic brain abscess through right-to-left shunt. PAVM can be eradicated by intervention or surgery, while HPS fundamentally requires liver transplantation. Notably, Clinical and radiological improvement following antimicrobial therapy may not represent definitive cure if the underlying right-to-left shunt remains untreated, and recurrence remains possible.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"45 ","pages":"Article e02660"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425349","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}

{"title":"A case report of Leptospirosis with positive cerebrospinal fluid targeted next-generation sequencing","authors":"X.X. Zhu,&nbsp;Y. Zhen,&nbsp;W.B. LI,&nbsp;X.H. Wang,&nbsp;F.L. Huang","doi":"10.1016/j.idcr.2026.e02677","DOIUrl":"10.1016/j.idcr.2026.e02677","url":null,"abstract":"<div><div>Leptospirosis is a global zoonotic disease caused by pathogenic Leptospira species, predominantly Leptospira interrogans. Transmission to humans typically occurs via mucosal or percutaneous exposure to water contaminated by the urine of reservoir hosts, such as rodents and livestock. We report a case of a 67-year-old male admitted with a 2-day history of fever and a 1-day history of altered mental status, complicated by jaundice and hepatorenal failure. A definitive diagnosis of leptospirosis (icterohemorrhagic phenotype) was established by correlating the patient’s clinical manifestations and history of occupational exposure in rice paddies with the detection of Leptospira species via cerebrospinal fluid (CSF) targeted next-generation sequencing (tNGS).After treatment with meropenem, corticosteroids to prevent the Jarisch–Herxheimer reaction, and therapy to protect the liver and reduce jaundice, the patient’s organ function and mental status improved.This case suggests that for febrile patients with epidemiological exposure, neurological symptoms, and multi-organ involvement, early use of CSF tNGS can improve the diagnosis of leptospirosis, providing a critical basis for early and precise treatment.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"45 ","pages":"Article e02677"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498256","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}

{"title":"Suspected early Aspergillus-related allergic airway disease with bacterial co-detection in a child with refractory asthma","authors":"Tung Viet Cao,&nbsp;Thuy Minh Ha,&nbsp;Ly Ha Pham,&nbsp;Khiem Van Nguyen","doi":"10.1016/j.idcr.2026.e02691","DOIUrl":"10.1016/j.idcr.2026.e02691","url":null,"abstract":"<div><div>Allergic bronchopulmonary aspergillosis (ABPA) is under-recognized in children with refractory asthma and may be obscured by concurrent respiratory infections. We describe a 10-year-old girl with poorly controlled asthma admitted with fever, productive cough, and wheezing. Investigations revealed marked peripheral eosinophilia (1.48 × 10⁹/L), markedly elevated total immunoglobulin E (1742 IU/mL), positive bronchoalveolar lavage (BAL) galactomannan, and positive BAL Aspergillus antigen. Multiplex respiratory polymerase chain reaction (PCR) detected Streptococcus pneumoniae, Haemophilus influenzae, and methicillin-resistant <em>Staphylococcus aureus</em>, whereas concurrent bacterial cultures, blood culture, fungal culture, and viral testing were negative. High-resolution chest computed tomography (HRCT) demonstrated diffuse ground-glass opacities and bronchial wall thickening without central bronchiectasis or mucus plugging. <em>A. fumigatus</em>–specific IgE was not available, precluding formal classification under contemporary diagnostic criteria. <em>A. fumigatus</em> IgM and IgG were positive on follow-up serology. After empirical antibacterial therapy with limited durable response, oral itraconazole was initiated with sustained clinical improvement, declining total IgE and eosinophils, and stable hepatic function. This presentation is best characterized as suspected early Aspergillus-related allergic airway disease rather than confirmed ABPA. The case highlights three lessons for infectious diseases clinicians: bacterial co-detection by multiplex PCR may anchor reasoning toward infection and delay recognition of allergic fungal airway disease; lower airway Aspergillus biomarkers are supportive but not diagnostic; and the absence of central bronchiectasis does not exclude early disease. Integrated clinical, immunologic, microbiologic, and radiologic reasoning is essential in pediatric refractory asthma.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"45 ","pages":"Article e02691"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148500861","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}

{"title":"Leclercia adecarboxylata cellulitis in a neutropenic Thai child with acute myeloid leukemia","authors":"Theppharit Thiamprasert,&nbsp;Paranyu Ruangsirinusorn,&nbsp;Yujinda Lektrakul,&nbsp;Chareeya Thanee","doi":"10.1016/j.idcr.2026.e02688","DOIUrl":"10.1016/j.idcr.2026.e02688","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Leclercia adecarboxylata</em> is a rare opportunistic Gram-negative organism that has increasingly been recognized as a pathogen in immunocompromised patients. In pediatric populations, infections are uncommon and rarely reported, particularly in Thailand.</div><div>Case presentation: We report a 3-year-old Thai boy with acute myeloid leukemia in the induction phase who presented with febrile neutropenia and right knee cellulitis following minor trauma. Pus culture grew <em>L. adecarboxylata</em>, which was confirmed by MALDI-TOF mass spectrometry, while blood culture remained negative. Despite profound neutropenia, the infection remained localized without bacteremia. The patient was treated with intravenous ceftazidime and amikacin, followed by oral amoxicillin-clavulanic acid, for a total of 14 days, with complete clinical recovery.</div></div><div><h3>Conclusion</h3><div>This case highlights <em>L. adecarboxylata</em> as a potential pathogen in immunocompromised children with skin and soft tissue infections, particularly following environmental exposure. Clinicians should be aware that <em>L. adecarboxylata</em> may cause clinically significant skin and soft tissue infections and, in high-risk patients, has also been associated with invasive infections, including bacteremia.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"45 ","pages":"Article e02688"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148500942","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}