IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02229

Kenji Nakano , Akira Kawashima , Takato Nakamoto , Kazuo Nakamichi , Ryo Kuwata , Seitaro Abe , Eri Inoue , Naokatsu Ando , Haruka Uemura , Daisuke Mizushima , Takahiro Aoki , Katsuji Teruya , Hiroyuki Gatanaga

{"title":"Early diagnosis of progressive multifocal leukoencephalopathy in untreated HIV infection via ultrasensitive PCR testing for JC virus: A case report","authors":"Kenji Nakano , Akira Kawashima , Takato Nakamoto , Kazuo Nakamichi , Ryo Kuwata , Seitaro Abe , Eri Inoue , Naokatsu Ando , Haruka Uemura , Daisuke Mizushima , Takahiro Aoki , Katsuji Teruya , Hiroyuki Gatanaga","doi":"10.1016/j.idcr.2025.e02229","DOIUrl":"10.1016/j.idcr.2025.e02229","url":null,"abstract":"<div><div>Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating disease triggered by the reactivation of JC virus (JCV) in individuals with immunodeficiency, particularly those with untreated human immunodeficiency virus (HIV) infection. This case report describes a 46-year-old HIV-positive man who initially presented with neurological symptoms and was incorrectly diagnosed as cerebral infarction. Although standard real-time polymerase chain reaction (PCR) testing for JCV in cerebrospinal fluid (CSF) at a commercial laboratory was negative, neuroimaging and clinical suspicion prompted ultrasensitive PCR testing at a national laboratory. This test detected a low viral load of JCV (28 copies/mL), confirming the diagnosis of PML. The patient underwent treatment with antiretroviral therapy and corticosteroids to prevent immune reconstitution inflammatory syndrome; however, his neurological symptoms persisted. This case highlights the importance of ultrasensitive CSF JCV testing for early PML diagnosis when standard PCR tests are inconclusive, particularly in HIV patients with atypically low JCV levels. It also highlights the diagnostic challenges of PML and emphasizes the clinical value of advanced PCR techniques for timely and accurate diagnosis in similar cases.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02229"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843717","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

Skull bone lytic lesions: A rare form of multifocal skeletal tuberculosis 颅骨溶解性病变：一种罕见的多灶性骨结核

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02228

Nazmun Naher, Chowdhury Adnan Sami, Md Mizanur Rahman Khan, Shohael Mahmud Arafat, Abed Hussain Khan

{"title":"Skull bone lytic lesions: A rare form of multifocal skeletal tuberculosis","authors":"Nazmun Naher, Chowdhury Adnan Sami, Md Mizanur Rahman Khan, Shohael Mahmud Arafat, Abed Hussain Khan","doi":"10.1016/j.idcr.2025.e02228","DOIUrl":"10.1016/j.idcr.2025.e02228","url":null,"abstract":"<div><div>Tuberculosis (TB) is a complex disease that can mimic numerous diseases involving different organ systems, making diagnosing TB challenging. Multifocal tubercular osteomyelitis is a rare form of skeletal TB that represents only a minority of all skeletal TB cases. Our patient, a 24-year-old immunocompetent male, complained of a low-grade fever that rises in the evening, scalp aches, right-sided chest pain, and non-inflammatory back pain with rest pain for six months. He had lost six kilograms over this period of illness. He was anemic, with mildly tender swelling in the right parietal region of the scalp. Diffuse tenderness was present over the dorsal spine and right side of the chest, with no evidence of gibbus. Multifocal skeletal tuberculosis was diagnosed based on the presence of lytic lesions in the skull, ribs, and vertebrae, along with high erythrocyte sedimentation rate and high tracer uptake on a bone scan, with a biopsy report showing a granulomatous lesion from the vertebra. After six months of anti-TB therapy, during a scheduled follow-up visit, the patient showed significant improvement in pain and general well-being, with an improvement of the skull lytic lesion on the x-ray. Multifocal tubercular osteomyelitis is rare in immunocompetent males without pulmonary involvement. Early recognition and subsequent treatment could prevent severe complications from bone destruction in these cases.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02228"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839059","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

Tropheryma whipplei infection presenting as indolent endophthalmitis 乳头状瘤感染表现为眼内炎

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02178

Rami Waked , Jeffrey K. Moore , Brandon Winward , Sophia Ham , Howard W. Hoyt , Leyla Azis

{"title":"Tropheryma whipplei infection presenting as indolent endophthalmitis","authors":"Rami Waked , Jeffrey K. Moore , Brandon Winward , Sophia Ham , Howard W. Hoyt , Leyla Azis","doi":"10.1016/j.idcr.2025.e02178","DOIUrl":"10.1016/j.idcr.2025.e02178","url":null,"abstract":"<div><div><em>Tropheryma whipplei</em> (<em>T. whipplei</em>) infection can be difficult to diagnose due to its variable clinical manifestations and the limitations of standard diagnostic tests. This case describes a 78-year-old male with blurry vision and floaters in his right eye five months after cataract surgery, along with new onset weight loss and arthralgias. Ophthalmologic examination revealed inflammation and posterior vitritis, and vitreous biopsy identified <em>T. whipplei</em> via broad-range bacterial PCR, despite negative vitreous cultures and unremarkable flow cytometry. Gastrointestinal endoscopic and cerebrospinal fluid studies revealed no pathological or molecular evidence of the disease, complicating the diagnosis. Treatment with intravenous ceftriaxone followed by oral trimethoprim-sulfamethoxazole for 12 months resulted in resolution of symptoms and inflammation, with normalization of laboratory markers. This case underscores the diagnostic utility of broad-range bacterial PCR in atypical infections and highlights Whipple infection as a differential diagnosis in ocular presentations. Comprehensive interdisciplinary evaluation was critical for effective management.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02178"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143360430","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

Cutaneous anthrax rapidly progressed into septic anthrax resulting in death – A case report 皮肤炭疽迅速发展为脓毒性炭疽导致死亡1例报告

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02216

Yufei Lyu , Shiyuan Li , Dongshu Wang , Meijie Feng , Wenjun Li , Xiankai Liu , Jia Zhou , Li Nie , Chao Pan , Shujuan Yu , Yan Guo , Hua Shao

引用次数: 0

Black tongue caused by linezolid in children: One case report and literature review 利奈唑胺致儿童黑舌1例报告并文献复习

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02181

Chunyu Zhang , Hongxia Shen , Jing Zhang , Lujie Xu , Meixing Yan , Chang Liu

引用次数: 0

Isolated tuberculoma involving multiple paranasal sinuses with aggressive features in an immunocompetent individual masquerading as a malignant neoplasm: A rarity unveiled with review of literature 孤立性结核瘤累及多个副鼻窦，具有侵袭性特征，免疫功能正常的个体伪装成恶性肿瘤：罕见的发现与文献回顾

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02179

Shaivy Malik , Rajat , Charanjeet Ahluwalia

{"title":"Isolated tuberculoma involving multiple paranasal sinuses with aggressive features in an immunocompetent individual masquerading as a malignant neoplasm: A rarity unveiled with review of literature","authors":"Shaivy Malik , Rajat , Charanjeet Ahluwalia","doi":"10.1016/j.idcr.2025.e02179","DOIUrl":"10.1016/j.idcr.2025.e02179","url":null,"abstract":"<div><div>Isolated primary tuberculoma of the paranasal sinuses is an exceedingly rare form of extra-pulmonary tuberculosis (EPTB), particularly in immunocompetent individuals. Its presentation is often atypical, mimicking aggressive neoplasms due to features such as local bone destruction, which complicates diagnosis and may lead to unnecessary invasive interventions. We report the case of a 32-year-old immunocompetent male presenting with chronic right nasal obstruction, rhinorrhoea, facial puffiness, hyposmia, and intermittent fever. Imaging revealed a heterogeneous mass in the right frontal, ethmoidal, and maxillary sinuses, with extensive bony erosion suggestive of a malignant etiology. Histopathological examination of biopsy tissue, however, demonstrated granulomatous inflammation with Langhans giant cells, necrosis, and acid-fast bacilli on Ziehl-Neelsen staining, confirming tuberculoma. Anti-tubercular treatment (ATT) was promptly initiated post-biopsy, leading to complete symptom resolution and no recurrence. This case sheds light on the importance of including tuberculoma in the differential diagnosis of aggressive sinonasal lesions in immunocompetent patients despite their rarity, and highlights the critical role of histopathology and ATT in effective management, potentially preventing extensive surgical resections and associated morbidity.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02179"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386996","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

Necrotic erythema nodosum leprosum – A case of severe lepromatous reaction in a multibacillary leprosy patient 麻风结节性坏死性红斑-一例多菌性麻风患者的严重麻风反应。

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02152

Hrithik Dakssesh Putta Nagarajan , Balakrishnan Kamaraj , Keerthivasan Selvanathan , Shubham Kumar , Shilpa Gaidhane , Sanjit Sah , Prakasini Satapathy , Rachana Mehta , Rodrigue Ndabashinze , Amogh Verma

引用次数: 0

Elizabethkingia meningoseptica: Case report on an emerging pathogen and its associated treatment challenges 伊莉莎白脑膜炎败血症：一种新出现的病原体及其相关治疗挑战的病例报告

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02248

Fabrizio Tropea , David Fraulino , Jeffrey Aeschlimann , P. Rocco LaSala , Sonia Magano

{"title":"Elizabethkingia meningoseptica: Case report on an emerging pathogen and its associated treatment challenges","authors":"Fabrizio Tropea , David Fraulino , Jeffrey Aeschlimann , P. Rocco LaSala , Sonia Magano","doi":"10.1016/j.idcr.2025.e02248","DOIUrl":"10.1016/j.idcr.2025.e02248","url":null,"abstract":"<div><div><em>Elizabethkingia meningoseptica</em> is a Gram-negative bacillus that was previously thought to rarely infect humans but recently has been identified as an emerging pathogen in both community and nosocomial settings. Typically found in the environment, this organism has been shown to infect predisposed hosts with an immunocompromised status and/or a prolonged exposure to healthcare settings. Herein, we report a case of a 78-year-old male with newly diagnosed myelodysplastic syndrome initially admitted to the hospital with pneumonia and then re-admitted after discharge with septic shock and evidence of <em>E. meningoseptica</em> bacteremia isolated from blood cultures. Treatment with piperacillin-tazobactam was initiated and later escalated to dual-therapy with the addition of levofloxacin. After hemodynamic stability was achieved, the patient was discharged on oral levofloxacin to complete a 21-day course of therapy. <em>E. meningoseptica</em> displays a unique multi-drug resistant profile that often makes initial antimicrobial selection challenging. This case illustrates the importance of early detection and use of in vitro susceptibility testing to guide therapeutic decision-making in <em>E. meningoseptica</em> infections; a pathogen known to have both high morbidity and mortality particularly in the immunocompromised.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02248"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143935043","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

A case report of sofosbuvir induced drug eruption and literature review 索非布韦致药疹1例报告并文献复习

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02249

Anyue Xia , Jinliang Liu , Cuilan Tang , Huan Xu

引用次数: 0

Nodular reverse halo sign in a hemodialysis patient with polycystic kidney disease and pulmonary tuberculosis 多囊肾病合并肺结核的血液透析患者的结节性反晕征

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02246

Guo Li , Shan Yuan , Peng Wang , Min Pang , Xianqiong Pang

引用次数: 0

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