IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02183

Moiz Topiwala , Mahender Kumar Medisetty , Deependra Verma , Sanjay Yadav

{"title":"Unresolved fever in methicillin-sensitive Staphylococcus aureus bacteremia: Insights from a case without an identifiable source","authors":"Moiz Topiwala , Mahender Kumar Medisetty , Deependra Verma , Sanjay Yadav","doi":"10.1016/j.idcr.2025.e02183","DOIUrl":"10.1016/j.idcr.2025.e02183","url":null,"abstract":"<div><h3>Background</h3><div>Methicillin-sensitive <em>Staphylococcus aureus</em> (MSSA) bacteremia is a serious infection that requires timely diagnosis and treatment to prevent complications. Persistent fever after clearing bacteremia is uncommon, especially with normal inflammatory markers and no clear source of infection. This presents a significant diagnostic and management challenge.</div></div><div><h3>Case presentation</h3><div>A 36-year-old man presented with a three-day history of intermittent fever and was diagnosed with MSSA bacteremia. Initial investigations revealed mild splenomegaly. Despite treatment with intravenous flucloxacillin and negative repeat blood cultures, the fever persisted, prompting further evaluation. Advanced imaging did not reveal the source of infection. After completing a 14-day course of flucloxacillin, the fever resolved, and the patient recovered completely.</div></div><div><h3>Conclusion</h3><div>This case highlights the challenges in managing MSSA with persistent fever and no clear source of infection. This emphasizes the importance of adhering to evidence-based therapy and thorough evaluations, even when clinical presentations deviate from the typical course.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02183"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143396275","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 disseminated Talaromyces marneffei infection in idiopathic CD4 lymphopenia 特发性CD4淋巴细胞减少症患者严重弥散性曼尼菲塔芳菌感染。

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02148

Bingkun Li , Tiantian Li , Qian Lu , Dong Liang , Cunwei Cao

引用次数: 0

Perforated colon cancer complicated by necrotizing soft tissue infection: A case report and literature review 结直肠癌穿孔并发软组织坏死感染1例并文献复习

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02167

Xin Xiang , Jian Zheng , Cheng-Wei Ma , Lei Ruan, Jing-Zheng Zhuang, Qing-Chun Li

引用次数: 0

Necrotizing soft tissue infection due to Nocardia brasiliensis in an immunocompetent host 免疫正常宿主中巴西诺卡菌引起的软组织坏死性感染

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02162

Malleswari Ravi , Denis Asiimwe , Virin Ramoutar

引用次数: 0

Atypical progression of Group B Streptococcus infection: Subdural empyema in an adult with diabetes mellitus B群链球菌感染的不典型进展：1例糖尿病成人硬膜下脓肿

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02212

Jo Onaka , Takahiro Fukushima , Akihito Yoshida , Nicole Leedy , Takaaki Kobayashi , Kyoichi Tomoto , Kazuaki Aoki

{"title":"Atypical progression of Group B Streptococcus infection: Subdural empyema in an adult with diabetes mellitus","authors":"Jo Onaka , Takahiro Fukushima , Akihito Yoshida , Nicole Leedy , Takaaki Kobayashi , Kyoichi Tomoto , Kazuaki Aoki","doi":"10.1016/j.idcr.2025.e02212","DOIUrl":"10.1016/j.idcr.2025.e02212","url":null,"abstract":"<div><div><em>Streptococcus agalactiae</em> (Group B Streptococcus, GBS), traditionally associated with neonatal meningitis and urinary tract infections in pregnant women, has emerged as a significant pathogen in non-pregnant adults. A broad spectrum of GBS infections in adults has been reported, including skin and soft tissue infections, bacteremia without a clear source, urinary tract infections, pneumonia, and less commonly, endocarditis, meningitis, or other invasive infections. We report a rare case of subdural empyema following GBS bacteremia in a 74-year-old man with poorly controlled type 2 diabetes mellitus. The patient presented to the outpatient clinic with progressive gait instability persisting for five days, preceded by a resolved headache and diarrhea. On examination, he was febrile but exhibited no nuchal rigidity or focal neurological deficits. He was discharged home, but blood cultures subsequently grew <em>S. agalactiae</em>, prompting emergent hospital admission. Initial neuroimaging, including magnetic resonance imaging (MRI) of the brain, was unremarkable. On hospital day 5, the patient developed worsening altered mental status and right upper limb weakness. A lumbar puncture confirmed GBS meningitis and repeat brain MRI revealed a subdural empyema. The patient underwent surgical drainage and received prolonged antibiotic therapy, resulting in significant clinical improvement. This case underscores the importance of maintaining a high index of suspicion for meningitis and subdural empyema in patients with GBS bacteremia who develop new neurological symptoms, even when initial imaging is unremarkable. Early recognition, repeat neuroimaging, and timely intervention are essential for managing invasive GBS infections and improving patient outcomes.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02212"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776990","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

Legionnaires' disease on azithromycin leading to lofty liver levels 军团病对阿奇霉素的影响导致肝脏水平升高

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02221

Sagar Modh , Mark Grijalva , Vignesh Krishnan , Angel Chacko , Shraboni Dey , Paranjyothy Rao Pirangi Sanjeeva , Adam Atoot

{"title":"Legionnaires' disease on azithromycin leading to lofty liver levels","authors":"Sagar Modh , Mark Grijalva , Vignesh Krishnan , Angel Chacko , Shraboni Dey , Paranjyothy Rao Pirangi Sanjeeva , Adam Atoot","doi":"10.1016/j.idcr.2025.e02221","DOIUrl":"10.1016/j.idcr.2025.e02221","url":null,"abstract":"<div><div>Legionnaires' disease is a serious, life-threatening pneumonia caused by the bacterium <em>Legionella pneumophila</em>. <em>Legionella</em> is a gram-negative bacillus transmitted via inhalation of water droplets, usually from air conditioners or hot tubs. Unlike many respiratory pathogens, <em>Legionella</em> does not spread from person to person. This bacterium primarily affects the pulmonary system, causing atypical community-acquired pneumonia often associated with gastrointestinal symptoms such as diarrhea. In rare cases, <em>Legionella</em> can involve the liver, leading to acute hepatitis. Fluoroquinolones and macrolides are the most effective and commonly used antibiotics for treating Legionnaires' disease. However, both antibiotic classes carry a potential risk of hepatotoxicity, which can result in elevated liver enzymes. Additionally, <em>Legionella</em>-induced liver injury may increase susceptibility to DILI. Here, we present a case of Legionnaires' disease treated with azithromycin, complicated by elevated liver enzymes, highlighting the need for careful monitoring of liver function during treatment.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02221"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792782","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

Meningoencephalitis in a background of inherited chromosomic integration of HHV-6 and CMV infection in an immunocompetent adult, which one is the culprit? 在免疫功能正常的成人中，HHV-6和巨细胞病毒感染的遗传染色体整合背景下的脑膜脑炎，哪一个是罪魁祸首？

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02219

Anne-Laure Lajoye , Doina Ciocanu , Gilles Duverlie , Patrick Berquin

{"title":"Meningoencephalitis in a background of inherited chromosomic integration of HHV-6 and CMV infection in an immunocompetent adult, which one is the culprit?","authors":"Anne-Laure Lajoye , Doina Ciocanu , Gilles Duverlie , Patrick Berquin","doi":"10.1016/j.idcr.2025.e02219","DOIUrl":"10.1016/j.idcr.2025.e02219","url":null,"abstract":"<div><div>HHV-6 meningoencephalitis has been reported in immunocompromised individuals but is very uncommon in immunocompetent individuals. However, HHV-6 is the second most frequently detected virus in multiplex PCR tests. As HHV-6 DNA integrates in the telomeric region of host chromosomes after primary infection and can be passed onto offspring, 1 % of the population carries an inherited HHV-6 genome (iciHHV-6). This makes it difficult to interpret a positive multiplex PCR test for HHV-6. Here, we describe a 39-year-old female patient with an unremarkable medical history and who was hospitalized for meningoencephalitis. The brain imaging findings were normal. The positive multiplex PCR test for HHV-6 was confirmed by qualitative and quantitative HHV-6 PCR tests, the viral load was higher in blood than in CSF. The presence of circulating anti-CMV IgM and IgG in a serologic test and the absence of other pathogens argued in favor of a primary CMV infection. However CMV PCR was negative. The chromosomal integration of HHV-6 was subsequently confirmed by the results of a hair bulb analysis. Our primary hypothesis was CMV meningoencephalitis in a context of inherited chromosomic integration of HHV-6 without be able to confirm the possible role of HHV-6 (reactivation or bystander) in this situation. A commercially available assay able to certify HHV-6 replication in a context of iciHHV-6 would have been useful to conclude.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02219"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792795","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

Aural myiasis caused by Lucilia sericata in an asymptomatic patient with dementia 无症状痴呆患者由丝光绿蝇引起的耳蝇病

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02227

Yasunori Maeda , Yusuke Kimura , Junnosuke Abe , Takeomi Ikematsu , Yasuyuki Nomura , Takeshi Oshima

引用次数: 0

Prosthetic joint infection as an unusual presentation of Francisella tularensis causing exposure of laboratory personnel 假体关节感染是引起实验室人员暴露的一种不寻常的土拉菌感染

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02195

Huma Aftab , Aoife Ronayne , Anders El-Galaly , Camilla Foged , Kristian Schønning

{"title":"Prosthetic joint infection as an unusual presentation of Francisella tularensis causing exposure of laboratory personnel","authors":"Huma Aftab , Aoife Ronayne , Anders El-Galaly , Camilla Foged , Kristian Schønning","doi":"10.1016/j.idcr.2025.e02195","DOIUrl":"10.1016/j.idcr.2025.e02195","url":null,"abstract":"<div><h3>Background</h3><div>Infections with <em>Francisella tularensis</em> subsp. <em>tularensis</em> (type A) is highly virulent with mortality up to 30 % in untreated cases. <em>Francisella tularensis</em> subsp. <em>holarctica</em> (type B) is both less infectious and virulent. Physicians/clinicians are often unfamiliar with epidemiological and clinical characteristics of tularaemia. <em>F. tularensis</em> type A has caused laboratory-acquired infections therefore diagnostic laboratories should be notified of samples from patients with suspected tularaemia, but breaches of laboratory safety measures still occur as tularaemia is not always recognised as a potential differential diagnosis.</div></div><div><h3>Case presentation</h3><div>A 70-year-old male with a history of type-2 diabetes and a primary total knee arthroplasty (TKA) 18 years earlier, was hospitalized with pneumonia in July 2024. The respiratory symptoms resolved on piperacillin-tazobactam, however the patient reported chronic pain in his TKA on admission, and these symptoms persisted. In August 2024 the TKA was replaced, and <em>Francisella tularensis</em> was cultured from the periprosthetic tissue samples. Since tularaemia was not suspected, and the microbiological laboratory not alerted, two laboratory scientists were potentially exposed to <em>Francisella</em> bacteria. One of the two medical laboratory scientists received post-exposure antibiotic prophylaxis, neither developed infection.</div></div><div><h3>Conclusion</h3><div>We present the first reported case of periprosthetic joint associated <em>F. tularensis</em> infection in Denmark. Unexpected culture of <em>F. tularensis</em> may be accompanied by pathogen exposure of laboratory personnel that generate concern and anxiety. Most laboratory associated infections are caused by <em>F. tularensis</em> type A, thus guidelines taking subspecies virulence and infectivity into consideration may be relevant, especially in a European context.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02195"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562135","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

SARS-CoV-2 induced abducens nerve palsy: A case report and response to methylprednisolone SARS-CoV-2诱导外展神经麻痹1例及甲泼尼龙治疗效果

IF 1.1

IDCases Pub Date : 2025-01-01 DOI: 10.1016/j.idcr.2025.e02201

João Hugo Abdalla Santos , Ligia Fernandes Abdalla , Cleitiene de Souza Sierpinski , Camila Feldberg Porto , Felipe Gomes Naveca

{"title":"SARS-CoV-2 induced abducens nerve palsy: A case report and response to methylprednisolone","authors":"João Hugo Abdalla Santos , Ligia Fernandes Abdalla , Cleitiene de Souza Sierpinski , Camila Feldberg Porto , Felipe Gomes Naveca","doi":"10.1016/j.idcr.2025.e02201","DOIUrl":"10.1016/j.idcr.2025.e02201","url":null,"abstract":"<div><h3>Introduction</h3><div>The abducens nerve (sixth cranial nerve) is a motor nerve that innervates the lateral rectus muscle, playing a key role in ocular abduction. Palsy of this nerve leads to convergent strabismus and diplopia. Common causes include strokes, trauma, inflammation, and infections, though in some cases, the etiology remains undetermined. With the emergence of COVID-19, neurological manifestations such as cranial neuropathies, including abducens nerve palsy, have been reported.</div></div><div><h3>Case presentation</h3><div>We present a case of a previously healthy 48-year-old male diagnosed with SARS-CoV-2 infection who developed abducens nerve palsy in the left eye. Following the resolution of respiratory symptoms, strabismus persisted. Treatment with methylprednisolone was initiated, resulting in partial recovery within one week and complete resolution after three months.</div></div><div><h3>Conclusion</h3><div>SARS-CoV-2-induced abducens nerve palsy can be reversible with conservative treatment using methylprednisolone. Early recognition and appropriate management are crucial for achieving a favorable prognosis.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02201"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683704","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

IDCases最新文献