{"title":"Gordonia bronchialis chronic tenosynovitis of the right wrist and hand in an immunocompetent patient: A case report","authors":"Donnapa Suparatit , Phadungkiat Khamnoi , Parichat Salee","doi":"10.1016/j.idcr.2026.e02580","DOIUrl":"10.1016/j.idcr.2026.e02580","url":null,"abstract":"<div><div><em>Gordonia bronchialis</em> is a rare aerobic, gram-positive, weakly acid-fast actinomycete that is increasingly recognized as a human pathogen following advances in microbiologic identification. However, it remains frequently misidentified because of phenotypic overlap with <em>Mycobacterium</em> and <em>Nocardia</em> species. Musculoskeletal infections caused by this organism are exceptionally uncommon. We report a 67-year-old immunocompetent male farmer who presented with a one-year history of progressive swelling and functional impairment of the right wrist and hand. Magnetic resonance imaging demonstrated chronic flexor tenosynovitis with extensive rice body formation. The patient underwent open surgical tenosynovectomy. Routine bacterial, fungal, and molecular investigations were negative. Synovial tissue submitted for mycobacterial culture yielded slow-growing colonies after prolonged incubation, which were identified as <em>G. bronchialis</em> using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Prolonged oral antimicrobial therapy with amoxicillin–clavulanate, doxycycline, and ciprofloxacin resulted in marked clinical improvement without recurrence. This case highlights <em>G. bronchialis</em> as a rare cause of chronic tenosynovitis mimicking tuberculous infection and underscores the importance of extended culture incubation and advanced diagnostic techniques in evaluating indolent, culture-negative musculoskeletal infections.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"44 ","pages":"Article e02580"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147747225","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}
IDCasesPub Date : 2026-01-01Epub Date: 2026-09-09DOI: 10.1016/j.idcr.2026.e02751
Srijana Basnet, Luna Bajracharya, Rachana Shrestha, Pradeep Gupta, Prabina Shrestha
{"title":"Missed opportunities and near-miss diagnoses in congenital syphilis: A case series of five infants at a tertiary care centre in Nepal","authors":"Srijana Basnet, Luna Bajracharya, Rachana Shrestha, Pradeep Gupta, Prabina Shrestha","doi":"10.1016/j.idcr.2026.e02751","DOIUrl":"10.1016/j.idcr.2026.e02751","url":null,"abstract":"<div><div>Congenital syphilis remains a preventable but underrecognized condition in Nepal, where routine antenatal screening is limited to the first visit. We report five infants with diverse clinical manifestations, including hydrops fetalis, bullous lesions, bone involvement, and persistent rhinitis. Four were classified as highly probable and one as possible congenital syphilis according to the 2021 CDC criteria. Four mothers had initially negative screening results, highlighting the possibility of infection acquired later in pregnancy. Due to penicillin unavailability, all infants received ceftriaxone despite limited supporting evidence. The cases emphasize the importance of appropriate repeat maternal testing, follow-up and treatment of seropositive mothers, systematic infant evaluation, and reliable access to penicillin.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"46 ","pages":"Article e02751"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149005815","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}
IDCasesPub Date : 2026-01-01Epub Date: 2026-09-29DOI: 10.1016/j.idcr.2026.e02785
Desalegn Kefale Semachew
{"title":"Oropharyngeal leech infestation as an unusual cause of severe anemia and hypovolemic shock in a 2-year-old child: A case report from Ethiopia","authors":"Desalegn Kefale Semachew","doi":"10.1016/j.idcr.2026.e02785","DOIUrl":"10.1016/j.idcr.2026.e02785","url":null,"abstract":"<div><h3>Background</h3><div>Leech infestations can cause significant, often unrecognized, blood loss. This type of infestation occurs most commonly in young children living in rural settings who consume unfiltered water from rivers.</div></div><div><h3>Case presentation</h3><div>A two-year-old female patient presented to a general hospital from a rural area of Ethiopia with a five-day history of epistaxis, blood-stained saliva, fatigue, and poor appetite. On examination, hemoglobin was 3 g/dL. A dark brown, mobile foreign body — subsequently identified as a leech — was found attached to the posterior oropharynx. The patient (weight 11 kg) received 20 mL/kg of intravenous fluids for resuscitation and two sequential 20 mL/kg whole-blood transfusions (cumulative 40 mL/kg) for anemia. Once stabilized, the leech was removed by direct laryngoscopy using McGill forceps. Hemoglobin had risen to 11 g/dL by the sixth hospital day, and the patient was discharged in good condition.</div></div><div><h3>Conclusion</h3><div>Oropharyngeal leech infestation should be considered in the differential diagnosis of sudden-onset epistaxis, blood-stained saliva, and severe anemia in children from rural settings who drink unfiltered river water. Early detection and removal of the leech can be lifesaving.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"46 ","pages":"Article e02785"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149155949","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}
IDCasesPub Date : 2026-01-01Epub Date: 2026-10-10DOI: 10.1016/j.idcr.2026.e02792
Samuel Jesus Borrero Sanchez, Mariana Quintero Carbono, Juan Jose Espitia De La Hoz, Hugo Andrés Macareno Arroyo
{"title":"Bacillus clausii-associated bacteremia following probiotic use: A report of two cases and a review of the literature","authors":"Samuel Jesus Borrero Sanchez, Mariana Quintero Carbono, Juan Jose Espitia De La Hoz, Hugo Andrés Macareno Arroyo","doi":"10.1016/j.idcr.2026.e02792","DOIUrl":"10.1016/j.idcr.2026.e02792","url":null,"abstract":"<div><div><em>Bacillus clausii</em> bacteremia is a rare but clinically significant complication associated with probiotic use in hospitalized patients. We report two cases in which a clear temporal relationship was observed between probiotic administration and subsequent isolation of <em>B. clausii</em> from blood cultures. In both patients, identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), identifying <em>B. clausii</em>, consistent with the microorganism contained in the administered probiotic. Comprehensive clinical evaluation did not identify an alternative source specifically accounting for the isolation of <em>B. clausii</em>. Although <em>B. clausii</em> bacteremia was microbiologically documented in both cases, its contribution to clinical deterioration and death in the second patient could not be established because of severe concomitant infections and other competing conditions. Both patients had significant comorbidities, recent exposure to broad-spectrum antibiotics, and clinical conditions potentially associated with impaired gastrointestinal barrier integrity, factors that may facilitate bacterial translocation and support the biological plausibility of probiotic-associated bacteremia. Although strain-specific evidence suggests that some probiotics, including <em>B. clausii</em>, may reduce antibiotic-associated diarrhea, these potential benefits should be weighed against the risk of invasive infection in vulnerable patients. These cases highlight the importance of individualized risk–benefit assessment when prescribing probiotics in vulnerable hospitalized patients.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"46 ","pages":"Article e02792"},"PeriodicalIF":0.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149212177","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}
IDCasesPub Date : 2026-01-01Epub Date: 2026-01-19DOI: 10.1016/j.idcr.2026.e02497
Seyed Reza Mirbadie , Mohammad Ali Mohaghegh , Fateme Skandary , Eissa Soleymani , Fatemeh Nikbin , Alireza Sazmand
{"title":"Nosocomial oral myiasis caused by Chrysomya bezziana in Iran: A new case and review of human myiasis in the country","authors":"Seyed Reza Mirbadie , Mohammad Ali Mohaghegh , Fateme Skandary , Eissa Soleymani , Fatemeh Nikbin , Alireza Sazmand","doi":"10.1016/j.idcr.2026.e02497","DOIUrl":"10.1016/j.idcr.2026.e02497","url":null,"abstract":"<div><div><em>Chrysomya bezziana</em> can potentially cause myiasis, a condition in which fly larvae infest living tissue in humans and animals. Contributing factors to this rare ailment include poor oral hygiene, alcohol abuse, and infected wounds. Hospital-acquired myiasis, a rare type of myiasis, occurs in patients following hospital admission. Herein, we report a case of <em>C. bezziana</em> oral myiasis in an 89-year-old female patient hospitalized in northeastern Iran. In this article, we also present an updated review of reported human myiasis cases in Iran up to 2025. According to our findings, <em>C. bezziana</em> has been responsible for 13 documented cases of myiasis in Iran. Most nosocomial myiasis cases in the country are related to pharyngeal and nasal infestations and are primarily observed in the ICU patients.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02497"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037660","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}
IDCasesPub Date : 2026-01-01Epub Date: 2026-01-19DOI: 10.1016/j.idcr.2026.e02490
Carta A. Gunawan, Henry P. Mangiri
{"title":"Severe falciparum malaria remains a threat in East Kalimantan: A case report","authors":"Carta A. Gunawan, Henry P. Mangiri","doi":"10.1016/j.idcr.2026.e02490","DOIUrl":"10.1016/j.idcr.2026.e02490","url":null,"abstract":"<div><div>The incidence of malaria has decreased significantly in East Kalimantan Province, a tropical forest area in Indonesia since the last 2 decades. Although malaria cases now are rare in most parts of this province, they do not disappear. Less experience with malaria cases could cause misdiagnosis or late diagnosis of malaria and severe malaria, a life-threatening disease.</div><div>It was reported a severe falciparum malaria in a 31-year-old male patient treated at a hospital in Samarinda, East Kalimantan Province, Indonesia. This patient was admitted to hospital with several complications including acute kidney injury, impaired consciousness, jaundice and liver dysfunction, high parasitemia, and severe thrombocytopenia. This patient was treated with artesunate injection and symptomatic and supportive treatments. Although the prognosis was poor due to many complications, this patient had full recovery. Early diagnosis and prompt and proper treatment play important role in managing severe malaria cases.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02490"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037653","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}
IDCasesPub Date : 2026-01-01DOI: 10.1016/j.idcr.2025.e02487
Afra Mohammed Alkaabi, Aadi Gupta, Maithah Mohammed Alkaabi, Mohammad Ilyas Bader
{"title":"Extensive necrotizing fasciitis in an immunocompetent neonate leading to rectovulvar and rectovaginal fistulae: A case report","authors":"Afra Mohammed Alkaabi, Aadi Gupta, Maithah Mohammed Alkaabi, Mohammad Ilyas Bader","doi":"10.1016/j.idcr.2025.e02487","DOIUrl":"10.1016/j.idcr.2025.e02487","url":null,"abstract":"<div><h3>Background</h3><div>Necrotizing fasciitis (NF) is a rare but life-threatening soft tissue infection in neonates, associated with high morbidity and mortality. Perineal involvement in female neonates is particularly uncommon and may lead to devastating complications.</div></div><div><h3>Case presentation</h3><div>A 5-week-old previously healthy female infant presented with a 10-day history of a generalized rash that later localized to the perianal region and limbs, developing into ulceration. The condition evolved into extensive perineal necrosis complicated by rectovulvar and rectovaginal fistulae. Initial clinical features were suggestive of eczema herpeticum with secondary bacterial infection, and empirical antiviral and broad-spectrum antibiotic therapy was initiated. HSV PCR was not performed, however, HSV-1/2 IgG levels were markedly elevated. Blood and peritoneal swab cultures were negative, while ulcer biopsy and wound swab cultures grew <em>Klebsiella pneumoniae.</em> Despite medical therapy, the infant deteriorated and required urgent surgical intervention. Management included superficial perineal debridement and a diverting sigmoid colostomy. Advanced immunological evaluation, including functional testing and whole-exome and whole-genome sequencing did not identify an underlying immunodeficiency. The perineal wounds healed with fecal diversion and local wound care, and the colostomy was successfully reversed six weeks later with good functional outcome.</div></div><div><h3>Conclusion</h3><div>This case highlights that severe perineal necrotizing fasciitis can occur in immunocompetent neonates and may be complicated by rare rectovulvar and rectovaginal fistulae. Early recognition, multidisciplinary care, and timely fecal diversion are critical to achieving favorable outcomes, even in the absence of identifiable immunodeficiency.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02487"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977807","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}
IDCasesPub Date : 2026-01-01Epub Date: 2025-12-29DOI: 10.1016/j.idcr.2025.e02471
Chandan Kumar Baranwal , Manish Thakur , Kanika Soni
{"title":"Typhoid Fever goes rogue: A rare & unusual case of concurrent typhoid hepatitis and splenic abscess in an immunocompetent adult","authors":"Chandan Kumar Baranwal , Manish Thakur , Kanika Soni","doi":"10.1016/j.idcr.2025.e02471","DOIUrl":"10.1016/j.idcr.2025.e02471","url":null,"abstract":"<div><h3>Summary</h3><div>This case report describes a rare instance of simultaneous typhoid hepatitis and splenic abscess in a 27-year-old immunocompetent male from India. The patient presented with high fever, jaundice, abdominal pain, and vomiting, and was mimicking acute viral hepatitis or disseminated tuberculosis finally diagnosed with Salmonella typhi infection following extensive diagnostic & therapeutic evaluations. Despite the seriousness of hepatic and splenic involvement, especially in the absence of underlying immunodeficiency, the patient responded well to appropriate antibiotic therapy. The report highlights the diagnostic challenges and clinical significance of atypical typhoid complications, emphasizing the importance of timely recognition and treatment to improve outcomes.</div></div><div><h3>Introduction</h3><div>In India, infection with <em>Salmonella typhi</em>, causing typhoid fever, is quite common. This may sometimes mimic other infectious diseases, complicating the diagnosis and management of these patients. Typhoid fever is a multisystem illness transmitted by the Feco-oral route, primarily through contaminated water and undercooked food, caused by Salmonella typhi and <em>Salmonella paratyphi.</em> It carries an important health concern, especially in tropical and developing countries. <span><span>[1]</span></span>, <span><span>[2]</span></span> The gastrointestinal complications related to <em>Salmonella typhi</em> infection are Ileal perforation/ulceration, and may lead to obstruction and have been commonly reported. <span><span>[1]</span></span> Apart from that, involvement of the liver and spleen in typhoid fever is a serious concern. Here we are representing a case that presented with typhoid hepatitis and typhoid splenic abscess.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02471"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145977806","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":"Multidrug-resistant Staphylococcus hominis endophthalmitis after cataract surgery: A case report","authors":"Athina Droulia , Foteini Gyftaki , Panagiotis Stavrakas , Vasileios Papastavrou , Evripidis Sykakis , George Margetis , Athanasios Margetis , Anastasia Tsiogka","doi":"10.1016/j.idcr.2026.e02508","DOIUrl":"10.1016/j.idcr.2026.e02508","url":null,"abstract":"<div><h3>Introduction</h3><div>Postoperative endophthalmitis is a rare but vision-threatening complication of cataract surgery. Multidrug-resistant organisms present additional therapeutic challenges.</div></div><div><h3>Case presentation</h3><div>We report a 52-year-old man who underwent uncomplicated phacoemulsification for posterior subcapsular cataract. On the first postoperative day, visual acuity was 8/10, but inflammation gradually appeared without the classic signs of endophthalmitis. On the fifth postoperative day, the patient's vision deteriorated significantly, reaching 1/10, accompanied by a strong inflammatory reaction in the anterior chamber. A pars plana vitrectomy was performed and vancomycin and ceftazidime were administered intravitreally. <em>Staphylococcus hominis</em>, resistant to most common antibiotics but sensitive to gentamicin, was isolated from the vitreous culture. The medication was modified accordingly, with topical gentamicin and oral doxycycline, under daily close monitoring. One month later, cystoid macular edema appeared, which was successfully treated with acetazolamide, topical corticosteroids, and bromfenac. Three months after surgery, the patient's vision had returned to 9/10 without any permanent damage.</div></div><div><h3>Conclusion</h3><div>Early surgical intervention, culture-guided therapy, and intensive follow-up can preserve vision even in postoperative endophthalmitis due to multidrug-resistant organisms.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02508"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167184","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":"Neurobrucellosis presenting with concurrent paraplegia and global aphasia in an elderly butcher: A case report and literature review","authors":"Davood Sanaei Delir Zavaragh , Negar Abbasi Jamaat , Yasamin Pourabedini Aghdam , Amir Ehtemami , Kamyar Khazaei","doi":"10.1016/j.idcr.2026.e02520","DOIUrl":"10.1016/j.idcr.2026.e02520","url":null,"abstract":"<div><h3>Background</h3><div>Brucellosis is a prevalent zoonotic infection and presents with wide range of clinical manifestations, including rare but severe neurological complications.</div></div><div><h3>Case presentation</h3><div>We report the case of a 68-year-old male butcher presenting with global aphasia, paraplegia, incontinence, excessive sweating two weeks prior to admission, and significant weight loss over eight months. Initial evaluations, including brain CT, lumbar puncture, and neurological studies were inconclusive. Spinal MRI showed L1-L2 spondylodiscitis. Serological tests, cerebrospinal fluid culture, and positive Brucella melitensis PCR supported a neurobrucellosis diagnosis. Treatment with a combination of gentamicin, ceftriaxone, rifampicin, and doxycycline was initiated, followed by outpatient therapy with rifampicin, doxycycline, and sulfamethoxazole-trimethoprim for three months. Significant symptom improvement and declining serological titers were observed over two years of follow-up.</div></div><div><h3>Conclusion</h3><div>This case underscores the diagnostic challenges of neurobrucellosis due to its nonspecific presentation and emphasize on the importance of considering such etiologies in patients with unexplained neurological symptoms, particularly in endemic regions like Iran.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"43 ","pages":"Article e02520"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229045","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}