IDCases最新文献

{"title":"Late BK Nephropathy 15 years post kidney transplant following chemotherapy: A case report","authors":"Anum Hamiduzzaman ,&nbsp;Jean Hou ,&nbsp;Tram Higgins ,&nbsp;Pryce Gaynor ,&nbsp;Abhirami Shankar ,&nbsp;Erik L. Lum","doi":"10.1016/j.idcr.2025.e02340","DOIUrl":"10.1016/j.idcr.2025.e02340","url":null,"abstract":"<div><div>BK Polyomavirus (BKPyV) is an important risk factor for premature graft loss following kidney transplant. Current practice guidelines recommend screening for BK virus DNA for 2 years after kidney transplant as the risk of BK Polyomavirus associated nephropathy (BKPyVAN) wanes over time. This case report presents a unique scenario of late onset BKPyVAN 15 years following kidney transplant precipitated by administration of chemotherapy to treat multiple myeloma. A woman in her 60 s with no prior history of BKPyV was diagnosed with multiple myeloma 14 years after kidney transplant. Her immunosuppression was tapered to tacrolimus and prednisone before undergoing chemotherapy treatment for her multiple myeloma. Although the chemotherapy was effective in achieving remission of her myeloma, she developed worsening renal dysfunction without proteinuria. Kidney biopsy revealed positive SV40 staining and subsequent BK DNA serum PCR was found to be 236,000 copies/mL suggestive of BKPyVAN. Although incredibly rare, late onset BKPyVAN should be considered as a cause of sustained elevation in serum creatinine, new onset proteinuria, or new onset hematuria in kidney transplant recipients who have experienced an augmentation in immunosuppression such as patients undergoing chemotherapy for underlying malignancies.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02340"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831324","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":"Abundant signet ring cells in bronchoalveolar lavage of an adolescent with severe pulmonary tuberculosis","authors":"Emma Hernández-Rosa ,&nbsp;Sílvia Planas ,&nbsp;Antoni Noguera-Julian","doi":"10.1016/j.idcr.2025.e02343","DOIUrl":"10.1016/j.idcr.2025.e02343","url":null,"abstract":"","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02343"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831326","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":"Descending necrotizing mediastinitis caused by Group A Streptococcus associated with influenza A infection","authors":"Ken-ichiro Kobayashi,&nbsp;Kenji Kubo,&nbsp;Nobuhiro Komiya","doi":"10.1016/j.idcr.2025.e02351","DOIUrl":"10.1016/j.idcr.2025.e02351","url":null,"abstract":"<div><div>Descending necrotizing mediastinitis (DNM), a severe complication arising from deep neck infection, developed in an obese 45-year-old Japanese male with diabetes. His condition was caused by a Group A Streptococcus (GAS) infection that arose following an earlier influenza A infection during a seasonal influenza outbreak. The patient had a good clinical course with surgical drainage and debridement with antibiotic treatment. Pre-existing medical conditions and co-infections such as influenza increase susceptibility to GAS infection, and invasive GAS infection leads to increased mortality. The patient initially presented with fever, sore throat, and cough following influenza A infection, symptoms that were difficult to distinguish from those of deep neck infection caused by GAS. As the GAS was detected in blood cultures, the initial diagnosis was primary bacteremia following influenza A. Subsequently, however, the appearance of erythema on the anterior neck and around the thyroid cartilage suggested a descending progression of the infection from the deep neck space. Contrast-enhanced CT led to a diagnosis of DNM. The reported cases of DNM associated with viral infections have so far been limited to those following varicella or Epstein-Barr virus (EBV) infection. To our knowledge, this is the first reported case of DNM caused by GAS associated with influenza A infection. DNM caused by GAS is a rare infection that requires prompt surgical intervention followed by thorough systemic management. Clinicians should carefully monitor patients with underlying medical conditions who manifest recurrent or new symptoms such as fever, sore throat, and dyspnea after influenza infection.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"41 ","pages":"Article e02351"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144886659","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":"Paradoxical pericarditis in an immunocompetent patient with mediastinal tuberculous lymphadenitis and endobronchial TB: A case report","authors":"Tomohiro Oba,&nbsp;Hidekazu Matsushima,&nbsp;Masako Amano,&nbsp;Keiichi Akasaka,&nbsp;Tomotaka Nishizawa","doi":"10.1016/j.idcr.2025.e02363","DOIUrl":"10.1016/j.idcr.2025.e02363","url":null,"abstract":"<div><h3>Background</h3><div>Paradoxical reaction (PR) refers to a worsening of existing or new TB-related lesions after initiating effective anti-tuberculosis therapy. While commonly observed in lymph node or CNS TB, PR involving the pericardium is exceedingly rare in immunocompetent patients.</div></div><div><h3>Case presentation</h3><div>A 22-year-old Vietnamese man with mediastinal tuberculous lymphadenitis and endobronchial TB was started on standard anti-TB therapy. After initial improvement, he developed pericardial effusion three months into treatment. Cultures and PCR were negative, but elevated ADA levels were detected. Based on clinical course and exclusion of treatment failure or coinfection, paradoxical pericarditis was diagnosed. Corticosteroids and levofloxacin were added empirically, with resolution of symptoms.</div></div><div><h3>Conclusion</h3><div>This case highlights a rare extrapulmonary manifestation of PR, reinforcing the need to distinguish it from treatment failure or TB progression in immunocompetent hosts.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"42 ","pages":"Article e02363"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050616","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":"Pulmonary nocardiosis in kidney transplant recipients: A case report and analysis of 60 published cases","authors":"Davood Dalil ,&nbsp;Fatemeh Yaghoubi ,&nbsp;Farnaz Tavakoli ,&nbsp;Seyyed Mohammad Hosseini ,&nbsp;Mahdi Isakhani","doi":"10.1016/j.idcr.2025.e02374","DOIUrl":"10.1016/j.idcr.2025.e02374","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary nocardiosis (PN) is a rare life-threatening opportunistic infection, particularly involving immunocompromised patients, including kidney transplant recipients (KTRs). This study aimed to present a case of PN in a KTR and review published cases to describe the demographic, clinical, and treatment characteristics of PN in this population.</div></div><div><h3>Methods and results</h3><div>Here, we report a case of PN in a 68-year-old diabetic patient with a history of kidney transplantation. Upon admission, antimicrobial and antifungal therapy was initiated empirically, considering a chest CT suggestive of fungal infection and pneumonia. In further evaluations, <em>Nocardia</em> was isolated from bronchoalveolar lavage cultures. After PN diagnosis and tailoring antibiotic regimen to Trimethoprim-sulfamethoxazole (TMP-SMX), the patient showed significant improvement. This study also reviewed the English-language literature published from 1981 to 2023 about PN in KTRs and described various characteristics of 60 similar patients. Moreover, antibiotics and the type of combination therapy used for treatment and outcomes were discussed. The median time of onset of PN after kidney transplantation was 182 days (70.5–730). Lung was the only affected organ by <em>Nocardia</em> in 37 patients, while in 13 patients, simultaneous involvement of the lungs and the brain was reported. Fever (74.5 %) was the most reported symptom, followed by cough (50.9 %), headache (41.8 %), and dyspnea (30.9 %). TMP-SMX was the most frequently prescribed antibiotic, having been provided in 32 patients (59.3 %). Other antibiotics included carbapenems, cephalosporins, amoxicillin/clavulanic acid, etc. Furthermore, 38 patients (70.4 %) received combination therapy, whereas 16 patients (29.6 %) received a single antibiotic agent. Lastly, the outcomes of 55 patients were reported. While the majority (81.8 %) were successfully treated, 10 patients (18.2 %) expired due to nocardiosis.</div></div><div><h3>Conclusion</h3><div>Physicians should consider the diagnosis of PN in the differential diagnosis of KTR presenting with pneumonia, especially within the first six months post-transplant, when the risk of nocardiosis is elevated due to intensive immunosuppression.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"42 ","pages":"Article e02374"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099930","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":"Speckled-egg staining appearance of cryptococcal osteomyelitis in an immunocompetent patient","authors":"Matthew Alexander Stack ,&nbsp;John-Paul Lavik ,&nbsp;Jack G. Schneider ,&nbsp;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}

{"title":"Corrigendum to ‘A rare case of acute liver failure due to disseminated Varicella-Zoster Virus (VZV) infection’ [IDCases 2025;40:e02224]","authors":"Harris T. Feldman ,&nbsp;Matthew Neale ,&nbsp;Ajay Batra ,&nbsp;Mark Mangano ,&nbsp;Michael C. Newstein","doi":"10.1016/j.idcr.2025.102239","DOIUrl":"10.1016/j.idcr.2025.102239","url":null,"abstract":"","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article 102239"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230304","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":"Contrast-induced encephalopathy following bronchial artery embolization: A case report and literature review in a patient with pulmonary tuberculosis and aspergillosis","authors":"Liu Deqing ,&nbsp;Wu Jingqiang ,&nbsp;Muhammad Tahir Khan ,&nbsp;Li Tianyi ,&nbsp;Zhang Lin ,&nbsp;Xiao Haihao","doi":"10.1016/j.idcr.2025.e02367","DOIUrl":"10.1016/j.idcr.2025.e02367","url":null,"abstract":"<div><div>The current study analyzed a case of contrast-induced encephalopathy (CIE) following bronchial artery embolization (BAE) in a patient with hemoptysis due to pulmonary tuberculosis complicated by pulmonary aspergillosis. A 56-year-old male patient developed CIE after BAE was retrospectively analyzed. An ectopic bronchial artery originates from the proximal segment of the right vertebral artery. The patient developed CIE postoperatively, which resolved after treatment with corticosteroids and intracranial pressure reduction. A follow-up cranial MRI after 6 months showed complete resolution of previous edema. A literature review identified three cases of CIE after BAE, all presenting with hemoptysis, and symptom resolution within 3 days.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"42 ","pages":"Article e02367"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145061269","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":"Aspergillus fumigatus pericarditis: A rare case in a lupus patient","authors":"Yousra Sbibih ,&nbsp;Abderrazak Saddari ,&nbsp;Said Ezrari ,&nbsp;Elmostapha Benaissa ,&nbsp;Yassine Ben Lahlou ,&nbsp;Aziza Hami ,&nbsp;Mostafa Elouennass ,&nbsp;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}

{"title":"Emphysematous osteomyelitis: A rare case report","authors":"Siddartha Guru ,&nbsp;Navami Guru ,&nbsp;Rezhan Hussein","doi":"10.1016/j.idcr.2025.e02168","DOIUrl":"10.1016/j.idcr.2025.e02168","url":null,"abstract":"<div><div>Emphysematous osteomyelitis is a rare entity that characteristically presents with intraosseous gas and positive bone cultures with gas-forming bacteria. We present a case of a 63-year-old woman who presented with lower back pain, decreased appetite, and unintentional weight loss over three weeks. Thoracic spine Computerized tomography image showed an ill-defined lytic lesion containing gas in the T12 vertebral body with anaerobic bone cultures, which grew <em>Clostridium septicum.</em> There was concern for possible complication of meningitis with abnormal CSF studies but no bacterial growth, though lumber puncture was done after being on antibiotics for five days. She was found to have underlying metastatic colon cancer as well. She was treated with six weeks of ceftriaxone and metronidazole and then transitioned to oral amoxicillin-clavulanic acid while on chemotherapy.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02168"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157745","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}