IDCasesPub Date : 2025-01-01DOI: 10.1016/j.idcr.2025.e02147
Kento Furuya , Naoya Itoh
{"title":"Urethrocutaneous fistula and subcutaneous abscess in the inguinal region with bacteremia caused by Bilophila wadsworthia in a Japanese patient: A case report","authors":"Kento Furuya , Naoya Itoh","doi":"10.1016/j.idcr.2025.e02147","DOIUrl":"10.1016/j.idcr.2025.e02147","url":null,"abstract":"<div><div><em>Bilophila wadsworthia</em> is an anaerobic, gram-negative bacillus commonly associated with acute appendicitis. However, bacteremia is exceedingly rare. Herein, we report a case of <em>B. wadsworthia</em> bacteremia associated with a urethrocutaneous fistula and a subcutaneous abscess in the left inguinal region. A 75-year-old man was referred to our hospital due to persistent fever despite piperacillin treatment. The patient was diagnosed with a urethrocutaneous fistula and a subcutaneous abscess in the left inguinal region. <em>B. wadsworthia</em> was isolated from his blood culture and identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. Subsequently, the patient underwent a four-week course of piperacillin-tazobactam therapy. Since a susceptibility breakpoint has not been established for <em>B. wadsworthia</em>, standardized treatment guidelines are currently unavailable. This case represents the first successful treatment of <em>B. wadsworthia</em> bacteremia with piperacillin-tazobactam, suggesting it may be an effective therapeutic option for infections caused by <em>B. wadsworthia</em>.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02147"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061135","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 : 2025-01-01DOI: 10.1016/j.idcr.2025.e02161
Qusai Alqudah , Akankcha Alok , Vidya S. Kollu
{"title":"Dual Peril: A rare case of simultaneous Bartonella and Brucella Endocarditis with unique epidemiological and clinical challenges","authors":"Qusai Alqudah , Akankcha Alok , Vidya S. Kollu","doi":"10.1016/j.idcr.2025.e02161","DOIUrl":"10.1016/j.idcr.2025.e02161","url":null,"abstract":"<div><div>We present a unique case of simultaneous Bartonella and Brucella endocarditis, the first reported instance of this co-infection, highlighting significant diagnostic and therapeutic challenges. A 63-year-old female with a bioprosthetic mitral valve presented with progressive weakness, weight loss, and a persistent dry cough. Evaluation revealed a large mitral valve vegetation, pulmonary nodules, and mediastinal adenopathy. Despite negative blood cultures and an inconclusive malignancy workup, the high clinical suspicion for culture-negative infective endocarditis prompted further serological testing, which confirmed Brucella IgM, IgG and Bartonella PCR positivity. She underwent successful redo mitral valve replacement, with pathology confirming the diagnosis. This case underscores the importance of detailed exposure history, as a kitten from a flea market emerged as a potential infection source. The coexistence of these pathogens highlights the complexity of culture-negative endocarditis and emphasizes the need for prompt, multidisciplinary management to mitigate poor outcomes.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02161"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158931","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 of typhoid fever with neurological presentation","authors":"Nikhat Shahla Afsar, Sumaiya Farah Marisa, Sayat Quayum Mohona, Sohely Ashraf, Mahfuzur Rahman, Chowdhury Adnan Sami","doi":"10.1016/j.idcr.2025.e02203","DOIUrl":"10.1016/j.idcr.2025.e02203","url":null,"abstract":"<div><h3>Introduction</h3><div>Typhoid fever, leading to systemic disease due to Salmonella enterica serotype Typhi, typically has gastrointestinal manifestation, however, neurologic complications—although uncommon, can arise. Aseptic meningitis and optic neuritis are rare manifestations that can be challenging to diagnose.</div></div><div><h3>Case summary</h3><div>Our patient a 31-year male presented with fever for 18 days associated with headache, rash, vomiting, diarrhea and progressive neurological symptoms in form of disorientation and blurred vision. On examination there was bilateral sixth cranial nerve palsy. Investigations were positive for typhoid fever with aseptic meningitis and optic neuritis. He was successfully treated with intravenous ceftriaxone and corticosteroids.</div></div><div><h3>Conclusion</h3><div>Atypical neurological symptoms of typhoid fever must be recognized. To prevent complications, early diagnosis and treatment are important. Typhoid fever should be considered in febrile patients with unexplainable neurological symptoms, especially in an endemic region.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02203"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697276","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 : 2025-01-01DOI: 10.1016/j.idcr.2025.e02197
Kei Yamamoto , Daisuke Ono , Yujin Nozaki , Yusuke Nishida , Jun Sakai , Kazuyuki Mimura , Masaaki Terao , Hajime Hasegawa , Hideaki Ohno , Hideaki Oka
{"title":"A case of Helicobacter cinaedi pleuritis and continuous ambulatory peritoneal dialysis-related peritonitis diagnosed by simultaneous-onset bacteremia","authors":"Kei Yamamoto , Daisuke Ono , Yujin Nozaki , Yusuke Nishida , Jun Sakai , Kazuyuki Mimura , Masaaki Terao , Hajime Hasegawa , Hideaki Ohno , Hideaki Oka","doi":"10.1016/j.idcr.2025.e02197","DOIUrl":"10.1016/j.idcr.2025.e02197","url":null,"abstract":"<div><div>A 42-year-old man undergoing peritoneal dialysis due to a chronic kidney disease of unknown etiology complained of fever and chills. Oral levofloxacin was started, but the symptoms did not improve. He was admitted, and the levofloxacin was switched to intravenous ciprofloxacin. Without improvement, the antibiotic was changed to intravenous meropenem, and he gradually got afebrile. Blood culture on admission yielded a Gram-negative rod (GNR), which was identified as <em>Helicobacter cinaedi</em> by Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI TOF-MS). Additionally, after admission, pleural effusion on the left side increased. The pleural effusion was determined as exudative, but the Gram stain and culture were negative. He was diagnosed with <em>H. cinaedi</em> pleuritis and bacteremia. After three-weeks of intravenous meropenem, he was discharged. However, he complained of fever and chills again and was re-admitted. Intravenous meropenem was re-started, and he got afebrile. Ascites test via peritoneal dialysis tube was conducted. The ascitic fluid was turbid, and the white blood cell count was elevated predominantly with neutrophils. Blood culture on re-admission yielded a GNR, identified as <em>H. cinaedi</em> by MALDI TOF-MS. After three-week intravenous meropenem administration, ten-days of intravenous tazobactam/piperacillin plus vancomycin plus oral minocycline, followed by twelve-days of intravenous cefepime plus oral minocycline were administrated due to hospital-acquired pneumonia. This was followed by a two-week oral minocycline intake. <em>H. cinaedi</em> infection did not recur thereafter. To our knowledge, this report is the first case of <em>H. cinaedi</em> pleuritis and continuous ambulatory peritoneal dialysis-related peritonitis diagnosed by simultaneous-onset of bacteremia.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02197"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643123","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 : 2025-01-01DOI: 10.1016/j.idcr.2025.e02213
Paul Dalmas , Elsa Kaphan , Coline Mortier , Margaux Froidefond , Barbara Doudier , Laeticia Ninove , Antoine Nougairede , Guillaume André Durand , Jean-Christophe Lagier , Nadim Cassir
{"title":"An autochthonous case of severe tick-borne encephalitis virus associated meningoencephalitis in France: Is there a place for polyvalent intravenous immunoglobulins?","authors":"Paul Dalmas , Elsa Kaphan , Coline Mortier , Margaux Froidefond , Barbara Doudier , Laeticia Ninove , Antoine Nougairede , Guillaume André Durand , Jean-Christophe Lagier , Nadim Cassir","doi":"10.1016/j.idcr.2025.e02213","DOIUrl":"10.1016/j.idcr.2025.e02213","url":null,"abstract":"<div><div>Tick-borne encephalitis virus (TBEV) is a common cause of viral encephalitis in parts of Central and Eastern Europe, with a recent resurgence of cases and geographical expansion. Active immunization results in a high rate of seroconversion and is the most effective measure to reduce the incidence of tick-borne encephalitis (TBE). In France, an endemic country, vaccination is recommended only for travelers staying in rural or forested areas in endemic regions. Polyvalent intravenous immunoglobulin (IVIG) is sometimes used as rescue treatment of viral encephalitis. However, few cases of TBEV meningoencephalitis treated with polyvalent IVIG have been described. We report here a case of autochthonous TBEV meningoencephalitis in a French patient with cranial nerve involvement that was treated with IVIG and discuss the possible mechanisms of action.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02213"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738632","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 : 2025-01-01DOI: 10.1016/j.idcr.2025.e02196
Zicong Wang , Zewei Liu , Kexin Yuan , Dezhi Li , Song Liu , Tao Jiang , Yahui Zhao
{"title":"A children patient with intracranial infection after brain surgery associated with elevated Torque Teno Virus","authors":"Zicong Wang , Zewei Liu , Kexin Yuan , Dezhi Li , Song Liu , Tao Jiang , Yahui Zhao","doi":"10.1016/j.idcr.2025.e02196","DOIUrl":"10.1016/j.idcr.2025.e02196","url":null,"abstract":"<div><h3>Introduction</h3><div>Intracranial infections are challenging to diagnose, especially in immunocompromised patients. Next-generation sequencing (NGS) has emerged as a powerful tool for broad pathogen detection, including Torque Teno Virus (TTV). Elevated TTV loads have been associated with immune dysfunction, potentially serving as a biomarker for opportunistic infections. However, the clinical significance of TTV in intracranial infections remains unclear.</div></div><div><h3>Case presentation</h3><div>An 8-year-old boy developed a complex intracranial infection following craniotomy, characterized by elevated TTV levels in cerebrospinal fluid (CSF) and subsequent fungal co-infection. Initial empirical antibiotics failed to fully control the infection. NGS identified TTV in the CSF, prompting the addition of intravenous immunoglobulin. Recurrent infection led to the suspicion of a fungal infection, confirmed by positive G/GM tests and successful treatment with fluconazole.</div></div><div><h3>Conclusion</h3><div>Elevated TTV levels in CSF may indicate underlying immunodeficiency and predispose patients to opportunistic fungal infections. Prompt fungal testing including qPCR is recommended when TTV is detected in CSF. Further research is needed to elucidate the role of TTV in clinical infections and optimize management strategies.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02196"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683705","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 : 2025-01-01DOI: 10.1016/j.idcr.2025.e02202
Takashi Shinha , Lan T.L. Nguyen , Kimberly R. Theos
{"title":"Zoster sine herpete in a patient with lymphoma","authors":"Takashi Shinha , Lan T.L. Nguyen , Kimberly R. Theos","doi":"10.1016/j.idcr.2025.e02202","DOIUrl":"10.1016/j.idcr.2025.e02202","url":null,"abstract":"<div><div>Zoster sine herpete (ZSH) is an atypical presentation of varicella-zoster virus (VZV) reactivation without characteristic vesicular lesions. Although ZSH presents with neuropathic pain, allodynia, and hyperesthesia in the dermatome distributed by the affected nerve similar to herpes zoster, absence of rash makes diagnosing ZSH challenging. It is necessary to demonstrate laboratory evidence of VZV reactivation to confirm diagnosis. High clinical suspicion is warranted since diagnostic and therapeutic delay can lead to devastating neurological sequelae such as encephalitis, vasculopathy, and postherpetic neuralgia.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"40 ","pages":"Article e02202"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761278","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 : 2024-11-26DOI: 10.1016/j.idcr.2024.e02119
Susanne O Ajao , Nehar Damle , Michelle Zhao , Gabriela Ferreira , Keith K Kaye , John P Mills
{"title":"Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report","authors":"Susanne O Ajao , Nehar Damle , Michelle Zhao , Gabriela Ferreira , Keith K Kaye , John P Mills","doi":"10.1016/j.idcr.2024.e02119","DOIUrl":"10.1016/j.idcr.2024.e02119","url":null,"abstract":"<div><div>Oral manifestations of disseminated histoplasmosis are rare but can present in immunocompromised individuals. We report a case of disseminated Histoplasmosis presenting with presumed oral involvement and <em>Pneumocystis jirovecii</em> pneumonia in a seropositive HIV individual. A 32-year-old male with HIV presented to the emergency department for a two-week history of abdominal pain and a tongue ulcer in the setting of significant weight loss, blood-tinged sputum, and non-adherence with antiretroviral therapy for three years. Physical exam revealed a verrucous ulcer on the lateral aspect of the tongue. CT scan of the chest revealed diffuse bilateral pulmonary nodules and ground glass opacities. At presentation, his CD4 + count was 12 cells/mm<sup>3</sup>. During his hospitalization, he developed acute hypoxic respiratory failure requiring non-invasive ventilation. His urine histoplasma antigen was positive at greater than 25 ng/mL and liposomal amphotericin was started. Shortly thereafter, <em>Pneumocystis jirovecii</em> PCR on bronchoalveolar lavage returned positive prompting additional therapy with trimethoprim-sulfamethoxazole. At discharge, the patient had no respiratory symptoms and near-resolution of his tongue ulcer.</div></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"39 ","pages":"Article e02119"},"PeriodicalIF":1.1,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743599","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 : 2024-01-01DOI: 10.1016/j.idcr.2024.e02073
Ashton D. Hall , Joshua M. Ferreri , Jennifer E. Baker , Eleanor A. Powell , Imran Ahmed , Timothy T. Klostermeier , Keith M. Luckett
{"title":"Clostridial gas gangrene involving the brain, gallbladder, heart, and soft tissue: A case report and literature review","authors":"Ashton D. Hall , Joshua M. Ferreri , Jennifer E. Baker , Eleanor A. Powell , Imran Ahmed , Timothy T. Klostermeier , Keith M. Luckett","doi":"10.1016/j.idcr.2024.e02073","DOIUrl":"10.1016/j.idcr.2024.e02073","url":null,"abstract":"<div><p>Clostridial gas gangrene (CGG) is among the most rapidly spreading infections in humans, with mortality rates approaching 100 % if not treated promptly. Most cases follow traumatic inoculation, although spontaneous infections occur in a minority of patients with immunodeficiency. Spontaneous CGG is primarily caused by <em>Clostridium septicum</em>, whereas traumatic infection is associated with <em>Clostridium perfringens</em>. Patients with CGG present abruptly with rapidly progressive symptoms, underscoring the importance of early recognition, prompt surgical intervention, and appropriate antimicrobial therapy. We describe an illustrative case of spontaneous CGG caused by <em>C. perfringens</em> in a polymorbid 73-year-old female patient. Despite aggressive medical and surgical management, she succumbed to metastatic infection within 48 h of presentation.</p></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"38 ","pages":"Article e02073"},"PeriodicalIF":1.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214250924001495/pdfft?md5=0f086d239b55083580bb1cff5f7ad56d&pid=1-s2.0-S2214250924001495-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171761","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 rare case of Bacillus subtilis variant natto-induced persistent bacteremia with liver and splenic abscesses in an immunocompetent patient","authors":"Tetsuro Amemiya , Kiyofumi Ohkusu , Miku Murayama , Tomokiyo Yamamoto , Naoya Itoh","doi":"10.1016/j.idcr.2024.e01925","DOIUrl":"https://doi.org/10.1016/j.idcr.2024.e01925","url":null,"abstract":"<div><p><em>Bacillus subtilis var. natto</em>, a low-pathogenic bacterium used in the traditional Japanese food \"natto\" (fermented soybeans), has rarely been reported as a pathogen of infectious diseases in humans. Herein, we report the first case of persistent bacteremia caused by <em>B. subtilis var. natto</em> in an immunocompetent patient without any gastrointestinal involvement. A 53-year-old Japanese woman who had been consuming natto every day was admitted to our hospital with complaints of fever and chills. <em>B. subtilis</em> was isolated from blood cultures collected during the initial visit. Abdominal contrast-enhanced computed tomography (CT) showed multiple low-absorption areas in the liver and spleen. Treatment commenced with vancomycin; however, <em>Bacillus sp.</em> was re-detected in the blood culture on day 4 after treatment initiation. The blood culture on day 8 was negative. Subsequently, the treatment was switched to ampicillin-sulbactam and oral amoxicillin-clavulanic acid, and the patient recovered after 28 days of treatment from the time the blood cultures became negative. Contrast-enhanced CT of the abdomen at the end of treatment showed that the multiple low-absorption areas in the liver and spleen had disappeared. Later, the variant of the bacteria was identified as <em>B. subtilis var. natto</em> by DNA analysis. <em>B. subtilis var. subtilis</em> and <em>B. subtilis var. natto</em> cannot be distinguished using matrix-assisted laser desorption/ionization-time of flight mass spectrometry or 16S rRNA analysis. Biotin auxotrophy of <em>B. subtilis var. natto</em> is used to distinguish between the two variants.</p></div>","PeriodicalId":47045,"journal":{"name":"IDCases","volume":"35 ","pages":"Article e01925"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2214250924000015/pdfft?md5=a945a8508e139d40307a82fc0daf4b1d&pid=1-s2.0-S2214250924000015-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139487562","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}