ASM case reports最新文献

{"title":"Invasive <i>Ureaplasma</i> infection in a pediatric patient: a case report.","authors":"Brice Laney, Daniel E Dulek, David C Gaston, Natalya Beneschott, Sophie E Katz, Jessica Gillon, Stephanie Rolsma","doi":"10.1128/asmcr.00164-25","DOIUrl":"10.1128/asmcr.00164-25","url":null,"abstract":"<p><strong>Background: </strong><i>Ureaplasma</i> spp. are a rare cause of invasive disease outside of the neonatal period. Recent studies have shown that immunosuppression with B-cell depleting therapies, such as rituximab or obinutuzumab, can increase the risk of invasive infection. We present a case in which a patient receiving B-cell depleting therapy for anti-neutrophil cytoplasmic antibody-associated vasculitis and pauci-immune nephritis was diagnosed with disseminated, invasive <i>Ureaplasma</i> infection.</p><p><strong>Case summary: </strong>A 17-year-old female with documented B-cell depletion presented to the emergency department from the pediatric infectious disease clinic with persistent shoulder pain. Within the first month of admission, the patient developed multifocal abscesses with joint involvement and an echodensity resembling a possible vegetation, all of which were unresponsive to broad-spectrum antibiotics. A broad-spectrum polymerase chain reaction test detected <i>Ureaplasma urealyticum</i> in aspirated joint fluid from multiple anatomic sites. Clinical improvement occurred after initiation of combination therapy with intravenous doxycycline and levofloxacin.</p><p><strong>Conclusion: </strong>We describe a patient with documented iatrogenic B cell depletion presenting with a disseminated, multifocal invasive <i>Ureaplasma</i> infection including osteoarthritis, cellulitis, and soft tissue abscess. Following a 6-week course of levofloxacin, the patient's C-reactive protein, fever, and pain resolved without further evidence of disease. This case report highlights the importance of considering disseminated, invasive <i>Ureaplasma</i> spp. when evaluating B-cell depleted patients with challenging multifocal symptom complexes. In addition, this case report highlights the critical role of molecular diagnosis in identifying this fastidious pathogen.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483219","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":"Ocular manifestations in a cohort of patients with mpox in the Democratic Republic of the Congo 2007-2011.","authors":"Placide Mbala-Kingebeni, Nam V Nguyen, Jean-Claude Mwanza, Jessica Carag, Susanne Linderman, Tolulope Fashina, Eddy Kinganda, Tony Wawina-Bokalanga, Amuri Aziza, Jean-Claude Makangara-Cigolo, Emmanuel Hasivirwe Vakaniaki, Yvon Anta, Jepsy Yango, Olivier Tshiani, Jason Kindrachuk, Laurens Liesenborghs, Christophe Van Dijck, Martine Peeters, Eric Delaporte, Anne W Rimoin, John W Huggins, Therese Riu-Rovira, Steve M Ahuka, James W Martin, Ian Crozier, Steven Yeh, Jean-Jacques Muyembe","doi":"10.1128/asmcr.00171-25","DOIUrl":"10.1128/asmcr.00171-25","url":null,"abstract":"<p><p>This report describes the ocular manifestations in a cohort of patients with Clade I mpox evaluated in the Democratic Republic of the Congo from 2007 to 2011, as well as the clinical course of a 3-year-old patient with mpox associated with ocular disease. Among 216 patients, ocular manifestations were observed in 8.3%, including conjunctivitis, eyelid lesions, eyelid swelling, eye pain, orbital swelling, keratitis, and corneal staphyloma. These findings highlight the broad spectrum of ocular manifestations with potentially sight-threatening consequences in patients with mpox.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483222","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":"Fatal refractory chronic active Epstein-Barr virus infection with hemophagocytic lymphohistiocytosis and NK/T-cell lymphoma: a case report.","authors":"Nicholas Mielke, Marlaena Nooney, Nagendra Natarajan, Rima El-Herte","doi":"10.1128/asmcr.00168-25","DOIUrl":"10.1128/asmcr.00168-25","url":null,"abstract":"<p><strong>Background: </strong>Epstein-Barr virus (EBV) is most often associated with asymptomatic infection or infectious mononucleosis syndrome. A rare and fatal underestimated complication is chronic active EBV infection (CAEBV) with hemophagocytic lymphohistiocytosis (HLH) and B or NK/T-cell lymphoma.</p><p><strong>Case summary: </strong>A 28-year-old woman presented with fevers, malaise, fatigue, abdominal pain, nausea, vomiting, and episodic skin rashes. Laboratory tests revealed pancytopenia, significantly elevated liver enzymes, and serology consistent with primary EBV infection, with very high EBV DNA in serum. All other causes of hepatitis were excluded. Liver biopsy showed EBV-positive T-cells infiltrating the liver parenchyma with erythrophagocytosis, consistent with CAEBV infection with HLH. Despite aggressive interventions, the patient ultimately succumbed to grave complications and refractory disease.</p><p><strong>Conclusion: </strong>CAEBV is a rare and fatal complication of EBV. Clinician education, early recognition, and expert consultation improve outcomes. Treatment so far consists of chemotherapy followed by hematopoietic stem cell transplantation.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483178","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":"Limited genome evolution of <i>Cryptococcus neoformans</i> following an accidental infection in the research laboratory.","authors":"Yunfan Fan, Madhura Kulkarni, Sean X Zhang, Winston Timp, David J Sullivan, Daniel F Q Smith, Arturo Casadevall, J Marie Hardwick","doi":"10.1128/asmcr.00209-25","DOIUrl":"10.1128/asmcr.00209-25","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous infections resulting from accidental exposure to fungal pathogen <i>Cryptococcus neoformans</i> in research laboratories are rarely reported in the literature. To fill a gap in published guidance for handling these situations promptly when they arise, we describe a case report plus three additional examples as a guide to effective resolution.</p><p><strong>Case summary: </strong>An immunocompetent laboratory researcher developed primary cutaneous cryptococcosis following accidental infection with <i>Cryptococcus neoformans</i> H99 via a needle scrape that was initially assumed not to have penetrated the skin. On day 8 after the incident, a characteristic nodular erythematous lesion developed on a finger at the exposure site. Antibacterial therapy was initiated for the clinical impression of bacterial cellulitis as clinical tests for cryptococcal serum antigen and cultures of aspirates from the wound site on day 13 after incident were negative. Eight-week fluconazole therapy initiated on day 15 after the incident was curative. Whole genome sequencing of yeast grown from wound exudate collected on day 18 confirmed high sequence similarity to H99 <i>Cryptococcus neoformans</i> var. <i>grubii</i> and sequence divergence from an archived sample isolated from an immunocompromised individual. Three additional cases with potential exposures to <i>C. neoformans</i> in the research lab received prophylactic fluconazole and remained asymptomatic.</p><p><strong>Conclusion: </strong>In a span of 5 years, four laboratory researchers from two research groups at the same institution sustained accidental exposures to <i>C. neoformans</i>, and all were successfully treated. These cases reinforce and update the recommendations for initiating antifungal therapy immediately after laboratory accidents involving <i>C. neoformans</i>.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483220","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":"Multisystem <i>Lomentospora prolificans</i> progression on fosmanogepix despite <i>in vitro</i> activity: a call for expanding clinical research on novel antifungals.","authors":"Ryan A Cooper, Sana Arif, Arthur W Baker, Nathan P Wiederhold, Stefanie Sarantopoulos, Mustafa Iftikhar, Kelly Stanly, Brennan Collis, Bin Ni, Beatrice Z Sim, John R Perfect, Barbara D Alexander, Madeleine R Heldman","doi":"10.1128/asmcr.00189-25","DOIUrl":"10.1128/asmcr.00189-25","url":null,"abstract":"<p><strong>Background: </strong><i>Lomentospora prolificans</i> is a rare and often fatal cause of invasive mold disease (IMD), particularly in immunocompromised individuals. Treatment remains difficult due to intrinsic resistance to most antifungals and the challenges of achieving therapeutic drug levels in the central nervous system. Fosmanogepix and olorofim are novel antifungal agents with promising activity against difficult-to-treat molds, including <i>L. prolificans</i>, and show potential for excellent central nervous system penetration.</p><p><strong>Case summary: </strong>We report a case of disseminated <i>L. prolificans</i> infection with pulmonary, ocular, and central nervous system involvement in a 73-year-old man following haploidentical hematopoietic cell transplantation for peripheral T-cell lymphoma. Despite early neutrophil engraftment, the absence of graft-versus-host disease, and treatment with fosmanogepix, his infection progressed to fatal fungal meningitis.</p><p><strong>Conclusion: </strong>This case underscores the limitations of relying on <i>in vitro</i> susceptibility results to predict clinical response in the absence of clinical breakpoints, particularly in deep-seated infections where drug penetration may be limited. While prior case reports have described successful outcomes with novel agents, publication bias may overrepresent favorable results. This case supports the urgent need for rigorous evaluation of emerging antifungal therapies in real-world settings.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483221","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":"Clearance of hypermutator XDR <i>Pseudomonas</i> osteomyelitis and hardware infection with adjunctive bacteriophage therapy.","authors":"Viseth Ngauy, Scott Bevans, Donna Kido, Rachel Ibrahimovic, Edwin Kamau, Angela Caldwell, Robert Pangilinan, Roy Levit, Francois Lebreton, Andrey A Filippov, Ting L Luo, Damon W Ellison, Mikeljon P Nikolich, Patrick McGann","doi":"10.1128/asmcr.00108-25","DOIUrl":"10.1128/asmcr.00108-25","url":null,"abstract":"<p><strong>Background: </strong>Bacteriophages (phages), viruses ubiquitous in the environment infecting bacteria, are an increasingly attractive option for adjunct therapy with conventional antibiotics in complicated, refractory multidrug-resistant infections. Bacteria (\"hypermutators\") with defects in methyl-directed mismatch repair (MMR) have been described in <i>Pseudomonas aeruginosa</i>, with the resultant defect in DNA repair responsible for rapid development of antimicrobial resistance.</p><p><strong>Case summary: </strong>A 72-year-old male with mild chronic obstructive pulmonary disease, diagnosed with resectable, advanced right frontoethmoid adenoid cystic carcinoma, underwent endoscopic resection to remove the affected bone and tissue. The subsequent large craniofacial defect was reconstructed with non-vascularized calvarial bone grafts, rigidly fixated with titanium hardware and externally covered with a vascularized pericranial flap. He developed complete dehiscence of the skull base reconstruction, and wound cultures grew multiple susceptible <i>P. aeruginosa</i> isolates with distinct morphologies that became progressively drug resistant on treatment. Whole-genome sequencing of isolates showed the presence of a non-synonymous mutation in the <i>mutS</i> gene impacting the MMR pathway, consistent with a hypermutator. Phage therapy was pursued due to ongoing infection with retained hardware, lack of clinical response to antibiotic therapy alone, extreme antibiotic resistance, and possible surgical cure of his cancer. He received twice-daily intravenous phage therapy in combination with cefiderocol for 2 weeks with clinical and microbiological resolution of his infection.</p><p><strong>Conclusion: </strong>This case suggests that phage therapy may be useful in the treatment of deep-seated hypermutator <i>P. aeruginosa</i> infections with retained hardware.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483188","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":"Septic arthritis due to <i>Corynebacterium propinquum</i>: first report of isolation from synovial fluid in a native joint.","authors":"Rudolf Kotula, Anna Kotula, Nagarjuna Reddy Cheemarla","doi":"10.1128/asmcr.00138-25","DOIUrl":"10.1128/asmcr.00138-25","url":null,"abstract":"<p><strong>Background: </strong>Septic arthritis of native joints remains an uncommon but serious clinical condition affecting approximately two per 100,000 individuals annually. The synovial membrane, being highly vascular and lacking a protective basement membrane, is particularly susceptible to hematogenous bacterial seeding, especially in patients with pre-existing joint disease. <i>Corynebacterium propinquum</i>, typically regarded as a respiratory commensal, has rarely been implicated in deep-seated infections.</p><p><strong>Case summary: </strong>We report the first known case of <i>C. propinquum</i> isolated from synovial fluid in a patient with native knee septic arthritis. The 59-year-old female had a history of bilateral knee osteoarthritis and recent intra-articular corticosteroid injections. Initial synovial fluid cultures were negative; however, enrichment using aerobic blood culture bottles, followed by subculture, yielded <i>C. propinquum</i> identified by MALDI-TOF MS. The organism grew on aerobic blood agar but not on anaerobic media or thioglycolate broth. The patient was successfully treated with intravenous daptomycin, followed by ceftriaxone, with subsequent clinical improvement.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic value of using enrichment culture and comprehensive laboratory-clinical correlation to recognize clinically significant, low-virulence organisms, such as <i>Corynebacterium propinquum</i>. Accurate species-level identification and thoughtful interpretation within the clinical context are essential to distinguish contamination from true infection, particularly in sterile-site cultures associated with native joint infections.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483223","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":"Remarkable recovery from a <i>Cladophialophora bantiana</i> fungal brain abscess in an immunocompromised patient: a case report.","authors":"Molly S Walkenhorst, Elizabeth Savage, Kellie Wark, Joanna Kimball, Rachel Weihe, Kathryn Lamberton, Robert Hamilton-Seth, Julia D Hankins, Nelli S Lakis","doi":"10.1128/asmcr.00150-25","DOIUrl":"10.1128/asmcr.00150-25","url":null,"abstract":"<p><strong>Background: </strong><i>Cladophialophora bantiana</i> is a globally distributed dematiaceous mold which acts as an uncommon source of human infection. With a predilection for the central nervous system (CNS), this organism accounts for nearly half of all cerebral phaeohyphomycosis, with a mortality rate over 60%. Due to the rarity of this disease, treatment regimens are primarily based on retrospective reviews of case reports. The best clinical response occurred with a dual approach of surgical resection and antifungal therapy, though mortality rates remain high.</p><p><strong>Case summary: </strong>A 68-year-old immunocompromised woman presented with imaging findings concerning for a neoplastic process, such as a glial neoplasm or CNS lymphoma. With microbiology, flow cytometry, and cytology of the cerebrospinal fluid negative and frozen section of the lesion favoring glial neoplasm, the scarce pigmented fungal hyphae on permanent sections were unexpected. Broad-range fungal DNA testing identified the organism as <i>C. bantiana</i>. Without further surgical resection, dual antifungal therapy was utilized to achieve clinical stability and return to pre-infection baselines.</p><p><strong>Conclusion: </strong>This is a rare case of a <i>C. bantiana</i> fungal brain abscess in an immunocompromised patient. Complete surgical resection was not possible; however, this case provides additional data to show the benefits of a dual antifungal treatment approach without additional surgical intervention, and the dosages used to achieve stability at 18 months post-presentation. This case highlights the importance of prompt efforts in determining causative organisms in unexpected fungal brain abscesses, which allows for targeted and improved success in the treatment of this highly fatal disease.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483224","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":"<i>Chlamydia psittaci</i> pneumonia in a patient using ustekinumab therapy for Crohn's disease.","authors":"J A M C Dirks, L Mulder, K Burgers, J G M C Damoiseaux, E R Heddema","doi":"10.1128/asmcr.00129-25","DOIUrl":"10.1128/asmcr.00129-25","url":null,"abstract":"<p><strong>Background: </strong>Ustekinumab, a monoclonal antibody targeting the p40 subunit of interleukin-12 and interleukin-23, is widely used for immune-mediated diseases such as Crohn's disease. By modulating Th1 and Th17 pathways, ustekinumab may increase susceptibility to intracellular pathogens. We report the first case of <i>Chlamydia psittaci</i> pneumonia in a patient treated with ustekinumab.</p><p><strong>Case summary: </strong>A 27-year-old woman with Crohn's disease presented with severe community-acquired pneumonia, progressive hypoxemia, and pulmonary embolism 3 weeks after initiating ustekinumab therapy. Despite broad-spectrum antibiotics, clinical improvement was limited. Her exposure history revealed contact with multiple pet birds, several of which died recently. Polymerase chain reaction testing confirmed <i>C. psittaci</i> genotype A infection. Targeted treatment with doxycycline led to clinical recovery. Ustekinumab therapy was temporarily postponed.</p><p><strong>Conclusion: </strong>This case highlights a potential association between ustekinumab and susceptibility to <i>C. psittaci</i>, a zoonotic intracellular pathogen. It underscores the importance of exposure history and considering atypical pathogens in immunocompromised patients. Clinicians should maintain vigilance for opportunistic infections in individuals receiving targeted biologic therapies.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483181","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":"Hyperammonemia syndrome due to <i>Pluralibacter gergoviae</i> bacteremia in an immunocompromised patient: case report.","authors":"Rami Waked, Jonathan Huang, Lucy S Witt, Eileen M Burd","doi":"10.1128/asmcr.00215-25","DOIUrl":"10.1128/asmcr.00215-25","url":null,"abstract":"<p><strong>Background: </strong><i>Pluralibacter gergoviae</i> is a rare, opportunistic, urease-producing gram-negative organism infrequently implicated in invasive infections. Reports in organ transplant or extracorporeal membrane oxygenation (ECMO) settings are exceedingly uncommon. This case is distinctive for describing <i>P. gergoviae</i> bacteremia potentially associated with severe hyperammonemia and encephalopathy in a lung transplant recipient on prolonged ECMO support, expanding the clinical spectrum of infection-related hyperammonemia beyond the traditionally recognized <i>Ureaplasma</i> and <i>Mycoplasma</i> species.</p><p><strong>Case summary: </strong>A 32-year-old woman with cystic fibrosis underwent bilateral lung transplantation while on ECMO for refractory hypoxemic respiratory failure. Her post-operative course was complicated by multiorgan failure, <i>Candida parapsilosis</i> fungemia, and later, surgical site infection. During the fourth month of hospitalization, <i>P. gergoviae</i> was isolated from surgical wound and blood cultures. Around the time of bacteremia, she developed acute encephalopathy with markedly elevated plasma ammonia (262 µmol/L) in the absence of hepatic dysfunction. The <i>P. gergoviae</i> isolate was confirmed to be urease positive. Management included targeted antimicrobial therapy with ceftriaxone and meropenem, along with lactulose, rifaximin, and zinc for hyperammonemia. Ammonia levels and mental status gradually normalized following treatment, and blood cultures cleared.</p><p><strong>Conclusion: </strong>This case illustrates <i>P. gergoviae</i> as an emerging opportunistic pathogen capable of causing invasive infection and possibly metabolic complications in profoundly immunocompromised hosts.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483206","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}