ASM case reports最新文献_第7页

False-negative CMV PCR results due to viral sequence variation: a diagnostic pitfall with the potential for serious consequences. 由于病毒序列变异导致的CMV PCR假阴性结果：具有潜在严重后果的诊断陷阱。

ASM case reports Pub Date : 2025-11-17 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00159-25

Huanyu Wang, Monica I Ardura, Sophonie J Oyeniran, Amy L Leber

{"title":"False-negative CMV PCR results due to viral sequence variation: a diagnostic pitfall with the potential for serious consequences.","authors":"Huanyu Wang, Monica I Ardura, Sophonie J Oyeniran, Amy L Leber","doi":"10.1128/asmcr.00159-25","DOIUrl":"10.1128/asmcr.00159-25","url":null,"abstract":"Background: Cytomegalovirus (CMV) continues to be a significant cause of morbidity and mortality in immunocompromised patients. Nucleic acid amplification tests (NAATs) are the preferred method for both diagnosing CMV infection and monitoring response to antiviral therapy in these patients. The use of a sensitive and specific CMV NAAT is essential to ensure early and reliable detection.Case summary: A 4-month-old patient with familial hemophagocytic lymphohistiocytosis received an allogeneic hematopoietic cell transplant (HCT). Weekly CMV monitoring before and after HCT was performed using an in-house quantitative CMV PCR assay that targets the CMV UL54 gene. Review of the amplification curves of PCR runs raised concerns about potential false-negative results. Sequencing of the patient sample identified nucleotide mutations within the probe-binding site, confirming the cause of the assay failure. These false-negative results led to delayed detection of CMV DNAemia before HCT and delayed initiation of CMV preemptive antiviral therapy after transplant.Conclusion: This case underscores the critical importance of rigorous and routine evaluation of CMV NAATs by clinical laboratories. Laboratories should recognize the limitations of NAATs and implement strategies to address them. In situations where laboratory findings conflict with clinical data, clinicians should critically assess a negative NAAT result. If CMV infection remains a concern, testing with an alternate PCR assay targeting a different gene should be considered.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Fulminant and fatal Trypanosoma cruzi reactivation in a patient with lymphoma. 淋巴瘤患者的暴发性和致死性克氏锥虫再激活。

ASM case reports Pub Date : 2025-11-17 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00157-25

Georgi Lukose, Anna Mertelsmann, Rebecca M Marrero Rolon, David J Pisapia, Sanjay Patel, Christina Coyle, Lars F Westblade, Michael Satlin, Jamie Marino

{"title":"Fulminant and fatal Trypanosoma cruzi reactivation in a patient with lymphoma.","authors":"Georgi Lukose, Anna Mertelsmann, Rebecca M Marrero Rolon, David J Pisapia, Sanjay Patel, Christina Coyle, Lars F Westblade, Michael Satlin, Jamie Marino","doi":"10.1128/asmcr.00157-25","DOIUrl":"10.1128/asmcr.00157-25","url":null,"abstract":"Background: Trypanosoma cruzi is a protozoan parasite and the causative agent of Chagas disease. This case describes a fulminant and fatal reactivation of T. cruzi after immunosuppression in a patient with a history of follicular lymphoma, with parasitemia detectable in peripheral blood smears and parasites seen in multiple autopsy tissue specimens.Case summary: A 61-year-old woman who had immigrated from El Salvador and was receiving obinutuzumab and zanubrutinib for follicular lymphoma in remission was admitted with persistent COVID-19 pneumonia. After multiple therapies for COVID-19, including more than 3 weeks of corticosteroid therapy for the possibility of organizing pneumonia, a peripheral blood smear identified T. cruzi trypomastigotes, and later amastigotes were identified in a bone marrow biopsy. The patient was treated with benznidazole but ultimately died. At autopsy, amastigotes were observed in multiple organs, including the heart, esophagus, stomach, small intestine, colon, bladder, and skeletal muscle.Conclusion: Most cases of Chagas reactivation are described in people living with HIV-1 or transplant recipients. Rarely, T. cruzi reactivation can occur in patients undergoing immunosuppressive therapies for malignancies or inflammatory states like COVID-19 infection, as seen in this case. If not recognized early, reactivation can be fatal despite antiparasitic treatment. Providers should consider screening patients from endemic areas who will start on immunosuppressive therapies. Repeating screening may be of value with periods of new immunosuppression. In patients with Chagas disease and malignancy, PCR from blood should be performed during enhanced immunosuppression so that preemptive treatment can be initiated prior to the presentation of fulminant disease.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of an infection from NDM-1-producing Escherichia coli with susceptibility to aztreonam. 对氨曲南敏感的产ndm -1大肠杆菌感染的处理。

ASM case reports Pub Date : 2025-11-17 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00173-25

Alison M Hixon, Sumanth Gandra, Rebekah E Dumm

引用次数: 0

Successful desensitization to liposomal amphotericin B for the treatment of disseminated cryptococcosis in pregnancy: a case report. 两性霉素B脂质体成功脱敏治疗妊娠播散性隐球菌病1例报告。

ASM case reports Pub Date : 2025-11-12 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00142-25

Susanne O Ajao, Julia M Nelson, Arsheena Yassin, Emily B Rosenfeld, Justin S Brandt, Catherine Monteleone, Pinki J Bhatt, Ahmed Abdul Azim

{"title":"Successful desensitization to liposomal amphotericin B for the treatment of disseminated cryptococcosis in pregnancy: a case report.","authors":"Susanne O Ajao, Julia M Nelson, Arsheena Yassin, Emily B Rosenfeld, Justin S Brandt, Catherine Monteleone, Pinki J Bhatt, Ahmed Abdul Azim","doi":"10.1128/asmcr.00142-25","DOIUrl":"10.1128/asmcr.00142-25","url":null,"abstract":"Background: Cryptococcosis is the most common opportunistic fungal infection in people with human immunodeficiency virus. On a global scale, it causes 15% of acquired immunodeficiency syndrome-related mortality.Case summary: We report the case of a 21-year-old cisgender pregnant woman living with human immunodeficiency virus who presented with headache and photophobia. Her clinical course was complicated by recurrent hospital admissions for disseminated cryptococcosis and a life-threatening reaction to liposomal amphotericin B, the mainstay of treatment. A desensitization protocol was implemented, allowing for continuation of therapy during pregnancy.Conclusion: The management of cryptococcosis in pregnancy is challenging due to the potential teratogenic effects of antifungals used and the limited therapeutic options available. This case highlights the complexities of treatment in pregnancy and demonstrates successful desensitization to liposomal amphotericin B during pregnancy.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acquisition of bedaquiline and clofazimine resistance in association with a novel loss-of-function mutation in the pepQ gene during treatment of multidrug-resistant tuberculosis. 贝达喹啉和氯法齐明耐药性的获得与多药耐药结核病治疗期间pepQ基因的一种新的功能丧失突变有关。

ASM case reports Pub Date : 2025-11-12 eCollection Date: 2026-03-01 DOI: 10.1128/asmcr.00126-25

Melissa Richard-Greenblatt, Ruchika Bagga, Carla Duncan, Maxime J Billick, Howard Song, Natasha F Sabur, Vincent Escuyer, Karen Lam, Sarah K Brode

{"title":"Acquisition of bedaquiline and clofazimine resistance in association with a novel loss-of-function mutation in the pepQ gene during treatment of multidrug-resistant tuberculosis.","authors":"Melissa Richard-Greenblatt, Ruchika Bagga, Carla Duncan, Maxime J Billick, Howard Song, Natasha F Sabur, Vincent Escuyer, Karen Lam, Sarah K Brode","doi":"10.1128/asmcr.00126-25","DOIUrl":"10.1128/asmcr.00126-25","url":null,"abstract":"Background: Bedaquiline (BDQ) has transformed the management of multidrug-resistant (MDR) and rifampin-resistant tuberculosis (TB). Unfortunately, the expanded use of BDQ in these regimens has been accompanied by resistance, which is steadily increasing in certain regions of the world. Nonetheless, our understanding of the mechanisms behind BDQ resistance remains poor, limiting the utility of more rapid molecular or genomic-based diagnostics for the detection of BDQ-resistant isolates.Case summary: We describe an unusual case of a rapid, 2-year evolution of a fully susceptible Mycobacterium tuberculosis strain to extensively drug-resistant TB in a 44-year-old Canadian-born woman with Crohn's disease. Comparative whole-genome sequencing captured the progressive development of resistance mutations and identified a novel loss-of-function mutation (Glu-177-STOP) in the M. tuberculosis pepQ gene that was associated with treatment failure while on BDQ and phenotypic BDQ/clofazimine (CFZ) cross-resistance. Therapeutic drug monitoring while on MDR therapy (daily ethambutol, pyrazinamide, linezolid, CFZ, and intravenous amikacin) detected low serum levels of CFZ, which was not addressed prior to the addition of BDQ to her 5-drug regimen and may have selected for BDQ/CFZ cross-resistance.Conclusion: This case contributes to the limited clinical data implicating pepQ in BDQ/CFZ cross-resistance and describes a novel loss-of-function mutation associated with resistance. As our understanding of genotypic BDQ resistance remains elementary, when novel drug mutations arise, practitioners should consider their significance in the context of phenotypic drug susceptibility test results and the patient's clinical response.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147483200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spots, stripes, and strains: a case report of multidrug-resistant Salmonella Newport in exotic felids. 斑点、条纹和菌株：异域野地多药耐药新港沙门氏菌一例报告。

ASM case reports Pub Date : 2025-11-10 eCollection Date: 2026-03-01 DOI: 10.1128/asmcr.00098-25

Brianna L S Stenger, Daniel R Evans, Sarah J Gefroh, Alyssa Breuer, Heidi L Pecoraro, Kelli J Maddock

引用次数: 0

A surprising diagnosis of paracoccidioidomycosis from routine bacterial culture of chronic finger lesions. 一个令人惊讶的诊断副球孢子菌病从常规细菌培养慢性手指病变。

ASM case reports Pub Date : 2025-11-05 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00133-25

Nikita Jaggernauth, Juan Pineda-Reyes, Claire Zurlo, Devin M Weber, Matthew A Pettengill, Nathan P Wiederhold, Connie Cañete-Gibas, Courtney E Comar

{"title":"A surprising diagnosis of paracoccidioidomycosis from routine bacterial culture of chronic finger lesions.","authors":"Nikita Jaggernauth, Juan Pineda-Reyes, Claire Zurlo, Devin M Weber, Matthew A Pettengill, Nathan P Wiederhold, Connie Cañete-Gibas, Courtney E Comar","doi":"10.1128/asmcr.00133-25","DOIUrl":"10.1128/asmcr.00133-25","url":null,"abstract":"Background: Paracoccidioidomycosis is a systemic mycosis endemic to Central and South America. Here, we describe an unusual case of an elderly female with cutaneous paracoccidioidomycosis and comorbidities limiting the use of first-line therapeutic agents.Case summary: An 89-year-old female with a past medical history of advanced systolic heart failure presented with decompensated heart failure along with chronic, progressive ulcerating lesions involving multiple fingers, unresponsive to antibiotic therapy. A biopsy showed evidence of yeast on pathology and samples grew Paracoccidioides brasiliensis within 5 days on routine bacterial culture. Further history revealed that she lived in Trinidad and Tobago for periods during her childhood and had visited Ecuador for 2 weeks decades prior. Due to her history of advanced congestive heart failure on dobutamine and ventricular arrhythmias, first-line therapy with itraconazole was contraindicated. Sulfamethoxazole-trimethoprim was initiated; however, she developed progressive renal dysfunction and hyperkalemia attributed to sulfamethoxazole-trimethoprim, necessitating a change in therapy. The patient was ultimately started on isavuconazole, which has been shown to be effective in the treatment of Paracoccidioides in a small phase 3 trial. Unfortunately, we were unable to observe clinical response to isavuconazole in our patient due to her demise in the setting of advanced heart disease.Conclusion: This case highlights the variable nature of paracoccidioidomycosis, with our patient having a prolonged latency prior to development of clinical signs and symptoms, an unusual diagnosis by growth in routine bacterial culture, and the need for further research in alternative therapeutic options.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Going for three: what is the role for triplex testing for HSV-1, HSV-2, and VZV? 第三点：对HSV-1、HSV-2和VZV进行三重检测的作用是什么？

ASM case reports Pub Date : 2025-11-04 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00152-25

David R Peaper

{"title":"Going for three: what is the role for triplex testing for HSV-1, HSV-2, and VZV?","authors":"David R Peaper","doi":"10.1128/asmcr.00152-25","DOIUrl":"10.1128/asmcr.00152-25","url":null,"abstract":"Herpes simplex virus-1 (HSV-1), HSV-2, and varicella zoster virus (VZV) are common causes of mucocutaneous lesions. Diagnostic methods have shifted from culture or direct fluorescent antibody testing to nucleic acid amplification tests (NAATs), but testing is (i) not often undertaken or (ii) often specific for either HSV-1/2 or VZV based upon classic clinical findings associated with typical disease. A recent study by B. W. Buchan and P. Pancholi published in ASM Case Reports (2:e00112-25, 2025, https://doi.org/10.1128/asmcr.00112-25) highlights the limitations of this approach, revealing a substantial number of cases where provider-ordered testing missed the causative virus. Accurate viral identification is critical in these cases, as missed or misdiagnosis impacts patient management. Treatment regimens, including antiviral dosage and duration, vary among clinical presentations of HSV-1, HSV-2, and VZV. More importantly, infection control protocols differ among these pathogens. Many cases of VZV require airborne and contact isolation in healthcare settings to prevent nosocomial transmission, a precaution not necessary for most HSV-1/2 infections. In some cases, clinical diagnosis may be insufficient for differentiation among HSV-1, HSV-2, and VZV. More studies are needed to help identify use cases where triplex testing is most appropriate, but broader availability and implementation of triplex NAATs have the potential to promote better patient management and infection prevention practices.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metagenomic next-generation sequencing reveals cross-reactivity of lateral flow cryptococcal antigen assay with Trichosporon inkin. 新一代宏基因组测序揭示了与Trichosporon油墨横向流动隐球菌抗原测定的交叉反应性。

ASM case reports Pub Date : 2025-11-04 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00140-25

Eileen M Burd

{"title":"Metagenomic next-generation sequencing reveals cross-reactivity of lateral flow cryptococcal antigen assay with Trichosporon inkin.","authors":"Eileen M Burd","doi":"10.1128/asmcr.00140-25","DOIUrl":"10.1128/asmcr.00140-25","url":null,"abstract":"Metagenomic next-generation sequencing (mNGS) in plasma, cerebrospinal fluid (CSF), and bronchoalveolar lavage fluid is a relatively new technology that offers a means to potentially provide a diagnosis in cases where infection is suspected, but conventional diagnostic testing has not revealed a pathogen. There have been many publications of individual cases and overall appraisals of its utility in detecting bacteria, fungi, and DNA viruses associated with otherwise undiagnosed systemic infections. A recent article by Phillips et al. published in ASM Case Reports (2:e00053-25, 2025, https://doi.org/10.1128/asmcr.00053-25) presents a case of meningitis in an immunosuppressed child that was ultimately determined to be caused by Trichosporon inkin using mNGS. Elevated ß-1,3-D-glucan (BDG) levels in CSF and serum projected a diagnosis of fungal meningitis. Bacterial, fungal, and mycobacterial cultures were negative. Positive lateral flow cryptococcal antigen titers in serum and CSF complicated the anticipated diagnosis since Cryptococcus spp. are thought to not have sufficient cell wall BDG to produce positive test results. Given the ultimate diagnosis of T. inkin meningitis and the known cross-reactivity with Trichosporon asahii per package insert, the unexpected cryptococcal antigen results raised the possibility of additional cross-reactivity. The authors uncovered this possibility by testing three known clinical isolates of T. inkin which generated positive results. This case adds to the growing literature that highlights the utility of mNGS in providing a diagnosis in otherwise unresolved cases and shows that mNGS can be further instructive in elucidating limitations in commonly used diagnostic tests.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Linezolid-resistant and vancomycin-resistant Enterococcus faecium urinary isolate in a pediatric B-ALL patient. 利奈唑胺耐药和万古霉素耐药的儿童B-ALL患者尿分离粪肠球菌。

ASM case reports Pub Date : 2025-10-22 eCollection Date: 2026-01-01 DOI: 10.1128/asmcr.00085-25

Emma Seevak, Tanvi S Sharma, Alaric W D'Souza

{"title":"Linezolid-resistant and vancomycin-resistant Enterococcus faecium urinary isolate in a pediatric B-ALL patient.","authors":"Emma Seevak, Tanvi S Sharma, Alaric W D'Souza","doi":"10.1128/asmcr.00085-25","DOIUrl":"10.1128/asmcr.00085-25","url":null,"abstract":"Background: Vancomycin-resistant Enterococcus faecium (VRE) is a major cause of healthcare-associated infections, especially in immunocompromised hosts. Linezolid is a key therapeutic agent due to its oral bioavailability and activity against resistant Gram-positive bacteria. While rare in U.S. pediatric patients, linezolid resistance can severely limit treatment options.Case summary: We describe a 16-year-old female with high-risk B-cell acute lymphoblastic leukemia whose hospitalization was complicated by urinary tract infection with VRE. Serial isolates tested on multiple antimicrobial susceptibility testing platforms yielded discordant results for linezolid susceptibility. Minimum inhibitory concentrations to linezolid and chloramphenicol increased together, suggesting potential ribosomal-target-mediated resistance. She ultimately required daptomycin therapy for linezolid-resistant VRE urinary tract infection treatment.Conclusion: This case underscores the diagnostic challenges in detecting emerging linezolid resistance in E. faecium, particularly in immunocompromised patients. Accurate, timely susceptibility testing and improved access to confirmatory or molecular diagnostics are essential to guide therapy for VRE where linezolid remains one of the few viable therapeutic options.","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12772393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0