Case Reports in Infectious Diseases最新文献

{"title":"Primary Pleural Tuberculosis Presenting With Noncaseating Granulomas: A Diagnostic Challenge.","authors":"Maria Akiki, Chebly Dagher, Jessica Abrantes-Figueiredo","doi":"10.1155/crdi/6448395","DOIUrl":"https://doi.org/10.1155/crdi/6448395","url":null,"abstract":"<p><p>Tuberculous pleural effusion is the second most common form of extrapulmonary tuberculosis after tuberculous lymphadenitis. Despite its frequency, diagnosis remains challenging due to its paucibacillary nature, and confirmation often requires invasive procedures. We report a 26-year-old male with no significant medical history who presented with persistent dyspnea, cough, and left-sided chest pain after recent travel to Pakistan. He denied known tuberculosis exposure. Imaging demonstrated a left pleural effusion, and thoracentesis revealed a lymphocytic exudate with elevated adenosine deaminase. Pleural fluid acid-fast bacilli smear and tuberculosis polymerase chain reaction were negative. Given the high clinical suspicion for tuberculosis, the patient underwent thoracoscopy with pleural biopsy, which demonstrated noncaseating granulomas. Although the histopathological findings were atypical, empiric antituberculous therapy was initiated. One month later, pleural biopsy cultures grew <i>Mycobacterium tuberculosis</i>, confirming the diagnosis. Pleural tuberculosis remains difficult to diagnose, as conventional microbiological tests are highly specific but have limited sensitivity. This case highlights the critical role of pleural biopsy in guiding early management and underscores that empiric therapy should be strongly considered when clinical suspicion and epidemiologic risk factors are high, even if initial diagnostic studies are negative.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"6448395"},"PeriodicalIF":0.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13147350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834093","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 Miliary Tuberculosis Complicated by Knee Joint Tuberculosis.","authors":"Saiki Yoshimura, Kentaro Satomi, Kohei Fujita, Hiromasa Tachibana, Yuta Okada, Naoki Fujimoto, Shogo Toyama, Takanori Ito, Takuma Imakita, Issei Oi, Osamu Kanai, Kiminobu Tanizawa","doi":"10.1155/crdi/9328618","DOIUrl":"https://doi.org/10.1155/crdi/9328618","url":null,"abstract":"<p><p>This case report details a 75-year-old male diagnosed with miliary tuberculosis (TB) who subsequently developed tuberculous arthritis in his left knee. The patient was initially admitted for a hemorrhagic gastric ulcer, where chest imaging and positive cultures from multiple sites confirmed miliary TB. Standard antitubercular therapy was started, but 6 weeks later, he presented with worsening pain and swelling in his left knee. A joint aspiration and MRI confirmed tuberculous arthritis with an abscess, which necessitated surgical debridement in addition to the drug regimen. We emphasize that orthopaedic TB often requires surgical intervention alongside medication for successful treatment. While total knee arthroplasty can be an effective treatment for joint destruction, the previous report suggests that it should be delayed until after a prolonged course of antitubercular therapy (e.g., 12 months or more) to prevent recurrence.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"9328618"},"PeriodicalIF":0.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763430","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":"Chagasic Esophagopathy With Achalasia and Megaesophagus: A Case Report.","authors":"Gabriel Xerez de Oliveira, Beatriz Lacerda Bezerra, José Antonio da Silva Júnior, Ellany Gurgel Cosme do Nascimento, Cléber de Mesquita Andrade","doi":"10.1155/crdi/9930462","DOIUrl":"https://doi.org/10.1155/crdi/9930462","url":null,"abstract":"<p><p>Chagasic esophagopathy, resulting from Trypanosoma cruzi-induced myenteric plexus denervation, leads to lower esophageal sphincter hypertonia, esophageal body hypertrophy, and dilation (megaesophagus), manifesting as progressive dysphagia and regurgitation that impair nutritional status and quality of life. This case report aims to describe chronic esophageal dysphagia in a patient from an endemic area in northeastern Brazil, highlighting diagnostic and therapeutic challenges within the public health system, including delays due to COVID-19 restrictions and resource limitations. A 67-year-old female from Rio Grande do Norte, with prior Chagas disease diagnosis (2004, etiologically treated), hypertension, and dyslipidemia, presented in 2019 with solid-food dysphagia and nocturnal regurgitation. Initial tests (chest X-ray, ECG, and echocardiography) were normal, but contrast studies (barium esophagogram, and colon) were delayed until 2022, revealing 7 cm esophageal dilation (Rezende Group III), cardia narrowing, and retained contrast/food residues. Symptoms worsened, with a 5 kg weight loss and liquid-only diet. Videolaparoscopic Heller-Pinotti cardiomyotomy was performed in September 2023 after clinical optimization (isosorbide dinitrate and domperidone). The 2 h procedure was uneventful; discharge occurred within 24 h on zero diet, progressing to normal intake by 5 weeks. By February 2024, she was asymptomatic, with a 2 kg weight gain (from 66 kg). This case confirms laparoscopic cardiomyotomy's efficacy (90% success in Rezende I-III) for symptom resolution in nonadvanced chagasic megaesophagus. Public health insights underscore Chagas underreporting, late diagnosis, and public health system barriers in vulnerable populations, advocating early serological screening and etiological treatment in acute phases to prevent chronic digestive forms in endemic regions.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"9930462"},"PeriodicalIF":0.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763518","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":"Recurrence of Postneurosurgical Central Nervous System Infection Caused by <i>Acinetobacter baumannii</i> in a Critically Ill Patient Treated With Cefiderocol. A Case Report.","authors":"Giuseppe Accurso, Angelica Ancona, Giovanni Marco Costa, Filippo Vitale, Domenico Petronaci, Giorgia Corpora, Luigi Profera, Antonino Giarratano, Santi Maurizio Raineri","doi":"10.1155/crdi/7327571","DOIUrl":"https://doi.org/10.1155/crdi/7327571","url":null,"abstract":"<p><strong>Introduction: </strong><i>Acinetobacter baumannii</i> (<i>A. baumannii</i>), a gram-negative bacterium, has become a significant hospital pathogen and the cause of severe nosocomial infections, especially in the intensive care unit (ICU). Bacterial meningitis is a recognized complication that can occur after neurosurgery, and the number of cases of multidrug-resistant (MDR) meningitis caused by <i>A. baumannii</i> is increasing. Critically ill patients in the ICU are at high risk, and the consequences are potentially fatal. Cefiderocol is a novel cephalosporin that can treat carbapenem-resistant infections in patients with limited treatment options. No clinical trials have investigated its capability to penetrate cerebrospinal fluid.</p><p><strong>Case presentation: </strong>We describe the case of a 66-year-old man who was admitted to our neurointensive care unit after head trauma. On the CT scan performed on admission to the hospital, there was evidence of a subdural hematoma and subarachnoid and intraparenchymal hemorrhages in the frontotemporal region bilaterally. The patient then underwent a decompressive craniectomy. During hospitalization and following cranioplasty, the patient experienced a central nervous recurrence of carbapenem-resistant <i>A. baumannii</i> (CRAB) meningitis, which was treated with cefiderocol, resulting in a resolution of signs and symptoms of infection within a few days.</p><p><strong>Conclusion: </strong>We present the first case of CRAB meningitis treated with this cefiderocol dosing regimen. In our case of postneurosurgical MDR meningitis reinfection caused by <i>A. baumannii</i>, cefiderocol as monotherapy brought about a clinical and microbiological cure in both blood and cerebrospinal fluid without the occurrence of adverse effects such as seizure.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"7327571"},"PeriodicalIF":0.8,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763544","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":"Beyond 'One Size Fits All': Abatement of Linezolid-Induced Thrombocytopenia Through Therapeutic Drug Monitoring and Precision Dosing-A Case Study.","authors":"Kennedy C Concannon, Taylor Gullickson, Daniel C DeSimone, Omar Abu Saleh, Tanner M Johnson, Ryan W Stevens, Josh Clement","doi":"10.1155/crdi/3214119","DOIUrl":"https://doi.org/10.1155/crdi/3214119","url":null,"abstract":"<p><strong>Background: </strong>Linezolid is an oxazolidinone antibiotic used in the treatment of Gram-positive bacterial infections. However, its prolonged use is often limited by adverse effects, including thrombocytopenia. Therapeutic drug monitoring (TDM) has been proposed to individualize linezolid dosing to mitigate such adverse effects. This study presents a case of linezolid-induced thrombocytopenia successfully managed with TDM and dose individualization in a patient receiving linezolid as chronic suppressive therapy for cardiac implantable electronic device (CIED) infection.</p><p><strong>Methods: </strong>A 92-year-old female with a history of recurrent <i>Corynebacterium striatum</i> bacteremia and complex cardiovascular conditions who completed a six-week course of intravenous therapy and were placed on chronic suppressive therapy with oral linezolid. Given the risk of thrombocytopenia, TDM was utilized to guide linezolid dosing. Platelet counts and linezolid trough levels were regularly monitored, and dose adjustments were made accordingly.</p><p><strong>Results: </strong>Upon initiation of linezolid (600 mg daily), the patient's baseline platelet count was 150 × 10⁹/L. On day 19, platelet counts declined to 73 × 10⁹/L. Linezolid was temporarily withheld, and TDM revealed a supratherapeutic trough level of 10.26 mcg/mL. The dosage was adjusted to 300 mg once daily, leading to the stabilization of platelet counts at 140 × 10⁹/L. Subsequent monitoring showed a trough level within the target range (7.62 mcg/mL) with no further episodes of thrombocytopenia or additional adverse effects out to day 172.</p><p><strong>Conclusion: </strong>This case highlights the utility of TDM in managing linezolid-induced thrombocytopenia, particularly in patients requiring prolonged therapy. TDM enabled precise dose adjustments, ensuring therapeutic efficacy while minimizing toxicity. The findings support the broader implementation of TDM in linezolid therapy to enhance patient safety and treatment outcomes, particularly in long-term therapy or deep-seated infections.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"3214119"},"PeriodicalIF":0.8,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763382","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":"Rare Case of Lemierre's Syndrome: <i>Porphyromonas asaccharolytica</i>-Induced Monoplegia, Epiduritis, and Meningitis in a 50-Year-Old Woman-A Case Report.","authors":"Alexis Krin, E Aldige, F Birot-Jaulin, F Labaste, S Buys","doi":"10.1155/crdi/5537970","DOIUrl":"https://doi.org/10.1155/crdi/5537970","url":null,"abstract":"<p><strong>Introduction: </strong>Lemierre's syndrome, characterized by internal jugular vein thrombosis and secondary septic emboli following an oropharyngeal infection, is mainly caused by <i>Fusobacterium necrophorum</i>. We report a case of Lemierre's syndrome caused by <i>Porphyromonas asaccharolytica</i>, resulting in pulmonary septic embolism, acute respiratory failure, meningitis, epiduritis, and monoplegia-a complication not previously reported.</p><p><strong>Case report: </strong>A 50-year-old woman initially presented with tonsillitis and subsequently developed severe sepsis. Clinical examination revealed meningeal stiffness, acute renal failure, elevated inflammatory markers, and severe thrombocytopenia. Cerebrospinal fluid analysis was consistent with meningitis, although cultures remained negative. Following admission, the patient developed acute respiratory failure, requiring transfer to intensive care unit for noninvasive ventilatory support. Computed tomography revealed tonsillar edema, thrombosis of the left internal jugular vein, and bilateral pulmonary consolidations. Empirical treatment was initiated with broad-spectrum antibiotics (ceftriaxone, metronidazole, piperacillin-tazobactam), platelet transfusions, and intravenous heparin. Blood cultures identified <i>P. asaccharolytica</i>, leading to de-escalation of antibiotic therapy to amoxicillin. Two days later, the patient developed left upper limb palsy. Magnetic resonance imaging showed cervical epiduritis extending from C3 to C7. Corticosteroid therapy was initiated on Day three. The patient was transferred to the medical ward on Day fifteen and discharged from hospital on Day 30. Treatment comprised 4 weeks of corticosteroids therapy and 6 weeks of antibiotic therapy. At follow-up, partial neurological recovery was observed; however, residual left upper limb paresis persisted. Anticoagulation therapy was maintained for 3 months. Electroneuromyography revealed axonal injury involving the C6-C7-C8-T1 nerve root distribution.</p><p><strong>Conclusion: </strong><i>P. asaccharolytica</i> is a rare etiological agent of Lemierre's syndrome. Neurological complications are uncommon but may include meningitis, cerebral abscess, or cranial nerve palsies, the latter being more commonly associated with <i>F. necrophorum</i>. We report the case of a 50-year-old woman with Lemierre's syndrome caused by <i>P. asaccharolytica</i>, who presented with monoplegia, epiduritis, and meningitis.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"5537970"},"PeriodicalIF":0.8,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763467","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":"Coinfection of <i>Salmonella</i> Typhi and Hepatitis A in a Patient With Prolonged Fever and Jaundice.","authors":"Mohammad Rasel, Abdullah Al-Jubair, Sudipta Banik, Afsana Mimi","doi":"10.1155/crdi/6681091","DOIUrl":"10.1155/crdi/6681091","url":null,"abstract":"<p><p>Both <i>Salmonella</i> Typhi and hepatitis A infections are endemic in developing countries like Bangladesh. Coinfection of hepatitis A and <i>S</i>. Typhi can present with prolonged fever and jaundice. We report a case of coinfection of hepatitis A and <i>S</i>. Typhi in a 13-year-old child.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"6681091"},"PeriodicalIF":0.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721663","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>Staphylococcus caprae</i> as an Emerging Pathogen in Infective Endocarditis: A Case Series and Review of the Literature.","authors":"Joel Isai Alcala-Gonzalez, Reynaldo Lara-Medrano, Karla Paola Cuellar-Calderon, Adrian Camacho-Ortiz","doi":"10.1155/crdi/9983702","DOIUrl":"10.1155/crdi/9983702","url":null,"abstract":"<p><p><i>Staphylococcus caprae</i>, a non-<i>aureus staphylococcus</i> primarily associated with goats, is typically regarded as a commensal organism. While its role in veterinary contexts is well established, its emergence as a human pathogen in healthcare settings has gained increasing recognition. It has been implicated in infections such as bacteremia, otitis externa, osteoarticular infections, and prosthetic device-related complications. However, infective endocarditis caused by <i>S. caprae</i> remains extremely rare, with only six cases reported in the literature since 1995. This report presents a case of native valve infective endocarditis due to methicillin-resistant <i>S. caprae</i> in a previously healthy 40-year-old male with no history of animal contact. The patient presented with fever, dyspnea, and signs of heart failure. Echocardiographic evaluation revealed vegetations on both the aortic and mitral valves, and blood cultures confirmed the presence of <i>S. caprae</i>. Initial empirical therapy with ceftriaxone and vancomycin was started and later adjusted to linezolid based on antimicrobial susceptibility testing. Despite appropriate antimicrobial treatment and intensive supportive care, the patient's condition progressively deteriorated. He experienced neurological decline, hemodynamic instability, and ultimately died following cardiac arrest before surgical intervention could be performed. This case highlights the diagnostic challenges in identifying <i>S. caprae</i>, as conventional phenotypic methods often misclassify the organism. Advanced techniques such as MALDI-TOF MS provide more accurate identification. Antimicrobial susceptibility testing is essential, as treatment options may vary. Fosfomycin resistance may serve as a presumptive marker for <i>S. caprae</i>, though cross-resistance with other species limits its specificity. Given the rarity of <i>S. caprae</i> endocarditis, clinicians should maintain awareness of its potential occurrence, even in patients without animal exposure but with healthcare-associated risks. Early microbiological diagnosis, targeted antibiotic therapy, and prompt surgical evaluation are crucial for managing this uncommon and clinically significant infection.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"9983702"},"PeriodicalIF":0.8,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721741","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":"Infective Endocarditis in Disseminated <i>Streptococcus dysgalactiae</i> Infection Originating From Hitherto Undetected Colorectal Adenocarcinoma.","authors":"Roel Meeus, Lander Bacquaert, Filip Baert, Karl Dujardin, Dirk Vogelaers","doi":"10.1155/crdi/4134020","DOIUrl":"https://doi.org/10.1155/crdi/4134020","url":null,"abstract":"<p><p>A 60-year-old woman presented with polyarthritis in the aftermath of an upper respiratory tract infection. Further investigation revealed infective mitral valve endocarditis necessitating acute surgical valve replacement due to <i>Streptococcus dysgalactiae</i>, as evidenced by positive blood and intraoperative cultures, with disseminated infection and septic emboli in kidneys, multiple joints, and brain. Subsequent colonoscopy revealed a hitherto undetected rectal adenocarcinoma. The co-occurrence of <i>S. dysgalactiae</i> endocarditis and colorectal malignancy in this patient, who was within the age range of elevated baseline risk, may represent coincidental coexistence rather than a causal relationship. This case adds to the sparse literature linking <i>S. dysgalactiae</i> infection with colorectal neoplasia and suggests that colonoscopy may be considered on an individualized, risk-adapted basis in selected patients with <i>S. dysgalactiae</i> endocarditis-an approach distinct from the evidence-based colonoscopy recommendations applicable to <i>Streptococcus gallolyticus</i> endocarditis.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"4134020"},"PeriodicalIF":0.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670636","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>Sarcina ventriculi</i> Revisited: A Rare Organism in the Setting of Gastric Dysmotility After Esophagectomy.","authors":"Sadaf Haiyat, Shabana Azad, Shashikant Patne","doi":"10.1155/crdi/8614596","DOIUrl":"https://doi.org/10.1155/crdi/8614596","url":null,"abstract":"<p><strong>Background: </strong><i>Sarcina ventriculi</i> is a rare gram-positive, obligate anaerobic coccus that thrives in acidic environments and has been increasingly recognized in association with delayed gastric emptying and gastric stasis. Although often considered an incidental finding, it has been linked to clinically significant complications, including emphysematous gastritis and gastric perforation Ratuapli S. K. (2013), Laass M. W. (2010), Tolentino L. F. (2003), Lam-Himlin D. (2011), Al Rasheed M. R. H. (2016). Recognition of this organism is important because identification relies primarily on histologic examination and may directly influence patient management.</p><p><strong>Case presentation: </strong>We report a 35-year-old male with a history of poorly differentiated adenocarcinoma of the lower esophagus treated with neoadjuvant chemotherapy followed by Ivor-Lewis esophagogastrectomy. Several months after surgery, he developed dysphagia, abdominal discomfort, and symptoms suggestive of impaired gastric emptying. Endoscopic evaluation demonstrated mucosal inflammation and retained food material at the anastomotic site. Histopathologic examination of biopsy specimens revealed inflamed gastric-type mucosa containing characteristic tetrad and octet packet formations consistent with <i>Sarcina ventriculi</i>, without evidence of recurrent malignancy. The histologic diagnosis was communicated to the treating team and directly guided initiation of targeted antimicrobial therapy with metronidazole in combination with proton pump inhibitors and prokinetic agents. The patient demonstrated significant clinical improvement and remained stable on follow-up.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognizing <i>Sarcina ventriculi</i> in patients with surgically altered gastrointestinal anatomy and delayed gastric emptying. Histologic identification can have direct therapeutic implications and underscores the need for multidisciplinary communication. Increased awareness of this rare but clinically relevant organism may help prevent potential complications and optimize patient outcomes.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"8614596"},"PeriodicalIF":0.8,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643909","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}