Case Reports in Infectious Diseases最新文献

{"title":"A Rare Clinical Presentation of Multifocal Tuberculous Osteomyelitis of the Right Parietal and Left Calcaneal Bones in an 11-Year-Old Male: A Case Report.","authors":"George Evele, Raoul Ndayong, Gaelle Ngoueffo, Francine Kouya, Ghislain Feudjio, Evans Mbanga, Richard Bardin","doi":"10.1155/crdi/4746841","DOIUrl":"10.1155/crdi/4746841","url":null,"abstract":"<p><p>Paediatric multifocal tuberculous osteomyelitis is a rare and severe clinical entity of extrapulmonary tuberculosis. Globally, <i>Mycobacterium tuberculosis</i> (MTB) is the most common cause of necrotising granulomatous inflammation. The diverse clinical presentations of multifocal osteoarticular tuberculosis and its paucibacillary characteristic pose a diagnostic challenge in children. We present the case of an 11-year-old male with painless right scalp swelling and painful left foot swelling, associated with intermittent fever. Clinical exam revealed a discharging sinus in the right parietal region, right anterior cervical lymphadenopathy and localised signs of inflammation over the left calcaneus. The C-reactive protein and erythrocyte sedimentation rate were elevated. The imaging of the skull and left foot showed osteolytic lesions in the right parietal and left calcaneal bones. Cytopathology of the right enlarged cervical lymph node showed necrotising granulomatous inflammation similar to the histopathology report of the left calcaneal lesion biopsy. Although the acid-fast bacilli smear was negative in the bone biopsy of the left calcaneal lesion, the GeneXpert MTB/RIF Ultra test was positive for MTB. The patient had a good clinical response with surgical intervention and an anti-tuberculous multidrug regimen. Tuberculosis should be ruled out in children with multifocal osteolytic lesions.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"4746841"},"PeriodicalIF":0.8,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058534","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":"Diagnostic Complexities in Congenital Tuberculosis: Insights From Preterm Twins Conceived via In Vitro Fertilization and a Literature Review.","authors":"Mei-Juan Zhou, Jian Yu, Feng-Xia Huang, Ning Wang, Qing Wang","doi":"10.1155/crdi/8016755","DOIUrl":"10.1155/crdi/8016755","url":null,"abstract":"<p><p>Congenital tuberculosis (CTB) poses significant diagnostic challenges, particularly in preterm infants. This case report describes the discordant clinical presentation of CTB in dizygotic twins conceived via in vitro fertilization (IVF) and born at 31⁺⁶ weeks' gestation. Both twins presented with nonspecific symptoms (fever and respiratory distress) on postnatal day (PND) 31 and 25, respectively, but followed distinct clinical courses: Twin 1 developed disseminated disease with facial palsy and central nervous system (CNS) involvement, whereas Twin 2 presented with a cervical mass and bone destruction. Diagnosis was markedly delayed, with confirmation on PND 99 and 98, respectively, and initially mistaken for sepsis or histiocytosis. Definitive diagnosis was achieved through next-generation sequencing (NGS) and Xpert Mycobacterium tuberculosis/Rifampicin (Xpert MTB/RIF) assays. The twins were treated with a 14-month antitubercular regimen including linezolid. Their asymptomatic mother was subsequently diagnosed with latent genital TB-a likely contributor to her primary infertility-and received standard therapy with isoniazid (INH), rifampicin (RIF), pyrazinamide (PZA), and ethambutol (EMB). At follow-up (chronological age 2 years), both twins showed adequate catch-up growth and normal visual function. This case illustrates that CTB can manifest as phenotypically diverse and disseminated disease in preterm IVF twins following reactivation of maternal latent infection. It also provides a clinical paradigm linking female genital tuberculosis (FGTB) pathogenesis-mediated by Th1/Th17-driven endometrial damage-to infertility, IVF-associated immunosuppressive reactivation, and congenital transmission. These findings highlight the potential value of considering latent TB screening in women undergoing infertility evaluation, particularly before IVF, to prevent severe maternal and neonatal outcomes. However, given that these observations are derived from a single case report, larger studies are warranted to establish definitive screening recommendations.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"8016755"},"PeriodicalIF":0.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058488","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":"Describing a Persistent SARS-CoV-2 Infection Outcomes and Mutations Associated With B-Cell Deficiency: A Case Report.","authors":"Rana Mohamed, Alex Shipe, Andrew Lail, Isla Emmen, William Vuyk, Nicholas Minor, Taylor Bradley, Angela Gifford, Nancy Wilson, David H O'Connor, Jacqueline Garonzik-Wang, Jeannina Smith","doi":"10.1155/crdi/6154094","DOIUrl":"10.1155/crdi/6154094","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised (IC) individuals are at an increased risk for persistent SARS-CoV-2 infections and can develop new viral mutations and lineages not seen in the community. In this case report, a persistent SARS-CoV-2 infection (330 days) in an IC patient is examined for viral mutations and mutations associated with cryptic lineages.</p><p><strong>Case presentation: </strong>The patient was followed up in a longitudinal study examining persistent SARS-CoV-2 in IC patients. The patient provided stool and nasal swab samples biweekly until 28 days postenrollment, then monthly, and then quarterly after 12 months post enrollment until the participant was no longer positive for SARS-CoV-2. Staff performed RT-qPCR and viral sequencing on the samples. Viral mutations from the XBK lineage were already present in the initial sample. By the end of the infection period, there were 40 fixed consensus changes from XBK of which two mutations were typical for cryptic lineages. Mutations increased steadily over time, with most mutations fixed by day 253, including the cryptic typical mutations.</p><p><strong>Conclusion: </strong>This case demonstrates the potential for persistent SARS-CoV-2 infections to develop mutations and lineages in IC patients and highlights the need for continued SARS-CoV-2 monitoring and treatment in this vulnerable population.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"6154094"},"PeriodicalIF":0.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036551","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 Report of Nosocomial Urosepsis due to <i>Klebsiella pneumoniae</i> in a Preterm Neonate Complicated by Acute Cystitis.","authors":"Bormey Sim, Sakada Kok, Sethikar Im, Sakviseth Bin","doi":"10.1155/crdi/3455145","DOIUrl":"10.1155/crdi/3455145","url":null,"abstract":"<p><p>Late-onset sepsis secondary to urinary tract infection in preterm infants is frequently underdiagnosed and rarely reported. Establishing this diagnosis remains challenging, as clinical manifestations are often nonspecific, inflammatory markers may be inconclusive, and urinalysis is not routinely performed in many NICUs. We report a case of urosepsis originating from <i>Klebsiella pneumoniae-</i>associated cystitis in a 41-day-old preterm infant who had been admitted to our NICU since birth. The infant had multiple risk factors for sepsis, including prolonged mechanical ventilation and the presence of an indwelling central line. This case highlights the importance of maintaining a high suspicion index for urinary tract infection in preterm neonates with unexplained clinical deterioration and emphasizes the need for early urine evaluation as part of the sepsis workup.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"3455145"},"PeriodicalIF":0.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954826","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":"Extreme Hyperleukocytosis in Meningococcal Bacteremia Mimicking Leukemia: A Case Report.","authors":"Camille Gorena, Borna Amir-Kabirian, Ju-Hsien Chao","doi":"10.1155/crdi/4514407","DOIUrl":"10.1155/crdi/4514407","url":null,"abstract":"<p><p>Hyperleukocytosis (> 100 × 10⁹/L) is typically associated with hematologic malignancies and is rarely reported in infection. A previously healthy 27-year-old man presented with acute gastrointestinal symptoms and was found to have meningococcal bacteremia complicated by thrombocytopenia, coagulopathy, and acute kidney injury. Despite appropriate antimicrobial therapy, his leukocyte count rose progressively, peaking at 173 × 10⁹/L on hospital day four. Bone marrow biopsy and cytogenetic studies excluded leukemia. With continued antibiotic therapy and supportive care, his leukocyte count, coagulopathy, and renal function gradually normalized over the following 10 days. This case highlights hyperleukocytosis as a rare manifestation of meningococcemia and emphasizes the importance of excluding malignancy while managing infection-related complications.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"4514407"},"PeriodicalIF":0.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918070","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":"Reactivation of <i>Cytomegalovirus</i> in Colonic Tuberculosis in an Immunocompetent Patient.","authors":"Aprilgate Wang, Samuel Ji, Sarah Semon, Sarah Waldman, Minh-Vu H Nguyen","doi":"10.1155/crdi/5455768","DOIUrl":"10.1155/crdi/5455768","url":null,"abstract":"<p><p><i>Cytomegalovirus</i> (CMV) reactivation in <i>Mycobacterium tuberculosis</i> (TB) infection is rare and has been only reported in immunocompromised patients. In this case report, we describe a patient with Type 2 diabetes with acute on chronic abdominal pain found to have miliary TB with terminal ileitis and ascending colon ulcers with biopsy-positive TB and CMV. The decision was made not to treat the local CMV reactivation, and he improved solely on standard drug-susceptible antituberculous therapy. This is the first reported case of gastrointestinal TB and CMV coinfection in a patient without known classic immunodeficiency.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"5455768"},"PeriodicalIF":0.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911091","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 Bartonellosis: A Case Report of Hepatic Tuberculosis as a Final Diagnosis in a Child With Down Syndrome.","authors":"Paula Camargos, Antonio Oliveira Filho, Joaquim Bustorff Silva, Márcia Cavalaro da Silva, Maria Giovana Farias, Priscilla Tosta, Ricardo Pereira, Mariana Tresoldi das Neves Romaneli","doi":"10.1155/crdi/3276122","DOIUrl":"10.1155/crdi/3276122","url":null,"abstract":"<p><p>Hepatic tuberculosis is a rare form of extrapulmonary manifestation. This case report depicts a 6-year-old boy with Down syndrome who presented with prolonged fever, weight loss, and hepatomegaly. The investigation revealed liver abnormalities suggestive of a granulomatous process, with the initial diagnosis of bartonellosis and, later, tuberculosis, with molecular testing and culture from a fragment of the liver biopsy. He underwent treatment and exhibited an excellent clinical response. This case highlights the importance of including hepatic tuberculosis in the differential diagnosis of liver diseases in children, even in the absence of evident pulmonary signs, especially in endemic regions including Brazil.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"3276122"},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905163","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":"Fulminant <i>Brucella melitensis</i> Infection Presenting With Severe Cholestatic Hepatitis, Acute Kidney Injury, and Disseminated Intravascular Coagulation: A Case Report.","authors":"Faruk Yıldız, Esra Manici, Habibe Tülin Elmaslar Mert, Volkan İnal","doi":"10.1155/crdi/6147749","DOIUrl":"10.1155/crdi/6147749","url":null,"abstract":"<p><p>Brucellosis commonly manifests with fever, arthralgia, and hepatosplenomegaly, whereas severe cholestatic hepatitis is exceedingly rare. We report a 54-year-old goat farmer who presented with a 4-day history of right upper quadrant tenderness, progressive jaundice, and generalized pruritus after consuming unpasteurized milk from his own herd, with which he also had daily close contact. Examination showed scleral icterus and mild lethargy without peritoneal signs. Laboratory investigation revealed profound, predominantly conjugated hyperbilirubinemia (total 25.1 mg/dL, direct 23 mg/dL) with a cholestatic enzyme pattern (alkaline phosphatase 565 U/L, gamma-glutamyl transferase 225 U/L; R factor 0.4) and only mild transaminase elevation, together with acute kidney injury, thrombocytopenia with an elevated mean platelet volume and no platelet aggregates, hypofibrinogenemia, a markedly elevated D-dimer, and scant schistocytes. Thrombotic microangiopathy was initially considered, but a positive direct antiglobulin test, overt coagulopathy, and absent reticulocytosis favored sepsis-associated disseminated intravascular coagulation, confirmed by an International Society on Thrombosis and Haemostasis score of 6. Marked hyperferritinemia prompted consideration of hemophagocytic lymphohistiocytosis, which was not substantiated. Cross-sectional abdominal imaging excluded mechanical obstruction and showed hepatosplenomegaly with subcentimeter splenic nodules and no hepatic focal lesions. <i>Brucella melitensis</i> grew from all three blood cultures, and Wright agglutination was positive at a titer of 1/160. Echocardiography excluded endocarditis, and magnetic resonance imaging excluded spondylodiscitis. Continuous venovenous hemodiafiltration was required for life-threatening uremia, and doxycycline plus rifampin was administered for 6 weeks, with near-complete biochemical normalization by the end of treatment. Brucellosis should be considered in patients with animal exposure who present with severe cholestatic jaundice and multiorgan involvement, since prompt combination antimicrobial therapy can achieve full recovery.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"6147749"},"PeriodicalIF":0.8,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896630","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":"Sepsis Secondary to Crusted Scabies Following Iatrogenic Treatment for Hansen's Disease in an Indigenous Amazonian Patient: A Case Report.","authors":"Ana Beatriz Nardelli da Silva, Maitê Silva Martins Gadelha, Giovanna Lourenço Cei, Adriani Ferreira do Carmo, Arlisson Macedo Rodrigues","doi":"10.1155/crdi/5279255","DOIUrl":"10.1155/crdi/5279255","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis secondary to crusted scabies is a rare but life-threatening complication of <i>Sarcoptes scabiei</i> infestation, particularly in vulnerable and underserved populations. Misdiagnosis with other dermatological conditions may lead to inappropriate treatment and severe outcomes.</p><p><strong>Clinical findings: </strong>A 50-year-old Indigenous man from the Brazilian Amazon presented with a one-year history of generalized pruritus, diffuse hyperkeratotic and crusted skin lesions, and progressive clinical deterioration.</p><p><strong>Diagnosis interventions and outcomes: </strong>The patient was initially misdiagnosed with Hansen's disease and atopic dermatitis and received prolonged corticosteroid therapy, which exacerbated his condition. Skin scraping confirmed crusted scabies, and blood cultures grew <i>Staphylococcus aureus</i>, establishing the diagnosis of sepsis secondary to skin infection. He was treated with oral ivermectin, topical 5% permethrin, and systemic antibiotics, with gradual tapering and discontinuation of corticosteroids. The patient achieved complete clinical recovery.</p><p><strong>Conclusion take‐home message: </strong>This case highlights the critical importance of early recognition of crusted scabies and the risks associated with misdiagnosis and inappropriate immunosuppressive therapy. Prompt diagnosis and treatment are essential to prevent severe complications such as sepsis, particularly in resource-limited and endemic settings.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"5279255"},"PeriodicalIF":0.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879068","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":"Delayed Diagnosis of Rhino-Orbito-Facial Mucormycosis in a Patient With Newly Diagnosed Diabetes and Diabetic Ketoacidosis: A Successful Case From a Resource-Limited Setting.","authors":"Filmon Tesfay Riesehaymanot, Ruth Ghirmay Gebregziabiher, Haben Dawit Tewelde, Meron Asheber Gebremicael, Meron Berhane Tesfay","doi":"10.1155/crdi/3763579","DOIUrl":"10.1155/crdi/3763579","url":null,"abstract":"<p><strong>Background: </strong>Rhino-orbito-facial mucormycosis is a rapidly progressive, life-threatening fungal infection that predominantly affects patients with uncontrolled diabetes mellitus, particularly those with diabetic ketoacidosis (DKA). Early diagnosis remains challenging in resource-limited settings because initial manifestations often mimic bacterial sinusitis.</p><p><strong>Case presentation: </strong>We report a 38-year-old woman with newly diagnosed diabetes mellitus presenting with left facial pain, swelling, and nasal discharge accompanied by mild DKA. She was initially treated for bacterial maxillary sinusitis with antibiotics and insulin therapy; however, progressive facial necrosis and subsequent orbital involvement prompted surgical debridement and histopathological examination, which confirmed mucormycosis. The patient underwent repeated surgical debridement, conventional amphotericin B therapy, and intensive glycemic control, resulting in complete clinical recovery without recurrence during 3 years of follow-up.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of mucormycosis in resource-limited settings and emphasizes the importance of maintaining a high index of suspicion in diabetic patients whose facial or orbital symptoms worsen despite appropriate antibacterial therapy. Early histopathological confirmation, prompt antifungal treatment, and multidisciplinary management remain essential for improving outcomes, even when advanced diagnostic resources are limited.</p>","PeriodicalId":9608,"journal":{"name":"Case Reports in Infectious Diseases","volume":"2026 ","pages":"3763579"},"PeriodicalIF":0.8,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878980","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}