scholarly journals Rapid Fatal Outcome of Cryptococcal Meningoencephalitis in a Non-HIV Immunocompromised Patient with a Low Fluconazole Susceptibility Isolate: A Case Report from Madagascar

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Mihaja Raberahona ◽  
Rivonirina A. Rakotoarivelo ◽  
Njary Randriamampionona ◽  
Angelot F. Rakotomalala ◽  
Tiana Razafinambinintsoa ◽  
...  
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Adult Patient ◽  
Immunocompromised Patient ◽  
Fatal Outcome ◽  
Accurate Diagnosis ◽  
Immunocompromised Patients ◽  
Cryptococcal Meningoencephalitis ◽  
Detailed Case ◽  
Hiv Negative

Cryptococcal meningoencephalitis is considered rare in HIV-negative individuals. In Madagascar, the epidemiology of cryptococcosis has not yet been well described, neither in immunocompetent nor in immunocompromised patients. We report here the first Malagasy detailed case of cryptococcal meningoencephalitis in a non-HIV immunocompromised adult patient carrying a low fluconazole susceptibility isolate. We emphasize the importance of early and accurate diagnosis to meet the challenges of managing cryptococcosis in developing countries.

scholarly journals Isolated Torticollis May Present as an Atypical Presentation of Meningitis

2012 ◽  
Vol 2012 ◽  
pp. 1-2
Author(s):  
Roger Chirurgi ◽  
Samrina Kahlon
Keyword(s):  
Case Report ◽  
Bacterial Meningitis ◽  
Adult Patient ◽  
Lumbar Puncture ◽  
Immunocompromised Patient ◽  
Medical Emergency ◽  
Atypical Presentation ◽  
Immunocompromised Patients ◽  
Nuchal Rigidity ◽  
Life Threatening

Background. Bacterial meningitis is a life-threatening medical emergency that requires urgent diagnosis and treatment. Diagnosis is infrequently missed if the patient presents with the classic symptoms of fever, headache, rash, nuchal rigidity, or Kernig or Brudzinski sign. However, it may be less obvious in neonates, elderly, or immunocompromised patients. Meningitis which presents as isolated torticollis, without any other signs or symptoms, is exceedingly rare.Objective. To identify an abnormal presentation of meningitis in an adult immunocompromised patient.Case Report. We present a case of an adult diabetic male who presented multiple times to the ED with complaint of isolated torticollis, who ultimately was diagnosed with bacterial meningitis.Conclusion. We propose that in the absence of sufficient explanation for acute painful torticollis in an immunocompromised adult patient, further evaluation, possibly including a lumbar puncture may be warranted.

scholarly journals Osteomyelitis Infection ofMycobacterium marinum: A Case Report and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hao H. Nguyen ◽  
Nada Fadul ◽  
Muhammad S. Ashraf ◽  
Dawd S. Siraj
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Literature Review ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Immunocompromised Patient ◽  
Skin Lesions ◽  
Immunocompromised Patients ◽  
Deep Soft Tissue ◽  
Invasive Infections

Mycobacterium marinum(M. marinum) is a ubiquitous waterborne organism that grows optimally at temperatures around 30°C. It is a nontuberculousMycobacteriumfound in nonchlorinated water with worldwide prevalence. It is the most common atypicalMycobacteriumthat causes opportunistic infection in humans.M. marinumcan cause superficial infections and localized invasive infections in humans, with the hands being the sites most frequently affected. It can cause skin lesions, which are either single, papulonodular lesions, confined to an extremity, or may resemble cutaneous sporotrichosis. This infection can also cause deeper infections including tenosynovitis, bursitis, arthritis, and osteomyelitis. Disseminated infections and visceral involvements have been reported in immunocompromised patients. We here report a case of severe deep soft tissue infection with necrotizing fasciitis and osteomyelitis of the left upper extremity (LUE) caused byM. marinumin an immunocompromised patient.

scholarly journals Tension Pneumatocele due toEnterobacter gergoviaePneumonia: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Emeka B. Kesieme ◽  
Chinenye N. Kesieme ◽  
George O. Akpede ◽  
Kelechi E. Okonta ◽  
Andrew E. Dongo ◽  
...  
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Complete Resolution ◽  
Nonoperative Management ◽  
State Of The Art ◽  
Fatal Outcome ◽  
Tube Thoracostomy ◽  
Human Pathogen ◽  
First Report ◽  
Complicated Pneumonia

Pneumatocele formation is a known complication of pneumonia. Very rarely, they may increase markedly in size, causing cardiorespiratory compromise. Many organisms have been implicated in the pathogenesis of this disease; however, this is the first report of tension pneumatocele resulting fromEnterobacter gergoviaepneumonia. We report a case of a 3-month-old Nigerian male child who developed two massive tension pneumatoceles while on treatment for postpneumonic empyema due toEnterobacter gergoviaepneumonia. Tube thoracostomy directed into both pneumatocele resulted in complete resolution and recovery.Enterobacter gergoviaeis a relevant human pathogen, capable of causing complicated pneumonia with fatal outcome if not properly managed. In developing countries where state-of the-art radiological facilities and expertise for prompt thoracic intervention are lacking, there is still room for nonoperative management of tension pneumatocele especially in very ill children.

scholarly journals Hemoptysis in the Immunocompromised Patient: Do Not Forget Strongyloidiasis

2019 ◽  
Vol 4 (1) ◽  
pp. 35 ◽  
Author(s):  
Prakash Shrestha ◽  
Sean E. O’Neil ◽  
Barbara S. Taylor ◽  
Olaoluwa Bode-Omoleye ◽  
Gregory M. Anstead
Keyword(s):  
Developing Countries ◽  
Differential Diagnosis ◽  
Immunocompromised Patient ◽  
Strongyloides Stercoralis ◽  
Immunocompromised Patients ◽  
Secondary Infections ◽  
Immunosuppressed Patients ◽  
Disseminated Strongyloidiasis ◽  
The Tropics ◽  
Candida Pneumonia

Strongyloidiasis, due to infection with the nematode Strongyloides stercoralis, affects millions of people in the tropics and subtropics. Strongyloides has a unique auto-infective lifecycle such that it can persist in the human host for decades. In immunosuppressed patients, especially those on corticosteroids, potentially fatal disseminated strongyloidiasis can occur, often with concurrent secondary infections. Herein, we present two immunocompromised patients with severe strongyloidiasis who presented with pneumonia, hemoptysis, and sepsis. Both patients were immigrants from developing countries and had received prolonged courses of corticosteroids prior to admission. Patient 1 also presented with a diffuse abdominal rash; a skin biopsy showed multiple intradermal Strongyloides larvae. Patient 1 had concurrent pneumonic nocardiosis and bacteremia with Klebsiella pneumoniae and Enterococcus faecalis. Patient 2 had concurrent Aspergillus and Candida pneumonia and developed an Aerococcus meningitis. Both patients had negative serologic tests for Strongyloides; patient 2 manifested intermittent eosinophilia. In both patients, the diagnosis was afforded by bronchoscopy with lavage. The patients were successfully treated with broad-spectrum antibiotics and ivermectin. Patient 1 also received albendazole. Strongyloidiasis should be considered in the differential diagnosis of hemoptysis in immunocompromised patients with possible prior exposure to S. stercoralis.

Cryptococcal meningoencephalitis in a non immunocompromised patient: Case report with necropsy

1993 ◽  
Vol 14 (1) ◽  
pp. 79-81
Author(s):  
C. Giraldi ◽  
M. Mazzoni ◽  
C. Sabò ◽  
F. Paterni ◽  
P. G. Morgantini ◽  
...  
Keyword(s):  
Case Report ◽  
Immunocompromised Patient ◽  
Patient Case ◽  
Cryptococcal Meningoencephalitis

scholarly journals Bear Maul Injury in Maxillofacial Region: A Case Report

2019 ◽  
Vol 1 (1) ◽  
pp. 22-25
Author(s):  
Arpit Vashistha ◽  
Manpreet Singh ◽  
Gagandeep Kaur ◽  
Shweta Gupta
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Adult Patient ◽  
Functional Impairment ◽  
Rural Areas ◽  
Clinical Report ◽  
Psychological Disturbance ◽  
Maxillofacial Region ◽  
Rare Presentation ◽  
Animal Attack

Face, has always been the point of attraction in a person’s physique, any disfigurement of that, caused either due to any sort of trauma or by animal attack, would lead to not only functional impairment but also severe psychological disturbance. The reasons for these injuries may vary from one country to another and even within the same country. Injuries due to bear mauling are most commonly seen in rural areas, but in developing countries like ours, stripping the wildlife of their natural habitation brings them close to more populated areas in the search of food. Increase in tourism may be another cause of these types of injuries. We herein report a rare presentation of bear maul injury in adult patient in maxillofacial region, and the purpose of this clinical report is to discuss the increase in incidence of such injuries and its subsequent management.

scholarly journals Disseminated Cryptococcosis Incorrectly Managed: a Case Report

2019 ◽  
pp. 28-31
Author(s):  
Adil Maleb ◽  
Aziza Hami ◽  
Yassine Ben Lahlou ◽  
Somiya Lamrabat ◽  
Safaa Rifai ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Blood Culture ◽  
Fungal Infection ◽  
Fatal Outcome ◽  
Microbiological Analysis ◽  
Immunocompromised Patients ◽  
Bacteriological Examination ◽  
Cryptococcal Infection ◽  
Immunocompetent Patients

Disseminated cryptococcosis is a rare fungal infection, which mainly occurs in immunocompromised patients, and the diagnosis is difficult. Therefore, it is less likely to be considered in immunocompetent patients. Here, we present a case of fatal cryptococcal infection of the pleural fluid and ascites in a patient seronegative for HIV. The patient was a 45-year old man who was followed for Crohn's disease and treated with steroids and an immunosuppressant (azathioprine). The culture of pleural and ascites fluids showed the presence of yeasts colonies identified as Cryptococcus neoformans. Bacteriological examination of the blood culture or cerebrospinal fluid (CSF) was not prescribed. The HIV serology was negative. At the fourth day of treatment, the patient died because of the deterioration of neurological and hepatocellular functions. The main diagnostic problems that led to this fatal outcome were non-suspicion of an at-risk patient, lack of microbiological analysis of the blood or CSF, and inadequate antifungal therapy.

scholarly journals Listeria monocytogenes brain abscess in an immunocompromised patient: a case report

2020 ◽  
Vol 8 (7) ◽  
pp. 2663
Author(s):  
Vinit Suri ◽  
S. Chatterjee ◽  
Rohini Handa ◽  
Swapnil Jain ◽  
Mohit Kalangi Venkata Naga ◽  
...  
Keyword(s):  
Case Report ◽  
Listeria Monocytogenes ◽  
Blood Culture ◽  
Brain Abscess ◽  
Immunocompromised Patient ◽  
Immunocompromised Patients ◽  
Neurological Manifestations ◽  
Oral Antibiotics ◽  
Mri Scan ◽  
Rare Presentation

Listeria monocytogenes is a facultative intracellular gram-positive bacillus which usually infects immunocompromised patients, though it can infrequently infect immunocompetent individuals, neonates and pregnant women as well. Neurological manifestations include meningitis and cerebritis. Brain Abscess is an extremely rare presentation with approximately 80 reported cases. Authors report a patient with a brain abscess identified on an MRI scan with positive blood culture for Listeria monocytogenes. Patient was managed conservatively with intravenous followed by oral antibiotics with resolution of the abscess. 

scholarly journals 779 An Unusual Manifestation of Tophaceous Gout in The Flexor Digitorum Superficialis Tendon of An Immunocompromised Patient: A Case Report and Literature Review

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
N Glynn ◽  
S Martin ◽  
H Lewis
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Immunocompromised Patient ◽  
High Risk Patient ◽  
Clinical Manifestations ◽  
Unusual Presentation ◽  
Immunocompromised Patients ◽  
Joint Movement ◽  
Tophaceous Gout ◽  
Transplant Patients

Abstract Aim This case report showcases an unusual presentation of tophaceous gout, in an immunocompromised patient. Furthermore, through a literature review, we highlight challenges posed by immunocompromised patients, the clinical manifestations of gout in the hand and principles of management. Method We report the case of a 62-year-old lady with previous liver transplant on immunosuppressants. She was admitted with a left palmar abscess, pyogenic tenosynovitis of the index finger and was taken to theatre for debridement and washout. Superimposed infection was apparent. This originated from an exophytic mass extending from the palm to FDS tendon insertion. This was debulked and histologically confirmed as gout. A review of the literature was performed using key search terms on PubMed relating to manifestations of gout in the tendons of the hand, and in patients on immunosuppression. Results Reports in the literature describe cases of gouty tendinopathy in both flexor and extensor tendons. Reported symptoms include triggering, tendon rupture and tenosynovitis. Gout occurs in a higher frequency in transplant patients. This can be attributed to medications such as cyclosporine which predispose to hyperuricaemia. Management of this condition involves medical optimisation. Despite concurrent problems with wound healing in the immunocompromised with gout, surgical intervention may be required. Indications include superimposed infection, attenuated tendon glide, joint movement, and neuropathy. Perioperative antibiotics are recommended in all immunocompromised patients. Conclusions This case highlights an unusual presentation of gout and the challenges of managing patients on immunosuppressant therapy. A greater awareness of this condition will allow for appropriate management in this high-risk patient cohort.

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