scholarly journals Sporotrichoid-Like Spread of Cutaneous Mycobacterium chelonae in an Immunocompromised Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Daria Marley Kemp ◽  
Anusha G. Govind ◽  
Jun Kang ◽  
Caroline C. Brugger ◽  
Young C. Kauh
Keyword(s):  
Lupus Erythematosus ◽  
Soft Tissues ◽  
Immunocompromised Patient ◽  
Immunocompromised Patients ◽  
Systemic Lupus ◽  
Mycobacterium Chelonae ◽  
Cutaneous Infections ◽  
Subcutaneous Nodules ◽  
Immunosuppressive Medications ◽  
Atypical Presentations

Mycobacterium chelonae is a rapidly growing mycobacterium found in water and soil that can cause local cutaneous infections in immunocompetent hosts but more frequently affects immunocompromised patients. Typically, patients will present with painful subcutaneous nodules of the joints or soft tissues from traumatic inoculation. However, exhibiting a sporotrichoid-like pattern of these nodules is uncommon. Herein, we report a case of sporotrichoid-like distribution of cutaneous Mycobacterium chelonae in a patient with systemic lupus erythematosus on significant immunosuppressive medications. Clinicians treating immunocompromised patients should be cognizant of their propensity to develop unusual infections and atypical presentations.

scholarly journals Recurrence of cutaneous Mycobacterium chelonae infection: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984523
Author(s):  
Anaïs DuBow ◽  
Meggie Morand ◽  
Delphine Désy ◽  
Mark Krasny
Keyword(s):  
Lupus Erythematosus ◽  
Soft Tissues ◽  
Lower Leg ◽  
American Thoracic Society ◽  
Prolonged Treatment ◽  
Cutaneous Infection ◽  
Systemic Lupus ◽  
Mycobacterium Chelonae ◽  
Immunocompromised Status ◽  
Subsequent Improvement

Mycobacterium chelonae is a species of mycobacteria that can be found ubiquitously in the environment. It can be found in soil, water, and in aquatic animals. Infections with this pathogen usually involve the soft tissues, eyes, bones, and skin. We present the case of a recurrence of a sporotrichoid cutaneous infection by M. chelonae in an immunocompromised 31-year-old woman with systemic lupus erythematosus. The patient originally developed a swelling of her right foot followed by a sporotrichoid pattern of infection on her right lower leg. A susceptibility profile was established, and treatment with linezolid and clarithromycin was administered for 8 months, in accordance with guidelines from the American Thoracic Society. The patient was clear of new lesions for approximately 1 month before noting a re-emergence. Treatment with linezolid and clarithromycin was re-initiated with subsequent improvement. This case underlines the need for prolonged treatment of this infection in patients with an immunocompromised status.

A Case of Subcutaneous Mycobacterium chelonae Infection in a Patient with Systemic Lupus Erythematosus

2011 ◽  
Vol 73 (5) ◽  
pp. 501-504
Author(s):  
Hiroko KONO ◽  
Monji KOGA ◽  
Shinichi IMAFUKU ◽  
Juichiro NAKAYAMA ◽  
Kaori KOGA
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Mycobacterium Chelonae

scholarly journals Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus

2021 ◽  
Vol 23 (9) ◽  
Author(s):  
Andrea Di Matteo ◽  
Gianluca Smerilli ◽  
Edoardo Cipolletta ◽  
Fausto Salaffi ◽  
Rossella De Angelis ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Soft Tissue ◽  
Lupus Erythematosus ◽  
Structural Damage ◽  
Structural Changes ◽  
Soft Tissues ◽  
Imaging Techniques ◽  
Joint Involvement ◽  
Systemic Lupus ◽  
Muscle Involvement

Abstract Purpose of Review To highlight the potential uses and applications of imaging in the assessment of the most common and relevant musculoskeletal (MSK) manifestations in systemic lupus erythematosus (SLE). Recent Findings Ultrasound (US) and magnetic resonance imaging (MRI) are accurate and sensitive in the assessment of inflammation and structural damage at the joint and soft tissue structures in patients with SLE. The US is particularly helpful for the detection of joint and/or tendon inflammation in patients with arthralgia but without clinical synovitis, and for the early identification of bone erosions. MRI plays a key role in the early diagnosis of osteonecrosis and in the assessment of muscle involvement (i.e., myositis and myopathy). Conventional radiography (CR) remains the traditional gold standard for the evaluation of structural damage in patients with joint involvement, and for the study of bone pathology. The diagnostic value of CR is affected by the poor sensitivity in demonstrating early structural changes at joint and soft tissue level. Computed tomography allows a detailed evaluation of bone damage. However, the inability to distinguish different soft tissues and the need for ionizing radiation limit its use to selected clinical circumstances. Nuclear imaging techniques are valuable resources in patients with suspected bone infection (i.e., osteomyelitis), especially when MRI is contraindicated. Finally, dual energy X-ray absorptiometry represents the imaging mainstay for the assessment and monitoring of bone status in patients with or at-risk of osteoporosis. Summary Imaging provides relevant and valuable information in the assessment of MSK involvement in SLE.

scholarly journals Fatal Disseminated Aspergillosis in a Patient with Systemic Lupus Erythematosus

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Rochelle Hardie ◽  
Tracian James-Goulbourne ◽  
Monsoon Rashid ◽  
Jeremy Sullivan ◽  
Yamen Homsi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Respiratory Failure ◽  
Lupus Erythematosus ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Shortness Of Breath ◽  
Systemic Lupus ◽  
Increased Risk ◽  
Life Threatening ◽  
Disseminated Aspergillosis

Patients with systemic lupus erythematosus (SLE) are at increased risk for infection including opportunistic infections. Fungal infection in particular can be difficult to diagnose and treat and often can be life-threatening in the immunocompromised patient. We present a case in which a patient with SLE presented to the hospital with shortness of breath and cough. Throughout the hospital course, the patient’s condition continued to decline leading to acute respiratory failure, and eventually, the patient expired. Postmortem autopsy revealed invasive fungal aspergillosis infection involving the heart, lungs, and brain. Earlier diagnosis and treatment with empiric antifungals may improve survival in these patients.

scholarly journals Changing paradigms in the treatment of systemic lupus erythematosus

2019 ◽  
Vol 6 (1) ◽  
pp. e000310 ◽  
Author(s):  
Antonis Fanouriakis ◽  
George Bertsias
Keyword(s):  
Lupus Erythematosus ◽  
Personal Experience ◽  
Calcineurin Inhibitors ◽  
Routine Care ◽  
Retinal Toxicity ◽  
Future Perspectives ◽  
Systemic Lupus ◽  
High Quality ◽  
Everyday Clinical Practice ◽  
Immunosuppressive Medications

SLE poses formidable therapeutic challenges due to its heterogeneity and treatment decisions often cannot be guided by data of high quality. In this review, we attempt to provide insights regarding the treatment of SLE in everyday clinical practice, based on contemporary evidence and our own personal experience. We focus on common therapeutic issues and dilemmas arising in routine care, including monitoring for retinal toxicity associated with hydroxychloroquine, handling of glucocorticoid regimens in order to minimise their adverse events, choice of immunosuppressive medications based on prevailing disease manifestations and optimal use of available biological agents (belimumab and rituximab). We also provide our view on the position of calcineurin inhibitors in the management of lupus nephritis and conclude with remarks on the future perspectives for this challenging disease.

scholarly journals Comparative Rates of Serious Infections Among Patients With Systemic Lupus Erythematosus Receiving Immunosuppressive Medications

2017 ◽  
Vol 69 (2) ◽  
pp. 387-397 ◽  
Author(s):  
Candace H. Feldman ◽  
Francisco M. Marty ◽  
Wolfgang C. Winkelmayer ◽  
Hongshu Guan ◽  
Jessica M. Franklin ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Immunosuppressive Medications ◽  
Serious Infections

scholarly journals Jaccoud’s Arthropathy in Gout: An Unusual Association

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Tayana Donato Alves ◽  
Isabela S. Oliveira ◽  
Luiza C. Fadul ◽  
Mittermayer B. Santiago
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Jaccoud’S Arthropathy ◽  
Chronic Gout ◽  
Subcutaneous Nodules ◽  
Unusual Association ◽  
Deforming Arthropathy ◽  
History Of ◽  
Jaccoud's Arthropathy

Jaccoud’s arthropathy (JA) is a deforming arthropathy observed mainly in patients with systemic lupus erythematosus. We report the case of a 41-year-old Brazilian man with a 10-year history of intermittent monoarthritis followed by bouts of polyarthritis affecting large and small joints. He presented deformities typical of JA and subcutaneous nodules. Histopathological findings of a nodule biopsy were consistent with gouty tophi. To our knowledge, this is the first report of JA secondary to chronic gout.

scholarly journals High-titre convalescent plasma therapy for an immunocompromised patient with systemic lupus erythematosus with protracted SARS-CoV-2 infection

2021 ◽  
Vol 14 (8) ◽  
pp. e244853
Author(s):  
Sara Moutinho-Pereira ◽  
Raquel Calisto ◽  
Federico Sabio ◽  
Luísa Guerreiro
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
High Titre ◽  
High Dose ◽  
Systemic Lupus ◽  
Plasma Therapy ◽  
Reverse Transcription Pcr ◽  
Anti Cd20

A 39-year-old woman with systemic lupus erythematosus treated with anti-CD20 monoclonal antibody rituximab was admitted to our hospital with COVID-19 pneumonia. Despite receiving dexamethasone, she developed hypoxaemia and persistent lung opacities. As bronchoalveolar lavage was suggestive of cryptogenic organising pneumonia, high-dose corticosteroid was administered, and she received antimicrobial therapy for opportunistic infections without improvement. Reverse transcription PCR was repeatedly positive for SARS-CoV-2, and virus replication was confirmed in cell cultures. As no anti-SARS-CoV-2 antibodies were detected more than 100 days after symptom onset, she was treated with convalescent plasma with fast clinical improvement, returning home days later. Our case shows that persistent SARS-CoV-2 infection in an immunocompromised patient may be overturned with the appropriate treatment.

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