- Volume 4, Issue 6, 2017
Volume 4, Issue 6, 2017
- Case Report
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- Gastrointestinal
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First case of human peritoneal cysticercosis mimicking peritoneal carcinosis: necessity of laparoscopy and histologic assessment for the correct diagnosis
Introduction. Correct diagnosis of peritoneal infectious disease can be extremely difficult due to non-specific clinical features. Thus, careful assessment with thorough histopathological work-up is essential. Here, we report the first case of human peritoneal cysticercosis mimicking peritoneal carcinosis.
Case presentation. The patient presented with recurring ascites and a tumour in the Douglas cavity accompanied by elevated tumour markers. There were no signs of systemic infection. On laparoscopy, the tumour was resected completely. Histology revealed a granulomatous reaction and a diagnosis suspicious of tuberculosis was made. Only after additional sections, avital cestode-fragments were visible and Taenia martis DNA was detected. Further staging by computerized tomography scan of the lung and brain turned out negative and the patient recovered quickly.
Conclusion. Laparoscopy and histopathological examination can be extremely helpful for correct diagnosis and management in uncertain recurrent ascites. This case clearly demonstrates that orphan infectious diseases should also be considered. Only complete histopathological examination with serial sections and additional molecular testing can lead to the appropriate diagnosis.
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Acute diarrhoea due to a Shiga toxin 2e-producing Escherichia coli O8 : H19
More LessIntroduction. Identification of non-O157 Shiga-toxin-producing Escherichia coli (STEC) infections may be underestimated in microbiological diagnosis.
Case presentation. A 58-year-old woman developed diarrhoea with watery and subsequently mucous stool. Initial multiplex PCR testing revealed a positive result for stx2 . Culture isolation of a STEC was successful only after repeated inoculation of chromogenic E. coli media. Molecular characterization was performed and identified the isolate as stx 2e-positive STEC of serotype O8 : H19. The strain harboured lpfA, but not eae.
Conclusion. This case highlights the usefulness of initial multiplex PCR for diagnosis of non-O157 STEC infection.
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- Soft Tissue
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Marked peripheral eosinophilia due to prolonged administration of posaconazole
More LessIntroduction. Posaconazole is a triazole antifungal that is used in the treatment of a variety of fungal infections, as well as in the management of mucormycosis (on an off-label basis). Eosinophilia associated with exposure to azole antifungals has been described rarely in the literature.
Case presentation. A 31-year-old male on peritoneal dialysis (PD) for end-stage renal disease, secondary to diabetic nephropathy, presented to hospital with abdominal pain after a trip to St Lucia. He was taken to the operating room, where the PD catheter was removed and an abdominal-wall abscess was debrided. R hizopus species was recovered on culture of the abdominal-wall tissue, and the patient was started on amphotericin B deoxycholate. He was subsequently stepped down to posaconazole, for a planned treatment duration of 12 months. Approximately 43 days after the initiation of posaconazole, it was noted that his peripheral eosinophil count started to rise. No other cause for the eosinophilia was identified. Posaconazole was discontinued, and the patient’s eosinophil count began to drop 2 days later. The temporal association of eosinophilia following initiation of posaconazole and the subsequent improvement after drug discontinuation suggests a probable causal relationship.
Conclusion. At the time of writing, there have been only two other published cases of azole-associated peripheral eosinophilia. In reporting this case, we hope to increase health-care provider awareness of this rare adverse event. For patients receiving prolonged therapy with posaconazole, periodic monitoring of the complete blood count with differential may be considered.
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- Respiratory
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A case of Exophiala dermatitidis infection in a child after allogeneic stem cell transplantation: case report and literature review of paediatric cases
Introduction. Exophiala dermatitidisis a relatively common environmental black yeast with worldwide distribution and is a rare cause of fungal infection, mostly in patients with certain predisposing factors. Due to the rarity of the infection, little is known about the specific predisposing factors, way of infection or treatment.
Case presentation. Here, we report what is to our knowledge the first case of E. dermatitidis infection in a child after allogeneic stem cell transplantation. We also review all paediatric cases reported in the literature since 1993.
Conclusion. This is, to our knowledge, the first reported case of E. dermatitidis infection in a child after allogeneic stem cell transplantation. This report should increase the awareness of E. dermatitidis in immunocompromised paediatric patients, particularly after stem cell transplantation.
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- Case Quiz
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- Urinary Tract and Reproductive Organs
- Soft Tissue