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  • 1.

    【2hr】Emphysematous Aortitis due to Clostridium septicum in an 89-Year-Old Female with Ileus

    包量

    机译 一名89岁的肠梗阻女性因败血梭状芽胞杆菌引起的气肿性主动脉炎
    摘要：Emphysematous aortitis is a rare but lethal form of infectious vasculitis. This condition was found incidentally on computed tomography of the chest during the evaluation of a patient presenting with pneumonia coincident with adynamic ileus. The patient did not have a history of malignancy. While colon cancer could not be ruled out, it is possible that ileus may have contributed to or resulted in bacterial translocation in this case. Appropriate investigations and empirical therapy against Clostridium septicum should be initiated in the presence of clinical and radiological findings suggestive of emphysematous aortitis.
  • 2.

    【2hr】Successful Management of Cryptococcal Meningitis and Bone Marrow Infiltration in a Young HIV/AIDS Patient: A Case Report and Review of the Literature

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    机译 一位年轻的艾滋病毒/艾滋病患者的隐球菌脑膜炎和骨髓浸润的成功治疗：病例报告和文献复习
    摘要：Bone marrow cryptococcosis has been rarely reported in the literature, and there are no established treatment guidelines specific to this AIDS-related complication. The recommended treatment for AIDS-related invasive fungal treatments include amphotericin B and flucytosine which are associated with an array of complications making optimal treatment recommendations difficult. This case presentation represents an example of a patient with newly diagnosed AIDS and bone marrow cryptococcosis, which was successfully managed with an antifungal regimen adjusted to her comorbidities.
  • 3.

    【2hr】Edwardsiella tarda Infection Triggering Acute Relapse in Pediatric Crohn's Disease

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    机译 爱德华氏菌感染引发小儿克罗恩病急性复发
    摘要：Crohn's disease exacerbations can often be associated with bacterial infections causing gastroenteritis. We report a child who experienced exacerbation of his Crohn's disease associated with a positive stool culture for Edwardsiella tarda (E. tarda). Endoscopy showed features of moderate inflammation similar to exacerbation of Crohn's disease. The patient was treated simultaneously with intravenous steroids and antibiotics, and his symptoms resolved. This case report highlights the importance of clinicians being able to promptly recognize and treat concurrent bacterial infections in Crohn's disease exacerbations.
  • 4.

    【2hr】Domestic Horse Bite: An Unusual Etiology of Crush Injury of the Fourth Finger—How to Manage?

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    机译 家马咬伤：四指挤压伤的不寻常病因-如何处理？
    摘要：Almost 2% of all emergency admissions involve an animal bite. While horses bite humans very rarely, their bites are mostly associated with fatalities. Herein, we report the case of a 23-year old bitten by a domestic horse causing a crush injury to his fourth finger with fracture dislocation of the proximal interphalangeal joint. The patient benefited upon arrival at the emergency department from copious irrigation with saline serum, tetanus toxoid, postexposure rabies vaccination, and prophylactic antibiotic therapy. In the operating room, surgical exploration found the ulnar digital pedicle sectioned, the flexor and extensor tendons sectioned and shredded, and the skin shredded. An excisional debridement of devitalized tissue with copious irrigation was performed, and the finger regularized at the level of traumatic amputation with tendon striping followed by coverage of the bone by the radial digital flap with careful clinical and biological monitoring after the surgery. At the last follow-up, the patient revealed no sign of infection, and he returned to his usual activities and has been discharged from care. This wound management, based on a careful examination, a meticulous debridement, and an efficient cleaning with early and targeted antibiotic therapy, might promote good results and avoid dangerous complications.
  • 5.

    【2hr】A Case of a Persistent Postoperative Infection Caused by Multidrug-Resistant Kluyvera ascorbata in the Oral and Maxillofacial Region

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    机译 一例口腔颌面部多药耐药克鲁维酵母引起的持续性术后感染
    摘要：Introduction Kluyvera ascorbata infection is rare, but it has been extensively studied because of its potential to cause a wide range of infections and its ability to transfer the gene encoding for CTX-M-type extended spectrum β-lactamases (ESBLs) to other Enterobacteriaceae.
  • 6.

    【2hr】A Report of Four Cases of Blackwater Fever after Quinine Treatment at Zinder National Hospital, Niger Republic

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    机译 尼日尔Zinder国家医院奎宁治疗后黑水热四例报道
    摘要：Background Blackwater fever (BWF) is a rare but serious complication of malaria that is a consequence of antimalarial treatment. Its prevalence seems to have increased. Its diagnosis is based on clinical symptoms and urine color. We report on 4 BWF cases admitted to the infectious diseases department of Zinder National Hospital.
  • 7.

    【2hr】An Unusual Case of Streptococcus pyogenes Causing Ruptured Aortic Mycotic Aneurysm

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    机译 化脓性链球菌引起破裂的主动脉霉菌性动脉瘤的罕见病例
    摘要：A 70-year-old male with a complex past medical history presents with confusion and slurred speech for 24 hours. His exam was unremarkable, and his CT head was negative. Both his C-reactive protein and white blood cell count were elevated. As part of the delirium workup, blood cultures were done which grew Streptococcus pyogenes with no obvious source. He was treated with appropriate antibiotics. To determine the source, a white blood cell scan was done, which showed increased localization within a left-sided upper mediastinum mass. Subsequently, chest CT scan with contrast showed an acute type B aortic dissection with mycotic aneurysm. Consequently, he was taken urgently for surgical management. He completed 6 weeks of penicillin G and was discharged to a rehabilitation center. This case illustrates both a rare entity, mycotic aneurysm secondary to Streptococcus pyogenes, and the importance of getting an Infectious Diseases consult in the setting of an unknown source of bacteremia.
  • 8.

    【2hr】A Rare Case of HHV-8 Associated Hemophagocytic Lymphohistiocytosis in a Stable HIV Patient

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    机译 稳定的HIV患者中HHV-8相关的噬血细胞淋巴细胞增多的罕见病例
    摘要：Background Hemophagocytic lymphohistiocytosis (HLH) is a rare condition associated with viral infections including HIV. Cases have been reported mainly in advanced HIV/AIDS. This is a rare case that reports HLH associated with human herpes virus-8 (HHV-8) associated multicentric Castleman disease in a stable HIV patient.
  • 9.

    【2hr】Cryptococcal Meningitis in a HIV Seronegative Patient: A Rare Complication of Cerebrospinal Fluid Leak Detected with a New Cisternographic Technique

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    机译 HIV血清阴性患者的隐球菌性脑膜炎：使用新的脑电图技术检测到的罕见的脑脊液漏并发症。
    摘要：Immune deficiency is usually the underlying predisposing factor for cryptococcal meningitis, though there have been case reports of immunocompetent patients presenting with same. The portal of entry for Cryptococcus neoformans is the respiratory tract, and by hematogenous spread, it causes systemic symptoms. The presence of CSF leak is described to have predisposed our immunocompetent patient to infection by this organism possibly through direct spread. The gold standard for diagnosing CSF leak is by cisternography. In this case, we added a technique where nasal gauze is inserted during the procedure and scanned afterwards for dye, thus increasing the confidence of diagnosis of CSF leak through the nares. Prompt diagnosis and treatment is key to prevent adverse outcomes, and we propose that in patients with cryptococcal meningitis without any identifiable risk factor, evaluation for CSF leak should be considered especially with history of head trauma.
  • 10.

    【2hr】Capnocytophaga canimorsus as Cause of Fatal Sepsis

    包量

    机译 Capnocytophaga canimorsus是致命性败血症的原因
    摘要：A rare consequence of dog bites is the infection with Capnocytophaga canimorsus, and only a few cases have been documented. We describe a 41-year-old, formerly healthy woman who died from septic shock and multiorgan failure. It is the first case of a young individual without obvious immunosuppression.
  • 11.

    【2hr】Miltefosine Rescue Treatment for Visceral Leishmaniasis Relapse Patient

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    机译 Miltefosine救治内脏利什曼病复发患者
    摘要：We report the first case of miltefosine rescue treatment carried out for visceral leishmaniasis (VL) relapse patient. Despite undergoing treatment regimens of liposomal amphotericin B (LAMB) 5 mg/kg (standard: 10 mg/kg) daily for 3 days during the first episode followed by LAMB 5 mg/kg stat and paromomycin 15 mg/kg IM for 10 days against the second episode, the patient suffered from a third relapse and was eventually treated with miltefosine 50 mg BID directly observed treatment for 28 days. Prior to treatment, the patient had a history of intermittent fever and vague abdominal pain for one week and epistaxis for 4 days. He had massive splenomegaly, tested positive for the rK39 test, and showed LD bodies in bone marrow aspirate. The patient tested negative for malaria and HIV. Upon treatment completion with miltefosine, the patient had clinically improved and showed no LD bodies in bone marrow.
  • 12.

    【2hr】Staphylococcal Pericarditis Causing Pericardial Tamponade and Concurrent Empyema

    包量

    机译 引起心包填塞和并发脓胸的葡萄球菌性心包炎
    摘要：Bacterial pericarditis is a rare presentation and is usually due to secondary infection from a hematogenous cause or can occur secondary to trauma, intrathoracic surgery, or due to spread of infection from a contiguous focus via ligaments that anchor the pericardium to its surrounding structures. Its course is fulminant characterized by a high mortality rate from sepsis, tamponade, and constriction. We describe a rare case of Staphylococcus aureus pericarditis with concurrent unilateral empyema. The patient rapidly developed tamponade and was successfully treated with antibiotics and urgent percutaneous pericardial drainage with placement of a temporary catheter. Treatment for bacterial pericarditis typically is 4–6 weeks long. Thoracic surgery should be consulted as soon as possible to determine need for surgical intervention, as fibrin deposition may occur, making percutaneous drainage incomplete and leading to complications of persistent purulent pericarditis or constrictive pericarditis.
  • 13.

    【2hr】A Case of Serratia marcescens Endocarditis in a Nonintravenous Drug-Using Male Patient and Review of Literature

    包量

    机译 一例非静脉吸毒男性患者的粘质沙雷氏菌心内膜炎一例并文献复习
    摘要：Introduction Serratia marcescens is a rare cause of infective endocarditis and has almost exclusively been associated with intravenous drug use and hospital-acquired infections. Here, we present a case of infective endocarditis caused by Serratia marcescens in an otherwise healthy, nonintravenous drug-using male patient.
  • 14.

    【2hr】Disseminated Cryptococcosis in a Non-HIV Patient in Singapore

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    机译 在新加坡的一名非艾滋病毒患者中传播隐球菌病
    摘要：We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition.
  • 15.

    【2hr】HIV-Associated Vacuolar Myelopathy and HIV-Associated Dementia as the Initial Manifestation of HIV/AIDS

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    机译 HIV相关的血管性脊髓病和HIV相关的痴呆是HIV / AIDS的最初表现
    摘要：HIV-associated vacuolar myelopathy (HIV-VM) is the most common cause of spinal disease in HIV/AIDS. HIV-VM causes progressive spastic paraparesis, sensory ataxia, and autonomic dysfunction. It is a progressive myelopathy that shares features with subacute combined degeneration seen in vitamin B12 deficiency as well as other neurological diseases and can occur synchronously with HIV-associated dementia (HAD). Here, we describe a rare case in which a patient's initial presentation of HIV/AIDS was both HIV-VM and HAD. A fifty-three-year-old man presented with a six-month history of numerous falls due to progressive gait instability with associated memory loss, tremor, urinary retention, and impotence. His exam was significant for hyperreflexia and weakness in bilateral lower extremities, upgoing plantar reflex, dysmetria, and ataxic gait. MRI-brain was notable for nonspecific volume loss and diffusely increased T2 signal throughout the supratentorial white matter. Lumbar puncture showed isolated lymphocytic pleocytosis with all other CSF testing unremarkable. He ultimately tested positive for HIV-1, with a CD4 count of 157 cells/mm3 and a viral load of 874,000 copies/mL. He was diagnosed with HIV-VM and HAD which improved after several months of antiretroviral therapy. This case highlights the importance of considering HIV testing in a patient with a sensory neuropathy and/or progressive cognitive impairment.
  • 16.

    【2hr】Severe Eosinophilic Meningoencephalitis Secondary to Suspected Neuroangiostrongyliasis with a Good Clinical Outcome

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    机译 重度嗜酸性脑膜脑炎继发于疑似神经血管平滑肌病，临床疗效良好
    摘要：Angiostrongylus cantonensis has caused sporadic cases of eosinophilic meningoencephalitis in Sydney, Australia. We describe a 36-year-old man who presented subacutely with fevers, reduced level of consciousness, confusion, ophthalmoplegia, and urinary incontinence. He was diagnosed with severe eosinophilic meningoencephalitis secondary to suspected Angiostrongylus cantonensis based on clinical, serological, and radiological findings. The patient was treated with albendazole and prednisolone with full neurological recovery. Management of neuroangiostrongyliasis with anthelminthic is controversial as it is thought to cause worsened outcomes through inciting an inflammatory response as a result of parasite killing. We managed to successfully treat our patient using albendazole and prednisolone and achieved a good outcome.
  • 17.

    【2hr】Cladophialophora bantiana Cerebral Phaeohyphomycosis Complicated by Pulmonary Nocardiosis: A Tale of Two Infections

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    机译 Cladophialophora bantiana并发肺部心肌病并发肺萎缩性真菌病：两种感染的故事
    摘要：Cladophialophora bantiana, a melanized neurotropic fungus, is the most commonly reported agent of cerebral phaeohyphomycosis. We present a case of cerebral phaeohyphomycosis due to C. bantiana with a concomitant Nocardia infection in the lung. The patient was a 64-year-old male who presented with one-week history of productive cough, confusion, and staggering gait. Brain MRI showed multiple enhancing masses, and chest CT demonstrated multifocal consolidation. To confirm diagnosis, brain biopsy was performed that showed Cladophialophora bantiana. Bronchoscopic lung biopsy confirmed infection with Nocardia araoensis. The patient was treated with trimethoprim-sulfamethoxazole, meropenem, voriconazole, and liposomal amphotericin in addition to partial resection of the brain mass. After several weeks in the hospital and deteriorating status with poor prognosis, medical care was withdrawn. Cladophialophora bantiana infection is rare and requires multidisciplinary approach for accurate diagnostic confirmation. Aggressive and long-term treatment with voriconazole along with early neurosurgical intervention may offer an improved chance of survival in these patients.
  • 18.

    【2hr】A Case of Fusobacterium necrophorum without Lemierre's Syndrome Mimicking Acute Leptospirosis

    包量

    机译 一例没有模拟急性钩端螺旋体病的无Lemierre综合征的坏死镰刀菌
    摘要：Jaundice, conjunctival hyperemia, and acute kidney injury (AKI) are the characteristics of leptospirosis. However, it is not well known that Fusobacterium necrophorum infection can have a clinical picture similar to that of leptospirosis. A 38-year-old man was admitted with jaundice, conjunctival hyperemia, and AKI for 7 days. Chest CT scan showed multiple pulmonary nodules, atypical for leptospirosis. We started treatment with IV piperacillin-tazobactam and minocycline. He became anuric and was urgently started on hemodialysis on the second hospital day. Later on, blood cultures grew Fusobacterium necrophorum and other anaerobic bacteria. Antibody and PCR assays for Leptospira were negative. We narrowed the antibiotics to IV ceftriaxone and metronidazole. He responded well to the treatment and was discharged on the 18th hospital day. F. necrophorum infection is known to cause mixed infection with other anaerobic bacteria. The resistance of many anaerobic bacteria continues to progress, and F. necrophorum itself sometimes produces β-lactamase. This case highlights the potential risks of using penicillin before diagnosis of leptospirosis.
  • 19.

    【2hr】Prepatellar Bursal Infection Caused by Mycobacterium tuberculosis with an In Situ Total Knee Arthroplasty: A Case Report and Comprehensive Literature Review

    包量

    机译 结核分枝杆菌伴原位全膝关节置换术引起的pat骨前囊感染：一例报道及综合文献复习
    摘要：Prepatellar bursal infection is a rare occurrence. The incidence of tuberculosis, including musculoskeletal type, is increasing. We present a case of isolated prepatellar bursal swelling associated with a discharging sinus; the condition developed in an elderly patient 4 years after total knee arthroplasty. Aspiration of the bursa revealed acid-fast bacilli on Ziehl–Neelsen staining, typical of Mycobacterium tuberculosis; this was confirmed later on culture. The patient was successfully treated with a 6-month course of antituberculous chemotherapy. To the best of our knowledge, only two previous cases of tuberculous prepatellar bursal infection have been reported in English literature. Our case illustrates the importance of considering tuberculous prepatellar bursal infection in the differential diagnosis of anterior knee swelling. All physicians treating patients with musculoskeletal disease should be aware of the possibility of this diagnosis and maintain a high index of suspicion; this is especially true in areas where tuberculosis is still endemic and in high-risk patients, such as the elderly.
  • 20.

    【2hr】Cerebellar Neurocysticercosis as Long-Term Complication of Allogeneic Haematopoietic Stem Cell Transplantation from Haploidentical Donor

    包量

    机译 小脑神经囊虫病作为单倍体供体的同种异体造血干细胞移植的长期并发症。
    摘要：Neurocysticercosis, an infection of the central nervous system with the larval stage of the cestode Taenia solium, is uncommon in developed countries. We report a case of allogeneic haematopoietic stem cell transplantation from a haploidentical donor complicated, in the long term, by T. solium infection of the central nervous system and successfully treated with empiric antiparasitic therapy with albendazole plus dexamethasone. Revised diagnostic criteria proposed by Del Brutto et al. were used for the definitive diagnosis of cerebellar neurocysticercosis.
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