Tropical splenomegaly in a migrant-in-transit crossing the Darien gap, Panamá: A probable case of hyper-reactive malarial splenomegaly.

Hyper-reactive malarial splenomegaly (HMS), or tropical splenomegaly syndrome, is a severe complication of chronic and recurrent infections caused by Plasmodium spp. This condition typically results in splenomegaly greater than or equal to 10 cm and a constellation of laboratory findings, including the absence of identifiable parasites in peripheral blood smears. However, patients with HMS demonstrate serological or molecular evidence of infection. Despite being a familiar entity in malaria holoendemic countries in Africa, and regions of Papua New Guinea, the pathophysiology, natural history, and treatment of the syndrome remains to be fully elucidated. Herein, we describe a highly suggestive case of HMS in a Senegalese patient migrating northbound to reach the U.S.-Mexico border and for whom we provided medical care during his crossing of the Darien Gap in Panama. We also reviewed the literature on diagnosing and treating HMS in-depth.

Descending Necrotizing Mediastinitis by Streptococcus anginosus and Prevotella buccae in an Intensive Care Unit Patient: A Case Report.

Necrotizing infections of deep neck spaces are a group of life-threatening infectious diseases acquired through trauma or as a descending infection from an odontogenic source. The isolation of pathogens is unusual because of the anaerobic nature of the infection; however, one way to achieve this is through the use of automated microbiological methods like matrix-assisted laser desorption/ionization and time-of-flight (MALDI-TOF) following standard microbiology protocols for analyzing samples from potential anaerobic infections. We present a case of a patient without risk factors for descending necrotizing mediastinitis with isolation of Streptococcus anginosus and Prevotella​​​​​​​ buccae managed at the intensive care unit with a multidisciplinary team. We present our approach and how we successfully treat this complicated infection.

Caterpillar Envenomation (Lepidopterism) in a Panamanian Jungle: About a Case.

Caterpillar venom has the potential to cause acute pain and systemic symptoms in individuals seeking medical attention in the jungles of Panama. Although this is not an obligatory notifiable disease, the hazards associated with exposure to this animal are widely recognized within the local community. Here, we present a case of a patient who sought medical attention after being rescued from a river in a Panamanian jungle after feeling acute pain in an upper extremity associated with shortness of breath and how tropical medicine teleconsult allowed for quick identification of the cause and assisted in the management. About his case, we examine the phenomenon of caterpillar envenomation and suggest that further research is needed to assess the potential impact of climate change on this disease. Of particular concern is the likelihood of an increase in contact accidents. We recommend that scientists and public health officials work together to understand the mechanisms of this disease better and to develop effective strategies for prevention and treatment. Our analysis underscores the importance of ongoing monitoring and surveillance to ensure we are prepared for future outbreaks.

Surgical Site Infection by Shewanella algae After Major Surgery in a Patient With Colorectal Cancer: Case Report.

Surgical site infections are a common complication in the management of patients with solid cancer tumors in cytotoxic chemotherapy. The antibiotic combination chosen depends on the neoadjuvant therapy used and the anatomical site and extent of the surgery. In this brief report, we describe a surgical site infection caused by an unusual microorganism and a succinct review of the pathogen's behavior.