Bacteriophages for the treatment of pseudomonas-infected vascular prosthesis.

We present a case report detailing therapeutic application of two lytic antipseudomonal bacteriophages to treat a chronic relapsing Pseudomonas aeruginosa infection of a prosthetic aortic graft. As there are currently no Danish laboratories offering phages for clinical therapy, and this case, to our knowledge represents the first applied phage therapy in Denmark, the practical and regulatory aspects of offering this treatment option in Denmark is briefly reviewed along with the clinical case.

Orientia tsutsugamushi detected by microbiome diagnostics.

Scrub typhus is caused by the mite-borne bacterium Orientia tsutsugamushi. Imported cases have been suspected in Denmark but no diagnostic method has yet been available to confirm the diagnosis. This is a case report of a 38-year-old male admitted to hospital with high fever, severe malaise and headache after returning from Malaysia. Scrub typhus was suspected and the patient recovered after one week of doxycycline treatment. The pathogen was identified by use of microbiome 16S/18S rRNA next-generation sequencing on ethylenediamine tetraacetic acid (EDTA) blood, which in the future may serve an important role in the investigation of travel-associated infections.

First molecular documented case of a rarely reported parasite: Plasmodium knowlesi infection in Denmark in a traveller returning from Malaysian Borneo.

Plasmodium knowlesi has been reported as an emerging infection throughout the Southeast Asian region, especially in the Malaysian state of Sabah, where it accounts for the majority of the malaria cases reported. This is in contrast to Europe, where imported P. knowlesi is a rarely reported infection. We present a case of P. knowlesi infection in a Danish woman returning from a short trip to Malaysian Borneo. Microscopy of blood smears revealed 0.8% infected erythrocytes, but due to the atypical morphological presentation, a conclusive species identification was made by molecular methods. Plasmodium knowlesi is a potentially fatal infection and taking the increasing travel activity into consideration after the coronavirus disease 2019 (COVID-19) pandemic, P. knowlesi should be a differential diagnosis in patients with travel-associated illness returning from highly endemic Southeast Asian areas.

Neoehrlichiosis is a new tick-borne infection.

Neoeherlichiosis is an emerging tick-borne infection causing disease in individuals with inadequate B-cell responses because of haematologic cancer or treatment with B-cell depletion therapies such as rituximab. The infection has recently been found as a cause of prolonged fever among several patients receiving rituximab in Denmark. This review covers current knowledge on the clinical spectrum among healthy as well as immune compromised individuals, transmission, pathogenesis, diagnosis, and treatment.

[Tick-borne CandidatusNeoehrlichiamikurensis was the cause of fever in a haematological patient].

A 77-year-old woman had a history of mantle cell lymphoma, splenechtomy and rituximab-treatment. For six months she had fever, night sweats and weight loss. Thorough investigations did not reveal the cause of the fever, and empiric antibiotics had no effect. Eventually she developed an erythema nodosum-like rash on both legs. A biopsy was sent for 16S rRNA PCR, which was positive for Candidatus Neoehrlichia mikurensis. She was treated with doxycycline with resolution of all symptoms. This is the first case report of neoehrlichiosis in Denmark, and the first case diagnosed on a skin biopsy.

[Talaromyces marneffei fungaemia in a patient from Thailand with newly diagnosed HIV].

Talaromyces marneffei is a dimorphic fungus, which may cause life-threatening opportunistic infections in immuno-compromised individuals. A 25-year-old woman from Thailand was admitted with fever, shortness of breath, cough, and weight loss. The symptoms had persisted for three weeks. The patient had a stopover in Copenhagen on her way to Thailand from Greenland. A thoracic X-ray showed bilateral interstitial changes. Examinations showed positive HIV-test with a CD4-count of 21/microlitre. Moreover, fungaemia with T. marneffei was detected by cultivation. Highly active antiretroviral therapy and IV amphotericin B treatment was initiated followed by perorally administrated itraconazole.