Aural myiasis in an infant.

Aural myiasis is a rare clinical state that usually occurs in developing countries and in patients who mentally retarded or have poor personal hygiene. However, the prevalence has decreased over the years, and now it is very rare. The authors describe a case of aural myiasis caused by Wohlfartia magnifica in a five-month-old infant. The treatment used was a combination of suctioning and microsurgical forceps under an operative microscope. Additionally, topical and oral antibiotics were given to avoid secondary infection.

Spontaneous rupture of the spleen associated with Legionella pneumonia.

Spontaneous rupture of the spleen associated with Legionella pneumonia is a rare and life-threatening complication; only three cases have been reported to date. The authors describe a case of a 47-year-old man who presented with pneumonia and abdominal pain. He underwent a splenectomy, and was successfully treated with clarithromycin and levofloxacin.

In vitro activity of daptomycin and comparator agents against Staphylococcus aureus isolates from intravenous drug users with right endocarditis.

There is an increasing need for alternative agents in endocarditis, especially with the increasing incidence of vancomycin-intermediate Staphylococcus aureus (VISA). We evaluated the in vitro activity of daptomycin and several comparator agents against 33 non-duplicate clinical Staphylococcus aureus isolates from intravenous drug users with right endocarditis. Wider microdilution panels were used for all the comparator agents and daptomycin. Daptomycin was also tested using E-test strips. E-test strips were used to confirm the vancomycin MICs. Methicillin-resistant Staphylococcus aureus (MRSA isolates with vancomycin MICs ≥ 2 g/mL were screened using the E-test GRD. In all, 30 isolates were methicillin-susceptible (MSSA) and 3 MRSA. The three MRSA isolates exhibited a false vancomycin MIC >2 g/mL determined by Wider microdilution panels. They were screened using the E-test GRD and they were GRD negative. Their final MIC was 2 g/mL. Three MSSA and three MRSA isolates had a vancomycin MIC of 2 g/mL. Four MSSA isolates had a vancomycin MIC of 1.5 g/mL, daptomycin MIC90 0.25 g/mL, linezolid MIC90 2 g/mL. As regards daptomycin, wider microdilution panels and E-test strips yielded the same results. Our findings suggest that daptomycin and linezolid are a viable alternative for treating right endocarditis and bacteraemia caused by MSSA, MRSA and hVISA.

Late-onset neonatal sepsis due to Hafnia alvei.

Hafnia alvei infections are uncommon, and usually occur in patients with underlying illnesses, mainly adults. The authors describe a rare case of late-onset community-acquired neonatal sepsis in an infant without any underlying disease. The infant was successfully treated with cefotaxime.

Urinary tract infection due to Staphylococcus lugdunensis in a healthy child.

Staphylococcus lugdunensis is being increasingly reported as a pathogen with an outcome resembling that of Staphylococcus aureus rather than coagulase-negative staphylococci. The authors describe a case of a child with left grade II vesicoureteral reflux and pyelonephritis caused by Staphylococcus lugdunensis. The child was successfully treated with cefotaxime.

Early-onset neonatal sepsis caused by vertical transmission of Morganella morganii.

The onset of Morganella morganii infection within the first 72 h after birth has only been reported on 1 occasion. The authors describe a second case in which M. morganii was cultured from both the neonate's blood and the mother's lochia. The infant was successfully treated with cefotaxime and gentamicin.

Deep venous thrombosis associated with pulmonary tuberculosis and transient protein S deficiency.

Vascular complications associated with Mycobacterium tuberculosis infection have rarely been reported in children. We describe a case of deep venous thrombosis of the left leg in association with pulmonary tuberculosis. The patient had transient protein S deficiency and anticardiolipin IgG and IgM antibodies were also present. The pathogenesis of the hypercoagulable state in tuberculosis is discussed.