RESUMEN
We describe a case of a 46-year-old man in Missouri, USA, with newly diagnosed advanced HIV and PCR-confirmed mpox keratitis. The keratitis initially resolved after intravenous tecovirimat and penicillin for suspected ocular syphilis coinfection. Despite a confirmatory negative PCR, he developed relapsed, ipsilateral PCR-positive keratitis and severe ocular mpox requiring corneal transplant.
Asunto(s)
Queratitis , Recurrencia , Humanos , Persona de Mediana Edad , Masculino , Queratitis/diagnóstico , Queratitis/microbiología , Queratitis/tratamiento farmacológico , Missouri , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Sífilis/diagnóstico , Sífilis/tratamiento farmacológicoRESUMEN
The epidemic of illicit intravenous drug use (IVDU) in the United States has been accompanied by a surge in drug overdose deaths and infectious sequelae. Candida albicans infections were associated with injection of contaminated impure brown heroin in the 1970s-1990s; however, candidiasis accompanying IVDU became considerably rarer as the purity of the heroin supply increased. We reviewed cases of candidemia occurring over a recent 7-year period in persons >14 years of age at a tertiary care hospital in central Massachusetts. Of the 198 patients with candidemia, 24 cases occurred in patients with a history of IVDU. Compared with non-IVDU patients, those with a history of IVDU were more likely to have non-albicans Candida, be co-infected with hepatitis C, and have end-organ involvement, including endocarditis and osteomyelitis. Thus, IVDU appears to be reemerging as a risk factor for invasive candidiasis.
Asunto(s)
Candidemia/epidemiología , Candidemia/etiología , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/etiología , Consumidores de Drogas , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Comorbilidad , Femenino , Humanos , Masculino , Massachusetts/epidemiología , Persona de Mediana Edad , Evaluación del Resultado de la Atención al Paciente , Medición de Riesgo , Factores de Riesgo , Adulto JovenRESUMEN
Streptococcus bovis/Streptococcus equinus complex includes the subspecies Streptococcus alactolyticus. The prevalence of systemic infection in humans with S alactolyticus is scarce. We present a case of infective endocarditis complicated with hemorrhagic and ischemic stroke in a healthy 31-year-old woman.
RESUMEN
Non-bacterial thrombotic endocarditis is mainly associated with malignancies and rheumatological diseases. We report the case of mildly symptomatic COVID-19 infection with non-bacterial aortic valve vegetation complicated by transient ischemic attack (TIA) and pulmonary embolism during his hospitalisation. This case emphasised rare life-threatening complications from a hypercoagulable state related to COVID-19 infection. To the best of our knowledge, this is the third case report of non-bacterial endocarditis in a patient with COVID-19 patients as a potential rare complication of COVID-19.