RESUMO
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.
Assuntos
Ceratite , Recidiva , Humanos , Pessoa de Meia-Idade , Masculino , Ceratite/diagnóstico , Ceratite/microbiologia , Ceratite/tratamento farmacológico , Missouri , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Sífilis/diagnóstico , Sífilis/tratamento farmacológicoRESUMO
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.
Assuntos
Candidemia/epidemiologia , Candidemia/etiologia , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/etiologia , Usuários de Drogas , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Comorbidade , Feminino , Humanos , Masculino , Massachusetts/epidemiologia , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Medição de Risco , Fatores de Risco , Adulto JovemRESUMO
Corynebacterium striatum is often considered a contaminant in blood cultures due to often being found colonizing skin and mucous membranes. This case displays C. striatum infective endocarditis (IE) identified in an immunocompetent patient on a native valve. Despite treatment with vancomycin, the case was complicated by embolic infarcts to the spleen and left cerebellum along with the development of a perivalvular abscess. This case highlights risk factors for C. striatum infection and exemplifies the importance of recognizing this bacteria species as a possible pathogen causing complicated IE.
RESUMO
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.
RESUMO
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.