Focal pachymeningitis in a returning traveler: Don't forget melioidosis.

Background: Melioidosis is an endemic disease in South-East Asia and Northern Australia caused by a Gram-negative bacillus, Burkholderia pseudomallei. Manifestations are wide and neurological involvement have rarely been described. Methods: In this paper, we report a patient returning from Asia with an unusual infection including CNS involvement consistent with a melioidosis. Results: This diagnosis was challenging and complex to carry out with multiple considerations, mainly because of the atypical nature of the germ. Burkholderia pseudomallei can be easily misidentified with Burkholderia thailandensis (rarely pathogenic to humans) during bacterial culture because of their phylogenetic proximity. The main pitfall of the management was that the responsible infectious agent was not referenced in the MALDI-TOF (considered as a bioterrorism agent) and led to a wrong strategy. Conclusions: This case of melioidosis shows the difficulty regarding the diagnosis of this disease in a patient returning from an endemic zone and its frequent multiple organs involvement. Melioidosis is an emerging, potentially fatal disease which requires prolonged antibiotic treatment. Difficulties in clinical microbiology laboratories diagnosis of melioidosis, especially in non-endemic areas where clinical suspicion is low, may delay treatment and affect disease outcomes.

Pleuropneumonia resulting from varicella and COVID-19 co-infection in a 10-month-old infant.

COVID-19 is a new disease leading to respiratory complications in adults. Children appear to have more modest symptoms than adults. Varicella is often described as a benign disease in the pediatric population. However, patients with varicella and COVID-19 co-infection can develop a more serious respiratory infection. We report the case of an infant who had a co-infection with both viruses that led to pleuropneumonia. The main question in the present case concerns the link between COVID-19 and varicella infection, and the possible modulation in immune response due to the two virus infections.

Long-Term Rasamsonia argillacea Complex Species Colonization Revealed by PCR Amplification of Repetitive DNA Sequences in Cystic Fibrosis Patients.

The aim of this work was to document molecular epidemiology of Rasamsonia argillacea species complex isolates from cystic fibrosis (CF) patients. In this work, 116 isolates belonging to this species complex and collected from 26 CF patients and one patient with chronic granulomatous disease were characterized using PCR amplification assays of repetitive DNA sequences and electrophoretic separation of amplicons (rep-PCR). Data revealed a clustering consistent with molecular species identification. A single species was recovered from most patients. Rasamsonia aegroticola was the most common species, followed by R. argillacea sensu stricto and R. piperina, while R. eburnea was not identified. Of 29 genotypes, 7 were shared by distinct patients while 22 were patient specific. In each clinical sample, most isolates exhibited an identical genotype. Genotyping of isolates recovered from sequential samples from the same patient confirmed the capability of R. aegroticola and R. argillacea isolates to chronically colonize the airways. A unique genotype was recovered from two siblings during a 6-month period. In the other cases, a largely dominant genotype was detected. Present results which support the use of rep-PCR for both identification and genotyping for the R. argillacea species complex provide the first molecular evidence of chronic airway colonization by these fungi in CF patients.

Semi-automated repetitive sequence-based PCR amplification for species of the Scedosporium apiospermum complex.

PURPOSE: The Scedosporium apiospermum species complex usually ranks second among the filamentous fungi colonizing the airways of patients with cystic fibrosis (CF), but little is known about the molecular epidemiology of the airway colonization. METHODS: Polymerase chain reaction (PCR) amplification of repetitive sequences (rep-PCR) was applied to the retrospective analysis of a panel of isolates already studied by random amplification of polymorphic DNA (RAPD) and comprising 63 isolates recovered from sputa from 9 CF patients. Results were compared to those obtained previously by RAPD, and herein by beta-tubulin (TUB) gene sequencing and Multilocus Sequence Typing (MLST). RESULTS: Within the panel of isolates studied,S. apiospermum sensu stricto and Scedosporium boydii, as expected, were the predominant species with 21 and 36 isolates, respectively. Four isolates from one patient were identified as Scedosporium aurantiacum, whereas two isolates belonged to the Pseudallescheria ellipsoidea subgroup of S. boydii rep-PCR analysis of these isolates clearly differentiated the three species and P. ellipsoidea isolates, whatever the rep-PCR kit used, and also permitted strain differentiation. When using the mold primer kit, results from rep-PCR were in close agreement with those obtained by MLST. For both S. apiospermum and S. boydii, 8 genotypes were differentiated by rep-PCR and MLST compared to 10 by RAPD. All S. aurantiacum isolates shared the same RAPD genotype and exhibited the same rep-PCR profile and sequence type. CONCLUSIONS: These results illustrate the efficacy of rep-PCR for both species identification within the S. apiospermum complex and genotyping for the two major species of this complex.Abstract presentation: Part of this work was presented during the 18th Congress of the International Society for Human and Animal Mycology, Berlin (Germany), June 2012.S. Giraud, C. Godon, A. Rougeron, J.P. Bouchara and L. Favennec are members of the ECMM/ISHAM working group on Fungal respiratory infections in Cystic Fibrosis(Fri-CF).

[Cervical spondylodiscitis inoculation revealed by abdominal infection]. / Spondylodiscite cervicale d'inoculation révélée par une infection abdominale.

We report a patient who presented successively peritonis concomitant bacteriema with Staphylococcus aureus then meningitis and finally a bone and joint infection. All the infections are associated with the same germ. This patient of 40 years suffers of diabet mellitus and has history of neck pain and cervical spondylosis. For this, he received corticosteroid injection locally one year before his hospitalization.