Erdheim-Chester Disease Involving the Central Nervous System with Latent Toxoplasmosis.

Erdheim-Chester disease (ECD) is a rare, non-Langerhans cell histiocytosis characterized by the infiltration of foamy histiocytes into multiple organs. We herein report a case of ECD with central nervous system (CNS) involvement in a 63-year-old man who also presented a positive result for Toxoplasma gondii nested polymerase chain reaction testing of cerebrospinal fluid. Since anti-Toxoplasma treatment proved completely ineffective, we presumed latent infection of the CNS with T. gondii. This case suggests the difficulty of distinguishing ECD with CNS involvement from toxoplasmic encephalitis and the possibility of a relationship between the pathogeneses of ECD and infection with T. gondii.

Dengue Virus in Traveler Returning to Japan from the Democratic Republic of the Congo, 2015.

Dengue fever (DF) is a mosquito-borne disease and a significant global public health problem. Although a few serological surveys in the literature suggest endemic DF in many parts of Africa, DF cases in these countries are generally underreported because of the lack of diagnostic testing and systematic surveillance; thus, little is known about the phylogenetic profile of circulating strains. In April 2015, DF was diagnosed in a Japanese national returning from the Democratic Republic of the Congo (DRC). Dengue virus 1 (DENV-1) RNA was detected in the patient's serum sample using real-time reverse transcription PCR. Phylogenetic analysis of the E gene revealed that the detected DENV-1 strain was classified as genotype V and was closely related, with 100% nucleotide identity, to the strain causing the 2013 DF epidemic in Angola, which is located directly south of the DRC. This is the first report to characterize the circulating DENV strain in the DRC, and the findings indicate that the DENV-1 strain causing the 2013 DF epidemic in Angola was also circulating in the DRC in 2015.

Multiple Medium Amoebic Liver Abscesses Successfully Treated with Medication and Comprehensive Percutaneous Catheter Drainage.

Solitary small (<5 cm) amoebic liver abscesses in the right lobe are generally treated using medication alone, while large abscesses are typically treated via a combination of medication and drainage. However, the therapeutic indications for multiple medium (5-10 cm) amoebic liver abscesses remain unclear. We herein report the findings of a 53-year-old woman who was receiving lenalidomide for multiple myeloma and subsequently developed multiple amoebic abscesses. Metronidazole alone was unsuccessful, although metronidazole and repeated percutaneous catheter drainage of the right lobe, left lobe, and thorax proved to ultimately be successful. Therefore, the successful use of medication alone may be associated with the total combined abscess volume.

[Human immunodeficiency virus-related non-hodgkin lymphoma: a clinical investigation at our hospital].

We investigated 8 cases of non-Hodgkin lymphoma(NHL)in human immunodeficiency virus(HIV)seropositive individuals who were diagnosed and treated at Osaka City General Hospital between April 2002 and October 2012. All patients were men, and the average age at the onset of NHL was 46 years(range: 30-61). Histological types were as follows: diffuse large B cell lymphoma in 4 patients, plasmablastic lymphoma in 2 patients, primary effusion lymphoma in 1 patient, and Burkitt lymphoma in 1 patient. In 3 cases, HIV infection was identified before the onset of NHL. Highly active anti-retroviral therapy (HAART)was initiated in 6 cases, and in 4 of these, we administered antineoplastic chemotherapy. Three patients who did not receive antineoplastic chemotherapy died within 1 month of diagnosis. Although 1 of the patients who received chemotherapy achieved complete remission, this patient died of BK virus nephritis. The remaining 3 patients achieved complete remission and are currently alive after 6 to 9 months. We believe that the combination of antineoplastic chemotherapy with HAART will lead to prognostic improvement in HIV-seropositive patients with NHL.