Assuntos
Procedimentos Cirúrgicos Cardíacos , Infecções por Mycobacterium não Tuberculosas , Mycobacterium , Osteomielite , Humanos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Osteomielite/etiologia , Osteomielite/microbiologia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/etiologiaRESUMO
BACKGROUND: Malignant syphilis is a rare manifestation of secondary syphilis and is commonly associated with human immunodeficiency virus coinfection. It can present with multiorgan involvement, which poses a diagnostic dilemma to clinicians. METHODS: We report a case of a middle aged male who presented with near complete vision loss in his right eye with initial concern for fungal endophthalmitis due to his injecting drug use history. He concurrently had right cheek and forearm ulcerative plaques. RESULTS: He was diagnosed with disseminated syphilis following the punch biopsy of his right cheek, with positive Treponema pallidum result on polymerase chain reaction and identification of spirochaetes on immunostaining from histopathology. CONCLUSIONS: We present the epidemiology of syphilis in Australia and highlight the importance of testing for common sexually transmitted diseases within the emergence of the monkeypox outbreak.
Assuntos
Infecções por HIV , Infecções Sexualmente Transmissíveis , Sífilis , Pessoa de Meia-Idade , Masculino , Humanos , Sífilis/diagnóstico , HIV , Infecções Sexualmente Transmissíveis/epidemiologia , Treponema pallidum , Infecções por HIV/epidemiologiaRESUMO
Hyperammonaemia syndrome secondary to Ureaplasma spp. infection is well documented in the post-lung transplant population. We report a case of a man in his fifties with hyperammonaemia syndrome secondary to disseminated Ureaplasma parvum infection. This occurred in the context of immunosuppression for chronic graft versus host disease and six years following an allogeneic stem cell transplant for diffuse large B-cell lymphoma. Following treatment of U. parvum septic arthritis with ciprofloxacin and doxycycline, the patient experienced a full neurological recovery, and continues on suppressive doxycycline therapy with no recurrence of symptoms to date.
Assuntos
Artrite Infecciosa , Hiperamonemia , Infecções por Ureaplasma , Masculino , Humanos , Ureaplasma , Doxiciclina , Hiperamonemia/etiologia , Infecções por Ureaplasma/complicações , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/tratamento farmacológico , Ureaplasma urealyticumRESUMO
Aspergillus osteomyelitis (AO) is a rare and often lethal opportunistic infection in predominantly immunocompromised patients. Treatment has shifted from amphotericin therapy to voriconazole monotherapy due to increased effectiveness and less toxicity. We report a case of an immunocompetent woman with vertebral osteomyelitis due to Aspergillus flavus who was successfully treated with surgery (requiring hardware implantation) and monotherapy posaconazole (following intolerance and hepatitis due to voriconazole). She remained well at follow-up post cessation of 12 months of antifungal therapy. We provide an updated literature review examining the role of azole monotherapy as the gold standard of treatment for AO.
Assuntos
Hepatite A , Osteomielite , Feminino , Humanos , Aspergillus flavus , Voriconazol/uso terapêutico , Osteomielite/tratamento farmacológico , AzóisAssuntos
Procedimentos Cirúrgicos Cardíacos , Infecções por Mycobacterium não Tuberculosas , Infecções por Mycobacterium , Mycobacterium , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Quimera , Humanos , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/etiologia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/etiologiaAssuntos
Insuficiência da Valva Aórtica , Insuficiência Cardíaca , Penicilina G/administração & dosagem , Sífilis Cardiovascular , Treponema pallidum/isolamento & purificação , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Antibacterianos/administração & dosagem , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/cirurgia , Contagem de Linfócito CD4/métodos , Coinfecção , Ecocardiografia/métodos , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Minorias Sexuais e de Gênero , Sífilis Cardiovascular/complicações , Sífilis Cardiovascular/diagnóstico , Sífilis Cardiovascular/fisiopatologia , Sífilis Cardiovascular/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
There is a global outbreak of infections due to Mycobacterium chimaera associated with cardiac surgery. The most serious infections involve prosthetic material implantation, and all have followed surgical procedures involving cardiopulmonary bypass. We describe a cluster of four cases following cardiac surgery at a tertiary referral centre in Sydney, Australia. We report novel clinical findings, including haemolysis and kidney rupture possibly related to immune reconstitution inflammatory syndrome. The positive effect of corticosteroids on haemodynamic function in two cases and the failure of currently recommended antimicrobial therapy to sterilise prosthetic valve material in the absence of surgery despite months of treatment are also critically examined. Positron emission tomography was positive in two cases despite normal transoesophageal echocardiograms. The proportion of cases with M. chimaera infection after aortic valve replacement (4/890, 0.45%; 95% confidence interval 0.18-1.15%) was significantly higher than after all other cardiothoracic surgical procedures (0/2433, 0%; 95% confidence interval 0-0.16%).